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Siddig EE, Mohamed NS, Ahmed A. Severe coinfection of dengue and malaria: A case report. Clin Case Rep 2024; 12:e9079. [PMID: 38868112 PMCID: PMC11166561 DOI: 10.1002/ccr3.9079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024] Open
Abstract
Key Clinical Message In countries like Sudan, where several infectious diseases are prevalent, health care providers should not be satisfied with initial detection of a single pathogen and whenever it is feasible, they should investigate coinfections. Infections with high mortality or severe morbidity should be prioritized during the differential diagnosis particularly for diseases with similar clinical manifestations to reduce the death and disability rates. However, this requires substantial improvement in the diagnostic capacity. Abstract Here we report a case of dengue and malaria coinfection from the southeast region of Sudan, bordering Ethiopia and Eritrea. A 25-year-old male from Sudan presented with symptoms of fever, chills, vomiting, and muscle and joint pain. Laboratory investigations confirmed a coinfection of dengue and malaria, which is assumingly not uncommon in areas heavily syndemic with several diseases but it is severely under-detected, underreported, and underestimated. The case has fully recovered after the supportive care for dengue and chemotherapy treatment for malaria. In such a case, it was important to monitor the patient's recovery and the treatment outcome through clinical indicators and laboratory parameters to update the treatment course whenever needed, according to response. The increasing burden and outbreaks of vector-borne diseases including dengue and malaria in Sudan, indicates the need for improving the implementation of the global vector control response that established by the World Health Organization. Additionally, the increasing prevalent of coinfections is urging substantial improvement in the diagnostic capacity in endemic countries.
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Affiliation(s)
- Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious DiseasesErasmusMC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Nouh Saad Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- Faculty of ScienceUniversity of BaselBaselSwitzerland
- Institute of Endemic DiseasesUniversity of KhartoumKhartoumSudan
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2
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Ebhodaghe FI, Sanchez-Vargas I, Isaac C, Foy BD, Hemming-Schroeder E. Sibling species of the major malaria vector Anopheles gambiae display divergent preferences for aquatic breeding sites in southern Nigeria. Malar J 2024; 23:60. [PMID: 38413961 PMCID: PMC10900747 DOI: 10.1186/s12936-024-04871-9] [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: 10/23/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND When integrated with insecticide-treated bed nets, larval control of Anopheles mosquitoes could fast-track reductions in the incidence of human malaria. However, larval control interventions may deliver suboptimal outcomes where the preferred breeding places of mosquito vectors are not well known. This study investigated the breeding habitat choices of Anopheles mosquitoes in southern Nigeria. The objective was to identify priority sites for mosquito larval management in selected urban and periurban locations where malaria remains a public health burden. METHODS: Mosquito larvae were collected in urban and periurban water bodies during the wet-dry season interface in Edo, Delta, and Anambra States. Field-collected larvae were identified based on PCR gel-electrophoresis and amplicon sequencing, while the associations between Anopheles larvae and the properties and locations of water bodies were assessed using a range of statistical methods. RESULTS Mosquito breeding sites were either man-made (72.09%) or natural (27.91%) and mostly drainages (48.84%) and puddles (25.58%). Anopheles larvae occurred in drainages, puddles, stream margins, and a concrete well, and were absent in drums, buckets, car tires, and a water-holding iron pan, all of which contained culicine larvae. Wild-caught Anopheles larvae comprised Anopheles coluzzii (80.51%), Anopheles gambiae sensu stricto (s.s.) (11.54%), and Anopheles arabiensis (7.95%); a species-specific PCR confirmed the absence of the invasive urban malaria vector Anopheles stephensi among field-collected larvae. Anopheles arabiensis, An. coluzzii, and An. gambiae s.s. displayed preferences for turbid, lowland, and partially sunlit water bodies, respectively. Furthermore, An. arabiensis preferred breeding sites located outside 500 m of households, whereas An. gambiae s.s. and An. coluzzii had increased detection odds in sites within 500 m of households. Anopheles gambiae s.s. and An. coluzzii were also more likely to be present in natural water bodies; meanwhile, 96.77% of An. arabiensis were in man-made water bodies. Intraspecific genetic variations were little in the dominant vector An. coluzzii, while breeding habitat choices of populations made no statistically significant contributions to these variations. CONCLUSION Sibling malaria vectors in the An. gambiae complex display divergent preferences for aquatic breeding habitats in southern Nigeria. The findings are relevant for planning targeted larval control of An. coluzzii whose increasing evolutionary adaptations to urban ecologies are driving the proliferation of the mosquito, and An. arabiensis whose adults typically evade the effects of treated bed nets due to exophilic tendencies.
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Affiliation(s)
- Faith I Ebhodaghe
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Irma Sanchez-Vargas
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Clement Isaac
- Department of Zoology, Faculty of Life Sciences, Ambrose Alli University, Ekpoma, Edo State, Nigeria
| | - Brian D Foy
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Elizabeth Hemming-Schroeder
- Center for Vector-Borne Infectious Diseases, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA.
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Zhou G, Zhong D, Yewhalaw D, Yan G. Anopheles stephensi ecology and control in Africa. Trends Parasitol 2024; 40:102-105. [PMID: 38142196 DOI: 10.1016/j.pt.2023.11.011] [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: 10/25/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/25/2023]
Abstract
The encroachment and rapid spread of Anopheles stephensi across Africa presents a significant challenge to malaria control and elimination efforts. Understanding the ecology and behavior of An. stephensi will critically inform control measures and provide prerequisite knowledge for exploring new larval and adult control tools to contain its spread.
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Affiliation(s)
- Guofa Zhou
- Program in Public Health, University of California, Irvine, CA 92697, USA.
| | - Daibin Zhong
- Program in Public Health, University of California, Irvine, CA 92697, USA
| | - Delenasaw Yewhalaw
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Guiyun Yan
- Program in Public Health, University of California, Irvine, CA 92697, USA
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Okoth WA, Ho MF, Zaman M, Cooper E, Som P, Burgess M, Walton M, Nevagi RJ, Beattie L, Murphy D, Stanisic DI, Good MF. A CAF01-adjuvanted whole asexual blood-stage liposomal malaria vaccine induces a CD4 + T-cell-dependent strain-transcending protective immunity in rodent models. mBio 2023; 14:e0254723. [PMID: 37962347 PMCID: PMC10746282 DOI: 10.1128/mbio.02547-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023] Open
Abstract
IMPORTANCE Malaria is a devastating disease that has claimed many lives, especially children <5 years of age in Sub-Saharan Africa, as documented in World Malaria Reports by WHO. Even though vector control and chemoprevention tools have helped with elimination efforts in some, if not all, endemic areas, these efforts have been hampered by serious issues (including drug and insecticide resistance and disruption to social cohesion caused by the COVID-19 pandemic). Development of an effective malaria vaccine is the alternative preventative tool in the fight against malaria. Vaccines save millions of lives each year and have helped in elimination and/or eradication of global diseases. Development of a highly efficacious malaria vaccine that will ensure long-lasting protective immunity will be a "game-changing" prevention strategy to finally eradicate the disease. Such a vaccine will need to counteract the significant obstacles that have been hampering subunit vaccine development to date, including antigenic polymorphism, sub-optimal immunogenicity, and waning vaccine efficacy.
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Affiliation(s)
- Winter A. Okoth
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Mei-Fong Ho
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Mehfuz Zaman
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Emily Cooper
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Priyanka Som
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Mark Burgess
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Maddison Walton
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Reshma J. Nevagi
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Lynette Beattie
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Declan Murphy
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Michael F. Good
- Institute for Glycomics, Griffith University, Southport, Queensland, Australia
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Good MF, Yanow SK. Hiding in plain sight: an epitope-based strategy for a subunit malaria vaccine. Trends Parasitol 2023; 39:929-935. [PMID: 37684152 PMCID: PMC10592166 DOI: 10.1016/j.pt.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 09/10/2023]
Abstract
Recent data suggest that approaches to developing a subunit blood-stage malaria vaccine may be misdirected. While antigenic polymorphism is recognized as a challenge, efforts to counter this have primarily involved enhancing the quantity and quality of antibody with potent adjuvants, identifying conserved target proteins, or combining multiple antigens to broaden the immune response. However, paradoxically, evidence has emerged that narrowing, rather than broadening, the immune response may be required to obtain an immune response protective against multiple Plasmodium strains. Non-immunodominant, conserved epitopes are crucial. The evidence comes from studying the immune response to red cell surface-expressed antigens but should also be applicable to merozoite surface antigens. Strategies to define the targets of these highly focused immune responses are provided.
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Affiliation(s)
- Michael F Good
- Institute for Glycomics, Griffith University, Gold Coast, Australia.
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Ahmed A, EL‐Sadig SM, Eltigani HF, Bongomin F, Siddig EE. The first Helicobacter pylori-induced Guillain-Barré syndrome in Sudan. Clin Case Rep 2023; 11:e8204. [PMID: 38028082 PMCID: PMC10645600 DOI: 10.1002/ccr3.8204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/15/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Key Clinical Message This case report highlights the role of Helicobacter pylori infection in the development of GBS. Healthcare providers should consider H. pylori in their differential diagnosis for patients with neurological syndromes. Astract We report the first known case of Guillain-Barré syndrome (GBS) associated with Helicobacter pylori infection in Sudan. This case highlights the role of H. pylori infection in the development of GBS. It also emphasizes the importance of wide screening of different endemic infections for patients with neurological syndromes for early detection and improves the case management in resource-limited settings like Sudan. Further research is needed to better understand the underlying mechanisms of H. pylori-inducing neurological disorders.
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Affiliation(s)
- Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- University of BaselBaselSwitzerland
- Institute of Endemic DiseaseUniversity of KhartoumKhartoumSudan
| | | | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of MedicineGulu UniversityGuluUganda
| | - Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious Diseases, ErasmusMCUniversity Medical Center RotterdamRotterdamThe Netherlands
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Siddig EE, Misbah El‐Sadig S, Eltigani HF, Musa AM, Mohamed NS, Ahmed A. Delayed cerebellar ataxia induced by Plasmodium falciparum malaria: A rare complication. Clin Case Rep 2023; 11:e8053. [PMID: 37867542 PMCID: PMC10589394 DOI: 10.1002/ccr3.8053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023] Open
Abstract
Key Clinical Message In endemic areas, malaria-induced cerebellar ataxia should be suspected in patients presenting with neurological disorders including slurred speech, tremors, and a sense of imbalance and dizziness while walking. Healthcare providers should be aware to properly investigate and early detect and manage infections associated with the development of cerebellar ataxia to improve the case management and clinical outcome cost-effectively. Abstract Here, we report the clinical manifestations, investigations, and outcomes of a patient developed delayed cerebellar ataxia following a malaria infection: an unusual complication of the disease. This report highlights the diagnostic challenges in a country endemic with several infectious diseases, yet it has a limited diagnostic and surveillance capacity.
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Affiliation(s)
| | | | | | | | - Nouh Saad Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Ayman Ahmed
- Institute of Endemic DiseaseUniversity of KhartoumKhartoumSudan
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- University of BaselBaselSwitzerland
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Ali Y, Siddig EE, Mohamed N, Ahmed A. Rift Valley fever and malaria co-infection: A case report. Clin Case Rep 2023; 11:e7926. [PMID: 37731970 PMCID: PMC10507219 DOI: 10.1002/ccr3.7926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
Key Clinical Message We report a case of febrile illness that was presented with mild symptoms. However, laboratory investigation confirmed a malaria and Rift Valley fever co-infection. Healthcare providers in settings endemic with several infectious diseases should seek rolling out possibilities of other infections prior to starting treatment for achieving effective case management with less resources and better safety of patients. Abstract Here we report a case of febrile illness that confirmed to be a co-infection of malaria and Rift Valley fever. The patient was initially diagnosed with malaria and started on treatment immediately. However, due to the lack of response to the treatment further laboratory investigations were pursued.
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Affiliation(s)
- Yousif Ali
- Sudan Field Epidemiology Training, Health Emergencies and Epidemics Control General DirectorateSudan Federal Ministry of HealthKhartoumSudan
| | - Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious DiseasesErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Nouh Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- Faculty of ScienceUniversity of BaselBaselSwitzerland
- Institute of Endemic DiseasesUniversity of KhartoumKhartoumSudan
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Ahmed A, El‐Amin R, Musa AM, Elsayed MA, Fahal LA, Ahmed ES, Ali Y, Nebie IE, Mohamed NS, Zinsstag J, Siddig EE, EL‐Sadig SM. Guillain-Barre syndrome associated with COVID-19 infection: A case series. Clin Case Rep 2023; 11:e6988. [PMID: 36852114 PMCID: PMC9957700 DOI: 10.1002/ccr3.6988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/03/2023] [Accepted: 02/06/2023] [Indexed: 02/27/2023] Open
Abstract
In this communication, we reported a series of six patients presented with Guillain-Barré syndrome that associated with COVID-19 infection, which was confirmed with RT-PCR. Here we discuss the laboratory investigation and case management, as well as clinical presentation and outcome of each case. The current report demonstrated the first case series of COVID-19-associated GBS-cases in Sudan.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic DiseaseUniversity of KhartoumKhartoumSudan,Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Rahba El‐Amin
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | | | | | | | | | - Yousif Ali
- Health Emergencies and Epidemics Control General DirectorateSudan Federal Ministry of HealthKhartoumSudan
| | - Ipyn Eric Nebie
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Nouh Saad Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Emmanuel Edwar Siddig
- Mycetoma Research CentreUniversity of KhartoumKhartoumSudan,Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
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