Systematic review: Global host range, case fatality and detection rates of Mycobacterium ulcerans in humans and potential environmental sources.

Fundamental aspects of the epidemiology and ecology of Mycobacterium ulcerans (MU) infections including disease burden, host range, reservoir, intermediate hosts, vector and mode of transmission are poorly understood. Understanding the global distribution and burden of MU infections is a paramount to fight against Buruli ulcer (BU). Four databases were queried from inception through December 2023. After critical review of published resources on BU, 155 articles (645 records) published between 1987 and 2023 from 16 countries were selected for this review. Investigating BU in from old endemic and new emerging foci has allowed detection of MU in humans, animals, plants and various environmental samples with prevalence from 0 % up to 100 % depending of the study design. A case fatality rate between 0.0 % and 50 % was described from BU patients and deaths occurred in Central African Republic, Gabon, Democratic Republic of the Congo, Burkina Faso and Australia. The prevalence of MU in humans was higher in Africa. Nucleic Acid Amplification Tests (NAAT) and non-NAAT were performed in > 38 animal species. MU has been recovered in culture from possum faeces, aquatic bugs and koala. More than 7 plant species and several environmental samples have been tested positive for MU. This review provided a comprehensive set of data on the updates of geographic distribution, the burden of MU infections in humans, and the host range of MU in non-human organisms. Although MU have been found in a wide range of environmental samples, only few of these have revealed the viability of the mycobacterium and the replicative non-human reservoirs of MU remain to be explored. These findings should serve as a foundation for further research on the reservoirs, intermediate hosts and transmission routes of MU.

Systematic review and meta-analysis of maternal and fetal outcomes among pregnant women with bacterial vaginosis.

BACKGROUND: Women of childbearing age are commonly affected by bacterial vaginosis (BV). Maternal-fetal outcomes associated with BV during pregnancy can be fatal for both the mother and the newborn. AIM: To identify maternal and fetal outcomes in pregnant women with BV encountered globally, highlight their prevalence, and identify maternal-fetal outcomes associated with BV. METHODS: The databases Embase, PubMed, Web of Science and Global Index Medicus were searched from inception until December 2022. No restrictions on time or geographical location were imposed when searching for published articles that examined maternal-fetal outcomes in pregnant women with BV. A random effects model was used to perform the meta-analysis. Sources of heterogeneity were investigated using subgroup analysis, and publication bias was assessed using funnel plots and Egger tests. FINDINGS: In total, 26 of the 8983 articles retrieved from the databases met the inclusion criteria and were included in this study. Twenty-two maternal outcomes and 22 fetal outcomes were recorded among pregnant women with BV worldwide. This study determined the prevalence of maternal-fetal outcomes reported in three or more studies. Among fetal outcomes, preterm birth (PTB) had the highest prevalence [17.9%, 95% confidence interval (CI) 13-23.3%], followed by mechanical ventilation (15.2%, 95% CI 0-45.9%), low birth weight (LBW) (14.2%, 95% CI 9.1-20.1%) and neonatal intensive care unit admission (11.2%, 95% CI 0-53.5%). BV was associated with PTB [odds ratio (OR) 1.76, 95% CI 1.32-2.35], LBW (OR 1.73, 95% CI 1.41-2.12) and birth asphyxia (OR 2.90, 95% CI 1.13-7.46). Among maternal outcomes, premature rupture of membranes (PROM) had the highest prevalence (13.2%, 95% CI 6.1-22.3%). BV was associated with the following maternal outcomes: intrauterine infection (OR 2.26, 95% CI 1.44-3.56), miscarriage (OR 2.34, 95% CI 1.18-4.64) and PROM (OR 2.59, 95% CI 1.39-4.82). Maternal and fetal outcomes were most prevalent in women whose BV was diagnosed using the Amsel criteria (37.2%, 95% CI 23-52.6%) and in the third trimester (29.6%, 95% CI 21.2-38.8%). Although reported in fewer than three studies, some maternal-fetal outcomes are highly prevalent, such as respiratory distress (76.67%, 95% CI 57.72-90.07%), dyspareunia (68.33%, 95% CI 55.04-79.74%) and malodorous discharge (85.00%, 95% CI 73.43-92.90%). CONCLUSION: BV has been associated with several adverse maternal-fetal outcomes around the world. While BV is a common vaginal infection, the types of maternal-fetal outcomes from pregnant women with BV vary by country.

Parasitological assessment of some fruits and vegetables commonly sold in retail outlets in the Mfoundi Division of Cameroon.

Background: Fruits and vegetables are very important for human diet as they provide all the nutrients needed to be healthy with just a daily-recommended intake of 400 to 600 mg. However, they constitute one of the major sources of human infectious agents. Thus monitoring of the microbial contaminants of the fruits and vegetables is very crucial for human safety. Method: A cross sectional study was conducted on fruits and vegetables in four markets (Mfoundi, Mokolo, Huitième and Acacia) of the Yaoundé city from October 2020 to March 2021. In all, 528 samples were purchased (carrots, cucumbers, cabbages, lettuces, leeks, green beans, okra, celeries, pepper, green peppers and tomatoes) and processed for infective agents using the centrifugation methods (Formalin, distilled and saline water). Seventy-four (74) soil/water samples collected from the sale environment were analysed using the same technics. Results: Overall, 149/528 (28.21%) were contaminated by at least one infective agent: 130 (24.62%) and 19 (3.6%) having one and two pathogen species respectively. Vegetables had high contamination rate (22.34%) than fruits (5.87%). Lettuce (52.08%), carrot (41.66%) and cabbage (35.41%), were the most contaminated while okra was the least (6.25%). Candida spp. (14.01%) and larva of Strongyloides stercoralis (7.76%) were more observed while Hookworms (1.13%) was the least. Frequency of Strongyloides stercoralis (p = 0.001) and Candida spp. (p = 0.01) were statistically high than other pathogens. Contamination rates were similar for washed (27.65%) and unwashed (28.78%) samples before sale. Candida spp. (p = 0.001), Strongyloides stercoralis (p = 0.01) and Entamoeba histolytica/dispar (p = 0.017) showed significant contamination rates by month. Contamination trends were high in the rainy season (42.6%) than the dry season (15.1%). Correlation between environment and products sold revealed same pathogens in both cases. Conclusion: The study highlights that the sale environment and products constitute potential source of microbial contamination. These data raised the concern of stakeholders about health risk related to vegetables and fruits sold in some local markets in Cameroon. Thus the necessity for them to development more appropriate policies on the surveillance of sale environment and on the management of these products during the different process phases by the population.