Filariasis Infection Research Articles

An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana.

Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs. From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management. Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries. This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.

Tropical eosinophilia: Case series on varying presentations

ABSTRACT Eosinophilia can be due to both infectious and non-infectious causes, many of which may be clinically indistinguishable. Filariasis, a tropical and subtropical infection, is caused by Wuchereria bancrofti, Brugia timori (B. timori), and Brugia malayi. Filariasis is conventionally diagnosed by demonstration of microfilaria in the peripheral blood smear. The disease may be missed if one is not aware of the possibility. We report two cases in two individuals with eosinophilia due to filaria resulting in tropical pulmonary eosinophilia and deep vein thrombosis (DVT). They had complete symptomatic improvement after a 3-week course of diethylcarbamazine (DEC) +/- ivermectin.

Spatial distribution and environmental correlations of Culex pipiens pallens (Diptera: Culicidae) in Haidian district, Beijing.

Culex pipiens pallens Coquillett, 1898 (Diptera: Culicidae) was the dominant health threat to mosquito species in Beijing, and it is important to unravel the spatial distribution and environmental correlations of Cx. pipiens pallens in Beijing. 3S technology methods and spatial statistics were used to clarify the distribution pattern. Subsequently, linear and spatial regression were performed to detect the environmental factors linked with the density of Cx. pipiens pallens. The same "middle peak" spatial distribution pattern was observed for Cx. pipiens pallens density at the community, subdistrict, and loop area levels in our study area. In addition, there were various correlated environmental factors at the community and subdistrict scales. At the community scale, the summary values of the Modified Normalized Difference Water Index (MNDWI) in 2 km buffer zone (MNDWI_2K) were negatively correlated, and the summary values of Normalized Difference Built-up Index (NDBI) in 800 m buffer zone (NDBI_800) was positively correlated to the Cx. pipiens pallens density. However, the summary values of Normalized Difference Vegetation Index and Nighttime Light Index significantly affected Cx. pipiens pallens density at the subdistrict scale. Our findings provide insight into the spatial distribution pattern of Cx. pipiens pallens density and its associated environmental risk factors at different spatial scales in the Haidian district of Beijing for the first time. The results could be used to predict the Cx. pipiens pallens density as well as the risk of lymphatic filariasis (LF) infection, which would help implement prevention and control measures to prevent future risks of biting and LF transmission in Beijing.

Application of Darbo-type generalized θ-[formula omitted]-contractions to the fractional order Lymphatic filariasis infection model

This work presents a significant contribution to the field of mathematical analysis by introducing θ-Fℵ-contractions of Darbo-type. These newly introduced contractions serve as pivotal tools within our study. By employing these contractions, we systematically establish several pivotal fixed point theorems that allow us to guarantee the existence of fixed points in the Banach spaces. We construct particular examples in order to support the validity and effectiveness of our theoretical results. Moreover, we extend the utility of our established theorems by applying them to solve real-world problems. Specifically, we direct our attention to exploring the existence of solutions to the fractional order Lymphatic filariasis infection model.

Assessment of Culicidae collection methods for xenomonitoring lymphatic filariasis in malaria co-infection context in Burkina Faso.

Entomological surveillance of lymphatic filariasis and malaria infections play an important role in the decision-making of national programs to control, or eliminate these both diseases. In areas where both diseases prevalence is low, a large number of mosquitoes need to be sampled to determine vectors infection rate. To do this, efficient mosquito collection methods must be used. This study is part in this framework, to assess appropriate mosquito collection methods for lymphatic filariasis xenomonitoring in a coexistence context with malaria in Burkina Faso. Mosquito collections were performed between August and September 2018 in four villages (Koulpissi, Seiga, and Péribgan, Saptan), distributed in East and South-West health regions of Burkina Faso. Different collection methods were used: Human Landing Catches (HLC) executed indoor and outdoor, Window Exit-Trap, Double Net Trap (DNT) and Pyrethrum Spray Catches (PSC). Molecular analyses were performed to identify Anopheles gambiae s.l. sibling species and to detect Wuchereria bancrofti and Plasmodium falciparum infection in Anopheles mosquitoes. A total of 3 322 mosquitoes were collected among this, Anopheles gambiae s.l. was the vector caught in largest proportion (63.82%). An. gambiae s.l. sibling species molecular characterization showed that An. gambiae was the dominant specie in all villages. The Human Landing Catches (indoor and outdoor) collected the highest proportion of mosquitoes (between 61.5% and 82.79%). For the sampling vectors infected to W. bancrofti or P. falciparum, PSC, HLC and Window Exit-Trap were found the most effective collection methods. This study revealed that HLC indoor and outdoor remained the most effective collection method. Likewise, the results showed the probability to use Window Exit-Trap and PSC collection methods to sample Anopheles infected.

Study of fractional variable-order lymphatic filariasis infection model

Abstract Variable-order derivatives are the natural extension of ordinary as well as of fractional-order differentiations and integration, respectively. Numerous suggestions for fractional variable-order operators have been made in the literature over time. Therefore, this is the moment to shine a light on the variable-order fractional calculus, due to the fact that it accurately describes the mathematical underpinnings and emphasizing the modeling utility via using contemporary numerical techniques. This study focuses on investigating a fractional variable-order model of lymphatic filariasis infection using with Atangana–Beleanue–Caputo derivative. Our investigations have led to the development of newly refined results, focusing on both qualitative and numerical aspects of analysis. To achieve our research objectives, we employ the fixed point theorems of Banach and Krasnoselskii. These theorems serve as powerful tools, allowing us to establish results regarding the existence of solutions to the model. Additionally, for precise numerical simulations, we employ the fractional Euler’s method, a sophisticated computational technique that allows us to effectively simulate and interpret the results both numerically and graphically. These graphs illustrate distinct variable-orders, providing a comprehensive understanding of the model’s behavior under different conditions. Here, it should be kept in mind that we have select various continuous functions for variable to present our graphical illustration.

Combinations of the azaquinazoline anti-Wolbachia agent, AWZ1066S, with benzimidazole anthelmintics synergise to mediate sub-seven-day sterilising and curative efficacies in experimental models of filariasis.

Lymphatic filariasis and onchocerciasis are two major neglected tropical diseases that are responsible for causing severe disability in 50 million people worldwide, whilst veterinary filariasis (heartworm) is a potentially lethal parasitic infection of companion animals. There is an urgent need for safe, short-course curative (macrofilaricidal) drugs to eliminate these debilitating parasite infections. We investigated combination treatments of the novel anti-Wolbachia azaquinazoline small molecule, AWZ1066S, with benzimidazole drugs (albendazole or oxfendazole) in up to four different rodent filariasis infection models: Brugia malayi-CB.17 SCID mice, B. malayi-Mongolian gerbils, B. pahangi-Mongolian gerbils, and Litomosoides sigmodontis-Mongolian gerbils. Combination treatments synergised to elicit threshold (>90%) Wolbachia depletion from female worms in 5 days of treatment, using 2-fold lower dose-exposures of AWZ1066S than monotherapy. Short-course lowered dose AWZ1066S-albendazole combination treatments also delivered partial adulticidal activities and/or long-lasting inhibition of embryogenesis, resulting in complete transmission blockade in B. pahangi and L. sigmodontis gerbil models. We determined that short-course AWZ1066S-albendazole co-treatment significantly augmented the depletion of Wolbachia populations within both germline and hypodermal tissues of B. malayi female worms and in hypodermal tissues in male worms, indicating that anti-Wolbachia synergy is not limited to targeting female embryonic tissues. Our data provides pre-clinical proof-of-concept that sub-seven-day combinations of rapid-acting novel anti-Wolbachia agents with benzimidazole anthelmintics are a promising curative and transmission-blocking drug treatment strategy for filarial diseases of medical and veterinary importance.

Understanding Mosquito Faunal Diversity: An Approach to Assess the Burden of Vector-Borne Diseases in Three Representative Topographies (Rural, Urban, and Peri-Urban) of Ganjam District in Odisha State, India.

Mosquitoes are the best-known disease vectors for most vector-borne diseases that significantly impact global health in terms of morbidity and mortality. In a geographical area, mosquito faunal diversity often alters with changing climatic factors and variable breeding habitats that differ across seasons. Using biodiversity indicators as tools, a study was conducted in rural, peri-urban, and urban areas of district Ganjam, Odisha state, to determine mosquito faunal diversity as an approach to forecast the possible risk of disease transmission in the three representative topographies. A two-year study was undertaken to assess the alpha diversity of mosquito species by the numerical strength of the species using various eco-diversity indices. Species richness and abundance of mosquito species are significantly higher in peri-urban areas compared to urban and rural areas. The species dominance of Culex quinquefasciatus was observed in all three topographies, while Aedes aegypti, Aedes albopictus, and Anopheles stephensi were in urban areas. Species richness may dilute the risk of disease in an area, but increased species dominance, mostly vector species, in a new habitat often allows pathogens to infect newer communities at risk, leading to the emergence of new diseases. The current study indicates the possible risk of lymphatic filariasis (LF) infection in all three topographies. On the other hand, the risk of malaria and dengue/chikungunya transmission is higher in urban areas. With routine entomological monitoring, including vector incrimination, the biodiversity indicators will be the best tool to forecast the risk of vector-borne diseases in an area; accordingly, judicious vector control strategies can be adopted.

New Results on the Asymptotic Behaviour of a Stochastic SEI Model of Lymphatic Filariasis

The goal of this article is to examine a new stochastic epidemic model for lymphatic filariasis, susceptible‐exposed‐infected (SEI). Like other diseases, the spread of lymphatic filariasis is subject to a degree of randomness due to fluctuations in the natural environment. This provides us with the opportunity to formulate a mathematical model of lymphatic filariasis that comprehensively considers external stochastic influences. By using carefully designed stochastic Lyapunov functions, we establish sufficient conditions for the eradication of lymphatic filariasis infections. Moreover, under specific conditions regarding the intensity of white noise, we also demonstrate the existence of a unique ergodic stationary distribution and the persistence of the mean for the model. Numerical simulations are conducted to substantiate the validity of our findings.

Imaging spectrum in tropical breast infections.

While breast carcinoma is the most feared pathology in women with breast lumps, infections continue to be an important aetiology, especially in countries with low to middle socio-economic status. The breast infections or mastitis can present as acute painful breast or recurrent episodes of breast lumps with or without pain. The common causes include puerperal, non-puerperal, and idiopathic mastitis whereas uncommon causes like tuberculosis, filariasis, hydatid and other parasitic infections are still seen in developing countries. Imaging with digital mammography may be difficult due to pain or inadequate due to increased breast density. Ultrasound serves as the modality of choice for detailed assessment in these patients. Since the imaging features are often overlapping with malignancy, biopsy is almost always indicated. However, there are certain imaging findings that may point to the diagnosis of mastitis and can help in accurate radiologic-pathologic correlation. This article aims to illustrate the varied clinico-radiological features of patients with tropical breast infections.

A hierarchical model-based framework for evaluating probabilities of area-wide freedom from lymphatic filariasis infection based on sentinel site surveillance data

The design of population surveys to substantiate the elimination of disease transmission across large implementation units (IUs) has become important as many parasite control efforts approach their final stages. This is especially true for the global program to eliminate lymphatic filariasis (LF), which has successfully reduced infection prevalence in many endemic countries, such that the focus has shifted to how best to determine that the area-wide elimination of this macroparasitic disease has been achieved. The WHO has recommended a two-stage lot quality assurance sampling (LQAS) framework based on sampling children from selected clusters within an IU, called the Transmission Assessment Survey (TAS), for supporting such decision-making, but questions have emerged regarding the reliability of this strategy for assessing if LF transmission is broken effectively everywhere within an area. In this study, we develop and describe an alternative probabilistic framework that combines infection status information from longitudinal parasitological surveys of whole communities carried out in sentinel sites, imperfect diagnostic tests, and locally-applicable extinction thresholds predicted by transmission models, to overcome the problems associated with TAS. We applied the framework to LF infection and intervention data from the country of Malawi, and demonstrated how our hierarchical coupled model-sentinel site survey tool can be used to estimate the probability that LF transmission has occurred at the individual survey, village, and countrywide scales. We also further demonstrated how the framework can be used in conjunction with zonal or areal design prevalences to estimate the number of sentinel sites and durations of interventions required to acquire sufficiently high confidence that an area is free from infection. Our results indicate that the application of the spatially driven model-data freedom-from-infection tool developed here to follow up data from high-risk sentinel sites in a region may offer a highly cost-effective framework for guiding the making of high-fiducial and defensible area-wide LF intervention stopping decisions.

The Prevalence of Lymphatic Filariasis Infection among Primary School Children (5-9 Years) of Infected Adults in Ihiala Local Government Area of Anambra State, Nigeria

Aims: To determine the prevalence of Lymphatic flariasis infection among primary school children and of infected adults in Ihiala LGA, Anambra State. Study design: Cross-sectional study. Place and Duration of Study: Department of the Ministry of Health Anambra State and a few selected primary school children in Ihiala Local Government Area between June 2021 and July 2022. Methodology: A total of 150 residents were examined for Lymphatic filariasis. In the Primary Health Centre, a screening for clinical manifestation was done among adults. Sample analysis was done using Filariasis Test Strip while Semi-structured questionnaires were used to collect data on knowledge, attitude and practices (KAP) among residents. Results: Out of 299 blood samples collected from school children and 150 questionnaires distributed to residents to ascertain the awareness of Lymphatic filariasis among residents in the study areas and also to evaluate the efficacy of Ivermectin and Albendazole distributed annually through Mass Drug Administration since 2014, Filariasis Test Strip (FTS) showed 0.0% prevalence of circulating filarial antigen among the school children while the total prevalence of clinical manifestations among residents was 43.33% with higher rate in males (57.33%) than females (42.67%) while forty to 49-year-olds recorded the highest prevalence (13.33%) of clinical manifestations. Statistical analysis was performed with ANOVA using SPSS package and the mean difference is significant at the .05 level that is the P value of the analysis is significant at ≥0.005 level. Conclusion: Our findings on Filariasis Test Strip (FTS) showed 0.0% prevalence of circulating filarial antigen among the school children implying that Lymphatic Filariasis transmissions is low in the study area, suggest the Ivermectin and Albendazole distributed through MDA since 2014 in the endemic areas of Anambra have been effective for Lymphatic filariasis control and should remain the recommended strategy for the elimination of Lymphatic filariasis.

Applying community health systems lenses to identify determinants of access to surgery among mobile & migrant populations with hydrocele in Zambia: A mixed methods assessment.

Hydrocele which is caused by long term lymphatic filariasis infection can be treated through the provision of surgery. Access to surgeries remains low particularly for hard to reach populations. This study applied community health system lenses to identify determinants to the adoption, implementation and integration of hydrocele surgeries among migrants &mobile populations in Luangwa District, Zambia. A concurrent mixed methods design consisting of cross-sectional survey with hydrocele patients (n = 438) and in-depth interviews with different community actors (n = 38) was conducted in October 2021. Data analysis was based on the relational and programmatic lenses of Community Health Systems. Under the Programmatic lens, insufficient resources resulted in most health facilities being incapable of providing the minimum package of care for lymphatic filariasis. The absence of cross border collaborative structures limits the continuity of care for patients moving across the three countries. Other programmatic barriers include language barriers, inappropriate appointment systems, direct and indirect costs. In the relational lens, despite the key role that community leaders play their engagement in service delivery was low. Community actors including patients were rarely included in planning, implementation or evaluation of hydrocele services. Some patients utilized their power within to act as champions for the surgery but local groups such as fishing associations remained underutilized. Community health systems provide a potential avenue through which access amongst mobile and migrant populations can be enhanced through strategies such engagement of patient groups, knowledge sharing across borders and use of community monitoring initiatives.

Mathematical study of the dynamics of lymphatic filariasis infection via fractional-calculus.

The infection of lymphatic filariasis (LF) is the primary cause of poverty and disability in individuals living with the disease. Many organizations globally are working toward mitigating the disease's impact and enhancing the quality of life of the affected patients. It is paramount to inspect the transmission pattern of this infection to provide effective interventions for its prevention and control. Here, we formulate an epidemic model for the progression process of LF with acute and chronic infection in the fractional framework. The basic concept of the novel Atangana-Baleanu operator is presented for the analysis of suggested system. We determine the basic reproduction number of the system via the approach of next-generation matrix and investigate the equilibria of the system for stability analysis. We have shown the impact of input factors on the outcomes of reproduction parameter with the help of partial rank correlation coefficient approach and visualize the most critical factors. To conceptualize the time series analysis of the suggested dynamics, we propose utilizing a numerical approach. The solution pathways of the system are illustrated to demonstrate how different settings affect the system. We demonstrate the dynamics of the infection numerically to educate the policy makers and health authorities about the mechanisms necessary for management and control.

Knowledge and participation in mass drug administration against lymphatic filariasis and soil-transmitted helminth infections among the community members in Dar es Salaam, Tanzania.

Although the WHO has made an effort to ensure optimal participation of the community in mass drug administration (MDA) against lymphatic filariasis (LF) and soil-transmitted helminth infections (STHIs), studies are still reporting suboptimal coverage. This study assessed the knowledge and participation of the community in MDA against LF and SHTIs in Tanzania to provide updates on its acceptability. A cross-sectional study was conducted in Dar es Salaam from December 2021 to February 2022 among market vendors. The information regarding demographic characteristics, knowledge and participation in MDA was collected using a questionnaire. Statistical Package for Social science version 26 was used for data analysis. More than half of the participants demonstrated an adequate level of knowledge of LF and STHI, 212 (50.8%) and 267 (64%), respectively. Only 286 (68.5%) reported having heard about MDA against LF and STHIs, out of which 119 (42%) had taken the medication. Of those who disagreed to participate in MDA, 20 (50%) claimed to fear the side effects of the medication. This study found that the community has average knowledge and poor participation in MDA against LF and STHIs. Community sensitization is recommended to increase the participation of the community.

Spatially Explicit Environmental Factors Associated with Lymphatic Filariasis Infection in American Samoa.

Under the Global Program to Eliminate Lymphatic Filariasis (LF) American Samoa conducted seven rounds of mass drug administration (MDA) between 2000 and 2006. Subsequently, the territory passed the WHO recommended school-based transmission assessment survey (TAS) in 2011/2012 (TAS-1) and 2015 (TAS-2) but failed in 2016, when both TAS-3 and a community survey found LF antigen prevalence above what it had been in previous surveys. This study aimed to identify potential environmental drivers of LF to refine future surveillance efforts to detect re-emergence and recurrence. Data on five LF infection markers: antigen, Wb123, Bm14 and Bm33 antibodies and microfilaraemia, were obtained from a population-wide serosurvey conducted in American Samoa in 2016. Spatially explicit data on environmental factors were derived from freely available sources. Separate multivariable Poisson regression models were developed for each infection marker to assess and quantify the associations between LF infection markers and environmental variables. Rangeland, tree cover and urban cover were consistently associated with a higher seroprevalence of LF-infection markers, but to varying magnitudes between landcover classes. High slope gradient, population density and crop cover had a negative association with the seroprevalence of LF infection markers. No association between rainfall and LF infection markers was detected, potentially due to the limited variation in rainfall across the island. This study demonstrated that seroprevalence of LF infection markers were more consistently associated with topographical environmental variables, such as gradient of the slope, rather than climatic variables, such as rainfall. These results provide the initial groundwork to support the detection of areas where LF transmission is more likely to occur, and inform LF elimination efforts through better understanding of the environmental drivers.

Occurrence of Lymphatic Filariasis infection after 15 years of mass drug administration in two hotspot districts in the Upper East Region of Ghana.

BackgroundLymphatic filariasis (LF) causes chronic morbidity, which usually manifests as lymphedema or hydrocele. Mass drug administration (MDA) began in Kassena Nankana East Municipal (KNEM) and Nabdam, two hotspot districts in the Upper East Region in Ghana, in 2000 and 2005, respectively. This cross-sectional study evaluated the impact of 15 years of MDA on the control of LF as determined by circulating filarial antigen (CFA) and microfilariae assessment in the KNEM and the Nabdam districts.Methodology/Principal findingsA total of 7,453 participants from eight sub-districts in the two hotspot districts (KNEM: N = 4604; Nabdam: N = 2849) were recruited into the study. The overall CFA prevalence as determined by the FTS was 19.6% and 12.8% in the KNEM and Nabdam districts, respectively. Manyoro, a sub-district on the border with Burkina Faso, recorded the highest CFA prevalence of 26% in the KNEM. Assessment of microfilariae and Og4C3 antigen was done from 1009 (KNEM: N = 799 (79.2%); Nabdam: N = 210 (20.8%)) randomly selected FTS-positive (N = 885) and FTS-negative (N = 124) individuals. The Og4C3 antigen was found in 22.6%/23.0% of the selected individuals (KNEM/Nabdam), whereas the night blood revealed microfilariae in only 0.7%/0.5%.Conclusions/SignificanceUsing the WHO endorsed FTS, CFA prevalence exceeded the long-standing <2% threshold—which may need revision and validation. Surprisingly, the Og4C3 ELISA showed positive results in only about one-fifth of the FTS positive samples. However, even this result would not have met the <2% CFA criteria for LF elimination. In contrast, projections from the microfilariae results revealed a halt in LF transmission. The global elimination target was due in 2020 but has been extended to 2030 since this could not be met. Focused MDA intervention intensification on seasonal migrants and non-compliers, and implementation of alternative treatment strategies may suffice for the elimination of the disease.

Charles Procedure for Elephantiasis in Lower Extremity: A Rare Case Report from Sanglah Hospital

Background: Elephantiasis is damage of the lymphatic vessels or destruction of lymph nodes that caused by filariasis infection. It was chronic and slowly progressive disease which decrease function and quality of life. There are two alternative approaches for surgery: reconstructive surgery and destructive surgery. The treatment aims to restore function, reduce physical and psychological suffering, and prevent the complication growth. Method: In this case report, a 43 years old male presented left lower extremity swelling. Based on clinical examination and investigation the patient was diagnosed with elephantiasis of lower extremity and a surgery will be done by Charles procedure. Result: This paper reported a successful Charles Procedure for elephantiasis of lower extremity. Due to the large mass of the tissue, our case was done by two-stage. After healthy granulation tissue is achieved, we planned to do skin grafting. Conclusion: Charles procedure is recommended for elephantiasis and can be adjuvant treatment. Although postoperative complication may occur, with the correct multidisciplinary support, significant improvements in function and quality of life can be achieved.

Impact of Semi-Annual Albendazole on Lymphatic Filariasis and Soil-Transmitted Helminth Infection: Parasitological Assessment after 14 Rounds of Community Treatment

ABSTRACT.Between October 2012 and October 2015, we conducted a community trial to assess the impact of semi-annual (twice yearly) community treatment with albendazole on lymphatic filariasis in Seke Pembe, a village in the Republic of the Congo. Semi-annual community treatment with albendazole has been continued in the community since October 2015. We conducted an additional parasitological assessment survey in October 2019, 6 months after the 14th round of semi-annual treatment. Between October 2012 and October 2015, Wuchereria bancrofti antigenemia and microfilaremia rates in the community had decreased from 17.3% to 4.7% and from 5.3% to 0.3%, respectively. In October 2019, the antigenemia rate had decreased further to 2.8% (19 of 687). No microfilariae were found in night blood smears from persons with circulating filarial antigenemia (0 of 16), suggesting that W. bancrofti transmission has been interrupted in Seke Pembe. Semi-annual albendazole treatments also reduced significantly infection rates with soil-transmitted helminths.

Prevalence of Methicillin-Resistant Staphylococcus Species Among Filarial Lymphedema Patients in Ahanta West District of Ghana

BackgroundFilarial pathologies such as lymphedema may be associated with complications such as chronic non-healing wounds. Nonetheless, the role of bacterial population colonizing the lymphedematous legs has been posited to worsen the conditions of those living with the infection. These bacteria are usually composed of staphylococcal species partly because they are commensals. Thus, this present study sought to type the methicillin-resistant Staphylococcus aureus (MRSA) prevalence among individuals presenting with filarial lymphedema, particularly as MRSA tends to affect treatments options.MethodsWe recruited individuals (n = 321) with stages I–VII of lymphedema in a cross-sectional study in the Ahanta West district of the Western Region of Ghana. Swabs from lymphedematous limb ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were later identified using Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry.ResultsA total of 192 Staphylococci species were isolated, with an overall prevalence of 39.7% (95% CI: 35%–44%; N = 483). S. hominis was the most prevalent species (23.95%), followed by S. haemolyticus (20.83%), S. epidermidis (15.10%), S. aureus (10.41%), and S. saprophyticus (9.32%). The remaining 20.34% were distributed among S. wanneri, S. sciuri, S. pasteuri, S. xylosus, S. simulans, S. cohnii, S. caprae, S. lugdunensis, and S. capitis. MRSA, containing mecA gene, was detected in 21 out of 31 Staphylococci isolates tested, with an overall prevalence of 68% (95% CI: 51%–84%). In addition, a virulent gene, Panton–Valentine leukocidin (PVL), which is usually associated with S. aureus, was detected in 20/31 (64.5%) S. aureus in the study.ConclusionThese results suggest that MRSA species may pose a challenge to the treatment of filarial lymphedema with antibiotics particularly, as doxycycline is currently being piloted in some endemic areas to treat the infection. Thus, intensive antimicrobial resistance surveillance should be conducted in endemic areas by health authorities to forestall the dilemma of multidrug resistance not only against lymphatic filariasis (LF) infection but other diseases.