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Protozoan agents and nematode agents (5th section). Transfusion 2024; 64 Suppl 1:S271-S287. [PMID: 38394043 DOI: 10.1111/trf.17694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/25/2024]
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Portela CS, Mendes de Araújo CP, Moura Sousa P, Gomes Simão CL, Silva de Oliveira JC, Crainey JL. Filarial disease in the Brazilian Amazon and emerging opportunities for treatment and control. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2023; 5:100168. [PMID: 38283060 PMCID: PMC10821485 DOI: 10.1016/j.crpvbd.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
Following the successful eradication of Wuchereria bancrofti, there are now just three species of conventional microfilaremic human filarial parasites endemic to the Brazilian Amazon region: Mansonella ozzardi, Mansonella perstans and Onchocerca volvulus. The zoonotic filarial parasite Dirofilaria immitis is also found in the Amazon region as are several sylvatic filarial parasites, some of which have been recorded causing zoonoses and some of which have never been recorded outside the region. Onchocerca volvulus is only found in the Amazonia onchocerciasis focus in the Brazilian state of Roraima where it affects the people of the Yanomami tribe living around the densely forested Venezuela border region. Mansonella ozzardi is by far the most common filarial parasite in Brazil and has a broad but patchy distribution throughout the western Amazon region. Recorded in the Brazilian states of Acre, Roraima, Matto Grosso, and within almost every municipality of Amazonas state, it is believed that pollution of the urban stream and river systems prevents the development of the simuliid vectors of M. ozzardi and explains the parasite's reduced distribution within urban areas and an absence of recent reports from the state capital Manaus. Decades of WHO-led periodic ivermectin treatment of Yanomami tribe's people have resulted in the partial suppression of O. volvulus transmission in this focus and has also probably affected the transmission of M. ozzardi in the region. Mansonella perstans, O. volvulus and very probably M. ozzardi infections can all be treated and most likely cured with a 4-6-week treatment course of doxycycline. The Brazilian Ministry of Health does not, however, presently recommend any treatment for mansonellosis infections and thus parasitic infections outside the Amazonia focus are typically left untreated. While the long treatment courses required for doxycycline-based mansonellosis therapies preclude their use in control programmes, new fast-acting filarial drug treatments are likely to soon become available for the treatment of both onchocerciasis and mansonellosis in the Amazon region. Filarial disease management in the Brazilian Amazon is thus likely to become dramatically more viable at a time when the public health importance of these diseases is increasingly being recognized.
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Affiliation(s)
- Cleudecir Siqueira Portela
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Cláudia Patrícia Mendes de Araújo
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Patrícia Moura Sousa
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Carla Letícia Gomes Simão
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Mestrado em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - João Carlos Silva de Oliveira
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Saúde Pública na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Manaus, Amazonas, Brazil
| | - James Lee Crainey
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
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Dahmer KJ, Palma-Cuero M, Ciuoderis K, Patiño C, Roitman S, Li Z, Sinha A, Hite JL, Bellido Cuellar O, Hernandez-Ortiz JP, Osorio JE, Christensen BM, Carlow CKS, Zamanian M. Molecular surveillance detects high prevalence of the neglected parasite Mansonella ozzardi in the Colombian Amazon. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289806. [PMID: 37215049 PMCID: PMC10197819 DOI: 10.1101/2023.05.10.23289806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mansonellosis is an undermapped insect-transmitted disease caused by filarial nematodes that are estimated to infect hundreds of millions of people globally. Despite their prevalence, there are many outstanding questions regarding the general biology and health impacts of the responsible parasites. Historical reports suggest that the Colombian Amazon is endemic for mansonellosis and may serve as an ideal location to pursue these questions in the backdrop of other endemic and emerging pathogens. We deployed molecular and classical diagnostic approaches to survey Mansonella prevalence among adults belonging to indigenous communities along the Amazon River and its tributaries near Leticia, Colombia. Deployment of a loop-mediated isothermal amplification (LAMP) assay on blood samples revealed an infection prevalence of ∼40% for Mansonella ozzardi . This assay identified significantly more infections than blood smear microscopy or LAMP assays performed using plasma, likely reflecting greater sensitivity and the ability to detect low microfilaremias or occult infections. Mansonella infection rates increased with age and were higher among males compared to females. Genomic analysis confirmed the presence of M. ozzardi that clusters closely with strains sequenced in neighboring countries. We successfully cryopreserved and revitalized M. ozzardi microfilariae, advancing the prospects of rearing infective larvae in controlled settings. These data suggest an underestimation of true mansonellosis prevalence, and we expect that these methods will help facilitate the study of mansonellosis in endemic and laboratory settings.
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Affiliation(s)
- KJ Dahmer
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
| | - M Palma-Cuero
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
| | - K Ciuoderis
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
- Universidad Nacional de Colombia - UW-GHI One Health Colombia, Medellín, Colombia
| | - C Patiño
- Universidad Nacional de Colombia - UW-GHI One Health Colombia, Medellín, Colombia
| | - S Roitman
- New England Biolabs, 240 County Road, Ipswich, MA USA
| | - Z Li
- New England Biolabs, 240 County Road, Ipswich, MA USA
| | - A Sinha
- New England Biolabs, 240 County Road, Ipswich, MA USA
| | - JL Hite
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
| | | | - JP Hernandez-Ortiz
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
- Universidad Nacional de Colombia - UW-GHI One Health Colombia, Medellín, Colombia
| | - JE Osorio
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
| | - BM Christensen
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
| | - CKS Carlow
- New England Biolabs, 240 County Road, Ipswich, MA USA
| | - M Zamanian
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI USA
- University of Wisconsin Global Health Institute One Health Colombia, Madison, WI USA
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Barbosa UC, Nava AFD, Ferreira Neto JV, Dias CA, Silva VCD, Mesquita HGD, Sampaio RTDM, Barros WG, Farias EDS, Silva TRRD, Crainey JL, Tadei WP, Koolen HHF, Pessoa FAC. Dirofilaria immitis is endemic in rural areas of the Brazilian Amazonas state capital, Manaus. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2023; 32:e000223. [PMID: 37132734 PMCID: PMC10153491 DOI: 10.1590/s1984-29612023018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/17/2023] [Indexed: 05/04/2023]
Abstract
The canine filarial parasite Dirofilaria immitis has not been reported in Brazil´s Amazonas state capital, Manaus, for over a century. Here, we report one imported and 27 autochthonous D. immitis infections from a microfilarial survey of 766 domestic dog blood samples collected between 2017 and 2021 in Manaus. An Overall prevalence estimate of 15.44% (23/149) was calculated from our two rural collection sites; a prevalence of 1.22% (4/328) was estimated at our periurban collection site, and an overall prevalence of 0.35% (1/289) was calculated from our two urban clinic collections. Our data suggest that in the urban areas of Manaus, where the parasites are very likely vectored by the same species of mosquito that historically vectored Wuchereria bancrofti (Culex quinquefasciatus), prevalence levels are very low and possibly maintained by an influx from rural areas where sylvatic reservoirs and/or more favorable vector transmission dynamics maintain high prevalences.
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Affiliation(s)
- Ulysses Carvalho Barbosa
- Programa de Pós-graduação em Biodiversidade e Biotecnologia PPG-Bionorte, Manaus, AM, Brasil
- Laboratório de Etnoepidemiologia, Coordenação de Sociedade Ambiente e Saúde, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | | | - José Vicente Ferreira Neto
- Programa de Pós-graduação em Entomologia, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | - Cindy Alves Dias
- Programa de Pós-graduação em Biointeração Parasita-Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
| | - Viviane Costa da Silva
- Laboratório de Ecologia Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
| | - Hugo Guimarães de Mesquita
- Laboratório de Etnoepidemiologia, Coordenação de Sociedade Ambiente e Saúde, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | - Raquel Telles de Moreira Sampaio
- Laboratório de Etnoepidemiologia, Coordenação de Sociedade Ambiente e Saúde, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | - Wanilze Gonçalves Barros
- Laboratório de Etnoepidemiologia, Coordenação de Sociedade Ambiente e Saúde, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | - Emanuelle de Sousa Farias
- Laboratório de Ecologia Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
| | | | - James Lee Crainey
- Laboratório de Ecologia Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
| | - Wanderli Pedro Tadei
- Laboratório de Malária e Dengue, Coordenação de Sociedade Ambiente e Saúde, Instituto Nacional de Pesquisas da Amazônia, Manaus, AM, Brasil
| | | | - Felipe Arley Costa Pessoa
- Laboratório de Ecologia Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
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Ta-Tang TH, Luz SLB, Crainey JL, Rubio JM. An Overview of the Management of Mansonellosis. Res Rep Trop Med 2021; 12:93-105. [PMID: 34079424 PMCID: PMC8163967 DOI: 10.2147/rrtm.s274684] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/30/2021] [Indexed: 02/02/2023] Open
Abstract
Mansonellosis is caused by three filarial parasite species from the genus Mansonella that commonly produce chronic human microfilaraemias: M. ozzardi, M. perstans and M. streptocerca. The disease is widespread in Africa, the Caribbean and South and Central America, and although it is typically asymptomatic it has been associated with mild pathologies including leg-chills, joint-pains, headaches, fevers, and corneal lesions. No robust mansonellosis disease burden estimates have yet been made and the impact the disease has on blood bank stocks and the monitoring of other filarial diseases is not thought to be of sufficient public health importance to justify dedicated disease management interventions. Mansonellosis´s Ceratopogonidae and Simuliidae vectors are not targeted by other control programmes and because of their small size and out-door biting habits are unlikely to be affected by interventions targeting other disease vectors like mosquitoes. The ivermectin and mebendazole-based mass drug administration (iMDA and mMDA) treatment regimens deployed by the WHO´s Elimination of Neglected Tropical Diseases (ESPEN) programme and its forerunners have, however, likely impacted significantly on the mansonellosis disease burden, principally by reducing the transmission of M. streptocerca in Africa. The increasingly popular plan of using iMDA to control malaria could also affect M. ozzardi parasite prevalence and transmission in Latin America in the future. However, a potentially far greater mansonellosis disease burden impact is likely to come from short-course curative anti-Wolbachia therapeutics, which are presently being developed for onchocerciasis and lymphatic filariasis treatment. Even if the WHO´s ESPEN programme does not choose to deploy these drugs in MDA interventions, they have the potential to dramatically increase the financial and logistical feasibility of effective mansonellosis management. There is, thus, now a fresh and urgent need to better characterise the disease burden and eco-epidemiology of mansonellosis so that effective management programmes can be designed, advocated for and implemented.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and NTDs Laboratory, National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio L B Luz
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas State, Brazil
| | - James L Crainey
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas State, Brazil
| | - José M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
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Drews SJ, Spencer BR, Wendel S, Bloch EM. Filariasis and transfusion-associated risk: a literature review. Vox Sang 2021; 116:741-754. [PMID: 33491765 DOI: 10.1111/vox.13073] [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: 10/01/2020] [Revised: 12/19/2020] [Accepted: 12/28/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Filariae are parasitic worms that include the pathogens Loa loa, Onchocerca volvulus, Wuchereria bancrofti, Brugia spp. and Mansonella spp. which are endemic in parts of Africa, Asia, Asia-Pacific, South and Central America. Filariae have a wide clinical spectrum spanning asymptomatic infection to chronic debilitating disease including blindness and lymphedema. Despite successful eradication programmes, filarial infections remain an important -albeit neglected - source of morbidity. We sought to characterize the risk of transfusion transmission of microfilaria with a view to guide mitigation practices in both endemic and non-endemic countries. MATERIALS AND METHODS A scoping review of scientific publications as well as grey literature was carried out by a group of domain experts in microbiology, transfusion medicine and infectious diseases, representing the parasite subgroup of the International Society of Blood Transfusion. RESULTS Cases of transfusion-transmitted filariasis are rare and confined to case reports of variable quality. Transfusion-associated adverse events related to microfilariae are confined to isolated reports of transfusion reactions. Serious outcomes have not been reported. No known strategies have been implemented, specifically, to mitigate transfusion-transmitted filariasis yet routine blood donor screening for other transfusion-transmissible infections (e.g. hepatitis B, malaria) may indirectly defer donors with microfilaremia in endemic areas. CONCLUSION Rare examples of transfusion-transmitted filariasis, without serious clinical effect, suggest that filariasis poses low transfusion risk. Dedicated mitigation strategies against filarial transfusion transmission are not recommended. Given endemicity in low-resource regions, priority should be on the control of filariasis with public health measures.
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Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology, Donor and Clinical Services, Edmonton, AB, Canada.,Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - Silvano Wendel
- Banco de Sangue Medical Director, Blood Bank, Hospital Sirio Libanês, São Paulo, Brasil
| | - Evan M Bloch
- Department of Pathology, Transfusion Medicine Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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