Mapping of intermediate host snails for schistosomiasis in the Democratic Republic of Congo: a systematic review.

Schistosomiasis is a snail-borne disease that has a considerable impact on human and animal health, particularly in sub-Saharan Africa. The intermediate hosts of the schistosome parasites are freshwater snails of the genera Biomphalaria Preston, 1910 and Bulinus Müller, 1781. In order to identify existing gaps in the spread of the disease in the Democratic Republic of Congo (DRC), this study compiled the available knowledge of the distribution, population dynamics and ecology of the intermediate hosts of schistosomiasis. A systematic literature search was conducted in PubMed, Embase and Scopus for all malacological studies on schistosoma intermediate hosts in DRC published between 1927 and October 2022. A total of 55 records were found, of which 31 met the inclusion criteria: these were published field and experimental studies conducted in the DRC and focused on snails as intermediate hosts of schistosomes. The analysis of these studies revealed that more up-to-date data on the distribution of snail intermediate hosts in the DRC are needed. Moreover, ecological factors have been less studied for Bulinus species than for Biomphalaria species. These factors play a crucial role in determining suitable snail habitats, and the lack of comprehensive information poses a challenge in snail control. This review makes it clear that there are no current malacological data in the DRC. There is a clear need for molecular and ecological research to update the exact species status and population dynamics of all potential intermediate host species. This will facilitate targeted snail control measures that complement drug treatment in the control of schistosomiasis in the country.

COVID-19 seroprevalence cohort survey among health care workers and their household members in Kinshasa, DR Congo, 2020-2022.

INTRODUCTION: Serological surveys offer the most direct measurement to define the immunity status for numerous infectious diseases, such as COVID-19, and can provide valuable insights into understanding transmission patterns. This study describes seroprevalence changes over time in the context of the Democratic Republic of Congo, where COVID-19 case presentation was apparently largely oligo- or asymptomatic, and vaccination coverage remained extremely low. METHODS: A cohort of 635 health care workers (HCW) from 5 health zones of Kinshasa and 670 of their household members was interviewed and sampled in 6 rounds between July 2020 and January 2022. At each round, information on risk exposure and a blood sample were collected. Serology was defined as positive when binding antibodies against SARS-CoV-2 spike and nucleocapsid proteins were simultaneously present. RESULTS: The SARS-CoV-2 antibody seroprevalence was high at baseline, 17.3% (95% CI 14.4-20.6) and 7.8% (95% CI 5.5-10.8) for HCW and household members, respectively, and fluctuated over time, between 9% and 62.1%. Seropositivity was heterogeneously distributed over the health zones (p < 0.001), ranging from 12.5% (95% CI 6.6-20.8) in N'djili to 33.7% (95% CI 24.6-43.8) in Bandalungwa at baseline for HCW. Seropositivity was associated with increasing rounds adjusted Odds Ratio (aOR) 1.75 (95% CI 1.66-1.85), with increasing age aOR 1.11 (95% CI 1.02-1.20), being a female aOR 1.35 (95% CI 1.10-1.66) and being a HCW aOR 2.38 (95% CI 1.80-3.14). There was no evidence that HCW brought the COVID-19 infection back home, with an aOR of 0.64 (95% CI 0.46-0.91) of seropositivity risk among household members in subsequent surveys. There was seroreversion and seroconversion over time, and HCW had a lower risk of seroreverting than household members (aOR 0.60 (95% CI 0.42-0.86)). CONCLUSION: SARS-CoV-2 IgG antibody levels were high and dynamic over time in this African setting with low clinical case rates. The absence of association with health profession or general risk behaviors and with HCW positivity in subsequent rounds in HH members, shows the importance of the time-dependent, and not work-related, force of infection. Cohort seroprevalence estimates in a 'new disease' epidemic seem insufficient to guide policy makers for defining control strategies.

Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo.

In the Democratic Republic of the Congo (DRC), the prevalence of mental health issues could be greater than in other low-income and middle-income countries because of major risk factors related to armed conflicts and poverty. Given that mental health is an essential component of health, it is surprising that no systematic evaluation of mental health in the DRC has yet been undertaken. This study aims to undertake the first systematic review of mental health literacy and service provision in the DRC, to bridge this gap and inform those who need to develop an evidence base. This could support policymakers in tackling the issues related to limited mental health systems and service provision in DRC. Following Cochrane and PRISMA guidelines, a systematic (Web of Science, Medline, Public Health, PsycINFO, and Google Scholar) search was conducted (January 2000 and August 2023). Combinations of key blocks of terms were used in the search such as DRC, war zone, mental health, post-traumatic stress disorder (PTSD), anxiety, depression, sexual violence, war trauma, resilience, mental health systems and service provision. We followed additional sources from reference lists of included studies. Screening was completed in two stages: title and abstract search, and full-text screening for relevance and quality. Overall, 50 studies were included in the review; the majority of studies (n = 31) were conducted in the Eastern region of the DRC, a region devastated by war and sexual violence. Different instruments were used to measure participants' mental health such as the Hopkins Symptoms Checklist (HSCL-25), The Harvard Trauma Questionnaire, Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7), and Positive and Negative Symptoms Scale (PANSS). Our study found that wartime sexual violence and extreme poverty are highly traumatic, and cause multiple, long-term mental health difficulties. We found that depression, anxiety, and PTSD were the most common problems in the DRC. Psychosocial interventions such as group therapy, family support, and socio-economic support were effective in reducing anxiety, depression, and PTSD symptoms. This systematic review calls attention to the need to support sexual violence survivors and many other Congolese people affected by traumatic events. This review also highlights the need for validating culturally appropriate measures, and the need for well-designed controlled intervention studies in low-income settings such as the DRC. Better public mental health systems and service provision could help to improve community cohesion, human resilience, and mental wellbeing. There is also an urgent need to address wider social issues such as poverty, stigma, and gender inequality in the DRC.

Geospatial and multilevel clustering of zero-dose children in Kikwit, Democratic Republic of the Congo in 2022.

Zero-dose children remain highly vulnerable to vaccine-preventable diseases and can sustain transmission even in highly vaccinated populations. The WHO Immunization Agenda 2030 has prioritised reaching out to these children. We assessed the spatial distribution of zero-dose children together with the associated risk factors in a provincial capital in the Democratic Republic of Congo. A cross sectional survey was conducted in the city of Kikwit between September 28 and October 14, 2022. Data were collected both at household and health area level. QGIS and SATscan were used to describe and identify hotspots among zero-dose children, and a mixed effect logistic regression model was used to identify risk factors. Overall, 1,863 children aged 12-23 months were enrolled. Kikwit city had a 16.3% zero-dose prevalence, with significant variation between and within health zones. Two hotspots were identified through geospatial analysis, each spanning multiple health areas. Multilevel analysis revealed significant clustering at health area level and found six associated risk factors. These include the absence of home visits by community health workers (aOR = 1.90), living more than a kilometre from a health centre (aOR = 1.95), the mother's lack of tetanus vaccination (aOR = 3.16), and inability to name a vaccine-preventable disease (aOR = 3.20). However, secondary (aOR = 0.56) or tertiary (aOR = 0.21) education of mothers/guardians and belonging to Bunda (aOR = 0.36) or Mbala (aOR = 0.52) ethnicity reduced the risk of zero-dose. We observed a high prevalence of zero-dose children with a heterogeneous spatial distribution of epidemiological importance. Due to sub-zonal diversity, a health zone approach to reduce zero-dose immunization appears very limited. Zero-dose prevalence was related to the community health workers' home visit, to the distance of residence to a health centre and to household-level factors. Geospatial results could help in targeting priority health areas and communities for vaccination.

Clade I-Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo.

We report a cluster of clade I monkeypox virus infections linked to sexual contact in the Democratic Republic of the Congo. Case investigations resulted in 5 reverse transcription PCR-confirmed infections; genome sequencing suggest they belonged to the same transmission chain. This finding demonstrates that mpox transmission through sexual contact extends beyond clade IIb.

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo.

Detection of Schistosoma eggs in stool or urine is known for its low sensitivity in diagnosing light infections. Alternative diagnostics with better sensitivity while remaining highly specific, such as real-time PCR and circulating antigen detection, are progressively used as complementary diagnostic procedures but have not yet replaced microscopy. This study evaluates these alternative methods for the detection of Schistosoma infections in the absence of microscopy. Schistosomiasis presence was determined retrospectively in 314 banked stool and urine samples, available from a previous survey on the prevalence of taeniasis in a community in the Democratic Republic of the Congo, using real-time PCR, the point-of-care circulating cathodic antigen (POC-CCA) test, as well as the up-converting particle lateral flow circulating anodic antigen (UCP-LF CAA) test. Schistosoma DNA was present in urine (3%) and stool (28%) samples, while CCA (28%) and CAA (69%) were detected in urine. Further analysis of the generated data indicated stool-based PCR and the POC-CCA test to be suitable diagnostics for screening of S. mansoni infections, even in the absence of microscopy. A substantial proportion (60%) of the 215 CAA-positive cases showed low antigen concentrations, suggesting that even PCR and POC-CCA underestimated the "true" number of schistosome positives.

Evaluation of a surrogate virus neutralization test for high-throughput serosurveillance of SARS-CoV-2.

High-throughput serological tests that can detect neutralizing antibodies against SARS-CoV-2 are desirable for serosurveillance and vaccine efficacy evaluation. Although the conventional neutralization test (cVNT) remains the gold standard to confirm the presence of neutralizing antibodies in sera, the test is too labour-intensive for massive screening programs and less reproducible as live virus and cell culture is involved. Here, we performed an independent evaluation of a commercially available surrogate virus neutralization test (sVNT, GenScript cPass™) that can be done without biosafety level 3 containment in less than 2 h. When using the cVNT and a Luminex multiplex immunoassay (MIA) as reference, the sVNT obtained a sensitivity of 94 % (CI 90-96 %) on a panel of 317 immune sera that were obtained from hospitalized and mild COVID-19 cases from Belgium and a sensitivity of 88 % (CI 81-93 %) on a panel of 184 healthcare workers from the Democratic Republic of Congo. We also found strong antibody titer correlations (rs>0.8) among the different techniques used. In conclusion, our evaluation suggests that the sVNT could be a powerful tool to monitor/detect neutralising antibodies in cohort and population studies. The technique could be especially useful for vaccine evaluation studies in sub-Saharan Africa where the basic infrastructure to perform cVNTs is lacking.

Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo.

Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median (interquartile range [IQR]) age of 46 (34-58) years. One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI: 10.9-15.8), and almost 50% among those in the ICU. Independent risk factors for death were age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI: 1.85-23.64), 40-59 years (aHR = 4.45, 95% CI: 1.83-10.79), and ≥ 60 years (aHR = 13.63, 95% CI: 5.70-32.60) compared with those aged 20-39 years, with obesity (aHR = 2.30, 95% CI: 1.24-4.27), and with chronic kidney disease (aHR = 5.33, 95% CI: 1.85-15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1.53, 95% CI: 0.88-2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI: 0.35-1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high mortality among patients aged < 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions.

Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo.

BACKGROUND: Clinical observations and animal studies have suggested that Salmonella intestinal carriage is promoted by concurrent Schistosoma infection. The present study assessed association of Salmonella intestinal carriage and Schistosoma mansoni infection among individuals in a Schistosoma endemic area in sub-Saharan Africa. METHODS: From November 2015 to March 2016, a cross-sectional community-wide study was conducted in Kifua II, a rural village in Kongo Central Province, Democratic Republic of Congo. Stool samples were collected and analyzed for Salmonella intestinal carriage (culture) and Schistosoma mansoni infection (Kato Katz microscopy with determination of egg load). Salmonella Typhimurium and Enteritidis isolates were assessed for genetic similarity with blood culture isolates obtained during the same period in a neighboring hospital using multi-locus variable-numbers tandem repeat analysis (MLVA). RESULTS: A total of 1,108 participants were included (median age 15 years (IQR: 7-36), male-to-female ratio of 1:1.1). The overall prevalence of Schistosoma mansoni infection and non-typhoidal Salmonella carriage was 51.2% (95% CI: 48.2-54.1) and 3.4% (95% CI: 2.5-4.7) respectively, with 2.2% (95% CI: 1.5-3.2) of participants coinfected. The proportion of Salmonella carriage tended to be higher among Schistosoma mansoni infected participants compared to non-infected participants but this difference did not reach statistical significance (4.2% versus 2.6%, p = 0.132). However, the proportion of Salmonella carriage among participants with a heavy Schistosoma mansoni infection was significantly higher compared to those with a light and moderate infection (8.7% versus 3.2%, p = 0.012) and compared to Schistosoma mansoni negatives (8.7% versus 2.6%, p = 0.002). The 38 Salmonella isolates comprised five and four Enteritidis and Typhimurium serotypes respectively, the majority of them had MLVA types identical or similar to those observed among blood culture isolates. CONCLUSION: Salmonella intestinal carriage was associated with a heavy intensity of Schistosoma mansoni infection. Further studies are needed to address causation.

Molecular identification of Wolbachia and Sodalis glossinidius in the midgut of Glossina fuscipes quanzensis from the Democratic Republic of Congo.

During the last 30 years, investigations on the microbiome of different tsetse species have generated substantial data on the bacterial flora of these cyclical vectors of African trypanosomes, with the overarching goal of improving the control of trypanosomiases. It is in this context that the presence of Wolbachia and Sodalis glossinidius was studied in wild populations of Glossina fuscipes quanzensis from the Democratic Republic of Congo. Tsetse flies were captured with pyramidal traps. Of the 700 Glossina f. quanzensis captured, 360 were dissected and their midguts collected and analyzed. Sodalis glossinidius and Wolbachia were identified by PCR. The Wolbachia-positive samples were genetically characterized with five molecular markers. PCR revealed 84.78% and 15.55% midguts infected by Wolbachia and S. glossinidius, respectively. The infection rates varied according to capture sites. Of the five molecular markers used to characterize Wolbachia, only the fructose bis-phosphate aldolase gene was amplified for about 60% of midguts previously found with Wolbachia infections. The sequencing results confirmed the presence of Wolbachia and revealed the presence of S. glossinidius in the midgut of Glossina f. quanzensis. A low level of midguts were naturally co-infected by both bacteria. The data generated in this study open a framework for investigations aimed at understanding the contribution of these symbiotic microorganisms to the vectorial competence of Glossina fuscipes quanzensis.

Epidemiology of polyparasitism with Taenia solium, schistosomes and soil-transmitted helminths in the co-endemic village of Malanga, Democratic Republic of Congo.

Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD.

Geospatial and age-related patterns of Taenia solium taeniasis in the rural health zone of Kimpese, Democratic Republic of Congo.

BACKGROUND: Taenia solium infections are mostly endemic in less developed countries where poor hygiene conditions and free-range pig management favor their transmission. Knowledge on patterns of infections in both human and pig is crucial to design effective control strategies. The aim of this study was to assess the prevalence, risk factors and spatial distribution of taeniasis in a rural area of the Democratic Republic of Congo (DRC), in the prospect of upcoming control activities. METHODS: A cross-sectional study was conducted in 24 villages of the health zone of Kimpese, Bas Congo Province. Individual and household characteristics, including geographical coordinates were recorded. Stool samples were collected from willing participants and analyzed using the copro-antigen enzyme-linked immunosorbent assay (copro-Ag ELISA) for the detection of taeniasis. Blood samples were collected from pigs and analyzed using the B158/B60 monoclonal antibody-based antigen ELISA (sero-Ag ELISA) to detect porcine cysticercosis. Logistic regression and multilevel analysis were applied to identify risk factors. Global clustering and spatial correlation of taeniasis and porcine cysticercosis were assessed using K functions. Local clusters of both infections were identified using the Kulldorff's scan statistic. RESULTS: A total of 4751 participants above 5 years of age (median: 23 years; IQR: 11-41) were included. The overall proportion of taeniasis positivity was 23.4% (95% CI: 22.2-24.6), ranging from 1 to 60% between villages, with a significant between-household variance of 2.43 (SE=0.29, p<0.05). Taeniasis was significantly associated with age (p<0.05) and the highest positivity was found in the 5-10 years age group (27.0% (95% CI: 24.4-29.7)). Overall, 45.6% (95% CI: 40.2-51) of sampled pigs were sero-positive. The K functions revealed a significant overall clustering of human and pig infections but no spatial dependence between them. Two significant clusters of taeniasis (p<0.001; n=276 and n=9) and one cluster of porcine cysticercosis (p<0.001; n=24) were found. CONCLUSION: This study confirms high endemicity and geographical dispersal of taeniasis in the study area. The role of age in taeniasis patterns and significant spatial clusters of both taeniasis and porcine cysticercosis were evidenced, though no spatial correlation was found between human and pig infections. Urgent control activities are needed for this endemic area.

Schistosomiasis in the Democratic Republic of Congo: a literature review.

Schistosomiasis is a poverty-related parasitic infection, leading to chronic ill-health. For more than a century, schistosomiasis has been known to be endemic in certain provinces of the Democratic Republic of Congo (DRC). However, a clear overview on the status of the disease within the country is currently lacking, which is seriously hampering control. Here, we review the available information on schistosomiasis in DRC of the past 60 years. Findings and data gaps are discussed in the perspective of upcoming control activities.An electronic literature search via PubMed complemented by manual search of non-peer-reviewed articles was conducted up to January 2015. The search concerned all relevant records related to schistosomiasis in the DRC from January 1955 onwards. A total of 155 records were found, of which 30 met the inclusion criteria. Results were summarized by geographical region, mapped, and compared with those reported sixty years ago. The available data reported schistosomiasis in some areas located in 10 of the 11 provinces of DRC. Three species of Schistosoma were found: S. mansoni, S. haematobium and S. intercalatum. The prevalence of schistosomiasis varied greatly between regions and between villages, with high values of up to 95 % observed in some communities. The overall trend over 60 years points to the spread of schistosomiasis to formerly non-endemic areas. The prevalence of schistosomiasis has increased in rural endemic areas and decreased in urban/peri-urban endemic areas of Kinshasa. Hepatosplenomegaly, urinary tract lesions and anaemia were commonly reported in schistosomiasis endemic areas but not always associated with infection status.The present review confirms that schistosomiasis is still endemic in DRC. However, available data are scattered across time and space and studies lack methodological uniformity, hampering a reliable estimation of the current status of schistosomiasis in DRC. There is a clear need for updated prevalence data and well-designed studies on the epidemiology and transmission of schistosomiasis in DRC. This will aid the national control program to adequately design and implement strategies for sustainable and comprehensive control of schistosomiasis throughout the country.

Malaria, schistosomiasis and soil transmitted helminth burden and their correlation with anemia in children attending primary schools in Kinshasa, Democratic Republic of Congo.

BACKGROUND: Anaemia reduces cognitive potential in school children, retards their growth and predisposes them to other diseases. As there is a paucity of data on the current burden of P. falciparum, S. mansoni and soil transmitted helminths (STH) infections and their correlation with schoolchildren's anemia in the Democratic Republic of Congo (DRC), we collect these data. METHODS: This study reports baseline data collected from a randomized controlled trial investigating the impact of IPT with SP and SP-PQ on anemia and malaria morbidity in Congolese schoolchildren (Trial registration: NCT01722539; PACTR201211000449323). S. mansoni and STH infections were assessed using kato-katz technique. Malaria infection and hemoglobin concentration were assessed using Blood smear and Hemocontrol device, respectively. RESULTS: A total of 616 primary schoolchildren from 4 to 13 years old were enrolled in the study. The prevalence of Plasmodium spp. infection was 18.5% (95%CI:15.6-21.9). Amongst those infected, 24 (21%), 40 (35.1%), 40 (35.1%), 10 (8.8%), had light, moderate, heavy, very high malaria parasite density, respectively. Above 9 years of age (p = 0.02), male and history of fever (p = 0.04) were both associated with malaria infection. The overall prevalence of S. mansoni infection was 6.4% (95%CI:4.4-9.1). Girls were associated with S. mansoni infection (p = 0.04). T. trichiura was the most prevalent STH infection (26.3%), followed by A. lumbricoides (20.1%). Co-infection with malaria-S. mansoni and malaria-STH was, respectively, 1.5% (CI95%:0.7-3.3) and 6.4% (CI95% 4.4-9.1). The prevalence of anemia was found to be 41.6% (95%CI:37.7-45.6) and anemia was strongly related with Plasmodium ssp infection (aOR:4.1; CI95%:2.6-6.5;p<0.001) and S. mansoni infection (aOR:3.3;CI95%:1.4-7.8;p<0.01). CONCLUSION: Malaria and S. mansoni infection were strongly associated with high prevalence of anemia in schoolchildren. Therefore, specific school-based interventions, such as intermittent preventive treatment or prophylaxis, LLITN distribution, anthelminthic mass treatment and micronutrient supplementation are needed to improve school children's health.

Identification of different trypanosome species in the mid-guts of tsetse flies of the Malanga (Kimpese) sleeping sickness focus of the Democratic Republic of Congo.

BACKGROUND: The Malanga sleeping sickness focus of the Democratic Republic of Congo has shown an epidemic evolution of disease during the last century. However, following case detection and treatment, the prevalence of the disease decreased considerably. No active survey has been undertaken in this focus for a couple of years. To understand the current epidemiological status of sleeping sickness as well as the animal African trypanosomiasis in the Malanga focus, we undertook the identification of tsetse blood meals as well as different trypanosome species in flies trapped in this focus. METHODS: Pyramidal traps were use to trap tsetse flies. All flies caught were identified and live flies were dissected and their mid-guts collected. Fly mid-gut was used for the molecular identification of the blood meal source, as well as for the presence of different trypanosome species. RESULTS: About 949 Glossina palpalis palpalis were trapped; 296 (31.2%) of which were dissected, 60 (20.3%) blood meals collected and 57 (19.3%) trypanosome infections identified. The infection rates were 13.4%, 5.1%, 3.5% and 0.4% for Trypanosoma congolense savannah type, Trypanosoma brucei s.l., Trypanosoma congolense forest type and Trypanosoma vivax, respectively. Three mixed infections including Trypanosoma brucei s.l. and Trypanosoma congolense savannah type, and one mixed infection of Trypanosoma vivax and Trypanosoma congolense savannah type were identified. Eleven Trypanosoma brucei gambiense infections were identified; indicating an active circulation of this trypanosome subspecies. Of all the identified blood meals, about 58.3% were identified as being taken on pigs, while 33.3% and 8.3% were from man and other mammals, respectively. CONCLUSION: The presence of Trypanosoma brucei in tsetse mid-guts associated with human blood meals is indicative of an active transmission of this parasite between tsetse and man. The considerable number of pig blood meals combined with the circulation of Trypanosoma brucei gambiense in this focus suggests a transmission cycle involving humans and domestic animals and could hamper eradication strategies. The various species of trypanosomes identified in the Malanga sleeping sickness focus indicates the coexistence of animal and human African Trypanosomiasis. The development of new strategies integrating control measures for human and animal trypanosomiasis may enable the reduction of the control costs in this locality.

High prevalence of Taenia solium cysticerosis in a village community of Bas-Congo, Democratic Republic of Congo.

Cysticercosis results from tissue infection with the larval stage of the pig tapeworm Taenia solium. Infection of the brain may cause neurocysticercosis, the most frequent cause of acquired epilepsy in developing countries. Information on human cysticercosis in the Democratic Republic of Congo (DRC) is scarce and outdated. We believe this is the first reported study on human cysticercosis and epilepsy in a village community of DRC. The proportion of villagers seropositive by ELISA for T. solium circulating antigen was 21.6%, the highest figure reported to date. The adjusted prevalence of active epilepsy in the community was 12.7 in 1,000.