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Epidemiology of Echinococcus granulosus sensu lato in the Greater Horn of Africa : a systematic review
(Public Library of Science, 2024-01-25) Aregawi, Weldegebrial G.; Levecke, Bruno; Ashenafi, Hagos; Byaruhanga, Charles; Kebede , Nigatu; Mulinge , Erastus; Wassermann, Marion; Romig, Thomas; Dorny, Pierre; Dermauw, Veronique
BACKGROUND : Cystic echinococcosis (CE) is a neglected zoonotic disease that is caused by Echinococcus granulosus sensu lato (s.l.), the life cycle of which involves multiple hosts. We conducted a systematic review (SR) on E. granulosus s.l. in the Greater Horn of Africa (GHA), to provide a picture of its recent epidemiology across all hosts.
METHODS : For this SR, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, five electronic databases, as well experts in the region were consulted to retrieve records published between 2000 and 2022, reporting the presence of E. granulosus s.l. infections in any natural host in the GHA (Djibouti, Eritrea, Ethiopia, Kenya, Sudan, Somalia, South Sudan, Tanzania and Uganda).
PRINCIPAL FINDINGS : A total of 247 records were retained, describing the presence of E. granulosus s.l. throughout the GHA, except for Djibouti. Only few population surveys on human CE were conducted in the area, with the prevalence ranging between 0.3 and 11.3%. In animals, the reported prevalence ranged up to 61.6% in camels, 88.4% in cattle; 65.2% in goats, 9.9% in pigs, 67.8% in sheep and 94.5% in dogs. In addition, E. granulosus s.l. was also reported in wildlife. A total of five species were reported in the different hosts, namely E. granulosus sensu stricto (G1, G3, GOmo), E. canadensis (G6/7), E. ortleppi (G5), E. felidis, and E. equinus (G4).
CONCLUSIONS : We confirm that E. granulosus s.l. is prevalent throughout the GHA. Nevertheless, despite our efforts to screen grey literature, an accurate assessment of the epidemiology in GHA remains challenging, due to the lack of combined host, in-depth risk factor and behavioural studies, as well as the wide diversity in subpopulations studied and diagnostic tools used. Interdisciplinary and transboundary partnerships would be essential for the design of effective control strategies, tuned to the GHA setting.
The importance of estimating the burden of disease from foodborne transmission of Trypanosoma cruzi
(Public Library of Science, 2024-02-08) Robertson, Lucy J.; Havelaar, Arie H.; Keddy, Karen H.; Devleesschauwer, Brecht; Sripa, Banchob; Torgerson, Paul R.
Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ transplant, laboratory accident, and foodborne transmission. Foodborne transmission may occur due to ingestion of meat or blood from infected animals or from ingestion of other foods (often fruit juice) contaminated by infected vectors or secretions from reservoir hosts. Despite the high disease burden associated with ChD, it was omitted from the original World Health Organization estimates of foodborne disease burden that were published in 2015. As these estimates are currently being updated, this review presents arguments for including ChD in new estimates of the global burden of foodborne disease. Preliminary calculations suggest a burden of at least 137,000 Disability Adjusted Life Years, but this does not take into account the greater symptom severity associated with foodborne transmission. Thus, we also provide information regarding the greater health burden in endemic areas associated with foodborne infection compared with vector-borne infection, with higher mortality and more severe symptoms. We therefore suggest that it is insufficient to use source attribution alone to determine the foodborne proportion of current burden estimates, as this may underestimate the higher disability and mortality associated with the foodborne infection route.
Seroprevalence and risk factors of brucellosis in pastoralists and their livestock in Central Equatoria State, South Sudan
(Public Library of Science, 2024-12-19) Lita, Emmanuel P.; Ochi, Erneo B.; Misinzo, Gerald; Van Heerden, Henriette; Katani, Robab; Godfroid, Jacques; Mathew, Coletha
BACKGROUND : Brucellosis poses serious public health implications and substantial economic losses in pastoral rural settings in South Sudan. In humans, brucellosis is almost always originating from animals. Current literature provides scant data regarding the seroprevalence of brucellosis in South Sudan. This cross-sectional study investigates the seroprevalence of brucellosis among the pastoral community and livestock and identifies risk factors for the disease from two Counties, Terekeka and Juba in Central Equatoria State (CES), South Sudan.
METHODOLOGY : A total of 986 sera; from humans (n = 143), cattle (n = 478), sheep (n = 86), and goats (n = 279) were randomly collected from 17 cattle camps in CES. Sera for the humans, cattle and goats were screened for Brucella-specific antibodies using Rose Bengal plate test (RBPT) and further confirmed by competitive enzyme-linked immunosorbent assay (c-ELISA) in series due to the cost of testing. All the sera from sheep were tested in parallel using RBPT and c-ELISA as the sheep samples were few and were all tested negative on the RBPT. A camp was considered positive when at least one animal of either species tested positive on the c-ELISA. A structured questionnaire was used to collect information on potential individual and herd level risk factors. Univariate analysis using binary logistic regression with a confidence interval of 95% at a p-value of ≤ 0.05 was used to identify the association between the potential individual risk factors and Brucella seropositivity. The investigated risk factors for livestock included age, sex, species, prior abortion history, retained placenta, parity, and reproductive status. Variables found to have associations in univariate analysis (p = 0.25) with Brucella seropositivity were further included in multivariable logistic regression. The risk factors investigated for humans included, gender, age, educational level, occupation, marital status, drinking of raw milk, aiding female animals during delivery, eating undercooked meat and blowing of air into the cow’s uterus through the vagina, a practice in South Sudan.
RESULTS : The study revealed seroprevalence of 21.7%, 11.8%, and 4.8% in cattle, goats, and humans, respectively. Our results indicated that all sheep serum samples were negative on both RBPT and c-ELISA. The seropositive in the 13 camps from Terekeka County was 100.0% (13/13) compared to 50.0% (2/4) seropositive from 4 camps in Juba County. All the variables investigated in the univariate analysis of risk factors in cattle were significantly associated with Brucella seropositivity: sex (OR:4.5, 95% CI: 2.2–8.9, p<0.001), age (OR:6.6, 95% CI: 2.3–19.1, p:<0.001), abortion history (OR:3.1, 95% CI: 1.8–5.2, p:<0.001), retained placenta (OR:2.5, 95% CI: 1.4–4.4, p = 0.001), parity (OR:2.3, 95% CI: 1.1–4.7, p = 0.020), However, in small ruminants, none of the potential risk factors were associated with Brucella seropositivity. In humans, blowing air through a cow’s vagina (OR: 1.4, 95%CI: 0.782–2.434, p = 0.035) was the only variable found to be significantly associated with Brucella seropositivity in the univariate analysis. The forceful blowing of air into a cow’s vagina to induce milk letdown is a common practice among the pastoral communities in South Sudan.
The multivariable logistic regression model identified sex, age, and abortion history as statistically significant factors for Brucella seropositivity in cattle. The odds of seropositivity were nearly threefold (OR: 2.8; 95% CI: 1.3–5.8, p = 0.006) higher in cows compared to bulls (male cattle). Cattle over two years old had higher odds of Brucella seropositivity than young animals (OR: 3.5, 95% CI: 1.2–10.3-, p: 0.025). Cows with a history of abortion had higher odds of Brucella seropositivity (OR: 2.8, 95% CI: 1.6–4.7, p = 0.001).
CONCLUSIONS : This study reports the occurrence of brucellosis in goats and its absence in sheep in (CES), South Sudan. The present study also shows the occurrence of brucellosis in cattle, goats and people in the pastoral community and recommends for the implementation of the One Health approach and awareness campaigns for effective mitigation of this disease.
Development of a molecular genetics and cell biology toolbox for the filamentous fungus Diplodia sapinea
(Public Library of Science, 2024-12-27) Oostlander, Anne Geertje; Brodde, Laura; Von Bargen, Miriam; Slippers, Bernard; Becker, Yvonne; Brandt, Ulrike; Klawonn, Frank; Grobler, Christiaan; Well, Lucas; Stenlid, Jan; Oliva, Jonas; Elfstrand, Malin; Fleissner, Andre
Diplodia sapinea (Fr.) Fuckel is a widespread fungal pathogen affecting conifers worldwide. Infections can lead to severe symptoms, such as shoot blight, canker, tree death, or blue stain in harvested wood, especially in Pinus species. Its impact on forest health is currently intensified, likely due to climate change, posing an increasing threat to global ecosystems and forestry. Despite extensive and successful research on this pathogen system, fundamental questions about its biology and plant-associated lifestyle remain unanswered. Addressing these questions will necessitate the development of additional experimental tools, including protocols for molecular genetics and cell biology approaches. In this study, we continue to address this need by establishing an Agrobacterium-mediated genetic transformation protocol for D. sapinea, enabling targeted mutagenesis and heterologous gene expression. We utilized this methodology to localize the histone H2B by tagging it with the fluorescent protein mCherry. Additionally, we established a time- and space-efficient laboratory-scale infection assay using two-week-old Pinus sylvestris seedlings. Integrating these tools in a proof-of-concept study enabled the visualization of D. sapinea in planta growth through the fluorescently labeled reporter strain.
Evaluation of oral health services and challenges faced by oral health practitioners working in Nyarugenge, Rwanda
(Public Library of Science, 2024-08-19) Nzabonimana, Emmanuel; Malele-Kolisa, Yolanda; Hlongwa, Phumzile
OBJECTIVE : Oral healthcare professionals encounter considerable challenges while providing services to curb the oral disease burden. The aim of this study was to explore the challenges faced by oral health practitioners providing oral health services in Nyarugenge, Rwanda and to appraise the availability and adequacy of oral hygiene equipment, instruments, and materials.
METHODS : This was a cross-sectional concurrent mixed methods study. The quantitative and qualitative parts were independent during data collection and analyses and merged during the interpretation phase. All seven public health facilities and 14 dental professionals working in Nyarugenge were included in the study. Data were collected using an audit checklist and an in-depth interview guide. Descriptive statistics were used to analyze the quantitative data. The interviews were analyzed using thematic content analysis.
RESULTS : Most of the dental health professionals were dental therapists (n = 11), women (n = 9), aged 31–40 years (n = 7), and with 11–20 years’ experience as oral health practitioners (n = 6). There were five health centers and two hospitals that were audited for equipment, instruments, and materials. The audit of the facilities revealed that most facilities have dental equipment and instruments, but none have adequate preventive dental instruments and materials. Four broad themes emerged from the interviews with the oral health practitioners, namely human resources, supply chain management, patients’ oral health awareness and service rendering, and strategic management and administration. The most significant challenges oral health practitioners faced included high dental practitioner/patient ratios, lack of adequate and appropriate equipment and materials, patients’ lack of oral health awareness, and a lack of administrative support.
CONCLUSIONS : Well-established community preventive interventions, such as a mobile oral health App, could reduce the patient/provider ratio by increasing population awareness of oral health and encouraging healthy behaviours. The management of the health facilities should address the human resource challenges and equipment supply chain issues.