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González R, Nhampossa T, Mombo-Ngoma G, Mischlinger J, Esen M, Tchouatieu AM, Mendes A, Figueroa-Romero A, Zoleko-Manego R, Lell B, Lagler H, Stoeger L, Dimessa LB, El Gaaloul M, Sanz S, Méndez S, Piqueras M, Sevene E, Ramharter M, Saúte F, Menendez C. Safety and efficacy of dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in pregnant women with HIV from Gabon and Mozambique: a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis 2024; 24:476-487. [PMID: 38224706 DOI: 10.1016/s1473-3099(23)00738-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND The cornerstone of malaria prevention in pregnancy, intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine, is contraindicated in women with HIV who are receiving co-trimoxazole prophylaxis. We assessed whether IPTp with dihydroartemisinin-piperaquine is safe and effective in reducing the risk of malaria infection in women with HIV receiving co-trimoxazole prophylaxis and antiretroviral drugs. METHODS For this randomised, double-blind, placebo-controlled clinical trial, women with HIV attending the first antenatal care clinic visit, resident in the study area, and with a gestational age up to 28 weeks were enrolled at five sites in Gabon and Mozambique. Participants were randomly assigned (1:1) to receive either IPTp with dihydroartemisinin-piperaquine at each scheduled antenatal care visit plus daily co-trimoxazole (intervention group) or placebo at each scheduled antenatal care visit plus daily co-trimoxazole (control group). Randomisation was done centrally via block randomisation (block sizes of eight), stratified by country. IPTp was given over 3 days under direct observation by masked study personnel. The number of daily IPTp tablets was based on bodyweight and according to the treatment guidelines set by WHO (target dose of 4 mg/kg per day [range 2-10 mg/kg per day] of dihydroartemisinin and 18 mg/kg per day [range 16-27 mg/kg per day] of piperaquine given once a day for 3 days). At enrolment, all participants received co-trimoxazole (fixed combination drug containing 800 mg trimethoprim and 160 mg sulfamethoxazole) for daily intake. The primary study outcome was prevalence of peripheral parasitaemia detected by microscopy at delivery. The modified intention-to-treat population included all randomly assigned women who had data for the primary outcome. Secondary outcomes included frequency of adverse events, incidence of clinical malaria during pregnancy, and frequency of poor pregnancy outcomes. All study personnel, investigators, outcome assessors, data analysts, and participants were masked to treatment assignment. This study is registered with ClinicalTrials.gov, NCT03671109. FINDINGS From Sept 18, 2019, to Nov 26, 2021, 666 women (mean age 28·5 years [SD 6·4]) were enrolled and randomly assigned to the intervention (n=332) and control (n=334) groups. 294 women in the intervention group and 308 women in the control group had peripheral blood samples taken at delivery and were included in the primary analysis. Peripheral parasitaemia at delivery was detected in one (<1%) of 294 women in the intervention group and none of 308 women in the control group. The incidence of clinical malaria during pregnancy was lower in the intervention group than in the control group (one episode in the intervention group vs six in the control group; relative risk [RR] 0·12, 95% CI 0·03-0·52, p=0·045). In a post-hoc analysis, the composite outcome of overall malaria infection (detected by any diagnostic test during pregnancy or delivery) was lower in the intervention group than in the control group (14 [5%] of 311 women vs 31 [10%] of 320 women; RR 0·48, 95% CI 0·27-0·84, p=0·010). The frequency of serious adverse events and poor pregnancy outcomes (such as miscarriages, stillbirths, premature births, and congenital malformations) did not differ between groups. The most frequently reported drug-related adverse events were gastrointestinal disorder (reported in less than 4% of participants) and headache (reported in less than 2% of participants), with no differences between study groups. INTERPRETATION In the context of low malaria transmission, the addition of IPTp with dihydroartemisinin-piperaquine to co-trimoxazole prophylaxis in pregnant women with HIV did not reduce peripheral parasitaemia at delivery. However, the intervention was safe and associated with a decreased risk of clinical malaria and overall Plasmodium falciparum infection, so it should be considered as a strategy to protect pregnant women with HIV from malaria. FUNDING European and Developing Countries Clinical Trials Partnership 2 (EDCTP2) and Medicines for Malaria Venture. TRANSLATIONS For the Portuguese and French translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Raquel González
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon; Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Dept of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Johannes Mischlinger
- Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Dept of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Meral Esen
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon; German Center for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany; Institut für Tropenmedizin, Eberhard Karls University of Tübingen, Tübingen, Germany; Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infection, Tübingen, Germany
| | | | - Anete Mendes
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique
| | - Antía Figueroa-Romero
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | | | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Heimo Lagler
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Linda Stoeger
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | | | | | - Sergi Sanz
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain; Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Méndez
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Mireia Piqueras
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique; Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Michael Ramharter
- Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Dept of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique
| | - Clara Menendez
- Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
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Mengome MFA, Kono HN, Bivigou EA, M’bondoukwe NP, Ngomo JMN, Ditombi BM, Ngondza BP, Bisseye C, Mawili-Mboumba DP, Bouyou Akotet MK. Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa. PLoS One 2024; 19:e0285907. [PMID: 38578783 PMCID: PMC10997135 DOI: 10.1371/journal.pone.0285907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. METHODS A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. RESULTS Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. CONCLUSION The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.
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Affiliation(s)
- Mérédith Flore Ada Mengome
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Héléna Noéline Kono
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Elsa Ayo Bivigou
- Faculté de Médecine, Département de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | - Noé Patrick M’bondoukwe
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Jacques-Mari Ndong Ngomo
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bridy Moutombi Ditombi
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bedrich Pongui Ngondza
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
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M'Bondoukwé NP, Owono-Medang M, Moussavou-Boussougou MN, Akoue Y, Migueba V, Bulaev D, Neven A, James LAJ, Ntsame Ella SA, Mawili-Mboumba DP, Atsame J, Vaillant M, Bouyou Akotet MK. Low diagnostic performance of thick blood smears of 50 µl in comparison with direct examination of 10 µl blood and the leukoconcentration technique of 5ml blood among loiasis-suspected patients with low microfilaremia in Gabon, Central Africa, using the STARD-BLCM guidelines. Parasit Vectors 2024; 17:138. [PMID: 38491557 PMCID: PMC10943916 DOI: 10.1186/s13071-023-06089-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/08/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The aim of this study was to determine performance indicators of thick blood smears of 50 µl (TBS-50), following the Standards for the Reporting of Diagnostic Accuracy Studies-Bayesian Latent Class Model (STARD-BLCM) guidelines. TBS-50 was compared with two common parasitological techniques-direct examination of 10 µl blood and a leukoconcentration of 5 ml-for the diagnosis of microfilaremic loiasis. METHODS The study population was recruited among patients of the Department of Parasitology-Mycology-Tropical Medicine over a period of 1 year. Age, sex, symptoms, and eosinophilia variables were recorded from laboratory registers and medical files. Direct examination of 10 µl of blood, TBS-50, and the leukoconcentration technique with 5 ml of blood were performed for each patient. The classical formula and BLCM were used to determine the diagnostic accuracy of the three techniques as well as the prevalence of microfilaremic loiasis. Three models were built within the framework of BLCM-the BLCM model I and alternative models II and III-for sensitivity analysis. RESULTS In total, 191 patients consented to be included. The direct blood examination and TBS-50 yielded comparable qualitative and quantitative results. Hence, they are reported together. The prevalence of Loa loa microfilaremia was 9.4% (95% CI 5.7-14.5; n = 18/191) with direct blood examination/TBS-50 and 12.6% [8.2-18.1] (n = 24/191) for leukoconcentration. Comparing TBS-50 with the leukoconcentration method using the classical formula, the sensitivity was 75.0% [53.3-90.2], specificity was 100.0% [97.8-100.0], the positive predictive value was 100.0% [81.5-100.0], and the negative predictive value was 96.5% [92.6-98.7]. The prevalence of microfilaremic loiasis was estimated at 9.7% [6.2-13.7] using BLCM model I. The outputs of BLCM model I showed sensitivity of 78.9% [65.3-90.3], specificity of 100.0% [99.3-100.0], a positive predictive value of 99.1% [87.2-100.0], and a negative predictive value of 93.0% [87.3-97.7] for direct blood examination/TBS-50. CONCLUSIONS TBS-50 demonstrates low sensitivity relative to two other techniques. In one in five cases, the result will be falsely declared negative using these methods. However, this method can be deployed with limited funds.
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Affiliation(s)
- Noé Patrick M'Bondoukwé
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon.
| | - Matthieu Owono-Medang
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Marie Noëlle Moussavou-Boussougou
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Yvan Akoue
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Valentin Migueba
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Dmitry Bulaev
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Anouk Neven
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Luice Aurtin Joel James
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | | | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
| | - Julienne Atsame
- Programme de Lutte Contre les Maladies Parasitaires, Ministère de la Santé du Gabon, Libreville, Gabon
| | - Michel Vaillant
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Marielle Karine Bouyou Akotet
- Department of Parasitology-Mycology-Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, 4009, Libreville, Gabon
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Kouna LC, Oyegue-Liabagui SL, Voumbo-Matoumona DF, Lekana-Douki JB. Malaria Prevalence in Asymptomatic and Symptomatic Children Living in Rural, Semi-Urban and Urban Areas in Eastern Gabon. Acta Parasitol 2024; 69:471-482. [PMID: 38194048 PMCID: PMC11001662 DOI: 10.1007/s11686-023-00783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Malaria remains a major public health issue in the world despite a decline in the disease burden. However, though symptomatic malaria is diagnosed and treated, asymptomatic infections remain poorly known and support transmission. This study assessed the prevalence of symptomatic and asymptomatic Plasmodium spp. infections in three areas in Gabon to monitor and evaluate the impact of malaria. METHODS AND RESULTS A cross-sectional study was conducted in three areas of Gabon. Febrile and afebrile children aged 6 months to 15 years were included in this study. Malaria prevalence was determined by microscopy of and using rapid diagnostic test (RDT). Plasmodium spp. species were identified by PCR according to the Snounou method. The data were recorded in Excel, and the statistical analyses were performed using the software R version R 64 × 3.5.0. A total of 2381(333 asymptomatic and 107 symptomatic) children were included. The overall prevalence of malaria was 40% (952/2381), with the majority (77% symptomatic and 98% asymptomatic) of infections caused by Plasmodium falciparum. A high prevalence of malaria was found in infected children in rural and semi-rural areas. In these two areas, a higher prevalence of Plasmodium malariae was observed in asymptomatic. Furthermore, mixed infections were more prevalent in asymptomatic children than in symptomatic. CONCLUSION This study showed that the prevalence of Plasmodium spp. infection varied according to the regions. The main species was Plasmodium falciparum, but in asymptomatic children the prevalence of Plasmodium malariae was high in rural areas. To help fight malaria more effectively asymptomatic infections should be taken into account and treated.
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Affiliation(s)
- Lady Charlène Kouna
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon
| | - Sandrine Lydie Oyegue-Liabagui
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
- Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Dominique Fatima Voumbo-Matoumona
- Département Masters/Licences, parcours types des sciences Biologiques, faculté des sciences et Techniques, Université Marien Ngouabi, Brazzaville, Congo
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon.
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon.
- Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Science de la Santé, Libreville, Gabon.
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Parkouda S, Saidou M, Bisseye C. Microfilariae Prevalence and its Association with Anemia Among First-time Blood Donors in Lambaréné, Gabon. Balkan Med J 2024; 41:139-143. [PMID: 38259115 PMCID: PMC10913112 DOI: 10.4274/balkanmedj.galenos.2023.2023-9-86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Background Anemia remains a significant public health concern in Gabon, particularly among children, adolescents, and females. Gabon is also home to two major species of filarial worms, Loa and Mansonella spp., which cause microfilaremia. The epidemiological nexus between hemoglobin (Hb) concentrations and microfilaremia in Gabonese first-time blood donors remains unknown. Aims To understand better the epidemiological relationship between anemia and microfilaremia to improve donor selection and management protocols. Study Design A retrospective cohort study. Methods This study was conducted among first-time blood donors in Lambaréné between March 2018 and October 2019. Participants aged 16-65 years old and weighing a minimum of 50 kg were enrolled using standard donor selection criteria. An automatic hematological analyzer was used to quantify Hb concentrations, and microscopy techniques were used to detect the presence of microfilariae. Results Microfilariae were found in 4.8% (35/723) of the 723 first-time blood donors from Lambaréné. Anemia was classified as mild in 35.5% (257/723) and moderate in 1% (7/723). No significant associations were found between the distribution of microfilariae and variables such as age, sex, socioprofessional classification, marital status, or residence. Blood group O donors had a higher prevalence of microfilariae (6%) than non-O donors (2.7%). However, the observed difference was not statistically significant (AOR =2.3, p = 0.052). Furthermore, microfilariae were associated with increased moderate anemia (3.7% vs. 29%, AOR =15.6, p = 0.003). Conclusion Our findings highlight microfilaremia as a possible etiological cause of anemia among Gabonese blood donors, emphasizing the need for further research and a potential review of donor management strategies.
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Affiliation(s)
- Soulemane Parkouda
- Biomedical Laboratory, Centre Hospitalier Régional Georges Rawiri, Lambaréné, Gabon
| | - Mahmoudou Saidou
- Biostatistiques, Centre de Recherches Medicales de Lambaréné, Lambaréné, Gabon
| | - Cyrille Bisseye
- Biologie/Unité de Recherche en Sciences Biologiques, Université des Sciences et Techniques de Masuku, Franceville, Gabon
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Becquart P, Bohou Kombila L, Mebaley TN, Paupy C, Garcia D, Nesi N, Olive MM, Vanhomwegen J, Boundenga L, Mombo IM, Piro-Mégy C, Fritz M, Lenguiya LH, Ar Gouilh M, Leroy EM, N’Dilimabaka N, Cêtre-Sossah C, Maganga GD. Evidence for circulation of Rift Valley fever virus in wildlife and domestic animals in a forest environment in Gabon, Central Africa. PLoS Negl Trop Dis 2024; 18:e0011756. [PMID: 38427694 PMCID: PMC10936825 DOI: 10.1371/journal.pntd.0011756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/13/2024] [Accepted: 02/10/2024] [Indexed: 03/03/2024] Open
Abstract
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by the Rift Valley fever virus (RVFV) that can infect domestic and wild animals. Although the RVFV transmission cycle has been well documented across Africa in savanna ecosystems, little is known about its transmission in tropical rainforest settings, particularly in Central Africa. We therefore conducted a survey in northeastern Gabon to assess RVFV circulation among wild and domestic animals. Among 163 wildlife samples tested using RVFV-specific RT-qPCR, four ruminants belonging to subfamily Cephalophinae were detected positive. The phylogenetic analysis revealed that the four RVFV sequences clustered together with a virus isolated in Namibia within the well-structured Egyptian clade. A cross-sectional survey conducted on sheep, goats and dogs living in villages within the same area determined the IgG RVFV-specific antibody prevalence using cELISA. Out of the 306 small ruminants tested (214 goats, 92 sheep), an overall antibody prevalence of 15.4% (95% CI [11.5-19.9]) was observed with a higher rate in goats than in sheep (20.1% versus 3.3%). RVFV-specific antibodies were detected in a single dog out of the 26 tested. Neither age, sex of domestic animals nor season was found to be significant risk factors of RVFV occurrence. Our findings highlight sylvatic circulation of RVFV for the first time in Gabon. These results stress the need to develop adequate surveillance plan measures to better control the public health threat of RVFV.
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Affiliation(s)
- Pierre Becquart
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement (IRD), Montpellier University, CNRS, Montpellier, France
| | - Linda Bohou Kombila
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Telstar Ndong Mebaley
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Christophe Paupy
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement (IRD), Montpellier University, CNRS, Montpellier, France
| | - Déborah Garcia
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement (IRD), Montpellier University, CNRS, Montpellier, France
| | - Nicolas Nesi
- INSERM Dynamicure UMR 1311, CHU Caen, department of virology, University of Caen Normandie, Caen, France
| | - Marie-Marie Olive
- ASTRE (Animaux, Santé, Territoires, Risques et Ecosystèmes), University of Montpellier, CIRAD (Centre de Coopération Internationale en Recherche Agronomique pour le Développement), INRAE (Institut national de recherche pour l’agriculture, l’alimentation et l’environnement), Montpellier, France
| | - Jessica Vanhomwegen
- Cellule d’Intervention Biologique d’Urgence (CIBU), Institut Pasteur, Paris, France
| | - Larson Boundenga
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Department of Anthropology, University of Durham, Durham, United Kingdom
| | - Illich Manfred Mombo
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Camille Piro-Mégy
- ASTRE (Animaux, Santé, Territoires, Risques et Ecosystèmes), University of Montpellier, CIRAD (Centre de Coopération Internationale en Recherche Agronomique pour le Développement), INRAE (Institut national de recherche pour l’agriculture, l’alimentation et l’environnement), Montpellier, France
| | - Matthieu Fritz
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement (IRD), Montpellier University, CNRS, Montpellier, France
| | | | - Meriadeg Ar Gouilh
- INSERM Dynamicure UMR 1311, CHU Caen, department of virology, University of Caen Normandie, Caen, France
| | - Eric M. Leroy
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche pour le Développement (IRD), Montpellier University, CNRS, Montpellier, France
| | - Nadine N’Dilimabaka
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Catherine Cêtre-Sossah
- ASTRE (Animaux, Santé, Territoires, Risques et Ecosystèmes), University of Montpellier, CIRAD (Centre de Coopération Internationale en Recherche Agronomique pour le Développement), INRAE (Institut national de recherche pour l’agriculture, l’alimentation et l’environnement), Montpellier, France
| | - Gael Darren Maganga
- Unité Emergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Institut National Supérieur d’Agronomie et de Biotechnologies (INSAB), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
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Mougeni F, Lell B, Kandala NB, Chirwa T. Bayesian spatio-temporal analysis of malaria prevalence in children between 2 and 10 years of age in Gabon. Malar J 2024; 23:57. [PMID: 38395876 PMCID: PMC10893641 DOI: 10.1186/s12936-024-04880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Gabon still bears significant malaria burden despite numerous efforts. To reduce this burden, policy-makers need strategies to design effective interventions. Besides, malaria distribution is well known to be related to the meteorological conditions. In Gabon, there is limited knowledge of the spatio-temporal effect or the environmental factors on this distribution. This study aimed to investigate on the spatio-temporal effects and environmental factors on the distribution of malaria prevalence among children 2-10 years of age in Gabon. METHODS The study used cross-sectional data from the Demographic Health Survey (DHS) carried out in 2000, 2005, 2010, and 2015. The malaria prevalence was obtained by considering the weighting scheme and using the space-time smoothing model. Spatial autocorrelation was inferred using the Moran's I index, and hotspots were identified with the local statistic Getis-Ord General Gi. For the effect of covariates on the prevalence, several spatial methods implemented in the Integrated Nested Laplace Approximation (INLA) approach using Stochastic Partial Differential Equations (SPDE) were compared. RESULTS The study considered 336 clusters, with 153 (46%) in rural and 183 (54%) in urban areas. The prevalence was highest in the Estuaire province in 2000, reaching 46%. It decreased until 2010, exhibiting strong spatial correlation (P < 0.001), decreasing slowly with distance. Hotspots were identified in north-western and western Gabon. Using the Spatial Durbin Error Model (SDEM), the relationship between the prevalence and insecticide-treated bed nets (ITNs) coverage was decreasing after 20% of coverage. The prevalence in a cluster decreased significantly with the increase per percentage of ITNs coverage in the nearby clusters, and per degree Celsius of day land surface temperature in the same cluster. It slightly increased with the number of wet days and mean temperature per month in neighbouring clusters. CONCLUSIONS In summary, this study showed evidence of strong spatial effect influencing malaria prevalence in household clusters. Increasing ITN coverage by 20% and prioritizing hotspots are essential policy recommendations. The effects of environmental factors should be considered, and collaboration with the national meteorological department (DGM) for early warning systems is needed.
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Affiliation(s)
- Fabrice Mougeni
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, 2193, South Africa.
- Centre de Recherches Médicales de Lambaréné, P.O. Box 242, Lambaréné, Gabon.
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, P.O. Box 242, Lambaréné, Gabon
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, 1090, Vienna, Austria
| | - Ngianga-Bakwin Kandala
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, 2193, South Africa
- Department of Epidemiology and Biostatistics, Western Centre for Public Health and Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Tobias Chirwa
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, 2193, South Africa
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8
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Ndjangangoye NK, Nzassi PM, Bangueboussa F, Ntigui CNMM, Kouna LC, Moukodoum ND, Atiga NC, Okouga AP, Ontoua SS, Lekana-Douki JB, Oyegue-Liabagui SL. High prevalence of asymptomatic Anaplasma spp. infection in school-aged children in southeastern Gabon. Int J Infect Dis 2024; 139:192-194. [PMID: 38065316 DOI: 10.1016/j.ijid.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/06/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the detection rates of asymptomatic Anaplasma spp. and Ehrlichia spp. infections in children in southeastern Gabon. METHODS We conducted a cross-sectional study among school-aged children in southeastern Gabon between May and June 2021. Blood samples were collected. Anaplasmataceae, Anaplasma spp., and Ehrlichia spp. were detected by microscopy and polymerase chain reaction. RESULTS Of the 452 blood samples collected, 57.5% (n/N=260/452) of the samples were positive for Anaplasma spp. and/or Ehrlichia spp. by microscopy, 86.9% (n/N=393/452) of the samples were positive for both Anaplasmataceae and Anaplasma spp., and none of the samples were found positive for Ehrlichia spp. PCR was more sensitive and specific than microscopy for detection of Anaplasma spp.. CONCLUSIONS In our study, a significant number of positive blood samples for Anaplasma spp. were found in school-aged children in southeastern Gabon. Further studies are needed to determine the prevalence of different species of Anaplasma, their pathogenicity, and their transmission patterns.
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Affiliation(s)
- Nal Kennedy Ndjangangoye
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon.
| | - Patrice Makouloutou Nzassi
- Département de Biologie et Écologie Animale, Institut de Recherche en Écologie Tropicale (IRET/CENAREST), Libreville, Gabon; Unité de Recherche en Écologie de la Santé, CIRMF, Franceville, Gabon
| | | | - Chérone Nancy Mbani Mpega Ntigui
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon; École Doctorale Régionale d'Afrique en infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Lady Charlene Kouna
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon
| | | | - Nick Chenis Atiga
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon
| | - Alain Prince Okouga
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon
| | - Steede Seinnat Ontoua
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon; École Doctorale Régionale d'Afrique en infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Jean-Bernard Lekana-Douki
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Sandrine Lydie Oyegue-Liabagui
- Unité Évolution, Épidémiologie et Résistances Parasitaires (UNEREEP), CIRMF, Franceville, Gabon; Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
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9
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Mouinga-Ondeme A, Longo-Pendy NM, Moussadji Kinga IC, Ngoubangoye B, Moussavou-Boundzanga P, Boundenga L, Diane A, Sica J, Mfouo-Tynga IS, Ngoungou EB. Risk Factors Associated with Opportunistic Infections among People Living with HIV/AIDS and Receiving an Antiretroviral Therapy in Gabon, Central Africa. Viruses 2024; 16:85. [PMID: 38257785 PMCID: PMC10819398 DOI: 10.3390/v16010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/11/2023] [Accepted: 11/11/2023] [Indexed: 01/24/2024] Open
Abstract
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is still one of the main causes of death in sub-Saharan Africa. Antiretroviral therapies (ARTs) have significantly improved the health conditions of people living with HIV/AIDS (PLWHA). Consequently, a significant drop in morbidity and mortality, along with a reduced incidence of opportunistic infections (OIs), has been observed. However, certain atypical and biological profiles emerge in ART patients post-examination. The objective of this study was to identify the risk factors that contributed to the onset of OIs in HIV patients undergoing ART in Gabon. Epidemiological and biological data were obtained from medical records (2017 to 2019) found at the outpatient treatment centre (CTA) of Franceville in Gabon. Samples for blood count, CD4, and viral load analysis at CIRMF were collected from PLWHA suffering from other pathogen-induced conditions. A survey was carried out and data were analysed using Rstudio 4.0.2 and Excel 2007 software. Biological and socio-demographic characteristics were examined concerning OIs through both a univariate analysis via Fisher's exact tests or chi2 (χ2), and a multivariate analysis via logistic regression. Out of the 300 participants initially selected, 223 were included in the study, including 154 (69.05%) women and 69 (30.95%) men. The mean age was 40 (38.6; 41.85), with individuals ranging from 2 to 77 years old. The study cohort was classified into five age groups (2 to 12, 20 to 29, 30 to 39, 40 to 49, and 50 to 77 years old), among which the groups aged 30 to 39 and 40 to 49 emerged as the largest, comprising 68 (30.5%) and 75 (33.6%) participants, respectively. It was noted that 57.9% of PLWHA had developed OIs and three subgroups were distinguished, with parasitic, viral, and bacterial infections present in 18%, 39.7%, and 55.4% of cases, respectively. There was a correlation between being male and having a low CD4 T-cell count and the onset of OIs. The study revealed a high overall prevalence of OIs, and extending the study to other regions of Gabon would yield a better understanding of the risk factors associated with the onset of these infections.
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Affiliation(s)
- Augustin Mouinga-Ondeme
- Unité des Infections Rétrovirales et Pathologies Associées, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-B.); (A.D.); (I.S.M.-T.)
| | - Neil Michel Longo-Pendy
- Unité de Recherches en Ecologie de la Santé, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (N.M.L.-P.); (L.B.)
| | - Ivan Cyr Moussadji Kinga
- Centre de Primatologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (I.C.M.K.); (B.N.)
| | - Barthélémy Ngoubangoye
- Centre de Primatologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (I.C.M.K.); (B.N.)
| | - Pamela Moussavou-Boundzanga
- Unité des Infections Rétrovirales et Pathologies Associées, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-B.); (A.D.); (I.S.M.-T.)
| | - Larson Boundenga
- Unité de Recherches en Ecologie de la Santé, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (N.M.L.-P.); (L.B.)
- Département d’Anthropologie, Université de Durham, South Road, Durham DH1 3LE, UK
| | - Abdoulaye Diane
- Unité des Infections Rétrovirales et Pathologies Associées, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-B.); (A.D.); (I.S.M.-T.)
| | - Jeanne Sica
- Centre de Traitement Ambulatoire, Franceville BP 277, Gabon;
| | - Ivan Sosthene Mfouo-Tynga
- Unité des Infections Rétrovirales et Pathologies Associées, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (P.M.-B.); (A.D.); (I.S.M.-T.)
| | - Edgard Brice Ngoungou
- Département d’Epidémiologie, Biostatistiques et Informatique Médicale (DEBIM)/Unité de Recherche en Epidémiologie des Maladies Chroniques et Santé Environnement (UREMCSE), Faculté de Médecine, Université des Sciences de la Santé, Libreville-Owendo BP 18231, Gabon;
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10
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Inoue J, Weber D, Fernandes JF, Adegnika AA, Agnandji ST, Lell B, Kremsner PG, Grobusch MP, Mordmüller B, Held J. HHV-6 infections in hospitalized young children of Gabon. Infection 2023; 51:1759-1765. [PMID: 37501013 PMCID: PMC10665219 DOI: 10.1007/s15010-023-02077-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE Fever is a common cause for hospitalization among the pediatric population. The spectrum of causative agents is diverse. Human herpesvirus 6 (HHV-6) is a ubiquitous virus that often causes hospitalization of children in western countries. Previously, we investigated the cause of fever of 600 febrile hospitalized children in Gabon, and in 91 cases the causative pathogen was not determined. In this study, we assessed HHV-6 infection as potential cause of hospitalization in this group. METHODS Blood samples were assessed for HHV-6 using real-time quantitative PCR. Three groups were investigated: (1) group of interest: 91 hospitalized children with febrile illness without a diagnosed causing pathogen; (2) hospitalized control: 91 age-matched children hospitalized with febrile illness with a potentially disease-causing pathogen identified; both groups were recruited at the Albert Schweitzer Hospital in Lambaréné, Gabon and (3) healthy control: 91 healthy children from the same area. RESULTS Samples from 273 children were assessed. Age range was two months to 14 years, median (IQR) age was 36 (12-71) months; 52% were female. HHV-6 was detected in 64% (58/91), 41% (37/91), and 26% (24/91) of the samples from groups 1, 2, and 3, respectively; with statistically significant odds of being infected with HHV-6 in group 1 (OR = 4.62, 95% CI [2.46, 8.90]). Only HHV-6B was detected. CONCLUSIONS Although tropical diseases account for a large proportion of children's hospitalizations, considering common childhood diseases such as HHV-6 when diagnosing febrile illnesses in pediatric populations in tropical countries is of importance.
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Affiliation(s)
- Juliana Inoue
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
| | - David Weber
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
| | - José Francisco Fernandes
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection & Immunity, Amsterdam Public Health, Amsterdam University Medical Centres, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Ayola Akim Adegnika
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Selidji Todagbe Agnandji
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter G Kremsner
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Martin Peter Grobusch
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection & Immunity, Amsterdam Public Health, Amsterdam University Medical Centres, Location University of Amsterdam, Amsterdam, The Netherlands
- Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Masanga Medical Research Unit, Masanga, Sierra Leone
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jana Held
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Tübingen, Germany.
- German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany.
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11
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Moutongo Mouandza R, Mourou JR, Moutombi Ditombi B, Roger Sibi Matotou H, Ekomi B, Bouyou-Akotet MK, Mawili-Mboumba DP. Sociodemographics, Clinical Factors, and Biological Factors Associated with Loiasis in Endemic Onchocerciasis Areas in Southern Gabon. Am J Trop Med Hyg 2023; 109:850-857. [PMID: 37339766 PMCID: PMC10551092 DOI: 10.4269/ajtmh.22-0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 04/22/2023] [Indexed: 06/22/2023] Open
Abstract
To implement the appropriate strategies for scale-up interventions to eliminate onchocerciasis without severe adverse events, clinical and biological factors associated with loiasis were analyzed in onchocerciasis-endemic areas. Blood was collected from volunteers after examination by a physician. Detection of microfilariae and measurement of Ov16 IgG4 were performed using direct microscopic examination of blood and onchocerciasis rapid test detection, respectively. Areas with sporadic, hypoendemic, and hyperendemic onchocerciasis endemicity were found. Participants with microfilaremia were considered microfilaremic, and those without microfilaremia were seen as amicrofilaremic. Of the 471 study participants, 40.5% (n = 191) had microfilariae. Among them, Mansonella spp. was the most common (78.2%, n = 147), followed by Loa loa (41.4%, n = 79). The association between the two species represented 18.3% (n = 35). The specific immunoglobulins of Onchocerca volvulus were detected in 24.2% of participants (n = 87/359). Overall prevalence of L. loa was 16.8%. Hypermicrofilaremia was found in 3% (N = 14), and one participant had more than 30,000 microfilaremiae per milliliter. The frequency of L. loa did not vary according to the level of onchocerciasis transmission. Pruritus was the most common clinical sign (60.5%, n = 285) reported, mainly in microfilaremic participants (72.2%, n = 138/191). The prevalence of L. loa microfilaria in the study population was below the threshold at risk for the occurrence of serious side effects due to ivermectin. Clinical manifestations frequently observed could be exacerbated by microfilaremia in areas where onchocerciasis transmission is high.
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Affiliation(s)
- Reinne Moutongo Mouandza
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Jean Romain Mourou
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Bridy Moutombi Ditombi
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Hadry Roger Sibi Matotou
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Bernadette Ekomi
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
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12
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IBA BA J, MFOUMOU AF, MBOUNJA M, LÉDAGA LENTOMBO L, KOMBILA UD, IGALA M, BOGUIKOUMA JB. [A rare association of Takayasu's disease and inflammatory bowel disease in Gabon]. Med Trop Sante Int 2023; 3:mtsi.v3i3.2023.386. [PMID: 38094489 PMCID: PMC10714603 DOI: 10.48327/mtsi.v3i3.2023.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023]
Abstract
Takayasu's disease is a vasculitis affecting large vessels, particularly the aorta and its main branches, for which the role of Mycobacterium tuberculosis has been suggested as a trigger by a hypersensitivity reaction. Inflammatory bowel diseases, which in sub-Saharan Africa can be confused with parasitic diseases, can rarely be found in association with Takayasu's disease. We report an association between both diseases in the Gabonese population.
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Affiliation(s)
- Josaphat IBA BA
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
| | - Annick Flore MFOUMOU
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
| | - Monique MBOUNJA
- Service de gastro-entérologie, Centre hospitalier universitaire de Libreville
| | - Léonie LÉDAGA LENTOMBO
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
| | - Ulrich Davy KOMBILA
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
| | - Marielle IGALA
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
| | - Jean Bruno BOGUIKOUMA
- Service de médecine interne, Centre hospitalier universitaire de Libreville, Libreville, Gabon
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13
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Wiethoff JP, Sandmann S, Theiler T, Nze Nkogue C, Akomo-Okoue EF, Varghese J, Kreidenweiss A, Mellmann A, Lell B, Adegnika AA, Held J, Schaumburg F. Pharyngeal Communities and Antimicrobial Resistance in Pangolins in Gabon. Microbiol Spectr 2023; 11:e0066423. [PMID: 37338382 PMCID: PMC10434165 DOI: 10.1128/spectrum.00664-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Abstract
Wildlife can be a reservoir and source of zoonotic pathogens for humans. For instance, pangolins were considered one of the potential animal reservoirs of SARS-CoV-2. The aim of this study was to assess the prevalence of antimicrobial-resistant species (e.g., extended-spectrum β-lactamase [ESBL]-producing Enterobacterales) and Staphylococcus aureus-related complex and to describe the bacterial community in wild Gabonese pangolins. The pharyngeal colonization of pangolins sold in Gabon (n = 89, 2021 to 2022) was analyzed using culture media selective for ESBL-producing Enterobacterales, S. aureus-related complex, Gram-positive bacteria and nonfermenters. Phylogenetic analyses of ESBL-producing Enterobacterales was done using core-genome multilocus sequence typing (cgMLST) and compared with publicly available genomes. Patterns of cooccurring species were detected by network analysis. Of the 439 bacterial isolates, the majority of species belonged to the genus Pseudomonas (n = 170), followed by Stenotrophomonas (n = 113) and Achromobacter (n = 37). Three Klebsiella pneumoniae isolates and one Escherichia coli isolate were ESBL-producers, which clustered with human isolates from Nigeria (MLST sequence type 1788 [ST1788]) and Gabon (ST38), respectively. Network analysis revealed a frequent cooccurrence of Stenotrophomonas maltophilia with Pseudomonas putida and Pseudomonas aeruginosa. In conclusion, pangolins can be colonized with human-related ESBL-producing K. pneumoniae and E. coli. Unlike in other African wildlife, S. aureus-related complex was not detected in pangolins. IMPORTANCE There is an ongoing debate if pangolins are a relevant reservoir for viruses such as SARS-CoV-2. Here, we wanted to know if African pangolins are colonized with bacteria that are relevant for human health. A wildlife reservoir of antimicrobial resistance would be of medical relevance in regions were consumption of so-called bushmeat is common. In 89 pangolins, we found three ESBL-producing Klebsiella pneumoniae strains and one ESBL-producing Escherichia coli strains, which were closely related to isolates from humans in Africa. This points toward either a transmission between pangolins and humans or a common source from which both humans and pangolins became colonized.
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Affiliation(s)
- Johanna P. Wiethoff
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Sarah Sandmann
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Tom Theiler
- Institute of Medical Microbiology, University of Münster, Münster, Germany
| | | | | | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | | | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Ayôla A. Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Jana Held
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Frieder Schaumburg
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Medical Microbiology, University of Münster, Münster, Germany
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14
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Lipenguet GM, Ngoungou EB, Ibinga E, Amani PG, Engohang-Ndong J, Bivigou EA, Nsounda AA, Wittwer J. Assessment of the direct hospital cost of medical care for patients hospitalized for a stroke in Gabon. Pan Afr Med J 2023; 45:95. [PMID: 37692986 PMCID: PMC10491710 DOI: 10.11604/pamj.2023.45.95.35702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/01/2023] [Indexed: 09/12/2023] Open
Abstract
While the incidence of stroke is increasing in developing countries, resulting in an extremely high economic burden, very few costing studies have been carried out to date. This study aims to measure the direct hospital costs of stroke management in Gabon. The study adopts a retrospective approach, based on a review of patient records in the Neurology and Cardiology Departments of the University Hospital of Libreville (CHUL) between January 2018 and December 2019. It focuses on all patients received for stroke at the CHUL during the study period, regardless of the outcome, analyzing direct hospital costs. Three hundred and thirteen (313) patients were admitted during the period in question, 72.52% in neurology and 27.48% in cardiology. The average age was 58.44 (±13.73 years). Fifty-six percent (56.23%) had health coverage. Ischemic stroke was more common than hemorrhagic stroke, at 79.55% and 20.45%, respectively. The average expenditure per patient was estimated at 619,633 CFA francs (€944.62). From the point of view of social security coverage, the average out-of-pocket expense per patient was 147,140 CFA francs (€224.31), for a reimbursement of 422,883 CFA francs (€644.68). The average direct cost of stroke is very high for both patients and administrations. This argues for the implementation of prevention programs for the disease. The results of this study may be useful for work on the efficiency of such programs.
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Affiliation(s)
- Gaëtan Moukoumbi Lipenguet
- Bordeaux Health Population, Inserm U1219 University of Bordeaux, 33076 Bordeaux Cedex, France
- Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), University of Health Sciences, Libreville, Gabon
- Department of Epidemiology, Biostatistics and Medical Informatics (DEBIM), University of Health Sciences, Faculty of Medicine, Libreville, Gabon
| | - Edgard Brice Ngoungou
- Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), University of Health Sciences, Libreville, Gabon
- Department of Epidemiology, Biostatistics and Medical Informatics (DEBIM), University of Health Sciences, Faculty of Medicine, Libreville, Gabon
| | - Euloge Ibinga
- Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), University of Health Sciences, Libreville, Gabon
- Department of Epidemiology, Biostatistics and Medical Informatics (DEBIM), University of Health Sciences, Faculty of Medicine, Libreville, Gabon
| | - Prudence Gnamien Amani
- Bordeaux Health Population, Inserm U1219 University of Bordeaux, 33076 Bordeaux Cedex, France
| | - Jean Engohang-Ndong
- Department of Epidemiology, Biostatistics and Medical Informatics (DEBIM), University of Health Sciences, Faculty of Medicine, Libreville, Gabon
- Department of Biological Sciences, Kent State University at Tuscarawas, New Philadelphia, United States of America
| | - Elsa Ayo Bivigou
- Department of Cardiology, Centre Hospitalier Universitaire de Libreville, Libreville, Gabon
| | - Andréa Annick Nsounda
- Department of Neurology, Centre Hospitalier Universitaire de Libreville, Libreville, Gabon
| | - Jérôme Wittwer
- Bordeaux Health Population, Inserm U1219 University of Bordeaux, 33076 Bordeaux Cedex, France
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15
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Veletzky L, Eberhardt KA, Hergeth J, Stelzl DR, Zoleko Manego R, Mombo-Ngoma G, Kreuzmair R, Burger G, Adegnika AA, Agnandji ST, Matsiegui PB, Boussinesq M, Mordmüller B, Ramharter M. Distinct loiasis infection states and associated clinical and hematological manifestations in patients from Gabon. PLoS Negl Trop Dis 2022; 16:e0010793. [PMID: 36121900 PMCID: PMC9521832 DOI: 10.1371/journal.pntd.0010793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/29/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background Loiasis–a filarial disease endemic in Central and West Africa–is increasingly recognized as significant individual and public health concern. While the understanding of the disease characteristics remains limited, significant morbidity and excess mortality have been demonstrated. Here, we characterize clinical and hematological findings in a large cohort from Gabon. Methods Loiasis-related clinical manifestations and microfilaremia, hemoglobin and differential blood counts were recorded prospectively during a cross-sectional survey. For analysis, participants were categorized into distinct infection states by the diagnostic criteria of eye worm history and microfilaremia. Results Analysis of data from 1,232 individuals showed that occurrence of clinical and hematological findings differed significantly between the infection states. Eye worm positivity was associated with a wide range of clinical manifestations while microfilaremia by itself was not. Loa loa infection was associated with presence of eosinophilia and absolute eosinophil counts were associated with extent of microfilaremia (p-adj. = 0.012, ß-estimate:0.17[0.04–0.31]). Conclusions Loiasis is a complex disease, causing different disease manifestations in patients from endemic regions. The consequences for the affected individuals or populations as well as the pathophysiological consequences of correlating eosinophilia are largely unknown. High-quality research on loiasis should be fostered to improve patient care and understanding of the disease. Loiasis is a parasitic disease, endemic in parts of Western and Central Africa. While the disease has traditionally been considered to be benign, only recently significant disease morbidity and mortality have been shown. Most of the knowledge about loiasis, however, stems from reports on returning travelers, while comprehensive data from patients living in endemic areas are missing. Blood microfilaremia and reported eye worm are important diagnostic manifestations of the disease, but they can occur independent of each other in affected individuals. We analyzed hematological and clinical findings according to loiasis infection states, comprising reported eye worm and microfilaremia positivity, in a large group of individuals from a highly endemic area. While we found that all loiasis infection states were significantly associated with absolute blood eosinophilia, the eosinophilia was more pronounced in microfilaremic loiasis. Further, there was an association between the extent of microfilaremia and absolute eosinophilia. Analyzing the frequency of clinical disease manifestations, we found that eye worm positive loiasis was associated with a range of symptoms, but microfilaremic loiasis was not. Summarizing, even in highly endemic populations different loiasis infection states are associated with distinct disease manifestations, underlining that loiasis is a versatile and indeed relevant disease.
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Affiliation(s)
- Luzia Veletzky
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center For Infection Research (DZIF), Hamburg-Borstel-Riems, Germany
- * E-mail: (LV); (MR)
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Daniel Robert Stelzl
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rella Zoleko Manego
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ruth Kreuzmair
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Gerrit Burger
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | | | - Michel Boussinesq
- Institut de Recherche pour le Développement (IRD), UMI 233-TransVIHMI-Inserm U1175-University of Montpellier, Montpellier, France
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
- Radboud University Medical Center, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center For Infection Research (DZIF), Hamburg-Borstel-Riems, Germany
- * E-mail: (LV); (MR)
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16
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Ekoka Mbassi FA, Mombo-Ngoma G, Ndoumba WN, Yovo EK, Eberhardt KA, Ekoka Mbassi D, Adegnika AA, Agnandji ST, Bouyou-Akotet MK, Ramharter M, Zoleko-Manego R. Performance of Field's Stain Compared with Conventional Giemsa Stain for the Rapid Detection of Blood Microfilariae in Gabon. Am J Trop Med Hyg 2022; 107:383-387. [PMID: 35895407 PMCID: PMC9393457 DOI: 10.4269/ajtmh.22-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/25/2021] [Indexed: 11/15/2022] Open
Abstract
Filarial infections caused by Loa loa and Mansonella perstans are a considerable public health burden in rural regions of Central Africa. Rapid diagnostic tools for the detection of microfilariae in the blood are needed. Field's stain is a rapid staining technique for microscopic slides originally established for malaria diagnostics. It requires less than 1 minute of staining compared with conventional staining protocols requiring at least 15 to 20 minutes for staining and could thus significantly accelerate diagnostics for human filariasis. Here we evaluated Field's stain as a rapid staining technique in comparison to Giemsa stain for the detection of microfilariae in peripheral blood. Blood smears were collected from 175 participants residing in the region of Lambaréné and Fougamou, Gabon. Each participant's samples were stained in parallel with Field's stain and conventional Giemsa stain. Slides were then microscopically assessed and compared for qualitative and quantitative results by a blinded assessor for the two endemic filarial blood pathogens M. perstans and L. loa. Field's stain shows excellent diagnostic performance characteristics for L. loa microfilariae compared with Giemsa staining. Concordance was favorable for M. perstans although lower than for L. loa. Field's stain offers a rapid alternative to Giemsa stain for detection of L. loa microfilariae in thick blood smears. This could help accelerate diagnostics of blood filarial pathogens in mass screening programs or resource constrained health care institutions with high patient load.
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Affiliation(s)
- Franck-A. Ekoka Mbassi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Kirsten A. Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Sites Hamburg-Lübeck-Borstel-Riems
| | - Dorothea Ekoka Mbassi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Sites Hamburg-Lübeck-Borstel-Riems
| | - Ayôla A. Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | | | - Marielle K. Bouyou-Akotet
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Sites Hamburg-Lübeck-Borstel-Riems
| | - Rella Zoleko-Manego
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical‚ Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Sites Hamburg-Lübeck-Borstel-Riems
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17
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Mouinga-Ondémé A, Boundenga L, Koumba Koumba IP, Idam Mamimandjiami A, Diané A, Engone-Ondo JD, Djuicy DD, Sica J, Mombo LE, Gessain A, Aghokeng Fobang A. Human T-Lymphotropic virus type 1 and human immunodeficiency virus co-infection in rural Gabon. PLoS One 2022; 17:e0271320. [PMID: 35867643 PMCID: PMC9307203 DOI: 10.1371/journal.pone.0271320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Human T-cell lymphotrophic virus type-1 (HTLV-1) and human immunodeficiency virus (HIV-1) co-infection occur in many populations. People living with HIV-1 and infected with HTLV-1 seem more likely to progress rapidly towards AIDS. Both HTLV-1 and HIV-1 are endemic in Gabon (Central Africa). We investigated HTLV-1 and HIV-1 co-infection in the Haut-Ogooué province, and assessed factors that may favor the rapid evolution and progression to AIDS in co-infected patients. Methods Plasma samples from HTLV-1 patients were tested using ELISA, and positive samples were then tested by western blot assay (WB). We used the polymerase chain reaction to detect HTLV-1 Tax/Rex genes using DNA extracted from the buffy coat of ELISA-positives samples. Results We recruited 299 individuals (mean age 46 years) including 90 (30%) men and 209 (70%) women, all of whom are under treatment at the Ambulatory Treatment Centre of the province. Of these, 45 were ELISA HTLV-1/2 seropositive. According to WB criteria, 21 of 45 were confirmed positive: 20 were HTLV-1 (44%), 1 was HTLV-1/2 (2%), 2 were indeterminate (4%) and 22 were seronegative (49%). PCR results showed that 23 individuals were positive for the Tax/Rex region. Considering both serological and molecular assays, the prevalence of HTLV-1 infection was estimated at 7.7%. Being a woman and increasing age were found to be independent risk factors for co-infection. Mean CD4+ cell counts were higher in HTLV-1/HIV-1 co-infected (578.1 (± 340.8) cells/mm3) than in HIV-1 mono-infected (481.0 (± 299.0) cells/mm3) Individuals. Similarly, the mean HIV-1 viral load was Log 3.0 (± 1.6) copies/ml in mono-infected and Log 2.3 (± 0.7) copies/ml in coinfected individuals. Conclusion We described an overall high prevalence of HTLV-1/HIV-1 co-infection in Gabon. Our findings stress the need of strategies to prevent and manage these co-infections.
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Affiliation(s)
- Augustin Mouinga-Ondémé
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- * E-mail:
| | - Larson Boundenga
- Groupe Evolution et Transmission Inter-espèces des Pathogènes (GETIP), Département de Parasitologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Ingrid Précilya Koumba Koumba
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Antony Idam Mamimandjiami
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Abdoulaye Diané
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Jéordy Dimitri Engone-Ondo
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Delia Doreen Djuicy
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Jeanne Sica
- Centre de Traitement Ambulatoire, Franceville, Gabon
| | - Landry Erik Mombo
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Antoine Gessain
- Unité d’Epidémiologie et de Physiopathologie des Virus Oncogènes (EPVO), et CNRS UMR3569, Institut Pasteur de Paris, Paris, France
| | - Avelin Aghokeng Fobang
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- MIVEGEC, Université de Montpellier, CNRS, IRD – Montpellier, Montpellier, France
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18
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Arnold B, Bélard S, Alabi A, Hufnagel M, Berner R, Toepfner N. High Diversity of emm Types and Marked Tetracycline Resistance of Group A Streptococci and Other ß-Hemolytic Streptococci in Gabon, Central Africa. Pediatr Infect Dis J 2022; 41:405-410. [PMID: 35213863 DOI: 10.1097/inf.0000000000003483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Group A ß-hemolytic streptococcus (GABHS) is a leading pathogen worldwide and post-streptococcal sequelae is a major cause of morbidity and mortality in resource-limited countries. The M protein (coded by the emm gene) is a key virulence factor and a component of GABHS vaccine candidates. As data on BHS in Central Africa are scarce, antibiotic resistance, emm diversity and potential vaccine coverage were investigated. METHODS In a prospective cross-sectional study, 1014 Gabonese were screened for streptococcal throat carriage, tonsillopharyngitis and pyoderma by throat and skin smear tests. All BHS were isolated, species were identified and analysis of antibiotic resistance, emm types and emm clusters was performed. RESULTS One hundred sixty-five BHS were detected, comprising 76 GABHS, 36 group C ß-hemolytic streptococcus (GCBHS) and 53 group G ß-hemolytic streptococcus (GGBHS) in 140 carrier, 9 tonsillopharyngitis and 16 pyoderma isolates. Eighty percentage of GABHS, 78% of GCBHS and 79% of GGBHS were tetracycline resistant. Forty-six emm types were identified. GABHS emm58, emm65 and emm81 were most prevalent (26%). Emm diversity of GABHS was the highest, GCBHS and GGBHS were less divers. Every second GABHS, every third GCBHS and every tenth GGBHS carrier was colonized with emm types detected in tonsillopharyngitis or pyoderma isolates. CONCLUSIONS Tetracycline resistance and emm type diversity was high among BHS carriers in Gabon with a potential coverage of 58% by the 30-valent GABHS vaccine. A relevant overlap of carrier emm types with emm types found in tonsillopharyngitis and pyoderma characterizes a shared pool of circulating BHS strains.
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Affiliation(s)
- Benjamin Arnold
- Department of Pediatrics, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
- Department of Infectious Disease/Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Leipzig, Germany
| | - Sabine Bélard
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Berlin Institute of Health, Berlin, Germany
| | - Abraham Alabi
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
| | - Markus Hufnagel
- Department of Pediatrics and Adolescent Medicine, University Medical Center, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Reinhard Berner
- Department of Pediatrics, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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19
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Minto'o S, Kamgaing EK, Bisvigou U, Loembe FC, Nze DZ, Ngoungou E, Ategbo SJ. Hepatitis B Vaccination Coverage of Preschool Children in Libreville, Gabon: Prevalence and Determining Factors. Indian Pediatr 2022; 59:290-292. [PMID: 35014612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We aimed to assess hepatitis B vaccination coverage (vaccine coverage) among preschool children in Libreville, Gabon, and determine associated factors. METHODS A cross-sectional study was done evaluating hepatitis B vaccination records, by cluster random sampling of children aged 4 months to 5 years from 5 medical centres. RESULTS Of the 500 children (243 males) included, we found a hepatitis B vaccine coverage of 78.6% (95% CI 75% to 82.2%). Factors significantly associated with vaccine coverage included parental confidence in the vaccine (OR=2.2;95% CI 1.4-5.5), the number of children at home lower than the median (aOR=1.6; 95% CI ; 1.3-3.7). and working mothers/fathers. CONCLUSION Hepatitis B vaccine coverage in Libreville is lower than WHO objectives. Healthcare providers have a crucial role in building up confidence among parents.
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Affiliation(s)
- S Minto'o
- Department of Pediatrics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon. Correspondence to: Dr Steeve Minto'o, Faculty of Medicine, P.O. Box 4009 Libreville,
| | - E Kuissi Kamgaing
- Department of Pediatrics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - U Bisvigou
- Department of Public Health and Biostatistics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - F C Loembe
- Department of Pediatrics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - D Zoua Nze
- Department of Pediatrics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - E Ngoungou
- Department of Public Health and Biostatistics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
| | - S J Ategbo
- 1Department of Pediatrics, Faculty of Medicine, University of Health Sciences; 2Department of Public Health and Biostatistics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
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20
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Nkwayep CH, Bowong S, Tsanou B, Alaoui MAA, Kurths J. Mathematical modeling of COVID-19 pandemic in the context of sub-Saharan Africa: a short-term forecasting in Cameroon and Gabon. Math Med Biol 2022; 39:1-48. [PMID: 35045180 DOI: 10.1093/imammb/dqab020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Abstract
In this paper, we propose and analyse a compartmental model of COVID-19 to predict and control the outbreak. We first formulate a comprehensive mathematical model for the dynamical transmission of COVID-19 in the context of sub-Saharan Africa. We provide the basic properties of the model and compute the basic reproduction number $\mathcal {R}_0$ when the parameter values are constant. After, assuming continuous measurement of the weekly number of newly COVID-19 detected cases, newly deceased individuals and newly recovered individuals, the Ensemble of Kalman filter (EnKf) approach is used to estimate the unmeasured variables and unknown parameters, which are assumed to be time-dependent using real data of COVID-19. We calibrated the proposed model to fit the weekly data in Cameroon and Gabon before, during and after the lockdown. We present the forecasts of the current pandemic in these countries using the estimated parameter values and the estimated variables as initial conditions. During the estimation period, our findings suggest that $\mathcal {R}_0 \approx 1.8377 $ in Cameroon, while $\mathcal {R}_0 \approx 1.0379$ in Gabon meaning that the disease will not die out without any control measures in theses countries. Also, the number of undetected cases remains high in both countries, which could be the source of the new wave of COVID-19 pandemic. Short-term predictions firstly show that one can use the EnKf to predict the COVID-19 in Sub-Saharan Africa and that the second vague of the COVID-19 pandemic will still increase in the future in Gabon and in Cameroon. A comparison between the basic reproduction number from human individuals $\mathcal {R}_{0h}$ and from the SARS-CoV-2 in the environment $\mathcal {R}_{0v}$ has been done in Cameroon and Gabon. A comparative study during the estimation period shows that the transmissions from the free SARS-CoV-2 in the environment is greater than that from the infected individuals in Cameroon with $\mathcal {R}_{0h}$ = 0.05721 and $\mathcal {R}_{0v}$ = 1.78051. This imply that Cameroonian apply distancing measures between individual more than with the free SARS-CoV-2 in the environment. But, the opposite is observed in Gabon with $\mathcal {R}_{0h}$ = 0.63899 and $\mathcal {R}_{0v}$ = 0.39894. So, it is important to increase the awareness campaigns to reduce contacts from individual to individual in Gabon. However, long-term predictions reveal that the COVID-19 detected cases will play an important role in the spread of the disease. Further, we found that there is a necessity to increase timely the surveillance by using an awareness program and a detection process, and the eradication of the pandemic is highly dependent on the control measures taken by each government.
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Affiliation(s)
- C H Nkwayep
- Laboratory of Mathematics, Department of Mathematics and Computer Science, University of Douala, PO Box 24157, Douala, Cameroon
- IRD, Sorbonne University, UMMISCO, F-93143, Bondy, France
| | - S Bowong
- Laboratory of Mathematics, Department of Mathematics and Computer Science, University of Douala, PO Box 24157, Douala, Cameroon
- IRD, Sorbonne University, UMMISCO, F-93143, Bondy, France
| | - B Tsanou
- University of Dschang Task-force for the Fighting of COVID-19, Department of Mathematics and Computer Science, University of Dschang, PO Box 67, Dschang,Cameroon
- Department of Mathematics and Applied Mathematics, University of Pretoria, Pretoria 0002, South Africa
- IRD, Sorbonne University, UMMISCO, F-93143, Bondy, France
| | - M A Aziz Alaoui
- Normandie University, UNIHAVRE, LMAH, FR-CNRS-3335, ISCN, Le Havre, 76600, France
| | - J Kurths
- Postdam Institute for Climate Impact Research (PIK), Telegraphenberg A 31, 14412 Potsdam, Germany
- Department of Physics, Humboldt Universitat zu Berlin, 12489 Berlin, Germany
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21
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Mintsa-Nguema R, Zoa-Assoumou S, Mewono L, M’Bondoukwé NP, Essono P, Mengue-Me-Ngou-Milama K, Boukandou-Mounanga M, Ndong-Ngomo JM, Mintsa-Ndong A, Ngoungou EB, Bouyou-Akotet MK, Mbongo-Kama E. Could pooled samples method affect SARS-CoV-2 diagnosis accuracy using BGI and Sansure-Biotech RT-PCR kits used in Gabon, Central Africa? PLoS One 2022; 17:e0262733. [PMID: 35061822 PMCID: PMC8782308 DOI: 10.1371/journal.pone.0262733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022] Open
Abstract
This study aims at establishing specimens pooling approach for the detection of SARS-CoV-2 using the RT-PCR BGI and Sansure-Biotech kits used in Gabon. To validate this approach, 14 positive samples, stored at -20°C for three to five weeks were analyzed individually (as gold standard) and in pools of five, eight and ten in the same plate. We created 14 pools of 5, 8 and 10 samples using 40 μL from each of the selected positive samples mixed with 4, 7 and 9 confirmed negative counterparts in a total volume of 200 μL, 320 μL and 400 μL for the pools of 5, 8 and 10 respectively. Both individual and pooled samples testing was conducted according to the BGI and Sansure-Biotech RT-PCR protocols used at the Professor Daniel Gahouma Laboratory (PDGL). Furthermore, the pooling method was also tested by comparing results of 470 unselected samples tested in 94 pools and individually. Results of our experiment showed that using a BGI single positive sample with cycle threshold (Ct) value of 28.42, confirmed by individual testing, detection occurred in all the pools. On the contrary samples with Ct >31 were not detected in pools of 10 and for these samples (Ct value as high as 37.17) their detection was possible in pool of 8. Regarding the Sansure-Biotech kit, positive samples were detected in all the pool sizes tested, irrespective of their Ct values. The specificity of the pooling method was 100% for the BGI and Sansure-Biotech RT-PCR assays. The present study found an increase in the Ct values with pool size for the BGI and Sansure-Biotech assays. This trend was statistically significant (Pearson’s r = 0.978; p = 0,022) using the BGI method where the mean Ct values were 24.04±1.1, 26.74±1.3, 27.91±1.1 and 28.32±1.1 for the individual, pool of 5, 8 and 10 respectively. The testing of the 470 samples showed that one of the 94 pools had a positive test similar to the individual test using the BGI and Sansure-Biotech kits. The saving of time and economizing test reagents by using the pooling method were demonstrated in this study. Ultimately, the pooling method could be used for the diagnosis of SARS-CoV-2 without modifying the accuracy of results in Gabon. We recommend a maximum pool size of 8 for the BGI kit. For the Sansure-Biotech kit, a maximum pool size of 10 can be used without affecting its accuracy compared to the individual testing.
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Affiliation(s)
- Rodrigue Mintsa-Nguema
- Research Institute in Tropical Ecology, National Center for Scientific and Technological Research, Libreville, Gabon
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- * E-mail:
| | - Samira Zoa-Assoumou
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- Department of Bacteriology-Virology, University of Health Science, Libreville, Gabon
| | - Ludovic Mewono
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- Department of Biology, Higher Normal School, Libreville, Gabon
| | - Noé P. M’Bondoukwé
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- Department of Parasitology-Mycology, University of Health Science, Libreville, Gabon
| | - Paulin Essono
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- National Laboratory of Public Health, Libreville, Gabon
| | - Krystina Mengue-Me-Ngou-Milama
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- National Laboratory of Public Health, Libreville, Gabon
| | - Marlaine Boukandou-Mounanga
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- Institute of Pharmacopeia and Traditional Medicine, National Center for Scientific and Technological Research, Libreville, Gabon
| | - Jacques M. Ndong-Ngomo
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
- Department of Parasitology-Mycology, University of Health Science, Libreville, Gabon
| | | | - Edgard B. Ngoungou
- Department of Parasitology-Mycology, University of Health Science, Libreville, Gabon
| | | | - Elvyre Mbongo-Kama
- Professor Daniel Gahouma Laboratory, Ministry of Health, Libreville, Gabon
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22
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Engone-Ondo JD, Bignoumba M, Boundzanga Moussavou P, Gafou A, Diane A, Yangawagou LM, Kassa Kassa RF, Onanga R, Mouinga-Ondémé A, Aghokeng AF. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:2035-2037. [PMID: 35474382 PMCID: PMC9244210 DOI: 10.1093/jac/dkac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jéordy D Engone-Ondo
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Michelle Bignoumba
- Unité de recherche et d’Analyses Médicales, Laboratoire de Bactériologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Pamela Boundzanga Moussavou
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées, (CIRMF-SSM), Libreville, Gabon
| | - Amahani Gafou
- Unité de recherche et d’Analyses Médicales, Laboratoire de Bactériologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Abdoulaye Diane
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | - Roland Fabrice Kassa Kassa
- Unité de recherche et d’Analyses Médicales, Laboratoire de Bactériologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Richard Onanga
- Unité de recherche et d’Analyses Médicales, Laboratoire de Bactériologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Augustin Mouinga-Ondémé
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées, (CIRMF-SSM), Libreville, Gabon
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23
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Mbehang Nguema PP, Onanga R, Ndong Atome GR, Tewa JJ, Mabika Mabika A, Muandze Nzambe JU, Obague Mbeang JC, Bitome Essono PY, Bretagnolle F, Godreuil S. High level of intrinsic phenotypic antimicrobial resistance in enterobacteria from terrestrial wildlife in Gabonese national parks. PLoS One 2021; 16:e0257994. [PMID: 34637441 PMCID: PMC8509864 DOI: 10.1371/journal.pone.0257994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/16/2021] [Indexed: 11/18/2022] Open
Abstract
Data on the prevalence of antibiotic resistance in Enterobacteriaceae in African wildlife are still relatively limited. The aim of this study was to estimate the prevalence of phenotypic intrinsic and acquired antimicrobial resistance of enterobacteria from several species of terrestrial wild mammals in national parks of Gabon. Colony culture and isolation were done using MacConkey agar. Isolates were identified using the VITEK 2 and MALDI-TOF methods. Antibiotic susceptibility was analysed and interpreted according to the European Committee on Antimicrobial Susceptibility Testing guidelines. The preliminary test for ESBL-producing Enterobacteriaceae was performed by replicating enterobacterial colonies on MacConkey agar supplemented with 2 mg/L cefotaxime (MCA+CTX). Extended-spectrum beta-lactamase (ESBL) production was confirmed with the double-disc synergy test (DDST). The inhibition zone diameters were read with SirScan. Among the 130 bacterial colonies isolated from 125 fecal samples, 90 enterobacterial isolates were identified. Escherichia coli (61%) was the most prevalent, followed by Enterobacter cloacae (8%), Proteus mirabilis (8%), Klebsiella variicola (7%), Klebsiella aerogenes (7%), Klebsiella oxytoca (4%), Citrobacter freundii (3%), Klebsiella pneumoniae (1%) and Serratia marcescens (1%). Acquired resistance was carried by E. coli (11% of all E. coli isolates) and E. cloacae (3% of all E. cloacae) isolates, while intrinsic resistance was detected in all the other resistant isolates (n = 31); K. variicola, K. oxytoca, K. pneumoniae, E. cloacae, K. aerogenes, S. marcescens and P. mirabilis). Our data show that most strains isolated in protected areas in Gabon are wild type isolates and carry intrinsic resistance rather than acquired resistance.
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Affiliation(s)
- Pierre Philippe Mbehang Nguema
- Departement Ecologie Animal, Institut de Recherche en Ecologie Tropicale (IRET), Libreville, Gabon
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- UMR CNRS/uB 6282 Biogéosciences, Université de Bourgogne-Franche-Comté, Dijon, France
| | - Richard Onanga
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- * E-mail:
| | - Guy Roger Ndong Atome
- Department de Chemie, Faculté des Sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Jean Jules Tewa
- Departement de Mathematiques et Informatique, Faculté des Sciences, Université de Douala, Douala, Cameroun
| | - Arsène Mabika Mabika
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | | | | | - François Bretagnolle
- UMR CNRS/uB 6282 Biogéosciences, Université de Bourgogne-Franche-Comté, Dijon, France
| | - Sylvain Godreuil
- Centre Hospitalier Universitaire de Montpellier, Laboratoire de Bactériologie, Université de Montpellier, Montpellier, France
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Ambounda NL, Woromogo SH, Yagata-Moussa FE, Ossouka LAO, Tekem VNS, Ango EO, Kouanang AJ. Primary postpartum haemorrhage at the Libreville University Hospital Centre: Epidemiological profile of women. PLoS One 2021; 16:e0257544. [PMID: 34543331 PMCID: PMC8452036 DOI: 10.1371/journal.pone.0257544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022] Open
Abstract
In Gabon, the proportion of maternal deaths directly related to Primary PostPartum Haemorrhage (PPPH) is 15 to 25%, despite the different means that the World Health Organization has made available to the providers of Emergency Obstetrical and Neonatal Care (EmONC). The objective of this study was to determine the prevalence and epidemiological characteristics of Primary PostPartum Haemorrhage to improve its management and reduce the rate of maternal deaths. An analytical retrospective study involved 42,728 records, whose data were collected using a chart collection form on the basis of information contained in partograms and other patient records. Sociodemographic variables were expressed using percentage. The relationship between the etiologies of PPPH and certain characteristics of the women was established using the ORs with their 95% confidence intervals. The difference was significant if p < 0.05. The prevalence of PPPH was 1.6%. Delivery haemorrhages accounted for 65.5% of PPPH. The main factors associated with delivery haemorrhages were pauci parity and multiparity (p = 0.003 and 0.051), post-term (p = 0.042), and birth weight >4,000 g (p = 0.006). Those associated with genital tract injuries were young maternal age (p = 0.008) and multiparity (p = 0.028). The most common etiology was haemorrhage from delivery. Multiparity remains the most common risk factor and the young age of the patients. It is important to improve management through better assessment of blood loss in the primary postpartum period as well as capacity building of health providers on EmONC.
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Affiliation(s)
| | - Sylvain Honore Woromogo
- InterStates Centre for Higher Public Health Education in Central Africa (CIESPAC), Brazzaville, Congo
- * E-mail:
| | | | | | - Vicky Noel Simo Tekem
- National Cancer Prevention and Control Programme, Ministry of Public Health, Libreville, Gabon
| | | | - Alain Jepang Kouanang
- University Hospital Centre of Libreville, Gynecology and Obstetric Service, Liberville, Gabon
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25
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Iroungou BA, Mangouka LG, Bivigou-Mboumba B, Moussavou-Boundzanga P, Obame-Nkoghe J, Nzigou Boucka F, Mouinga-Ondeme A, Aghokeng AF, Tchoua R, Pineau P, Nzenze JR. Demographic and Clinical Characteristics Associated With Severity, Clinical Outcomes, and Mortality of COVID-19 Infection in Gabon. JAMA Netw Open 2021; 4:e2124190. [PMID: 34519768 PMCID: PMC8441589 DOI: 10.1001/jamanetworkopen.2021.24190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Since the emergence of COVID-19 in central China, sub-Saharan African countries, with the exception of South Africa, have been relatively spared during the COVID-19 pandemic. Consequently, few descriptive studies from this region are available. OBJECTIVE To describe the clinical characteristics and outcomes of patients with COVID-19 infection in Gabon, from March to June 2020. DESIGN, SETTING, AND PARTICIPANTS A single-center, cross-sectional study of 837 patients with COVID-19 was conducted from March to June 2020 in the Armed Forces Hospital in Libreville, Gabon. MAIN OUTCOMES AND MEASURES Demographic and clinical characteristics and imaging findings of hospitalized patients with COVID-19. RESULTS Of the 837 patients enrolled, 572 (68.3%) were men, and 264 (31.5%) were women (male to female ratio, 2:1); the median (interquartile range [IQR]) age was 35 (30-45) years (mean [SD] age, 38.0 [12.2] years. The mortality rate associated with COVID-19 was low (1.4%). Of these 837 patients, 524 (62.6%) were categorized as having no symptoms, 282 (33.7%) as having mild symptoms, and 31 (3.7%) as having severe symptoms. Patients with severe symptoms were older (mean [SD] age, 46.1 [14.7] years) than patients with mild symptoms (mean [SD] age, 41.3 [12.5] years) and those with no symptoms (mean [SD] age, 35.7 [11.3] years) (Kruskal-Wallis χ22 = 53.5; P < .001). History of diabetes was the principal risk factor associated with both severe symptoms in 5 of 31 patients (16.1%) and mild symptoms in 11 of 282 (3.9%) compared with no symptoms in 5 of 524 (0.9%) (Pearson χ22 = 30.9; P < .001). Patients with severe symptoms and a fatal outcome were older (mean [SD] age, 53.4 [15.1] years) than survivors (mean [SD] age, 41.5 [12.9] years) (t20.83 = 2.2; P = .03). CONCLUSIONS AND RELEVANCE In this single-center, cross-sectional study in Libreville, Gabon, the mortality rate associated with COVID-19 infection from March to June 2020 was low, and patients who died of COVID-19 infection were younger on average than reported elsewhere, possibly reflecting a smaller elderly population in Gabon.
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Affiliation(s)
- Berthe Amélie Iroungou
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | | | - Berthold Bivigou-Mboumba
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Pamela Moussavou-Boundzanga
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Judicaël Obame-Nkoghe
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
- Unité Écologie des Systèmes Vectoriels, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | | | - Augustin Mouinga-Ondeme
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Avelin Fobang Aghokeng
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Unité Mixite de Recherche, Institut de Recherche pour Developpement 224, Centre National de la Recherche Scientifique 5290, Maladies infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle, Université de Montpellier, Montpellier, France
| | - Romain Tchoua
- Service de Réanimation, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
| | - Pascal Pineau
- Unité “Organisation Nucléaire et Oncogenèse,” INSERM U993, Institut Pasteur, Paris, France
| | - Jean Raymond Nzenze
- Service de Médecine Interne, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
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26
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Mischlinger J, Manego RZ, Mombo-Ngoma G, Ekoka Mbassi D, Hackbarth N, Ekoka Mbassi FA, Davi SD, Kreuzmair R, Veletzky L, Hergeth J, Ndoumba WN, Pitzinger P, Groger M, Matsiegui PB, Adegnika AA, Agnandji ST, Lell B, Ramharter M. Diagnostic performance of capillary and venous blood samples in the detection of Loa loa and Mansonella perstans microfilaraemia using light microscopy. PLoS Negl Trop Dis 2021; 15:e0009623. [PMID: 34398886 PMCID: PMC8389422 DOI: 10.1371/journal.pntd.0009623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/26/2021] [Accepted: 07/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Loa loa and Mansonella perstans-the causative agents of loiasis and mansonellosis-are vector-borne filarial parasites co-endemic in sub-Saharan Africa. Diagnosis of both infections is usually established by microscopic analysis of blood samples. It was recently established that the odds for detecting Plasmodium spp. is higher in capillary (CAP) blood than in venous (VEN) blood. In analogy to this finding this analysis evaluates potential differences in microfilaraemia of L. loa and M. perstans in samples of CAP and VEN blood. METHODS Recruitment took place between 2015 and 2019 at the CERMEL in Lambaréné, Gabon and its surrounding villages. Persons of all ages presenting to diagnostic services of the research center around noon were invited to participate in the study. A thick smear of each 10 microliters of CAP and VEN blood was prepared and analysed by a minimum of two independent microscopists. Differences of log2-transformed CAP and VEN microfilaraemia were computed and expressed as percentages. Furthermore, odds ratios for paired data were computed to quantify the odds to detect microfilariae in CAP blood versus in VEN blood. RESULTS A total of 713 participants were recruited among whom 52% were below 30 years of age, 27% between 30-59 years of age and 21% above 60 years of age. Male-female ratio was 0.84. Among 152 participants with microscopically-confirmed L. loa infection median (IQR) microfilaraemia was 3,650 (275-11,100) per milliliter blood in CAP blood and 2,775 (200-8,875) in VEN blood (p<0.0001), while among 102 participants with M. perstans this was 100 (0-200) and 100 (0-200), respectively (p = 0.44). Differences in linear models amount up to an average of +34.5% (95% CI: +11.0 to +63.0) higher L. loa microfilaria quantity in CAP blood versus VEN blood and for M. perstans it was on average higher by +24.8% (95% CI: +0.0 to +60.5). Concordantly, the odds for detection of microfilaraemia in CAP samples versus VEN samples was 1.24 (95% CI: 0.65-2.34) and 1.65 (95% CI: 1.0-2.68) for infections with L. loa and M. perstans, respectively. CONCLUSION This analysis indicates that average levels of microfilaraemia of L. loa are higher in CAP blood samples than in VEN blood samples. This might have implications for treatment algorithms of onchocerciasis and loiasis, in which exact quantification of L. loa microfilaraemia is of importance. Furthermore, the odds for detection of M. perstans microfilariae was higher in CAP than in VEN blood which may pre-dispose CAP blood for detection of M. perstans infection in large epidemiological studies when sampling of large blood quantities is not feasible. No solid evidence for a higher odds of L. loa microfilariae detection in CAP blood was revealed, which might be explained by generally high levels of L. loa microfilaraemia in CAP and VEN blood above the limit of detection of 100 microfilariae/ml. Yet, it cannot be excluded that the study was underpowered to detect a moderate difference.
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Affiliation(s)
- Johannes Mischlinger
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | - Rella Zoleko Manego
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Ghyslain Mombo-Ngoma
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Dorothea Ekoka Mbassi
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | - Nina Hackbarth
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | - Franck-Aurelien Ekoka Mbassi
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Saskia Dede Davi
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | - Ruth Kreuzmair
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Luzia Veletzky
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | | | | | | | - Mirjam Groger
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | | | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Partner Site Tübingen, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
- * E-mail:
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Koumavor CAK, Elguero E, Leroy EM. Potential Association between Zika Infection and Microcephaly during 2007 Fever Outbreak, Gabon. Emerg Infect Dis 2021; 27:672-674. [PMID: 33496651 PMCID: PMC7853567 DOI: 10.3201/eid2702.202987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although Zika virus (ZIKV) circulates in sub-Saharan Africa, no case of ZIKV-associated microcephaly has thus far been reported. Here, we report evidence of a possible association between a 2007 outbreak of febrile illness and an increase in microcephaly and possibly ZIKV infection in Gabon.
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Ushijima Y, Abe H, Nguema Ondo G, Bikangui R, Massinga Loembé M, Zadeh VR, Essimengane JGE, Mbouna AVN, Bache EB, Agnandji ST, Lell B, Yasuda J. Surveillance of the major pathogenic arboviruses of public health concern in Gabon, Central Africa: increased risk of West Nile virus and dengue virus infections. BMC Infect Dis 2021; 21:265. [PMID: 33731022 PMCID: PMC7966894 DOI: 10.1186/s12879-021-05960-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Increasing arbovirus infections have been a global burden in recent decades. Many countries have experienced the periodic emergence of arbovirus diseases. However, information on the prevalence of arboviruses is largely unknown or infrequently updated because of the lack of surveillance studies, especially in Africa. METHODS A surveillance study was conducted in Gabon, Central Africa, on arboviruses, which are a major public health concern in Africa, including: West Nile virus (WNV), dengue virus (DENV), Zika virus (ZIKV), yellow fever virus (YFV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV). Serological and molecular assays were performed to investigate past infection history and the current status of infection, using serum samples collected from healthy individuals and febrile patients, respectively. RESULTS The overall seroprevalence during 2014-2017 was estimated to be 25.3% for WNV, 20.4% for DENV, 40.3% for ZIKV, 60.7% for YFV, 61.2% for CHIKV, and 14.3% for RVFV. No significant differences were found in the seroprevalence of any of the viruses between the male and female populations. However, a focus on the mean age in each arbovirus-seropositive individual showed a significantly younger age in WNV- and DENV-seropositive individuals than in CHIKV-seropositive individuals, indicating that WNV and DENV caused a relatively recent epidemic in the region, whereas CHIKV had actively circulated before. Of note, this indication was supported by the detection of both WNV and DENV genomes in serum samples collected from febrile patients after 2016. CONCLUSIONS This study revealed the recent re-emergence of WNV and DENV in Gabon as well as the latest seroprevalence state of the major arboviruses, which indicated the different potential risks of virus infections and virus-specific circulation patterns. This information will be helpful for public health organizations and will enable a rapid response towards these arbovirus infections, thereby preventing future spread in the country.
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Affiliation(s)
- Yuri Ushijima
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Haruka Abe
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | - Rodrigue Bikangui
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Marguerite Massinga Loembé
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
- Africa Centres for Disease Control and Prevention, Johannesburg, South Africa
| | - Vahid R. Zadeh
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Joseph G. E. Essimengane
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | | | | | - Selidji T. Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
- Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Jiro Yasuda
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- National Research Center for the Control and Prevention of Infectious Diseases (CCPID), Nagasaki University, Nagasaki, Japan
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Mangombi JB, N’dilimabaka N, Lekana-Douki JB, Banga O, Maghendji-Nzondo S, Bourgarel M, Leroy E, Fenollar F, Mediannikov O. First investigation of pathogenic bacteria, protozoa and viruses in rodents and shrews in context of forest-savannah-urban areas interface in the city of Franceville (Gabon). PLoS One 2021; 16:e0248244. [PMID: 33684147 PMCID: PMC7939261 DOI: 10.1371/journal.pone.0248244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/23/2021] [Indexed: 12/29/2022] Open
Abstract
Rodents are reservoirs of numerous zoonotic diseases caused by bacteria, protozoans, or viruses. In Gabon, the circulation and maintenance of rodent-borne zoonotic infectious agents are poorly studied and are often limited to one type of pathogen. Among the three existing studies on this topic, two are focused on a zoonotic virus, and the third is focused on rodent Plasmodium. In this study, we searched for a wide range of bacteria, protozoa and viruses in different organs of rodents from the town of Franceville in Gabon. Samples from one hundred and ninety-eight (198) small mammals captured, including two invasive rodent species, five native rodent species and 19 shrews belonging to the Soricidae family, were screened. The investigated pathogens were bacteria from the Rickettsiaceae and Anaplasmataceae families, Mycoplasma spp., Bartonella spp., Borrelia spp., Orientia spp., Occidentia spp., Leptospira spp., Streptobacillus moniliformis, Coxiella burnetii, and Yersinia pestis; parasites from class Kinetoplastida spp. (Leishmania spp., Trypanosoma spp.), Piroplasmidae spp., and Toxoplasma gondii; and viruses from Paramyxoviridae, Hantaviridae, Flaviviridae and Mammarenavirus spp. We identified the following pathogenic bacteria: Anaplasma spp. (8.1%; 16/198), Bartonella spp. (6.6%; 13/198), Coxiella spp. (5.1%; 10/198) and Leptospira spp. (3.5%; 7/198); and protozoans: Piroplasma sp. (1%; 2/198), Toxoplasma gondii (0.5%; 1/198), and Trypanosoma sp. (7%; 14/198). None of the targeted viral genes were detected. These pathogens were found in Gabonese rodents, mainly Lophuromys sp., Lemniscomys striatus and Praomys sp. We also identified new genotypes: Candidatus Bartonella gabonensis and Uncultured Anaplasma spp. This study shows that rodents in Gabon harbor some human pathogenic bacteria and protozoans. It is necessary to determine whether the identified microorganisms are capable of undergoing zoonotic transmission from rodents to humans and if they may be responsible for human cases of febrile disease of unknown etiology in Gabon.
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Affiliation(s)
- Joa Braïthe Mangombi
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Aix Marseille Univ, IRD, AP-HM, Microbes, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Nadine N’dilimabaka
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Département de Biologie, Faculté des sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Jean-Bernard Lekana-Douki
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Département de Parasitologie, Université des Sciences de la Santé (USS), Owendo, Libreville
| | - Octavie Banga
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Sydney Maghendji-Nzondo
- Département Epidémiologie-Biostatistique et Informatique Médicale (DEBIM), Université des Sciences de la Santé (USS), Owendo, Libreville
| | - Mathieu Bourgarel
- CIRAD, UMR ASTRE, Harare, Zimbabwe
- ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France
| | - Eric Leroy
- Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- UMR MIVEGEC IRD-CNRS-UM, IRD, Montpellier, France
| | - Florence Fenollar
- Aix Marseille Univ, IRD, AP-HM, Microbes, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Oleg Mediannikov
- IHU Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, Microbes, MEPHI, Marseille, France
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30
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Honkpehedji YJ, Adegnika AA, Dejon-Agobe JC, Zinsou JF, Mba RB, Gerstenberg J, Rakotozandrindrainy R, Rakotoarivelo RA, Rasamoelina T, Sicuri E, Schwarz NG, Corstjens PLAM, Hoekstra PT, van Dam GJ, Kreidenweiss A. Prospective, observational study to assess the performance of CAA measurement as a diagnostic tool for the detection of Schistosoma haematobium infections in pregnant women and their child in Lambaréné, Gabon: study protocol of the freeBILy clinical trial in Gabon. BMC Infect Dis 2020; 20:718. [PMID: 32993559 PMCID: PMC7523491 DOI: 10.1186/s12879-020-05445-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosoma antigen detection in urine is a valuable diagnostic approach for schistosomiasis control programmes because of the higher sensitivity compared to parasitological methods and preferred sampling of urine over stool. Highly accurate diagnostics are important in low Schistosoma transmission areas. Pregnant women and young children could particularly benefit from antigen testing as praziquantel (PZQ) can be given to only confirmed Schistosoma cases. This prevents the unborn baby from unnecessary exposure to PZQ. We present here the protocol of a diagnostic study that forms part of the freeBILy project. The aim is to evaluate the accuracy of circulating anodic antigen (CAA) detection for diagnosis of Schistosoma haematobium infections in pregnant women and to validate CAA as an endpoint measure for anti-Schistosoma drug efficacy. The study will also investigate Schistosoma infections in infants. METHODS A set of three interlinked prospective, observational studies is conducted in Gabon. The upconverting phosphor lateral flow (UCP-LF) CAA test is the index diagnostic test that will be evaluated. The core trial, sub-study A, comprehensively evaluates the accuracy of the UCP-LF CAA urine test against a set of other Schistosoma diagnostics in a cross-sectional trial design. Women positive for S. haematobium will proceed with sub-study B and will be randomised to receive PZQ treatment immediately or after delivery followed by weekly sample collection. This approach includes comparative monitoring of CAA levels following PZQ intake and will also contribute further data for safety of PZQ administration during pregnancy. Sub-study C is a longitudinal study to determine the incidence of S. haematobium infection as well as the age for first infection in life-time. DISCUSSION The freeBILy trial in Gabon will generate a comprehensive set of data on the accuracy of the UCP-LF CAA test for the detection of S. haematobium infection in pregnant women and newborn babies and for the use of CAA as a marker to determine PZQ efficacy. Furthermore, incidence of Schistosoma infection in infants will be reported. Using the ultrasensitive diagnostics, this information will be highly relevant for Schistosoma prevalence monitoring by national control programs as well as for the development of medicaments and vaccines. TRIAL REGISTRATION The registration number of this study is NCT03779347 ( clinicaltrials.gov , date of registration: 19 December 2018).
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Affiliation(s)
- Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Jean Claude Dejon-Agobe
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Romuald Beh Mba
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Jacob Gerstenberg
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | | | | | | | - Elisa Sicuri
- Fundación Privada Instituto de Salud Global Barcelona, Barcelona, Spain
| | | | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands.
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Lengongo JVK, Ngondza BP, Ditombi BM, M'Bondoukwé NP, Ngomo JMN, Delis AM, Lekounga PB, Bouyou-Akotet M, Mawili-Mboumba DP. Prevalence and associated factors of intestinal parasite infection by HIV infection status among asymptomatic adults in rural Gabon. Afr Health Sci 2020; 20:1024-1034. [PMID: 33402948 PMCID: PMC7751509 DOI: 10.4314/ahs.v20i3.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Intestinal parasites infections are endemic in Gabon. Nevertheless, they are rarely described in people living with HIV (PLHIV). OBJECTIVE The frequency of intestinal parasite infection was estimated and compared between HIV-positive and HIV uninfected individuals in Gabon; factors associated with intestinal parasites were also analysed. MATERIAL AND METHODS Using a cross-sectional study design sociodemographic data, life style habits, antiretroviral therapy, cotrimoxazole use and CD4 cell count were recorded.. Stool samples from participants living in Koulamoutou and Oyem were analysed using microscopy. Chi-squared or fisher's exact tests and logistic regression were performed. RESULTS Among participants (n=332), female gender was predominant (73.7%; n=135/183) and the median age was 45 [33-57] years old. Among 183 samples, 53.6% (n = 98/183) were infected by intestinal parasites. The proportion was higher (72.1%) in HIV negative participants compared to PLHIV (42.6%) (p <0.01). PLHIV were more frequently poly-infected. Infection was frequent in patients using external toilets and tap water (>70.0%). CONCLUSION Prevalence of intestinal parasites is higher in seronegative participants but polyparasitism is more frequent in PLHIV. Strategies are focused on HIV negative population, but this study shows the importance of sensitization for PLHIV to improve their quality of life.
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Fonseca AM, González R, Bardají A, Jairoce C, Rupérez M, Jiménez A, Quintó L, Cisteró P, Vala A, Sacoor C, Gupta H, Hegewisch-Taylor J, Brew J, Ndam NT, Kariuki S, López M, Dobaño C, Chitnis CE, Ouma P, Ramharter M, Abdulla S, Aponte JJ, Massougbodji A, Briand V, Mombo-Ngoma G, Desai M, Cot M, Nhacolo A, Sevene E, Macete E, Menéndez C, Mayor A. VAR2CSA Serology to Detect Plasmodium falciparum Transmission Patterns in Pregnancy. Emerg Infect Dis 2020; 25:1851-1860. [PMID: 31538557 PMCID: PMC6759269 DOI: 10.3201/eid2510.181177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Pregnant women constitute a promising sentinel group for continuous monitoring of malaria transmission. To identify antibody signatures of recent Plasmodium falciparum exposure during pregnancy, we dissected IgG responses against VAR2CSA, the parasite antigen that mediates placental sequestration. We used a multiplex peptide-based suspension array in 2,354 samples from pregnant women from Mozambique, Benin, Kenya, Gabon, Tanzania, and Spain. Two VAR2CSA peptides of limited polymorphism were immunogenic and targeted by IgG responses readily boosted during infection and with estimated half-lives of <2 years. Seroprevalence against these peptides reflected declines and rebounds of transmission in southern Mozambique during 2004–2012, reduced exposure associated with use of preventive measures during pregnancy, and local clusters of transmission that were missed by detection of P. falciparum infections. These data suggest that VAR2CSA serology can provide a useful adjunct for the fine-scale estimation of the malaria burden among pregnant women over time and space.
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MESH Headings
- Adult
- Antibodies, Protozoan/immunology
- Antigens, Protozoan/blood
- Antigens, Protozoan/immunology
- Benin/epidemiology
- Female
- Gabon/epidemiology
- Humans
- Immunoglobulin G/immunology
- Kenya/epidemiology
- Malaria, Falciparum/complications
- Malaria, Falciparum/diagnosis
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/transmission
- Mozambique/epidemiology
- Plasmodium falciparum/immunology
- Pregnancy
- Pregnancy Complications, Parasitic/blood
- Pregnancy Complications, Parasitic/diagnosis
- Pregnancy Complications, Parasitic/epidemiology
- Serologic Tests/methods
- Spain/epidemiology
- Tanzania/epidemiology
- Young Adult
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Dejon-Agobé JC, Honkpehedji YJ, Zinsou JF, Edoa JR, Adégbitè BR, Mangaboula A, Agnandji ST, Mombo-Ngoma G, Ramharter M, Kremsner PG, Lell B, Grobusch MP, Adegnika AA. Epidemiology of Schistosomiasis and Soil-Transmitted Helminth Coinfections among Schoolchildren Living in Lambaréné, Gabon. Am J Trop Med Hyg 2020; 103:325-333. [PMID: 32431272 PMCID: PMC7356410 DOI: 10.4269/ajtmh.19-0835] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/18/2020] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is a parasitic infection highly prevalent in Central Africa where it is co-endemic with many other parasitic infections, including soil-transmitted helminths (STHs). For its optimal control, there is a need of descriptive epidemiological data for each endemic region. The objective of the present study was to determine the epidemiological situation around schistosomiasis in Lambaréné, Gabon. A cross-sectional study was conducted among schoolchildren. One urine sample per day was collected on three consecutive days for the diagnosis of schistosomiasis using a urine filtration technique. One stool sample was collected for the detection of Schistosoma spp. and STH spp. eggs using the Kato-Katz technique, and for larvae, using the coproculture technique. A total of 614 schoolchildren were included in the analysis. The overall prevalence of schistosomiasis and STH infections was 26% (159/614) and 15% (70/473), respectively. Human-freshwater contact was the main risk factor for schistosomiasis in the area (relative risk (RR) = 2.96 [2.20-4.00], P < 0.001). Hematuria (RR = 5.53 [4.30-7.10], P < 0.001) and proteinuria (RR = 2.12 [1.63-2.75], P < 0.001) as well as infection with Trichuris trichiura (RR = 1.86 [1.33-2.61], P = 0.002) and Ascaris lumbricoides (RR = 1.96 [1.19-3.21], P = 0.039) were associated with an increased risk of schistosomiasis. Trichuris trichiura was the highest prevalent STH species in the area. Our study reports a moderate prevalence for schistosomiasis with human-water contact as the main risk factor, whereas the prevalence of STH infections appears to be low. Our results stress the need for the implementation of WHO recommendations for schistosomiasis control.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Division of Internal Medicine, Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | | | - Ance Mangaboula
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
- I. Department of Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Centre-Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- I. Department of Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Centre-Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), African Partner Institution, CERMEL, Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Division of Internal Medicine, Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), African Partner Institution, CERMEL, Lambaréné, Gabon
- German Center for Infection Research (DZIF), Partner Site, Tübingen, Germany
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Veletzky L, Hergeth J, Stelzl DR, Mischlinger J, Manego RZ, Mombo-Ngoma G, McCall MBB, Adegnika AA, Agnandji ST, Metzger WG, Matsiegui PB, Lagler H, Mordmüller B, Budke C, Ramharter M. Burden of disease in Gabon caused by loiasis: a cross-sectional survey. Lancet Infect Dis 2020; 20:1339-1346. [PMID: 32585133 DOI: 10.1016/s1473-3099(20)30256-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Loiasis is a highly prevalent helminth infection found in distinct regions of sub-Saharan Africa. The disease has been considered to be of minor clinical significance, but this belief is being increasingly challenged by recent evidence. We aimed to prospectively quantify the overall burden of disease caused by loiasis in an endemic region of Gabon, using disability-adjusted life years (DALYs). METHODS We did a cross-sectional survey during 2017 and 2018 in rural Gabon. Volunteers underwent diagnostic tests for loiasis and were given a standardised questionnaire on symptoms. Participants reporting eye worm migration or harbouring Loa loa microfilariae were defined as loiasis positive. Morbidity-based DALYs associated with loiasis were estimated for the rural population of Gabon. FINDINGS Between Sept 1, 2017 and May 31, 2018, 1235 participants residing in 38 villages in the Gabonese departments of Tsamba-Magotsi and Ogooué et des Lacs were screened. 626 (50·8%) of 1232 eligible participants had loiasis. 520 (42·2%) of 1232 participants reported eye worm migration. 478 (93·9%) of 509 individuals with eye worm migration also reported associated pain, and 397 (78·6%) of 505 reported vision disturbances. After correcting for age and sex, loiasis was significantly associated with a variety of symptoms, including transient painful oedema (adjusted odds ratio 1·76 [95% CI 1·37-2·26]) and arthralgia (1·30 [1·01-1·69]). Application of attributable fractions of correlating symptoms resulted in 412·9 (95% CI 273·9-567·7) morbidity-based DALYs per 100 000 people in rural Gabon. INTERPRETATION Loiasis, with the pathognomonic sign of eye worm migration, appears to not be benign, but severely impeding to affected individuals. Furthermore, loiasis is associated with substantial morbidity, comparable to that of other neglected tropical parasitic diseases. These findings call for reconsideration of L loa as a relevant pathogen in affected populations, with a need for more concerted research and control of these infections. FUNDING Federal Ministry of Science, Research and Economy of Austria, and the European Union.
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Affiliation(s)
- Luzia Veletzky
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Lambaréné Medical Research Centre, Lambaréné, Gabon; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | | | | | - Johannes Mischlinger
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Rella Zoleko Manego
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Lambaréné Medical Research Centre, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Lambaréné Medical Research Centre, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Matthew B B McCall
- Lambaréné Medical Research Centre, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany; Radboud University Medical Centre, Department of Medical Microbiology, Nijmegen, Netherlands
| | - Ayôla A Adegnika
- Lambaréné Medical Research Centre, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Selidji T Agnandji
- Lambaréné Medical Research Centre, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Wolfram G Metzger
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | | | - Heimo Lagler
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen, Germany
| | - Christine Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Lambaréné Medical Research Centre, Lambaréné, Gabon.
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Maganga GD, Pinto A, Mombo IM, Madjitobaye M, Mbeang Beyeme AM, Boundenga L, Ar Gouilh M, N'Dilimabaka N, Drexler JF, Drosten C, Leroy EM. Genetic diversity and ecology of coronaviruses hosted by cave-dwelling bats in Gabon. Sci Rep 2020; 10:7314. [PMID: 32355260 PMCID: PMC7192909 DOI: 10.1038/s41598-020-64159-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 04/06/2020] [Indexed: 01/06/2023] Open
Abstract
Little research on coronaviruses has been conducted on wild animals in Africa. Here, we screened a wide range of wild animals collected in six provinces and five caves of Gabon between 2009 and 2015. We collected a total of 1867 animal samples (cave-dwelling bats, rodents, non-human primates and other wild animals). We explored the diversity of CoVs and determined the factors driving the infection of CoVs in wild animals. Based on a nested reverse transcription-polymerase chain reaction, only bats, belonging to the Hipposideros gigas (4/156), Hipposideros cf. ruber (13/262) and Miniopterus inflatus (1/249) species, were found infected with CoVs. We identified alphacoronaviruses in H. gigas and H. cf. ruber and betacoronaviruses in H. gigas. All Alphacoronavirus sequences grouped with Human coronavirus 229E (HCoV-229E). Ecological analyses revealed that CoV infection was significantly found in July and October in H. gigas and in October and November in H. cf ruber. The prevalence in the Faucon cave was significantly higher. Our findings suggest that insectivorous bats harbor potentially zoonotic CoVs; highlight a probable seasonality of the infection in cave-dwelling bats from the North-East of Gabon and pointed to an association between the disturbance of the bats' habitat by human activities and CoV infection.
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Affiliation(s)
- Gael Darren Maganga
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon.
- Université des Sciences et Techniques de Masuku (USTM), Institut National Supérieur d'Agronomie et de Biotechnologies (INSAB), BP, 913, Franceville, Gabon.
| | - Anaïs Pinto
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
| | - Illich Manfred Mombo
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
| | - Mankomra Madjitobaye
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
| | - Antoine Mitte Mbeang Beyeme
- Université des Sciences et Techniques de Masuku (USTM), Institut National Supérieur d'Agronomie et de Biotechnologies (INSAB), BP, 913, Franceville, Gabon
| | - Larson Boundenga
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
| | - Meriadeg Ar Gouilh
- Normandie Université, EA2656, Groupe de Recherche sur l'Adaptation Microbienne, 14000, Caen, France
| | - Nadine N'Dilimabaka
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu, Berlin, Germany
- German Centre for Infection Research (DZIF), Heidelberg, Germany
| | - Christian Drosten
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu, Berlin, Germany
- German Centre for Infection Research (DZIF), Heidelberg, Germany
| | - Eric Maurice Leroy
- Centre International de Recherches Médicales de Franceville (CIRMF), BP, 769, Franceville, Gabon
- UMR (IRD 224/CNRS 5290/UM1-UM2), Institut de Recherche pour le Développement, Montpellier, France
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Abstract
An association between malaria and risk for death among patients with Ebola virus disease has suggested within-host interactions between Plasmodium falciparum parasites and Ebola virus. To determine whether such an interaction might also influence the probability of acquiring either infection, we used a large snapshot surveillance study from rural Gabon to test if past exposure to Ebola virus is associated with current infection with Plasmodium spp. during nonepidemic conditions. We found a strong positive association, on population and individual levels, between seropositivity for antibodies against Ebola virus and the presence of Plasmodium parasites in the blood. According to a multiple regression model accounting for other key variables, antibodies against Ebola virus emerged as the strongest individual-level risk factor for acquiring malaria. Our results suggest that within-host interactions between malaria parasites and Ebola virus may underlie epidemiologic associations.
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Sanogo NA, Yaya S. Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence from Gabon. Biomed Res Int 2020; 2020:4036830. [PMID: 32461984 PMCID: PMC7212326 DOI: 10.1155/2020/4036830] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/18/2019] [Accepted: 12/18/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND To achieve the universal health coverage among other Sustainable Development Goals, African countries have shown the commitment by implementing strategies to improve access and coverage of health care services whose access is still very low. The achievement of universal health care requires the provision and availability of an adequate financing system. This study explored the wealth-related association of compulsory health insurance on maternal health care utilization in Gabon. METHODS The study used the 6th round of Gabon Demographic and Health Surveys (GDHSs)-2012 data to explore three outcome measures of maternal health care utilization extracted on number of antenatal care (ANC) visits during pregnancy, place of birth delivery, and postnatal health care. The dependent variable was women with health insurance coverage against those without. Logistic regression and propensity scoring matching analysed associations of health insurance coverage on women's utilization of health care. RESULTS Mean (+/- SD) age of women respondents of reproductive age was 29 years (9.9). The proportion of at least 4 antenatal care visits was 69.2%, facility-based delivery was 84.7%, and postnatal care utilization was 67.9%. The analysis of data showed disparities in maternal health care services utilization. The GDHS showed maternal age, and geographical region was significantly associated with maternal health care service utilization. A high proportion of urban dwellers and Christian women used maternal health care services. According to the wealth index, maternal health services utilization was higher in women from wealthy households compared to lower households wealth index (ANC (Conc. Index = 0.117; p ≤ 0.001), facility-based delivery (Conc. Index = 0.069; p ≤ 0.001), and postnatal care (Conc. Index = 0.075; p ≤ 0.001), respectively). With regard to health care insurance coverage, women with health insurance were more likely to use ANC and facility-based delivery services than those without (concentration indices for ANC and facility-based delivery were statistically significant; ANC: z-stat = 2.69; p=0.007; Conc. Index: 0.125 vs. 0.096 and facility-based delivery: z-stat = 3.38; p=0.001; Conc. Index: 0.076 vs. 0.053, respectively). CONCLUSION Women enrollment in health insurance and improved household's financial status can improve key maternal health services utilization.
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Kombila UD, Oumar Toure N, Nzengue EE, Mounguengui D, Mackanga JR, Iba Ba J, Boguikouma JB. [Behavior and attitudes towards smoking among student midwives in Libreville]. Rev Mal Respir 2019; 36:342-349. [PMID: 30902446 DOI: 10.1016/j.rmr.2018.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/26/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The midwife, in taking on a public health role, is one of the most important resources for the prevention of smoking and in helping smoking cessation among women of childbearing age thanks to their numerous contacts with pregnant women. With this in mind, we conducted a study among student midwives to examine their smoking behavior, their attitudes towards smoking, and their participation in prevention. METHOD This was a descriptive cross-sectional study conducted from 15 January to 15 February 2018 using a self-administered questionnaire and included the student midwives of the University of Health Science at Libreville (Gabon). RESULTS A total of 188 student midwives completed the questionnaires (70.7% of students of the 1st year, 15.0% of students of the 2nd year and 14.3% of students of the 3rd year). Gaps exist in the knowledge of student midwives regarding the risks of cigarette smoking in pregnancy and its role in the development of complications for the mother and foetus. Overall, 17.1% of student midwives think that smoking is responsible for the occurrence of ectopic pregnancies, 20.3% believe it is responsible for retro-placental haematoma, 17.6% for premature rupture of the membranes. The prevalence of smoking was 11.1% and was most frequent in 2nd year students (25.0%) and 3rd year students (14.8%) (P<0.023). The mean age of beginning smoking was 19.0±4.4 years. The main initiating factors were peer influence (28.6%), pleasure (19.0%) and stress (14.3%). Nicotine dependence was weak to moderate among 48.8% of smokers and absent in 52.2%. CONCLUSION Gaps exist in the knowledge of student midwives regarding the risks of cigarette smoking to complications of pregnancy. There is need therefore to include formal training on tobacco control strategies at an early stage in the medical curriculum.
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Affiliation(s)
- U D Kombila
- Service de médecineinterne, centre hospitalier universitaire de Libreville (CHUL), Libreville, Gabon; Département de médecine interne et spécialités médicales, faculté de médecine des sciences de la santé (FMSS), université des sciences de la santé (USS), Libreville, Gabon.
| | - N Oumar Toure
- Clinique de pneumologie, centre national hospitalier universitaire de Fann (CNHUF), Avenue Cheikh ANTA DIOP, BP 5035, Dakar, Sénégal
| | - E E Nzengue
- Service de cardiologie, centre hospitalier universitaire de Libreville (CHUL), Libreville, Gabon; Département de médecine interne et spécialités médicales, faculté de médecine des sciences de la santé (FMSS), université des sciences de la santé (USS), Libreville, Gabon
| | - D Mounguengui
- Service de médecine polyvalente, hôpital d'instructions des armées Omar Bongo Ondimba (HIA OBO), Libreville, Gabon
| | - J R Mackanga
- Service de médecineinterne, centre hospitalier universitaire de Libreville (CHUL), Libreville, Gabon; Département de médecine interne et spécialités médicales, faculté de médecine des sciences de la santé (FMSS), université des sciences de la santé (USS), Libreville, Gabon
| | - J Iba Ba
- Service de médecineinterne, centre hospitalier universitaire de Libreville (CHUL), Libreville, Gabon; Département de médecine interne et spécialités médicales, faculté de médecine des sciences de la santé (FMSS), université des sciences de la santé (USS), Libreville, Gabon
| | - J B Boguikouma
- Service de médecineinterne, centre hospitalier universitaire de Libreville (CHUL), Libreville, Gabon; Département de médecine interne et spécialités médicales, faculté de médecine des sciences de la santé (FMSS), université des sciences de la santé (USS), Libreville, Gabon
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Lekana-Douki SE, Sir-Ondo-Enguier PN, Banga-Mve-Ella O, Imboumy-Limoukou RK, Maganga GD, Lekana-Douki JB, Berthet N. Epidemiology and molecular characterization of the re-emerging measles virus among children and adults in the Haut-Ogooue, Gabon. BMC Infect Dis 2019; 19:90. [PMID: 30683064 PMCID: PMC6347803 DOI: 10.1186/s12879-019-3731-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measles is one of the most infectious diseases with a high mortality rate worldwide. It is caused by the measles virus (MeV) which is a single stranded RNA virus with genetic diversity based on the nucleoprotein gene, including 24 genotypes. In Gabon, several outbreaks occurred in the past few years, especially in 2016 in Libreville and Oyem. A surveillance network of infectious diseases highlighted a measles outbreak which occurred in the south of Gabon from April to June 2017. METHODS Clinical specimens of urine, blood, throat and nasal swabs were collected in the two main cities of the Haut-Ogooue province, Franceville and Moanda. Virological investigations based on real-time polymerase chain reaction for molecular diagnosis and conventional PCR for genotype identification were done. RESULTS Specimens were collected from 139 suspected measles patients. A total of 46 (33.1%) children and adults were laboratory-confirmed cases among which 16 (34.8%) were unvaccinated, 16 (34.8%) had received one dose, and 11 (23.9%) had received two doses of the measles vaccine. Phylogenetic analysis revealed that all the sequences of the nucleoprotein gene belonged to genotype B3. CONCLUSIONS Measles infection was more commonly confirmed among those with one recorded dose compared to suspect cases with none, unknown or two recorded doses. The molecular characterization of the strains showed the circulation of the B3 genotype which is endemic on the African continent, thirty years after the B2 genotype was described in an outbreak in Libreville, the capital of Gabon. These findings highlight that surveillance and molecular investigation of measles should be continued in Gabon.
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Affiliation(s)
- Sonia Etenna Lekana-Douki
- Unité Emergence des maladies virales, Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
| | - Pater Noster Sir-Ondo-Enguier
- Unité Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
| | - Octavie Banga-Mve-Ella
- Unité Emergence des maladies virales, Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
| | - Romeo Karl Imboumy-Limoukou
- Unité Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
| | - Gael D. Maganga
- Unité Emergence des maladies virales, Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
| | - Jean-Bernard Lekana-Douki
- Unité Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
- Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Sante, 4009 Libreville, BP Gabon
| | - Nicolas Berthet
- Unité Emergence des maladies virales, Centre International de Recherches Médicales de Franceville, 769 Franceville, BP Gabon
- Centre National de Recherche Scientifique (CNRS) UMR3569, 25 rue du docteur Roux, Paris, France
- Institut Pasteur, Unité Environnement et risques infectieux, Cellule d’Intervention Biologique d’Urgence, 25 rue du docteur Roux, Paris, France
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Abstract
Human African trypanosomiasis is endemic to parts of sub-Saharan Africa and should be considered in the differential diagnosis of patients who have visited or lived in Africa. We report a 2017 case of stage 2 Trypanosoma brucei gambiense disease in an emigrant who returned to China from Gabon.
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Ndong Ngomo JM, Amiah Ahou M, Yavo W, Karine Bouyou-Akotet M, Mawili-Mboumba DP. High Frequency of Pfcrt-76T Allele in Plasmodium falciparum Isolates From Gabon and Ivory Coast After the Withdrawal of Chloroquine. Bull Soc Pathol Exot 2019; 112:8-11. [PMID: 31225725 DOI: 10.3166/bspe-2019-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to assess the proportion of Pfcrt-76T mutant allele four years after the adoption of new malaria control guidelines in Gabon and Ivory Coast. Frequency of K76T mutation of Pfcrt gene was compared between Plasmodium falciparum isolates from Gabon and Ivory Coast. Samples were collected in 2008 in Gabon and in 2009 in Ivory Coast. In total, 151 isolates were selected and analysed by nested-PCR-RFLP for Pfcrt-76 allele identification: 63 in Abobo (Ivory Coast) and 78 in Oyem (Gabon). The proportion of Pfcrt-76T mutant allele was higher in Oyem (70%) compared to Abobo (46%) (p=0.005). This allele was more frequently detected in patients less than 5 years old in Oyem (75 %) compared to Abobo (52%) (p<0.01). The present work showed different prevalence of Pfcrt-76T allele between both sites probably due to a different drug pressure on P. falciparum strains circulating in these areas. Moreover, a decrease of the mutation frequency is observed compared to data obtained in 2005. Therefore, a continuous monitoring of this allele and other drug resistance molecular markers is required in these countries.
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Affiliation(s)
- J M Ndong Ngomo
- Faculté de médecine, Département de parasitologie et de mycologie, Université des sciences de la Santé, BP 4009, Libreville, Gabon
- Laboratoire de génétique, UFR biosciences, Université Félix Houphouët-Boigny, BPV 34, Abidjan, Côte d'Ivoire
| | - M Amiah Ahou
- Centre de recherche et de lutte contre le paludisme, Institut national de santé publique, BPV 47, Abidjan, Côte d'Ivoire
- Laboratoire de génétique, UFR biosciences, Université Félix Houphouët-Boigny, BPV 34, Abidjan, Côte d'Ivoire
| | - W Yavo
- Centre de recherche et de lutte contre le paludisme, Institut national de santé publique, BPV 47, Abidjan, Côte d'Ivoire
- Laboratoire de génétique, UFR biosciences, Université Félix Houphouët-Boigny, BPV 34, Abidjan, Côte d'Ivoire
| | - M Karine Bouyou-Akotet
- Faculté de médecine, Département de parasitologie et de mycologie, Université des sciences de la Santé, BP 4009, Libreville, Gabon
| | - D P Mawili-Mboumba
- Faculté de médecine, Département de parasitologie et de mycologie, Université des sciences de la Santé, BP 4009, Libreville, Gabon
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Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Ateba-Ngoa U, Edoa JR, Adegbite BR, Mombo-Ngoma G, Agnandji ST, Ramharter M, Kremsner PG, Lell B, Grobusch MP, Adegnika AA. Schistosoma haematobium effects on Plasmodium falciparum infection modified by soil-transmitted helminths in school-age children living in rural areas of Gabon. PLoS Negl Trop Dis 2018; 12:e0006663. [PMID: 30080853 PMCID: PMC6095623 DOI: 10.1371/journal.pntd.0006663] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/16/2018] [Accepted: 07/05/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Malaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection. METHODOLOGY This longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria. MAIN FINDINGS The overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7-9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45-0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium. CONCLUSIONS Our results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Yabo Josiane Honkpehedji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ulysse Ateba-Ngoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean-Ronald Edoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Bayodé Roméo Adegbite
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Ghyslain Mombo-Ngoma
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Departement de Parasitologie-Mycologie, Faculté de Médecine, Université des Sciences de la Santé, Owendo, Gabon
| | - Selidji Todagbe Agnandji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Michael Ramharter
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I, Department of Medicine, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
- * E-mail:
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Rada S, Gamper J, González R, Mombo-Ngoma G, Ouédraogo S, Kakolwa MA, Zoleko-Manego R, Sevene E, Kabanywanyi AM, Accrombessi M, Briand V, Cot M, Vala A, Kremsner PG, Abdulla S, Massougbodgi A, Nhacolo A, Aponte JJ, Macete E, Menéndez C, Ramharter M. Concordance of three alternative gestational age assessments for pregnant women from four African countries: A secondary analysis of the MIPPAD trial. PLoS One 2018; 13:e0199243. [PMID: 30080869 PMCID: PMC6078285 DOI: 10.1371/journal.pone.0199243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/04/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND At times, ultrasound is not readily available in low resource countries in Africa for accurate determination of gestational age, so using alternative methods is pivotal during pregnancy. These assessments are used to aid the risk analysis for an infant and management strategies for premature delivery, if necessary. Currently, date of last menstrual period, fundal height measurements, and the New Ballard Score are commonly used in resource-limited settings. However, concordance of these measures is unknown for sub-Saharan Africa. We obtained data from an open-label randomized controlled trial, to assess the concordance of these alternative assessment methods. The purpose of our study was to determine the agreement between these alternative methods when used in sub-Saharan African populations. METHODS A total of 4,390 pregnant women from Benin, Gabon, Mozambique and Tanzania were included in our analysis. The assessment methods compared were: 1) reported last menstrual period, 2) symphysis-fundal height measurement, and 3) the New Ballard Score. The Bland-Altman method and intraclass correlation coefficient (ICC) were used to test the degree of agreement. Survival range gestational age, used as an inclusion criterion for further analysis, was from 22 to 44 weeks. FINDINGS Plots showed a lack of agreement between methods and the 95% limits of agreement too wide to be clinically useful. ICC = 0.25 indicated poor agreement. A post-hoc analysis, restricted from 32 to 42 weeks, was done to check for better agreement in this near-term population. The plots and ICC = 0.16 still confirmed poor agreement. CONCLUSION The alternative assessments do not result in comparable outcomes and discrepancies are far beyond the clinically acceptable range. Last menstrual period should not be used as the only estimator of gestational age. In the absence of reliable early ultrasound, symphysis-fundal height measurements may be most useful during pregnancy for fetal risk assessment and the New Ballard Score after delivery as a confirmation of these estimations and for further neonatal management. However, promotion of portable ultrasound devices is required for accurate assessment of gestational age in sub-Sahara Africa.
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Affiliation(s)
- Samantha Rada
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
- Institut für Medizinische Informationsverarbeitung Biometrie und Epidemiologie, Ludwig-Maximilians University, Munich, Germany
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Jutta Gamper
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Raquel González
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
- Department of Parasitology, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Smaïla Ouédraogo
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement (IRD), Paris, France
- Ministère de la Santé, Burkina Faso
| | | | - Rella Zoleko-Manego
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
- Ngounie Medical Research Centre, Fougamou, Gabon
| | | | | | - Manfred Accrombessi
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement (IRD), Paris, France
| | - Valérie Briand
- Institut de Recherche pour le Développement (IRD), Paris, France
- Université René Descartes, Paris, France
| | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Paris, France
- Université René Descartes, Paris, France
| | - Anifa Vala
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infectious Diseases (DZIF), Tübingen, Germany
| | | | - Achille Massougbodgi
- Faculté des Sciences de la Santé (FSS), Université d’Aboméy Calavi, Cotonou, Benin
| | | | - John J. Aponte
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Eusébio Macete
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Clara Menéndez
- Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Manhiça Health Research Center (CISM), Manhiça, Mozambique
| | - Michael Ramharter
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
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Moussounda M, Diene SM, Dos Santos S, Goudeau A, François P, van der Mee-Marquet N. Emergence of bla NDM-7-Producing Enterobacteriaceae in Gabon, 2016. Emerg Infect Dis 2018; 23:356-358. [PMID: 28098536 PMCID: PMC5324794 DOI: 10.3201/eid2302.161182] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Reports of carbapenemase-producing Enterobacteriaceae in Africa remain rare and assess mostly blaOXA-48–producing isolates from Mediterranean countries and South Africa. We identified blaNDM-7–producing Enterobacteriaceae in Gabon in 2016. The isolates contained blaNDM-7 IncX3 plasmids that were unusual and similar to the one described in a colistin-resistant Klebsiella pneumoniae SZ04 isolate from China.
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45
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Klöckner A, Nagel M, Greub G, Aeby S, Hoffmann K, Liégeois F, Rouet F, De Benedetti S, Borel N, Henrichfreise B. Chlamydia-Related Bacteria in Free-Living and Captive Great Apes, Gabon. Emerg Infect Dis 2018; 22:2199-2201. [PMID: 27869611 PMCID: PMC5189123 DOI: 10.3201/eid2212.150893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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M’bondoukwé NP, Kendjo E, Mawili-Mboumba DP, Koumba Lengongo JV, Offouga Mbouoronde C, Nkoghe D, Touré F, Bouyou-Akotet MK. Prevalence of and risk factors for malaria, filariasis, and intestinal parasites as single infections or co-infections in different settlements of Gabon, Central Africa. Infect Dis Poverty 2018; 7:6. [PMID: 29378644 PMCID: PMC5789590 DOI: 10.1186/s40249-017-0381-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 12/13/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Malaria, filariasis, and intestinal parasitic infections (IPIs) are common and frequently overlap in developing countries. The prevalence and predictors of these infections were investigated in three different settlements (rural, semi-urban, and urban) of Gabon. METHODS During cross-sectional surveys performed from September 2013 to June 2014, 451 individuals were interviewed. In addition, blood and stool samples were analysed for the presence of Plasmodium, filarial roundworm, intestinal protozoan, and helminth infections. RESULTS Intestinal parasitic infections (61.1%), including intestinal protozoa (56.7%) and soil-transmitted helminths (STHs) (22.2%), predominated, whereas Plasmodium falciparum (18.8%), Loa loa (4.7%), and Mansonella perstans (1.1%) were less prevalent. Filariasis and STHs were mainly found in rural settlements, whereas a higher plasmodial infection prevalence rate was observed in the periurban area. The most common IPI was blastocystosis (48.6%), followed by ascaridiasis (13.7%), trichuriasis (11.8%), amoebiasis (9.3%), giardiasis (4.8%), and strongyloidiasis (3.7%). Hookworm was detected in one adult from rural Dienga. Adults had a higher prevalence of Blastocystis hominis and STHs, whereas Giardia duodenalis was more frequently observed among children aged below 5 years (P < 0.01). The polyparasitism rate was 41.5%, with 7.0% Plasmodium-IPIs and 1.8% Plasmodium-STH co-infections. The multivariate analysis showed that living in a suburban area, belonging to the age group of 5-15 years, having none or a secondary education, or having an open body water close to home were significant risk factors for malaria (P ≤ 0.01). For STH infections, identified risk factors were drinking untreated water and living in a rural area (P ≤ 0.04). No significant predictors were identified for IPIs and malaria-IPI co-infection. CONCLUSIONS This study reports a high prevalence of IPIs and intestinal protozoa, but a low rate of malaria-IPI co-infections in the study sites. Improvements in the living conditions of the population such as adequate water supply and proper health education and sanitation should be integrated into control strategies for malaria, STHs, and IPIs.
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Affiliation(s)
- Noé Patrick M’bondoukwé
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Eric Kendjo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Jeanne Vanessa Koumba Lengongo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Christelle Offouga Mbouoronde
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Dieudonné Nkoghe
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Fousseyni Touré
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
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Bivigou-Mboumba B, Amougou-Atsama M, Zoa-Assoumou S, M’boyis Kamdem H, Nzengui-Nzengui GF, Ndojyi-Mbiguino A, Njouom R, François-Souquière S. Hepatitis B infection among HIV infected individuals in Gabon: Occult hepatitis B enhances HBV DNA prevalence. PLoS One 2018; 13:e0190592. [PMID: 29315352 PMCID: PMC5760027 DOI: 10.1371/journal.pone.0190592] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/17/2017] [Indexed: 12/15/2022] Open
Abstract
In Gabon, a central African country, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are endemic. In a recent study, conducted in a semi-urban area (Franceville, Gabon), HBV infection was found to be more prevalent among HIV infected individuals. This study aims to investigate the prevalence and genetic diversity of hepatitis B virus infection among HIV infected individuals, predominantly under antiretroviral therapy, living in fully urbanized area: Libreville, capital of Gabon. Serological and molecular tests were performed to detect HBV infection among patients living with HIV/AIDS (PLHA). We used Monolisa HBsAg ULTRA, Anti-HBc Plus and Anti-HBs Plus EIA kits for serological analyses. HBV DNA viral load (HBV DNA VL) was determined by real time PCR and molecular characterization of HBV strains was performed by sequencing and phylogenetic analysis of partial HBV surface and core genes. At all, 70.2% of patients were under antiretroviral therapy. The prevalence of HBsAg was 8.8% (43/487). Detectable HBV DNA was found in 69.7% (30/43) of HBsAg positive patients and in 17.5% (24/137) HBsAg negative patients. HBV DNA VL was significantly higher among patient with CD4 cell counts less than 200 cells/mm3 than those with CD4 cell counts greater than 500 cells/mm3 (p = 0.008). We confirmed the presence of HBV sub-genotypes QS-A3 (40%), and A4 (20%) and HBV-E genotype (40%). The percentage of resistance to Lamivudine was high (40%) and varied according to the M204V/I motif. Occult hepatitis B infection (OBI) was found in patients with isolated HBcAb and among patients who had completed their HBsAg seroconversion. We detected HBV DNA for one patient without any HBV serological marker. This study provides a new landmark for the comprehension of HBV infection in PLHA in urban areas. OBI enhances HBV DNA prevalence and should be investigated in all HBsAg negative individuals.
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Affiliation(s)
- Berthold Bivigou-Mboumba
- Unité Mixte de Recherches VIH et Maladies Infectieuses Associées (UMR VIH-MIA), Centre International de Recherches Médicales (CIRMF), Libreville, Gabon
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
- * E-mail:
| | | | - Samira Zoa-Assoumou
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
| | - Hervé M’boyis Kamdem
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
| | - Guy Francis Nzengui-Nzengui
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
| | - Angélique Ndojyi-Mbiguino
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
| | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroun
| | - Sandrine François-Souquière
- Unité Mixte de Recherches VIH et Maladies Infectieuses Associées (UMR VIH-MIA), Centre International de Recherches Médicales (CIRMF), Libreville, Gabon
- Laboratoire de Bactériologie-Virologie, Laboratoire de Référence IST-SIDA, Université des Sciences de la Santé, Owendo, Gabon
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48
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Koumba AA, Zinga Koumba CR, Mintsa Nguema R, Obame Ondo P, Bibang Bengono G, Comlan P, Ketoh GK, Djogbenou LS, Faye O, M'batchi B, Mavoungou JF. [Susceptibility status of Anopheles gambiae s.s. and An. coluzzii to Organophosphates and Carbamates in the Agricultural Exploitation Zones of oil Palm at Mouila, Gabon]. Bull Soc Pathol Exot 2018; 111:176-182. [PMID: 30793573 DOI: 10.3166/bspe-2018-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 09/14/2018] [Indexed: 06/09/2023]
Abstract
This study was conducted during the rainy season of 2017 in the agricultural areas at Mouila, with the aim to assess the determination of susceptibility of Anopheles gambiae complex to insecticides and the detection of Ace 1R mutation. Mosquito larvae were collected by using the dipping method and nursed to adult stage. The susceptibility of adult Anopheles gambiae s.l. populations to organophosphates and carbamates was assessed using the standard WHO susceptibility test protocol. The tested mosquitoes species were identified by PCR. These tested mosquitoes were used to search for the Ace 1R mutation. The insecticides used were pirimiphos-methyl 0.25% and 1.25%, fenitrothion 1%, malathion 5%, propoxur 0.1%, bendiocarb 0.1%, 0.5% and 1%. In the prospected areas, An. gambiae s.l. included An. gambiae s.s. and An. coluzzii sympatric in their larval habitats. However, An. gambiae s.s. was predominant in all studied areas (99.1%) comparatively to An. coluzzii Moreover, the susceptibility tests of Anopheles to organophosphates and carbamates revealed mortality rates of 100% regardless of the origin of the mosquitoes. PCR diagnosis of Ace 1R mutation showed that none tested mosquito (An. gambiae s.s. and An. coluzzii) from prospected areas harbored the Ace 1R gene in all prospected areas. The lack of Ace 1R mutation in An. gambiae s.l. reveals the current effectiveness of organophosphates and carbamates for the control of these mosquitoes. Bboth these classes of insecticides could be used for the anopheline populations control in the agricultural spaces at Mouila.
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Affiliation(s)
- A A Koumba
- Institut de recherche en écologie tropicale (IRET), BP 13354, Libreville, Gabon
- Université d'Abomey-Calavi (UAC), 05 BP 1604, Cotonou, Benin
- Institut régional de santé publique (IRSP), BP 918, Ouidah, Bénin
| | - C R Zinga Koumba
- Institut de recherche en écologie tropicale (IRET), BP 13354, Libreville, Gabon
| | - R Mintsa Nguema
- Institut de recherche en écologie tropicale (IRET), BP 13354, Libreville, Gabon
| | - P Obame Ondo
- Programme national de lutte contre le Paludisme (PNLP), BP 14426, Libreville, Gabon
| | - G Bibang Bengono
- Université des sciences et techniques de Masuku (USTM), BP 941, Franceville, Gabon
| | - P Comlan
- Université des sciences de la santé (USS), BP 4009, Libreville, Gabon
| | - G K Ketoh
- Unité de recherche en écotoxicologue, Université de Lomé (UL), BP 1515, Lomé, Togo
| | - L S Djogbenou
- Université d'Abomey-Calavi (UAC), 05 BP 1604, Cotonou, Benin
- Institut régional de santé publique (IRSP), BP 918, Ouidah, Bénin
| | - O Faye
- Université Cheikh Anta Diop de Dakar (UCAD), BP 5005, Dakar, Sénégal
| | - B M'batchi
- Université des sciences et techniques de Masuku (USTM), BP 941, Franceville, Gabon
| | - J F Mavoungou
- Institut de recherche en écologie tropicale (IRET), BP 13354, Libreville, Gabon
- Université des sciences et techniques de Masuku (USTM), BP 941, Franceville, Gabon
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Day KP, Artzy-Randrup Y, Tiedje KE, Rougeron V, Chen DS, Rask TS, Rorick MM, Migot-Nabias F, Deloron P, Luty AJF, Pascual M. Evidence of strain structure in Plasmodium falciparum var gene repertoires in children from Gabon, West Africa. Proc Natl Acad Sci U S A 2017; 114:E4103-E4111. [PMID: 28461509 PMCID: PMC5441825 DOI: 10.1073/pnas.1613018114] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Existing theory on competition for hosts between pathogen strains has proposed that immune selection can lead to the maintenance of strain structure consisting of discrete, weakly overlapping antigenic repertoires. This prediction of strain theory has conceptual overlap with fundamental ideas in ecology on niche partitioning and limiting similarity between coexisting species in an ecosystem, which oppose the hypothesis of neutral coexistence. For Plasmodium falciparum, strain theory has been specifically proposed in relation to the major surface antigen of the blood stage, known as PfEMP1 and encoded by the multicopy multigene family known as the var genes. Deep sampling of the DBLα domain of var genes in the local population of Bakoumba, West Africa, was completed to define whether patterns of repertoire overlap support a role of immune selection under the opposing force of high outcrossing, a characteristic of areas of intense malaria transmission. Using a 454 high-throughput sequencing protocol, we report extremely high diversity of the DBLα domain and a large parasite population with DBLα repertoires structured into nonrandom patterns of overlap. Such population structure, significant for the high diversity of var genes that compose it at a local level, supports the existence of "strains" characterized by distinct var gene repertoires. Nonneutral, frequency-dependent competition would be at play and could underlie these patterns. With a computational experiment that simulates an intervention similar to mass drug administration, we argue that the observed repertoire structure matters for the antigenic var diversity of the parasite population remaining after intervention.
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Affiliation(s)
- Karen P Day
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia;
- Department of Microbiology, New York University, New York, NY 10016
| | - Yael Artzy-Randrup
- Theoretical Ecology Group, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, 1090 GE Amsterdam, The Netherlands
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
| | - Kathryn E Tiedje
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Virginie Rougeron
- Department of Microbiology, New York University, New York, NY 10016
- Laboratoire Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, UMR 224-5290 CNRS, Institut de Recherche pour le Développement-Université de Montpellier, Centre Institut de Recherche pour le Développement de Montpellier, 34394 Montpellier, France
| | - Donald S Chen
- Department of Microbiology, New York University, New York, NY 10016
- Department of Medicine, New York Medical College, Valhalla, NY 10595
| | - Thomas S Rask
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Mary M Rorick
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Adrian J F Luty
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
- Santa Fe Institute, Santa Fe, NM 87501
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Imboumy-Limoukou RK, Maghendi-Nzondo S, Kouna CL, Bounaadja L, Mbang S, Biteghe JC, Eboumbou C, Prugnolle F, Florent I, Lekana-Douki JB. Immunoglobulin response to the low polymorphic Pf113 antigen in children from Lastoursville, South-East of Gabon. Acta Trop 2016; 163:149-56. [PMID: 27523305 DOI: 10.1016/j.actatropica.2016.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 08/08/2016] [Accepted: 08/11/2016] [Indexed: 02/03/2023]
Abstract
Pf113 is a P. falciparum putatively GPI-anchored protein that has been so far localized at the surface of merozoites, suggesting it could interact with RBC surface during merozoite invasion. Previous studies conducted in Papua New Guinea and in Kenya have revealed that this protein is recognized by natural antibodies in individuals living in malaria-endemic areas and is associated with protective immunity in malaria, further supporting the potential of Pf113 for the development of anti-malaria vaccines. However, in Central Africa, no study on the immunogenicity of this protein has been conducted. Here, we report the characterization of the Pf113 immune response in 103 children by Enzyme-Linked Immunoabsorbent Assay (ELISA), using a recombinant form of Pf113 expressed in Escherichia coli, together with the study of the Pf113 polymorphism, after amplification and sequencing of 40 field isolates. Data showed that almost 51% of the studied individuals had positive antibody responses to the recombinant Pf113 protein, and that IgG subclass response was dominated by IgG3 (84%) followed by IgG1 (50%). Surprisingly the prevalence of IgG4 was 92%. In addition, gene analysis in field isolates from this region indicated that Pf113 was not highly polymorphic, in particular regarding high-activity binding peptides (HABPs). Our data reinforce the idea that Pf113 may be considered for inclusion in multicomponent blood-stage vaccines.
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Affiliation(s)
- Roméo Karl Imboumy-Limoukou
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon; Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR 7245), Sorbonne Universités, Muséum National d'Histoire Naturelle, CNRS, CP52, 57 Rue Cuvier, 75005 Paris, France; Ecole Doctorale Régionale en Infectiologie Tropicale d'Afrique Centrale (ECODRAC), BP 876 Franceville, Gabon.
| | - Sidney Maghendi-Nzondo
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon
| | - Charlene Lady Kouna
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon
| | - Lotfi Bounaadja
- Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR 7245), Sorbonne Universités, Muséum National d'Histoire Naturelle, CNRS, CP52, 57 Rue Cuvier, 75005 Paris, France
| | - Sophie Mbang
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala Biological Sciences Unit, BP 2701 Douala, Cameroon
| | - Jean Claude Biteghe
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon; Ecole Doctorale Régionale en Infectiologie Tropicale d'Afrique Centrale (ECODRAC), BP 876 Franceville, Gabon
| | - Carole Eboumbou
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala Biological Sciences Unit, BP 2701 Douala, Cameroon
| | - Franck Prugnolle
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon; UMR 5290 MIVEGEC (CNRS/IRD/UM), BP, 911 Avenue Agropolis BP 64501, 34394 Montpellier cedex 5, France
| | - Isabelle Florent
- Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR 7245), Sorbonne Universités, Muséum National d'Histoire Naturelle, CNRS, CP52, 57 Rue Cuvier, 75005 Paris, France
| | - Jean-Bernard Lekana-Douki
- Centre International de Recherches Médicales de Franceville (CIRMF), Unité de Parasitologie Médicale (UPARAM), BP 769 Franceville, Gabon; Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009 Libreville, Gabon.
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