Endemic Areas Research Articles

The COVID-19 pandemic impacted the activities of the Schistosomiasis Control Program in Brazil: is the goal of controlling the disease by 2030 at risk?

Schistosomiasis continues to represent a serious public health problem in Brazil. With the coronavirus disease 2019 (COVID-19) pandemic, several control strategies were suspended, probably compromising the goals of eradicating the disease in the country. We aimed to assess the impact of the COVID-19 pandemic on Schistosomiasis Control Program (PCE) actions in all endemic states of Brazil. We performed an ecological study using spatial analysis techniques. The PCE variables assessed were the population surveyed, the number of Kato-Katz tests, positive cases of schistosomiasis and the percentage of cases treated between 2015 and 2021. The percent change was calculated to verify if there was an increase or decrease in 2020 and 2021, along with time trend analyses provided by the Joinpoint model. Spatial distribution maps were elaborated considering the percent change. The surveyed population decreased in 2020 (-65.38%) and 2021 (-37.94%) across Brazil. There was a proportional reduction in the number of Kato-Katz tests (2020, -67.48%; 2021, -40.52%), a decrease in the percentage of positive cases (2020, -71.16%; 2021, -40.5%) and a reduction in the percentage of treated cases (2020, -72.09%; 2021, -41.67%). Time trend analyses showed a decreasing trend in most PCE variables. The PCE activities were impacted by the COVID-19 pandemic in Brazil and PCE strategies must be urgently reviewed, focusing on investments in all endemic areas.

Barriers and misconceptions hindering reduction of intestinal schistosomiasis in Mbita Sub-County, Western Kenya

BackgroundCommunity and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures.MethodsThis was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children.ResultsAmong pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7–48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant’s level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection.ConclusionsDespite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.

Comparison of malaria diagnostic methods for detection of asymptomatic Plasmodium infections among pregnant women in northwest Ethiopia

BackgroundMalaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women.MethodsA health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen’s kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated.ResultsThe prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax.ConclusionPrevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools.

Onchocerciasis in the Cameroon–Chad border area after more than 20 years of annual mass ivermectin distribution

BackgroundThe main vectors of onchocerciasis in Africa are Simulium damnosum sensu lato, which transmit the causative agent Onchocerca volvulus. The force of transmission is driven by the vector density, hence influencing the disease prevalence and intensity. Onchocerciasis is currently targeted for elimination using mass drug administration (MDA) of ivermectin, a potent microfilaricide. MDA in Cameroon began in 1987 in the Vina Valley, an endemic cross-border area with Chad, known for high vector densities and precontrol endemicity. Evaluations in 2008–2010 in this area showed ongoing transmission, while border areas in Chad were close to interrupting transmission. This study aimed to evaluate transmission in this area after several rounds of MDA since the last evaluation surveys.MethodsBlack flies were collected by human landing catches at seven border sites in Cameroon, twice a week, from August 2021 to March 2022. A fraction of the flies was dissected for parity assessment and identification of Onchocerca larval stages. The transmission indices were estimated. Black fly larvae were also collected from the breeding sites at the fly catching sites and identified to species level by cytotaxonomy.ResultsA total of 14,303 female flies were collected, and 6918 were dissected. Of these, 4421 (64.0%) were parous. The total biting rates were high, reaching up to 16,407 bites/person/study period, and transmission potential (third-stage larvae (L3) from head/all L3) were 367/702, 146/506, 51/55, 20/32, 0/3, 0/0, and 0/0 infective larvae/person, respectively, for Mbere-Tchad, Babidan, Hajam/V5, Gor, Djeing, Touboro, and Koinderi. Infectivity rates (L3 from head) were 16.00, 12.75, 5.15, and 4.07 infective females (L3H)/1000 parous flies for Haijam, Mbere-Tchad, Babidan, and Gor, respectively. These values exceed the World Health Organization (WHO) thresholds of ≤ 20 annual transmission potential (ATP) or < 1 infective female/1000 parous females. The major vectors identified were Simulium damnosum sensu stricto, S. squamosum, and for the first time in the area, S. yahense.ConclusionsMore than 20 years of MDA has not eliminated onchocerciasis in the study area; hence, this area is a potential source of reintroduction of onchocerciasis in Chad and would require alternative treatment strategies. Many factors such as MDA efficiency, effectiveness of ivermectin, and cytospecies composition may be contributing to transmission persistence.Graphical

Diagnosis of filariasis: A case report of a reemerging neglected tropical disease

Filariasis is a neglected tropical disease (NTD) of humans caused by the helminthic filarial species Wuchereria (W.) bancrofti, Brugia (B.) timori, and B. malayi. Diverse species of mosquitoes transmit the microfilariae of these worms to cause filaria infection, with the disease presenting classical clinical manifestations such as lymphedema, adenolymphangitis, and hydrocele, which result in permanent disfigurement and psychosocial and economic stigmatization. These sequelae necessitate the need for proper identification and characterization of the etiological agent for therapy and prevention. In this study, we report a case of unilateral lymphedema in a 28-year-old gateman/farmer from the Sabon Gari Local Government Area of Kaduna State, Northern Nigeria. Microscopy of the patient’s blood sample demonstrated the presence of microfilariae, leading to PCR characterization to be W. bancrofti. Upon diagnosis, the patient was treated with tablets of doxycycline 200 mg daily and albendazole 200 mg bid for six weeks, followed by a single dose of ivermectin 150 mg/kg (15 mg) at the 4th week of initiating treatment. This treatment regimen was complemented by a combination of bed rest, use of compression bandage, and limb elevation at night, resulting in remarkable improvement of the patient’s health after six weeks. In conclusion, lymphatic filariasis diagnosis was microscopically confirmed by the demonstration of microfilaria in the blood film obtained at night, leading to molecular characterization by PCR to be W. bancrofti. This is a workup for treating filarial infections in patients with unilateral leg swelling and a history of living in or traveling to endemic areas. This should also be a wake-up call to policymakers and practitioners regarding the possible recrudescence of filariasis in Nigeria.

Phylogenetic diversity and regionalization in the temperate arid zone

AbstractAstragalus (Fabaceae) is astoundingly diverse in temperate, cold arid regions of Earth, positioning this group as a model clade for investigating the distribution of plant diversity in the face of environmental challenges. Here, we identify the spatial distribution of diversity and endemism in Astragalus using species distribution models for 752 species and a phylogenetic tree comprising 847 species. We integrated these to map centers of species richness (SR) and relative phylogenetic diversity (RPD) and used randomization approaches to investigate centers of endemism. We also used clustering methods to identify phylogenetic regionalizations. We then assembled predictor variables of current climate conditions to test environmental factors predicting these phylogenetic diversity results, especially temperature and precipitation seasonality. We find that SR centers are distributed globally at temperate middle latitudes in arid regions, but the Mediterranean Basin is the most important center of RPD. Endemism centers also occur globally, but Iran represents a key endemic area with a concentration of both paleo‐ and neoendemism. Phylogenetic regionalization recovered an east‐west gradient in Eurasia and an amphitropical disjunction across North and South America; American phyloregions are overall most closely related to east and central Asia. SR, RPD, and lineage turnover are driven mostly by precipitation and seasonality, but endemism is driven primarily by diurnal temperature variation. Endemism and regionalization results point to western Asia and especially Iran as a biogeographic gateway between Europe and Asia. RPD and endemism highlight the importance of temperature and drought stress in determining plant diversity and endemism centers.

Areas of Endemism and Biogeographic Regionalization of the Iberian Peninsula Based on Ants (Hymenoptera: Formicidae)

Based on the distribution of 275 species of ants native to the Iberian Peninsula (IP), we identified areas of endemism (AE) within its geographical limits and present a biogeographic regionalization using two complementary methods and two types of operational geographical units. For endemicity analysis (EA), we used a 100 km2 grid cell, and for parsimony analysis of endemicity (PAE), we used hydrological basins as natural units. The EA revealed twelve areas of endemism that were grouped into five consensus areas. These are the Northeastern area, South plateau, Guadalquivir Valley, Baetic System, and Iberian Peninsula (whole). PAE resulted in a cladogram that classified hydrological basins into at least two successively nested subsets: an Atlantic group that is more related to northern European fauna and an Iberian subset that is well supported by synapomorphies. The Iberian subset was differentiated into four main areas: (a) a Northeastern area formed by the Pyrenees and the Catalan Coastal Range, (b) a mainland area containing the Central System and Guadiana and Tajo valleys, (c) a Southern area consisting of the Guadalquivir Valley and the Baetic System, and (d) a Northern coastal area. The results showed congruence between the two methods since many of the synapomorphies are shared among the diagnostic and IP endemic species of the EA. Both EA and PAE showed the relevance of the heterogeneous peninsular orography that combines mountainous regions with valleys and plateaus, which have acted as historical barriers or corridors. The presence of numerous endemic species, particularly in the southern third of the IP, suggests that several Iberian refuges for ants originated during glacial periods. These areas constitute priority sites for the conservation of ants in particular and biodiversity in general on the IP and allow further research about the processes that generated these distributional patterns.

Causal factors and time in formation of areas of endemism for land planarians in the Atlantic Forest

AbstractHere, we discovered areas of endemism (AoE) for land planarians (Geoplaninae) and tested the influence of the past climate in the formation of AoEs in the southeastern AF in Brazil.LocationSoutheastern Atlantic Forest, Brazil.Materials and MethodsWe used 1888 records of 371 species in Endemicity Analysis and Geographic Interpolation of Endemism to uncover AoEs. We also carried out a species distribution modelling (SDM) of three genera to see the suitability regions where they were distributed during Mid‐Pliocene, Last Interglacial Maximum, Last Glacial Maximum and present time. Finally, we inferred a molecular phylogeny of Geoplaninae aiming to estimate divergence times of the taxa to test the relative influence of more recent climatic fluctuations in the speciations.ResultsWe delimited 15 robust AoEs. SDM corroborates past climate altered some genera distribution. However, results of the phylogenetic analysis resulted in time estimation older than Pleistocene climatic fluctuations for more recent speciations. These endemic patterns could be explained through processes of reduction and expansion of suitability areas but in older times as generally reported in the literature. Geological events that formed mountains, sedimentary basins and major rivers are integrated with climate to explain high endemism and diversification.Main ConclusionsPlanarians have shown to be an optimal model for fine‐scale studies of AoE and diversification in AF. Pleistocene climatic fluctuations seem to have not been responsible for their diversification, but older climatic changes with geological events seem to have influenced their speciations and the present‐day high levels of endemism. In the future, robust phylogenies with more comprehensive sampling integrated with palaeoecological models will help to understand the diversification of the AF.

Seroprevalence and molecular characterization of viral hepatitis and HIV co-infection in the Central African Republic.

The Central African Republic (CAR) is one of the countries with the highest prevalence of viral hepatitis infection in the world. Coinfection with HIV increases the morbidity and mortality beyond that of mono-infection with either hepatitis or HIV. The present study describes the geographic distribution of viral hepatitis infections and molecular characterization of these viruses in the CAR. Out of 12,599 persons enrolled during the fourth Multiple Indicator Cluster Survey of 2010 in the CAR, 10,621 Dried Blood Spot (DBS) samples were obtained and stored at -20°C. Of these DBS, 4,317 samples were randomly selected to represent all regions of the CAR. Serological tests for hepatitis B, D, and C viruses were performed using the ELISA technique. Molecular characterization was performed to identify strains. Of the 4,317 samples included, 53.2% were from men and 46.8% from women. The HBsAg prevalence among participants was 12.9% and that HBc-Ab was 19.7%. The overall prevalence of HCV was 0.6%. Co-infection of HIV/HBV was 1.1% and that of HBV/HDV was 16.6%. A total of 77 HBV, 6 HIV, and 6 HDV strains were successfully sequenced, with 72 HBV (93.5%) strains belonging to genotype E and 5 (6.5%) strains belonging to genotype D. The 6 HDV strains all belonged to clade 1, while 4 recombinants subtype were identified among the 6 strains of HIV. Our study found a high prevalence of HBV, HBV/HDV and HBV/HIV co-infection, but a low prevalence of HCV. CAR remains an area of high HBV endemicity. This study's data and analyses would be useful for establishing an integrated viral hepatitis and HIV surveillance program in the CAR.

Metformin as adjunctive therapy in combination with multidrug treatment for multibacillary leprosy: A protocol for a randomized double-blind, controlled Phase 2 trial in Indonesia (MetLep Trial).

The clinical management of leprosy is complicated by leprosy reactions (LR) causing irreversible nerve damage and disabilities. LR often require long-term use of corticosteroids causing serious side effects. Adjunct host-directed therapy (HDT) is a potentially attractive strategy in leprosy to prevent LR and associated immunopathology, modulate immunological memory that protects against recurrence, and thereby reduce nerve damage, disability and corticosteroid-associated morbidities. Metformin, a well-tolerated, safe and cheap anti-hyperglycaemic drug, is repurposed as HDT in auto-immune and infectious diseases, like tuberculosis (TB). Metformin use in people with diabetes is associated with reduced risks of TB-infection, progression to active TB, treatment failure and TB-mortality. Given the similarities both mycobacteria share, we hypothesize that among persons with multibacillary (MB) leprosy, adjunctive metformin may prevent/mitigate LR. We will perform a double-blind controlled proof-of-concept trial in which people with newly diagnosed multibacillary leprosy will be randomized (1:1) to metformin hydrochloride 1000mg extended release once daily versus placebo for 24 weeks in addition to standard-of-care WHO MB multidrug therapy (MDT) during 48 weeks. We aim to enrol 166 participants aged between 18 and 65 years, across five clinical sites in two leprosy endemic areas in Indonesia. Primary outcomes are the proportion of participants experiencing a LR and the frequency of (serious) adverse events. Secondary outcomes are the severity and time to first LR, the cumulative corticosteroid usage, and quality of life. The total study follow-up is 48 weeks. LR signify the most important cause of irreversible nerve damage leading to anatomical deformities and disabilities, imposing a social and financial burden on those affected. Our study aims to evaluate the efficacy, tolerability and safety of adjunct metformin added to MDT in persons with multibacillary leprosy, and explore its effects on clinical and immunological outcomes. NCT05243654 (17/02/2022).

Female genital schistosomiasis burden and risk factors in two endemic areas in Malawi nested in the Morbidity Operational Research for Bilharziasis Implementation Decisions (MORBID) cross-sectional study.

Female genital schistosomiasis (FGS), caused by the parasite Schistosoma haematobium (Sh), is prevalent in Sub-Saharan Africa. FGS is associated with sexual dysfunction and reproductive morbidity, and increased prevalence of HIV and cervical precancerous lesions. Lack of approved guidelines for FGS screening and diagnosis hinder accurate disease burden estimation. This study evaluated FGS burden in two Sh-endemic areas in Southern Malawi by visual and molecular diagnostic methods. Women aged 15-65, sexually active, not menstruating, or pregnant, were enrolled from the MORBID study. A midwife completed a questionnaire, obtained cervicovaginal swab and lavage, and assessed FGS-associated genital lesions using hand-held colposcopy. 'Visual-FGS' was defined as specific genital lesions. 'Molecular-FGS' was defined as Sh DNA detected by real-time PCR from swabs. Microscopy detected urinary Sh egg-patent infection. In total, 950 women completed the questionnaire (median age 27, [IQR] 20-38). Visual-and molecular-FGS prevalence were 26·9% (260/967) and 8·2% (78/942), respectively. 6·5% of women with available genital and urinary samples (38/584) had egg-patent Sh infection. There was a positive significant association between molecular- and visual-FGS (AOR = 2·9, 95%CI 1·7-5·0). 'Molecular-FGS' was associated with egg-patent Sh infection (AOR = 7·5, 95% CI 3·27-17·2). Some villages had high 'molecular-FGS' prevalence, despite <10% prevalence of urinary Sh among school-age children. Southern Malawi carries an under-recognized FGS burden. FGS was detectable in villages not eligible for schistosomiasis control strategies, potentially leaving girls and women untreated under current WHO guidelines. Validated field-deployable methods could be considered for new control strategies.

Haematochemical Profile of Healthy Dogs Seropositive for Single or Multiple Vector-Borne Pathogens.

the present study aimed to investigate the immunological response to common vector-borne pathogens and to evaluate their impact on haematochemical parameters in owned dogs. Blood samples were collected from 400 clinically healthy dogs living in an endemic area (Sardinia Island, Italy). All dogs were serologically tested for VBDs and divided into groups based on their negative (Neg) or positive response towards Ehrlichia (Ehrl), Rickettsia (Rick), Leishmania (Leish), Borrelia (Borr), Anaplasma (Anapl), and Bartonella (Barto). A Kruskall-Wallis's test, followed by Dunn's post hoc comparison test, was applied to determine the statistical effect of negativity and single or multiple positivity on the studied parameters. the group of dogs simultaneously presenting antibodies towards Leishmania, Ehrlichia, and Rickettsia showed higher values of total proteins, globulins, creatine phosphokinase, aspartate aminotransferase, alanine aminotransferase, and amylase than dogs that tested negative or dogs with antibodies toward a single pathogen investigated herein. Our results seem to suggest that exposure to more vector-borne pathogens could lead to greater liver function impairment and a greater inflammatory state. Further investigations are needed in order to better clarify how co-infections affect haematochemical patterns in dogs living in endemic areas of VBDs.

Global Re-emergence of Monkeypox: A Synoptic Review

AbstractAs the coronavirus disease 2019 pandemic continues to rage, the unprecedented manifold increase in monkeypox (mpox) cases throughout the world is raising qualms about a possible pandemic. As of January 2024, the disease has been reported in around 116 countries, with nearly 92,500 confirmed cases and 170 deaths. In this mini-review, we have endeavored to cover multiple aspects of the mpox disease. Mpox virus is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus. The disease is endemic in certain African countries. Until recently, however, the disease was rarely reported in Europe and the United States. In contrast to the previous outbreaks outside Africa, reported cases in the 2022 outbreak did not travel to the endemic areas. Superspreading events at mass gatherings, multiple-partner sexual encounters, and international travel were major drivers of the recent global outbreak of mpox. The 2022 mpox virus may have undergone accelerated evolution. It diverges from the related 2018 to 2019 viruses by around 50 single-nucleotide polymorphisms, some of which brought about amino acid changes in immunogenic surface glycoprotein B21. Differential diagnosis for mpox could be quite challenging since it can masquerade as a wide variety of illnesses. Worse still, some patients may be asymptomatic or show subtle symptoms. The infection is confirmed by conventional or real-time polymerase chain reaction on lesion material. Although there is no specific therapy approved for mpox infections, two antivirals (tecovirimat and brincidofovir) and vaccinia immune globulin may be used. Vaccines also provide protection against mpox when properly administered prior to exposure. Finally, the implementation of preventive measures is of paramount importance, especially in regions where mpox transmission is widespread and among high-risk populations.

Establishment of an ELISA Based on a Recombinant Antigenic Protein Containing Multiple Prominent Epitopes for Detection of African Swine Fever Virus Antibodies.

African swine fever virus (ASFV) poses a significant threat to the global pig industry, necessitating accurate and efficient diagnostic methods for its infection. Previous studies have often focused on a limited number of epitopes from a few proteins for detecting antibodies against ASFV. Therefore, the current study aimed to use multiple B-cell epitopes in developing an indirect Enzyme-Linked Immunosorbent Assay (ELISA) for enhanced detection of ASFV antibodies. For the expression of recombinant protein, k3 derived from 27 multiple peptides of 11 ASFV proteins, such as p72, pA104R, pB602L, p12, p14.5, p49, pE248R, p30, p54, pp62, and pp220, was used. To confirm the expression of the recombinant protein, we used the Western blotting analysis. The purified recombinant K3 protein served as the antigen in our study, and we employed the indirect ELISA technique to detect anti-ASFV antibodies. The present finding showed that there was no cross-reactivity with antibodies targeting Foot-and-mouth disease virus (FMDV), Porcine circovirus type 2 (PCV2), Pseudorabies virus (PRV), Porcine reproductive and respiratory syndrome virus (PRRSV), and Classical swine fever virus (CSFV). Moreover, the current finding was sensitive enough to find anti-ASFV in serum samples that had been diluted up to 32 times. The test (k3-iELISA) showed diagnostic specificity and sensitivity of 98.41% and 97.40%, respectively. Moreover, during the present investigation, we compared the Ingenasa kit and the k3-iELISA to test clinical pig serum, and the results revealed that there was 99.00% agreement between the two tests, showing good detection capability of the k3-iELISA method. Hence, the current finding showed that the ELISA kit we developed can be used for the rapid detection of ASFV antibodies and used as an alternative during serological investigation of ASF in endemic areas.

Visceral Leishmaniasis-Human Immunodeficiency Virus-Coinfected Patients Are Highly Infectious to Sandflies in an Endemic Area in India.

In an area endemic with Indian visceral leishmaniasis (VL), we performed direct xenodiagnosis to evaluate the transmission of Leishmania donovani from patients with VL-human immunodeficiency virus (HIV) coinfection to the vector sandflies, Phlebotomus argentipes. Fourteen patients with confirmed VL-HIV coinfection, with a median parasitemia of 42 205 parasite genome/mL of blood, were exposed to 732 laboratory-reared pathogen-free female P argentipes sandflies on their lower arms and legs. Microscopy revealed that 16.66% (122/732) of blood-fed flies were xenodiagnosis positive. Notably, 93% (13/14) of the VL-HIV group infected the flies, as confirmed by quantitative polymerase chain reaction and/or microscopy, and were 3 times more infectious than those who had VL without HIV.

Helminth community of Nectomys squamipes naturally infected by Schistosoma mansoni in an endemic area in Brazil: A comparison of 22 years apart

The municipality of Sumidouro in the state of Rio de Janeiro, southeastern Brazil, is considered an area with low endemicity of Schistosoma mansoni. In this municipality, the wild water rat Nectomys squamipes is a wild reservoir of S. mansoni. A helminth community survey was carried out on N. squamipes populations in Sumidouro from 1997 to 1999. In the present study, we compared the helminth fauna and the helminth community structure of N. squamipes with a recent survey after a 22-year time interval, considering that the prevalence of S. mansoni infection in humans remained stable and that the area showed the same environmental characteristics. Seventy-three host specimens of N. squamipes collected between 1997 and 1999 and 21 specimens collected in 2021 were analyzed in this study. Seven helminth species were found in each collection period. The nematode Syphacia evaginata was recorded for the first time in N. squamipes in 2021. Syphacia venteli was the most abundant species in both periods and the most prevalent in 2021. During the period from 1997 to 1999, the most prevalent species was Hassalstrongylus epsilon. Significant differences in prevalence and abundance in relation to host sex were observed only for S. mansoni in 1997–1999. Significant differences in the abundance of the helminth species over time were observed only in Physaloptera bispiculata. Hassalstrongylus epsilon, S. venteli and S. mansoni were the dominant species in both periods. Litomosoides chagasfilhoi, Echinostoma paraensei paraensei and P. bispiculata became dominant, codominant and subordinate, respectively, over time. In conclusion, the helminth community of N. squamipes remained stable, with similar species richness, prevalence and abundance values and low beta-diversity over time. The occurrence of S. mansoni in the water rat has remained stable for decades, highlighting its importance for schistosomiasis control.

Multi-epitope protein production and its application in the diagnosis of opisthorchiasis

BackgroundOpisthorchiasis and cholangiocarcinoma (CCA) continue to be public health concerns in many Southeast Asian countries. Although the prevalence of opisthorchiasis is declining, reported cases tend to have a light-intensity infection. Therefore, early detection by using sensitive methods is necessary. Several sensitive methods have been developed to detect opisthorchiasis. The immunological detection of antigenic proteins has been proposed as a sensitive method for examining opisthorchiasis.MethodsThe Opisthorchis viverrini antigenic proteins, including cathepsin B (OvCB), asparaginyl endopeptidase (OvAEP), and cathepsin F (OvCF), were used to construct multi-antigenic proteins. The protein sequences of OvCB, OvAEP, and OvCF, with a high probability of B cell epitopes, were selected using BepiPred 1.0 and the IEDB Analysis Resource. These protein fragments were combined to form OvCB_OvAEP_OvCF recombinant DNA, which was then used to produce a recombinant protein in Escherichia coli strain BL21(DE3). The potency of the recombinant protein as a diagnostic target for opisthorchiasis was assessed using immunoblotting and compared with that of the gold standard method, the modified formalin-ether concentration technique.ResultsThe recombinant OvCB_OvAEP_OvCF protein showed strong reactivity with total immunoglobulin G (IgG) antibodies against light-intensity O. viverrini infections in the endemic areas. Consequently, a high sensitivity (100%) for diagnosing opisthorchiasis was reported. However, cross-reactivity with sera from other helminth and protozoan infections (including taeniasis, strongyloidiasis, giardiasis, E. coli infection, enterobiasis, and mixed infection of Echinostome spp. and Taenia spp.) and no reactivity with sera from patients with non-parasitic infections led to a reduced specificity of 78.4%. In addition, the false negative rate (FNR), false positive rate (FPR), positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were 0%, 21.6%, 81.4%, 100%, and 88.9%, respectively.ConclusionsThe high sensitivity of the recombinant OvCB_OvAEP_OvCF protein in detecting opisthorchiasis demonstrates its potential as an opisthorchiasis screening target. Nonetheless, research on reducing cross-reactivity should be undertaken by detecting other antibodies in other sample types, such as saliva, urine, and feces.Graphical

Masquerading parasites: A case study on pulmonary echinococcosis mimicking lung cancer and bronchogenic cyst

Introduction: Pulmonary echinococcosis, caused by the larval stage of Echinococcus granuloses, presents significant diagnostic challenges, often mimicking more common thoracic pathologies, such as lung cancer and bronchogenic cysts. This report underscores the importance of considering echinococcosis in differential diagnoses for lung lesions. Case Report: We discuss the case of a 24-year-old male, initially suspected to have an intrapulmonary bronchogenic cyst, later diagnosed with pulmonary echinococcosis. The diagnosis was established through a combination of radiological findings, surgical intervention, and pathological examination, highlighting the complexities involved in correctly identifying this parasitic infection. Conclusion: This case illustrates the critical need for heightened awareness and a comprehensive diagnostic approach to pulmonary echinococcosis, particularly in endemic areas. It emphasizes the role of detailed imaging and consideration of echinococcosis in the differential diagnosis of cystic lung lesions to prevent misdiagnosis and ensure appropriate treatment.

Mayaro virus, a potential threat for Europe: vector competence of autochthonous vector species

BackgroundMayaro virus (MAYV) is an emerging alphavirus, primarily transmitted by the mosquito Haemagogus janthinomys in Central and South America. However, recent studies have shown that Aedesaegypti, Aedesalbopictus and various Anopheles mosquitoes can also transmit the virus under laboratory conditions. MAYV causes sporadic outbreaks across the South American region, particularly in areas near forests. Recently, cases have been reported in European and North American travelers returning from endemic areas, raising concerns about potential introductions into new regions. This study aims to assess the vector competence of three potential vectors for MAYV present in Europe.MethodsAedesalbopictus from Italy, Anophelesatroparvus from Spain and Culexpipiens biotype molestus from Belgium were exposed to MAYV and maintained under controlled environmental conditions. Saliva was collected through a salivation assay at 7 and 14 days post-infection (dpi), followed by vector dissection. Viral titers were determined using focus forming assays, and infection rates, dissemination rates, and transmission efficiency were calculated.ResultsResults indicate that Ae.albopictus and An.atroparvus from Italy and Spain, respectively, are competent vectors for MAYV, with transmission possible starting from 7 dpi under laboratory conditions. In contrast, Cx.pipiens bioform molestus was unable to support MAYV infection, indicating its inability to contribute to the transmission cycle.ConclusionsIn the event of accidental MAYV introduction in European territories, autochthonous outbreaks could potentially be sustained by two European species: Ae.albopictus and An.atroparvus. Entomological surveillance should also consider certain Anopheles species when monitoring MAYV transmission.Graphical abstract

Epidemiological update of cystic echinococcosis in livestock and assessment of practices related to its control in the Mediterranean area

Cystic echinococcosis (CE), caused by the tapeworm Echinococcus granulosus, is a zoonotic parasitic disease that still represents a serious threat to human and animal health worldwide. The Mediterranean basin is recognized as one of the major hotspots of CE due to several factors, including the presence of diverse intermediate host species as well as socio-economic and cultural conditions of local communities. This study aims to take a closer look at epidemiological data on CE in the Mediterranean area and assess the knowledge attitudes and practices of shepherds towards this disease in four countries (Algeria, Greece, Italy and Tunisia), highly endemic for CE, with the final goal of identifying highly endemic risk areas and practices in use which might potentially allow the persistence of E. granulosus infection in these areas. To update the epidemiological scenario of CE in Mediterranean areas, a comprehensive review of peer-reviewed literature on CE prevalence data published during the 2017–2023 period was carried out and, through a geographical information system (GIS), a map displaying the current CE distribution in the Mediterranean area was generated. In addition, a questionnaire survey was conducted through in-depth interviews of the farmers to collect information on their management system as well as knowledge attitudes and practices towards CE. From the farmer-participatory survey some risky practices emerged including the non-regular deworming of dogs or the use of ineffective drugs or dosing, as well as the provision of uncooked animal viscera to dogs. Finally, lower levels of knowledge and awareness of the disease was observed among farmers from North Africa compared with those of European countries. In conclusion, the results obtained highlight that CE is still a very serious problem in Mediterranean areas and increased efforts are needed to promote awareness among farmers and to turn research results into policy in order to reduce the spread of this disease, according to the One Health perspective.