Human African Trypanosomiasis Foci Research Articles

Domestic animals as potential reservoir hosts ofTrypanosoma brucei gambiensein sleeping sickness foci in Cameroon

An explanation of the endemic nature and/or the resurgence of Human African Trypanosomiasis (HAT) in the historic foci in West and Central Africa may be the existence of an animal reservoir. In some HAT foci, pigs were found infected by Trypanosoma brucei gambiense but the implication of the other domestic animals was not quite evaluated. This study aims to determine the prevalence of T. b. gambiense in domestic animal species (goat, sheep, pig and dog) commonly found in the four active HAT foci in Cameroon (Bipindi, Fontem, Campo and Doumé). Blood samples were collected from 307 pigs, 264 goats, 267 sheep and 37 dogs and used for parasitological (QBC), immunological (LiTat 1.3 CATT) and molecular (PCR) analyses. QBC detected trypanosomes in 3.88% domestic animals while 22.7% were sero-positive with LiTat 1.3 CATT tests. Of the 875 animals analysed, 174 (19.88%) harboured T. brucei s.l. DNA, found in each of the four types of animal and in the four localities. The infection rate significantly differed among the animal species (p < 0.0001) and localities (p < 0.0001). The PCR also revealed T. b. gambiense group 1 DNA in 27 (3.08 %) domestic animals. The specific infection rates were as follows: sheep (6.74%), goats (3.08%), pigs (0.32%) and dogs (O%). T. b. gambiense was found in 8 (3.92%) animals from Bipindi, 15 (4.83%) from Campo, 4 (2.59%) from FontemCenter and none from Doumé. The infection rates significantly differed between the localities, and correlated with the intensity of HAT transmission in the foci.

Tripartite interactions between tsetse flies, Sodalis glossinidius and trypanosomes—An epidemiological approach in two historical human African trypanosomiasis foci in Cameroon

Epidemiological surveys were conducted in two historical human African trypanosomiasis foci in South Cameroon, Bipindi and Campo. In each focus, three sampling areas were defined. In Bipindi, only Glossina palpalis was identified, whereas four species were identified in Campo, G. palpalis being highly predominant (93%). For further analyses, 75 flies were randomly chosen among the flies trapped in each of the six villages. Large and statistically significant differences were recorded between both (1) the prevalence of Sodalis glossinidius (tsetse symbiont) and the prevalence of trypanosome infection of the major fly species G. p. palpalis and (2) the respective prevalence of symbiont and infection between the two foci. Despite these differences, the rate of infected flies harbouring the symbiont was very similar (75%) in both foci, suggesting that symbionts favour fly infection by trypanosomes. This hypothesis was statistically tested and assessed, showing that S. glossinidius is potentially an efficient target for controlling tsetse fly vectorial competence and consequently sleeping sickness.

Molecular identification of T. brucei s.l. in tsetse flies after long-term permanence in field traps

Tsetse flies (Glossina spp.) are responsible for the transmission of trypanosomes, agents of animal and Human African Trypanosomiasis (HAT). These diseases are associated with considerable animal and human economical loss, morbidity and mortality. The correct identification of trypanosomes species infecting tsetse flies is crucial for adequate control measures. Identification presently requires technically difficult, cumbersome and expensive on-site fly dissection. To obviate this difficulty we explored the possibility of correctly identifying trypanosomes in tsetse collected, under field conditions, only for number determination. Tsetse flies, that remained exposed for weeks in field traps in the Vista Alegre HAT focus in Angola, were obtained. The flies were not dissected on site and were stored at room temperature for months. DNA extraction using the whole tsetse bodies and PCR analysis were performed in 73 randomly chosen flies. Despite the extensive degradation of the tsetse, DNA extraction was conducted successfully in 62 out of the 73 flies. PCR analysis detected the presence of T. brucei s.l DNA in 3.2 % of the tsetse. This approach could be cost-effective and suitable for vector related HAT control activities in the context of countries where entomological trained personnel is missing and financial resources are limited.

Spatially and Genetically Distinct African Trypanosome Virulence Variants Defined by Host Interferon‐γ Response

We describe 2 spatially distinct foci of human African trypanosomiasis in eastern Uganda. The Tororo and Soroti foci of Trypanosoma brucei rhodesiense infection were genetically distinct as characterized by 6 microsatellite and 1 minisatellite polymorphic markers and were characterized by differences in disease progression and host-immune response. In particular, infections with the Tororo genotype exhibited an increased frequency of progression to and severity of the meningoencephalitic stage and higher plasma interferon (IFN)- gamma concentration, compared with those with the Soroti genotype. We propose that the magnitude of the systemic IFN- gamma response determines the time at which infected individuals develop central nervous system infection and that this is consistent with the recently described role of IFN- gamma in facilitating blood-brain barrier transmigration of trypanosomes in an experimental model of infection. The identification of trypanosome isolates with differing disease progression phenotypes provides the first field-based genetic evidence for virulence variants in T. brucei rhodesiense.

Tsetse fly host preference from sleeping sickness foci in Cameroon: Epidemiological implications

To determine the tsetse fly host preferences in two sleeping sickness foci of southern Cameroon, four entomological surveys (two in each focus) were carried out. For the whole study, 4929 tsetse flies were caught: 3933 (79.8%) Glossina palpalis palpalis, 626 (12.7%) Glossina pallicera pallicera, 276 (5.6%) Glossina nigrofusca and 94 (1.9%) Glossina caliginea. One hundred and thirty-eight blood meals were collected and the origin of 118 (85.5%) meals was successfully identified: 38.4% from man, 23.9% from pig, 20.3% from sitatunga ( Tragelaphus spekeii), 2.2% from sheep and 0.7% from golden cat ( Profilis aurata). The number of Glossina palpalis palpalis with man blood meals is more important in the Human African Trypanosomiasis (HAT) focus showing endemic evolution (Campo) than in the focus (Bipindi) presenting a flare up of the disease. The consideration of both results of the prevalence of Trypanosoma brucei gambiense in vertebrate hosts and those of the tsetse fly host preferences indicates a wild animal reservoir of Gambian sleeping sickness and three transmission cycles (human, domestic and wild animals’ cycles) in southern Cameroon HAT foci.

Hosts ofGlossina fuscipes fuscipesandG. pallidipesin areas of western Kenya with endemic sleeping sickness, as determined using an egg-yolk (IgY) ELISA

Bloodmeal sources of Glossina fuscipes fuscipes and G. pallidipes, from the western Kenyan foci of human African trypanosomiasis (HAT) on Mageta Island and in Busia district, were identified using an ELISA based on chicken egg-yolk (IgY) antibodies. After absorption with cross-reacting antigens, the antibodies, which were produced against representatives of eight families of vertebrate host, were capable of differentiating serum from the different families. With the ELISA, it was possible to identify the family of host for 100% of laboratory-fed flies tested up to 48 h post-bloodmeal but only for 12% of such flies tested 96 h post-feed. Subsequently, attempts were made to identify the family of host that was the source of the (most recent) bloodmeal for each of 223 wild-caught flies, and these attempts were successful for 142 (63.7%) of the samples. Among the flies with identified bloodmeals, most (81.9%) of the G. f. fuscipes caught on Mageta Island had last fed on reptiles whereas most of the G. f. fuscipes (70.4%) and G. pallidipes (57.1%) caught in Busia had last fed on bovids. Bloodmeals of human origin accounted for <2% of the bloodmeals identified, perhaps indicating that, in the presence of alternative hosts, humans are not attractive hosts for tsetse in the study areas. This finding may account for the low reported incidence of HAT, despite the presence of circulating human-infective trypanosomes. In Busia at least, the use of animals, especially cattle, covered in insecticide would probably be an effective method of controlling the tsetse vectors of the trypanosomes that cause human and 'animal' trypanosomiases.

Wild fauna as a probable animal reservoir for Trypanosoma brucei gambiense in Cameroon

In order to study the existence of a wild animal reservoir for Trypanosoma brucei gambiense in South Cameroon, blood was collected from wild animals in three human African trypanosomiasis foci and from a nonendemic control area. The 1142 wild animals sampled belonged to 36 different species pertaining to eight orders (407 primates, 347 artiodactyls, 265 rodents, 54 pangolins, 53 carnivores, 11 saurians and crocodilians, and five hyraxes). QBC ® and KIVI tests detected trypanosomes on 1.7% (13/762) and 18.4% (43/234) of animals examined, respectively. Using specific primers, T. brucei non-gambiense group 1 DNA was detected on 56 animals (4.9%). This infection rate was 5.3% in the endemic zone and 3.8% in the control zone. Of the 832 animals of the endemic zone, PCR revealed T. b. gambiense group 1 DNA in 18 (2.2%). These hosts included two rodents, two artiodactyls, two carnivores and two primates. T. b. gambiense group 1 was absent from animals from the nonendemic zone. A decrease in the prevalence of T. b. gambiense group 1 was observed in wild animals from the Bipindi sleeping sickness focus after a medical survey and vector control in this area. The epidemiological implications of these findings remain to be determined with further investigations.

Trypanosoma brucei s.l.: Characterisation of stocks from Central Africa by PCR analysis of mobile genetic elements

To better understand the epidemiology of sleeping sickness in the Central African sub-region, notably the heterogeneity of Human African Trypanosomiasis (HAT) foci, the mobile genetic element PCR (MGE-PCR) technique was used to genotype Trypanosoma brucei s.l. ( T. brucei s.l.) isolates from this sub-region. Using a single primer REV B, which detects positional variation of the mobile genetic element RIME, via amplification of flanking regions, MGE-PCR revealed a micro genetic variability between Trypanosoma brucei gambiense ( T. b. gambiense) isolates from Central Africa. The technique also revealed the presence of several T. b. gambiense genotypes and allowed the identification of minor and major ubiquitous genotypes in HAT foci. The presence of several T. b. gambiense genotypes in HAT foci may explain the persistence and the resurgence phenomena of the disease and also the epidemic and the endemic status of some Central African sleeping sickness foci. The MGE-PCR technique represents a simple, rapid, and specific method to differentiate Central African T. brucei s.l. isolates.

Resurgence of sleeping sickness in Tambura County, Sudan.

Endemic foci of human African trypanosomiasis are present in southern Sudan. In 1996 and 1997, trypanosomiasis increased sharply in Tambura County. To define the magnitude and geographic distribution of the outbreak, we conducted a prevalence survey using population-based cluster sampling in 16 villages: 1,358 participants answered questions about routine activities and tsetse fly contact and received serologic testing. Seroprevalence in the surveyed area was 19.4% (95% confidence interval = 16.9%, 21.8%). We confirmed infection in 66% of seropositive persons who received one parasitologic examination and in 95% of those who had serial examinations of lymph node fluid and blood. Activities related to the civil war, such as temporary migration, were not associated with seropositive status. Since the previous population screening in 1988, the trypanosomiasis prevalence increased two orders of magnitude, and the proportion of villages affected increased from 54% to 100%. Our results suggest that there may be 5,000 cases in Tambura County. The absence of trypanosomiasis control for nearly a decade is a factor in the resurgence of the disease.

Incidence of African trypanosomiasis and the density of settlements in the forests of Côte d'Ivoire: the possibility of predicting high risk areas for surveillance of disease reservoirs

In the forests of Côte d'Ivoire a surveillance network is needed to quickly and continuously detect cases of Human African Trypanosomiasis (HAT). This requires knowledge of high risk areas, and thus of an appropriate epidemiological indicator. Study of several HAT foci in Côte d'Ivoire shows a striking correlation between epidemiological risk and settlement density by square kilometer (r = 0983; P < 0.05). Epidemiological risk and disease incidence will increase up to the point when human influence eradicates the vector. This hypothesis is supported by the correlation between settlement density (d) and cumulative incidence: i = 0988 d - 0967 (r = 0.951). The prevalence would be 0.5% from 1.5 settlements per km2, and 1% from a density of 2. The first results of remote sensing indicate that it is possible to identify forest areas where settlement density has reached a critical level.

Measurement of risk in endemic areas of human African trypanosomiasis in Côte d'Ivoire

An index of epidemiological risk was developed for the foci of human African trypanosomiasis (HAT) in the forest zone of Côte d'Ivoire, based on the following characteristics of Glossina palpalis palpalis populations: daily survival rate, apparent density of teneral males and females, and frequency of human-fly contact. The index agreed well with HAT prevalence. It varied according to ethnic groups and with seasonal changes in agricultural activities and fell rapidly to zero following the start of an anti-vector control campaign. Further studies in different biogeographical zones are desirable in order to substantiate the validity of the index.

The Laboratory Diagnosis of Malaria

Human and animal African trypanosomiases impose a large economic and health burden in their endemic regions. Large strides have been made in the control of human African trypanosomiasis (HAT), yet these efforts have largely focused on the non-zoonotic form of the disease. Using a mathematical model with a 10 year time horizon, we demonstrate the role of the cattle treatment with trypanocides in the epidemiology of zoonotic and non-zoonotic HAT in Uganda, and its potential implications on elimination and eradication of the disease.We created two compartmental, deterministic models, each comprised of three sub-models: humans, the tsetse fly vector (Glossina fuscipes fuscipes), and cattle. We applied these models to two HAT foci in Uganda: the gambiense (chronic, non-zoonotic) form in the Northern Region, and the rhodesiense (acute, zoonotic) form in the Eastern Region. Parameters were derived from prior literature or assumed. In both foci we assumed G. fuscipes fuscipes expresses zoophilic biting behavior.With trypanocide treatment of cattle administered every 3 months, treatment in stage I (representing engagement in active or passive surveillance) had a larger impact on HAT burden than cattle treatment coverage. However increasing cattle treatment coverage allowed for further reduction in prevalence in both foci. Using these model parameters, our estimated R0 suggests humans cannot alone sustain the HAT epidemic in Uganda.Even in the absence of zoonotic transmission, loss of a preferred tsetse host species can affect HAT risk. Thus One Health strategies which integrate HAT and animal African trypanosomiasis control may improve the timeliness and sustainability of gHAT and rHAT elimination and eradication in Uganda. Furthermore, such strategies reduce the burden of a high-morbidity livestock disease of economic importance.