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Ndiour CN, Senghor B, Thiam O, Niang S, Wotodjo AN, Faye BT, Ndiaye NA, Sow O, Sylla K, Ndiaye M, Gaye O, Faye B, Sokhna C, Doucouré S, Sow D. Prevalence and associated factors of schistosomiasis among pregnant women in northern Senegal. BMC Infect Dis 2024; 24:682. [PMID: 38982383 PMCID: PMC11232235 DOI: 10.1186/s12879-024-09443-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/28/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Schistosomiasis remains a public health concern worldwide. It is responsible for more than 240 million cases in 78 countries, 40 million of whom are women of childbearing age. In the Senegal River basin, both Schistosoma haematobium and Schistosoma mansoni are very prevalent in school-age children. However, there is a lack of information on the burden of schistosomiasis in pregnant women, which can cause complications in the pregnancy outcome. This study aimed to determine the prevalence and associated factors of schistosomiasis in pregnant women. METHODS We conducted a prospective cross-sectional study of pregnant women attending antenatal clinics at the health center of the Senegalese Sugar Company and at the hospital of Richard Toll between August and December 2021. The urine and stool samples collected were examined using microscopy techniques and quantitative polymerase chain reaction (qPCR) to detect the presence of S. haematobium and S. mansoni. The urines were previously tested using urine reagent strips to detect hematuria and proteinuria. Socio-demographical, clinical, and diagnostically data were recorded by the midwife and the gynaecologist. The data were analyzed using a logistic regression model. RESULTS Among the 298 women examined for the infection by microscopic, 65 (21.81%) were infected with urogenital schistosomiasis, 10 (3.36%) with intestinal schistosomiasis, and 4 (1.34%) were co-infected with both types of schistosomiasis. Out of the 288 samples tested by qPCR, 146 (48.99%) were positive for S. haematobium, 49 (35.51%) for S. mansoni and 22 (15.94%) for both species (co-infection). Pregnant women having microscopic haematuria and proteinuria were significantly more infected (p < 0.05). CONCLUSION This study has revealed a high prevalence of schistosomiasis in pregnant women in Senegal. The qPCR allowed us to detect more cases compared to the microscopy. There is a need to conduct more studies to understand the real burden of the disease and to set up a surveillance system to prevent pregnancy-related complications.
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Affiliation(s)
- Coumba Nar Ndiour
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, de Saint-Louis, Senegal
| | - Bruno Senghor
- EMR MINES: Maladies Infectieuses, Négligées et Émergentes au Sud, Institut de Recherche pour le Développement, Campus International Institut de Recherche pour le Développement-Université-Cheikh Anta Diop of Hann, BP 1386, Dakar, Sénégal
| | - Ousmane Thiam
- Service de Gynécologie-Obstétrique, UFR Sciences de la Santé, Université Gaston Berger, de Saint-Louis, Senegal
| | - Souleymane Niang
- Centre de Santé, Compagnie Sucrière Sénégalaise, Richard Toll, Richard Toll, Senegal
| | - Amélé Nyedzie Wotodjo
- EMR MINES: Maladies Infectieuses, Négligées et Émergentes au Sud, Institut de Recherche pour le Développement, Campus International Institut de Recherche pour le Développement-Université-Cheikh Anta Diop of Hann, BP 1386, Dakar, Sénégal
| | - Babacar Thiendella Faye
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, de Saint-Louis, Senegal
| | - Ndeye Amy Ndiaye
- Direction de la Santé de la Mère et de l'Enfant, Ministère de la Santé et de l'Action Sociale, Dakar, Senegal
| | - Omar Sow
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, de Saint-Louis, Senegal
| | - Khadime Sylla
- Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, de Dakar, Senegal
| | - Magatte Ndiaye
- Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, de Dakar, Senegal
| | - Oumar Gaye
- Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, de Dakar, Senegal
| | - Babacar Faye
- Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, de Dakar, Senegal
| | - Cheikh Sokhna
- EMR MINES: Maladies Infectieuses, Négligées et Émergentes au Sud, Institut de Recherche pour le Développement, Campus International Institut de Recherche pour le Développement-Université-Cheikh Anta Diop of Hann, BP 1386, Dakar, Sénégal
| | - Souleymane Doucouré
- EMR MINES: Maladies Infectieuses, Négligées et Émergentes au Sud, Institut de Recherche pour le Développement, Campus International Institut de Recherche pour le Développement-Université-Cheikh Anta Diop of Hann, BP 1386, Dakar, Sénégal
| | - Doudou Sow
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, de Saint-Louis, Senegal.
- EMR MINES: Maladies Infectieuses, Négligées et Émergentes au Sud, Institut de Recherche pour le Développement, Campus International Institut de Recherche pour le Développement-Université-Cheikh Anta Diop of Hann, BP 1386, Dakar, Sénégal.
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2
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Perera DJ, Koger-Pease C, Paulini K, Daoudi M, Ndao M. Beyond schistosomiasis: unraveling co-infections and altered immunity. Clin Microbiol Rev 2024; 37:e0009823. [PMID: 38319102 PMCID: PMC10938899 DOI: 10.1128/cmr.00098-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Cal Koger-Pease
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Kayla Paulini
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mohamed Daoudi
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Canada
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3
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Kołodziej P, Szostakowska B, Lass A, Sulima M, Sikorska K, Kocki J, Krupski W, Starownik D, Bojar P, Szumiło J, Kasztelan-Szczerbińska B, Cichoż-Lach H, Bogucki J, Szymańska M, Fota-Markowska H, Bogucka-Kocka A. Chronic intestinal schistosomiasis caused by co-infection with Schistosoma intercalatum and Schistosoma mansoni. THE LANCET. INFECTIOUS DISEASES 2024; 24:e196-e205. [PMID: 37783223 DOI: 10.1016/s1473-3099(23)00486-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/23/2023] [Accepted: 07/19/2023] [Indexed: 10/04/2023]
Abstract
The Grand Round concerns a 24-year-old man from Zimbabwe who was studying and living in Poland. The patient had been complaining of abdominal pain, fatigue, alternating diarrhoea and constipation, and presence of blood in his stool for 3 years. The patient had the following diagnostic tests: colonoscopy, CT scan, histopathology, and parasitological and molecular tests. Results of the examinations showed that the cause of the patient's complaints was chronic intestinal schistosomiasis due to the co-infection with Schistosoma intercalatum and Schistosoma mansoni. The patient had two cycles of praziquantel therapy (Biltricide) and responded well to the treatment. In the Grand Round, we describe full diagnostics as well as clinical and therapeutic management in the patient with S intercalatum and S mansoni co-infection. This case allows us to draw attention to cases of forgotten chronic tropical diseases (including rare ones) in patients from regions with a high endemic index staying in non-endemic regions of the world for a long time. Co-infection with S intercalatum and S mansoni should be considered as a very rare clinical case.
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Affiliation(s)
- Przemysław Kołodziej
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland.
| | - Beata Szostakowska
- Department of Tropical Parasitology, Medical University of Gdańsk, Gdańsk, Poland.
| | - Anna Lass
- Department of Tropical Parasitology, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Sulima
- Division of Tropical and Parasitic Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna Sikorska
- Division of Tropical and Parasitic Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Janusz Kocki
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Witold Krupski
- Department of Medical Radiology, Medical University of Lublin, Lublin, Poland
| | - Dorota Starownik
- Independent Public Clinical Hospital No. 4 in Lublin, Medical University of Lublin, Lublin, Poland
| | - Paweł Bojar
- Department of Pathomorphology, Beskid Oncology Centre-John Paul II Memorial City Hospital in Bielsko-Biala, Bielsko-Biała, Poland
| | - Justyna Szumiło
- Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
| | | | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Lublin, Poland
| | - Jacek Bogucki
- Department of Organic Chemistry, Medical University of Lublin, Lublin, Poland
| | - Magdalena Szymańska
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland
| | | | - Anna Bogucka-Kocka
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland
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Bottieau E, Mbow M, Brosius I, Roucher C, Gueye CT, Mbodj OT, Faye BT, De Hondt A, Smekens B, Arango D, Burm C, Tsoumanis A, Paredis L, Van Herrewege Y, Potters I, Richter J, Rosanas-Urgell A, Cissé B, Mboup S, Polman K. Antimalarial artesunate-mefloquine versus praziquantel in African children with schistosomiasis: an open-label, randomized controlled trial. Nat Med 2024; 30:130-137. [PMID: 38177851 PMCID: PMC10803269 DOI: 10.1038/s41591-023-02719-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024]
Abstract
Schistosomiasis treatment entirely relies on a single drug, praziquantel, prompting research into alternative therapeutics. Here we evaluated the efficacy and safety of the antimalarial combination artesunate-mefloquine for the treatment of schistosomiasis in a proof-of-concept, pragmatic, open-label, randomized controlled trial in primary schools of six villages endemic for schistosomiasis in northern Senegal. Children (6-14 years) were eligible if Schistosoma eggs were detected by microscopy in urine and/or stool. In total, 726 children were randomized 1:1 to praziquantel (standard care: 40 mg kg-1 single dose; n = 364) or to artesunate-mefloquine (antimalarial dosage: artesunate 4 mg kg-1 and mefloquine 8 mg kg-1 daily for three consecutive days; n = 362). Eight children not meeting the inclusion criteria were excluded from efficacy analysis. Median age of the remaining 718 participants was 9 years; 399 (55.6%) were male, and 319 (44.4%) female; 99.3% were infected with Schistosoma haematobium and 15.2% with S. mansoni. Primary outcomes were cure rate, assessed by microscopy, and frequency of drug-related adverse effects of artesunate-mefloquine versus praziquantel at 4 weeks after treatment. Cure rate was 59.6% (208/349) in the artesunate-mefloquine arm versus 62.1% (211/340) in the praziquantel arm. The difference of -2.5% (95% confidence interval (CI) -9.8 to 4.8) met the predefined criteria of noninferiority (margin set at 10%). All drug-related adverse events were mild or moderate, and reported in 28/361 children receiving artesunate-mefloquine (7.8%; 95% CI 5.4 to 11.0) versus 8/363 (2.2%; 95% CI 1.1 to 4.3) receiving praziquantel (P < 0.001). Artesunate-mefloquine at antimalarial dosage was moderately safe and noninferior to standard-care praziquantel for the treatment of schistosomiasis, predominantly due to S. haematobium. Multicentric trials in different populations and epidemiological settings are needed to confirm these findings. ClinicalTrials.gov identifier: NCT03893097 .
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Affiliation(s)
- Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Moustapha Mbow
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
- Department of Immunology, Cheikh Anta Diop University, Dakar, Senegal
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Clémentine Roucher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Cheikh Tidiane Gueye
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Ousmane Thiam Mbodj
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Babacar Thiendella Faye
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Annelies De Hondt
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bart Smekens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Diana Arango
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christophe Burm
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Linda Paredis
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Idzi Potters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Berlin, Germany
| | - Anna Rosanas-Urgell
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Badara Cissé
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Souleymane Mboup
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Katja Polman
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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5
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Diop B, Sylla K, Kane NDMB, Boh OK, Guèye B, Ba M, Talla I, Mané M, Monteil R, Kinvi B, Zoure HGM, Ortega JC, Mwinzi P, Sacko M, Faye B. Schistosomiasis control in Senegal: results from community data analysis for optimizing preventive chemotherapy intervention with praziquantel. Infect Dis Poverty 2023; 12:106. [PMID: 38008772 PMCID: PMC10680307 DOI: 10.1186/s40249-023-01155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Over the past two decades, preventive chemotherapy (PC) with praziquantel (PZQ) is the major strategy for controlling schistosomiasis in Senegal. The objective of this analysis was to update the endemicity of schistosomiasis at community level for better targeting mass treatment with PZQ in Senegal. METHODS Demographic and epidemiological data from 1610 community health areas were analyzed using the schistosomiasis community data analysis tool of Expanded Special Project for Elimination of Neglected Tropical Diseases which developed by World Health Organization/Africa Office (WHO/AFRO). The tool uses a WHO/AFRO decision tree for areas without epidemiological data to determine whether mass treatment should be continued at community level. Descriptive analysis was performed. RESULTS Overall, the endemicity of 1610 community health areas were updated based on the data from the district endemicity (33.5%) and the form of Join request for selected PC medicine (40.5%). Up to 282 (17.5%) and 398 (24.7%) of community health areas were classified as moderate and high endemicity. 41.1% of communities were non endemic. High endemicity was more important in Tambacounda, Saint Louis, Matam, Louga and Kedougou. A change in endemicity category was observed when data was disagregted from district level to community level. Implementation units classified non endemic were more important at community level (n = 666) compared to district level (n = 324). Among 540 areas previously classified high endemic at district level, 392 (72.6%) remained high prevalence category, while 92 (17.0%) became moderate, 43 (8.0%) low and 13 (2.4%) non-endemics at community level. Number of implementation units requiring PC was more important at district level (1286) compared to community level (944). Number of school aged children requiring treatment was also more important at district level compared to community level. CONCLUSIONS The analysis to disaggregate data from district level to community level using the WHO/AFRO schistosomiasis sub-district data optimization tool provide an update of schistosomiasis endemicity at community level. This study has allowed to better target schistosomiasis interventions, optimize use of available PZQ and exposed data gaps.
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Affiliation(s)
- Boubacar Diop
- Programme National de Lutte Contre les Bilharzioses et les Géo-Helminthiases, Direction de la Lutte Contre la Maladie (DLM), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Khadime Sylla
- Department of Parasitology and Mycology Faculty of Medicine, Pharmacy and Odontology, Université Cheikh Anta Diop de Dakar (UCAD), Dakar, Senegal.
| | - NDèye MBacké Kane
- Programme National de Lutte Contre les Bilharzioses et les Géo-Helminthiases, Direction de la Lutte Contre la Maladie (DLM), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Oumou Kaltoum Boh
- Programme National de Lutte Contre les Bilharzioses et les Géo-Helminthiases, Direction de la Lutte Contre la Maladie (DLM), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Babacar Guèye
- Programme National de Lutte Contre les Bilharzioses et les Géo-Helminthiases, Direction de la Lutte Contre la Maladie (DLM), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Mady Ba
- WHO Country Office, Dakar, Senegal
| | - Idrissa Talla
- Département de Santé Publique, Faculté des Sciences de la Santé, Université Amadou Hampathé Ba, Dakar, Senegal
| | - Malang Mané
- FHI 360, Chargé des Enquêtes et Evaluation des Maladies et des Campagnes de DMM, Dakar, Senegal
| | - Rose Monteil
- FHI 360, Chargé des Enquêtes et Evaluation des Maladies et des Campagnes de DMM, Dakar, Senegal
| | - Boniface Kinvi
- Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO Africa Regional Office, Brazzaville, Congo
| | - Honorat Gustave Marie Zoure
- Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO Africa Regional Office, Brazzaville, Congo
| | - Jorge Cano Ortega
- Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO Africa Regional Office, Brazzaville, Congo
| | - Pauline Mwinzi
- Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO Africa Regional Office, Brazzaville, Congo
| | - Moussa Sacko
- Service de Parasitologie, Institut National de Santé Publique (INSP), BP 1771, Bamako, Mali
| | - Babacar Faye
- Department of Parasitology and Mycology Faculty of Medicine, Pharmacy and Odontology, Université Cheikh Anta Diop de Dakar (UCAD), Dakar, Senegal
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6
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Mohammed SA, Hetta HF, Zahran AM, Tolba MEM, Attia RAH, Behnsawy HM, Algammal AM, Batiha GES, Mohammed AQ, Ahmad AA. T cell subsets, regulatory T, regulatory B cells and proinflammatory cytokine profile in Schistosoma haematobium associated bladder cancer: First report from Upper Egypt. PLoS Negl Trop Dis 2023; 17:e0011258. [PMID: 37068081 PMCID: PMC10109487 DOI: 10.1371/journal.pntd.0011258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The function of different populations of the immune system in bladder cancer (BCa) is well established. However, the cohesive role of the immune cell profile of schistosomal BCa at systemic and tissue levels is still lacking, especially in endemic countries. The balance hypothesized between protumorigenic and antitumor molecules determines the prognosis of tumor progression. This study aimed to investigate the frequency of T cell subsets at both blood and tumor tissue, regulatory T(Treg), regulatory B cells (Breg) and proinflammatory cytokines in S. haematobium-related BCa patients in Egypt. METHODOLOGY/PRINCIPAL FINDINGS The frequency of T cell subsets at both blood and tumor tissue, regulatory T(Treg), regulatory B cells (Breg) were studied by flow cytometry and proinflammatory cytokines by ELISA in S. haematobium-related BCa patients in Egypt. The results indicated a significant increase in the activity of T-cell populations, particularly CD3+, CD4+, and regulatory T cells (Tregs), and a decrease in cytotoxic CD8+ T cells in the patient group. An increased proportion of CD19+CD24+CD38+ Bregs and proinflammatory cytokines (IL-1β, IL-6, and TNF-α) was also observed. However, T-cell subpopulations in the tumor microenvironment showed a significant reduction in cancer patients compared to controls. Moreover, positive correlations were observed between the frequencies of Bregs and Tregs, suggesting the promotion of cancer progression besides their relation to the intensity of schistosomal infection. CONCLUSIONS/SIGNIFICANCE Trapped Schistosoma haematobium eggs in bladder tissue might lead to persistent inflammation that contributes to immunomodulation and promotes tumor progression, as evidenced by the increase in peripheral T helper, Tregs, Bregs and serum tumor-promoting cytokines. Considering the role and integrated functions of specific immune responses in BCa could help future diagnostic and therapeutic implications.
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Affiliation(s)
- Sara Abdelal Mohammed
- Department of Parasitology, Faculty of veterinary medicine, Assiut University, Assiut, Egypt
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Asmaa M Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut Egypt
| | - Mohammed E M Tolba
- Department of Parasitology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Rasha A H Attia
- Department of Parasitology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hosny M Behnsawy
- Department of Urology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdelazeem M Algammal
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicines, Damanhour University, Damanhour, Egypt
| | - Ahmed Qasem Mohammed
- Department of Gastroenterology, Hepatology and infectious diseases, Al-Azhar University, Assuit, Egypt
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7
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Hoekstra PT, Madinga J, Lutumba P, van Grootveld R, Brienen EAT, Corstjens PLAM, van Dam GJ, Polman K, van Lieshout L. Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo. Trop Med Infect Dis 2022; 7:315. [PMID: 36288056 PMCID: PMC9608707 DOI: 10.3390/tropicalmed7100315] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Detection of Schistosoma eggs in stool or urine is known for its low sensitivity in diagnosing light infections. Alternative diagnostics with better sensitivity while remaining highly specific, such as real-time PCR and circulating antigen detection, are progressively used as complementary diagnostic procedures but have not yet replaced microscopy. This study evaluates these alternative methods for the detection of Schistosoma infections in the absence of microscopy. Schistosomiasis presence was determined retrospectively in 314 banked stool and urine samples, available from a previous survey on the prevalence of taeniasis in a community in the Democratic Republic of the Congo, using real-time PCR, the point-of-care circulating cathodic antigen (POC-CCA) test, as well as the up-converting particle lateral flow circulating anodic antigen (UCP-LF CAA) test. Schistosoma DNA was present in urine (3%) and stool (28%) samples, while CCA (28%) and CAA (69%) were detected in urine. Further analysis of the generated data indicated stool-based PCR and the POC-CCA test to be suitable diagnostics for screening of S. mansoni infections, even in the absence of microscopy. A substantial proportion (60%) of the 215 CAA-positive cases showed low antigen concentrations, suggesting that even PCR and POC-CCA underestimated the "true" number of schistosome positives.
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Affiliation(s)
- Pytsje T. Hoekstra
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Joule Madinga
- Institute of Health and Society, Université Catholique de Louvain, 1348 Brussels, Belgium
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Pascal Lutumba
- Institut National de Recherche Biomédicale, Kinshasa 1197, Democratic Republic of the Congo
- Department of Tropical Medicine, University of Kinshasa, Kinshasa 7948, Democratic Republic of the Congo
| | - Rebecca van Grootveld
- Department of Clinical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Eric A. T. Brienen
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Department of Health Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Summers S, Bhattacharyya T, Allan F, Stothard JR, Edielu A, Webster BL, Miles MA, Bustinduy AL. A review of the genetic determinants of praziquantel resistance in Schistosoma mansoni: Is praziquantel and intestinal schistosomiasis a perfect match? FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.933097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Schistosomiasis is a neglected tropical disease (NTD) caused by parasitic trematodes belonging to the Schistosoma genus. The mainstay of schistosomiasis control is the delivery of a single dose of praziquantel (PZQ) through mass drug administration (MDA) programs. These programs have been successful in reducing the prevalence and intensity of infections. Due to the success of MDA programs, the disease has recently been targeted for elimination as a public health problem in some endemic settings. The new World Health Organization (WHO) treatment guidelines aim to provide equitable access to PZQ for individuals above two years old in targeted areas. The scale up of MDA programs may heighten the drug selection pressures on Schistosoma parasites, which could lead to the emergence of PZQ resistant schistosomes. The reliance on a single drug to treat a disease of this magnitude is worrying should drug resistance develop. Therefore, there is a need to detect and track resistant schistosomes to counteract the threat of drug resistance to the WHO 2030 NTD roadmap targets. Until recently, drug resistance studies have been hindered by the lack of molecular markers associated with PZQ resistance. This review discusses recent significant advances in understanding the molecular basis of PZQ action in S. mansoni and proposes additional genetic determinants associated with PZQ resistance. PZQ resistance will also be analyzed in the context of alternative factors that may decrease efficacy within endemic field settings, and the most recent treatment guidelines recommended by the WHO.
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Lund AJ, Sokolow SH, Jones IJ, Wood CL, Ali S, Chamberlin A, Sy AB, Sam MM, Jouanard N, Schacht AM, Senghor S, Fall A, Ndione R, Riveau G, De Leo GA, López-Carr D. Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. PLoS Negl Trop Dis 2021; 15:e0009806. [PMID: 34610025 PMCID: PMC8525765 DOI: 10.1371/journal.pntd.0009806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 10/19/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the environmental hazard of snails and parasites is also present in the water. By increasing reliance on hazardous activities and environments, socio-economic vulnerability can hinder reductions in exposure to a hazard. We aimed to quantify the contributions of exposure, hazard, and vulnerability to the presence and intensity of Schistosoma haematobium re-infection. Methodology/Principal findings In 13 villages along the Senegal River, we collected parasitological data from 821 school-aged children, survey data from 411 households where those children resided, and ecological data from all 24 village water access sites. We fit mixed-effects logistic and negative binomial regressions with indices of exposure, hazard, and vulnerability as explanatory variables of Schistosoma haematobium presence and intensity, respectively, controlling for demographic variables. Using multi-model inference to calculate the relative importance of each component of risk, we found that hazard (Ʃwi = 0.95) was the most important component of S. haematobium presence, followed by vulnerability (Ʃwi = 0.91). Exposure (Ʃwi = 1.00) was the most important component of S. haematobium intensity, followed by hazard (Ʃwi = 0.77). Model averaging quantified associations between each infection outcome and indices of exposure, hazard, and vulnerability, revealing a positive association between hazard and infection presence (OR = 1.49, 95% CI 1.12, 1.97), and a positive association between exposure and infection intensity (RR 2.59–3.86, depending on the category; all 95% CIs above 1) Conclusions/Significance Our findings underscore the linkages between social (exposure and vulnerability) and environmental (hazard) processes in the acquisition and accumulation of S. haematobium infection. This approach highlights the importance of implementing both social and environmental interventions to complement mass drug administration. While the impacts of natural hazards tend to be described in terms of social determinants such as exposure and vulnerability, the risk for infectious disease is often expressed in terms of environmental determinants without fully considering the socio-ecological processes that put people in contact with infective agents of disease. In the case of schistosomiasis, risk is determined by human interactions with freshwater environments where schistosome parasites circulate between people and aquatic snails. In this study, we quantified the relative contributions of exposure, hazard, and vulnerability to schistosome re-infection among schoolchildren in an endemic region of northern Senegal. We find that hazard and vulnerability influence whether a child becomes infected, while exposure and hazard influence the burden of worms once infection is acquired. Increasing numbers of worms is known to be positively associated with increasing severity of disease. Our findings underscore the importance of evaluating social and environmental determinants of disease simultaneously; omitting measures of exposure, hazard or vulnerability may limit our understanding of risk.
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Affiliation(s)
- Andrea J. Lund
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California, United States of America
- * E-mail:
| | - Susanne H. Sokolow
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - Isabel J. Jones
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
| | - Chelsea L. Wood
- School of Aquatic and Fishery Sciences, University of Washington, Seattle, Washington, United States of America
| | - Sofia Ali
- Stanford University, Stanford, California, United States of America
| | - Andrew Chamberlin
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
| | - Alioune Badara Sy
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - M. Moustapha Sam
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Nicolas Jouanard
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- Station d’Innovation Aquacole, Saint Louis, Sénégal
| | - Anne-Marie Schacht
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- University of Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Simon Senghor
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Assane Fall
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Raphael Ndione
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Gilles Riveau
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- University of Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Giulio A. De Leo
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - David López-Carr
- Department of Geography, University of California, Santa Barbara, CA, United States of America
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Hybridized Zoonotic Schistosoma Infections Result in Hybridized Morbidity Profiles: A Clinical Morbidity Study amongst Co-Infected Human Populations of Senegal. Microorganisms 2021; 9:microorganisms9081776. [PMID: 34442855 PMCID: PMC8401530 DOI: 10.3390/microorganisms9081776] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Hybridization of infectious agents is a major emerging public and veterinary health concern at the interface of evolution, epidemiology, and control. Whilst evidence of the extent of hybridization amongst parasites is increasing, their impact on morbidity remains largely unknown. This may be predicted to be particularly pertinent where parasites of animals with contrasting pathogenicity viably hybridize with human parasites. Recent research has revealed that viable zoonotic hybrids between human urogenital Schistosoma haematobium with intestinal Schistosoma species of livestock, notably Schistosoma bovis, can be highly prevalent across Africa and beyond. Examining human populations in Senegal, we found increased hepatic but decreased urogenital morbidity, and reduced improvement following treatment with praziquantel, in those infected with zoonotic hybrids compared to non-hybrids. Our results have implications for effective monitoring and evaluation of control programmes, and demonstrate for the first time the potential impact of parasite hybridizations on host morbidity.
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Panzner U, Excler JL, Kim JH, Marks F, Carter D, Siddiqui AA. Recent Advances and Methodological Considerations on Vaccine Candidates for Human Schistosomiasis. FRONTIERS IN TROPICAL DISEASES 2021; 2:719369. [PMID: 39280170 PMCID: PMC11392908 DOI: 10.3389/fitd.2021.719369] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Schistosomiasis remains a neglected tropical disease of major public health concern with high levels of morbidity in various parts of the world. Although considerable efforts in implementing mass drug administration programs utilizing praziquantel have been deployed, schistosomiasis is still not contained. A vaccine may therefore be an essential part of multifaceted prevention control efforts. In the 1990s, a joint United Nations committee promoting parasite vaccines shortlisted promising candidates including for schistosomiasis discussed below. After examining the complexity of immune responses in human hosts infected with schistosomes, we review and discuss the antigen design and preclinical and clinical development of the four leading vaccine candidates: Sm-TSP-2 in Phase 1b/2b, Sm14 in Phase 2a/2b, Sm-p80 in Phase 1 preparation, and Sh28GST in Phase 3. Our assessment of currently leading vaccine candidates revealed some methodological issues that preclude a fair comparison between candidates and the rationale to advance in clinical development. These include (1) variability in animal models - in particular non-human primate studies - and predictive values of each for protection in humans; (2) lack of consensus on the assessment of parasitological and immunological parameters; (3) absence of reliable surrogate markers of protection; (4) lack of well-designed parasitological and immunological natural history studies in the context of mass drug administration with praziquantel. The controlled human infection model - while promising and unique - requires validation against efficacy outcomes in endemic settings. Further research is also needed on the impact of advanced adjuvants targeting specific parts of the innate immune system that may induce potent, protective and durable immune responses with the ultimate goal of achieving meaningful worm reduction.
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Affiliation(s)
- Ursula Panzner
- International Vaccine Institute, Seoul, South Korea
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Jerome H Kim
- International Vaccine Institute, Seoul, South Korea
| | - Florian Marks
- International Vaccine Institute, Seoul, South Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- University of Antananarivo, Antananarivo, Madagascar
| | | | - Afzal A Siddiqui
- Center for Tropical Medicine and Infectious Diseases, Texas Tech University Health Sciences Center, Lubbock, TX, United States
- Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States
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12
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Ojo JA, Adedokun SA, Akindele AA, Olorunfemi AB, Otutu OA, Ojurongbe TA, Thomas BN, Velavan TP, Ojurongbe O. Prevalence of urogenital and intestinal schistosomiasis among school children in South-west Nigeria. PLoS Negl Trop Dis 2021; 15:e0009628. [PMID: 34314428 PMCID: PMC8345861 DOI: 10.1371/journal.pntd.0009628] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 08/06/2021] [Accepted: 07/05/2021] [Indexed: 01/25/2023] Open
Abstract
Background The risk of co-infection with Schistosoma haematobium and S. mansoni and the potential harmful effect on morbidity and control is enhanced by the overlapping distribution of both species in sub-Saharan Africa. Despite the reported high endemicity of both species in Nigeria, studies on the spread and effect of their mixed infection are limited. Therefore, a cross-sectional survey was conducted among school children in two communities in South-west Nigeria to investigate the prevalence of mixed human schistosome infection, intensity, and possible ectopic egg elimination. Methods Urine and stool samples were collected from consenting school children in Ilie and Ore communities of Osun State, Nigeria. Schistosoma haematobium eggs were detected in urine using the urine filtration technique, while S. mansoni eggs were detected in stool using the Kato–Katz thick smear technique. Results The study enrolled 466 primary and secondary school children (211; 45.3% males vs. 255; 54.7% females; mean age 11.6 ± 3.16 years). The overall prevalence of schistosomiasis was 40% (185/466), with 19% (89/466) recording single S. haematobium infection while 9% (41/465) had a single S. mansoni infection. The geometric mean egg count for S. haematobium was 189.4 egg/10ml urine; 95% CI: range 115.9–262.9, while for S. mansoni, it was 115.7 epg; 95% CI: range 78.4–152.9. The prevalence of ectopic S mansoni (S. mansoni eggs in urine) was 4.7%, while no ectopic S. haematobium (S. haematobium eggs in stool) was recorded. Mixed infection of S. haematobium/S. mansoni had a prevalence of 9.5% (44/466). More females (54.5%) presented with S. haematobium/S. mansoni co-infection. For both parasites, males had higher infection intensity, with a significant difference observed with S. haematobium (p = 0.0004). Hematuria was significant in individuals with single S. haematobium infection (p = 0.002), mixed ectopic S. haematobium/S. mansoni (p = 0.009) and mixed S. haematobium/S. mansoni/ectopic S. mansoni (p = 0.0003). Conclusions These findings suggest the probability of interspecific interactions between S. haematobium and S. mansoni. Scaling up of mass administration of praziquantel and control measures in the study areas is highly desirable. In sub-Saharan Africa, human schistosomiasis is a neglected disease of public health concern caused mostly by Schistosoma haematobium and Schistosoma mansoni. The overlapping range of both species in Africa considerably increases the chance of co-infection. School-aged children are the most vulnerable, as they participate in water contact activities that expose them to free-swimming cercariae released by infected snail species in freshwater. This study examined the probable mixed human Schistosoma infections and associated disease variables in school children in the communities of Ilie and Ore in southwest Nigeria. This study reveals a high prevalence of mixed S. haematobium and S. mansoni, and ectopic S. mansoni eggs (S. mansoni eggs in urine) elimination, highlighting the possible ongoing control challenges in this area. Furthermore, this study indicates that some form of inter-specific interaction exists between S. haematobium and S. mansoni, and may produce potentially significant consequences for developing morbidity in the study areas.
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Affiliation(s)
- Johnson A. Ojo
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Samuel A. Adedokun
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Akeem A. Akindele
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Adedolapo B. Olorunfemi
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Olawumi A. Otutu
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Taiwo A. Ojurongbe
- Department of Mathematical Sciences, Osun State University, Osogbo, Nigeria
| | - Bolaji N. Thomas
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester New York, United States of America
| | - Thirumalaisamy P. Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam
| | - Olusola Ojurongbe
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- * E-mail:
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13
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Panzner U, Boissier J. Natural Intra- and Interclade Human Hybrid Schistosomes in Africa with Considerations on Prevention through Vaccination. Microorganisms 2021; 9:microorganisms9071465. [PMID: 34361901 PMCID: PMC8305539 DOI: 10.3390/microorganisms9071465] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/04/2022] Open
Abstract
Causal agents of schistosomiasis are dioecious, digenean schistosomes affecting mankind in 76 countries. Preventive measures are manifold but need to be complemented by vaccination for long-term protection; vaccine candidates in advanced pre-clinical/clinical stages include Sm14, Sm-TSP-2/Sm-TSP-2Al®, Smp80/SchistoShield®, and Sh28GST/Bilhvax®. Natural and anthropogenic changes impact on breaking species isolation barriers favoring introgressive hybridization, i.e., allelic exchange among gene pools of sympatric, interbreeding species leading to instant large genetic diversity. Phylogenetic distance matters, thus the less species differ phylogenetically the more likely they hybridize. PubMed and Embase databases were searched for publications limited to hybridale confirmation by mitochondrial cytochrome c oxidase (COX) and/or nuclear ribosomal internal transcribed spacer (ITS). Human schistosomal hybrids are predominantly reported from West Africa with clustering in the Senegal River Basin, and scattering to Europe, Central and Eastern Africa. Noteworthy is the dominance of Schistosoma haematobium interbreeding with human and veterinary species leading due to hybrid vigor to extinction and homogenization as seen for S. guineensis in Cameroon and S. haematobium in Niger, respectively. Heterosis seems to advantage S. haematobium/S. bovis interbreeds with dominant S. haematobium-ITS/S. bovis-COX1 profile to spread from West to East Africa and reoccur in France. S. haematobium/S. mansoni interactions seen among Senegalese and Côte d’Ivoirian children are unexpected due to their high phylogenetic distance. Detecting pure S. bovis and S. bovis/S. curassoni crosses capable of infecting humans observed in Corsica and Côte d’Ivoire, and Niger, respectively, is worrisome. Taken together, species hybridization urges control and preventive measures targeting human and veterinary sectors in line with the One-Health concept to be complemented by vaccination protecting against transmission, infection, and disease recurrence. Functional and structural diversity of naturally occurring human schistosomal hybrids may impact current vaccine candidates requiring further research including natural history studies in endemic areas targeted for clinical trials.
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Affiliation(s)
- Ursula Panzner
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University of Munich, 80539 Munich, Germany
- Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland
- Correspondence: ; Tel.: +49-176-6657-2910
| | - Jerome Boissier
- IHPE, University of Montpellier, CNRS, Ifremer, University of Perpignan, 66860 Perpignan, France;
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14
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Enabulele EE, Platt RN, Adeyemi E, Agbosua E, Aisien MS, Ajakaye OG, Ali MU, Amaechi EC, Atalabi TE, Auta T, Awosolu OB, Dagona AG, Edo-Taiwo O, Ejikeugwu CE, Igbeneghu C, Njom VS, Orji MKN, Oyinloye FO, Ozemoka HJ, Ugah UI, Anderson TJ. Urogenital schistosomiasis in Nigeria post receipt of the largest single praziquantel donation in Africa. Acta Trop 2021; 219:105916. [PMID: 33878306 DOI: 10.1016/j.actatropica.2021.105916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
Schistosomiasis control efforts in Nigeria received a boost in 2016 when Merck Group made the largest single donation of praziquantel to an African country. We examined urine samples from 2,023 school age children from 15 locations in 10 states and an Internally Displaced Person's (IDP) camp in Nigeria. We recorded an overall Schistosoma haematobium prevalence of 10.4% in the 10 states that ranged between 6 - 37%, while prevalence in the IDP camp was 2.9%. The highest infection prevalence (37%) recorded was from the population in Wasai Dam area in Minjibir (Kano State), while five locations had no positive urine samples. We observed heavy intensity of infection (≥ 50 eggs/10 ml urine) in 87.9% of infected samples and co-occurrence of the eggs of S. haematobium and S. mansoni in urine for two participants. The overall prevalence we recorded is slightly above the national average (9.5%) reported in 2015. Our findings indicate that despite the ongoing administration of praziquantel in Nigeria, urogenital schistosomiasis is still prevalent with heavy intensity of infection. Large-scale epidemiological monitoring is required to monitor the efficacy of schistosomiasis control in Nigeria.
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Gillardie ML, Babba O, Mahinc C, Duthel M, de Bengy C, Morineaud C, Rivollier E, Flori P. Molecular approach to the epidemiology of urinary schistosomiasis in France. PLoS Negl Trop Dis 2021; 15:e0009515. [PMID: 34228747 PMCID: PMC8284649 DOI: 10.1371/journal.pntd.0009515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/16/2021] [Accepted: 05/28/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The diagnosis of urogenital schistosomiasis is based on the complementarity of serological technique and microscopic examination (ME). Between 2015 and 2019, the number of urinary schistosomiasis tests received in our laboratory increased sharply from 300 to 900 per year. Therefore, we wanted to evaluate the reliability of urine microscopic examination (ME, reference and routine technique) from urine sample by comparing it to other techniques (antigenic technique and PCR). To this end, we optimized two real-time PCRs targeting respectively Schistosoma haematobium (Sh) and Schistosoma mansoni (Sm). METHODOLOGY/PRINCIPAL FINDINGS 914 urine samples from 846 patients suspected of urogenital schistosomiasis were prescribed and analyzed by PCR and also by antigenic technique for the first 143 samples. The antigenic technique evaluated was Schisto POC-CCA, Rapid Medical Diagnostics. These results (antigenic technique and PCR) were compared to ME which was performed from all urines. The percentage of 14% (128/914) positive cases with the PCR technique and the percentage of 6.0% (54/914) positive cases with ME is significantly different (Chi 2 test, p<0.001). These 128 positive PCRs correspond to 120 different patients, 88.3% (106/120) of them were young migrants and 11.7% (14/120) were French patients returning from travel. Among these migrants, more than 75% (80/106) came from French-speaking West Africa. In addition, the Schisto POC-CCA showed a specificity of 39% (46/117), too poor to be used as a screening tool in low or non-endemic areas. CONCLUSION/SIGNIFICANCE Targeted Sh and Sm PCRs in urine are reliable techniques compared to ME (reference technique). In view of our results, we decided to screen urinary schistosomiasis by direct ME always coupled by the PCR technique, which has shown better reliability criteria.
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Affiliation(s)
- Marie-Laure Gillardie
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Oussama Babba
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Caroline Mahinc
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Maureen Duthel
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire de Bengy
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Clotilde Morineaud
- Department of Public Health, University Hospital of Poitiers, Poitiers, France
| | - Elisabeth Rivollier
- Department PASS, University Hospital of Saint-Etienne, Saint Etienne, France
| | - Pierre Flori
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
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16
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N'Diaye M, Keita BF, Danfakha F, Keita F, Keita G, Senghor CS, Diop B, Diawara L, Bessin F, Vernet C, Barbier D, Dewavrin P, Klotz F. A 12-year follow-up of intestinal schistosomiasis in pre-school-aged children in Assoni Village, Eastern Senegal. Infect Dis Poverty 2021; 10:89. [PMID: 34176498 PMCID: PMC8237420 DOI: 10.1186/s40249-021-00867-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/21/2021] [Indexed: 12/29/2022] Open
Abstract
Background To monitor the prevalence of schistosomiasis in school-aged children (SAC), the National Bilharzia Control Program (PNLB) was set up by the Senegalese authorities; however, geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni. This observation led us to implement a new schistosomiasis control program in 2008 under the aegis of the non-governmental organization “Le Kaïcedrat” and in partnership with the PNLB/WHO to monitor the prevalence of schistosomiasis in this area. In the village of Assoni, where 100% of SAC were infected, analysis of the stools of pre-school-aged children (PSAC) showed that they were massively infected, so we decided to focus our program on them. Methods From 2008 to 2020, we (i) monitored the prevalence of S. mansoni in PSAC in Assoni using double-stool smear preparation, (ii) treated the infected PSAC with a standard dose of praziquantel 40 mg/kg, (iii) ran educational campaigns each year in the village, and (iv) built latrines to improve sanitation and reduce schistosomiasis transmission. Linear regression was used to examine the trend in the annual schistosomiasis prevalence and a two-sided of Chi-squared test was used to compare prevalence between the different age groups of PSAC. Results We observed an extremely high prevalence of schistosomiasis (78%) in PSAC before implementation of the program in 2008. Contamination occurred in very young children, as 64.3% of children under 2 years old were infected. Moreover, prevalence increased with age and reached 96.8% in children 4 to < 6 years old. Our annual interventions in Assoni Village raised awareness among villagers that water bodies were areas of significant infestation, allowed the building of 88 latrines and led to a decrease in prevalence in PSAC as only 11% of these children were infected in 2020. Conclusion Our study allowed Assoni to be the first village in Senegal to treat PSAC since 2014, but only on an individual basis. It also shows that schistosomiasis is difficult to eradicate and that multi-sectorial actions are required to keep its prevalence at a low level. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00867-8.
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Affiliation(s)
- Monique N'Diaye
- Normandy University, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancer Prevention and Treatment), BioTICLA Axis (Biology and Innovative Therapeutics for Ovarian Cancers), Caen, France. .,Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France. .,NGO Le Kaïcedrat, Paris, France.
| | | | | | - Fili Keita
- Health Post, Bandafassi, Kedougou District, Dakar, Senegal
| | - Gérald Keita
- Health Post, Bandafassi, Kedougou District, Dakar, Senegal
| | | | - Bocar Diop
- Programme National de Lutte Contre Les Bilharzioses (PNLB), Ministry of Health, Dakar, Senegal
| | - Lamine Diawara
- Neglected Tropical Diseases, Inter-Country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - François Bessin
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | - Charlotte Vernet
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | - Dominique Barbier
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | | | - Francis Klotz
- NGO Le Kaïcedrat, Paris, France.,Military Hospital Val-de-Grâce, Paris, France
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17
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Roucher C, Brosius I, Mbow M, Faye BT, De Hondt A, Smekens B, Arango D, Burm C, Tsoumanis A, Paredis L, van Herrewege Y, Potters I, Cisse B, Mboup S, Polman K, Bottieau E. Evaluation of Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children (SchistoSAM): protocol of a proof-of-concept, open-label, two-arm, individually-randomised controlled trial. BMJ Open 2021; 11:e047147. [PMID: 34168029 PMCID: PMC8231067 DOI: 10.1136/bmjopen-2020-047147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Alternative drugs and diagnostics are needed for the treatment and control of schistosomiasis. The exclusive use of praziquantel (PZQ) in mass drug administration programmes may result in the emergence of drug resistance. PZQ has little activity against Schistosoma larvae, thus reinfection remains a problem in high-risk communities. Furthermore, the insufficient sensitivity of conventional microscopy hinders therapeutic response assessment. Evaluation of artesunate-mefloquine (AM) as a Novel Alternative Treatment for Schistosomiasis in African Children (SchistoSAM) aims to evaluate the safety and efficacy of the antimalarial combination artesunate-mefloquine, re-purposed for the treatment of schistosomiasis, and to assess the performance of highly sensitive novel antigen-based and DNA-based assays as tools for monitoring treatment response. METHODS AND ANALYSIS The SchistoSAM study is an open-label, two-arm, individually randomised controlled non-inferiority trial, with a follow-up of 48 weeks. Primary school-aged children from the Richard Toll district in northern Senegal, an area endemic for Schistosoma mansoni and Schistosoma haematobium, are allocated to the AM intervention arm (3-day courses at 6-week intervals) or the PZQ control arm (single dose of 40 mg/kg). The trial's primary endpoints are the efficacy (cure rate (CR), assessed by microscopy) and safety (frequency and pattern of drug-related adverse events) of one AM course versus PZQ at 4 weeks after treatment. Secondary endpoints include (1) cumulative CR, egg reduction rate and safety after each additional course of AM, and at weeks 24 and 48, (2) prevalence and severity of schistosomiasis-related morbidity and (3) malaria prevalence, incidence and morbidity, both after 24 and 48 weeks. CRs and intensity reduction rates are also assessed by antigen-based and DNA-based diagnostic assays, for which performance for treatment monitoring is evaluated. ETHICS AND DISSEMINATION Ethics approval was obtained both in Belgium and Senegal. Oral assent from the children and signed informed consent from their legal representatives was obtained, prior to enrolment. The results will be disseminated in peer-reviewed journals and at international conferences. TRIAL REGISTRATION NUMBER NCT03893097; pre-results.
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Affiliation(s)
- Clémentine Roucher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Moustapha Mbow
- Department of Immunology, Cheikh Anta Diop University, Dakar, Senegal
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | | | - Annelies De Hondt
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Bart Smekens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Diana Arango
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Christophe Burm
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Linda Paredis
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Yven van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Idzi Potters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Badara Cisse
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Souleymane Mboup
- Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), Dakar, Senegal
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
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18
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Kebede T, Bech N, Allienne JF, Olivier R, Erko B, Boissier J. Genetic evidence for the role of non-human primates as reservoir hosts for human schistosomiasis. PLoS Negl Trop Dis 2020; 14:e0008538. [PMID: 32898147 PMCID: PMC7500647 DOI: 10.1371/journal.pntd.0008538] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 09/18/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Background Schistosomiasis is a chronic parasitic disease, that affects over 207 million people and causes over 200,000 deaths annually, mainly in sub-Saharan Africa. Although many health measures have been carried out to limit parasite transmission, significant numbers of non-human primates such as Chlorocebus aethiops (Ch. aethiops) (vervet) and Papio anubis (baboon) are infected with S. mansoni, notably in Ethiopia, where they are expected to have potentially significant implications for transmission and control efforts. Objective The objective of this study was to assess and compare the genetic diversity and population structure of S. mansoni isolates from human and non-human primates free-ranging in close proximity to villages in selected endemic areas of Ethiopia. Methods A cross-sectional study was conducted in three transmission sites: Bochesa, Kime and Fincha. A total of 2,356 S. mansoni miracidia were directly isolated from fecal specimens of 104 hosts (i.e. 60 human hosts and 44 non-human primates). We performed DNA extraction and PCR amplification using fourteen microsatellite loci. Results At population scale we showed strong genetic structure between the three sample sites. At the definitive host scale, we observed that host factors can shape the genetic composition of parasite infra-populations. First, in male patients, we observed a positive link between parasite genetic diversity and the age of the patients. Second, we observed a difference in genetic diversity which was high in human males, medium in human females and low in non-human primates (NHPs). Finally, whatever the transmission site no genetic structure was observed between human and non-human primates, however, there appears to be little barriers, if any, host specificity of the S. mansoni populations with cross-host infections. Conclusion Occurrence of infection of a single host with multiple S. mansoni strains and inter- and intra-host genetic variations was observed. Substantial genetic diversity and gene flow across the S. mansoni population occurred at each site and non-human primates likely play a role in local transmission and maintenance of infection. Therefore, public health and wildlife professionals should work together to improve disease control and elimination strategies. Schistosomiasis is a chronic disease caused by flukes (trematodes). The definitive host spectrum of schistosomes, whether human, non-human primates (NHPs) or other mammals, is highly dependent on the schistosome species concerned. Genetic diversity and population structure studies of S. mansoni have provided insights into the variation of natural populations. Understanding S. mansoni genetic diversity and population structure of isolates from human and non-human primate hosts living in close proximity showed the occurrence of infection of a single host with multiple S. mansoni strains and inter- and intra-host genetic variations. In this article, the researchers assert the fact that genetic approach reveals that parasites from the three different sites are independent. Thus, we could consider the three sites as geographical replicates showing the influence of NHPs in parasitic transmission in Ethiopia. This study provides insights into the epidemiology, genetic diversity and population structure of S. mansoni in human and non-human primates in Ethiopia, all of which are crucial for the control of schistosomiasis.
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Affiliation(s)
- Tadesse Kebede
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Laboratoire Interactions Hôtes-Pathogènes-Environnements (IHPE), UMR 5244 CNRS, University of Perpignan, IFREMER, Univ. Montpellier, F-66860 Perpignan, France
- * E-mail:
| | - Nicolas Bech
- Laboratory of Ecologie et Biologie des Interactions (EBI), UMR CNRS 7267, Poitiers University, Poitiers, France
| | - Jean-François Allienne
- Laboratoire Interactions Hôtes-Pathogènes-Environnements (IHPE), UMR 5244 CNRS, University of Perpignan, IFREMER, Univ. Montpellier, F-66860 Perpignan, France
| | - Rey Olivier
- Laboratoire Interactions Hôtes-Pathogènes-Environnements (IHPE), UMR 5244 CNRS, University of Perpignan, IFREMER, Univ. Montpellier, F-66860 Perpignan, France
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jerome Boissier
- Laboratoire Interactions Hôtes-Pathogènes-Environnements (IHPE), UMR 5244 CNRS, University of Perpignan, IFREMER, Univ. Montpellier, F-66860 Perpignan, France
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19
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Combes AD, Magdy M, Morris DL. Intestinal schistosomiasis mimicking caecal malignancy. ANZ J Surg 2020; 90:2576-2577. [PMID: 32437075 DOI: 10.1111/ans.15944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/05/2020] [Accepted: 04/17/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Alexander D Combes
- Department of Surgery, St George Hospital, Sydney, New South Wales, Australia.,Sutherland Hospital Department of Surgery, Sydney, New South Wales, Australia
| | - Mark Magdy
- Department of Surgery, St George Hospital, Sydney, New South Wales, Australia.,Sutherland Hospital Department of Surgery, Sydney, New South Wales, Australia.,The University of New South Wales Department of Surgery, Sydney, New South Wales, Australia
| | - David L Morris
- Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Sydney, New South Wales, Australia
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20
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Pillay P, Downs JA, Changalucha JM, Brienen EAT, Ramarokoto CE, Leutscher PDC, Vennervald BJ, Taylor M, Kjetland EF, Van Lieshout L. Detection of Schistosoma DNA in genital specimens and urine: A comparison between five female African study populations originating from S. haematobium and/or S. mansoni endemic areas. Acta Trop 2020; 204:105363. [PMID: 32035055 DOI: 10.1016/j.actatropica.2020.105363] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 01/16/2023]
Abstract
Female Genital Schistosomiasis (FGS) is a neglected disease affecting millions, however challenging to diagnose. This explorative descriptive study compares Schistosoma real-time PCR analysis of cervico-vaginal lavages (CVL) with corresponding urine and stool samples of 933 women from five different previously described study populations. Sampling included 310 women from an S. mansoni endemic region in Mwanza, Tanzania and 112 women from a nearby S. haematobium endemic region. Findings were compared with samples collected from S. haematobium endemic regions in South Africa from 394 women and from 117 women from Madagascar of which 79 were urine pre-selected microscopy positive cases from highly-endemic communities and 38 were urine microscopy negatives from a low-endemic community. As anticipated, urine and stool microscopy and gynecological investigations varied substantially between study populations; however, the same Schistosoma real-time PCR was performed in one reference laboratory. Schistosoma DNA was detected in 13% (120/933) of the CVL, ranging from 3% in the S. mansoni Tanzanian endemic region to 61% in the pre-selected Malagasy urine microscopy positive cases. Detectable Schistosoma DNA in CVL was associated with Schistosoma DNA in urine but not with microscopic detection of eggs in urine or by cytological examination. This study confirmed real-time PCR for the detection of Schistosoma DNA in gynecological samples to be a valuable diagnostic tool to study the distribution of FGS within schistosomiasis endemic areas.
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Affiliation(s)
- P Pillay
- Department of Biomedical and Clinical Technology, Durban University of Technology, South Africa; Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - J A Downs
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, USA
| | - J M Changalucha
- Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | - E A T Brienen
- Department of Parasitology, Leiden University Medical Center, The Netherlands
| | - C E Ramarokoto
- Department of Epidemiology, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - P D C Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - B J Vennervald
- Section for Parasitology and Aquatic Pathobiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - M Taylor
- Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - E F Kjetland
- Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo Norway
| | - L Van Lieshout
- Department of Parasitology, Leiden University Medical Center, The Netherlands
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21
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No barrier breakdown between human and cattle schistosome species in the Senegal River Basin in the face of hybridisation. Int J Parasitol 2019; 49:1039-1048. [PMID: 31734338 DOI: 10.1016/j.ijpara.2019.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/06/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023]
Abstract
Schistosomiasis is widely distributed along the Senegal River Basin (SRB), affecting both the human population and their livestock. Damming of the Senegal River for irrigation purposes in the 1980s induced ecological changes that resulted in a large outbreak of Schistosoma mansoni, followed a few years later by an increase and spread of Schistosoma haematobium infections. The presence of hybrid crosses between the human and cattle schistosomes, S. haematobium and Schistosoma bovis, respectively, is adding complexity to the disease epidemiology in this area, and questions the strength of the species boundary between these two species. This study aimed to investigate the epidemiology of S. haematobium, S. bovis and their hybrids along the Senegal River basin using both microsatellite genetic markers and analysis of mitochondrial and nuclear DNA markers. Human schistosome populations with a S. haematobium cox1 mtDNA profile and those with a S. bovis cox1 mtDNA profile (the so-called hybrids) appear to belong to a single randomly mating population, strongly differentiated from the pure S. bovis found in cattle. These results suggest that, in northern Senegal, a strong species boundary persists between human and cattle schistosome species and there is no prolific admixing of the populations. In addition, we found that in the SRB S. haematobium was spatially more differentiated in comparison to S. mansoni. This may be related either to the presence and susceptibility of the intermediate snail hosts, or to the colonisation history of the parasite.
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22
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Anyan WK, Abonie SD, Aboagye-Antwi F, Tettey MD, Nartey LK, Hanington PC, Anang AK, Muench SB. Concurrent Schistosoma mansoni and Schistosoma haematobium infections in a peri-urban community along the Weija dam in Ghana: A wake up call for effective National Control Programme. Acta Trop 2019; 199:105116. [PMID: 31356786 DOI: 10.1016/j.actatropica.2019.105116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/31/2019] [Accepted: 07/25/2019] [Indexed: 11/30/2022]
Abstract
Globally over 200 million people are infected with schistosomiasis, and approximately 80% are caused by just two of five species, Schistosoma haematobium and Schitosoma mansoni that are broadly distributed, and often overlap across sub-Saharan Africa. Like most neglected tropical diseases, mortality is low (an estimated 200,000 deaths annually) and morbidity is considerably high and probably underestimated. Surprisingly, little attention has been given to co-infection with these two species. We have studied co-infection with S. mansoni and S. haematobium in a peri-urban community in Ghana, one of the most highly endemic countries for schistosomiasis. We collected and examined snails of the two intermediate host species from the reservoir adjacent to the community. We also used microscopical examination of stool and urine samples to determine the level of concurrent S. mansoni and S. haematobium infections in school and administered questionnaires to assess water contact activities that predispose pupils to infections Examination of the snail hosts revealed that 0.7% (7/896) of Bulinus truncatus and 1.7% (14/780) of Biomphalaria pfeifferi snails were found to be hosting cercariae morphologically consistent with that of S. haematobium and S. mansoni respectively. The overall prevalence values for urogenital and intestinal schistosomiasis were 66.8% (135/202) and 90.1% (163/181) respectively. Only 50 of 181 schistosome-infected pupils had single-species infections and the remaining 131 pupils presented concurrent infections. Among the 131 infected with both species were 50 individuals having only S. mansoni eggs in stool and S. haematobium eggs in urine (conventional presentation). Eighty-one children (81) had eggs of both species in either urine and/or stool (ectopic presentation). From these 81, 63 had eggs of both species in urine, 6 had both species in stool, and 12 had eggs of both species present in both urine and stool. A comparatively large number of individuals from the concurrent infected group presented high and moderate infection intensities than the single infected groups. The overwhelmingly high prevalence of concurrent infections indicates further study of co-infection is needed, and points to a need call for a holistic disease control plan so Ghana can be part of nations to achieve the WHO roadmap target for schistosomiasis control by 2020.
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Affiliation(s)
- William K Anyan
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana.
| | - Severin D Abonie
- Department of Animal Biology and Conservation Science, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Fred Aboagye-Antwi
- Department of Animal Biology and Conservation Science, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Mabel D Tettey
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Linda K Nartey
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Abraham K Anang
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Susan B Muench
- Biology Department, State University of New York at Geneseo, Geneseo, NY, USA
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23
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Guegan H, Fillaux J, Charpentier E, Robert-Gangneux F, Chauvin P, Guemas E, Boissier J, Valentin A, Cassaing S, Gangneux JP, Berry A, Iriart X. Real-time PCR for diagnosis of imported schistosomiasis. PLoS Negl Trop Dis 2019; 13:e0007711. [PMID: 31509538 PMCID: PMC6756557 DOI: 10.1371/journal.pntd.0007711] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/23/2019] [Accepted: 08/15/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The diagnosis of schistosomiasis currently relies on microscopic detection of schistosome eggs in stool or urine samples and serological assays. The poor sensitivity of standard microscopic procedures performed in routine laboratories, makes molecular detection methods of increasing interest. The aim of the study was to evaluate two in-house real-time Schistosoma PCRs, targeting respectively S. mansoni [Sm] and S. haematobium [Sh] in excreta, biopsies and sera as potential tools to diagnose active infections and to monitor treatment efficacy. METHODS Schistosoma PCRs were performed on 412 samples (124 urine, 86 stools, 8 biopsies, 194 sera) from patients with suspected schistosomiasis, before anti-parasitic treatment. Results were compared to microscopic examination and serological assays (enzyme-linked immunosorbent assay (ELISA), indirect haemagglutination (HA) and Western Blot (WB) assay). RESULTS Compared to microscopy, PCRs significantly increased the sensitivity of diagnosis, from 4% to 10.5% and from 33.7% to 48.8%, for Sh in urine and Sm in stools, respectively. The overall sensitivity of PCR on serum samples was 72.7% and reached 94.1% in patients with positive excreta (microscopy). The specificity of serum PCR was 98.9%. After treatment, serum PCR positivity rates slowly declined from 93.8% at day 30 to 8.3% at day 360, whereas antibody detection remained positive after 1 year. CONCLUSION Schistosoma PCRs clearly outperform standard microscopy on stools and urine and could be part of reference methods combined with WB-based serology, which remains a gold standard for initial diagnosis. When serological assays are positive and microscopy is negative, serum PCRs provide species information to guide further clinical exploration. Biomarkers such as DNA and antibodies are of limited relevance for early treatment monitoring but serum PCR could be useful when performed at least 1 year after treatment to help confirm a cured infection.
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Affiliation(s)
- Hélène Guegan
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé Environnement et Travail) – UMR_S 1085, Rennes, France
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Judith Fillaux
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Eléna Charpentier
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Université de Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Pamela Chauvin
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Emilie Guemas
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Jérôme Boissier
- Université de Perpignan Via Domitia, IHPE UMR 5244, CNRS, IFREMER, Université de Montpellier, Perpignan, France
| | - Alexis Valentin
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
| | - Jean-Pierre Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé Environnement et Travail) – UMR_S 1085, Rennes, France
| | - Antoine Berry
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Université de Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - Xavier Iriart
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Centre de Physiopathologie de Toulouse Purpan (CPTP), Université de Toulouse, CNRS, INSERM, UPS, Toulouse, France
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Depaquit J, Akhoundi M, Haouchine D, Mantelet S, Izri A. No limit in interspecific hybridization in schistosomes: observation from a case report. Parasite 2019; 26:10. [PMID: 30821247 PMCID: PMC6396650 DOI: 10.1051/parasite/2019010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 02/18/2019] [Indexed: 11/15/2022] Open
Abstract
Schistosomiasis is one of the most significant parasitic diseases of humans. The hybridization of closely related Schistosoma species has already been documented. However, hybridization between phylogenetically distant species is unusual. In the present study, we characterized the causative agent of schistosomiasis in a 14-year-old patient with hematuria from Côte d'Ivoire, using morphological and molecular approaches. A 24-hour parasitological examination of urine showed the presence of numerous eggs (150 μm long × 62 μm wide) with a lateral spine (25 μm), identified morphologically as Schistosoma mansoni. Examination of stools performed on the same day found no parasites. The urine and stool examinations of the patient's family members performed two weeks later showed neither parasites nor hematuria; but in contrast, many S. mansoni eggs were found again in the patient's urine, but never in his stools. Conventional PCRs were performed, using two primer pairs targeting 28S-rDNA and COI mtDNA. The 28S-rDNA sequence of these eggs, compared with two reference sequences from GenBank demonstrated a hybrid with 25 double peaks, indicating clearly hybrid positions (5.37%) between S. mansoni and S. haematobium. Similarly, we identified a unique S. mansoni COI sequence for the two eggs, with 99.1% homology with the S. mansoni reference sequence. Consequently, this case was the result of hybridization between an S. haematobium male and an S. mansoni female. This should be taken into consideration to explore the elimination of ectopic schistosome eggs in the future.
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Affiliation(s)
- Jérôme Depaquit
- EA7510 ESCAPE, USC ANSES “VECPAR”, UFR Pharmacie, Université de Reims Champagne-Ardenne France
- Laboratoire de Parasitologie-Mycologie, Hôpital Maison Blanche Reims France
| | - Mohammad Akhoundi
- Département de Parasitologie-Mycologie, Hôpital Avicenne AP-HP Bobigny France
| | - Djamel Haouchine
- Département de Parasitologie-Mycologie, Hôpital Avicenne AP-HP Bobigny France
| | - Stéphane Mantelet
- Département de Parasitologie-Mycologie, Hôpital Avicenne AP-HP Bobigny France
| | - Arezki Izri
- Département de Parasitologie-Mycologie, Hôpital Avicenne AP-HP Bobigny France
- Unité des Virus Emergents (Université Aix-Marseille– IRD 190 – Inserm 1207 – IHU Méditerranée infection) Marseille France
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Le Govic Y, Kincaid-Smith J, Allienne JF, Rey O, de Gentile L, Boissier J. Schistosoma haematobium-Schistosoma mansoni Hybrid Parasite in Migrant Boy, France, 2017. Emerg Infect Dis 2019; 25:365-367. [PMID: 30526763 PMCID: PMC6346478 DOI: 10.3201/eid2502.172028] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Schistosomiasis is frequently detected in persons entering Europe. In 2017, we detected a Schistosoma mansoni–Schistosoma haematobium hybrid parasite infection in a migrant boy from Côte d’Ivoire entering France. Because such parasites might be established in Europe, as illustrated by an outbreak on Corsica Island, vectors of these parasites should be investigated.
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Urogenital schistosomiasis and hybridization between Schistosoma haematobium and Schistosoma bovis in adults living in Richard-Toll, Senegal. Parasitology 2018; 145:1723-1726. [PMID: 30185248 DOI: 10.1017/s0031182018001415] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Since the construction of the Diama Dam (1985), the epidemiology of schistosomiasis along the Senegal River Basin (SRB) has been extremely dynamic with outbreaks of both intestinal and urogenital schistosomiasis. In the early 2000s, technicians reported cases of suspected urogenital schistosomiasis in adults from the local hospital in Richard-Toll, Lower SRB. The genetic analysis of schistosome miracidia isolated from 11 patients in 2012 from two neighbourhoods (Campement and Gaya) of Richard-Toll confirmed infection with Schistosoma haematobium but also S. haematobium/S. bovis hybrids. Thirty-seven per cent of the miracidia were S. bovis/S. haematobium hybrids and 63% were pure S. haematobium. The data are discussed in relation to the ongoing dynamic epidemiology of the schistosomes in Senegal and the need to treat non-target individuals.
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Knowledge, Attitudes, and Practices Related to Schistosomiasis Among Children in Northern Senegal. Ann Glob Health 2018; 82:840-847. [PMID: 28283138 DOI: 10.1016/j.aogh.2016.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematuria and dysuria. Children's comprehension of the disease is fundamental to preventing the infection. OBJECTIVES The aim of this study was to investigate the knowledge attitudes, and practices related to schistosomiasis among schoolchildren in 2 rural villages in Northern Senegal and to evaluate their impact on the disease. METHODS A cross-sectional study was conducted. Data about children's knowledge of schistosomiasis, behavior, and preventive measures were collected through a questionnaire. FINDINGS Questionnaire responses from 575 schoolchildren were analyzed. Correct answers about risky behavior for schistosomiasis were associated with early symptoms (P = 0.010). Wearing shoes and washing hands with soap were associated with not having hematuria and dysuria (P = 0.007 and 0.049, respectively). Playing in rivers was associated with the aforementioned symptoms (P < 0.001). Children who had good knowledge of schistosomiasis reportedly did not have symptoms (P = 0.002). A logistic regression model showed that female sex (odds ratio = 0.35; P = 0.01) and attending a primary school (odds ratio = 0.13; P < 0.001) were significant predictors of a lower risk of the early symptoms of urinary schistosomiasis. CONCLUSIONS This study revealed that the level of knowledge among children in North Senegal about the causes, transmission, prevention, and treatment of schistosomiasis warrants implementing educational intervention.
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Barcoding hybrids: heterogeneous distribution of Schistosoma haematobium × Schistosoma bovis hybrids across the Senegal River Basin. Parasitology 2018; 145:634-645. [PMID: 29667570 DOI: 10.1017/s0031182018000525] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hybridization events between Schistosoma species (Digenea, Platyhelminthes) are reported with increasing frequency, largely due to improved access to molecular tools. Nevertheless, little is known about the distribution and frequency of hybrid schistosomes in nature. Screening for hybrids on a large scale is complicated by the need for nuclear and mitochondrial sequence information, precluding a 'simple' barcoding approach. Here we aimed to determine and understand the spatiotemporal distribution of Schistosoma haematobium × Schistosoma bovis hybrids in the Senegal River Basin. From ten villages, distributed over the four main water basins, we genotyped a total of 1236 schistosome larvae collected from human urine samples using a partial mitochondrial cox1 fragment; a subset of 268 parasites was also genotyped using ITS rDNA. Hybrid schistosomes were unevenly distributed, with substantially higher numbers in villages bordering Lac de Guiers than in villages from the Lampsar River and the Middle Valley of the Senegal River. The frequency of hybrids per village was not linked with the prevalence of urinary schistosomiasis in that village. However, we did find a significant positive association between the frequency of hybrids per village and the prevalence of Schistosoma mansoni. We discuss the potential consequences of adopting a barcoding approach when studying hybrids in nature.
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Evolutionary epidemiology of schistosomiasis: linking parasite genetics with disease phenotype in humans. Int J Parasitol 2017; 48:107-115. [PMID: 29154994 DOI: 10.1016/j.ijpara.2017.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 06/15/2017] [Accepted: 07/05/2017] [Indexed: 12/21/2022]
Abstract
Here we assess the role of parasite genetic variation in host disease phenotype in human schistosomiasis by implementing concepts and techniques from environmental association analysis in evolutionary epidemiology. Schistosomiasis is a tropical disease that affects more than 200 million people worldwide and is caused by parasitic flatworms belonging to the genus Schistosoma. While the role of host genetics has been extensively studied and demonstrated, nothing is yet known on the contribution of parasite genetic variation to host disease phenotype in human schistosomiasis. In this study microsatellite genotypes of 1561 Schistosoma mansoni larvae collected from 44 human hosts in Senegal were linked to host characteristics such as age, gender, infection intensity, liver and bladder morbidity by means of multivariate regression methods (on each parasite locus separately). This revealed a highly significant association between allelic variation at the parasite locus L46951 and host infection intensity and bladder morbidity. Locus L46951 is located in the 3' untranslated region of the cGMP-dependent protein kinase gene that is expressed in reproductive organs of adult schistosome worms and appears to be linked to egg production. This putative link between parasite genetic variation and schistosomiasis disease phenotype sets the stage for further functional research.
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Houldcroft CJ, Ramond JB, Rifkin RF, Underdown SJ. Migrating microbes: what pathogens can tell us about population movements and human evolution. Ann Hum Biol 2017; 44:397-407. [PMID: 28511559 DOI: 10.1080/03014460.2017.1325515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The biology of human migration can be observed from the co-evolutionary relationship with infectious diseases. While many pathogens are brief, unpleasant visitors to human bodies, others have the ability to become life-long human passengers. The story of a pathogen's genetic code may, therefore, provide insight into the history of its human host. The evolution and distribution of disease in Africa is of particular interest, because of the deep history of human evolution in Africa, the presence of a variety of non-human primates, and tropical reservoirs of emerging infectious diseases. METHODS This study explores which pathogens leave traces in the archaeological record, and whether there are realistic prospects that these pathogens can be recovered from sub-Saharan African archaeological contexts. RESULTS Three stories are then presented of germs on a journey. The first is the story of HIV's spread on the back of colonialism and the railway networks over the last 150 years. The second involves the spread of Schistosoma mansoni, a parasite which shares its history with the trans-Atlantic slave trade and the origins of fresh-water fishing. Finally, we discuss the tantalising hints of hominin migration and interaction found in the genome of human herpes simplex virus 2. CONCLUSIONS Evidence from modern African pathogen genomes can provide data on human behaviour and migration in deep time and contribute to the improvement of human quality-of-life and longevity.
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Affiliation(s)
- Charlotte J Houldcroft
- a Department of Archaeology and Anthropology, Division of Biological Anthropology , University of Cambridge , Cambridge , UK.,b McDonald Institute of Archaeological Research, University of Cambridge , Cambridge , UK
| | - Jean-Baptiste Ramond
- c Department of Genetics , Centre for Microbial Ecology and Genomics, Genomic Research Institute, University of Pretoria , Hatfield , South Africa
| | - Riaan F Rifkin
- c Department of Genetics , Centre for Microbial Ecology and Genomics, Genomic Research Institute, University of Pretoria , Hatfield , South Africa
| | - Simon J Underdown
- d Department of Anthropology & Geography, Human Origins and Palaeoenvironmental Research Group (HOPE) , Oxford Brookes University , Oxford , UK.,e Leverhulme Centre for Human Evolutionary Studies , Henry Wellcome Building , Cambridge , UK
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Detecting hybridization in African schistosome species: does egg morphology complement molecular species identification? Parasitology 2017; 144:954-964. [PMID: 28215207 DOI: 10.1017/s0031182017000087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Hybrid parasites may have an increased transmission potential and higher virulence compared to their parental species. Consequently, hybrid detection is critical for disease control. Previous crossing experiments showed that hybrid schistosome eggs have distinct morphotypes. We therefore compared the performance of egg morphology with molecular markers with regard to detecting hybridization in schistosomes. We studied the morphology of 303 terminal-spined eggs, originating from 19 individuals inhabiting a hybrid zone with natural crosses between the human parasite Schistosoma haematobium and the livestock parasite Schistosoma bovis in Senegal. The egg sizes showed a high variability and ranged between 92·4 and 176·4 µm in length and between 35·7 and 93·0 µm in width. No distinct morphotypes were found and all eggs resembled, to varying extent, the typical S. haematobium egg type. However, molecular analyses on the same eggs clearly showed the presence of two distinct partial mitochondrial cox1 profiles, namely S. bovis and S. haematobium, and only a single nuclear ITS rDNA profile (S. haematobium). Therefore, in these particular crosses, egg morphology appears not a good indicator of hybrid ancestry. We conclude by discussing strengths and limitations of molecular methods to detect hybrids in the context of high-throughput screening of field samples.
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Hybridizations within the Genus Schistosoma: implications for evolution, epidemiology and control. Parasitology 2016; 144:65-80. [PMID: 27572906 DOI: 10.1017/s0031182016001190] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hybridization of parasites is an emerging public health concern in our changing world. Hybridization and introgression in parasites and pathogens can have major impacts on the host and the epidemiology and evolution of disease. Schistosomiasis is a Neglected Tropical Disease of profound medical and veterinary importance across many parts of the world, with the greatest human burden within sub-Saharan Africa. Here we review how early phenotypic identification and recent confirmation through molecular studies on naturally occurring infections, combined with experimental manipulations, have revealed evidence of viable hybridization and introgressions within and between human and animal schistosome species. Environmental and anthropogenic changes in selective pressures following, for instance, new dam constructions, altered agricultural practices, together with mass drug administration programmes, may all be predicted to further impact the availability of suitable definitive and intermediate hosts for schistosomes. It is therefore imperative to understand the distribution and role of such novel zoonotic hybrid schistosomes on host range, drug efficacy, and hence ultimately transmission potential, if we are to achieve and maintain sustainable control.
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N'Diaye M, Dioukhane EM, Ndao B, Diedhiou K, Diawara L, Talla I, Vernet C, Bessin F, Barbier D, Dewavrin P, Klotz F, Georges P. Schistosomiasis Sustained Control Program in Ethnic Groups Around Ninefescha (Eastern Senegal). Am J Trop Med Hyg 2016; 95:614-22. [PMID: 27430549 DOI: 10.4269/ajtmh.15-0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 03/25/2016] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is the second most significant parasitic disease in children in several African countries. For this purpose, the "Programme National de Lutte contre les Bilharzioses" (PNLB) was developed in partnership with the World Health Organization (WHO) to control this disease in Senegal. However, geographic isolation of Bedik ethnic groups challenged implementation of the key elements of the schistosomiasis program in eastern Senegal, and therefore, a hospital was established in Ninefescha to improve access to health care as well as laboratory support for this population. The program we have implemented from 2008 in partnership with the PNLB/WHO involved campaigns to 1) evaluate schistosomiasis prevalence in children of 53 villages around Ninefescha hospital, 2) perform a mass drug administration following the protocol established by the PNLB in school-aged children, 3) monitor annual prevalence, 4) implement health education campaigns, and 5) oversee the building of latrines. This campaign led to a drop in schistosomiasis prevalence but highlighted that sustainable schistosomiasis control by praziquantel treatment, awareness of the use of latrines, and inhabitants' voluntary commitment to the program are crucial to improve Schistosoma elimination. Moreover, this study revealed that preschool-aged children, for whom praziquantel was not recommended until 2014 in Senegal, constituted a significant reservoir for the parasite.
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Affiliation(s)
- Monique N'Diaye
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France.
| | | | | | - Kemo Diedhiou
- Programme National de Lutte contre les Bilharzioses/World Health Organization Neglected Tropical Diseases, Dakar, Senegal
| | - Lamine Diawara
- Inter-country Support Team for West Africa, World Health Organization Neglected Tropical Diseases, Ouagadougou, Burkina Faso
| | - Idrissa Talla
- Programme National de Lutte contre les Bilharzioses/World Health Organization Neglected Tropical Diseases, Dakar, Senegal
| | - Charlotte Vernet
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | - François Bessin
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | - Dominique Barbier
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | | | | | - Pierre Georges
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
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Abstract
In recent years, through a national programme for schistosomiasis control, this infection has been eliminated from Iran. The aim of this study was to report the process of significant decrease of urogenital schistosomiasis in southwestern Iran. During national programme surveillance for urogenital schistosomiasis control which was implemented by Centres for Disease Control and Prevention (CDC) of Khuzestan province from 1975 to 2013, more than 1·3 million urine samples were taken from inhabitants of high risk foci. All urine samples were gathered between 10:00 a.m and 02:00 p.m and, after centrifuging, specimens were tested under optical microscope in order to detect Schistosoma haematobium eggs. Data analysis was performed using SPSS 18 software. In this retrospective study significant reduction was seen in number of infections between 1975 and 2013. During the years 1975-1980, 1981-1990 and 1991-2000 there were 1582, 761 and 79 cases of S. haematobium, respectively. In 2001 only one case was reported from Ahvaz and indeed this was the last case of urogenital schistosomiasis in Khuzestan and of course, in Iran. Prevalence from 1·064% between 1975 and 1980 slumped to 0% in 2012-2013. During several projects for surveillance of urogenital schistosomiasis, selective population chemotherapy, snail control, population education, environmental improvement, etc were carried out throughout the surveillance period. According to elimination of S. haematobium in Khuzestan province, the only endemic region of Iran, control of disease, especially the campaign with intermediate host snails should be continued. Iran can be a successful model for countries suffering from this disease.
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Afifi MA, Jiman-Fatani AA, Al-Hussainy NH, Al-Rabia MW, Bogari AA. Genetic diversity among natural populations of Schistosoma haematobium might contribute to inconsistent virulence and diverse clinical outcomes. J Microsc Ultrastruct 2016; 4:222-227. [PMID: 30023230 PMCID: PMC6014255 DOI: 10.1016/j.jmau.2016.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 11/30/2022] Open
Abstract
There is an evident difference in the intensity of morbidity caused by Schistosoma haematobium in North-African zones compared to Sub-Saharan ones. Clinical outcome dichotomy corresponds to two geographically distinct intermediate host snail species that are only infected by the related strain of the parasite. In concert, there is a manifest hybridization of the parasite with other Schistosoma species confined to certain regions of Africa. This raises a reasonable suggestion that S. haematobium has no less than two phylogenetic clusters that have different virulence. The aim of the study was to examine the possible diversity among S. haematobium using simultaneous amplification of genomic DNA of selected isolates. Random amplified polymorphic DNA-polymerase chain reaction markers were used to study the genetic diversity among S. haematobium natural isolates from selected regions of Africa (Egypt, Zimbabwe, and South Africa) that represent different ecological conditions, different species of intermediate host, and different possibilities of field hybridization with other schistosomes. A moderate to high level of genetic diversity was evident among the three isolates. More bands were shared by the isolates from Zimbabwe and South Africa (similarity index = 0.721) than those shared by each with the Egyptian isolate (similarity index = 0.551 and 0.566, respectively), suggesting that at least two phylogenetic groups of S. haematobium do exist in distinct geographic regions of Africa. The elucidation of the possible genetic diversity among S. haematobium parasites may explain many ambiguous aspects of the biology of the parasite-like virulence, immune evasion and drug resistance.
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Affiliation(s)
- Mohammed A Afifi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Parasitology, Faculty of Medicine, Beni-Suef University, Beni-Suef City, Egypt
| | - Asif A Jiman-Fatani
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nabeel H Al-Hussainy
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed W Al-Rabia
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anas A Bogari
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Epidemiological Interactions between Urogenital and Intestinal Human Schistosomiasis in the Context of Praziquantel Treatment across Three West African Countries. PLoS Negl Trop Dis 2015; 9:e0004019. [PMID: 26469347 PMCID: PMC4607489 DOI: 10.1371/journal.pntd.0004019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/30/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In many parts of sub-Saharan Africa, urogenital and intestinal schistosomiasis co-occur, and mixed species infections containing both Schistosoma haematobium and S. mansoni can be common. During co-infection, interactions between these two species are possible, yet the extent to which such interactions influence disease dynamics or the outcome of control efforts remains poorly understood. METHODOLOGY/PRINCIPAL FINDINGS Here we analyse epidemiological data from three West African countries co-endemic for urogenital and intestinal schistosomiasis (Senegal, Niger and Mali) to test whether the impact of praziquantel (PZQ) treatment, subsequent levels of re-infection or long-term infection dynamics are altered by co-infection. In all countries, positive associations between the two species prevailed at baseline: infection by one species tended to predict infection intensity for the other, with the strength of association varying across sites. Encouragingly, we found little evidence that co-infection influenced PZQ efficacy: species-specific egg reduction rates (ERR) and cure rates (CR) did not differ significantly with co-infection, and variation in treatment success was largely geographical. In Senegal, despite positive associations at baseline, children with S. mansoni co-infection at the time of treatment were less intensely re-infected by S. haematobium than those with single infections, suggesting competition between the species may occur post-treatment. Furthermore, the proportion of schistosome infections attributable to S. mansoni increased over time in all three countries examined. CONCLUSIONS/SIGNIFICANCE These findings suggest that while co-infection between urinary and intestinal schistosomes may not directly affect PZQ treatment efficacy, competitive interspecific interactions may influence epidemiological patterns of re-infection post-treatment. While re-infection patterns differed most strongly according to geographic location, interspecific interactions also seem to play a role, and could cause the community composition in mixed species settings to shift as disease control efforts intensify, a situation with implications for future disease management in this multi-species system.
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Development of novel multiplex microsatellite polymerase chain reactions to enable high-throughput population genetic studies of Schistosoma haematobium. Parasit Vectors 2015; 8:432. [PMID: 26329827 PMCID: PMC4557312 DOI: 10.1186/s13071-015-1044-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/12/2015] [Indexed: 11/24/2022] Open
Abstract
Background Human urogenital schistosomiasis caused by Schistosoma haematobium is widely distributed across Africa and is increasingly targeted for control and regional elimination. The development of new high-throughput, cost-effective molecular tools and approaches are needed to monitor and evaluate the impact of control programs on the parasite populations. Microsatellite loci are genetic markers that can be used to investigate how parasite populations change over time and in relation to external influences such as control interventions. Findings Here, 18 existing S. haematobium microsatellite loci were optimised to enable simultaneous amplification across two novel multiplex microsatellite PCR’s, each containing nine loci. Methods were developed for the cost effective and rapid processing and microsatellite analysis of S. haematobium larval stages stored on Whatman-FTA cards and proved robust on miracidia and cercariae collected from Zanzibar and Niger. Conclusion The development of these novel and robust multiplex microsatellite assays, in combination with an improved protocol to elute gDNA from Whatman-FTA fixed schistosome larval stages, enables the high-throughput population genetic analysis of S. haematobium. The molecular resources and protocols described here advance the way researchers can perform multi locus-based population genetic analyses of S. haematobium as part of the evaluation and monitoring of schistosomiasis control programmes. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1044-6) contains supplementary material, which is available to authorized users.
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Van den Broeck F, Maes GE, Larmuseau MHD, Rollinson D, Sy I, Faye D, Volckaert FAM, Polman K, Huyse T. Reconstructing Colonization Dynamics of the Human Parasite Schistosoma mansoni following Anthropogenic Environmental Changes in Northwest Senegal. PLoS Negl Trop Dis 2015; 9:e0003998. [PMID: 26275049 PMCID: PMC4537236 DOI: 10.1371/journal.pntd.0003998] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 07/20/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Anthropogenic environmental changes may lead to ecosystem destabilization and the unintentional colonization of new habitats by parasite populations. A remarkable example is the outbreak of intestinal schistosomiasis in Northwest Senegal following the construction of two dams in the '80s. While many studies have investigated the epidemiological, immunological and geographical patterns of Schistosoma mansoni infections in this region, little is known about its colonization history. METHODOLOGY/PRINCIPAL FINDINGS Parasites were collected at several time points after the disease outbreak and genotyped using a 420 bp fragment of the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) and nine nuclear DNA microsatellite markers. Phylogeographic and population genetic analyses revealed the presence of (i) many genetically different haplotypes at the non-recombining mitochondrial marker and (ii) one homogenous S. mansoni genetic group at the recombining microsatellite markers. These results suggest that the S. mansoni population in Northwest Senegal was triggered by intraspecific hybridization (i.e. admixture) between parasites that were introduced from different regions. This would comply with the extensive immigration of infected seasonal agricultural workers from neighboring regions in Senegal, Mauritania and Mali. The spatial and temporal stability of the established S. mansoni population suggests a swift local adaptation of the parasite to the local intermediate snail host Biomphalaria pfeifferi at the onset of the epidemic. CONCLUSIONS/SIGNIFICANCE Our results show that S. mansoni parasites are very successful in colonizing new areas without significant loss of genetic diversity. Maintaining high levels of diversity guarantees the adaptive potential of these parasites to cope with selective pressures such as drug treatment, which might complicate efforts to control the disease.
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Affiliation(s)
- Frederik Van den Broeck
- Department of Biology, University of Leuven, Leuven, Belgium
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gregory E. Maes
- Department of Biology, University of Leuven, Leuven, Belgium
- College of Marine and Environmental Sciences, James Cook University, Townsville, Australia
| | - Maarten H. D. Larmuseau
- Department of Biology, University of Leuven, Leuven, Belgium
- Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - David Rollinson
- Division of Life Sciences, Natural History Museum, London, United Kingdom
| | - Ibrahima Sy
- UFR Pharmacy, University of Caen Basse-Normandie, Caen, France
| | | | | | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tine Huyse
- Department of Biology, University of Leuven, Leuven, Belgium
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biology, Royal Museum for Central Africa, Tervuren, Belgium
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Meurs L, Brienen E, Mbow M, Ochola EA, Mboup S, Karanja DMS, Secor WE, Polman K, van Lieshout L. Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya. PLoS Negl Trop Dis 2015. [PMID: 26217948 PMCID: PMC4517772 DOI: 10.1371/journal.pntd.0003959] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The current reference test for the detection of S. mansoni in endemic areas is stool microscopy based on one or more Kato-Katz stool smears. However, stool microscopy has several shortcomings that greatly affect the efficacy of current schistosomiasis control programs. A highly specific multiplex real-time polymerase chain reaction (PCR) targeting the Schistosoma internal transcriber-spacer-2 sequence (ITS2) was developed by our group a few years ago, but so far this PCR has been applied mostly on urine samples. Here, we performed more in-depth evaluation of the ITS2 PCR as an alternative method to standard microscopy for the detection and quantification of Schistosoma spp. in stool samples. METHODOLOGY/PRINCIPAL FINDINGS Microscopy and PCR were performed in a Senegalese community (n = 197) in an area with high S. mansoni transmission and co-occurrence of S. haematobium, and in Kenyan schoolchildren (n = 760) from an area with comparatively low S. mansoni transmission. Despite the differences in Schistosoma endemicity the PCR performed very similarly in both areas; 13-15% more infections were detected by PCR when comparing to microscopy of a single stool sample. Even when 2-3 stool samples were used for microscopy, PCR on one stool sample detected more infections, especially in people with light-intensity infections and in children from low-risk schools. The low prevalence of soil-transmitted helminthiasis in both populations was confirmed by an additional multiplex PCR. CONCLUSIONS/SIGNIFICANCE The ITS2-based PCR was more sensitive than standard microscopy in detecting Schistosoma spp. This would be particularly useful for S. mansoni detection in low transmission areas, and post-control settings, and as such improve schistosomiasis control programs, epidemiological research, and quality control of microscopy. Moreover, it can be complemented with other (multiplex real-time) PCRs to detect a wider range of helminths and thus enhance effectiveness of current integrated control and elimination strategies for neglected tropical diseases.
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Affiliation(s)
- Lynn Meurs
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Brienen
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Moustapha Mbow
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Elizabeth A. Ochola
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Diana M. S. Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - W. Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail: ,
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Lai YS, Biedermann P, Ekpo UF, Garba A, Mathieu E, Midzi N, Mwinzi P, N'Goran EK, Raso G, Assaré RK, Sacko M, Schur N, Talla I, Tchuenté LAT, Touré S, Winkler MS, Utzinger J, Vounatsou P. Spatial distribution of schistosomiasis and treatment needs in sub-Saharan Africa: a systematic review and geostatistical analysis. THE LANCET. INFECTIOUS DISEASES 2015; 15:927-40. [PMID: 26004859 DOI: 10.1016/s1473-3099(15)00066-3] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 01/26/2015] [Accepted: 02/24/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Schistosomiasis affects more than 200 million individuals, mostly in sub-Saharan Africa, but empirical estimates of the disease burden in this region are unavailable. We used geostatistical modelling to produce high-resolution risk estimates of infection with Schistosoma spp and of the number of doses of praziquantel treatment needed to prevent morbidity at different administrative levels in 44 countries. METHODS We did a systematic review to identify surveys including schistosomiasis prevalence data in sub-Saharan Africa via PubMed, ISI Web of Science, and African Journals Online, from inception to May 2, 2014, with no restriction of language, survey date, or study design. We used Bayesian geostatistical meta-analysis and rigorous variable selection to predict infection risk over a grid of 1 155 818 pixels at 5 × 5 km, on the basis of environmental and socioeconomic predictors and to calculate the number of doses of praziquantel needed for prevention of morbidity. FINDINGS The literature search identified Schistosoma haematobium and Schistosoma mansoni surveys done in, respectively, 9318 and 9140 unique locations. Infection risk decreased from 2000 onwards, yet estimates suggest that 163 million (95% Bayesian credible interval [CrI] 155 million to 172 million; 18·5%, 17·6-19·5) of the sub-Saharan African population was infected in 2012. Mozambique had the highest prevalence of schistosomiasis in school-aged children (52·8%, 95% CrI 48·7-57·8). Low-risk countries (prevalence among school-aged children lower than 10%) included Burundi, Equatorial Guinea, Eritrea, and Rwanda. The numbers of doses of praziquantel needed per year were estimated to be 123 million (95% CrI 121 million to 125 million) for school-aged children and 247 million (239 million to 256 million) for the entire population. INTERPRETATION Our results will inform policy makers about the number of treatments needed at different levels and will guide the spatial targeting of schistosomiasis control interventions. FUNDING European Research Council, China Scholarship Council, UBS Optimus Foundation, and Swiss National Science Foundation.
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Affiliation(s)
- Ying-Si Lai
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Patricia Biedermann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Uwem F Ekpo
- Department of Biological Sciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Amadou Garba
- Réseau International Schistosomose, Environnement, Amenagement et Lutte, Niamey, Niger
| | - Els Mathieu
- National Center of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Pauline Mwinzi
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Rufin K Assaré
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Moussa Sacko
- Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Nadine Schur
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Idrissa Talla
- Direction de la Lutte Contre la Maladie, Ministère de la Santé, Dakar, Senegal
| | - Louis-Albert Tchuem Tchuenté
- Laboratory of Parasitology and Ecology, University of Yaoundé, and Center for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Seydou Touré
- Programme National de Lutte Contre la Schistosomiase, Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Mirko S Winkler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
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Meurs L, Mbow M, Boon N, Vereecken K, Amoah AS, Labuda LA, Dièye TN, Mboup S, Yazdanbakhsh M, Polman K. Cytokine responses to Schistosoma mansoni and Schistosoma haematobium in relation to infection in a co-endemic focus in northern Senegal. PLoS Negl Trop Dis 2014; 8:e3080. [PMID: 25101661 PMCID: PMC4125161 DOI: 10.1371/journal.pntd.0003080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 06/27/2014] [Indexed: 11/20/2022] Open
Abstract
Background In Africa, many areas are co-endemic for the two major Schistosoma species, S. mansoni and S. haematobium. Epidemiological studies have suggested that host immunological factors may play an important role in co-endemic areas. As yet, little is known about differences in host immune responses and possible immunological interactions between S. mansoni and S. haematobium in humans. The aim of this study was to analyze host cytokine responses to antigens from either species in a population from a co-endemic focus, and relate these to S. mansoni and S. haematobium infection. Methodology Whole blood cytokine responses were investigated in a population in the north of Senegal (n = 200). Blood was stimulated for 72 h with schistosomal egg and adult worm antigens of either Schistosoma species. IL-10, IL-5, IFN-γ, TNF-α, and IL-2 production was determined in culture supernatants. A multivariate (i.e. multi-response) approach was used to allow a joint analysis of all cytokines in relation to Schistosoma infection. Principal Findings Schistosoma haematobium egg and worm antigens induced higher cytokine production, suggesting that S. haematobium may be more immunogenic than S. mansoni. However, both infections were strongly associated with similar, modified Th2 cytokine profiles. Conclusions/Significance This study is the first to compare S. mansoni and S. haematobium cytokine responses in one population residing in a co-endemic area. These findings are in line with previous epidemiological studies that also suggested S. haematobium egg and worm stages to be more immunogenic than those of S. mansoni. In the developing world, over 207 million people are infected with blood-dwelling parasitic Schistosoma worms. Schistosoma haematobium and S. mansoni are the most widespread species. In Africa, they often occur together in the same area, with many people carrying both species. Yet, little is known about the differences in immune response that the human host develops against these two species. It is also unknown whether the presence of one species may affect the immune response to the other. We here investigated 200 people from an area in the north of Senegal where both species occur. They were examined for Schistosoma infections, as well as for immune responses to the two species. We observed that both infections were characterized by very similar cytokine responses. However, S. haematobium antigens induced higher levels of cytokines than S. mansoni. This suggests that S. haematobium may give rise to stronger immune responses, and may help to explain differences between the two most important Schistosoma species regarding the occurrence of infection and morbidity.
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Affiliation(s)
- Lynn Meurs
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - Moustapha Mbow
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nele Boon
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Kim Vereecken
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Abena Serwaa Amoah
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Lucja A. Labuda
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Tandakha Ndiaye Dièye
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Turner JD, Bourke CD, Meurs L, Mbow M, Dièye TN, Mboup S, Polman K, Mountford AP. Circulating CD14brightCD16+ 'intermediate' monocytes exhibit enhanced parasite pattern recognition in human helminth infection. PLoS Negl Trop Dis 2014; 8:e2817. [PMID: 24762736 PMCID: PMC3998941 DOI: 10.1371/journal.pntd.0002817] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/11/2014] [Indexed: 12/17/2022] Open
Abstract
Circulating monocyte sub-sets have recently emerged as mediators of divergent immune functions during infectious disease but their role in helminth infection has not been investigated. In this study we evaluated whether ‘classical’ (CD14brightCD16−), ‘intermediate’ (CD14brightCD16+), and ‘non-classical’ (CD14dimCD16+) monocyte sub-sets from peripheral blood mononuclear cells varied in both abundance and ability to bind antigenic material amongst individuals living in a region of Northern Senegal which is co-endemic for Schistosoma mansoni and S. haematobium. Monocyte recognition of excretory/secretory (E/S) products released by skin-invasive cercariae, or eggs, of S. mansoni was assessed by flow cytometry and compared between S. mansoni mono-infected, S. mansoni and S. haematobium co-infected, and uninfected participants. Each of the three monocyte sub-sets in the different infection groups bound schistosome E/S material. However, ‘intermediate’ CD14brightCD16+ monocytes had a significantly enhanced ability to bind cercarial and egg E/S. Moreover, this elevation of ligand binding was particularly evident in co-infected participants. This is the first demonstration of modulated parasite pattern recognition in CD14brightCD16+ intermediate monocytes during helminth infection, which may have functional consequences for the ability of infected individuals to respond immunologically to infection. The parasite Schistosoma infects over 200 million people world-wide and can cause serious morbidity. Infection occurs following exposure to larvae (cercariae) which release excretory/secretory (E/S) material to aid their entry into exposed skin. Larvae mature into adult worms that produce hundreds of eggs per day which also release E/S material. Both sources of E/S material have the potential to stimulate the host’s innate immune system. Circulating monocytes are important cells that act as potential sentinels in the recognition of these E/S materials. Different sub-sets of human monocytes can be identified according to their expression of CD14 and CD16 but their role following infection with schistosome helminths has not been investigated. In the current study, three sub-sets (classical, intermediate and non-classical) were enumerated in individuals living in a region co-endemic for S. mansoni and S. haematobium. Although all three monocyte sub-sets bound to fluorescently-labelled schistosome E/S material, the intermediate sub-set had significantly enhanced ability to recognise cercarial and egg E/S in co-infected participants. This is the first demonstration that circulating human monocytes can recognize schistosome E/S antigens and that their ability to do so is modulated by infection which may affect the development of schistosome immunopathology and/or protective immunity.
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Affiliation(s)
- Joseph D Turner
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
| | - Claire D Bourke
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
| | - Lynn Meurs
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Moustapha Mbow
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Immunology Department of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Tandakha Ndiaye Dièye
- Immunology Department of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Souleymane Mboup
- Immunology Department of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital, Dakar, Senegal
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Adrian P Mountford
- Centre for Immunology and Infection, Department of Biology, University of York, York, United Kingdom
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Sang HC, Muchiri G, Ombok M, Odiere MR, Mwinzi PNM. Schistosoma haematobium hotspots in south Nyanza, western Kenya: prevalence, distribution and co-endemicity with Schistosoma mansoni and soil-transmitted helminths. Parasit Vectors 2014; 7:125. [PMID: 24667030 PMCID: PMC3994281 DOI: 10.1186/1756-3305-7-125] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/09/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Schistosomiasis studies in western Kenya have mainly focused on the intestinal form, with evidence of urinary schistosomiasis remaining anecdotal. Detailed disease mapping has been carried out predominantly along the shores of Lake Victoria, but there is a paucity of information on intestinal and urinary schistosomiasis in inland sites. METHODS This cross-sectional survey of 3,487 children aged 7-18 years from 95 schools in south Nyanza, western Kenya determined the prevalence, infection intensity, and geographical distribution of Schistosoma haematobium, evaluating its co-endemicity with Schistosoma mansoni and soil-transmitted helminths (STHs). Helminth eggs were analyzed from single urine (for S. haematobium) and stool (for S. mansoni and STHs) samples by centrifugation and Kato-Katz, respectively. Hematuria was used as a proxy indicator for S. haematobium. Schools and water bodies (ponds, water-points, streams, dams and rivers) were mapped using Geographical Information System and prevalence maps obtained using ArcView GIS Software. RESULTS S. haematobium infections with an overall prevalence of 9.3% (95% CI = 8.4-10.2%) were mostly prevalent in Rachuonyo, 22.4% (95% CI = 19.2-25.9% and 19.7 eggs/10 ml) and Migori, 10.7% (95% CI = 9.2-12.3% and 29.5 eggs/10 ml) districts, particularly around Kayuka pond and Ongoche river respectively. Overall infections correlated with hematuria (r = 0.9, P < 0.0001) and were more likely in boys (P < 0.0001, OR = 0.624). S. mansoni infections with an overall prevalence of 13% (95% CI =11.9-14.1%) were majorly confined along the shores of Lake Victoria. STH infections were homogenously distributed with A. lumbricoides occurring in 5.4% (95% CI = 4.7-6.3%) and T. trichiura in 2.8% (95% CI = 2.3-3.4%) of the children. Although S. mansoni infections were more co-endemic with S. haematobium, only A. lumbricoides infections were positively associated with S. haematobium (P = 0.0295, OR = 0.4585). Overall prevalence of S. haematobium monoinfection was 7.2% (95% CI = 6.4-8%), S. mansoni monoinfection was 12.3% (95% CI = 10.4-12.5%), and S. haematobium-S. mansoni coinfection was 1.2% (95% CI = 0.9-1.6%). There was no significant difference in infection intensity between mono and coinfections. CONCLUSION Prevalence distribution maps obtained are important for planning and implementing disease control programs in these areas.
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Affiliation(s)
- Huldah C Sang
- Center for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Geoffrey Muchiri
- Center for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Maurice Ombok
- Center for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Maurice R Odiere
- Center for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Pauline NM Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
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Van den Broeck F, Meurs L, Raeymaekers JAM, Boon N, Dieye TN, Volckaert FAM, Polman K, Huyse T. Inbreeding within human Schistosoma mansoni: do host-specific factors shape the genetic composition of parasite populations? Heredity (Edinb) 2014; 113:32-41. [PMID: 24619176 DOI: 10.1038/hdy.2014.13] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 01/09/2014] [Accepted: 01/17/2014] [Indexed: 11/09/2022] Open
Abstract
The size, structure and distribution of host populations are key determinants of the genetic composition of parasite populations. Despite the evolutionary and epidemiological merits, there has been little consideration of how host heterogeneities affect the evolutionary trajectories of parasite populations. We assessed the genetic composition of natural populations of the parasite Schistosoma mansoni in northern Senegal. A total of 1346 parasites were collected from 14 snail and 57 human hosts within three villages and individually genotyped using nine microsatellite markers. Human host demographic parameters (age, gender and village of residence) and co-infection with Schistosoma haematobium were documented, and S. mansoni infection intensities were quantified. F-statistics and clustering analyses revealed a random distribution (panmixia) of parasite genetic variation among villages and hosts, confirming the concept of human hosts as 'genetic mixing bowls' for schistosomes. Host gender and village of residence did not show any association with parasite genetics. Host age, however, was significantly correlated with parasite inbreeding and heterozygosity, with children being more infected by related parasites than adults. The patterns may be explained by (1) genotype-dependent 'concomitant immunity' that leads to selective recruitment of genetically unrelated worms with host age, and/or (2) the 'genetic mixing bowl' hypothesis, where older hosts have been exposed to a wider variety of parasite strains than children. The present study suggests that host-specific factors may shape the genetic composition of schistosome populations, revealing important insights into host-parasite interactions within a natural system.
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Affiliation(s)
- F Van den Broeck
- 1] Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium [2] Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - L Meurs
- Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - N Boon
- 1] Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium [2] Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - T N Dieye
- Laboratory of Bacteriology and Virology, Aristide Le Dantec University Hospital, Dakar, Senegal
| | - F A M Volckaert
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - K Polman
- Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - T Huyse
- 1] Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium [2] Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium [3] Section Invertebrates, Royal Museum for Central Africa, Tervuren, Belgium
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Meurs L, Mbow M, Boon N, van den Broeck F, Vereecken K, Dièye TN, Abatih E, Huyse T, Mboup S, Polman K. Micro-geographical heterogeneity in Schistosoma mansoni and S. haematobium infection and morbidity in a co-endemic community in northern Senegal. PLoS Negl Trop Dis 2013; 7:e2608. [PMID: 24386499 PMCID: PMC3873272 DOI: 10.1371/journal.pntd.0002608] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosoma mansoni and S. haematobium are co-endemic in many areas in Africa. Yet, little is known about the micro-geographical distribution of these two infections or associated disease within such foci. Such knowledge could give important insights into the drivers of infection and disease and as such better tailor schistosomiasis control and elimination efforts. METHODOLOGY In a co-endemic farming community in northern Senegal (346 children (0-19 y) and 253 adults (20-85 y); n = 599 in total), we studied the spatial distribution of S. mansoni and S. haematobium single and mixed infections (by microscopy), S. mansoni-specific hepatic fibrosis, S. haematobium-specific urinary tract morbidity (by ultrasound) and water contact behavior (by questionnaire). The Kulldorff's scan statistic was used to detect spatial clusters of infection and morbidity, adjusted for the spatial distribution of gender and age. PRINCIPAL FINDINGS Schistosoma mansoni and S. haematobium infection densities clustered in different sections of the community (p = 0.002 and p = 0.023, respectively), possibly related to heterogeneities in the use of different water contact sites. While the distribution of urinary tract morbidity was homogeneous, a strong geospatial cluster was found for severe hepatic fibrosis (p = 0.001). Particularly those people living adjacent to the most frequently used water contact site were more at risk for more advanced morbidity (RR = 6.3; p = 0.043). CONCLUSIONS/SIGNIFICANCE Schistosoma infection and associated disease showed important micro-geographical heterogeneities with divergent patterns for S. mansoni and S. haematobium in this Senegalese community. Further in depth investigations are needed to confirm and explain our observations. The present study indicates that local geospatial patterns should be taken into account in both research and control of schistosomiasis. The observed extreme focality of schistosomiasis even at community level, suggests that current strategies may not suffice to move from morbidity control to elimination of schistosomiasis, and calls for less uniform measures at a finer scale.
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Affiliation(s)
- Lynn Meurs
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Moustapha Mbow
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Nele Boon
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Frederik van den Broeck
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | | | - Tandakha Ndiaye Dièye
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | | | - Tine Huyse
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Katja Polman
- Institute of Tropical Medicine, Antwerp, Belgium
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Sambe-Ba B, Espié E, Faye ME, Timbiné LG, Sembene M, Gassama-Sow A. Community-acquired diarrhea among children and adults in urban settings in Senegal: clinical, epidemiological and microbiological aspects. BMC Infect Dis 2013; 13:580. [PMID: 24321175 PMCID: PMC3893462 DOI: 10.1186/1471-2334-13-580] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 12/02/2013] [Indexed: 01/17/2023] Open
Abstract
Background Only limited data are available relating to the etiology of diarrhea in children and adults in Senegal. The aim of this prospective study was to describe the epidemiology and etiology of community-acquired diarrheal infections in children and adults living in urban settings. Methods A prospective study was carried out from March 2009 to December 2010, in the urban region of Dakar, Senegal. Patients with acute diarrhea were enrolled, interviewed to collect their clinical history, and their stools were tested for bacteria, virus and parasites. Results A total of 223 patients (including 112 children younger than five years old) with diarrhea were included. At least one enteropathogen was detected in 81% (180/223) of the patients: 29% (64/223) had bacterial infections (mainly diarrheagenic E. coli and Shigella spp), 21% (39/185) viral infections (mainly rotavirus) and 14% (31/223) parasitic infections. Co-infection was identified in 17.8% (32/180) of the patients. Viral infection was significantly more frequent in children under five years old during the dry season. Bacteria and parasites were equally frequent in all age groups. There was a seasonal variation of bacterial infections during the study period, with a higher proportion of infections being bacterial, and due to Salmonella spp. in particular, during the rainy season. Conclusion Our study suggests that in urban settings in Senegal, rotavirus is the principal cause of pediatric diarrhea during the dry season and that the proportion of bacterial infections seems to be higher during the rainy season. Further work is needed to document the burden of diarrheal diseases in sub-Saharan urban communities and to identify risk factors, including those linked to the rapid and unplanned urbanization in Africa.
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Affiliation(s)
- Bissoume Sambe-Ba
- Experimental Bacteriology Unit, Pasteur Institute of Dakar, 36 avenue Pasteur, BP 220 Dakar, Senegal.
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Huyse T, Van den Broeck F, Jombart T, Webster BL, Diaw O, Volckaert FAM, Balloux F, Rollinson D, Polman K. Regular treatments of praziquantel do not impact on the genetic make-up of Schistosoma mansoni in Northern Senegal. INFECTION GENETICS AND EVOLUTION 2013; 18:100-5. [PMID: 23684792 DOI: 10.1016/j.meegid.2013.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 05/03/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
Abstract
The Senegal River Basin (SRB) experienced a major epidemic of intestinal schistosomiasis in the early nineties, after the construction of a dam for irrigation purposes. Exceptionally low cure rates following praziquantel (PZQ) treatment at the onset of the epidemic raised concerns about PZQ resistant strains of Schistosoma mansoni, although they could also be attributed to the intense transmission at that time. A field study in the same region more than 15 years later found cure rates for S. mansoni still to be low, whereas Schistosomahaematobium responded well to treatment. We collected S. mansoni miracidia from children at base-line prior to treatment, six months after two PZQ treatments and two years after the start of the study when they had received a total of five PZQ treatments. In total, 434 miracidia from 12 children were successfully genotyped with at least six out of nine DNA microsatellite loci. We found no significant differences in the genetic diversity of, and genetic differentiation between parasite populations before and after repeated treatment, suggesting that PZQ treatment does not have an impact on the neutral evolution of the parasite. This is in stark contrast with a similar study in Tanzania where a significant decrease in genetic diversity was observed in S. mansoni miracidia after a single round of PZQ treatment. We argue that PZQ resistance might play a role in our study area, although rapid re-infection cannot be excluded. It is important to monitor this situation carefully and conduct larger field studies with short-term follow-up after treatment. Since PZQ is the only general schistosomicide available, the possibility of PZQ resistance is of great concern both for disease control and for curative use in clinical practice.
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Affiliation(s)
- T Huyse
- Institute of Tropical Medicine, Department of Biomedical Sciences, Nationalestraat 155, B-2000 Antwerpen, Belgium.
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Turner JD, Meurs L, Dool P, Bourke CD, Mbow M, Dièye TN, Mboup S, Polman K, Mountford AP. Schistosome infection is associated with enhanced whole-blood IL-10 secretion in response to cercarial excretory/secretory products. Parasite Immunol 2013; 35:147-56. [DOI: 10.1111/pim.12028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/15/2013] [Indexed: 01/21/2023]
Affiliation(s)
- J. D. Turner
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - L. Meurs
- Department of Biomedical Sciences; Institute of Tropical Medicine; Antwerp; Belgium
| | - P. Dool
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - C. D. Bourke
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - M. Mbow
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - T. N. Dièye
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - S. Mboup
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - K. Polman
- Department of Biomedical Sciences; Institute of Tropical Medicine; Antwerp; Belgium
| | - A. P. Mountford
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
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Huyse T, Van den Broeck F, Hellemans B, Volckaert FAM, Polman K. Hybridisation between the two major African schistosome species of humans. Int J Parasitol 2013; 43:687-9. [PMID: 23643461 DOI: 10.1016/j.ijpara.2013.04.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 04/08/2013] [Accepted: 04/09/2013] [Indexed: 10/26/2022]
Abstract
It is generally accepted that Schistosoma mansoni and Schistosoma haematobium, causing intestinal and urinary schistosomiasis, respectively, are not able to hybridise, due to the high phylogenetic distance between them. Cloning of nuclear internal transcribed spacer rDNA and partial mitochondrial cytochrome c oxidase 1 fragments revealed two internal transcribed spacer rDNA genotypes within single eggs and miracidia, one identical to S. mansoni and the other identical to S. haematobium, suggesting hybrid ancestry. The cytochrome c oxidase 1 clones always belonged to only one of the parental species. This demonstrates that offspring of heterologous pairing between these two species is not (always) parthenogenetic.
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Affiliation(s)
- T Huyse
- Institute of Tropical Medicine, Unit of Medical Helminthology, Antwerpen, Belgium.
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Stete K, Krauth SJ, Coulibaly JT, Knopp S, Hattendorf J, Müller I, Lohourignon LK, Kern WV, N'goran EK, Utzinger J. Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children. Parasit Vectors 2012; 5:298. [PMID: 23259435 PMCID: PMC3558406 DOI: 10.1186/1756-3305-5-298] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 12/11/2012] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Praziquantel is the drug of choice in preventive chemotherapy targeting schistosomiasis. Increasing large-scale administration of praziquantel requires monitoring of drug efficacy to detect early signs of development of resistance. Standard protocols for drug efficacy monitoring are necessary. Here, we determined the optimal time point for praziquantel efficacy assessment against Schistosoma haematobium and studied the dynamics of infection parameters following treatment. METHODS Ninety school-aged children from south Côte d'Ivoire with a parasitologically confirmed S. haematobium infection were treated with a single oral dose of praziquantel (40 mg/kg) and followed up for 62 days post-treatment. Urine samples were collected on 23 schooldays during this period and were subjected to visual examination (macrohaematuria), urine filtration and microscopy (S. haematobium eggs) and reagent strip testing (microhaematuria, proteinuria and leukocyturia). RESULTS Observed cure and egg reduction rates were highly dependent on the time point post-treatment. Egg reduction rates were high (>97%) in weeks 3-9 post-treatment. Cure rates were highest in weeks 6 (92.9%) and 9 (95.0%) post-treatment. The prevalence of infection-associated parameters decreased after treatment, reaching a minimum of 2.4% in weeks 5 (proteinuria) and 7 (leukocyturia) post-treatment, and 16.3% at the end of week 8 (microhaematuria). Macrohaematuria disappeared between weeks 3 and 6 post-treatment. CONCLUSIONS For monitoring praziquantel efficacy against S. haematobium, we recommend that the cure rate is assessed at week 6 post-treatment. The egg reduction rate can be evaluated earlier, from day 14 post-treatment onwards. Reagent strips are a useful additional tool for evaluating treatment outcomes in areas with high endemicity, preferably at weeks 5 and 6 post-treatment. The delayed decrease of microhaematuria confirms that lesions in the urinary tract persist longer than egg excretion post-treatment.
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Affiliation(s)
- Katarina Stete
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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