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Osei-Owusu J, Aidoo OF, Eshun F, Gaikpa DS, Dofuor AK, Vigbedor BY, Turkson BK, Ochar K, Opata J, Opoku MJ, Ninsin KD, Borgemeister C. Buruli ulcer in Africa: Geographical distribution, ecology, risk factors, diagnosis, and indigenous plant treatment options - A comprehensive review. Heliyon 2023; 9:e22018. [PMID: 38034712 PMCID: PMC10686891 DOI: 10.1016/j.heliyon.2023.e22018] [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: 07/04/2023] [Revised: 10/09/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
Buruli ulcer (BU), a neglected tropical disease (NTD), is an infection of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. The disease has been documented in many South American, Asian, and Western Pacific countries and is widespread throughout much of Africa, especially in West and Central Africa. In rural areas with scarce medical care, BU is a devastating disease that can leave patients permanently disabled and socially stigmatized. Mycobacterium ulcerans is thought to produce a mycolactone toxin, which results in necrosis of the afflicted tissue and may be involved in the etiology of BU. Initially, patients may notice a painless nodule or plaque on their skin; as the disease progresses, however, it may spread to other parts of the body, including the muscles and bones. Clinical signs, microbial culture, and histological analysis of afflicted tissue all contribute to a diagnosis of BU. Though antibiotic treatment and surgical removal of infected tissue are necessary for BU management, plant-derived medicine could be an alternative in areas with limited access to conventional medicine. Herein we reviewed the geographical distribution, socioeconomic, risk factors, diagnosis, biology and ecology of the pathogen. Complex environmental, socioeconomic, and genetic factors that influence BU are discussed. Further, our review highlights future research areas needed to develop strategies to manage the disease through the use of indigenous African plants.
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Affiliation(s)
- Jonathan Osei-Owusu
- Department of Physical and Mathematical Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Owusu Fordjour Aidoo
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Fatima Eshun
- Department of Geography and Earth Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - David Sewordor Gaikpa
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Aboagye Kwarteng Dofuor
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Bright Yaw Vigbedor
- Department of Basic Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Bernard Kofi Turkson
- Department of Herbal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kingsley Ochar
- Council for Scientific and Industrial Research, Plant Genetic Resources Research Institute, Bunso, Ghana
| | - John Opata
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Maxwell Jnr. Opoku
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Kodwo Dadzie Ninsin
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Christian Borgemeister
- Centre for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113 Bonn, Germany
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Chaptal M, Andrejak C, Bonifay T, Beillard E, Guillot G, Guyomard-Rabenirina S, Demar M, Trombert-Paolantoni S, Jacomo V, Mosnier E, Veziris N, Djossou F, Epelboin L. Epidemiology of infection by pulmonary non-tuberculous mycobacteria in French Guiana 2008–2018. PLoS Negl Trop Dis 2022; 16:e0010693. [PMID: 36084148 PMCID: PMC9491559 DOI: 10.1371/journal.pntd.0010693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 09/21/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Unlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due attention in French Guiana. The main objective of the current study was to define the incidence of these PNTM infections: NTM pulmonary diseases (NTM-PD) and casual PNTM isolation (responsible of latent infection or simple colonization). The secondary objectives were to determine species diversity and geographic distribution of these atypical mycobacteria. Methods A retrospective observational study (2008–2018) of French Guiana patients with at least one PNTM positive respiratory sample in culture was conducted. Patients were then classified into two groups: casual PNTM isolation or pulmonary disease (NTM-PD), according to clinical, radiological and microbiological criteria defined by the American Thoracic Society / Infectious Disease Society of America (ATS / IDSA) in 2007. Results 178 patients were included, out of which 147 had casual PNTM isolation and 31 had NTM-PD. Estimated annual incidence rate of respiratory isolates was 6.17 / 100,000 inhabitants per year while that of NTM-PD was 1.07 / 100,000 inhabitants per year. Among the 178 patients, M. avium complex (MAC) was the most frequently isolated pathogen (38%), followed by M. fortuitum then M. abscessus (19% and 6% of cases respectively), the latter two mycobacteria being mainly found in the coastal center region. Concerning NTM-PD, two species were mainly involved: MAC (81%) and M. abscessus (16%). Discussion/Conclusion This is the first study on the epidemiology of PNTM infections in French Guiana. PNTM’s incidence looks similar to other contries and metropolitan France and NTM-PD is mostly due to MAC and M.abscessus. Although French Guiana is the French territory with the highest tuberculosis incidence, NTM should not be overlooked.
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Affiliation(s)
- Milène Chaptal
- Tropical and Infectious Diseases Department, Andrée Rosemon Hospital, Cayenne, French Guiana
- Pneumology Department, University Hospital of Guadeloupe, Pointe-à-Pitre, France
- * E-mail:
| | | | - Timothée Bonifay
- Penitentiary ambulatory care and consultation unit, Andrée Rosemon Hospital, Cayenne, French Guiana
| | | | - Geneviève Guillot
- Medical Department, Andrée Rosemon Hospital, Cayenne, Guyane française
| | | | - Magalie Demar
- Laboratory, Andrée Rosemon Hospital, Cayenne, French Guiana
| | | | | | - Emilie Mosnier
- Tropical and Infectious Diseases Department, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Nicolas Veziris
- Sorbonne Université, INSERM U1135, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Département de Bactériologie, Groupe hospitalier APHP, Sorbonne Université, Site Saint-Antoine, Paris, France
| | - Felix Djossou
- Tropical and Infectious Diseases Department, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Loïc Epelboin
- Tropical and Infectious Diseases Department, Andrée Rosemon Hospital, Cayenne, French Guiana
- Centre d’investigation Clinique INSERM 1424, Centre Hospitalier de Cayenne, Andrée Rosemon, Cayenne, French Guiana
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Osei L, Basurko C, Nacher M, Vignier N, Elenga N. About the need to address pediatric health inequalities in French Guiana : a scoping review. Arch Pediatr 2022; 29:340-346. [DOI: 10.1016/j.arcped.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/26/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
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Faber WR, Menke H, Rutten V, Pieters T. Lepra Bubalorum, a Potential Reservoir of Mycobacterium leprae. Front Microbiol 2021; 12:786921. [PMID: 34925294 PMCID: PMC8674755 DOI: 10.3389/fmicb.2021.786921] [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: 09/30/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
In 1926, a mycobacterial skin disease was observed in water buffaloes by researchers in Indonesia. The disease was designated as skin tuberculosis, though it was hypothesized that it might be a form of leprosy or a leprosy-like disease. In a follow-up study (Ph.D. thesis Lobel, 1934, Utrecht University, Netherlands) a similar nodular skin disease was described in Indonesian water buffaloes and named "lepra bubalorum" or "nodular leprosy." Two decades later Kraneveld and Roza (1954) reported that, so far, the diagnosis lepra bubalorum had been made in 146 cases in Indonesia. After a final series of research reports by Indonesian veterinarians in 1961, no subsequent cases were published. Based on information from these reports, it can be concluded that, even though evidence of nerve involvement in buffaloes was not reported, similarities exist between lepra bubalorum and Hansen's disease (leprosy), i.e., nodular skin lesions with a chronic course and microscopically granulomatous reactions with AFB in globi in vacuoles. This raises the question as to whether these historical cases might indeed have been caused by Mycobacterium leprae, Mycobacterium lepromatosis or another representative of the M. leprae complex. The future use of state-of-the-art molecular techniques may answer this question and may also help to answer the question whether water buffaloes should be considered as a potential natural reservoir of the causative pathogen of Hansen's disease.
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Affiliation(s)
- William R Faber
- Department of Dermatology, Amsterdam University Medical Centre (UMC), University of Amsterdam, Amsterdam, Netherlands
| | - Henk Menke
- Faculty of Science, Freudenthal Institute, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, Netherlands
| | - Victor Rutten
- Division of Infectious Disease and Immunology, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands.,Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Toine Pieters
- Faculty of Science, Freudenthal Institute, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, Netherlands
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Simpson H, Tabah EN, Phillips RO, Frimpong M, Maman I, Ampadu E, Timothy J, Saunderson P, Pullan RL, Cano J. Mapping suitability for Buruli ulcer at fine spatial scales across Africa: A modelling study. PLoS Negl Trop Dis 2021; 15:e0009157. [PMID: 33657104 PMCID: PMC7959670 DOI: 10.1371/journal.pntd.0009157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 03/15/2021] [Accepted: 01/17/2021] [Indexed: 12/14/2022] Open
Abstract
Buruli ulcer (BU) is a disabling and stigmatising neglected tropical disease (NTD). Its distribution and burden are unknown because of underdiagnosis and underreporting. It is caused by Mycobacterium ulcerans, an environmental pathogen whose environmental niche and transmission routes are not fully understood. The main control strategy is active surveillance to promote early treatment and thus limit morbidity, but these activities are mostly restricted to well-known endemic areas. A better understanding of environmental suitability for the bacterium and disease could inform targeted surveillance, and advance understanding of the ecology and burden of BU. We used previously compiled point-level datasets of BU and M. ulcerans occurrence, evidence for BU occurrence within national and sub-national areas, and a suite of relevant environmental covariates in a distribution modelling framework. We fitted relationships between BU and M. ulcerans occurrence and environmental predictors by applying regression and machine learning based algorithms, combined in an ensemble model to characterise the optimal ecological niche for the disease and bacterium across Africa at a resolution of 5km x 5km. Proximity to waterbodies was the strongest predictor of suitability for BU, followed potential evapotranspiration. The strongest predictors of suitability for M. ulcerans were deforestation and potential evapotranspiration. We identified patchy foci of suitability throughout West and Central Africa, including areas with no previous evidence of the disease. Predicted suitability for M. ulcerans was wider but overlapping with that of BU. The estimated population living in areas predicted suitable for the bacterium and disease was 46.1 million. These maps could be used to inform burden estimations and case searches which would generate a more complete understanding of the spatial distribution of BU in Africa, and may guide control programmes to identify cases beyond the well-known endemic areas.
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Affiliation(s)
- Hope Simpson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Earnest Njih Tabah
- National Yaws, Leishmaniasis, Leprosy and Buruli ulcer Control Programme, Cameroon
| | - Richard O. Phillips
- School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Frimpong
- School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Issaka Maman
- National Reference Laboratory for Buruli Ulcer Disease in Togo, Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA), Laboratoire des Sciences Biologiques et des Substances Bioactives, Université de Lomé, Lomé, Togo
| | - Edwin Ampadu
- National Buruli Ulcer Control Program, Ghana Health Service, Accra, Ghana
| | - Joseph Timothy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paul Saunderson
- Accelerating Integrated Management (AIM) Initiative, Accra, Ghana
| | - Rachel L. Pullan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jorge Cano
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Vandelannoote K, Pluschke G, Bolz M, Bratschi MW, Kerber S, Stinear TP, de Jong BC. Introduction of Mycobacterium ulcerans disease in the Bankim Health District of Cameroon follows damming of the Mapé River. PLoS Negl Trop Dis 2020; 14:e0008501. [PMID: 32886658 PMCID: PMC7473558 DOI: 10.1371/journal.pntd.0008501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022] Open
Abstract
Buruli ulcer (BU) is an emerging ulcerative skin disease caused by infection with Mycobacterium ulcerans. Efforts to control its spread have been hampered by our limited understanding of M. ulcerans reservoirs and transmission, and the factors leading to the emergence of BU disease in a particular region. In this report we investigate an anecdotal link between damming the Mapé River in Cameroon and the emergence of BU in the Health Districts bordering Lake Bankim, the impoundment created by the Mapé dam. We used bacterial population genomics and molecular dating to find compelling support for a 2000 M. ulcerans introduction event that followed about 10 years after the filling of the newly created impoundment in 1988. We compared the genomic reconstructions with high-resolution satellite imagery to investigate what major environmental alterations might have driven the emergence of the new focus.
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Affiliation(s)
- Koen Vandelannoote
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection & Immunity, Melbourne, Australia
| | - Gerd Pluschke
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Miriam Bolz
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin W. Bratschi
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sarah Kerber
- Molecular Immunology, Swiss Tropical Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, The University of Melbourne at the Doherty Institute for Infection & Immunity, Melbourne, Australia
| | - Bouke C. de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
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7
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Combe M, Couppié P, Blaizot R, Valentini A, Gozlan RE. Are all Buruli ulcers caused by Mycobacterium ulcerans? Br J Dermatol 2020; 183:968-970. [PMID: 32470150 DOI: 10.1111/bjd.19260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/11/2020] [Accepted: 05/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M Combe
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, Montpellier, France
| | - P Couppié
- Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Equipe EPAT 3593 Ecosystèmes amazoniens et pathologies tropicales, Université de Guyane, Cayenne, French Guiana
| | - R Blaizot
- Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | | | - R E Gozlan
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, Montpellier, France
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8
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Fevereiro J, Sajjadi N, Fraga AG, Teixeira PM, Pedrosa J. Individual and clinical variables associated with the risk of Buruli ulcer acquisition: A systematic review and meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008161. [PMID: 32267838 PMCID: PMC7170268 DOI: 10.1371/journal.pntd.0008161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/20/2020] [Accepted: 02/21/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Buruli ulcer (BU) is a necrotizing skin disease, caused by Mycobacterium ulcerans, with poorly understood acquisition risk factors. This review aims at evaluating the importance of individual-sex, age, family ties with history of BU, gene variants-and clinical-Bacillus Calmette-Guérin (BCG) immunization, Human Immunodeficiency Virus (HIV) infection-variables in this process. METHODS A systematic review was performed considering the following databases: ClinicalTrials.gov, Cochrane Controlled Register of Trials (CENTRAL), Current Contents Connect, Embase, MEDLINE, SciELO, Scopus and Web of Science. Eligible studies were critically appraised with The Joanna Briggs Institute checklists and heterogeneity was assessed with Cochran Q-test and I2 statistic. Published demographic data was descriptively analysed and clinical data pooled within random-effects modelling for meta-analysis. RESULTS A total of 29 studies were included in the systematic review. Two randomized controlled trials (RCTs) and 21 case-control studies were selected for meta-analysis. Studies show that BU mainly affects age extremes, more preponderately males among children. Data pooled from RCTs do not reveal BCG to be protective against BU (odds ratio (OR) = 0.63; 95% CI = 0.38-1.05; I2 = 56%), a finding case-control studies appear to corroborate. HIV infection (OR = 6.80; 95% CI = 2.33-19.85; I2 = 0%) and SLC11A1 rs17235409 A allele (OR = 1.86; 95% CI = 1.25-2.77; I2 = 0%) are associated with increased prevalence of the disease. No definite conclusions can be drawn regarding the influence of previous family history of BU. DISCUSSION While available evidence warrants further robustness, these results have direct implications on current interventions and future research programs, and foster the development of more cost-effective preventive and screening measures. REGISTRATION The study was registered at PROSPERO with number CRD42019123611.
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Affiliation(s)
- João Fevereiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nikta Sajjadi
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra G. Fraga
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro M. Teixeira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Jorge Pedrosa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Jagadesh S, Combe M, Couppié P, Nacher M, Gozlan RE. Global Emergence of Buruli Ulcer. ECOHEALTH 2019; 16:591-593. [PMID: 31628633 DOI: 10.1007/s10393-019-01445-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/28/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Soushieta Jagadesh
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, 34090, Montpellier, France.
- Equipe EPAT 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana.
| | - Marine Combe
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, 34090, Montpellier, France
| | - Pierre Couppié
- Equipe EPAT 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
- Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Avenue des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Mathieu Nacher
- Equipe EPAT 3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
- Centre d'Investigation Clinique (CIC Inserm 1424), Centre Hospitalier Andrée Rosemon, Avenue des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Rodolphe Elie Gozlan
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, 34090, Montpellier, France
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Jagadesh S, Combe M, Couppié P, Le Turnier P, Epelboin L, Nacher M, Gozlan RE. Emerging human infectious diseases of aquatic origin: a comparative biogeographic approach using Bayesian spatial modelling. Int J Health Geogr 2019; 18:23. [PMID: 31694656 PMCID: PMC6833193 DOI: 10.1186/s12942-019-0188-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the increase in unprecedented and unpredictable disease outbreaks due to human-driven environmental changes in recent years, we need new analytical tools to map and predict the spatial distribution of emerging infectious diseases and identify the biogeographic drivers underpinning their emergence. The aim of the study was to identify and compare the local and global biogeographic predictors such as landscape and climate that determine the spatial structure of leptospirosis and Buruli Ulcer (BU). METHODS We obtained 232 hospital-confirmed leptospirosis (2007-2017) cases and 236 BU cases (1969-2017) in French Guiana. We performed non-spatial and spatial Bayesian regression modeling with landscape and climate predictor variables to characterize the spatial structure and the environmental drivers influencing the distribution of the two diseases. RESULTS Our results show that the distribution of both diseases is spatially dependent on environmental predictors such as elevation, topological wetness index, proximity to cropland and increasing minimum temperature at the month of potential infection. However, the spatial structure of the two diseases caused by bacterial pathogens occupying similar aquatic niche was different. Leptospirosis was widely distributed across the territory while BU was restricted to the coastal riverbeds. CONCLUSIONS Our study shows that a biogeographic approach is an effective tool to identify, compare and predict the geographic distribution of emerging diseases at an ecological scale which are spatially dependent to environmental factors such as topography, land cover and climate.
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Affiliation(s)
- Soushieta Jagadesh
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France. .,Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana.
| | - Marine Combe
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France
| | - Pierre Couppié
- Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana.,Service de Dermatologie, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Paul Le Turnier
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Loïc Epelboin
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Mathieu Nacher
- Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana.,Centre d'investigation clinique (CIC Inserm 1424), Centre hospitalier Andrée Rosemon, Avenue des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Rodolphe Elie Gozlan
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France
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Combe M, Gozlan RE, Jagadesh S, Velvin CJ, Ruffine R, Demar MP, Couppié P, Djossou F, Nacher M, Epelboin L. Comparison of Mycobacterium ulcerans (Buruli ulcer) and Leptospira sp. (Leptospirosis) dynamics in urban and rural settings. PLoS Negl Trop Dis 2019; 13:e0007074. [PMID: 30615683 PMCID: PMC6336349 DOI: 10.1371/journal.pntd.0007074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/17/2019] [Accepted: 12/13/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Zoonotic pathogens respond to changes in host range and/or pathogen, vector and host ecology. Environmental changes (biodiversity, habitat changes, variability in climate), even at a local level, lead to variability in environmental pathogen dynamics and can facilitate their transmission from natural reservoirs to new susceptible hosts. Whilst the environmental dynamics of aquatic bacteria are directly linked to seasonal changes of their habitat they also rely on the ecological processes underpining their transmission. However data allowing the comparison of these ecological processes are lacking. Here we compared the environmental dynamics of generalist and vector-borne aquatic bacterial pathogens in the same unit of time and space, and across rural and urban habitats in French Guiana (South America). PRINCIPAL FINDINGS Using Leptospira sp. and Mycobacterium ulcerans we performed an environmental survey that allowed the detection of both pathogens in urban vs. rural areas, and during rainy vs. dry weather conditions. All samples were subjected to qPCR amplifications of LipL32 (Leptospira sp.) and IS2404 and KR (M. ulcerans) genetic markers. We found (i) a greater presence of M. ulcerans in rural areas compared with Leptospira sp., (ii) that modified urban environments were more favourable to the establishment of both pathogens, (iii) that Leptospira sp. presence was enhanced during the rainy season and M. ulcerans during the dry period, and (iv) differences in the spatial distribution of both bacteria across urban sites, probably due to the mode of dissemination of each pathogen in the environment. CONCLUSIONS We propose that in French Guiana simplified and modified urban ecosystems might favour leptospirosis and Buruli ulcer emergence and transmission. Moreover, disease risk was also constrained by seasonality. We suggest that the prevention of aquatic bacterial disease emergence in impoverished urban areas of developing countries would benefit from seasonal diseases targeted surveys, which would maximise limited budgets from cash-strapped health agencies.
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Affiliation(s)
- Marine Combe
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France
| | | | - Soushieta Jagadesh
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France
| | | | - Rolland Ruffine
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, Centre IRD de Cayenne, Guyane française
| | - Magalie Pierre Demar
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Laboratoire hospitalo-universitaire de parasitologie mycologie, Centre hospitalier Andrée Rosemon, Guyane française
| | - Pierre Couppié
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Service de Dermatologie, Cayenne Hospital, rue des Flamboyant, Cayenne, French Guiana, France
| | - Felix Djossou
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, Guyane française
| | - Mathieu Nacher
- Centre d’investigation clinique (CIC Inserm 1424), Centre hospitalier Andrée Rosemon, Guyane française
| | - Loïc Epelboin
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, Guyane française
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12
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Bretzel G, Beissner M. PCR detection of Mycobacterium ulcerans-significance for clinical practice and epidemiology. Expert Rev Mol Diagn 2018; 18:1063-1074. [PMID: 30381977 DOI: 10.1080/14737159.2018.1543592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Buruli ulcer (BU) is a neglected disease which has been reported from mostly impoverished, remote rural areas from 35 countries worldwide. BU affects skin, subcutaneous tissue, and bones, and may cause massive tissue destruction and life-long disabilities if not diagnosed and treated early. Without laboratory confirmation diagnostic and treatment errors may occur. This review describes the application of IS2404 PCR, the preferred diagnostic test, in the area of individual patient management and clinico-epidemiological studies. Areas covered: A Medline search included publications on clinical sample collection, DNA extraction, and PCR detection formats of the past and present, potential and limitations of clinical application, as well as clinico-epidemiological studies. Expert commentary: A global network of reference laboratories basically provides the possibility for PCR confirmation of 70% of all BU cases worldwide as requested by the WHO. Keeping laboratory confirmation on a constant level requires continuous outreach activities. Among the potential measures to maintain sustainability of laboratory confirmation and outreach activities are decentralized or mobile diagnostics available at point of care, such as IS2404-based LAMP, which complement the standard IS2404-based diagnostic tools available at central level.
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Affiliation(s)
- Gisela Bretzel
- a Division of Infectious Diseases and Tropical Medicine , University Hospital, Ludwigs-Maximilians-University , Munich , Germany
| | - Marcus Beissner
- a Division of Infectious Diseases and Tropical Medicine , University Hospital, Ludwigs-Maximilians-University , Munich , Germany
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Abstract
Mycobacterium ulcerans is recognised as the third most common mycobacterial infection worldwide. It causes necrotising infections of skin and soft tissue and is classified as a neglected tropical disease by the World Health Organization (WHO). However, despite extensive research, the environmental reservoir of the organism and mode of transmission of the infection to humans remain unknown. This limits the ability to design and implement public health interventions to effectively and consistently prevent the spread and reduce the incidence of this disease. In recent years, the epidemiology of the disease has changed. In most endemic regions of the world, the number of cases reported to the WHO are reducing, with a 64% reduction in cases reported worldwide in the last 9 years. Conversely, in a smaller number of countries including Australia and Nigeria, reported cases are increasing at a rapid rate, new endemic areas continue to appear, and in Australia cases are becoming more severe. The reasons for this changing epidemiology are unknown. We review the epidemiology of M. ulcerans disease worldwide, and document recent changes. We also outline and discuss the current state of knowledge on the ecology of M. ulcerans, possible transmission mechanisms to humans and what may be enabling the spread of M. ulcerans into new endemic areas.
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O'Brien DP. Unlocking of the secrets of Mycobacterium ulcerans disease transmission. Lancet Planet Health 2017; 1:e52-e53. [PMID: 29851578 DOI: 10.1016/s2542-5196(17)30026-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Daniel Patrick O'Brien
- Barwon Health, Department of Infectious Diseases, Geelong, VIC 3220, Australia; Department of Medicine and Infectious Diseases, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia; Manson Unit, Médecins Sans Frontières, London, UK.
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