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Zhao W, Ren G, Jiang W, Wang L, Wang J, Yuan Z, Yan L, Li Y, Sun Y, Xue X, Jiang Y, Lu G, Huang H. Genetic characterizations of Cryptosporidium spp. from children with or without diarrhea in Wenzhou, China: high probability of zoonotic transmission. BMC Microbiol 2024; 24:113. [PMID: 38575881 PMCID: PMC10993503 DOI: 10.1186/s12866-024-03273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Cryptosporidium is a highly pathogenic parasite responsible for diarrhea in children worldwide. Here, the epidemiological status and genetic characteristics of Cryptosporidium in children with or without diarrhea were investigated with tracking of potential sources in Wenzhou City, China. METHODS A total of 1032 children were recruited, 684 of whom had diarrhea and 348 without, from Yuying Children's Hospital in Wenzhou, China. Samples of stool were collected from each participant, followed by extraction of DNA, genotyping, and molecular identification of Cryptosporidium species and subtypes. RESULTS Twenty-two of the 1032 (2.1%) children were infected with Cryptosporidium spp. with 2.5% (17/684) and 1.4% (5/348) in diarrhoeic and asymptomatic children, respectively. Four Cryptosporidium species were identified, including C. parvum (68.2%; 15/22), C. felis (13.6%; 3/22), C. viatorum (9.1%; 2/22), and C. baileyi (9.1%; 2/22). Two C. parvum subtypes named IIdA19G1 (n = 14) and IInA10 (n = 1), and one each of C. felis (XIXa) and C. viatorum (XVaA3g) subtype was found as well. CONCLUSIONS This is the first research that identified Cryptosporidium in children of Wenzhou, China, using PCR. Identification of zoonotic C. parvum, C. felis, C. viatorum, and their subtypes indicate potential cross-species transmission of Cryptosporidium between children and animals. Additionally, the presence of C. baileyi in children suggests that this species has a wider host range than previously believed and that it possesses the capacity to infect humans.
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Affiliation(s)
- Wei Zhao
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Guangxu Ren
- Department of Pathogenic Biology, Hainan Medical University, Haikou, Hainan, China
- Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, 571199, China
| | - Weiyan Jiang
- The Second School of Medical, Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Long Wang
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Jiayang Wang
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Zhongying Yuan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Lanzhu Yan
- Department of Laboratory and Pathology, Hebei Provincial Corps Hospital of Chinese People's Armed Police Force, Shijiazhuang, Hebei, 050081, China
| | - Yongtai Li
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Yanbin Sun
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Xinjie Xue
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China
| | - Yanyan Jiang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China.
| | - Gang Lu
- Department of Pathogenic Biology, Hainan Medical University, Haikou, Hainan, China.
- Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan, China.
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, 571199, China.
| | - Huicong Huang
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China.
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Mthethwa-Hlongwa NP, Amoah ID, Gomez A, Davison S, Reddy P, Bux F, Kumari S. Profiling pathogenic protozoan and their functional pathways in wastewater using 18S rRNA and shotgun metagenomics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169602. [PMID: 38154626 DOI: 10.1016/j.scitotenv.2023.169602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
Despite extensive research, little is known about the composition of eukaryotic protists in environmental samples. This is due to low parasite concentrations, the complexity of parasite diversity, and a lack of suitable reference databases and standardized protocols. To bridge this knowledge gap, this study used 18S rRNA short amplicon and shotgun metagenomic sequencing approaches to profile protozoan microbial communities as well as their functional pathways in treated and untreated wastewater samples collected from different regions of South Africa. Results demonstrated that protozoan diversity (Shannon index P-value = 0.03) and taxonomic composition (PERMANOVA, P-value = 0.02) was mainly driven by the type of wastewater samples (treated & untreated) and geographic location. However, these WWTPs were also found to contain a core community of protozoan parasites. The untreated wastewater samples revealed a predominant presence of free-living, parasitic, and potentially pathogenic protists typically found in humans and animals, ranging from Alveolata (27 %) phylum (Apicomplexa and Ciliophora) to Excavata (3.88 %) (Discoba and Parasalia) and Amoebozoa (2.84 %) (Entamoeba and Acanthamoeba). Shotgun metagenomics analyses in a subset of the untreated wastewater samples confirmed the presence of public health-importance protozoa, including Cryptosporidium species (3.48 %), Entamoeba hystolitica (6.58 %), Blastocystis hominis (2.91 %), Naegleria gruberi (2.37 %), Toxoplasma gondii (1.98 %), Cyclospora cayetanensis (1.30 %), and Giardia intestinalis (0.31 %). Virulent gene families linked to pathogenic protozoa, such as serine/threonine protein phosphatase and mucin-desulfating sulfatase were identified. Additionally, enriched pathways included thiamine diphosphate biosynthesis III, heme biosynthesis, Methylerythritol 4-Phosphate Pathway, methyl erythritol phosphate (MEP), and pentose phosphate pathways. These findings suggest that protozoan pathogens may possess metabolic and growth potential within WWTPs, posing a severe risk of transmission to humans and animals if inadequately disinfected before release. This study provides a baseline for the future investigation of diverse protozoal communities in wastewater, which are of public health importance.
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Affiliation(s)
- Nonsikelelo P Mthethwa-Hlongwa
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa; Department Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - Isaac D Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa; Department of Environmental Science, The University of Arizona, Shantz Building Rm 4291177 E 4th St., Tucson, AZ 85721, USA
| | - Andres Gomez
- Department of Animal Science, University of Minnesota, St. Paul, MN, USA
| | - Sam Davison
- Department of Animal Science, University of Minnesota, St. Paul, MN, USA
| | - Poovendhree Reddy
- Department Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa.
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Toriro R, Pallett S, Woolley S, Bennett C, Hale I, Heylings J, Wilkins D, Connelly T, Muia K, Avery P, Stuart A, Morgan L, Davies M, Nevin W, Quantick O, Robinson G, Elwin K, Chalmers R, Burns D, Beeching N, Fletcher T, O’Shea M. Outbreak of Diarrhea Caused by a Novel Cryptosporidium hominis Subtype During British Military Training in Kenya. Open Forum Infect Dis 2024; 11:ofae001. [PMID: 38250201 PMCID: PMC10798851 DOI: 10.1093/ofid/ofae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Background We report clinical, epidemiological, and laboratory features of a large diarrhea outbreak caused by a novel Cryptosporidium hominis subtype during British military training in Kenya between February and April 2022. Methods Data were collated from diarrhea cases, and fecal samples were analyzed on site using the multiplex polymerase chain reaction (PCR) BioFire FilmArray. Water was tested using Colilert kits (IDEXX, UK). DNA was extracted from feces for molecular characterization of Cryptosporidium A135, Lib13, ssu rRNA, and gp60 genes. Results One hundred seventy-two of 1200 (14.3%) personnel at risk developed diarrhea over 69 days. One hundred six primary fecal samples were tested, and 63/106 (59.4%; 95% CI, 0.49%-0.69%) were positive for Cryptosporidium spp. Thirty-eight had Cryptosporidium spp. alone, and 25 had Cryptosporidium spp. with ≥1 other pathogen. A further 27/106 (25.5%; 95% CI, 0.18%-0.35%) had non-Cryptosporidium pathogens only, and 16/106 (15.1%; 95% CI, 0.09%-0.23%) were negative. C. hominis was detected in 58/63 (92.1%) Cryptosporidium spp.-positive primary samples, but the others were not genotypable. Twenty-seven C. hominis specimens were subtypable; 1 was gp60 subtype IeA11G3T3, and 26 were an unusual subtype, ImA13G1 (GenBank accession OP699729), supporting epidemiological evidence suggesting a point source outbreak from contaminated swimming water. Diarrhea persisted for a mean (SD) of 7.6 (4.6) days in Cryptosporidium spp. cases compared with 2.3 (0.9) days in non-Cryptosporidium cases (P = .001). Conclusions Real-time multiplex PCR fecal testing was vital in managing this large cryptosporidiosis outbreak. The etiology of a rare C. hominis gp60 subtype emphasizes the need for more genotypic surveillance to identify widening host and geographic ranges of novel C. hominis subtypes.
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Affiliation(s)
- Romeo Toriro
- Army Medical Services, Robertson House, Royal Military Academy Sandhurst, Camberley, Surrey, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Scott Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Stephen Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Charlie Bennett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Isra Hale
- 3 Medical Regiment, Fulwood Barracks, Preston, Lancashire, UK
| | - Jennifer Heylings
- 28 (C-CBRN) Engineer Regiment, Rock Barracks, Woodbridge, Suffolk, UK
| | - Daniel Wilkins
- 2nd Battalion the Rifles, Thiepval Barracks, Lisburn, UK
| | - Thomas Connelly
- 29 Public Health Division Medical Group, HQ 3 (UK) Division, Bulford, Wiltshire, UK
| | - Kennedy Muia
- British Army Training Unit (Kenya), Nanyuki, Kenya
| | - Patrick Avery
- Defence Primary Healthcare, Medical Centre, Nanyuki, Kenya
| | - Andrew Stuart
- Defence Primary Healthcare, Medical Centre, Nanyuki, Kenya
| | - Laura Morgan
- HQ 1st (UK) Division, Imphal Barracks, York, Yorkshire, UK
| | - Mark Davies
- British Army Training Unit (Kenya), Nanyuki, Kenya
| | - William Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | | | - Guy Robinson
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
- Swansea University Medical School, Swansea, Wales, UK
| | - Kristin Elwin
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
| | - Rachel Chalmers
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
- Swansea University Medical School, Swansea, Wales, UK
| | - Daniel Burns
- Royal Centre for Defence Medicine, Birmingham, UK
| | - Nicholas Beeching
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Thomas Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Royal Centre for Defence Medicine, Birmingham, UK
| | - Matthew O’Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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Berendes DM, Omore R, Prentice-Mott G, Fagerli K, Kim S, Nasrin D, Powell H, Jahangir Hossain M, Sow SO, Doh S, Jones JCM, Ochieng JB, Juma J, Awuor AO, Ogwel B, Verani JR, Widdowson MA, Kasumba IN, Tennant SM, Roose A, Zaman SMA, Liu J, Sugerman CE, Platts-Mills JA, Houpt ER, Kotloff KL, Mintz ED. Exploring Survey-Based Water, Sanitation, and Animal Associations With Enteric Pathogen Carriage: Comparing Results in a Cohort of Cases With Moderate-to-Severe Diarrhea to Those in Controls in the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015-2018. Clin Infect Dis 2023; 76:S140-S152. [PMID: 37074442 PMCID: PMC10116566 DOI: 10.1093/cid/ciac918] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The magnitude of pediatric enteric pathogen exposures in low-income settings necessitates substantive water and sanitation interventions, including animal feces management. We assessed associations between pediatric enteric pathogen detection and survey-based water, sanitation, and animal characteristics within the Vaccine Impact on Diarrhea in Africa case-control study. METHODS In The Gambia, Kenya, and Mali, we assessed enteric pathogens in stool of children aged <5 years with moderate-to-severe diarrhea and their matched controls (diarrhea-free in prior 7 days) via the TaqMan Array Card and surveyed caregivers about household drinking water and sanitation conditions and animals living in the compound. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using modified Poisson regression models, stratified for cases and controls and adjusted for age, sex, site, and demographics. RESULTS Bacterial (cases, 93%; controls, 72%), viral (63%, 56%), and protozoal (50%, 38%) pathogens were commonly detected (cycle threshold <35) in the 4840 cases and 6213 controls. In cases, unimproved sanitation (RR, 1.56; 95% CI, 1.12-2.17), as well as cows (RR, 1.61; 95% CI, 1.16-2.24) and sheep (RR, 1.48; 95% CI, 1.11-1.96) living in the compound, were associated with Shiga toxin-producing Escherichia coli. In controls, fowl (RR, 1.30; 95% CI, 1.15-1.47) were associated with Campylobacter spp. In controls, surface water sources were associated with Cryptosporidium spp., Shigella spp., heat-stable toxin-producing enterotoxigenic E. coli, and Giardia spp. CONCLUSIONS Findings underscore the importance of enteric pathogen exposure risks from animals alongside more broadly recognized water and sanitation risk factors in children.
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Affiliation(s)
- David M Berendes
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Graeme Prentice-Mott
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kirsten Fagerli
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sunkyung Kim
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dilruba Nasrin
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Helen Powell
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - M Jahangir Hossain
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine; Banjul, The Gambia
| | - Samba O Sow
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Sanogo Doh
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Joquina Chiquita M Jones
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine; Banjul, The Gambia
| | - John B Ochieng
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Jane Juma
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Alex O Awuor
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Billy Ogwel
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Jennifer R Verani
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Marc-Alain Widdowson
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Irene N Kasumba
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sharon M Tennant
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Anna Roose
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Syed M A Zaman
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine; Banjul, The Gambia
| | - Jie Liu
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
- School of Public Health at Qingdao University, Qingdao, China
| | - Ciara E Sugerman
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Eric R Houpt
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Eric D Mintz
- Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Caravedo MA, White AC. Treatment of cryptosporidiosis: nitazoxanide yes, but we can do better. Expert Rev Anti Infect Ther 2023; 21:167-173. [PMID: 36533398 DOI: 10.1080/14787210.2023.2160704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Cryptosporidiosis was initially recognized as an important cause of diarrhea in AIDS patients. It has been underdiagnosed in other populations. Recent studies have highlighted the importance of Cryptosporidium as a cause of diarrhea and malnutrition in young children in resource-poor countries and an emerging pathogen in organ-transplant recipients. AREAS COVERED Nitazoxanide is FDA approved for treatment of cryptosporidiosis in immunocompetent people. However, it is less effective in HIV and transplant patients and malnourished children. In transplant recipients, there is emerging data on antiparasitic combinations for cryptosporidiosis, including combinations of nitazoxanide, azithromycin, and in one case rifaximin. High-throughput phenotypic screens have identified some potential treatments. Among them, clofazimine was no better than placebo in a trial in AIDS patients. There have also been efforts to develop drug versus specific parasite targets. However, in part due to safety issues, none of these compounds have advanced into clinical trials. EXPERT OPINION Development of new and more efficacious therapies for cryptosporidium is imperative. Current approve therapy is far from optimal and lacks efficacy in high-risk populations, such as, patients living with HIV. Additionally, there is limited data on patients with other types of immunosuppression (Transplanted, autoimmune conditions, etc).
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Affiliation(s)
- Maria A Caravedo
- Infectious Disease Division Department of Internal Medicine University of Texas Medical Branch, Galveston, Texas, USA
| | - A Clinton White
- Infectious Disease Division Department of Internal Medicine University of Texas Medical Branch, Galveston, Texas, USA
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Wong JT, Lane JK, Allan FK, Vidal G, Vance C, Donadeu M, Jackson W, Nwankpa V, Abera S, Mekonnen GA, Kebede N, Admassu B, Amssalu K, Lemma A, Fentie T, Smith W, Peters AR. Reducing Calf Mortality in Ethiopia. Animals (Basel) 2022; 12:ani12162126. [PMID: 36009716 PMCID: PMC9405078 DOI: 10.3390/ani12162126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Disease and death of young livestock cause financial and production difficulties to farmers around the world. High rates of disease and death occur in various production systems in Ethiopia, hampering livestock production, reducing incomes, and damaging livelihoods. Over the last 10 years, studies carried out in Ethiopia have reported death and disease incidence rates in young livestock as high as 31% and 67%, respectively. Diarrhea and respiratory infections are the two leading causes of disease and death in calves in all production systems. In this paper, we describe findings from the experience of the Young Stock Mortality Reduction Consortium. This unique group produced important information on the main causes of disease and death in Ethiopia and created activities for small-scale farmers to address these problems. We found that several diseases caused diarrhea and respiratory infections in young calves in Ethiopia. Improving farmer knowledge and behaviors with respect to basic livestock management led to considerable reductions in young livestock disease and death and has the potential to help improve livestock productivity and human livelihoods in Ethiopia. Abstract Morbidity and mortality of young stock present economic and production challenges to livestock producers globally. In Ethiopia, calf morbidity and mortality rates, particularly due to diarrhea and respiratory disease, are high, limiting production, incomes, and the ability of farmers to improve their livelihoods. In this paper, we present findings from the combined experience of the Young Stock Mortality Reduction Consortium, which conducted epidemiological and intervention testing in calves across three production systems. This innovative alliance identified Cryptosporidium parvum and E. Coli K99 as the most common causes of diarrhea in pastoral and peri-urban calves; Strongyloides spp. as the most common fecal parasite in mixed crop–livestock and peri-urban calves; and bovine adenovirus, parainfluenza virus-3, and bovine respiratory syncytial virus as the most common respiratory pathogens in peri-urban calves. Furthermore, by improving producer knowledge with respect to fundamental livestock husbandry, feeding, housing, and neonatal care practices, calf mortality risk across production systems was reduced by 31.4 to 71.4% compared to baseline (between 10.5 and 32.1%), whereas risk of diarrhea was reduced by 52.6–75.3% (baseline between 11.4 and 30.4%) and risk of respiratory disease was reduced by 23.6–80.8% (baseline between 3.3 and 16.3%). These findings have informed scaling strategies and can potentially contribute to improved livestock productivity and human livelihoods in Ethiopia.
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Affiliation(s)
- Johanna T. Wong
- Supporting Evidence Based Interventions-Livestock, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - Jennifer K. Lane
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
- Correspondence:
| | - Fiona K. Allan
- Supporting Evidence Based Interventions-Livestock, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - Gema Vidal
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Ciara Vance
- Supporting Evidence Based Interventions-Livestock, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - Meritxell Donadeu
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC 3030, Australia
| | - Wendi Jackson
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Veronica Nwankpa
- Department of Microbial Cellular and Molecular Biology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia
| | - Shubisa Abera
- Animal Health Institute (AHI), Sebeta P.O. Box 04, Ethiopia
| | | | - Nigatu Kebede
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia
| | - Berhanu Admassu
- Feinstein International Center, Tufts University, Boston, MA 02111, USA
| | - Kassaw Amssalu
- Ministry of Agriculture, Addis Ababa P.O. Box 62347, Ethiopia
| | - Alemayehu Lemma
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu P.O. Box 34, Ethiopia
| | - Tsegaw Fentie
- College of Veterinary Medicine and Animal Sciences, Tewodros Campus, University of Gondar, Gondar P.O. Box 169, Ethiopia
| | - Woutrina Smith
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Andrew R. Peters
- Supporting Evidence Based Interventions-Livestock, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
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Johansen ØH, Abdissa A, Zangenberg M, Mekonnen Z, Eshetu B, Sharew B, Moyo S, Sommerfelt H, Langeland N, Robertson LJ, Hanevik K. A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. PLoS Negl Trop Dis 2022; 16:e0010508. [PMID: 35666717 PMCID: PMC9203008 DOI: 10.1371/journal.pntd.0010508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/16/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea.
Methodology/Principal findings
We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors—specifically low maternal education—and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea.
Conclusions/Significance
Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of cryptosporidiosis.
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Affiliation(s)
- Øystein Haarklau Johansen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Norway
- * E-mail:
| | - Alemseged Abdissa
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mike Zangenberg
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Beza Eshetu
- Department of Paediatrics, Jimma Medical Centre, Jimma University, Jimma, Ethiopia
| | - Bizuwarek Sharew
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Sabrina Moyo
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Halvor Sommerfelt
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lucy J. Robertson
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Kurt Hanevik
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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8
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Chen D, Mechlowitz K, Li X, Schaefer N, Havelaar AH, McKune SL. Benefits and Risks of Smallholder Livestock Production on Child Nutrition in Low- and Middle-Income Countries. Front Nutr 2021; 8:751686. [PMID: 34778344 PMCID: PMC8579112 DOI: 10.3389/fnut.2021.751686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
Livestock production may improve nutritional outcomes of pregnant women and children by increasing household income, availability of nutrient-dense foods, and women's empowerment. Nevertheless, the relationship is complex, and the nutritional status of children may be impaired by presence of or proximity to livestock and their pathogens. In this paper, we review the benefits and risks of livestock production on child nutrition. Evidence supports the nutritional benefits of livestock farming through income, production, and women's empowerment. Increasing animal source food consumption requires a combination of efforts, including improved animal management so that herd size is adequate to meet household income needs and consumption and addressing sociocultural and gendered norms. Evidence supports the inclusion of behavior change communication strategies into livestock production interventions to facilitate the sustainability of nutritional benefits over time, particularly interventions that engage women and foster dimensions of women's empowerment. In evaluating the risks of livestock production, evidence indicates that a broad range of enteric pathogens may chronically infect the intestines of children and, in combination with dietary deficits, may cause environmental enteric dysfunction (EED), a chronic inflammation of the gut. Some of the most important pathogens associated with EED are zoonotic in nature with livestock as their main reservoir. Very few studies have aimed to understand which livestock species contribute most to colonization with these pathogens, or how to reduce transmission. Control at the point of exposure has been investigated in a few studies, but much less effort has been spent on improving animal husbandry practices, which may have additional benefits. There is an urgent need for dedicated and long-term research to understand which livestock species contribute most to exposure of young children to zoonotic enteric pathogens, to test the potential of a wide range of intervention methods, to assess their effectiveness in randomized trials, and to assure their broad adaptation and sustainability. This review highlights the benefits and risks of livestock production on child nutrition. In addition to identifying research gaps, findings support inclusion of poor gut health as an immediate determinant of child undernutrition, expanding the established UNICEF framework which includes only inadequate diet and disease.
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Affiliation(s)
- Dehao Chen
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Karah Mechlowitz
- Department of Social and Behavioral Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Xiaolong Li
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Nancy Schaefer
- Health Science Center Libraries, University of Florida, Gainesville, FL, United States
| | - Arie H. Havelaar
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
- Institute for Sustainable Food Systems, University of Florida, Gainesville, FL, United States
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Center for African Studies, University of Florida, Gainesville, FL, United States
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9
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Omolabi KF, Odeniran PO, Soliman ME. A meta-analysis of Cryptosporidium species in humans from southern Africa (2000-2020). J Parasit Dis 2021; 46:304-316. [PMID: 34421234 PMCID: PMC8371598 DOI: 10.1007/s12639-021-01436-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/05/2021] [Indexed: 10/25/2022] Open
Abstract
Abstract The epidemiology of cryptosporidiosis in southern Africa is largely unknown. The disease is associated with diarrhea and nutritional deficiencies, leading to severe morbidity and mortality among immune-compromised patients. This study aimed to assess the pooled prevalence of Cryptosporidium spp. infection among immune-compromised humans in southern Africa over the past 20 years. Reports of Cryptosporidium spp. infection in humans published between 2000 and 2020 using Google Scholar, PubMed, Ovid Medline, African Journal Online (AJOL), and Web of Science literature databases were obtained. Inclusion criteria of sorted articles for Cryptosporidium spp. infection were standardized using preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. A total of 22 eligible studies were sorted for meta-analysis. Overall prevalence of Cryptosporidium spp. infection in southern African countries with reports was 16.8% (95% CI 9.7-25.3). Sub-group analysis showed a pooled prevalence of 25.2, 20.5, and 17.9% among HIV/AIDS patients, children, and diarrhoeic individuals, respectively. Pooled prevalence was highest in South Africa and lowest in Zimbabwe across examined individuals. The pooled prevalence of Cryptosporidium spp. infections in diarrhoeic patients was highest in individuals from Botswana (17.6%) which is significantly different (Χ 2 = 9.337; P = 0.002) from South Africans (12.7%). South African individuals with HIV/AIDS showed the highest pooled prevalence of Cryptosporidium infections than other countries. The high prevalence of Cryptosporidium spp. infections among immune-compromised patients in southern Africa showed that the pathogen is of significant importance in this region. Continuous studies on the genetic characterization of Cryptosporidium spp. isolates and associated risk factors are needed across southern Africa to identify the predominant subtypes in humans. Graphic abstract Supplementary Information The online version contains supplementary material available at 10.1007/s12639-021-01436-4.
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Affiliation(s)
- Kehinde Foluke Omolabi
- Molecular Bio-Computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001 South Africa
| | - Paul Olalekan Odeniran
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mahmoud E Soliman
- Molecular Bio-Computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001 South Africa
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10
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Messa A, Köster PC, Garrine M, Nhampossa T, Massora S, Cossa A, Bassat Q, Kotloff K, Levine MM, Alonso PL, Carmena D, Mandomando I. Molecular Characterisation of Cryptosporidium spp. in Mozambican Children Younger than 5 Years Enrolled in a Matched Case-Control Study on the Aetiology of Diarrhoeal Disease. Pathogens 2021; 10:452. [PMID: 33918893 PMCID: PMC8070020 DOI: 10.3390/pathogens10040452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022] Open
Abstract
Cryptosporidium is a leading cause of childhood diarrhoea and associated physical and cognitive impairment in low-resource settings. Cryptosporidium-positive faecal samples (n = 190) from children aged ≤ 5 years enrolled in the Global Enteric Multicenter Study (GEMS) in Mozambique detected by ELISA (11.5%, 430/3754) were successfully PCR-amplified and sequenced at the gp60 or ssu rRNA loci for species determination and genotyping. Three Cryptosporidium species including C. hominis (72.6%, 138/190), C. parvum (22.6%, 43/190), and C. meleagridis (4.2%, 8/190) were detected. Children ≤ 23 months were more exposed to Cryptosporidium spp. infections than older children. Both C. hominis and C. parvum were more prevalent among children with diarrhoeal disease compared to those children without it (47.6% vs. 33.3%, p = 0.007 and 23.7% vs. 11.8%, p = 0.014, respectively). A high intra-species genetic variability was observed within C. hominis (subtype families Ia, Ib, Id, Ie, and If) and C. parvum (subtype families IIb, IIc, IIe, and IIi) but not within C. meleagridis (subtype family IIIb). No association between Cryptosporidium species/genotypes and child's age was demonstrated. The predominance of C. hominis and C. parvum IIc suggests that most of the Cryptosporidium infections were anthroponotically transmitted, although zoonotic transmission events also occurred at an unknown rate. The role of livestock, poultry, and other domestic animal species as sources of environmental contamination and human cryptosporidiosis should be investigated in further molecular epidemiological studies in Mozambique.
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Affiliation(s)
- Augusto Messa
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain;
| | - Marcelino Garrine
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
- Instituto Nacional de Saúde, Ministério da Saúde, Marracuene, Maputo 1120, Mozambique
| | - Sérgio Massora
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
| | - Anélsio Cossa
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
- Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Karen Kotloff
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201-1509, USA; (K.K.); (M.M.L.)
| | - Myron M. Levine
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201-1509, USA; (K.K.); (M.M.L.)
| | - Pedro L. Alonso
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain
- Global Malaria Program, World Health Organization, 1211 Geneva, Switzerland
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain;
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça, Maputo 1929, Mozambique; (A.M.J.); (M.G.); (T.N.); (S.M.); (A.C.); (Q.B.); (P.L.A.)
- Instituto Nacional de Saúde, Ministério da Saúde, Marracuene, Maputo 1120, Mozambique
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11
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Molecular Epidemiology of Human Cryptosporidiosis in Low- and Middle-Income Countries. Clin Microbiol Rev 2021; 34:34/2/e00087-19. [PMID: 33627442 DOI: 10.1128/cmr.00087-19] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cryptosporidiosis is one of the most important causes of moderate to severe diarrhea and diarrhea-related mortality in children under 2 years of age in low- and middle-income countries. In recent decades, genotyping and subtyping tools have been used in epidemiological studies of human cryptosporidiosis. Results of these studies suggest that higher genetic diversity of Cryptosporidium spp. is present in humans in these countries at both species and subtype levels and that anthroponotic transmission plays a major role in human cryptosporidiosis. Cryptosporidium hominis is the most common Cryptosporidium species in humans in almost all the low- and middle-income countries examined, with five subtype families (namely, Ia, Ib, Id, Ie, and If) being commonly found in most regions. In addition, most Cryptosporidium parvum infections in these areas are caused by the anthroponotic IIc subtype family rather than the zoonotic IIa subtype family. There is geographic segregation in Cryptosporidium hominis subtypes, as revealed by multilocus subtyping. Concurrent and sequential infections with different Cryptosporidium species and subtypes are common, as immunity against reinfection and cross protection against different Cryptosporidium species are partial. Differences in clinical presentations have been observed among Cryptosporidium species and C. hominis subtypes. These observations suggest that WASH (water, sanitation, and hygiene)-based interventions should be implemented to prevent and control human cryptosporidiosis in low- and middle-income countries.
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12
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Van Voorhis WC, Hulverson MA, Choi R, Huang W, Arnold SLM, Schaefer DA, Betzer DP, Vidadala RSR, Lee S, Whitman GR, Barrett LK, Maly DJ, Riggs MW, Fan E, Kennedy TJ, Tzipori S, Doggett JS, Winzer P, Anghel N, Imhof D, Müller J, Hemphill A, Ferre I, Sanchez-Sanchez R, Ortega-Mora LM, Ojo KK. One health therapeutics: Target-Based drug development for cryptosporidiosis and other apicomplexa diseases. Vet Parasitol 2020; 289:109336. [PMID: 33418437 DOI: 10.1016/j.vetpar.2020.109336] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 12/14/2022]
Abstract
This is a review of the development of bumped-kinase inhibitors (BKIs) for the therapy of One Health parasitic apicomplexan diseases. Many apicomplexan infections are shared between humans and livestock, such as cryptosporidiosis and toxoplasmosis, as well as livestock only diseases such as neosporosis. We have demonstrated proof-of-concept for BKI therapy in livestock models of cryptosporidiosis (newborn calves infected with Cryptosporidium parvum), toxoplasmosis (pregnant sheep infected with Toxoplasma gondii), and neosporosis (pregnant sheep infected with Neospora caninum). We discuss the potential uses of BKIs for the treatment of diseases caused by apicomplexan parasites in animals and humans, and the improvements that need to be made to further develop BKIs.
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Affiliation(s)
- Wesley C Van Voorhis
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA.
| | - Matthew A Hulverson
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
| | - Ryan Choi
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
| | - Wenlin Huang
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA
| | - Samuel L M Arnold
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
| | - Deborah A Schaefer
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Dana P Betzer
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Rama S R Vidadala
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA
| | - Sangun Lee
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536, USA
| | - Grant R Whitman
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
| | - Lynn K Barrett
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
| | - Dustin J Maly
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA
| | - Michael W Riggs
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Erkang Fan
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA
| | | | - Saul Tzipori
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536, USA
| | - J Stone Doggett
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Pablo Winzer
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - Nicoleta Anghel
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - Dennis Imhof
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - Joachim Müller
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - Andrew Hemphill
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland
| | - Ignacio Ferre
- Saluvet, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040, Madrid, Spain
| | - Roberto Sanchez-Sanchez
- Saluvet, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040, Madrid, Spain
| | - Luis Miguel Ortega-Mora
- Saluvet, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040, Madrid, Spain
| | - Kayode K Ojo
- Center for Emerging and Re-emerging Infectious Diseases (CERID), Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, 98109, USA
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13
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Deichsel EL, Hillesland HK, Gilchrist CA, Naulikha JM, McGrath CJ, Van Voorhis WC, Rwigi D, Singa BO, Walson JL, Pavlinac PB. Prevalence and Correlates of Cryptosporidium Infections in Kenyan Children With Diarrhea and Their Primary Caregivers. Open Forum Infect Dis 2020; 7:ofaa533. [PMID: 33335937 PMCID: PMC7731525 DOI: 10.1093/ofid/ofaa533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/27/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Cryptosporidium is a leading cause of diarrhea in Sub-Saharan Africa and is associated with substantial morbidity and mortality in young children. METHODS We analyzed data from children aged 6-71 months presenting to 2 public hospitals in Western Kenya with acute diarrhea and their primary caregivers, including detection of Cryptosporidium by quantitative polymerase chain reaction (PCR) and immunoassay analysis in stool samples from both children and their caregivers. Associations between potential transmission sources and child/caregiver Cryptosporidium infection were evaluated using prevalence ratios (PRs). Secondary analyses evaluated host and clinical risk factors of child/caregiver Cryptosporidium infection. RESULTS Among 243 child-caregiver pairs enrolled, 77 children (32%) and 57 caregivers (23%) had Cryptosporidium identified by either immunoassay or PCR. Twenty-six of the 243 child-caregiver pairs (11%) had concordant detection of Cryptosporidium. Cryptosporidium infection in children was associated with detection of Cryptosporidium in caregivers (adjusted PR [aPR], 1.8; 95% CI, 1.2 to 2.6; P = .002) and unprotected water source (aPR, 2.0; 95% CI, 1.3 to 3.2; P = .003). Risk factors for Cryptosporidium detection in caregivers included child Cryptosporidium infection (aPR, 2.0; 95% CI, 1.3 to 3.0; P = .002) as well as cow (aPR, 3.1; 95% CI, 1.4 to 7.0; P = .02) and other livestock ownership (aPR, 2.6; 95% CI, 1.1 to 6.3; P = .03) vs no livestock ownership. Recent diarrhea in caregivers and children was independently associated with child and caregiver Cryptosporidium infections, respectively. CONCLUSIONS Our results are consistent with the hypothesis that Cryptosporidium transmission can occur directly between child-caregiver dyads as well as through other pathways involving water and livestock. Additional research into caregivers as a source of childhood Cryptosporidium infection is warranted.
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Affiliation(s)
| | | | | | | | | | | | - Doreen Rwigi
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Judd L Walson
- University of Washington, Seattle, Washington, USA
- Child Acute Illness and Nutrition (CHAIN) Network, Nairobi, Kenya
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14
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Omolabi KF, Agoni C, Olotu FA, Soliman MES. Molecular Basis of P131 Cryptosporidial-IMPDH Selectivity-A Structural, Dynamical and Mechanistic Stance. Cell Biochem Biophys 2020; 79:11-24. [PMID: 33058015 DOI: 10.1007/s12013-020-00950-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 01/10/2023]
Abstract
Cryptosporidiosis accounts for a surge in infant (<5 years) mortality and morbidity. To date, several drug discovery efforts have been put in place to develop effective therapeutic options against the causative parasite. Based on a recent report, P131 spares inosine monophosphate dehydrogenase (IMPDH) in a eukaryotic model (mouse IMPDH (mIMPDH)) while binding selectively to the NAD+ site in Cryptosporidium parvum (CpIMPDH). However, no structural detail exists on the underlining mechanisms of P131-CpIMPDH selective targeting till date. To this effect, we investigate the selective inhibitory dynamics of P131 in CpIMPDH relative to mIMPDH via molecular biocomputation methods. Pairwise sequence alignment revealed prominent variations at the NAD+ binding regions of both proteins that accounted for disparate P131 binding activities. The influence of these variations was further revealed by the MM/PBSA energy estimations coupled with per-residue energy decomposition which monitored the systematic binding of the compound. Furthermore, relative high-affinity interactions occurred at the CpIMPDH NAD+ site which were majorly mediated by SER22, VAL24, PRO26, SER354, GLY357, and TYR358 located on chain D. These residues are unique to the parasite IMPDH form and not in the eukaryotic protein, highlighting variations that account for preferential P131 binding. Molecular insights provided herein corroborate previous experimental reports and further underpin the basis of CpIMPDH inhibitor selectivity. Findings from this study could present attractive prospects toward the design of novel anticryptosporidials with improved selectivity and binding affinity against parasitic targets.
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Affiliation(s)
- Kehinde F Omolabi
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Clement Agoni
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Fisayo A Olotu
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Mahmoud E S Soliman
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa.
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15
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Robertson LJ, Johansen ØH, Kifleyohannes T, Efunshile AM, Terefe G. Cryptosporidium Infections in Africa-How Important Is Zoonotic Transmission? A Review of the Evidence. Front Vet Sci 2020; 7:575881. [PMID: 33195574 PMCID: PMC7580383 DOI: 10.3389/fvets.2020.575881] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/27/2020] [Indexed: 01/25/2023] Open
Abstract
Cryptosporidium, a protozoan parasite in the phylum Apicomplexa, is the etiological agent of cryptosporidiosis, an intestinal infection characterized by profuse watery diarrhea. Over 30 species of Cryptosporidium are recognized, some host specific whereas others infect a broader host range. Cryptosporidium hominis and Cryptosporidium parvum are the species most commonly associated with human infection; C. hominis is largely associated only with human infections, but C. parvum is also associated with infection in animals, especially young ruminants. In some regions, cryptosporidiosis is a serious veterinary problem, particularly for calves, and lambs. Many outbreaks of human cryptosporidiosis have been associated with zoonotic transmission following contact with infected animals. In Africa, where cryptosporidiosis is a major contributor to pediatric morbidity and mortality, evidence suggests transmission is principally anthroponotic. Given the frequent close contact between humans and animals in Africa, the apparent predominance of human-to-human transmission is both interesting and puzzling. In this article, after a brief "text book" introduction to the parasite, we consider in separate sections the different aspects of relevance to Cryptosporidium transmission in African countries, describing different aspects of the various species and subtypes in human and animal infections, considering livestock management practices in different African countries, and looking for any characteristic "hot spots" where zoonotic transmission has apparently occurred. Studies where transmission networks have been investigated are particularly relevant. Finally, in a separate section, we try to gather these different strands of evidence together in order to assess the reasons behind the apparent predominance of anthroponotic transmission in Africa. Reviewing the available evidence provides an opportunity to re-think transmission pathways, not only in Africa but also elsewhere, and also to pose questions. Does the predominance of human-to-human transmission in Africa reflect a relative absence of zoonotic C. parvum in African livestock? Are Africans less susceptible to zoonotic Cryptosporidium infection, perhaps resulting from early immunostimulation by C. hominis or due to inherent genetic traits? Is the African environment-in all its variety-simply more detrimental to oocyst survival? Will the so-called hypertransmissible subtypes, currently relatively rare in Africa, be introduced from Europe or elsewhere, and, if so, will they fade out or establish and spread? Our intention with this manuscript is not only to summarize and consolidate diverse data, thereby providing an overview of data gaps, but also to provide food for thought regarding transmission of a parasite that continues to have a considerable impact on both human and animal health.
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Affiliation(s)
- Lucy J. Robertson
- Parasitology Laboratory, Department of Paraclinical Science, Faculty of Veterinary Medicine Norwegian University of Life Sciences, Oslo, Norway
| | - Øystein Haarklau Johansen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tsegabirhan Kifleyohannes
- Parasitology Laboratory, Department of Paraclinical Science, Faculty of Veterinary Medicine Norwegian University of Life Sciences, Oslo, Norway
- Department of Veterinary Basic and Diagnostic Sciences, College of Veterinary Medicine, Mekelle University, Mekelle, Ethiopia
| | - Akinwale Michael Efunshile
- Department of Medical Microbiology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
- Department of Medical Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | - Getachew Terefe
- College of Veterinary Medicine and Agriculture, Department of Pathology and Parasitology, Addis Ababa University, Bishoftu, Ethiopia
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Trajano Gomes da Silva D, Ebdon J, Okotto-Okotto J, Ade F, Mito O, Wanza P, Kwoba E, Mwangi T, Yu W, Wright JA. A longitudinal study of the association between domestic contact with livestock and contamination of household point-of-use stored drinking water in rural Siaya County (Kenya). Int J Hyg Environ Health 2020; 230:113602. [PMID: 32911124 PMCID: PMC7607227 DOI: 10.1016/j.ijheh.2020.113602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2020] [Accepted: 08/05/2020] [Indexed: 11/08/2022]
Abstract
Background Emerging evidence suggests close domestic proximity of livestock and humans may lead to microbiological contamination of hands, objects, food and water supplies within domestic environments, adversely impacting public health. However, evidence quantifying the relationship between livestock, domestic animals, humans and microbiological contamination of household stored water remains limited. Aim This longitudinal study aimed to examine the relationship between domestic contact with livestock and domestic animals on microbiological contamination of household Point-of-Use (POU) stored drinking water in rural Kenya and assess the influence of choice of faecal indicator on such associations. Methodology A survey was performed in 234 households in Siaya county, Kenya, to observe presence of livestock (cattle, goats, poultry) and domestic animals (cats, dogs) in household compounds, alongside other risk factors for contamination of POU stored drinking water such as sanitation, storage conditions and hygiene practices. Samples from water sources (e.g. piped, spring/wells, boreholes, surface and rainwater) and from POU storage containers were tested for E. coli and intestinal enterococci. Livestock-related risk factors for water contamination were examined through multinomial regression, controlling for confounders. Results Rainwater was the main POU water source and was found to be highly susceptible to contamination. Multivariate analysis showed greater risk of gross (>100 CFU/100 mL) water contamination (with E. coli) for households where goats were observed, and/or where poultry roosted in proximity to stored household water (relative risk RR = 2.71; p = 0.001 and RR = 2.02; p = 0.012 respectively). Presence of a poultry coop was also associated with elevated intestinal enterococci densities (RR = 4.46; p = 0.001). Associations between contamination and livestock risk factors were thus similar for both bacteria groups, but E. coli counts declined more rapidly following collection from surface waters than enterococci counts (p = 0.024). Conclusion The presence of livestock (particularly goats) and poultry within household compounds increases POU water contamination risk, suggesting the need for improved interventions to address cross-contamination within rural domestic settings. Within Siaya county, more effective community education is needed to raise awareness of POU water quality protection, particularly of rainwater. Poultry and goats are risk factors for household stored water contamination. Poultry are risk factors for both enterococci and E. coli contamination. Attenuation of enterococci in household stored water is lower than for E. coli. Residual free chlorine is mostly too low to prevent stored water recontamination.
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Affiliation(s)
- Diogo Trajano Gomes da Silva
- School of Environment and Technology, University of Brighton, Cockcroft Building, Lewes Road, Brighton, BN2 4GJ, UK.
| | - James Ebdon
- School of Environment and Technology, University of Brighton, Cockcroft Building, Lewes Road, Brighton, BN2 4GJ, UK
| | - Joseph Okotto-Okotto
- Victoria Institute for Research on Environment and Development (VIRED) International, P.O. Box 6423-40103, Off Nairobi Road, Rabour, Kisumu, Kenya
| | - Frederick Ade
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Oscar Mito
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Peggy Wanza
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Emmah Kwoba
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Thumbi Mwangi
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Weiyu Yu
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
| | - Jim A Wright
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
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17
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Carter BL, Chalmers RM, Davies AP. Health sequelae of human cryptosporidiosis in industrialised countries: a systematic review. Parasit Vectors 2020; 13:443. [PMID: 32887663 PMCID: PMC7650228 DOI: 10.1186/s13071-020-04308-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cryptosporidium is a protozoan parasite which is a common cause of gastroenteritis worldwide. In developing countries, it is one of the most important causes of moderate to severe diarrhoea in young children; in industrialised countries it is a cause of outbreaks of gastroenteritis associated with drinking water, swimming pools and other environmental sources and a particular concern in certain immunocompromised patient groups, where it can cause severe disease. However, over recent years, longer-term sequelae of infection have been recognised and a number of studies have been published on this topic. The purpose of this systematic review was to examine the literature in order to better understand the medium- to long-term impact of cryptosporidiosis. METHODS This was a systematic review of studies in PubMed, ProQuest and Web of Science databases, with no limitations on publication year or language. Studies from any country were included in qualitative synthesis, but only those in industrialised countries were included in quantitative analysis. RESULTS Fifteen studies were identified for qualitative analysis which included 3670 Cryptosporidium cases; eight studies conducted in Europe between 2004-2019 were suitable for quantitative analysis, including five case-control studies. The most common reported long-term sequelae were diarrhoea (25%), abdominal pain (25%), nausea (24%), fatigue (24%) and headache (21%). Overall, long-term sequelae were more prevalent following infection with Cryptosporidium hominis, with only weight loss and blood in stool being more prevalent following infection with Cryptosporidium parvum. Analysis of the case-control studies found that individuals were 6 times more likely to report chronic diarrhoea and weight loss up to 28 months after a Cryptosporidium infection than were controls. Long-term abdominal pain, loss of appetite, fatigue, vomiting, joint pain, headache and eye pain were also between 2-3 times more likely following a Cryptosporidium infection. CONCLUSIONS This is the first systematic review of the long-term sequelae of cryptosporidiosis. A better understanding of long-term outcomes of cryptosporidiosis is valuable to inform the expectations of clinicians and their patients, and public health policy-makers regarding the control and prevention of this infection. Systematic review registration PROSPERO Registration number CRD42019141311.
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Affiliation(s)
- Bethan L Carter
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, UK
| | - Rachel M Chalmers
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, UK.,Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty Lane, Swansea, Wales, UK
| | - Angharad P Davies
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, UK. .,Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty Lane, Swansea, Wales, UK.
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Abstract
The World Health Organization (WHO) currently classifies 20 diseases and conditions as neglected tropical diseases (NTDs). However, since its inception in 2007, PLOS Neglected Tropical Diseases has considered an expanded list that includes additional diseases with the chronic and/or debilitating, and poverty-promoting features of NTDs. Described here is an update of our current scope, which attempts to embrace all of the NTDs, and a discussion of the status of some of the more debated medical conditions in terms of whether or not they constitute an NTD.
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Affiliation(s)
- Peter J. Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
- Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, United States of America
- Department of Biology, Baylor University, Waco, TX, United States of America
- James A Baker III Institute of Public Policy, Rice University, Houston, TX, United States of America
- Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M University, College Station, TX, United States of America
- * E-mail: (PJH); (SA); (PJB); (SK)
| | - Serap Aksoy
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States of America
- * E-mail: (PJH); (SA); (PJB); (SK)
| | - Paul J. Brindley
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University School of Medicine, Washington, DC, United States of America
- * E-mail: (PJH); (SA); (PJB); (SK)
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
- * E-mail: (PJH); (SA); (PJB); (SK)
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He Y, Wang H, Zheng J, Beiting DP, Masci AM, Yu H, Liu K, Wu J, Curtis JL, Smith B, Alekseyenko AV, Obeid JS. OHMI: the ontology of host-microbiome interactions. J Biomed Semantics 2019; 10:25. [PMID: 31888755 PMCID: PMC6937947 DOI: 10.1186/s13326-019-0217-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Host-microbiome interactions (HMIs) are critical for the modulation of biological processes and are associated with several diseases. Extensive HMI studies have generated large amounts of data. We propose that the logical representation of the knowledge derived from these data and the standardized representation of experimental variables and processes can foster integration of data and reproducibility of experiments and thereby further HMI knowledge discovery. METHODS Through a multi-institutional collaboration, a community-based Ontology of Host-Microbiome Interactions (OHMI) was developed following the Open Biological/Biomedical Ontologies (OBO) Foundry principles. As an OBO library ontology, OHMI leverages established ontologies to create logically structured representations of (1) microbiomes, microbial taxonomy, host species, host anatomical entities, and HMIs under different conditions and (2) associated study protocols and types of data analysis and experimental results. RESULTS Aligned with the Basic Formal Ontology, OHMI comprises over 1000 terms, including terms imported from more than 10 existing ontologies together with some 500 OHMI-specific terms. A specific OHMI design pattern was generated to represent typical host-microbiome interaction studies. As one major OHMI use case, drawing on data from over 50 peer-reviewed publications, we identified over 100 bacteria and fungi from the gut, oral cavity, skin, and airway that are associated with six rheumatic diseases including rheumatoid arthritis. Our ontological study identified new high-level microbiota taxonomical structures. Two microbiome-related competency questions were also designed and addressed. We were also able to use OHMI to represent statistically significant results identified from a large existing microbiome database data analysis. CONCLUSION OHMI represents entities and relations in the domain of HMIs. It supports shared knowledge representation, data and metadata standardization and integration, and can be used in formulation of advanced queries for purposes of data analysis.
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Affiliation(s)
- Yongqun He
- University of Michigan Medical School, Ann Arbor, MI 48109 USA
| | - Haihe Wang
- University of Michigan Medical School, Ann Arbor, MI 48109 USA
- Daqing Branch of Harbin Medical University, Daqing, 163319 Heilongjiang China
| | - Jie Zheng
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Daniel P. Beiting
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104 USA
| | - Anna Maria Masci
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710 USA
| | - Hong Yu
- University of Michigan Medical School, Ann Arbor, MI 48109 USA
- People’s Hospital of Guizhou Province, Guiyang, 550025 Guizhou China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Jianmin Wu
- Center for Cancer Bioinformatics, Peking University Cancer Hospital & Institute, Beijing, 100142 China
| | - Jeffrey L. Curtis
- University of Michigan Medical School, Ann Arbor, MI 48109 USA
- Pulmonary & Critical Care Medicine Section, Medical Service, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105 USA
| | - Barry Smith
- University at Buffalo, Buffalo, NY 14260 USA
| | - Alexander V. Alekseyenko
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425 USA
| | - Jihad S. Obeid
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425 USA
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20
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Bitilinyu-Bangoh J, Voskuijl W, Thitiri J, Menting S, Verhaar N, Mwalekwa L, de Jong DB, van Loenen M, Mens PF, Berkley JA, Bandsma RHJ, Schallig HDFH. Performance of three rapid diagnostic tests for the detection of Cryptosporidium spp. and Giardia duodenalis in children with severe acute malnutrition and diarrhoea. Infect Dis Poverty 2019; 8:96. [PMID: 31775877 PMCID: PMC6882336 DOI: 10.1186/s40249-019-0609-6] [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: 05/10/2019] [Accepted: 11/14/2019] [Indexed: 02/01/2023] Open
Abstract
Background There is significant need for accurate diagnostic tools for Cryptosporidium spp. and Giardia duodenalis infections in resource limited countries where diarrhoeal disease caused by these parasites is often prevalent. The present study assessed the diagnostic performance of three commercially available rapid diagnostic tests (RDTs) based on faecal-antigen detection for Cryptosporidium spp. and/or G. duodenalis infections in stool samples of children admitted with severe acute malnutrition (SAM) and diarrhoea. An established multiplex PCR was used as reference test. Methods Stool samples from children with SAM and diarrhoea enrolled in a randomized controlled trial (registered at clinicaltrials.gov/ct2/show/NCT02246296) in Malawi (n = 175) and Kenya (n = 120) between December 2014 and December 2015 were analysed by a multiplex PCR for the presence of Cryptosporidium spp., G. duodenalis or Entamoeba histolytica parasite DNA. Cryptosporidium-positive samples were species typed using restriction fragment length polymorphism analysis. A sub-sample of the stool specimens (n = 236) was used for testing with three different RDTs. Diagnostic accuracy of the tests under evaluation was assessed using the results of PCR as reference standard using MedCalc software. Pearson Chi-square test and Fisher’s exact test were used to determine (significant) difference between the number of cryptosporidiosis or giardiasis cases found by PCR in Malawi and Kenya. The overall diagnostic accuracy of each RDT was calculated by plotting a receiver operating characteristic (ROC) curve for each test and to determine the area under the curve (AUC) using SPSS8 software. Results Prevalence of Cryptosporidium spp. by PCR was 20.0 and 21.7% in Malawi and Kenya respectively, mostly C. hominis. G. duodenalis prevalence was 23.4 and 5.8% in Malawi and Kenya respectively. E. histolytica was not detected by PCR. RDT testing followed the same pattern of prevalence. RDT sensitivities ranged for cryptosporidiosis from 42.9 to 76.9% and for G. duodenalis from 48.2 to 85.7%. RDT specificities ranged from 88.4 to 100% for Cryptosporidium spp. and from 91.2 to 99.2% for G. duodenalis infections. Based on the estimated area under the curve (AUC) values, all tests under evaluation had an acceptable overall diagnostic accuracy (> 0.7), with the exception of one RDT for Cryptosporidium spp. in Malawi. Conclusions All three RDTs for Cryptosporidium spp. and Giardia duodenalis evaluated in this study have a moderate sensitivity, but sufficient specificity. The main value of the RDTs is within their rapidness and their usefulness as screening assays in surveys for diarrhoea.
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Affiliation(s)
- Joseph Bitilinyu-Bangoh
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.,Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Wieger Voskuijl
- College of Medicine, Department of Paediatrics and Child Health, University of Malawi, Blantyre, Malawi.,Global Child Health Group, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands.,The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya
| | - Johnstone Thitiri
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sandra Menting
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Nienke Verhaar
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | | | - Daisy B de Jong
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Merlin van Loenen
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Petra F Mens
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - James A Berkley
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Robert H J Bandsma
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,Translational Medicine Program, Hospital for Sick Children, Toronto, Canada
| | - Henk D F H Schallig
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
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21
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Odeniran PO, Ademola IO. Epidemiology of Cryptosporidium infection in different hosts in Nigeria: A meta-analysis. Parasitol Int 2019; 71:194-206. [PMID: 30974207 DOI: 10.1016/j.parint.2019.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/28/2019] [Accepted: 04/07/2019] [Indexed: 01/27/2023]
Abstract
Cryptosporidium is a medical and veterinary significant protozoan parasite that infects all classes of vertebrates. Environmental contamination with infective oocyst increases the risk of transmission to susceptible host. Estimates of Cryptosporidium prevalence in humans and animals are lacking in Nigeria, therefore a systematic review and meta-analysis were performed to understand the epidemiology of the disease over a period of 30 years using publications from EMBASE, Ovid MEDLINE, Web of Science, AJOL and Google Scholar databases. Studies that met the inclusion criteria of Cryptosporidium infections under the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist were analysed. Point estimates prevalence and subgroup analyses based on potential risk factors and diagnostic techniques were evaluated at 95% confidence interval (CI). A total of 64 eligible studies published between 1987 and 2017 were selected for meta-analysis. The prevalence of Cryptosporidium infection using quality effects model among human, cattle, sheep, goat, pigs, laboratory animals and birds was estimated as 15.0, 26.1, 16.6, 26.0, 20.1, 9.0 and 7.2%, respectively. The high report of C. parvum subtype family IIc indicates the importance of anthroponotic transmission of Cryptosporidium in Nigeria. Heterogeneity of subgroup (regions, species) and risk factors (HIV status, age, gender, faecal type) analyses were determined. The pooled prevalence of Cryptosporidium spp. in different hosts were high and linked with several risk factors such as environmental contamination and animal contact. There is need for increased awareness on the prevalence of the disease to provide strategies that mitigate the disease in humans and animals.
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Affiliation(s)
- Paul Olalekan Odeniran
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Nigeria
| | - Isaiah Oluwafemi Ademola
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, Nigeria.
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Ahmed SA, Guerrero Flórez M, Karanis P. The impact of water crises and climate changes on the transmission of protozoan parasites in Africa. Pathog Glob Health 2018; 112:281-293. [PMID: 30332341 PMCID: PMC6381522 DOI: 10.1080/20477724.2018.1523778] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Waterborne protozoa (WBP) are important cause of several outbreaks all over the world. The report system of WBP in Africa is weak. More than one third of African countries (21/54) reported WBP with absent reports in the remaining countries (33/54). The top reported WBP were Cryptosporidium, Giardia, FLA and Entamoeba contaminating different African water resources. Other protozoa were less documented even though it is abundant and robust. More than one protozoa were detected in contaminated African water including drinking sources, a prediction index to popular epidemics and real presence of undocumented WBP outbreaks. Risk factors in Africa were observed to be abundant and multi-factorial 'socioeconomic, governmental, pathogen in water and climate change. Climate change is an important factor impacting Africa. Increasing droughts in Africa with other extreme weather events will lead to water crises. Incidence and transmission of WBP will change, with new manifested strains/species. Recognizing future consequences of water crises in Africa are important. Governments and population unity will be needed to protect against expected raise and spread of WBP diseases and water shortages.
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Affiliation(s)
- Shahira A. Ahmed
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Milena Guerrero Flórez
- Center for Health Studies CESUN, University of Nariño. Ciudad Universitaria-Torobajo, Pasto, Colombia
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