The role of domestic animals in the epidemiology of human African trypanosomiasis in Ngorongoro conservation area, Tanzania

Molecular genotyping reveals mixed bovine and human trypanosomiasis in cattle from West Africa

Background and Aim

Animal trypanosomiasis is a major contributor to agricultural and economic losses, especially in sub-Saharan Africa. We have shown that some animal species expressed genes that are significant players in immune response to bovine trypanosomosis, impeding signs and symptoms of the disease. We hypothesize that such animals are contributors to disease transmission dynamics and severe outcomes. Therefore, this study aims to ascertain trypanosome species diversity in cattle and their potential role as reservoirs for the transmission of human disease.

Materials and Methods

We performed a molecular genotyping of trypanosome internal transcribed spacer 1 (ITS-1) and 18S ribosomal RNA genes on genomic DNA extracts from randomly sampled N'Dama cattle from slaughterhouses in Nigeria. We identified trypanosome species circulating among the animals through polymerase chain reaction and genomic sequencing. We performed multiple sequence alignments as well as conducted a phylogenetic relationship between identified species.

Results

In all, 9 of 127 (7.1%) samples were positively amplified (band sizes ranging from 250 bp to 710 bp), including an isolate with two distinct bands (700 and 710 bp), indicating two trypanosome types. Sequence similarity and homology analysis identified four species, namely: Trypanosoma vivax, Trypanosoma congolense forest type, T. congolense savannah type, and Trypanosoma brucei. Interestingly, one of the bands, additionally verified by nucleotide sequencing, was identified as a human trypanosome (Trypanosoma brucei gambiense), confirming our hypothesis that cattle are potential reservoir hosts for human trypanosomes.

Conclusion

Overall, we observed different trypanosome species in our study area, with animals on the same farm infected with multiple species, which could complicate treatment and disease control strategies. Finding human trypanosome species strengthens the argument that disease transmission dynamics are modulated by other vertebrates, further complicating control programs.

The clinical effect of experimental infection with Trypanosoma congolense on Dutch belted rabbits

The clinical effect of Trypanosoma congolense infection on Dutch belted (does) rabbits was investigated. Sixteen Dutch belted rabbits weighing between 1.6 and 1.8 kg were grouped into two groups of eight each. Animals were accessed for packed cell volume (PCV), total leucocyte count (TLC), rectal temperature (RT), heart rate (HR), and body weight (BW) before infection as well as 18, 25, and 58 days post inoculation (PI). The level of parasitaemia was estimated on a weekly basis and was graded by number of parasites/field. There was a significant difference (P < 0.05) in the mean PCV between treatment and control groups of the rabbits on all days PI. The other parameters were not significantly different between uninfected controls and treatment group although the rectal temperature fluctuated. The mean PCV of infected rabbits was 36.0 ± 0.53%, 35.3 ± 0.19%, and 28.0 ± 0.89% at days 18, 25, and 58 PI, while for uninfected, the mean PCV was 40.8 ± 0.11%, 41.8 ± 0.19%, and 41.3 ± 0.08% across the same time periods. Parasitaemia was detected at 6th day PI and remained high to the end of the study. The study suggests that the use of haematinics and anti-pyrexia treatments as part of disease management for rabbits would be useful.

Molecular Identification of Trypanosome Diversity in Domestic Animals Reveals the Presence of Trypanosoma brucei gambiense in Historical Foci of Human African Trypanosomiasis in Gabon

Human African Trypanosomiasis (HAT) is an infectious disease caused by protozoan parasites belonging to the Trypanosoma genus. In sub-Saharan Africa, there is a significant threat as many people are at risk of infection. Despite this, HAT is classified as a neglected tropical disease. Over the last few years, several studies have reported the existence of a wide diversity of trypanosome species circulating in African animals. Thus, domestic and wild animals could be reservoirs of potentially dangerous trypanosomes for human populations. However, very little is known about the role of domestic animals in maintaining the transmission cycle of human trypanosomes in central Africa, especially in Gabon, where serious cases of infection are recorded each year, sometimes leading to hospitalization or death of patients. Komo-Mondah, located within Estuaries (Gabonese province), stays the most active HAT disease focus in Gabon, with a mean of 20 cases per year. In this study, we evaluated the diversity and prevalence of trypanosomes circulating in domestic animals using the Polymerase Chain Reaction (PCR) technique. We found that 19.34% (53/274) of the domestic animals we studied were infected with trypanosomes. The infection rates varied among taxa, with 23.21% (13/56) of dogs, 16.10% (19/118) of goats, and 21.00% (21/100) of sheep infected. In addition, we have observed a global mixed rate of infections of 20.75% (11/53) among infected individuals. Molecular analyses revealed that at least six Trypanosome species circulate in domestic animals in Gabon (T. congolense, T. simiae, T. simiae Tsavo, T. theileri, T. vivax, T. brucei (including T. brucei brucei, and T. brucei gambiense)). In conclusion, our study showed that domestic animals constitute important potential reservoirs for trypanosome parasites, including T. brucei gambiense, which is responsible for HAT.

The detection of African trypanosomes in goats reared in tsetse infested villages of Eastern Zambia

Control programmes for African animal trypanosomiasis (AAT) in livestock have been mainly focused on cattle with very little focus on goats, an important reservoir for the disease. Using the polymerase chain reaction (PCR), this study investigated trypanosome infection in village goats in Mambwe, a rural District in Eastern Zambia. Filter paper blood spots were collected from 326 goats and tested for infection with Trypanosoma congolense, Trypanosoma vivax and Trypanosoma brucei s.l. using ribosomal RNA internal transcribed spacers (ITS)-PCR. The frequency of trypanosomes from the sampled goats was 4.6% (95% CI = 2.3-6.8). Results indicated significantly high infections with Trypanosoma vivax (4.0%; 95% CI = 1.9-6.1) than T. congolense (0.6%; 95% CI =  - 0.2 to 1.5), and T. brucei (0.0%), P = 0.04. Findings show the circulation of trypanosomes that causes AAT in goats and that they may pose serious threats to not only goats but also to other livestock reared alongside goats.

Prevalence of Trypanosome Species in Cattle Near Ruma National Park, Lambwe Valley, Kenya: An Update From the Historical Focus for African Trypanosomosis

The effective control of diseases in areas shared with wildlife depends on the validity of the epidemiologic parameters that guide interventions. Epidemiologic data on animal trypanosomosis in Lambwe valley are decades old, and the recent suspected outbreaks of the disease in the valley necessitate the urgent bridging of this data gap. This cross-sectional study estimated the prevalence of bovine trypanosomosis, identified risk factors, and investigated the occurrence of species with zoonotic potential in Lambwe valley. The area is ~324 km², of which 120 km² is the Ruma National Park. Blood was sampled from the jugular and marginal ear veins of 952 zebu cattle between December 2018 and February 2019 and tested for trypanosomes using the Buffy Coat Technique (BCT) and PCR-High-Resolution Melting (HRM) analysis of the 18S RNA locus. Risk factors for the disease were determined using logistic regression. The overall trypanosome prevalence was 11.0% by BCT [95% confidence interval (CI): 9.0–13.0] and 27.9% by PCR-HRM (95% CI: 25.1–30.8). With PCR-HRM as a reference, four species of trypanosomes were detected at prevalences of 12.7% for T. congolense savannah (95% CI: 10.6–14.8), 7.7% for T. brucei brucei (CI: 6.0–9.4), 8.7% for T. vivax (CI: 6.9–10.5), and 1.3% for T. theileri (CI: 0.6–2.0). About 2.4% of cattle had mixed infections (CI: 1.4–3.41). No human-infective trypanosomes were found. Infections clustered across villages but were not associated with animal age, sex, herd size, and distance from the park. Approximately 85% of infections occurred within 2 km of the park. These findings add to evidence that previous interventions eliminated human trypanosomosis but not bovine trypanosomosis. Risk-tailored intervention within 2 km of Ruma Park, especially in the north and south ends, coupled with stringent screening with molecular tools, could significantly reduce bovine trypanosomosis.

Challenges in the Diagnostic Performance of Parasitological and Molecular Tests in the Surveillance of African Trypanosomiasis in Eastern Zambia

African animal trypanosomiasis (AAT) control programs rely on active case detection through the screening of animals reared in disease endemic areas. This study compared the application of the polymerase chain reaction (PCR) and microscopy in the detection of trypanosomes in cattle blood in Mambwe, a rural district in eastern Zambia. Blood samples were collected from 227 cattle and tested for infection with trypanosomes using microscopy and Ribosomal RNA Internal Transcribed Spacers (ITS)-PCR. Microscopy on the buffy coat detected 17 cases, whilst thin and thick smears detected 26 cases and 28 cases, respectively. In total, microscopy detected 40 cases. ITS-PCR-filter paper (FP) on blood spots stored on FP detected 47 cases, and ITS-PCR-FTA on blood spots stored on Whatman FTA Classic cards detected 83 cases. Using microscopy as the gold standard, ITS-PCR-FTA had a better specificity (SP) and sensitivity (SE) (SP = 72.2%; SE = 77.5%; kappa = 0.35) than ITS-PCR-FP (SP = 88%; SE = 60%; kappa = 0.45). The prevalence of Trypanosoma brucei s.l. was higher on ITS-PCR-FTA (19/227) than on ITS-PCR-FP (0/227). Our results illustrate the complexities around trypanosomiasis surveillance in rural Africa and provide evidence of the impact that field conditions and staff training can have on diagnostic results, which in turn impact the success of tsetse and trypanosomiasis control programs in the region.

Sustainable Elimination (Zero Cases) of Sleeping Sickness: How Far Are We from Achieving This Goal?

The recent massive reduction in the numbers of fresh Human African Trypanosomiasis (HAT) infection has presented an opportunity for the global elimination of this disease. To prevent a possible resurgence, as was the case after the reduced transmission of the 1960s, surveillance needs to be sustained and the necessary tools for detection and treatment of cases need to be made available at the points of care. In this review, we examine the available resources and make recommendations for improvement to ensure the sustenance of the already achieved gains to keep the trend moving towards elimination.

A systematic review and meta-analysis of small ruminant and porcine trypanosomiasis prevalence in sub-Saharan Africa (1986 to 2018)

The appraisal of the disease burden of African animal trypanosomiasis (AAT) in some livestock at country level could invite a re-evaluation of trypanosomiasis-control strategy. This study thus estimates small ruminant and porcine trypanosomiasis prevalence in sub-Saharan African countries. It also describes Trypanosoma species prevalence in small ruminants and pigs and attempts identification of factors explaining between-study variations in prevalence. Articles reporting animal trypanosomiasis prevalence in sheep, goats, and pigs in countries within sub-Saharan Africa were retrieved from different databases (PubMed, Science Direct, Google Scholar, and African Journal Online) and reference lists of relevant literatures. A total of 85 articles from 13 countries published between 1986 and 2018 were included in the analysis. Overall random-effects meta-analytic mean prevalence estimates were: 7.67% (95% CI: 5.22-10.49), 5.84% (95% CI: 3.81-8.23), and 19.46% (95% CI: 14.61-24.80) respectively, for sheep, goats, and pigs with substantial heterogeneity (I² = >95.00%. p < 0.0001) noted between studies. Ovine, caprine, and porcine prevalence were highest in Tanzania (91.67%. 95% CI: 76.50-99.84), Equatorial Guinea (27%. 95% CI: 0-81.09), and Cameroon (47%. 95% CI: 29.67-66.06), respectively. Trypanosoma brucei s. l., T. vivax, and T. congolense were the most prevalent in the livestock. Trypanosoma brucei subspecies (T. b. gambiense and T. b. rhodesiense) occurred in all three livestock being mostly prevalent in pigs. Country of study was a significant predictor of trypanosomiasis prevalence in each livestock in addition to time and sample size for caprine hosts, diagnostic technique for both caprine and ovine hosts, and sample size for porcine hosts. The pattern of animal trypanosomiasis prevalence in the studied livestock reflects their susceptibility to trypanosomal infections and tsetse fly host feeding preferences. In conclusion, sheep, goats, and especially pigs are reservoirs of human infective trypanosomes in sub-Saharan Africa; consequently, their inclusion in sleeping sickness control programmes could enhance the goal of the disease elimination.

A meta-analysis of the prevalence of bovine trypanosomiasis in some African countries from 2000 to 2018

Bovine trypanosomiasis is a disease of cattle. In sub-Saharan Africa, the disease mean prevalence estimates are unknown in most endemic countries. We therefore performed a meta-analysis with the aim of estimating national mean prevalence of bovine trypanosomiasis in endemic countries across sub-Saharan Africa. Relevant articles reporting bovine trypanosomiasis prevalence were retrieved through systematic literature search and scanning of articles reference-lists. Eligibility criteria included that articles reported sample size, prevalence, and diagnostic technique adopted. Overall, data from 180 eligible articles from 19 countries satisfied the inclusion criteria. Meta-analysis of prevalence data based on the random-effects model resulted in an overall mean prevalence of 15.10% (95% CI: 13.22-17.08). National prevalence estimates were generally high except those of Benin and Senegal where estimates ranked below 10.00%. Significant heterogeneity (I² = 98.75%. p = <0.0001) was noted between studies, and univariate meta-regression analysis identified choice of diagnostic method being major contributor to observed heterogeneity (R² = 36.37%); while country of study (R² = 9.57%) and sample size (R² = 3.47%) had marginal effect on heterogeneity. In spite of past and ongoing control activities, bovine trypanosomiasis remains highly prevalent in most endemic sub-Saharan African countries. Nevertheless, dearth of epidemiological data in some countries and the use of less sensitive diagnostic tools limit reliable estimation of the disease prevalence. Therefore, there is the need to intensify efforts in aspects of surveillance and increased application of molecular diagnostic tool(s) across endemic locations as this would raise the chances of achieving a near-accurate estimate of the disease prevalence which is the first step to attempting eradication.

African Trypanosomiasis-Associated Anemia: The Contribution of the Interplay between Parasites and the Mononuclear Phagocyte System

African trypanosomosis (AT) is a chronically debilitating parasitic disease of medical and economic importance for the development of sub-Saharan Africa. The trypanosomes that cause this disease are extracellular protozoan parasites that have developed efficient immune escape mechanisms to manipulate the entire host immune response to allow parasite survival and transmission. During the early stage of infection, a profound pro-inflammatory type 1 activation of the mononuclear phagocyte system (MPS), involving classically activated macrophages (i.e., M1), is required for initial parasite control. Yet, the persistence of this M1-type MPS activation in trypanosusceptible animals causes immunopathology with anemia as the most prominent pathological feature. By contrast, in trypanotolerant animals, there is an induction of IL-10 that promotes the induction of alternatively activated macrophages (M2) and collectively dampens tissue damage. A comparative gene expression analysis between M1 and M2 cells identified galectin-3 (Gal-3) and macrophage migration inhibitory factor (MIF) as novel M1-promoting factors, possibly acting synergistically and in concert with TNF-α during anemia development. While Gal-3 enhances erythrophagocytosis, MIF promotes both myeloid cell recruitment and iron retention within the MPS, thereby depriving iron for erythropoiesis. Hence, the enhanced erythrophagocytosis and suppressed erythropoiesis lead to anemia. Moreover, a thorough investigation using MIF-deficient mice revealed that the underlying mechanisms in AT-associated anemia development in trypanosusceptible and tolerant animals are quite distinct. In trypanosusceptible animals, anemia resembles anemia of inflammation, while in trypanotolerant animals’ hemodilution, mainly caused by hepatosplenomegaly, is an additional factor contributing to anemia. In this review, we give an overview of how trypanosome- and host-derived factors can contribute to trypanosomosis-associated anemia development with a focus on the MPS system. Finally, we will discuss potential intervention strategies to alleviate AT-associated anemia that might also have therapeutic potential.

The study of trypanosome species circulating in domestic animals in two human African trypanosomiasis foci of Côte d'Ivoire identifies pigs and cattle as potential reservoirs of Trypanosoma brucei gambiense

Background

Important control efforts have led to a significant reduction of the prevalence of human African trypanosomiasis (HAT) in Côte d’Ivoire, but the disease is still present in several foci. The existence of an animal reservoir of Trypanosoma brucei gambiense may explain disease persistence in these foci where animal breeding is an important source of income but where the prevalence of animal African trypanosomiasis (AAT) is unknown. The aim of this study was to identify the trypanosome species circulating in domestic animals in both Bonon and Sinfra HAT endemic foci.

Methodology/Principal findings

552 domestic animals (goats, pigs, cattle and sheep) were included. Blood samples were tested for trypanosomes by microscopic observation, species-specific PCR for T. brucei sl, T. congolense, T. vivax and subspecies-specific PCR for T. b. gambiense and T. b. gambiense immune trypanolysis (TL). Infection rates varied significantly between animal species and were by far the highest in pigs (30%). T. brucei s.l was the most prevalent trypanosome species (13.7%) followed by T. congolense. No T. b. gambiense was identified by PCR while high TL positivity rates were observed using T. b. gambiense specific variants (up to 27.6% for pigs in the Bonon focus).

Conclusion

This study shows that domestic animals are highly infected by trypanosomes in the studied foci. This was particularly true for pigs, possibly due to a higher exposure of these animals to tsetse flies. Whereas T. brucei s.l. was the most prevalent species, discordant results were obtained between PCR and TL regarding T. b. gambiense identification. It is therefore crucial to develop better tools to study the epidemiological role of potential animal reservoir for T. b. gambiense. Our study illustrates the importance of “one health” approaches to reach HAT elimination and contribute to AAT control in the studied foci.

In Africa, significant efforts to control human African trypanosomiasis (HAT) over the past three decades have drastically reduced the prevalence of the disease and elimination seems today an achievable goal. However, potential animal reservoirs of Trypanosoma brucei gambiense may compromise this ambitious objective. In the Bonon and Sinfra HAT endemic foci in Côte d’Ivoire, no recent data are available about the prevalence of animal African trypanosomiasis (AAT). The aim of this study was to identify trypanosomes circulating in domestic animals in these two HAT foci using serological, parasitological and molecular tools. We showed that T. brucei s.l. and T. congolense were the most prevalent trypanosome species and that pigs and cattle were the most infected animals. Discordant results were observed between the T. b. gambiense specific molecular and serological tools and the presence of an animal reservoir for T. b. gambiense remains unclear. Nevertheless, improved control strategies can be proposed based on this study to reach HAT elimination and contribute to AAT control in the study areas.