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Mbanzulu KM, Mboera LEG, Wumba R, Zanga JK, Luzolo FK, Misinzo G, Kimera SI. Community Knowledge, Attitude, and Practices Regarding Mosquitoes and Mosquito-Borne Viral Diseases in Kinshasa, Democratic Republic of the Congo. EPIDEMIOLOGIA (BASEL, SWITZERLAND) 2022; 4:1-17. [PMID: 36648775 PMCID: PMC9844489 DOI: 10.3390/epidemiologia4010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Mosquito-borne viral diseases (MBVDs) create a dramatic health situation worldwide. There is a need to improve the understanding of factors to be addressed in intervention programmes. This study explored community knowledge, attitudes, and practices (KAP) regarding MBVD in Kinshasa. MATERIALS AND METHODS A cross-sectional survey was carried out between January and April 2019. The socio-demographic and KAP data collected through a questionnaire were analysed using Epi Info 7. RESULTS The study included 1464 male and female respondents aged from 18 to 70 years old. Open garbage cans and outdoor water storage units were found in 61.2% and 33.4% of respondent residences, respectively. Polluted water bodies (80.3%) were the most mentioned as mosquito breeding places. Among 86.6% of the respondents that had heard about yellow fever, 12% knew that it is an MBVD. The majority of respondents (72.5%) were perceived to be at risk of contracting MBVD. Environment sanitation (58%) and insecticide use (25%) were among the measures implemented to control mosquitoes. The greater overall knowledge score and attitude were not associated with good practice. CONCLUSION The residents of Kinshasa had limited knowledge of MBVD. Raising awareness and educational sessions are essential in empowering the community regarding the correct attitudes and practices to effectively manage the risk posed by MBVD.
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Affiliation(s)
- Kennedy M. Mbanzulu
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3019, Tanzania
- Correspondence: ; Tel.: +243-898788072
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
| | - Roger Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Josué K. Zanga
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Flory K. Luzolo
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3019, Tanzania
| | - Sharadhuli I. Kimera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3021, Tanzania
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Mbanzulu KM, Wumba R, Mboera LEG, Kayembe JMN, Engbu D, Bojabwa MM, Zanga JK, Misinzo G, Kimera SI. Pattern of Aedes aegypti and Aedes albopictus Associated with Human Exposure to Dengue Virus in Kinshasa, the Democratic Republic of the Congo. Trop Med Infect Dis 2022; 7:392. [PMID: 36422943 PMCID: PMC9695267 DOI: 10.3390/tropicalmed7110392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 08/27/2023] Open
Abstract
Dengue is a worldwide public health concern. The current study assessed the extent of human exposure to the dengue virus in relation to the distribution pattern of Aedes aegypti and Ae. albopictus in Kinshasa. Cross-sectional surveys were carried out in 2021 and 2022. The baseline entomological survey involved 19 municipalities using a grid cell sampling approach. All containers holding water were inspected for the presence of larvae in each grid. The collected larvae were kept in an insectary until the adult emergence for morphological identification. Four hundred febrile patients attending the hospital were screened for the presence of dengue antibodies (IgG, IgM) and NS1 antigen using a rapid diagnostic test (RDT) Biosynex®. Residences of positive cases were geo-referenced. We evaluated 1850 grid cells, of which 19.5% were positive for Aedes larvae. The positive grid cells were identified in the Ndjili (44.0%), Mont Ngafula (32.0%) and Ngaliema (26.0%), and Limete (32.0%) municipalities. The Ae. aegypti (11.2%) predominated in the northwestern, and Ae. albopictus (9.1%) appeared in the high vegetation coverage areas. Of 61 (15.3%) participants exposed to dengue, 8.3% presented acute dengue. Young, (6-17 years), male, and Mont Amba district participants were most exposed to dengue. In conclusion, dengue occurrence in Kinshasa overlaps somewhat the geographical and ecological distributions of Ae. aegypti and Ae. albopictus. Both species are not homogenously distributed, likely due to environmental factors. These findings can assist the targeted control activities.
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Affiliation(s)
- Kennedy Makola Mbanzulu
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 01306, Democratic Republic of the Congo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania
| | - Roger Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 01306, Democratic Republic of the Congo
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
| | - Jean-Marie Ntumba Kayembe
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
- Department of Internal Medicine, University of Kinshasa, Kinshasa P.O. Box 747, Democratic Republic of the Congo
| | - Danoff Engbu
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 01306, Democratic Republic of the Congo
| | - Michael Mondjo Bojabwa
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 01306, Democratic Republic of the Congo
| | - Josué Kikana Zanga
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa P.O. Box 01306, Democratic Republic of the Congo
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania
| | - Sharadhuli Iddi Kimera
- SACIDS Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
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Sang R, Lutomiah J, Chepkorir E, Tchouassi DP. Evolving dynamics of Aedes-borne diseases in Africa: a cause for concern. CURRENT OPINION IN INSECT SCIENCE 2022; 53:100958. [PMID: 35878761 DOI: 10.1016/j.cois.2022.100958] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
Aedes-borne viruses, yellow fever (YF), dengue, Chikungunya and Zika are taking a huge toll on global health as Africa faces re-emergence with potential for massive human catastrophe. Transmission driven by diverse vectors in ecological settings that range from urban to rural and sylvatic habitats with human and nonhuman primate/reservoir activities across such habitats has facilitated virus movement and spillover to susceptible human populations. Approved vaccine exists for YF, although availability for routine and mass vaccination is often constrained. Integrating vector surveillance, understanding disease ecology with rationalised vaccination in high-risk areas (YF) remains important in disease prevention and control. We review trends in disease occurrence in Africa, hinting on gaps in disease detection and management and the prospects for prevention and/or control.
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Affiliation(s)
- Rosemary Sang
- International Centre of Insect Physiology and Ecology, P.O. Box 30772-00100, Nairobi, Kenya.
| | - Joel Lutomiah
- Center for Virus Research, Kenya Medical Research Institute, Kenya
| | - Edith Chepkorir
- Center for Virus Research, Kenya Medical Research Institute, Kenya
| | - David P Tchouassi
- International Centre of Insect Physiology and Ecology, P.O. Box 30772-00100, Nairobi, Kenya
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Oyono MG, Kenmoe S, Abanda NN, Takuissu GR, Ebogo-Belobo JT, Kenfack-Momo R, Kengne-Nde C, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Lontuo Fogang R, Zeuko’o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Bowo-Ngandji A, Nkie Esemu S, Ndip L. Epidemiology of yellow fever virus in humans, arthropods, and non-human primates in sub-Saharan Africa: A systematic review and meta-analysis. PLoS Negl Trop Dis 2022; 16:e0010610. [PMID: 35867659 PMCID: PMC9307179 DOI: 10.1371/journal.pntd.0010610] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/13/2022] Open
Abstract
Yellow fever (YF) has re-emerged in the last two decades causing several outbreaks in endemic countries and spreading to new receptive regions. This changing epidemiology of YF creates new challenges for global public health efforts. Yellow fever is caused by the yellow fever virus (YFV) that circulates between humans, the mosquito vector, and non-human primates (NHP). In this systematic review and meta-analysis, we review and analyse data on the case fatality rate (CFR) and prevalence of YFV in humans, and on the prevalence of YFV in arthropods, and NHP in sub-Saharan Africa (SSA). We performed a comprehensive literature search in PubMed, Web of Science, African Journal Online, and African Index Medicus databases. We included studies reporting data on the CFR and/or prevalence of YFV. Extracted data was verified and analysed using the random effect meta-analysis. We conducted subgroup, sensitivity analysis, and publication bias analyses using the random effect meta-analysis while I2 statistic was employed to determine heterogeneity. This review was registered with PROSPERO under the identification CRD42021242444. The final meta-analysis included 55 studies. The overall case fatality rate due to YFV was 31.1% (18.3–45.4) in humans and pooled prevalence of YFV infection was 9.4% (6.9–12.2) in humans. Only five studies in West and East Africa detected the YFV in mosquito species of the genus Aedes and in Anopheles funestus. In NHP, YFV antibodies were found only in members of the Cercopithecidae family. Our analysis provides evidence on the ongoing circulation of the YFV in humans, Aedes mosquitoes and NHP in SSA. These observations highlight the ongoing transmission of the YFV and its potential to cause large outbreaks in SSA. As such, strategies such as those proposed by the WHO’s Eliminate Yellow Fever Epidemics (EYE) initiative are urgently needed to control and prevent yellow fever outbreaks in SSA.
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Affiliation(s)
- Martin Gael Oyono
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
- Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- * E-mail:
| | - Ngu Njei Abanda
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Cyprien Kengne-Nde
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
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Mbanzulu KM, Mboera LEG, Wumba R, Engbu D, Bojabwa MM, Zanga J, Mitashi PM, Misinzo G, Kimera SI. Physicochemical Characteristics of Aedes Mosquito Breeding Habitats in Suburban and Urban Areas of Kinshasa, Democratic Republic of the Congo. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.789273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe knowledge of key elements of the ecosystem affecting mosquito distribution and their population dynamics is essential for designing mosquito-borne disease interventions. The present study characterized the physicochemical properties of Aedes mosquito breeding habitats in Democratic Republic of the Congo.MethodsA cross-sectional survey was carried out in Kinshasa, from February to April 2021. The physicochemical characteristics of the natural and artificial aquatic habitats of Aedes were measured using a multiparametric device.ResultsOut of 438 breeding habitats inspected, 273 (62.3%) contained mosquito larvae. The Aedes mosquitoes identified in 76.19% of positive breeding sites were Aedes albopictus (67.30%) and Aedes aegypti (37.98%). The median values of dissolved oxygen (DO) (1.0), turbidity (19.15), and salinity (0.115) in water breeding sites of Aedes were respectively 0.8, 55.0, and 0.29 in Culex breeding sites (p < 0.05). The physicochemical characteristics of the breeding habitat for Ae. aegypti and Ae. albopictus were almost identical. In urban areas, the median temperature was 29.82 while it was 29.60 in suburban areas (p < 0.05). Significantly, the salinity was higher in bamboo and metal containers while DO was higher in tins. After analysis using simple linear regression, total dissolved solids (r = 0.23; p = 0.000), conductivity (r = 0.23), salinity (r = 0.23), and temperature (r = 0.13) were associated with larval density (p < 0.05). In the final model (r = 0.30, p = 0.01), salinity (r = 0.23) and DO (r = 0.138) adjusted to temperature, pH, and turbidity were associated positively to larvae density.ConclusionThe Aedes breeding sites and mosquito density were significantly influenced by water salinity, DO, temperature, pH, and turbidity.
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Nwaiwu AU, Musekiwa A, Tamuzi JL, Sambala EZ, Nyasulu PS. The incidence and mortality of yellow fever in Africa: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1089. [PMID: 34688249 PMCID: PMC8536483 DOI: 10.1186/s12879-021-06728-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/01/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Understanding the occurrence of yellow fever epidemics is critical for targeted interventions and control efforts to reduce the burden of disease. We assessed data on the yellow fever incidence and mortality rates in Africa. METHODS We searched the Cochrane Library, SCOPUS, MEDLINE, CINAHL, PubMed, Embase, Africa-wide and Web of science databases from 1 January 1975 to 30th October 2020. Two authors extracted data from included studies independently and conducted a meta-analysis. RESULTS Of 840 studies identified, 12 studies were deemed eligible for inclusion. The incidence of yellow fever per 100,000 population ranged from < 1 case in Nigeria, < 3 cases in Uganda, 13 cases in Democratic Republic of the Congo, 27 cases in Kenya, 40 cases in Ethiopia, 46 cases in Gambia, 1267 cases in Senegal, and 10,350 cases in Ghana. Case fatality rate associated with yellow fever outbreaks ranged from 10% in Ghana to 86% in Nigeria. The mortality rate ranged from 0.1/100,000 in Nigeria to 2200/100,000 in Ghana. CONCLUSION The yellow fever incidence rate is quite constant; in contrast, the fatality rates vary widely across African countries over the study period. Standardized demographic health surveys and surveillance as well as accurate diagnostic measures are essential for early recognition, treatment and control.
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Affiliation(s)
- Akuoma U Nwaiwu
- Division of Epidemiology & Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alfred Musekiwa
- Division of Epidemiology & Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
- School of Health Systems & Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Jacques L Tamuzi
- Division of Epidemiology & Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Evanson Z Sambala
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Peter S Nyasulu
- Division of Epidemiology & Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Adam A, Jassoy C. Epidemiology and Laboratory Diagnostics of Dengue, Yellow Fever, Zika, and Chikungunya Virus Infections in Africa. Pathogens 2021; 10:pathogens10101324. [PMID: 34684274 PMCID: PMC8541377 DOI: 10.3390/pathogens10101324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022] Open
Abstract
Arbovirus infections are widespread, and their disease burden has increased in the past decade. In Africa, arbovirus infections and fever with unknown etiology are common. Due to the lack of well-established epidemiologic surveillance systems and accurate differential diagnosis in most African countries, little is known about the prevalence of human arbovirus infections in Africa. The aim of this review is to summarize the available epidemiological data and diagnostic laboratory tools of infections with dengue, yellow fever, Zika, and chikungunya viruses, all transmitted by Aedes mosquitoes. Studies indicate that these arboviral infections are endemic in most of Africa. Surveillance of the incidence and prevalence of the infections would enable medical doctors to improve the diagnostic accuracy in patients with typical symptoms. If possible, arboviral diagnostic tests should be added to the routine healthcare systems. Healthcare providers should be informed about the prevalent arboviral diseases to identify possible cases.
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Affiliation(s)
- Awadalkareem Adam
- Correspondence: (A.A.); (C.J.); Tel.: +49-341-9714314 (C.J.); Fax: +49-341-9714309 (C.J.)
| | - Christian Jassoy
- Correspondence: (A.A.); (C.J.); Tel.: +49-341-9714314 (C.J.); Fax: +49-341-9714309 (C.J.)
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Women's Empowerment and Children's Complete Vaccination in the Democratic Republic of the Congo: A Cross-Sectional Analysis. Vaccines (Basel) 2021; 9:vaccines9101117. [PMID: 34696225 PMCID: PMC8540931 DOI: 10.3390/vaccines9101117] [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: 08/06/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The empowerment of women contributes to better child health and wellness. This study aimed to examine the association between women’s empowerment and complete vaccination of children, as recommended in the National Expanded Program on Immunization (EPI) in the Democratic Republic of the Congo (DRC). (2) Methods: In this cross-sectional study, a principal component analysis (PCA) was conducted on data from the Multiple-Indicator Cluster Survey 6 (MICS-6) to determine the dimensions of women’s empowerment. Logistic regression analysis was used to assess the association between women’s empowerment and complete vaccination of children stratified by household wealth. In total, 3524 women with children aged 12–23 months were included in the study. (3) Results: Women’s empowerment was defined by three dimensions, namely intrinsic agency, enabling resources, and social independence. Children of women with high levels of empowerment had higher odds of complete vaccination, with values of 1.63 (p = 0.002) and 1.59 (p = 0.012) for intrinsic agency and enabling resources of the empowerment, respectively, compared to the children of women with low levels of empowerment; however, social independence failed to be associated with the vaccination status of children. After stratification by household wealth, the OR of complete vaccination was higher in women from middle-income households with high levels of intrinsic agency (OR: 2.35, p = 0.021) compared to women from poor households with high levels of intrinsic agency (OR: 1.92, p = 0.004). (4) Conclusions: Higher levels of women’s empowerment, especially intrinsic agency and enabling resources, were associated with complete vaccination in children in the DRC. Household wealth status influenced the associations. The empowerment of women is crucial in promoting the complete vaccination of children and providing equal access to vaccines.
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Dong HL, Wang HJ, Liu ZY, Ye Q, Qin XL, Li D, Deng YQ, Jiang T, Li XF, Qin CF. Visualization of yellow fever virus infection in mice using a bioluminescent reporter virus. Emerg Microbes Infect 2021; 10:1739-1750. [PMID: 34379047 PMCID: PMC8425728 DOI: 10.1080/22221751.2021.1967705] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Yellow fever virus (YFV) is a re-emerging flavivirus, which can lead to severe clinical manifestations and high mortality, with no specific antiviral therapies available. The live-attenuated yellow fever vaccine 17D (YF17D) has been widely used for over eighty years. However, the emergence of yellow fever vaccine-associated viscerotropic disease (YFL-AVD) and yellow fever vaccine-associated neurotropic disease (YFL-AND) raised non-negligible concerns. Additionally, the attenuation mechanism of YF17D is still unclear. Thus, the development of convenient models is crucial to understand the mechanisms behind YF17D attenuation and its adverse effects. In this work, we generated a reporter YF17D expressing nano-luciferase (NLuc). In vitro and in vivo characterization demonstrated that the NLuc-YF17D shared similar biological properties with its parental strain and the NLuc activity can reflect viral infectivity reliably. Combined with in vivo bioluminescence imaging, a series of mice models of YF17D infection was established, which will be useful for the evaluation of antiviral medicines and novel vaccine candidates. Especially, we demonstrated that intraperitoneally (i.p.) infection of NLuc-YF17D in type I interferon receptor-deficient mice A129 resulted in outcomes resembling YEL-AVD and YEL-AND, evidenced by viral replication in multiple organs and invasion of the central neuronal system. Finally, in vitro and in vivo assays based on this reporter virus were established to evaluate the antiviral activities of validated antiviral agents. In conclusion, the bioluminescent reporter virus described herein provides a powerful platform to study YF17D attenuation and vaccine-associated diseases as well as to develop novel countermeasures against YFV.
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Affiliation(s)
- Hao-Long Dong
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China
| | - Hong-Jiang Wang
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China.,Department of Comprehensive Basic Experiment, The Chinese People's Liberation Army Strategic Support Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Zhong-Yu Liu
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China.,The Center for Infection and Immunity Studies, School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Qing Ye
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China
| | - Xiao-Ling Qin
- Research Unit of Discovery and Tracing of Natural Focus Diseases, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Department of Medicine and Health, Guangxi Vocational and Technical Institute of industry, Nanning, People's Republic of China
| | - Dan Li
- The Center for Infection and Immunity Studies, School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yong-Qiang Deng
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China
| | - Tao Jiang
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China
| | - Xiao-Feng Li
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China.,Department of Pharmacology, Chinese Academy of Medical Sciences, Beijing, Republic of China
| | - Cheng-Feng Qin
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China.,Research Unit of Discovery and Tracing of Natural Focus Diseases, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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Servadio JL, Muñoz-Zanzi C, Convertino M. Estimating case fatality risk of severe Yellow Fever cases: systematic literature review and meta-analysis. BMC Infect Dis 2021; 21:819. [PMID: 34399718 PMCID: PMC8365934 DOI: 10.1186/s12879-021-06535-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Case fatality risk (CFR), commonly referred to as a case fatality ratio or rate, represents the probability of a disease case being fatal. It is often estimated for various diseases through analysis of surveillance data, case reports, or record examinations. Reported CFR values for Yellow Fever vary, offering wide ranges. Estimates have not been found through systematic literature review, which has been used to estimate CFR of other diseases. This study aims to estimate the case fatality risk of severe Yellow Fever cases through a systematic literature review and meta-analysis. METHODS A search strategy was implemented in PubMed and Ovid Medline in June 2019 and updated in March 2021, seeking reported severe case counts, defined by fever and either jaundice or hemorrhaging, and the number of those that were fatal. The searches yielded 1,133 studies, and title/abstract review followed by full text review produced 14 articles reporting 32 proportions of fatal cases, 26 of which were suitable for meta-analysis. Four studies with one proportion each were added to include clinical case data from the recent outbreak in Brazil. Data were analyzed through an intercept-only logistic meta-regression with random effects for study. Values of the I2 statistic measured heterogeneity across studies. RESULTS The estimated CFR was 39 % (95 % CI: 31 %, 47 %). Stratifying by continent showed that South America observed a higher CFR than Africa, though fewer studies reported estimates for South America. No difference was seen between studies reporting surveillance data and studies investigating outbreaks, and no difference was seen among different symptom definitions. High heterogeneity was observed across studies. CONCLUSIONS Approximately 39 % of severe Yellow Fever cases are estimated to be fatal. This study provides the first systematic literature review to estimate the CFR of Yellow Fever, which can provide insight into outbreak preparedness and estimating underreporting.
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Affiliation(s)
- Joseph L Servadio
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, 55401, MN, USA.
| | - Claudia Muñoz-Zanzi
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, 55401, MN, USA
| | - Matteo Convertino
- Nexus Group and Gi-CORE, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Hokkaido, Japan
- Institute of Environment and Ecology, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
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11
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Wat'senga Tezzo F, Fasine S, Manzambi Zola E, Marquetti MDC, Binene Mbuka G, Ilombe G, Mundeke Takasongo R, Smitz N, Bisset JA, Van Bortel W, Vanlerberghe V. High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo. Parasit Vectors 2021; 14:92. [PMID: 33522947 PMCID: PMC7852359 DOI: 10.1186/s13071-021-04588-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts. METHODS In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N'Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats, which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA barcoding of the specimens to validate identifications. RESULTS The most rural commune (Mont Ngafula) had the highest pupal index (number of Aedes spp. pupae per 100 inspected houses) at 246 (20) pupae/100 houses, and Breteau index (BI; number of containers positive for immature stages of Aedes spp. per 100 households) at 82.2 (19.5) positive containers/100 houses for the rainy (and dry) season, respectively. The BI was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N'Djili in the rainy (and dry) season, respectively. The house index (number of houses positive for at least one container with immature stages of Aedes spp. per 100 inspected houses) was, on average, across all communes, 27.5% (7.6%); and the container index (number of containers positive for immature stages of Aedes spp. per 100 inspected containers) was 15.0% (10.0%) for the rainy (and dry) season, respectively. The vast majority of Aedes-positive containers were found outside the houses [adjusted odds ratio 27.4 (95% confidence interval 14.9-50.1)]. During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. CONCLUSIONS In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key types of containers for Aedes larvae, which are mainly located in outdoor spaces, for larval habitat destruction or reduction.
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Affiliation(s)
- Francis Wat'senga Tezzo
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Sylvie Fasine
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Emile Manzambi Zola
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Maria Del Carmen Marquetti
- Department of Vector Control, Instituto Medicina Tropical Pedro Kourí (IPK), Avenida Novia del Mediodía, KM 6 1/2, La Lisa, Havana, Cuba
| | - Guillaume Binene Mbuka
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Gillon Ilombe
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Richard Mundeke Takasongo
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Smitz
- Department of Biology, Royal Museum for Central Africa (BopCo), Leuvensesteenweg 13-17, Tervuren, Belgium
| | - Juan Andre Bisset
- Department of Vector Control, Instituto Medicina Tropical Pedro Kourí (IPK), Avenida Novia del Mediodía, KM 6 1/2, La Lisa, Havana, Cuba
| | - Wim Van Bortel
- Outbreak Research Team, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium
- Unit of Entomology, Biomedical Science Department, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium
| | - Veerle Vanlerberghe
- Tropical Infectious Disease Group, Public Health Department, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium.
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Raulino R, Thaurignac G, Butel C, Villabona-Arenas CJ, Foe T, Loul S, Ndimbo-Kumugo SP, Mbala-Kingebeni P, Makiala-Mandanda S, Ahuka-Mundeke S, Kerkhof K, Delaporte E, Ariën KK, Foulongne V, Mpoudi Ngole E, Peeters M, Ayouba A. Multiplex detection of antibodies to Chikungunya, O'nyong-nyong, Zika, Dengue, West Nile and Usutu viruses in diverse non-human primate species from Cameroon and the Democratic Republic of Congo. PLoS Negl Trop Dis 2021; 15:e0009028. [PMID: 33476338 PMCID: PMC7853492 DOI: 10.1371/journal.pntd.0009028] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 02/02/2021] [Accepted: 12/01/2020] [Indexed: 11/18/2022] Open
Abstract
Background Epidemic arbovirus transmission occurs among humans by mosquito bites and the sylvatic transmission cycles involving non-human primates (NHPs) still exists. However, limited data are available on the extent in NHPs infections and their role. In this study, we have developed and validated a high-throughput serological screening tool to study the circulation of multiple arboviruses that represent a significant threat to human health, in NHPs in Central Africa. Methodology/Principal findings Recombinant proteins NS1, envelope domain-3 (DIII) for the dengue (DENV), yellow fever (YFV), usutu (USUV), west nile (WNV) and zika (ZIKV) and envelope 2 for the chikungunya (CHIKV) and o'nyong-nyong (ONNV) were coupled to Luminex beads to detect IgG directed against these viruses. Evaluation of test performance was made using 161 human sera of known arboviral status (66 negative and 95 positive). The sensitivity and specificity of each antigen were determined by statistical methods and ROC curves (except for ONNV and USUV). All NS1 antigens (except NS1-YFV), CHIKV-E2 and WNV-DIII had sensitivities and specificities > 95%. For the other DIII antigens, the sensitivity was low, limiting the interest of their use for seroprevalence studies. Few simultaneous reactions were observed between the CHIKV+ samples and the NS1 antigens to the non-CHIKV arboviruses. On the other hand, the DENV+ samples crossed-reacted with NS1 of all the DENV serotypes (1 to 4), as well as with ZIKV, USUV and to a lesser extent with YFV. A total of 3,518 samples of 29 species of NHPs from Cameroon and the Democratic Republic of Congo (DRC) were tested against NS1 (except YFV), E2 (CHIKV/ONNV) and DIII (WNV) antigens. In monkeys (n = 2,100), the global prevalence varied between 2 and 5% for the ten antigens tested. When we stratified by monkey’s biotope, the arboreal species showed the highest reactivity. In monkeys from Cameroon, the highest IgG prevalence were observed against ONNV-E2 and DENV2-NS1 with 3.95% and 3.40% respectively and in DRC, ONNV-E2 (6.63%) and WNV-NS1 (4.42%). Overall prevalence was low in apes (n = 1,418): ranging from 0% for USUV-NS1 to 2.6% for CHIKV-E2. However, a very large disparity was observed among collection site and ape species, e.g. 18% (9/40) and 8.2% (4/49) of gorillas were reactive with CHIKV-E2 or WNV-NS1, respectively in two different sites in Cameroon. Conclusions/Significance We have developed a serological assay based on Luminex technology, with high specificity and sensitivity for simultaneous detection of antibodies to 10 antigens from 6 different arboviruses. This is the first study that evaluated on a large scale the presence of antibodies to arboviruses in NHPs to evaluate their role in sylvatic cycles. The overall low prevalence (<5%) in more than 3,500 NHPs samples from Cameroon and the DRC does not allow us to affirm that NHP are reservoirs, but rather, intermediate hosts of these viruses. In the last decades, chikungunya, zika, yellow fever, usutu and dengue viruses have (re)-emerged in different parts of the world and many of these outbreaks occur in resource-limited countries with limited or under-equipped health facilities and where endemic malaria with very similar clinical symptoms confounds surveillance. Most arboviruses that circulate today likely originated in Africa where sporadic human outbreaks occur. In this work, we developed a serological tool that allows simultaneous detection of IgG antibodies to multiple arbovirus in a biological sample. With this highly sensitive and specific multiplex assay, we screened more than 3,500 samples collected from 29 species of monkeys and apes in Africa. We found a global IgG antibody prevalence of less than 5%. However, this seroprevalence varied by collection site, NPHs species and virus type. Given these findings, we concluded that African non-human primates are most likely not the reservoirs, but rather are intermediate hosts.
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Affiliation(s)
- Raisa Raulino
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Guillaume Thaurignac
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Christelle Butel
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Christian Julian Villabona-Arenas
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Thomas Foe
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Severin Loul
- Centre de Recherches sur les Maladies Émergentes, Ré-émergentes et la Médecine Nucléaire, Institut de Recherches Médicales et D'études des Plantes Médicinales, Yaoundé, Cameroun
| | | | | | | | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicales, Kinshasa, République Démocratique du Congo
| | - Karen Kerkhof
- Department of Biomedical Sciences, Virology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Delaporte
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Kevin K. Ariën
- Department of Biomedical Sciences, Virology Unit, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Foulongne
- Département de bactériologie-virologie, CHU de Montpellier, Montpellier, France
| | - Eitel Mpoudi Ngole
- Centre de Recherches sur les Maladies Émergentes, Ré-émergentes et la Médecine Nucléaire, Institut de Recherches Médicales et D'études des Plantes Médicinales, Yaoundé, Cameroun
| | - Martine Peeters
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Ahidjo Ayouba
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
- * E-mail:
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Sanchez-Velazquez R, de Lorenzo G, Tandavanitj R, Setthapramote C, Bredenbeek PJ, Bozzacco L, MacDonald MR, Clark JJ, Rice CM, Patel AH, Kohl A, Varjak M. Generation of a reporter yellow fever virus for high throughput antiviral assays. Antiviral Res 2020; 183:104939. [PMID: 32980446 PMCID: PMC7649875 DOI: 10.1016/j.antiviral.2020.104939] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/30/2023]
Abstract
Yellow fever virus (YFV), a member of the Flaviviridae family, is an arthropod-borne virus that can cause severe disease in humans with a lethality rate of up to 60%. Since 2017, increases in YFV activity in areas of South America and Africa have been described. Although a vaccine is available, named strain 17D (Theiler and Smith, 1937), it is contraindicated for use in the elderly, expectant mothers, immunocompromised people, among others. To this day there is no antiviral treatment against YFV to reduce the severity of viral infection. Here, we used a circular polymerase extension reaction (CPER)-based reverse genetics approach to generate a full-length reporter virus (YFVhb) by introducing a small HiBit tag in the NS1 protein. The reporter virus replicates at a similar rate to the parental YFV in HuH-7 cells. Using YFVhb, we designed a high throughput antiviral screening luciferase-based assay to identify inhibitors that target any step of the viral replication cycle. We validated our assay by using a range of inhibitors including drugs, immune sera and neutralizing single chain variable fragments (scFv). In light of the recent upsurge in YFV and a potential spread of the virus, this assay is a further tool in the development of antiviral therapy against YFV. Bacteria-free approach to rescue yellow fever virus. Novel tagged yellow fever virus that permits quantifiable assays. Usage of the novel tagged virus for screening of antivirals and immune sera. Novel antiviral compounds against YFV were identified.
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Affiliation(s)
| | | | | | | | - Peter J Bredenbeek
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Leonia Bozzacco
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Margaret R MacDonald
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Jordan J Clark
- MRC-University of Glasgow, Centre for Virus Research, Glasgow, UK
| | - Charles M Rice
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Arvind H Patel
- MRC-University of Glasgow, Centre for Virus Research, Glasgow, UK
| | - Alain Kohl
- MRC-University of Glasgow, Centre for Virus Research, Glasgow, UK
| | - Margus Varjak
- MRC-University of Glasgow, Centre for Virus Research, Glasgow, UK.
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14
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Mbanzulu KM, Mboera LEG, Luzolo FK, Wumba R, Misinzo G, Kimera SI. Mosquito-borne viral diseases in the Democratic Republic of the Congo: a review. Parasit Vectors 2020; 13:103. [PMID: 32103776 PMCID: PMC7045448 DOI: 10.1186/s13071-020-3985-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/18/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Mosquito-borne viral infections have in recent years, become a public health threat globally. This review aimed to provide an overview of the ecological and epidemiological profiles of mosquito-borne viral infections in the Democratic Republic of the Congo (DRC). METHODS A search of literature was conducted using Google Scholar, PubMed and the WHO website using the following keywords: "Democratic Republic of the Congo", "Zaire", "Belgian Congo" and either of the following: "mosquito-borne virus", "arbovirus", "yellow fever", "dengue", "chikungunya", "West Nile", "Rift Valley fever", "O'nyong'nyong", "Zika", "epidemiology", "ecology", "morbidity", "mortality". Published articles in English or French covering a period between 1912 and October 2018 were reviewed. RESULTS A total of 37 articles were included in the review. The findings indicate that the burden of mosquito-borne viral infections in DRC is increasing over time and space. The north-western, north-eastern, western and central regions have the highest burden of mosquito-borne viral infections compared to south and eastern highland regions. Yellow fever, chikungunya, dengue, Zika, Rift Valley fever, West Nile and O'nyong'nyong have been reported in the country. These mosquito-borne viruses were found circulating in human, wildlife and domestic animals. Yellow fever and chikungunya outbreaks have been frequently reported. Aedes aegypti and Ae. simpsoni were documented as the main vectors of most of the mosquito-borne viral infections. Heavy rains, human movements, forest encroachment and deforestation were identified as drivers of mosquito-borne viruses occurrence in DRC. CONCLUSIONS Mosquito-borne viral infections are becoming common and a serious public health problem in DRC. In the current context of climate change, there is urgent need to improve understanding on ecological and epidemiology of the diseases and strengthen surveillance systems for prompt response to epidemics in DRC.
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Affiliation(s)
- Kennedy M. Mbanzulu
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3019, Chuo Kikuu, Morogoro, Tanzania
| | - Leonard E. G. Mboera
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
| | - Flory K. Luzolo
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
| | - Roger Wumba
- Department of Tropical Medicine, Infectious and Parasitic Diseases, University of Kinshasa, P.O. Box 747, Kinshasa, Democratic Republic of the Congo
| | - Gerald Misinzo
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3019, Chuo Kikuu, Morogoro, Tanzania
| | - Sharadhuli I. Kimera
- SACIDS-Africa Centre of Excellence for Infectious Diseases of Humans and Animals in Eastern and Southern Africa, Sokoine University of Agriculture, P.O. Box 3297, Chuo Kikuu, Morogoro, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Chuo Kikuu, Morogoro, Tanzania
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Yellow Fever: Integrating Current Knowledge with Technological Innovations to Identify Strategies for Controlling a Re-Emerging Virus. Viruses 2019; 11:v11100960. [PMID: 31627415 PMCID: PMC6832525 DOI: 10.3390/v11100960] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/30/2019] [Accepted: 10/11/2019] [Indexed: 01/17/2023] Open
Abstract
Yellow fever virus (YFV) represents a re-emerging zoonotic pathogen, transmitted by mosquito vectors to humans from primate reservoirs. Sporadic outbreaks of YFV occur in endemic tropical regions, causing a viral hemorrhagic fever (VHF) associated with high mortality rates. Despite a highly effective vaccine, no antiviral treatments currently exist. Therefore, YFV represents a neglected tropical disease and is chronically understudied, with many aspects of YFV biology incompletely defined including host range, host–virus interactions and correlates of host immunity and pathogenicity. In this article, we review the current state of YFV research, focusing on the viral lifecycle, host responses to infection, species tropism and the success and associated limitations of the YFV-17D vaccine. In addition, we highlight the current lack of available treatments and use publicly available sequence and structural data to assess global patterns of YFV sequence diversity and identify potential drug targets. Finally, we discuss how technological advances, including real-time epidemiological monitoring of outbreaks using next-generation sequencing and CRISPR/Cas9 modification of vector species, could be utilized in future battles against this re-emerging pathogen which continues to cause devastating disease.
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Stolka KB, Ngoyi BF, Grimes KEL, Hemingway-Foday JJ, Lubula L, Nzanzu Magazani A, Bikuku J, Mossoko M, Manya Kitoto L, Mpangi Bashilebo S, Lufwa Maya D, Kebela Ilunga B, Rhea S, MacDonald PDM. Assessing the Surveillance System for Priority Zoonotic Diseases in the Democratic Republic of the Congo, 2017. Health Secur 2019; 16:S44-S53. [PMID: 30480506 DOI: 10.1089/hs.2018.0060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
High-functioning communicable disease surveillance systems are critical for public health preparedness. Countries that cannot quickly detect and contain diseases are a risk to the global community. The ability of all countries to comply with the International Health Regulations is paramount for global health security. Zoonotic diseases can be particularly dangerous for humans. We conducted a surveillance system assessment of institutional and individual capacity in Kinshasa and Haut Katanga provinces in the Democratic Republic of the Congo for nationally identified priority zoonotic diseases (eg, viral hemorrhagic fever [VHF], yellow fever, rabies, monkeypox, and influenza monitored through acute respiratory infections). Data were collected from 79 health workers responsible for disease surveillance at 2 provincial health offices, 9 health zone offices, 9 general reference hospitals, and 18 health centers and communities. A set of questionnaires was used to assess health worker training in disease surveillance methods; knowledge of case definitions; availability of materials and tools to support timely case detection, reporting, and data interpretation; timeliness and completeness of reporting; and supervision from health authorities. We found that health workers either had not been recently or ever trained in surveillance methods and that their knowledge of case definitions was low. Timeliness and completeness of weekly notification of epidemic-prone diseases was generally well performed, but the lack of available standardized reporting forms and archive of completed forms affected the quality of data collected. Lessons learned from our assessment can be used for targeted strengthening efforts to improve global health security.
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Affiliation(s)
- Kristen B Stolka
- Kristen B. Stolka, MPH, is a Research Public Health Analyst, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
| | - Bonaventure Fuamba Ngoyi
- Bonaventure Fuamba Ngoyi, MD, MPH-FELTP, is a Surveillance Officer, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
| | - Kathyrn E L Grimes
- Kathyrn E. L. Grimes, MPH, is a Research Public Health Analyst, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
| | - Jennifer J Hemingway-Foday
- Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
| | - Leopold Lubula
- Leopold Lubula, MD, MPH-FELTP, is a Surveillance Manager, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Alain Nzanzu Magazani
- Alain Nzanzu Magazani, MD, MPH-FELTP, is a Technical Expert, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Joseph Bikuku
- Joseph Bikuku, MD, MPH, is a Technical Expert, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Mathias Mossoko
- Mathias Mossoko, MSc, is an Epidemiologist and Data Manager, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Leonie Manya Kitoto
- Leonie Manya Kitoto, MD, MPH, is a Technical Expert, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Sylvie Mpangi Bashilebo
- Sylvie Mpangi Bashilebo, MSc, is an Epidemiologist and Surveillance Supervisor, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Dieudonné Lufwa Maya
- Dieudonné Lufwa Maya, MD, MPH, is a Database Analyst, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Benoit Kebela Ilunga
- Benoit Kebela Ilunga, MD, MPH, is Director, the Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Sarah Rhea
- Sarah Rhea, DVM, PhD, is a Research Epidemiologist, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
| | - Pia D M MacDonald
- Pia D. M. MacDonald, PhD, CPH, is a Senior Epidemiologist, Biostatistics and Epidemiology, RTI International, Durham, North Carolina
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Weimer A, Tagny CT, Tapko JB, Gouws C, Tobian AAR, Ness PM, Bloch EM. Blood transfusion safety in sub-Saharan Africa: A literature review of changes and challenges in the 21st century. Transfusion 2018; 59:412-427. [PMID: 30615810 DOI: 10.1111/trf.14949] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Access to a safe, adequate blood supply has proven challenging in sub-Saharan Africa, where systemic deficiencies spanning policy, collections, testing, and posttransfusion surveillance have long been recognized. Progress in transfusion safety in the early 2000s was in large part due to intervention by the World Health Organization and other foreign governmental bodies, coupled with an influx of external funding. STUDY DESIGN AND METHODS A review of the literature was conducted to identify articles pertaining to blood safety in sub-Saharan Africa from January 2009 to March 2018. The search was directed toward addressing the major elements of the blood safety chain, in the countries comprising the World Health Organization African region. Of 1380 articles, 531 met inclusion criteria and 136 articles were reviewed. RESULTS External support has been associated with increased recruitment of voluntary donors and expanded testing for the major transfusion-transmitted infections (TTIs). However, the rates of TTIs among donors remain high. Regional education and training initiatives have been implemented, and a tiered accreditation process has been adopted. However, a general decline in funding for transfusion safety (2009 onwards) has strained the ability to maintain or improve transfusion-related services. Critical areas of need include data collection and dissemination, epidemiological surveillance for TTIs, donor recruitment, quality assurance and oversight (notably laboratory testing), and hemovigilance. CONCLUSION Diminishing external support has been challenging for regional transfusion services. Critical areas of deficiency in regional blood transfusion safety remain. Nonetheless, substantive gains in education, training, and accreditation suggest durable gains in regional capacity.
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Affiliation(s)
- A Weimer
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - C T Tagny
- Hematology and Blood Transfusion service, University Teaching Hospital, Yaoundé, Cameroon
| | - J B Tapko
- African Society of Blood Transfusion, Yaoundé, Cameroon
| | - C Gouws
- Blood Transfusion Service of Namibia, Windhoek, Namibia
| | - A A R Tobian
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - P M Ness
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - E M Bloch
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
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18
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Willcox AC, Collins MH, Jadi R, Keeler C, Parr JB, Mumba D, Kashamuka M, Tshefu A, de Silva AM, Meshnick SR. Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo. Am J Trop Med Hyg 2018; 99:756-763. [PMID: 29988000 DOI: 10.4269/ajtmh.18-0156] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Flaviviruses such as Zika, dengue, and yellow fever cause epidemics throughout the tropics and account for substantial global morbidity and mortality. Although malaria and other vector-borne diseases have long been appreciated in Africa, flavivirus epidemiology is incompletely understood. Despite the existence of an effective vaccine, yellow fever continues to cause outbreaks and deaths, including at least 42 fatalities in the Democratic Republic of the Congo (DRC) in 2016. Here, we leveraged biospecimens collected as part of the nationally representative 2013-2014 Demographic and Health Survey in the DRC to examine serological evidence of flavivirus infection or vaccination in children aged 6 months to 5 years. Even in this young stratum of the Congolese population, we find evidence of infection by dengue and Zika viruses based on results from enzyme-linked immunosorbent assay and neutralization assay. Surprisingly, there was remarkable discordance between reported yellow fever vaccination status and results of serological assays. The estimated seroprevalences of neutralizing antibodies against each virus are yellow fever, 6.0% (95% confidence interval [CI] = 4.6-7.5%); dengue, 0.4% (0.1-0.9%); and Zika, 0.1% (0.0-0.5%). These results merit targeted, prospective studies to assess effectiveness of yellow fever vaccination programs, determine flavivirus seroprevalence across a broader age range, and investigate how these emerging diseases contribute to the burden of acute febrile illness in the DRC.
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Affiliation(s)
- Alexandra C Willcox
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Matthew H Collins
- Department of Medicine, Division of Infectious Diseases, Hope Clinic of the Emory Vaccine Center, Emory School of Medicine, Decatur, Georgia
| | - Ramesh Jadi
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Corinna Keeler
- Department of Geography, University of North Carolina, Chapel Hill, North Carolina
| | - Jonathan B Parr
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Dieudonné Mumba
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Melchior Kashamuka
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoinette Tshefu
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Aravinda M de Silva
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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Abstract
Mosquito-transmitted viruses are spread globally and present a great risk to human health. Among the many approaches investigated to limit the diseases caused by these viruses are attempts to make mosquitos resistant to virus infection. Coinfection of mosquitos with the bacterium Wolbachia pipientis from supergroup A is a recent strategy employed to reduce the capacity for major vectors in the Aedes mosquito genus to transmit viruses, including dengue virus (DENV), Chikungunya virus (CHIKV), and Zika virus (ZIKV). Recently, a supergroup B Wolbachia wStri, isolated from Laodelphax striatellus, was shown to inhibit multiple lineages of ZIKV in Aedes albopictus cells. Here, we show that wStri blocks the growth of positive-sense RNA viruses DENV, CHIKV, ZIKV, and yellow fever virus by greater than 99.9%. wStri presence did not affect the growth of the negative-sense RNA viruses LaCrosse virus or vesicular stomatitis virus. Investigation of the stages of the ZIKV life cycle inhibited by wStri identified two distinct blocks in viral replication. We found a reduction of ZIKV entry into wStri-infected cells. This was partially rescued by the addition of a cholesterol-lipid supplement. Independent of entry, transfected viral genome was unable to replicate in Wolbachia-infected cells. RNA transfection and metabolic labeling studies suggested that this replication defect is at the level of RNA translation, where we saw a 66% reduction in mosquito protein synthesis in wStri-infected cells. This study’s findings increase the potential for application of wStri to block additional arboviruses and also identify specific blocks in viral infection caused by Wolbachia coinfection. Dengue, Zika, and yellow fever viruses are mosquito-transmitted diseases that have spread throughout the world, causing millions of infections and thousands of deaths each year. Existing programs that seek to contain these diseases through elimination of the mosquito population have so far failed, making it crucial to explore new ways of limiting the spread of these viruses. Here, we show that introduction of an insect symbiont Wolbachia wStri, into mosquito cells is highly effective at reducing yellow fever virus, dengue virus, Zika virus, and Chikungunya virus production. Reduction of virus replication was attributable to decreases in entry and a strong block of virus gene expression at the translational level. These findings expand the potential use of Wolbachia wStri to block viruses and identify two separate steps for limiting virus replication in mosquitos that could be targeted via microbes or other means as an antiviral strategy.
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20
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Bowman NM, Akialis K, Cave G, Barrera R, Apperson CS, Meshnick SR. Pyrethroid insecticides maintain repellent effect on knock-down resistant populations of Aedes aegypti mosquitoes. PLoS One 2018; 13:e0196410. [PMID: 29763445 PMCID: PMC5953453 DOI: 10.1371/journal.pone.0196410] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/12/2018] [Indexed: 12/31/2022] Open
Abstract
Pyrethroid-treated clothing is commonly worn for protection against mosquitoes; pyrethroids are both insecticides and repellents. Pyrethroid resistance has become increasingly common in Aedes aegypti, the vector of dengue, Zika, and other arboviruses, but it is not clear whether resistance is associated with reductions in repellency. In order to determine whether long-lasting permethrin impregnated (LLPI) clothing is protective, we used Aedes aegypti from New Orleans, LA (pyrethroid-sensitive) and San Juan, PR (resistant) to measure both lethality and repellency. PCR and Sanger sequencing were used to confirm resistance status by detecting mutations in the kdr gene at positions 1016 and 1534. Arm-in-cage trials of 100 Aedes aegypti females from both populations were performed for 10 minutes to bare arm or an arm clothed in untreated military camouflage or military camouflage impregnated with deltamethrin, permethrin, or etofenprox. Trials were repeated 4–5 times on different days. Number of landings, number of blood meals, and immediate and 24-hour mortality were recorded. Mortality was extremely low in all trials. Compared to untreated cloth, mosquitoes demonstrated a trend towards a 2%-63% reduction in landings and a statistically significant 78–100% reduction in blood feeding on pyrethroid-treated cloth for most insecticides. Effects were observed in both pyrethroid-sensitive and pyrethroid-resistant mosquito populations. Our data show that kdr mutations are associated with pyrethroid resistance but are likely not the only contributors. Pyrethroids appear to maintain repellent effect against resistant mosquitoes. This finding suggests that even in places where pyrethroid resistance is widespread, permethrin still has a role for use as a repellent on clothing to protect against mosquito bites.
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Affiliation(s)
- Natalie M. Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Kristin Akialis
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Grayson Cave
- Department of Entomology and Plant Pathology, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Roberto Barrera
- Centers for Disease Control and Prevention, San Juan, Puerto Rico, United States of America
| | - Charles S. Apperson
- Department of Entomology and Plant Pathology, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Steven R. Meshnick
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
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