Abstract
BackgroundMansonellosis was first reported in Ghana by Awadzi in the 1990s. Co-infections of Mansonella perstans have also been reported in a small cohort of patients with Buruli ulcer and their contacts. However, no study has assessed the exact prevalence of the disease in a larger study population. This study therefore aimed to find out the prevalence of M. perstans infection in some districts in Ghana and to determine the diversity of Culicoides that could be potential vectors for transmission.MethodsFrom each participant screened in the Asante Akim North (Ashanti Region), Sene West and Atebubu Amantin (Brong Ahafo Region) districts, a total of 70 μl of finger prick blood was collected for assessment of M. perstans microfilariae. Centre for Disease Control (CDC) light traps as well as the Human Landing Catch (HLC) method were used to assess the species diversity of Culicoides present in the study communities.ResultsFrom 2,247 participants, an overall prevalence of 32% was recorded although up to 75% prevalence was demonstrated in some of the communities. Culicoides inornatipennis was the only species of Culicoides caught with the HLC method. By contrast, C. imicola (47%), C. neavei (25%) and C. schultzei (15%) were caught by the CDC light trap method. A wide diversity of other Culicoides spp. was also identified but correlation was only found between the prevalence of C. inornatipennis and M. perstans during the dry season.ConclusionsHere we demonstrate for the first time that M. perstans is highly prevalent in three districts in Ghana. We found a wide spectrum of Culicoides spp. Culicoides inornatipennis was the most anthropophilic and is therefore likely to be the species responsible for transmission of infection but formal proof has yet to be obtained.Trial registrationNCT02281643. Registered October 26, 2014. ‘Retrospectively registered’. Trial Registry: ClinicalTrials.gov.
Highlights
Mansonellosis was first reported in Ghana by Awadzi in the 1990s
Characteristics of the study populations according to districts A total of 2,247 participants from 18 communities in Ashanti Akim North District, Atebubu Amantin District and Sene West Districts was screened for the presence of M. perstans MF in their blood
Upon comparison of participating districts, there was no significant difference in gender or age distribution with the exception of participants from the Sene West District where the proportion of female volunteers was significantly higher than males (Table 1)
Summary
Mansonellosis was first reported in Ghana by Awadzi in the 1990s. Co-infections of Mansonella perstans have been reported in a small cohort of patients with Buruli ulcer and their contacts. This study aimed to find out the prevalence of M. perstans infection in some districts in Ghana and to determine the diversity of Culicoides that could be potential vectors for transmission. Infective larvae are introduced into the host during a blood meal and develop into adult worms that reside in the coelomic cavity, peritoneal and pleural cavities as well as mesenteric perirenal and retroperitoneal tissues [4]. They produce thousands of unsheathed microfilariae (MF) that appear in the blood stream with no particular periodicity and are taken up by another biting midge for transmission to continue [1]. The exact lifespan of M. perstans adult worms has not been deciphered there is a report of the presence of MF in the blood of a person who left the endemic community 10 years earlier [5]
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