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Pietrzak D, Łuczak JW, Wiśniewski M. Beyond Tradition: Exploring Cutting-Edge Approaches for Accurate Diagnosis of Human Filariasis. Pathogens 2024; 13:447. [PMID: 38921745 PMCID: PMC11206659 DOI: 10.3390/pathogens13060447] [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: 04/29/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Filariasis is recognised as a global public health threat, particularly in tropical and subtropical regions. It is caused by infection with a nematode parasite of the superfamily Filarioidea, including Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, and Onchocerca lupi. Three main types of filariasis have been classified: lymphatic filariasis, subcutaneous filariasis, and serous cavity filariasis. The symptoms exhibited by individuals afflicted with filariasis are diverse and contingent upon several variables, including the species of parasite, the host's health and immune response, and the stage of infection. While many classical parasitological techniques are considered indispensable tools for the diagnosis of parasitic infections in humans, alternative methods are being sought due to their limitations. Novel tests based on host-parasite interactions offer a rapid, simple, sensitive, and specific diagnostic tool in comparison to traditional parasitological methods. This article presents methods developed in the 21st century for the diagnosis of filariasis caused by invasion from W. bancrofti, B. malayi, O. volvulus, and O. lupi, as well as techniques that are currently in use. The development of modern diagnostic methods based on molecular biology constitutes a significant advancement in the fight against filariasis.
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Affiliation(s)
- Damian Pietrzak
- Division of Parasitology and Parasitic Diseases, Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
| | - Julia Weronika Łuczak
- Faculty of Animal Breeding, Bioengineering and Conservation, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
| | - Marcin Wiśniewski
- Division of Parasitology and Parasitic Diseases, Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
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Cama VA, Mendizabal-Cabrera R, de Leon O, White M, McDonald C, Thiele E, Ogawa GM, Morales Z, Prince-Guerra J, Cantey P, Rizzo N. Changes in Anti-OV-16 IgG4 Responses to Onchocerciasis after Elimination of Transmission in the Central Endemic Zone of Guatemala. Am J Trop Med Hyg 2024; 110:943-950. [PMID: 38507804 PMCID: PMC11066353 DOI: 10.4269/ajtmh.23-0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/11/2024] [Indexed: 03/22/2024] Open
Abstract
Current WHO guidelines for onchocerciasis elimination provide requirements for stopping mass drug administration of ivermectin and the verification of elimination of transmission. These guidelines also recommend post-elimination surveillance (PES) based on entomological surveys. Serological markers in humans could complement entomological PES once the longevity of anti-OV-16 antibody responses is better understood. In 2014-2015 we evaluated ELISA anti-OV-16 IgG4 antibody persistence among previously seropositive people from the central endemic zone of Guatemala. The country stopped all onchocerciasis program interventions in 2012 and was verified by WHO as having eliminated transmission of onchocerciasis in 2016. A total of 246 participants with prior OV-16 ELISA results from 2003, 2006, 2007, or 2009 were enrolled in a follow-up study. Of these, 77 people were previously OV-16 seropositive and 169 were previously seronegative. By 2014 and 2015, 56 (72.7%) previously seropositive individuals had sero-reverted, whereas all previous negatives remained seronegative. The progression of antibody responses over time was estimated using a mixed-effects linear regression model, using data from seropositive participants who had sero-reverted. The temporal variation showed a mean activity unit decay of 0.20 per year (95% credible interval [CrI]: 0.17, 0.23), corresponding to an estimated antibody response half-life of 3.3 years (95% CrI: 2.7, 4.1). These findings indicate that the majority of seropositive people will sero-revert over time.
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Affiliation(s)
- Vitaliano A. Cama
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Oscar de Leon
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Michael White
- Infectious Disease Epidemiology and Analytics G5 Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Circe McDonald
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Thiele
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Guilherme M. Ogawa
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zoraida Morales
- Onchocerciasis Sub-Program, Ministerio de Salud Publica y Asistencia Social, Ciudad de Guatemala, Guatemala
| | | | - Paul Cantey
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nidia Rizzo
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
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Mansour A, Rodriguez L, Mansour H, Yehia M, Battaglia Parodi M. Presumed Onchocerciasis Chorioretinitis Spilling over into North America, Europe and Middle East. Diagnostics (Basel) 2023; 13:3626. [PMID: 38132210 PMCID: PMC10743067 DOI: 10.3390/diagnostics13243626] [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: 11/05/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Newer generation ophthalmologists practicing in the developed world are not very familiar with some tropical ocular diseases due to the absence of reports in the ophthalmic literature over the past thirty years. Because of world globalization or due to influx of immigrants from sub-Saharan Africa, exotic retinal diseases are being encountered more often in ophthalmology clinics. METHODS A multicenter case series of chorioretinitis or optic neuritis with obscure etiology that used serial multimodal imaging. RESULTS Four cases qualified with the diagnosis of presumed ocular onchocerciasis based on their residence near fast rivers in endemic areas, multimodal imaging, long term follow-up showing progressive disease and negative workup for other diseases. Characteristic findings include peripapillary choroiditis with optic neuritis or atrophy, subretinal tracts of the microfilaria, progressive RPE atrophy around heavily pigmented multifocal chorioretinal lesions of varying shapes, subretinal white or crystalline dots, and response to ivermectin. Typical skin findings are often absent in such patients with chorioretinitis rendering the diagnosis more challenging. CONCLUSIONS Familiarity with the myriad ocular findings of onchocerciasis, and a high-degree of suspicion in subjects residing in endemic areas can help in the correct diagnosis and implementation of appropriate therapy. Onchocercal chorioretinitis is a slow, insidious, progressive, and prolonged polymorphous disease.
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Affiliation(s)
- Ahmad Mansour
- Retina Service, Department of Ophthalmology, American University of Beirut, Beirut 1107, Lebanon
| | - Linnet Rodriguez
- Retina Service, Wills Eye Hospital, Thomas Jefferson Medical Center, Philadelphia, PA 19107, USA; (L.R.); (H.M.)
| | - Hana Mansour
- Retina Service, Wills Eye Hospital, Thomas Jefferson Medical Center, Philadelphia, PA 19107, USA; (L.R.); (H.M.)
| | - Madeleine Yehia
- Retina Service, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Maurizio Battaglia Parodi
- Retina Service, Department of Ophthalmology, Ospedale San Raffaele, University Vita-Salute, 20132 Milan, Italy;
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Furtado JM, Fernandes AG, Silva JC, Del Pino S, Hommes C. Indigenous Eye Health in the Americas: The Burden of Vision Impairment and Ocular Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3820. [PMID: 36900846 PMCID: PMC10000964 DOI: 10.3390/ijerph20053820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Review of the burden of vision impairment and blindness and ocular disease occurrence in Indigenous Peoples of the Americas. We systematically reviewed findings of the frequency of vision impairment and blindness and/or frequency of ocular findings in Indigenous groups. The database search yielded 2829 citations, of which 2747 were excluded. We screened the full texts of 82 records for relevance and excluded 16. The remaining 66 articles were examined thoroughly, and 25 presented sufficient data to be included. Another 7 articles derived from references were included, summing a total of 32 studies selected. When considering adults over 40 years old, the highest frequencies of vision impairment and blindness in Indigenous Peoples varied from 11.1% in high-income North America to 28.5% in tropical Latin America, whose rates are considerably higher than those in the general population. Most of the ocular diseases reported were preventable and/or treatable, so blindness prevention programs should focus on accessibility to eye examinations, cataract surgeries, control of infectious diseases, and spectacles distribution. Finally, we recommend actions in six areas of attention towards improving the eye health in Indigenous Peoples: access and integration of eye services with primary care; telemedicine; customized propaedeutics; education on eye health; and quality of data.
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Affiliation(s)
- João Marcello Furtado
- Pan American Health Organization, Washington, DC 20037, USA
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14015-010, Brazil
| | - Arthur Gustavo Fernandes
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, Sao Paulo 04023-062, Brazil
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB T2N 4N1, Canada
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Lazo-Porras M, Liu H, Ouyang M, Yin X, Malavera A, Bressan T, Guzman-Vilca WC, Pacheco N, Benito M, Miranda JJ, Moore G, Chappuis F, Perel P, Beran D. Process evaluation of complex interventions in non-communicable and neglected tropical diseases in low- and middle-income countries: a scoping review. BMJ Open 2022; 12:e057597. [PMID: 36581963 PMCID: PMC9438086 DOI: 10.1136/bmjopen-2021-057597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES The aim of this review is to map out the use of process evaluation (PE) in complex interventions that address non-communicable diseases (NCDs) and neglected tropical diseases (NTDs) to identify gaps in the design and conduct, as well as strengths, limitations and implications, of this type of research in low- and middle-income countries (LMICs). DESIGN Scoping review of PE studies of complex interventions implemented in LMICs. Six databases were searched focused on studies published since 2008. DATA SOURCES Embase, PubMed, EbscoHost, Web of Science (WOS), Virtual Health Library (VHL) Regional Portal and Global Index Medicus: Regional Indexes AIM (AFRO), LILACS (AMRO/PAHO), IMEMR (EMRO), IMSEAR (SEARO), WPRIM (WPRO) Global Index Regional Indexes, MEDLINE, SciELO. ELIGIBILITY CRITERIA Studies conducted in LMICs on PEs of randomised controlled trials (RCTs) and non-RCTs published between January 2008 and January 2020. Other criteria were studies of interventions for people at risk or having physical and mental NCDs, and/or NTDs, and/or their healthcare providers and/or others related to achieve better health for these two disease groups. Studies were excluded if they were not reported in English or Spanish or Portuguese or French, not peer-reviewed articles, not empirical research and not human research. DATA EXTRACTION AND SYNTHESIS Data extracted to be evaluated were: available evidence in the utilisation of PE in the areas of NCDs and NTDs, including frameworks and theories used; methods applied to conduct PEs; and in a subsample, the barriers and facilitators to implement complex interventions identified through the PE. Variables were extracted and categorised. The information was synthesised through quantitative analysis by reporting frequencies and percentages. Qualitative analysis was also performed to understand facilitators and barriers presented in these studies. The implications for PEs, and how the information from the PE was used by researchers or other stakeholders were also assessed in this approach. RESULTS 303 studies were identified, 79% were for NCDs, 12% used the label 'PE', 27% described a theory or framework for the PE, and 42% used mixed methods to analyse their findings. Acceptability, barriers and facilitators to implement the interventions, experiences and perceptions, and feasibility were the outcomes most frequently evaluated as part of the PEs. Barriers and facilitators themes identified were contextual factors, health system factors, human resources, attitudes and policy factors. CONCLUSIONS PEs in NCDs and NTDs are used in LMICs with a wide variety of methods. This review identified many PEs that were not labelled by the authors as such, as well as a limited application of PE-related theories and frameworks, and heterogeneous reporting of this type of study.
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Affiliation(s)
- Maria Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Hueiming Liu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Menglu Ouyang
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute China at Peking University Health Science Center, Beijing, China
| | - Xuejun Yin
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute China at Peking University Health Science Center, Beijing, China
| | - Alejandra Malavera
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Wilmer Cristobal Guzman-Vilca
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Cayetano Heredia (SOCEMCH), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Niels Pacheco
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Melissa Benito
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Graham Moore
- DECIPHer, UKCRC Centre of Excellence, Cardiff University, Cardiff, UK
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Pablo Perel
- Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
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Dusabimana A, Siewe Fodjo JN, Ndahura MM, Mmbando BP, Jada SR, Boven A, De Smet E, Ukety T, Njamnshi AK, Laudisoit A, Abrams S, Colebunders R. Surveillance for Onchocerciasis-Associated Epilepsy and OV16 IgG4 Testing of Children 6–10 Years Old Should Be Used to Identify Areas Where Onchocerciasis Elimination Programs Need Strengthening. Pathogens 2022; 11:pathogens11030281. [PMID: 35335605 PMCID: PMC8949980 DOI: 10.3390/pathogens11030281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 01/27/2023] Open
Abstract
To eliminate onchocerciasis-associated morbidity, it is important to identify areas where there is still high ongoing Onchocerca volvulus transmission. Between 2015 and 2021, door-to-door surveys were conducted in onchocerciasis-endemic villages in Cameroon, the Democratic Republic of Congo (DRC), Nigeria, South Sudan, and Tanzania to determine epilepsy prevalence and incidence, type of epilepsy and ivermectin therapeutic coverage. Moreover, children aged between six and 10 years were tested for anti-Onchocerca antibodies using the Ov16 IgG4 rapid diagnostic test (RDT). A mixed-effect binary logistic regression analysis was used to assess significantly associated variables of Ov16 antibody seroprevalence. A high prevalence and incidence of epilepsy was found to be associated with a high Ov16 antibody seroprevalence among 6–10-year-old children, except in the Logo health zone, DRC. The low Ov16 antibody seroprevalence among young children in the Logo health zone, despite a high prevalence of epilepsy, may be explained by a recent decrease in O. volvulus transmission because of a decline in the Simulium vector population as a result of deforestation. In the Central African Republic, a new focus of O. volvulus transmission was detected based on the high Ov16 IgG4 seropositivity among children and the detecting of nodding syndrome cases, a phenotypic form of onchocerciasis-associated epilepsy (OAE). In conclusion, Ov16 IgG4 RDT testing of 6–10-year-old children is a cheap and rapid method to determine the level of ongoing O. volvulus transmission and to assess, together with surveillance for OAE, the performance of onchocerciasis elimination programs.
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Affiliation(s)
- Alfred Dusabimana
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
| | - Joseph Nelson Siewe Fodjo
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon;
| | - Michel Mandro Ndahura
- Provincial Health Division Ituri, Ministry of Health, Bunia P.O. Box 57, Ituri, Democratic Republic of the Congo;
| | - Bruno P. Mmbando
- National Institute for Medical Research, Tanga Centre, Tanga P.O. Box 5004, Tanzania;
| | | | - Annelies Boven
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
| | - Eric De Smet
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
| | - Tony Ukety
- Centre de Recherche en Maladies Tropicales (CRMT), Bunia P.O. Box 143, Ituri, Democratic Republic of the Congo;
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon;
- Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 25625, Cameroon
- Neurology Department, Yaoundé Central Hospital, Yaoundé P.O. Box 25625, Cameroon
| | - Anne Laudisoit
- EcoHealth Alliance, 520 8th Ave Ste. 1200, New York, NY 10018, USA;
- Evolutionary Ecology Group (EVECO), University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Steven Abrams
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, UHasselt, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Robert Colebunders
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium; (A.D.); (J.N.S.F.); (A.B.); (E.D.S.); (S.A.)
- Correspondence:
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Evaluating the diagnostic test accuracy of molecular xenomonitoring methods for characterising the community burden of Onchocerciasis. PLoS Negl Trop Dis 2021; 15:e0009812. [PMID: 34637436 PMCID: PMC8509893 DOI: 10.1371/journal.pntd.0009812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Molecular xenomonitoring (MX), the detection of parasite nucleic acid in the vector population, is recommended for onchocerciasis surveillance in elimination settings. However, the sensitivity of MX for detecting onchocerciasis-positive communities has not previously been evaluated. MX may have additional applications for control programmes but its utility is restricted by a limited understanding of the relationship between MX results and human prevalence. Methods We conducted a systematic review of studies reporting the prevalence of Onchocerca volvulus DNA in wild-caught Simulium spp. flies (MX rate) and corresponding prevalence of microfilaria (mf) in humans. We evaluated the sensitivity of MX for detecting onchocerciasis-positive communities and describe the characteristics of studies with reduced sensitivity. We conducted a linear regression to evaluate the relationship between mf prevalence and MX rate. Results We identified 15 relevant studies, with 13 studies comprising 34 study communities included in the quantitative analyses. Most communities were at advanced stages towards elimination and had no or extremely low human prevalence. MX detected positive flies in every study area with >1% mf prevalence, with the exception of one study conducted in the Venezuelan Amazonian focus. We identified a significant relationship between the two measurements, with mf prevalence accounting for half of the variation in MX rate (R2 0.50, p<0.001). Conclusion MX is sensitive to communities with ongoing onchocerciasis transmission. It has potential to predict human mf prevalence, but further data is required to understand this relationship, particularly from MX surveys conducted earlier in control programmes before transmission has been interrupted. Traditional surveillance of onchocerciasis relies on the detection of Onchocerca volvulus microfilaria or antibodies in human skin or blood samples. Molecular xenomonitoring, the detection of parasite nucleic acid in vector insects, provides a non-invasive alternative. The sensitivity of molecular xenomonitoring to areas where infected people are found has not previously been evaluated and the extent to which xenomonitoring can be used to predict human prevalence is unknown. We searched for previous studies that reported the infection rates in humans and detection rates in black flies, finding 15 studies comprising 34 study communities that contributed to our analyses. Studies were conducted across Africa and the Americas, mostly in areas of very low prevalence. The findings show molecular xenomonitoring was sensitive to areas with greater than 1% microfilaria prevalence in the human population, indicating that molecular xenomonitoring is effective at detecting ongoing transmission. We further found evidence that infection rates in humans and detection rates in flies were related, providing scope for the use of xenomonitoring to predict human prevalence. With further research to better understand this relationship, control programmes may be able to use xenomonitoring for other purposes such as identifying areas that require intervention and monitoring the impact of treatments.
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Rinaldi G, Porter K. Mass drug administration for endemic scabies: a systematic review. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2021; 7:21. [PMID: 34193305 PMCID: PMC8247067 DOI: 10.1186/s40794-021-00143-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022]
Abstract
Background Scabies is an extremely fastidious infestation caused by the Sarcoptes scabiei mite. It causes a persistent itch that can disrupt a person’s mental health, sleep, and overall quality of life. In endemic areas, treatment by targeting symptomatic individuals and their contacts is often unsuccessful due to an asymptomatic period and high rates of re-infection. To overcome this, Mass Drug Administration (MDA) is often used to treat the whole community, irrespective of whether individuals presently have scabies. This review summarises the evidence for the effectiveness of MDA in treating scabies. Methods An exhaustive literature review was conducted on MEDLINE, EMBASE, Web of Science and Scopus. All peer-reviewed articles published in English January 1990 to March 2020 were eligible and only if the studies were primary and interventional. Furthermore, the intervention had to be a pharmacological MDA method involving human subjects. Results TWELVE articles that qualified for inclusion were identified. MDA for scabies significantly reduced its prevalence in communities at follow up. Some of the drivers of success were communities with low levels of migration, an uptake of MDA of > 85%, the use of oral Ivermectin therapy, the treatment of children and pregnant women within the treated population, and repeated treatment for participants diagnosed with scabies at baseline. Conclusions The average absolute reduction in prevalence of scabies was 22.0% and the relative reduction average was 73.4%. These results suggest MDA is effective in treating scabies in the endemic community. Further evidence is needed surrounding MDA use in urban areas with increased levels of migration. Importantly, MDA should not substitute the tackling of socioeconomic factors which contribute to endemic disease such as good sanitation and hygiene. Supplementary Information The online version contains supplementary material available at 10.1186/s40794-021-00143-5.
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Affiliation(s)
- Giulia Rinaldi
- Institute for Global Health, University College London, London, UK.
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
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Bennuru S, Oduro-Boateng G, Osigwe C, Del Valle P, Golden A, Ogawa GM, Cama V, Lustigman S, Nutman TB. Integrating Multiple Biomarkers to Increase Sensitivity for the Detection of Onchocerca volvulus Infection. J Infect Dis 2021; 221:1805-1815. [PMID: 31201416 DOI: 10.1093/infdis/jiz307] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/13/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Serological assessments for human onchocerciasis are based on IgG4 reactivity against the OV-16 antigen, with sensitivities of 60-80%. We have previously identified 7 novel proteins that could improve serodiagnosis. METHODS IgG4 responses to these 7 proteins were assessed by luciferase immunoprecipitation (LIPS) and enzyme-linked immunosorbent (ELISA) immunoassays. RESULTS OVOC10469 and OVOC3261 were identified as the most promising candidates by IgG4-based immunoassays with sensitivities of 53% for rOVOC10469 and 78% for rOVOC3261 while specificity for each was >99%. These 2 antigens in combination with OV-16 increased the sensitivity for patent infections to 94%. The kinetics of appearance of these IgG4 responses based on experimentally infected non-human primates indicated that they were microfilarial- driven. Further, the IgG4 responses to both OVOC10469 and OVOC3261 (as well as to OV-16) drop significantly (p<0.05) following successful treatment for onchocerciasis. A prototype lateral flow rapid diagnostic test to detect IgG4 to both Ov-16 and OVOC3261 was developed and tested demonstrating an overall 94% sensitivity. CONCLUSION The combined use of rOVOC3261 with OV-16 improved serologic assessment of O. volvulus infection, a current unmet need toward the goal of elimination of transmission of O. volvulus.
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Affiliation(s)
- Sasisekhar Bennuru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Georgiette Oduro-Boateng
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Chinweoke Osigwe
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Priscilla Del Valle
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | | | - Guilherme Maerschner Ogawa
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vitaliano Cama
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sara Lustigman
- Laboratory of Molecular Parasitology, Lindsley F. Kimball Research Institute, New York Blood Center
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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Lakwo T, Oguttu D, Ukety T, Post R, Bakajika D. Onchocerciasis Elimination: Progress and Challenges. Res Rep Trop Med 2020; 11:81-95. [PMID: 33117052 PMCID: PMC7548320 DOI: 10.2147/rrtm.s224364] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/16/2020] [Indexed: 01/08/2023] Open
Abstract
Onchocerciasis is a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted through the bites of black flies of the genus Similium that breed in rivers and streams. The impact of mass treatment with ivermectin and supplemented by vector control in some countries has changed the global scene of onchocerciasis. There has been reported progress made in elimination of onchocerciasis in central and southern American countries and in some localities in Africa. The target for elimination in the Americas has been set at 2022 while for 12 countries in Africa this is expected in 2030. This review was conducted to examine the current status of onchocerciasis elimination at the global level and report on progress made. Literature searches were made through PubMed, articles in English or English abstracts, reports and any other relevant articles related to the subject. The global burden of onchocerciasis is progressively reducing and is no longer a public health problem in some regions. However, programs are challenged with a range of issues: cross-border transmission, diagnostic tools, Loa loa co-endemicity, limited workforce in entomology and maintaining enthusiasm among community drug distributors. More concerted effort using appropriate tools is required to overcome the challenges.
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Affiliation(s)
- Thomson Lakwo
- Neglected Tropical Disease Control Program, Vector Control Division, Ministry of Health, Kampala, Uganda
| | - David Oguttu
- Neglected Tropical Disease Control Program, Vector Control Division, Ministry of Health, Kampala, Uganda
| | - Tony Ukety
- Centre de Recherche pour les Maladies Tropicales, Rethy, Ituri Province, The Democratic Republic of the Congo
| | - Rory Post
- Disease Control Department, London School of Hygiene & Tropical Medicine, London, UK.,School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Didier Bakajika
- Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Congo
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11
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Murdoch ME. Mapping the burden of onchocercal skin disease. Br J Dermatol 2020; 184:199-207. [PMID: 32302410 DOI: 10.1111/bjd.19143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 02/06/2023]
Abstract
Onchocerciasis is a neglected tropical disease caused by a nematode parasite, Onchocerca volvulus, and transmitted by bites of Simulium blackflies which breed near fast-flowing rivers. In humans, thousands of microfilariae (immature worms) migrate to the skin and eyes where they cause pathology. Historically, much research was devoted to the serious effect of blindness, from which the disease earns its alternative name of 'river blindness'. Mapping the burden of onchocercal skin disease (OSD) was expedited by the development of a clinical classification and grading system that facilitated comparison of data from different countries. After successful field testing in Nigeria, the classification scheme was used in a multicountry study in seven endemic sites, to estimate the true burden of OSD across Africa. High levels of OSD were found, affecting 28% of the population. A new control programme, the African Programme for Onchocerciasis Control (APOC) was launched in 20 countries using annual doses of ivermectin, donated by Merck & Co., Inc. The multicountry study also found a close correlation between the levels of itching and OSD with the level of endemicity, as determined by the prevalence of onchocercal nodules. This enabled APOC to use Rapid Epidemiological Mapping of Onchocerciasis, which entailed identifying likely vector breeding sites near rivers, then sampling 50 adult males in nearby villages to determine the prevalence of nodules and delineate which villages required treatment. Onchocerciasis is now targeted for elimination in Africa, and the challenge is to complete Onchocerciasis Elimination Mapping of hypoendemic areas using serology.
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Affiliation(s)
- M E Murdoch
- Department of Dermatology, West Herts Hospitals NHS Trust, Watford General Hospital, Watford, WD18 0HB, UK
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12
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Partridge FA, Forman R, Bataille CJR, Wynne GM, Nick M, Russell AJ, Else KJ, Sattelle DB. Anthelmintic drug discovery: target identification, screening methods and the role of open science. Beilstein J Org Chem 2020; 16:1203-1224. [PMID: 32550933 PMCID: PMC7277699 DOI: 10.3762/bjoc.16.105] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/12/2020] [Indexed: 12/13/2022] Open
Abstract
Helminths, including cestodes, nematodes and trematodes, are a huge global health burden, infecting hundreds of millions of people. In many cases, existing drugs such as benzimidazoles, diethylcarbamazine, ivermectin and praziquantel are insufficiently efficacious, contraindicated in some populations, or at risk of the development of resistance, thereby impeding progress towards World Health Organization goals to control or eliminate these neglected tropical diseases. However, there has been limited recent progress in developing new drugs for these diseases due to lack of commercial attractiveness, leading to the introduction of novel, more efficient models for drug innovation that attempt to reduce the cost of research and development. Open science aims to achieve this by encouraging collaboration and the sharing of data and resources between organisations. In this review we discuss how open science has been applied to anthelmintic drug discovery. Open resources, including genomic information from many parasites, are enabling the identification of targets for new antiparasitic agents. Phenotypic screening remains important, and there has been much progress in open-source systems for compound screening with parasites, including motility assays but also high content assays with more detailed investigation of helminth physiology. Distributed open science compound screening programs, such as the Medicines for Malaria Venture Pathogen Box, have been successful at facilitating screening in diverse assays against many different parasite pathogens and models. Of the compounds identified so far in these screens, tolfenpyrad, a repurposed insecticide, shows significant promise and there has been much progress in creating more potent and selective derivatives. This work exemplifies how open science approaches can catalyse drug discovery against neglected diseases.
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Affiliation(s)
- Frederick A Partridge
- Centre for Respiratory Biology, UCL Respiratory, Division of Medicine, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Ruth Forman
- The Lydia Becker Institute for Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Carole J R Bataille
- Department of Chemistry, Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford, OX1 3TA United Kingdom
| | - Graham M Wynne
- Department of Chemistry, Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford, OX1 3TA United Kingdom
| | - Marina Nick
- Centre for Respiratory Biology, UCL Respiratory, Division of Medicine, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Angela J Russell
- Department of Chemistry, Chemistry Research Laboratory, University of Oxford, 12 Mansfield Road, Oxford, OX1 3TA United Kingdom
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, United Kingdom
| | - Kathryn J Else
- The Lydia Becker Institute for Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - David B Sattelle
- Centre for Respiratory Biology, UCL Respiratory, Division of Medicine, University College London, Gower Street, London, WC1E 6BT, United Kingdom
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13
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Pinazo MJ, Pereiro A, Herazo R, Chopita M, Forsyth C, Lenardón M, Losada I, Torrico F, Marchiol A, Vera M. Interventions to bring comprehensive care to people with Chagas disease: Experiences in Bolivia, Argentina and Colombia. Acta Trop 2020; 203:105290. [PMID: 31811865 DOI: 10.1016/j.actatropica.2019.105290] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 11/14/2019] [Accepted: 12/03/2019] [Indexed: 11/19/2022]
Abstract
Chagas disease (CD) affects over six million people and is a leading cause of heart failure in the Americas. Few are able to access diagnosis and treatment for CD, resulting in a missed opportunity to prevent morbimortality. Integration of testing and treatment with the primary healthcare level is a key step in ensuring affected people receive timely antitrypansomal therapy, which increasing evidence shows can prevent chronic complications from the disease and halt congenital transmission. This article describes three collaborative projects focused on increasing access to testing and treatment for CD through primary healthcare facilities in Bolivia, Argentina, and Colombia.
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Affiliation(s)
| | - Ana Pereiro
- Fundacion Mundo Sano, Buenos Aires, Argentina, Madrid, Spain.
| | - Rafael Herazo
- Drugs for Neglected Diseases initiative, Rio de Janeiro, Brazil.
| | - Marina Chopita
- Secretariat of Health and Social Medicine of the Municipality of La Plata, Argentina
| | - Colin Forsyth
- Drugs for Neglected Diseases initiative, Rio de Janeiro, Brazil
| | - Mabel Lenardón
- Secretariat of Health and Social Medicine of the Municipality of La Plata, Argentina
| | - Irene Losada
- ISGlobal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Faustino Torrico
- Universidad Mayor de San Simón, Faculty of Medicine, Cochabamba, Bolivia; Fundación CEADES, Cochabamba, Bolivia
| | - Andrea Marchiol
- Drugs for Neglected Diseases initiative, Rio de Janeiro, Brazil
| | - Mauricio Vera
- Ministry of Health and Social Protection, Bogotá, Colombia
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14
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Katabarwa MN, Zarroug IMA, Negussu N, Aziz NM, Tadesse Z, Elmubark WA, Shumo Z, Meribo K, Kamal H, Mohammed A, Bitew Y, Seid T, Bekele F, Yilak A, Endeshaw T, Hassen M, Tillahun A, Samuel F, Birhanu H, Asmare T, Boakye D, Feleke SM, Unnasch T, Post R, Higazi T, Griswold E, Mackenzie C, Richards F. The Galabat-Metema cross-border onchocerciasis focus: The first coordinated interruption of onchocerciasis transmission in Africa. PLoS Negl Trop Dis 2020; 14:e0007830. [PMID: 32027648 PMCID: PMC7004312 DOI: 10.1371/journal.pntd.0007830] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/05/2019] [Indexed: 11/18/2022] Open
Abstract
Background Onchocerciasis transmission across international borders is not uncommon, yet a coordinated cross border stops mass drug administration (MDA) decision has not been documented. Methods/Principle findings The Galabat-Metema focus involves neighboring districts on the border between Sudan and Ethiopia. Mass drug administration (MDA) was provided once and subsequently twice per year in this focus, with twice-per-year beginning in Ethiopia’s Metema subfocus in 2016 and in the Sudan’s Galabat subfocus in 2008. Ov16 ELISA-based serosurveys were conducted in 6072 children under 10 years of age in the Metema subfocus in 2014, and 3931 in the Galabat in 2015. Between 2014 and 2016, a total of 27,583 vector Simulium damnosum flies from Metema and 9,148 flies from Galabat were tested by pool screen PCR for Onchocerca volvulus O-150 DNA. Only 8 children were Ov16 seropositive (all in the Metema subfocus); all were negative by skin snip PCR. The upper limit of the 95% confidence interval (UCL) for Ov16 seropositive was <0.1% for the overall focus and 0.14 positive fly heads per 2000 (UCL = 0.39/2000). However, an entomological ‘hotspot’ was detected on the Wudi Gemzu river in Metema district. The hotspot was confirmed when 4 more positive fly pools were found on repeat testing in 2017 (1.04 L3/2000 flies (UCL = 2.26/2000). Information exchange between the two countries led to stopping MDA in a coordinated fashion in 2018, with the exception of the hotspot at Wudi Gemzu, where MDA with ivermectin was increased to every three months to hasten interruption of transmission. Conclusion Coordinated stop MDA decisions were made by Sudan and Ethiopia based on data satisfying the World Health Organization’s criteria for interruption of onchocerciasis transmission. Definitions of entomological ‘hotspots’ and buffer zones around the focus are proposed. Onchocerciasis is a vector-borne tropical disease caused by the parasitc worm, Onchocerca volvulus. The vector is Simulium flies that breed in fast flowing rivers and streams. The infection can cause skin disease and loss of vision, giving risk to the common name of ‘river blindness’ for the condition. Ivermectin (Mectizan) mass drug administration (MDA) given at high coverage for many years can interrupt transmission such that MDA can eventually be stopped. The present paper provides highlights of onchocerciasis transmission interruption in the first known coordinated international cross border focus with ivermectin MDA program in Africa, where 99% of the global onchocerciasis burden exists. This focus known as Galabat-Metema is shared between Ethiopia and Sudan, both of which have established a nationwide policy for elimination of onchocerciasis. The paper provides the history of MDA in the border area and the results leading a coordinated end to MDA in the focus in 2017.
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Affiliation(s)
- Moses N. Katabarwa
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
- * E-mail:
| | | | | | | | | | | | | | - Kadu Meribo
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Thomas Unnasch
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Rory Post
- London School of Hygiene & Tropical Medicine, London, United Kingdom, United Kingdom
| | - Tarig Higazi
- Department of Biological Sciences, Ohio University, Zanesville, Ohio, United States of America
| | - Emily Griswold
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Charles Mackenzie
- NTD Support Center, Task Force for Global Health, Atlanta, Georgia, United States of America
| | - Frank Richards
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
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15
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Schwartz RA, Al-Qubati Y, Zieleniewski Ł, Shah R, Kapila R. Onchocerciasis (river blindness): larva-induced eczema (onchodermatitis) from an important oculocutaneous tropical disease spilling over into North America and Europe. Int J Dermatol 2019; 59:1065-1070. [PMID: 31513297 DOI: 10.1111/ijd.14614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 11/28/2022]
Abstract
Onchocerciasis is a leading cause of blindness in the world. It may be seen in temperate climates of the United States and Europe in immigrants and travelers from endemic regions, often linked to poverty and war. One should be aware of an incubation period that can be up to 15 months. In its early stage and throughout its course, onchocerciasis has noteworthy skin findings, facilitating diagnosis, as onchodermatitis resembles common eczema with variable degrees of papular, lichenoid, atrophic, and pigmentary alterations, features not suggestive if one is unaware of an individual's immigration and travel history. The same concept applies for the encysted worms (onchocercomas), as they tend to appear as common skin cysts and benign neoplasms. New methods can be employed to increase diagnostic sensitivity and specificity. Ivermectin is the gold standard of therapy, the use of which has almost miraculously eliminated this disease from large areas of the earth. However, its effect remains isolated to microfilariae and can be devastating in those coinfected with Loa loa. Recently, the symbiotic relationship between adult worms and Wolbachia bacteria has been discovered and, with it, the possibility of adding doxycycline as a treatment option. We also discuss coinfection with HIV and other diseases.
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Affiliation(s)
- Robert A Schwartz
- Professor & Head, Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Łukasz Zieleniewski
- Nicolaus Copernicus University Ludwig Rydygier Medical College, Bydgoszcz, Poland
| | - Radhika Shah
- Professor & Head, Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rajendra Kapila
- Professor & Head, Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA
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16
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Cupp E, Sauerbrey M, Cama V, Eberhard M, Lammie PJ, Unnasch TR. Elimination of onchocerciasis in Africa by 2025: the need for a broad perspective. Infect Dis Poverty 2019; 8:50. [PMID: 31303176 PMCID: PMC6628485 DOI: 10.1186/s40249-019-0557-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background In response to the recent publication “Is onchocerciasis elimination in Africa feasible by 2025: a perspective based on lessons learnt from the African control programmes” by Dadzie et al., it is important to clarify and highlight the positive and unequivocal research and operational contributions from the American experience towards the worldwide elimination of human onchocerciasis (river blindness). Main text The strategies of twice or more rounds of mass drug administration (MDA) of ivermectin per year, as well as the use of OV-16 serology have allowed four American countries to be verified by World Health Organization to have eliminated transmission of Onchocerca volvulus, the etiological agent. These advances were also implemented in Sudan and Uganda; currently, both are the only African countries where ivermectin MDA was safely stopped in several transmission zones. Conclusions Programmatic treatment and evaluation approaches, pioneered in the Americas, are the most efficient among the existing tools for elimination, and their broader use could catalyze the successful elimination of this disease in Africa. Electronic supplementary material The online version of this article (10.1186/s40249-019-0557-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ed Cupp
- Department of Entomology and Plant Pathology, Auburn University, Auburn, AL, 36849, USA
| | - Mauricio Sauerbrey
- Onchocerciasis Elimination Program for the Americas, 14 Calle 3-51 Zona 10, Edificio Murano Center, Oficina, 1401, Guatemala City, Guatemala
| | - Vitaliano Cama
- Centers for Disease Control and Prevention, 1600 Clifton Rd, MS D-65, Atlanta, GA, 30329, USA
| | - Mark Eberhard
- Centers for Disease Control and Prevention, 1600 Clifton Rd, MS D-65, Atlanta, GA, 30329, USA
| | - Patrick J Lammie
- Task Force for Global Health, 330 W. Ponce de Leon Ave, Decatur, GA, 30030, USA
| | - Thomas R Unnasch
- Center for Global Health Infectious Diseases, University of South Florida College of Public Health, 3720 Spectrum Blvd, Suite 304, Tampa, FL, 33612, USA.
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17
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Gupta N, Singh G, Xess I, Soneja M. Managing mucormycosis in a resource-limited setting: challenges and possible solutions. Trop Doct 2019; 49:153-155. [PMID: 30691355 DOI: 10.1177/0049475519825561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mucormycosis is a potentially fatal fungal infection with high prevalence in poor-resource settings. Besides being an extremely expensive disease to treat, the challenges range from lack of experienced mycologists or mycology department to knowledge and availability of treatment regimes.
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Affiliation(s)
- Nitin Gupta
- 1 Senior resident, Infectious diseases, Department of Medicine and Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Gagandeep Singh
- 2 Assistant Professor, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Immaculata Xess
- 3 Professor, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- 4 Associate Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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18
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Murdoch ME. Onchodermatitis: Where Are We Now? Trop Med Infect Dis 2018; 3:E94. [PMID: 30274490 PMCID: PMC6160948 DOI: 10.3390/tropicalmed3030094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 02/07/2023] Open
Abstract
Onchocerciasis causes debilitating pruritus and rashes as well as visual impairment and blindness. Prior to control measures, eye disease was particularly prominent in savanna areas of sub-Saharan Africa whilst skin disease was more common across rainforest regions of tropical Africa. Mass drug distribution with ivermectin is changing the global scene of onchocerciasis. There has been successful progressive elimination in Central and Southern American countries and the World Health Organization has set a target for elimination in Africa of 2025. This literature review was conducted to examine progress regarding onchocercal skin disease. PubMed searches were performed using keywords 'onchocerciasis', 'onchodermatitis' and 'onchocercal skin disease' over the past eight years. Articles in English, or with an English abstract, were assessed for relevance, including any pertinent references within the articles. Recent progress in awareness of, understanding and treatment of onchocercal skin disease is reviewed with particular emphasis on publications within the past five years. The global burden of onchodermatitis is progressively reducing and is no longer seen in children in many formerly endemic foci.
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Affiliation(s)
- Michele E Murdoch
- Department of Dermatology, West Herts Hospitals NHS Trust, Vicarage Road, Watford, Hertfordshire WD18 0HB, UK.
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19
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King CH. Helminthiasis Epidemiology and Control: Scoring Successes and Meeting the Remaining Challenges. ADVANCES IN PARASITOLOGY 2018; 103:11-30. [PMID: 30878055 DOI: 10.1016/bs.apar.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Parasitic helminth infections remain a significant challenge to global health. These are highly prevalent diseases, affecting over 1 billion persons worldwide. Their prevalence is closely linked to the presence of severe poverty and its associated sub-standard housing and sanitation. The last decade has seen a remarkable increase in our understanding of the true disease burden of helminth infections, and there has been increasing momentum on the part of national and non-governmental developmental organizations for prevention and control of these diseases. The expansion in mass treatment programmes for their control has yielded some significant successes. However, challenges remain in terms of ecological heterogeneity in transmission, incomplete drug uptake, and the likelihood of emerging drug resistance. The development of new, more-sensitive diagnostics is now broadening our knowledge of infection prevalence and of the risk of reinfection and has enhanced our knowledge of the prevalence of concurrent helminth infections. Adoption of these new diagnostic techniques for large-scale screening and surveillance will require adaptation of current mass treatment guidelines for control as programmes move from initial morbidity control objectives toward coordinated interventions aimed at local elimination.
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Affiliation(s)
- Charles H King
- Center for Global Health and Diseases, WHO Collaborating Centre for Research and Training on Schistosomiasis Elimination, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), University of Georgia, Athens, GA, United States.
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20
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Richards FO, Katabarwa M, Bekele F, Tadesse Z, Mohammed A, Sauerbrey M, Dominguez-Vazquez A, Rodriguez-Perez MA, Fernández-Santos NA, Rizzo N, Schuler Martínez HR, Lovato Silva R, Morales Monroy Z, Habomugisha P, Oguttu DW, Zarroug IMA, Aziz NA, Unnasch TR. Operational Performance of the Onchocerca volvulus "OEPA" Ov16 ELISA Serological Assay in Mapping, Guiding Decisions to Stop Mass Drug Administration, and Posttreatment Surveillance Surveys. Am J Trop Med Hyg 2018; 99:749-752. [PMID: 30014821 DOI: 10.4269/ajtmh.18-0341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Onchocerciasis is a neglected tropical disease targeted for elimination. The World Health Organization (WHO) has developed guidelines for the verification of onchocerciasis elimination that include entomological and epidemiological criteria. The latter require demonstrating with statistical confidence that the infection prevalence in children is less than 0.1%, necessitating an assay with a high degree of specificity. We present an analysis of the performance of the Onchocerciasis Elimination Program for the Americas (OEPA) version of the Ov16 enzyme-linked immunosorbant assay (ELISA) when used under operational conditions. In Africa and Latin America, the assay demonstrated 99.98% specificity in 69,888 children in 20 foci where transmission was believed to be interrupted. The assay produced a prevalence estimate equal to that of skin snip microscopy when applied in putatively hypo-endemic zones of Ethiopia. The OEPA Ov16 ELISA demonstrated the specificity required to be effectively deployed to verify transmission elimination under the WHO guidelines, while exhibiting a sensitivity equivalent to skin snip microscopy to identify hypo-endemic areas.
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Affiliation(s)
| | | | | | | | | | - Mauricio Sauerbrey
- Onchocerciasis Elimination Program for the Americas, Guatemala City, Guatemala
| | | | | | | | - Nidia Rizzo
- Centro de Estudios en Salud of the Universidad del Valle de, Guatemala (UVG), Guatemala City, Guatemala
| | | | | | | | | | - David W Oguttu
- NTD Control Program, Vector Control Division, Kampala, Uganda
| | | | | | - Thomas R Unnasch
- Center for Global Health Infectious Disease Research, The University of South Florida, Tampa, Florida
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