Endemic Areas Research Articles

Diagnostic accuracy of DPP Fever Panel II Asia tests for tropical fever diagnosis.

Fever is the most frequent symptom in patients seeking care in South and Southeast Asia. The introduction of rapid diagnostic tests (RDTs) for malaria continues to drive patient management and care. Malaria-negative cases are commonly treated with antibiotics without confirmation of bacteraemia. Conventional laboratory tests for differential diagnosis require skilled staff and appropriate access to healthcare facilities. In addition, introducing single-disease RDTs instead of conventional laboratory tests remains costly. To overcome some of the delivery challenges of multiple separate tests, a multiplexed RDT with the capacity to diagnose a diverse range of tropical fevers would be a cost-effective solution. In this study, a multiplex lateral flow immunoassay (DPP Fever Panel II Assay) that can detect serum immunoglobulin M (IgM) and specific microbial antigens of common fever agents in Asia (Orientia tsutsugamushi, Rickettsia typhi, Leptospira spp., Burkholderia pseudomallei, Dengue virus, Chikungunya virus, and Zika virus), was evaluated. Whole blood (WB) and serum samples from 300 patients with undefined febrile illness (UFI) recruited in Vientiane, Laos PDR were tested using the DPP Fever Panel II, which consists of an Antibody panel and Antigen panel. To compare reader performance, results were recorded using two DPP readers, DPP Micro Reader (Micro Reader 1) and DPP Micro Reader Next Generation (Micro Reader 2). WB and serum samples were run on the same fever panel and read on both micro readers in order to compare results. ROC analysis and equal variance analysis were performed to inform the diagnostic validity of the test compared against the respective reference standards of each fever agent (S1 Table). Overall better AUC values were observed in whole blood results. No significant difference in AUC performance was observed when comparing whole blood and serum sample testing, except for when testing for R. typhi IgM (p = 0.04), Leptospira IgM (p = 0.02), and Dengue IgG (p = 0.03). Linear regression depicted R2 values had ~70% agreement across WB and serum samples, except when testing for leptospirosis and Zika, where the R2 values were 0.37 and 0.47, respectively. No significant difference was observed between the performance of Micro Reader 1 and Micro Reader 2, except when testing for the following pathogens: Zika IgM, Zika IgG, and B pseudomallei CPS Ag. These results demonstrate that the diagnostic accuracy of the DPP Fever Panel II is comparable to that of commonly used RDTs. The optimal cut-off would depend on the use of the test and the desired sensitivity and specificity. Further studies are required to authenticate the use of these cut-offs in other endemic regions. This multiplex RDT offers diagnostic benefits in areas with limited access to healthcare and has the potential to improve field testing capacities. This could improve tropical fever management and reduce the public health burden in endemic low-resource areas.

Development and implementation of a strategy for early diagnosis and management of scrub typhus: an emerging public health threat.

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease in the tropics with considerable morbidity and mortality rates. This disease, which is mostly prevalent in rural areas, remains underdiagnosed and underreported because of the low index of suspicion and non-specific clinical presentation. Limited access to healthcare, diagnostics, and treatment in rural settings further makes it challenging to distinguish it from other febrile illnesses. While easily treatable, improper treatment leads to severe forms of the disease and even death. As there is no existing public health program to address scrub typhus in India, there is an urgent need to design a program and test its effectiveness for control and management of the disease. With this backdrop, this implementation research protocol has been developed for a trial in few of the endemic "pockets" of Odisha, an eastern Indian state that can be scalable to other endemic areas of the country, if found effective. The main goal of the proposed project is to include scrub typhus as a differential diagnosis of fever cases in every tier of the public health system, starting from the community level to the health system, for the early diagnosis among suspected cases and to ensure that individuals receive complete treatment. The current study aimed to describe the protocol of the proposed Scrub Typhus Control Program (STCP) in detail so that it can receive valuable views from peers which can further strengthen the attempt.

Demographic characteristics and prevalence of asymptomatic Leishmania donovani infection in migrant workers working in an endemic area in Northwest Ethiopia.

Visceral leishmaniasis (VL), a neglected tropical disease that causes substantial morbidity and mortality, is a serious health problem in Ethiopia. Infections are caused by Leishmania (L.) donovani parasites. Most individuals remain asymptomatic, but some develop VL, which is generally fatal if not treated. We identified the area of Metema-Humera in Northwest Ethiopia as a setting in which we could follow migrant workers when they arrived in an endemic area. The demographic characteristics of this population and factors associated with their risk of asymptomatic infection are poorly characterised. We divided our cohort into individuals who visited this area for the first time (first comers, FC) and those who had already been in this area (repeat comers, RC). We followed them from the beginning (Time 1, T1) to the end of the agricultural season (Time 2, T2), performing tests for sand fly bite exposure (anti-sand fly saliva antibody ELISA) and serology for Leishmania infection (rK39 rapid diagnostic test and the direct agglutination test) at each time point and collecting information on risk factors for infection. Our results show that most migrant workers come from non-endemic areas, are male, young (median age of 20 years) and are farmers or students. At T1, >80% of them had been already exposed to sand fly bites, as shown by the presence of anti-saliva antibodies. However, due to seasonality of sand flies there was no difference in exposure between FC and RC, or between T1 and T2. The serology data showed that at T1, but not at T2, a significantly higher proportion of RC were asymptomatic. Furthermore, 28.6% of FC became asymptomatic between T1 and T2. Over the duration of this study, one FC and one RC developed VL. In multivariable logistic regression of asymptomatic infection at T1, only age and the number of visits to Metema/Humera were significantly associated with asymptomatic infection. A better understanding of the dynamics of parasite transmission and the risk factors associated with the development of asymptomatic infections and potentially VL will be essential for the development of new strategies to prevent leishmaniasis.

Establishment and application of TaqMan real-time PCR method for detection of Theileria annulata resistant to buparvaquone

Tropical theileriosis is a tick-borne disease that caused by Theileria annulata, and leads to substantial economic impact in endemic area. Distinguishes to other piroplasms, Theileria is the only eukaryotic parasite could transform mammalian leukocytes. At present, buparvaquone is the most effective drug used for treatment of Theileria infection. However, frequently reported of failure treatment with buparvaquone for some T. annulata isolates. Mutation of TaPIN1 was reported to be the direct reason for failure of buparvaquone treatment. Through in vitro culture, a T. annulata isolate with a TaPIN1 mutation that is similar to the reported strain was recently identified in China. In order to understand the distribution of Theileria with mutation of TaPIN1 in China, here we developed a TaqMan probe-based real-time PCR technology to detect the mutated TaPIN1 gene. The specificity, sensitivity and reproducibility of the established TaqMan Real-time PCR method were evaluated, and field cattle blood samples collected from Xinjiang Uyghur Autonomous Region were used to test its application. Among 1683 samples, 335 samples were confirmed positive for T. annulata by traditional PCR method and 34 samples were positive for buparvaquone-resistant. The TaPIN1 gene of those 34 samples was sequenced and analyzed with the published gene sequences from NCBI database. The results showed that the sequence obtained from the present study has good consistency with those published sequences. In conclusion, the TaqMan probe-based real-time PCR targeting T. annulata mutated TaPIN1 gene was successfully established and can be used to detect clinical samples to investigation of buparvaquone-resistant parasites in Xinjiang region quickly and accurately, which will be useful for guiding clinical medicine application.

Antifungal-resistant Trichophyton indotineae - transmission is occurring outside the previously identified endemic areas: are we prepared?

This is a response to ‘Rapid emergence of recalcitrant dermatophytosis caused by a cluster of multidrug-resistant Trichophyton indotineae in China’ by Xie et al.

The discovery of human Plasmodium among domestic animals in West Sumba and Fakfak, Indonesia

Background In Indonesia, malaria incidence is at a high rate despite maximum preventive efforts. Therefore, this study aims to determine the possibility of a Plasmodium reservoir among domestic animals in malaria-endemic areas. Methods Animal blood was collected using EDTA tubes, then smeared and stained with Giemsa for Plasmodium microscopic identification. About 10 μl of blood was dropped on to a filter paper to capture Plasmodium DNA. Nested PCR was used for parasite molecular detection, while Plasmodium species were identified using the sequenced DNA. Results A total of 208 and 62 animal blood samples were collected from Gaura village, West Sumba and Fakfak village, West Papua, Indonesia respectively. In total, 32 samples from Gaura contained P. falciparum or P. vivax, while the Plasmodium percentage in buffalo, horse, goat, and dogs were 20.7%, 14.3%, 5.8%, 16.7%, respectively. P. knowlesi was not found in any of the samples, and no other species were detected in 18 pig blood samples. Conclusion Human Plasmodium existence among domestic animals in Indonesia partly explains the high prevalence and persistence of malaria in some endemic areas due to a reservoir host presence. Therefore, future studies need to ascertain the cause.

INVESTIGATION OF A FOCUS OF BRUCELLOSIS AMONG ANIMALS AND PEOPLE IN THE REPUBLIC OF TATARSTAN

Over the past 3 years, the Russian Federation has seen an increase in the incidence of newly diagnosed brucellosis. The problem of brucellosis remains important in regions with developed livestock farming; however, cases of diseases in animals and humans can also be recorded in other regions of the country.
 The article describes an outbreak of brucellosis in a peasant farm in the Novosheshminsky municipal district of the Republic of Tatarstan, affecting 148 heads of cattle and 4 farm employees. The disease was caused by Brucella abortus. An analysis of maps of the epizootic and epidemiological survey of the outbreak, acts on the sanitary and epidemiological survey, and sanitary and hygienic characteristics of the working conditions of workers was carried out. Data from the case histories of 4 peasant farm workers with brucellosis are also presented.
 The most likely cause of the epizootic was the unauthorized import of cattle, and human diseases were caused by non-compliance with working conditions and personal protective measures for farm workers.
 Conclusion: Cases of brucellosis in our days are more often recorded in endemic areas. However, with defects in veterinary and sanitary control in any territory, epizootics are possible, which pose a serious danger both in terms of the damage they cause to the national economy and the possible infection of people, primarily belonging to professional risk groups. The disease does not have pathognomonic symptoms and can be suspected only if doctors are alert, evaluate the results of preliminary and periodic medical examinations with laboratory examinations of “at-risk” populations, and subject to a thorough collection of epidemiological history.

Impacts of Climate Change on Vector-Borne Diseases of Animals and Humans with Special Emphasis on Afghanistan

Vectors are organisms that transmit pathogenic microorganisms among animals and humans. Infections transmitted by the bites of blood-sucking arthropods are called vector-borne diseases (VBDs). This review highlights the impacts of climate change on the distribution, seasonal variation, and socioeconomic effects of VBDs in affected countries, especially Afghanistan. There is good enough evidence indicating that recent climate change has affected the interaction of the vector-pathogen-host cycle in many parts of the world. The emergence and re-emergence of bluetongue virus (BTV), Rift Valley Fever (RVF), lumpy skin disease (LSD), West Nile Virus (WNV), and malaria in new areas previously considered free of the diseases, and shift of seasonal occurrence of many VBDs in endemic areas, are the clear examples of climate change impacts on VDBs. Although significant progress has been made regarding VBD surveillance systems, diagnostic capacity, vaccine development, and vector control programs in resource-rich countries, failure in adaptation programs and ineffective mitigation strategies against VBDs in developing countries, especially in low and middle-income countries (LMICs), including Afghanistan facilitate widespread distribution of VBDs in these regions. Furthermore, developing drug resistance among the pathogens and their vectors makes the conditions more suitable for VBDs wide dispersion. Such situations cause severe health and socio-economic burdens to affected countries. Developing early-warning systems for detecting VBDs, identifying and developing resistant livestock species and breeds, and applying interceptive measures based on integrated research programs are crucial to effectively reduce the harmful impacts of VBDs on human and animal populations.

The First Record of Omsk Hemorrhagic Fever Virus and Tick-Borne Encephalitis Virus of Baltic Lineage from the Kemerovo Region of Russia.

Objectives: Tick-borne encephalitis virus Siberian subtype (TBEV-Sib) and Omsk hemorrhagic fever virus (OHFV) are causative agents of natural focal infections in Western Siberia, Russia. The distribution of TBEV phylogenetic lineages and OHFV in the Kemerovo Region of Western Siberia remains poorly investigated. Methods: The phylogenetic analyses of fragment genome sequences 26 flaviviruses identified in 2019 were performed, and the amino acid variation was determined to reveal to which clusteron they belong. The age of Baltic and Asian lineages of the TBEV-Sib was calculated for Kemerovo District and Region, respectively. Results: Twenty-five isolates were members of three TBEV-Sib phylogenetic lineages: Baltic (48%), Asian (36%), and East Siberian (16%). The Baltic lineage's eastern boundary is commonly thought to be in the Novosibirsk Region, but our data suggest that it may reach further east. Analysis of the Baltic lineage clusteron structure showed that the isolates found are unique (6) or belong to clusteron-founder 3D (1) and derived clusteron 3O (5). Based on the age of 3O clusteron, Baltic lineage could have appeared in the Kemerovo Region by the late 1970s. One of the isolated viruses turned out to be the OHFV of the first subtype and not to belong to any known clusteron. This finding is the first known detection of the virus outside the endemic area of Russia. Given the recent discovery of OHFV in Kazakhstan, it can be assumed that the area of this virus distribution is much wider than previously thought. Conclusions: This report provides insights into the population structure of TBEV and OHFV, which may be helpful for epidemiological investigation and surveillance of the viruses.

Modeling of the Spread of Malaria in the Bangka Belitung Islands Province Using the SEIR Method

Malaria is an infectious disease caused by plasmodium through the bite of the Anopheles sp mosquito. female (Roach, 2012). Malaria disease which hit the Bangka Belitung Islands Province in 2005 experienced a spike, reaching 36,901 people out of 981,573 residents and claimed the lives of 12 local residents. In 2011, the Bangka Belitung Islands Province was declared an endemic area for malaria. This research aims to model and interpret the spread of malaria using the SEIR model and predict the spread of malaria using parameter estimates. The steps in analyzing the SEIR model on the spread of malaria are making assumptions, forming a SEIR model, determining the equilibrium point and analyzing the stability of the equilibrium point, determining the basic reproduction number, and carrying out a simulation of the SEIR model that has been obtained. The SEIR model is classified into 4 classes, namely Susceptible (susceptible individuals), Exposed (individuals who have symptoms), Infected (infected individuals), and Recovered (recovered individuals). The data used in this research is data on the number of Susceptible, Exposed, Infected and Recovered malaria cases in 2022 obtained from the Bangka Belitung Islands Provincial Health Service. The SEIR mathematical model is used to calculate the equilibrium point and basic reproduction number. Based on the SEIR model simulation results, it was found that the susceptible population decreased from the 0th month to the 48th month. As for the exposed population, there were 9,623 people in month 0, but in this condition the population decreased drastically per month. Furthermore, for the infected population there were 129 people in month 0, but in this condition the number of infected decreased drastically per month along with the decrease in the exposed population. For individuals who recovered, there was a decrease from the 0th month to the 48th month.

Susceptibility of Phlebotomus papatasi (Diptera: Psychodidae) against DDT and Deltamethrin in an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in Iran

Background: Phlebotomus papatasi (Diptera: Psychodidae) is the main vector of zoonotic cutaneous leishmaniasis (ZCL) in Iran. The nonstandard use of pesticides against pests, particularly in agriculture, indirectly has caused the de­velopment of resistance and, consequently, the threat of control measures in ZCL endemic areas. Up to 2023, several reports of resistance in Ph. papatasi have been declared in the Old World. The purpose of this study was to measure the lethal time (LT50 and LT90) of Ph. papatasi sand flies in the ZCL endemic center of Esfahan to DDT and deltamethrin insecticides.
 Methods: Sand flies were collected in Borkhar and were tested using WHO adult mosquito test kit against DDT 4% and deltamethrin 0.0002%. The sand fly’s survival was recorded during exposure time in 225, 450|, 900, 1800, and 3600-seconds’ intervals for DDT and Deltamethrin and they were allowed to recover for 24 hours. Then LT50 and LT90 were analyzed using probit software. Phlebotomus papatasi were identified using morphological keys and other sand flies’ species were excluded from the analysis.
 Results: The insecticide against female Ph. papatasi revealed hundred percent mortality when exposed to DDT 4% and deltamethrin 0.0002%. The LT50 and LT90 were 19.32 and 22.74 minutes for DDT 4% and 39.92 and 51.33 minutes for deltamethrin 0.0002% respectively.
 Conclusion: Results of this study revealed that Ph. papatasi is still susceptible to DDT and deltamethrin. This data pro­vides valuable knowledge to implement effective control strategies against ZCL main vector and help to manage insec­ticide resistance in the region.

Multiple Disseminated Hydatidosis with Rare Locations: Mediastinal, Pancreatic and Pelvic (Case Report)

Hydatid disease is an anthropozoonosis due to the development of the larval form of Echinococcus granulosus in the human body, which constitutes a ‘dead-end’ host. It’s a common parasitosis in North African countries and constitutes a public health problem in Morocco. The liver and lung are the most affected while the mediastinum, pancreas and pelvis are rarely affected. We report the case of a 40-year-old patient operated 15 yearsago for cerebral and cervical hydatid cysts and who was hospitalized for generalized mucocutaneous jaundice. On exploration, we discover the presence of disseminated abdominal hydatidosis with association of 3 rare locations: mediastinal, pancreatic and pelvic. Indirect diagnostic tests were positive: indirect hemagglutination (IHA) and Elisa. The Western blot test also showed the presence of specific bands, thus making it possible to retain the diagnosis of hydatidosis. The hydatid cyst with mediastinal, pancreatic and pelvic location is rare and their association is very exceptional. It is essential to evoke the hydatid origin of any cystic lesion in a patient staying in an endemic area.

SEROLOGICAL SURVEY OF LYME BORRELIOSIS IN THE SOUTH REGION OF KAZAKHSTAN

Lyme borreliosis (LB) is an infectious disease caused by spirochetes of the Borrelia burgdorferi sensu lato complex. Transmission occurs through the bites of hard ticks within the genus Ixodes. Cases of fever of unknown origin are recorded in southern Kazakhstan, however, the prevalence of LB in this area remains unstudied. Almaty oblast is recognized as an endemic area for LB. Ixodid tick vectors also inhabit Jambyl oblast, where antibodies to LB agent were previously detected among residents, while it is classified as non-endemic. Turkistan oblast is also considered non-endemic for LB. The purpose of this study was to investigate the seroprevalence of IgG antibodies to B. burgdorferi s.l. among apparently healthy residents of Almaty city (Almaty oblast), Taraz city (Jambyl oblast), and Shymkent city (Turkistan oblast). A total of 465 human serum samples were collected from March 2022 to September 2023. Using the ELISA method, we detected the presence of IgG antibodies to the LB agent in 5.4% of the entire study group (24/465, 95% CI: 3.3-7.6%), and specifically in 9.3% of residents of Almaty city (11/118, 95% CI: 4.7-16.1%, p=0.03), 4.5% – Taraz city (11/242, 95% CI: 2.3-8.0%) and 1.9% – Shymkent city (2/105, 95% CI: 0.2-6.7%). The results of the study confirm the seroprevalence of IgG antibodies to B. burgdorferi s.l. among the population of Almaty city and Jambyl oblast, and also reveal seropositive samples in residents of Turkistan oblast, suggesting possible infection during travel to endemic regions. It is important to continue LB surveillance in endemic and emerging regions, as well as to raise awareness of the infection among healthcare workers and the general public in non-endemic areas.

Neurobrucellosis complicated with cerebral venous sinus thrombosis in a young syrian male: A case report

Introduction and importance Neurobrucellosis occurs when Brucella affects the nervous system and it has several presentations. One of its rarest complications is cerebral venous sinus thrombosis (CVST). Case presentation: A 16-year-old male patient complaining of a sudden onset of bilateral pulsatile headache accompanied by fever, dizziness, nausea, vomiting, and blurred vision. On neurological examination the patient had neck stiffness and a bilateral 2nd degree papilledema. Brain CT didn’t reveal any space-occupying lesions. Lumbar puncture showed an elevated lymphocyte count in the CSF and the Brucella PCR was positive. MRI with contrast and MRV revealed a left transverse sinus thrombosis and a diagnosis of neurobrucellosis complicated with CVST was made. Discussion: Cerebral venous sinus thrombosis is a rare but serious complication of neurobrucellosis, it has been described in only a handful of cases. The diagnosis mainly consists of establishing the presence of neurobrucellosis using the CSF analysis and the Brucella PCR, and proving the existence of CVST using the brain MRI. Although, the management of this complication remains a controversy, the use of an antibiotic combination and anticoagulation therapy may improve the symptoms greatly. Conclusion: Although Brucella seldom affects the nervous system, with CVST being an extremely rare complication. Physicians should consider brucella as the cause of CVST, in endemic areas. Usually, it’s treated with a combination of antibiotics. However, anticoagulation should be considered in some cases and future studies must be conducted to assess the role of anticoagulation treatment.

Falciparum malaria case acquired by wound exposed to the blood of infected malaria patient

Malaria is a serious Anopheles mosquito-borne disease. It is not endemic in Egypt but continues to be imported by travelers returning from endemic areas. The transmission of malaria in non-endemic areas is an extremely unusual event, but it is possible under certain conditions.Herein, we report a case of prolonged fever in a patient living in the countryside of Egypt with no reported travel history following accidental blood exposure to a malaria patient. The purpose is to shed light on this rare mode of malaria transmission and also to alert physicians and infectious disease specialists to consider malaria in the differential diagnosis in case of contact history to the blood of a malaria patient.

A randomized assessors-blind clinical trial to evaluate the safety and the efficacy of albendazole alone and in combination with mebendazole or pyrantel for the treatment of Trichuris trichiura infection in school-aged children in Lambaréné and surroundings.

Helminthiasis remains a public health issue in endemic areas. Various drugs have been proposed to improve efficacy against helminths. The study aimed to assess the safety and efficacy of three different anthelmintic combinations to treat Trichuris trichiura infections. We conducted a randomized assessors-blind clinical trial involving children aged 2-17 years with T. trichiura. Participants were randomly assigned to one of three treatment arms. On the first and third days, all participants got albendazole 400 mg, and on the second day, albendazole (arm A), mebendazole 500 mg (arm B), or pyrantel 125 mg/kg (arm C). We assessed treatment efficacy using the cure rate (CR) and egg reduction rate (ERR) at 3 and 6 weeks post-treatment. At 3 weeks post-treatment, ERR and CR were highest in study arm A [ERR = 94%, 95% confidence interval (CI): 92-95; CR = 71%; 95% CI: 58-81] compared to the B and C arms. Decrease in ERR was significant only for arm B versus arm A (P-value <0.001); decrease in ERR was significant for arms B and C (P-value <0.001). No statistical difference was observed in CR when comparing arms A and B (P-value =1.00) and C (P-value =0.27). At 6 weeks, a decrease in ERR was observed in three arms, significant only for arm C, 81% (95% CI: 78-83). A significant increase in egg counts was observed between 3 and 6 weeks post-treatment. All treatments were safe with mild adverse events. Albendazole 400 mg/day (arm A) showed the highest efficacy against trichuriasis. Nonetheless, this treatment regimen was able to cure half of the treated individuals highlighting concerns about controlling the transmission of T. trichiura.CLINICAL TRIALRegistered at ClinicalTrials.gov (NCT04326868).

African Swine Fever Diagnosis in Africa: Challenges and Opportunities.

The global spread of African swine fever (ASF) in recent decades has led to the need for technological advances in sampling and diagnostic techniques. The impetus for these has been the need to enable sampling by lay persons and to obtain at least a preliminary diagnosis in the field for early control measures to be put in place before final laboratory confirmation. In rural Africa, rapid diagnosis is hampered by challenges that include lack of infrastructure as well as human and financial resources. Lack of animal health personnel, access to affordable means to transport field samples to a laboratory, and lack of laboratories with the capacity to make the diagnosis result in severe under-reporting of ASF, especially in endemic areas. This review summarizes the challenges identified in gap analyses relevant to low- and middle-income countries, with a focus on Africa, and explore the opportunities provided by recent research to improve field diagnosis and quality of diagnostic samples used. Sampling techniques include invasive sampling techniques requiring trained personnel and non-invasive sampling requiring minimal training, sampling of decomposed carcass material, and preservation of samples in situations where cold chain maintenance cannot be guaranteed. Availability and efficacy of point-of-care (POC) tests for ASF has improved considerably in recent years and their application, as well as advantages and limitations, are discussed. The adequacy of existing laboratory diagnostic capacity is evaluated and opportunities for networking amongst reference and other laboratories offering diagnostic services are discussed. Maintaining laboratory diagnostic efficiency in the absence of samples during periods of quiescence is another issue that requires attention, and the role of improved laboratory networking is emphasized. Early diagnosis of ASF is key to managing the disease spread. Therefore, the establishment of the Africa Chapter of the Global African Swine Fever Research Alliance (GARA) increases opportunities for collaboration and networking among the veterinary diagnostic laboratories in the region.

LMP1 Expression of Esptein Baar Virus in Pediatric Lymphomas: A 06-Year Retrospective Series in Dakar

Persistent Epstein Baar Virus (EBV) infection may be a perfect target for the treatment of EBV-associated lymphomas and improved patient outcomes. The aim of this work was to evaluate the frequency of LMP1 (Latence membrane Protein 1) expression in pediatric lymphomas in Dakar. &amp;lt;i&amp;gt;Material and Methods&amp;lt;/i&amp;gt;: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2020. It was based on blocks and anatomopathological reports of pediatric Lymphomas in 04 ACP laboratories in Dakar. The immunohistochemical study was carried out at the IBN ROCHD Hospital in Casablanca, Morocco, using a manual method. LMP1 immunostaining was considered positive if 10% of tumour cells showed cytoplasmic staining. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Positive staining for LMP1 was noted in 13 of the 42 cases of pediatric lymphomas tested, i.e. 31% of cases. These included 09 cases of Hodgkin&amp;apos;s lymphoma, i.e. 69% (9/13), and 04 cases of non-Hodgkin&amp;apos;s lymphoma, i.e. 31%. LMP1-positive classical Hodgkin&amp;apos;s lymphomas accounted for 40.09% (9/22) of Hodgkin&amp;apos;s lymphomas, and were of the mixed cellularity (6/22) and scleronodular (3/22) subtypes. The frequency of LMP1-positive samples in non-Hodgkin&amp;apos;s lymphomas was 20% (4/20). These included 3 cases of Burkitt&amp;apos;s lymphoma and 1 case of diffuse large B-cell lymphoma. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The frequency of EBV infection in pediatric lymphomas in Senegal is lower than in endemic areas of Africa.

A One Health approach toward the control and elimination of soil-transmitted helminthic infections in endemic areas

Soil-transmitted helminths (STHs) pose significant health challenges, particularly in developing countries. Over 2 billion people are estimated to have been infected with at least one STH species. These parasites rely on the soil for part of their life cycle and are transmitted to humans through ova ingestion or skin penetration. Key risk factors include poor water, sanitation, hygiene practices, limited healthcare access, and poverty. Globally, STHs are primarily controlled through chemo-preventive deworming of high-risk groups in moderate (where prevalence of STHs is between 20 % and 50 %) to highly endemic areas (prevalence >50 %). Despite the use of deworming to control the STHs in endemic areas, infections still occur. The aim of this article is to explore the potential for enhancing STH control and elimination as Neglected Tropical Diseases (NTDs) in endemic areas through an integrated approach—the One Health approach. The current control program has a single strategy of chemoprophylaxis; in the integrated approach to control of STHs, the parasite control strategies besides being based on the epidemiology of the parasite (endemicity), also include strategies based on the biology (transmission cycle) of the parasites and human behavior patterns in endemic areas. Through the involvement of local communities, healthcare authorities, and stakeholders, participatory approaches foster collaborative efforts to devise and implement control measures. By integrating this integrated approach into existing healthcare and educational initiatives, more effective results can be achieved. The promotion of health education, clean water access, improved sanitation, and hygiene awareness can further enhance control strategies and reduce STH prevalence sustainably. Here, we highlight the benefits of adopting an integrated (One Health) approach to tackle STHs in endemic areas. Through community empowerment and multi-sectorial collaboration, we can strengthen our collective efforts to combat STHs and alleviate the burden of these NTDs.

Clinical Characteristics of Non-B and Non-C Biopsy-Proven Primary Liver Cancers in an HBV- Endemic Area: A Retrospective Study.

To explore the distribution of probable causes and clinical characteristics of non-B and non-C (NBNC) primary liver cancer (PLC) patients in the HBV-endemic region. A total of 86 individuals with biopsy-proven NBNC-PLC were enrolled. NBNC-PLC patients were defined as negative for both anti-HCV antibodies and five serum hepatitis B markers. Patients' characteristics were collected from medical records. Among them, most of the NBNC-PLC patients had intrahepatic cholangiocarcinoma (ICC) (81.4%), and 12.8% had hepatocellular carcinoma (HCC). The NBNC ICC group had more platelet count, GGT, and CA199 levels; approximately two-thirds were female, and it was more often present in patients with biliary inflammatory diseases, especially intrahepatic biliary lithiasis. The NBNC HCC group was older and had a higher proportion of dyslipidemia, obesity, cirrhosis, and AFP levels. Our data revealed that most of the NBNC PLC patients were ICC. Female patients with biliary inflammatory diseases and higher CA199 levels had an increased risk of ICC, and patients with metabolic risk factors and elevated AFP levels were more likely to develop HCC. Additional research should be performed to verify this finding.