Production and evaluation of a new set of recombinant antigens for the serological diagnosis of human cysticercosis.

Human cysticercosis caused by Taenia soliun (T. soliun) is endemic in certain areas of Latin America, Asia and Sub-Saharan Africa. Neurocysticercosis (NCC) is mainly diagnosed by neuroimaging, which, in most cases, is unavailable in endemic areas. Due to their high sensitivity and specificity, serological tests such as enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) based on the glycosylated fraction of the cyst CS50 are widely used for the detection of the anti-cysticercus IgG antibodies despite their significant cost and the need of cysticercus material. Given their cost-effectivess and simplicity, immunoassays based on recombinant proteins could provide new alternatives for human cysticercosis diagnosis: such tests would be aimed at screening those people living in remote areas who need further examination. To date, however, no test using recombinant antigens is commercially available. Herein, five recombinant proteins (R14, R18, R93.1, R914.1, and R915.2) were produced, three of which (R93.1, R914.1, and R915.2) were newly identified from the cyst fluid. Evaluation of the diagnostic performance of these recombinant antigens by ELISA was done using sera from 200 epileptic and non-epileptic individuals in comparison with the WB-CS50 as the reference serological method. Recombinant proteins-based ELISA showed a level of diagnostic performance that is inferior than the reference serological method, but similar to that of the native antigen ELISA for human cysticercosis (commonly used for screening). Further optimization of expression conditions is still needed in order to improve proteins solubility and enhance diagnostic performance for human cysticercosis detection. However, this preliminary evaluation of the recombinant antigens has shown their potential valuable use for screening cysticercosis in patients with epilepsy attending dispensaries in remote areas. Future studies should be conducted to evaluate our recombinant antigens in a large group of patients with different stages of NCC, and in correlation with imaging findings.

Study of laboratory staff' knowledge of biobanking in Côte d'Ivoire.

BACKGROUND: A biobank is a structure which collects and manages biological samples and their associated data. The collected samples will then be made available for various uses. The sharing of those samples raised ethical questions which have been answered through specific rules. Thus, a Biobank functioning under tight ethical rules would be immensely valuable from a scientific and an economic view point. In 2009, Côte d'Ivoire established a biobank, which has been chosen to house the regional biobank of Economic Community of West African States (ECOWAS) countries in 2018. To ensure optimal and efficient use of this biobank, the scientific community must be aware of its existence and its role. It was therefore necessary to evaluate the knowledge of laboratories staff on the role and activities of a biobank. METHODS: This descriptive study was done by questioning staff from laboratories working on human's health, animals or plants. The laboratories were located in southern Côte d'Ivoire. RESULTS: A total of 205 people completed the questionnaire. Of these 205 people, 34.63% were biologists, 7.32% engineers, 48.78% technicians and 9.27% PhD students. The average length of work experience was 10.11 ± 7.83 years. In this study, 43.41% of the participants had never heard of biobanking. Only 48.78% of participants had a good understanding of the role of a biobank. Technicians and PhD students were less educated on the notion of biobank (p < 0.000001). Although biologists were more educated on this issue, 21.13% of them had a misconception of biobank. Good knowledge of the role of a biobank was not significantly related to the work experience's length (p > 0.88). CONCLUSION: The level of knowledge of laboratory staff about biobanking needs to be improved. Training on the role, activities and interests of the biobank is important.

Seroprevalence of porcine cysticercosis in traditional farms in South-Eastern Côte d'Ivoire.

Background: Porcine cysticercosis is an endemic parasitic zoonosis in many developing countries. The objective of this study was to estimate the seroprevalence of porcine cysticercosis in traditional pig farms in the departments of Dabou, Aboisso and Agboville. Methods: Blood samples were taken from pigs and analyzed by ELISA (IgG) and western blot. Data on farming practices and pig characteristics were collected. Multivariate logistic regression models were constructed to identify risk factors. Results: A total of 668 pigs were sampled from 116 farms and 639 samples were analyzed. The seroprevalence of cysticercosis was estimated at 13.2%. Overweight [OR = 2.6; 95%CI (1.3-4.9)] and fat pigs [OR = 2.3; 95%CI (1.0-4.8)] were twice as likely to be seropositive for cysticercosis. This risk was increased in farms using well water for drinking [OR = 2.5; 95%CI (1.0-6.3)] as well as those reporting veterinary care of the animals (OR = 2.9; 95%CI (1.2-7.3)). Conclusions: This study demonstrated the circulation of Taenia solium in pig farms in southern Côte d'Ivoire.

Seroprevalence of Cysticercosis among Epileptic Patients Attending Neurological Units in the Urban Area of Abidjan.

Cysticercosis is one of the main causes of secondary epilepsy in sub-Saharan Africa. To estimate the seroprevalence of cysticercosis among epileptic patients, we conducted a cross-sectional study of patients attending neurology consultation in Abidjan, Côte d'Ivoire. Methods: Patients' socio-demographic and lifestyle data were collected as well as blood samples for serological testing using ELISA and Western blot based on IgG antibodies detection. For qualitative variables comparison, Chi2 or Fisher tests were used; a Student's t-test was used to compare quantitative variables. A multivariate logistic regression model was fit to identify risks factors. Results: Among 403 epileptic patients included in the study, 55.3% were male; the median age was 16.9 years; 77% lived in Abidjan; 26.5% were workers. Most patients included in the study had tonic-clonic seizures (80%), and 11.2% had focal deficit signs. The seroprevalence of cysticercosis was 6.0%. The risk was higher in patients over 30 years old (aOR = 5.1 (1.3-20.0)) than in patients under 16. The risk was also considerably high in patients who reported epileptics in the family (aOR = 5 (1.7-14.6)). The risk was three-fold less in females than in males. Conclusions: This study highlighted the exposure of epileptic patients to Taenia solium larvae in an urban area. The risk of positive serology was increased with age, male gender, and family history of epilepsy.

Construction of an exchange interface for the transmission of laboratory results: a case of the National Tuberculosis Center.

Introduction The transmission of test results by laboratories and their receipt by health facilities are common tasks in the processing of medical information. Managing the flow of information generated by these tasks remains a challenge for these centers. We describe a new system that will allow for electronic management of the transmission of results. Materials and methods The information system implemented is a client-server system consisting three main components: the server installed in the laboratory, the client distributed in the Anti-Tuberculosis Center and the communication channel represented by a Virtual Network. The exchange protocol is based on the HL7 standard that used messages of type ORU_R01. Results During the two months of implementation of this electronic result transmission system between the National Tuberculosis Reference Center in Abidjan and the Anti-Tuberculosis Center in Adzopé, which is about 110 kilometers away, twenty laboratory results were transmitted as soon as they left the laboratory, an improvement from the previous long turn-around-time of about 1 month. The minimalist interface and ease of use of the system have allowed it to be adopted by users. Discussion The use of the HL7 protocol for electronic notifications has proven its effectiveness in making transmissions of results instantaneous. Our system specifically addresses the problems related to efficient transmission of results; reduction of transmission time, information loss attributed to the use of paper, and transport costs incurred when transmitting results from remote sites. This system representing the 1rst version use a local codification that limits it to an interoperability with other environment that use a different code system. The use of a code system such as LOINC would allow full interoperability between different information systems.

Taenia solium cysticercosis in West Africa: status update.

Cysticercosis is caused by the larvae of the cestode Taenia solium. Few data are available on the prevalence of this disease in pigs and humans in West African countries. The aim of this study was to provide an overview of existing data concerning the spread of this parasitosis in the countries of the Economic Community of West African States (ECOWAS) on the basis of the literature published over the last five decades. Systematic searches for publications were carried out on PubMed and Google Scholar, as well as in certain regional and local journals. From a total of 501 articles initially retrieved concerning T. solium cysticercosis in West African countries, only 120 articles were relevant for this review and therefore finally retained. For pigs, only eight out of sixteen countries of the region have reported porcine cysticercosis. Post-mortem examination of carcasses at slaughterhouses, meat inspection at butcheries or tongue inspection in herds have been the main source of data, but may not entirely reflect actual parasite distribution. For humans, only five out of sixteen countries reported epidemiological data on neurocysticercosis. Most data referred to neurocysticercosis prevalence among epileptic patients or isolated clinical cases. Furthermore, existing data are often old. Overall, T. solium cysticercosis remains largely neglected in West Africa, and its prevalence appears not to be affected by any religion in particular. There is an urgent need to promote and implement health partnerships and programs on this disease in order to collect more data and identify sensitive populations in the countries of the ECOWAS area.

TITLE: La cysticercose à Taenia solium en Afrique de l'Ouest : état des lieux. ABSTRACT: La cysticercose est causée par les larves du cestode Taenia solium. Peu de données sont disponibles sur la prévalence de cette maladie chez les porcs et les humains dans les pays d'Afrique de l'Ouest. Le but de cette étude est de fournir un aperçu des données existantes concernant la propagation de cette parasitose dans les pays de la Communauté économique des États de l'Afrique de l'Ouest (CEDEAO) sur la base de la littérature publiée au cours des cinq dernières décennies. Des recherches systématiques de publications ont été effectuées sur PubMed, Google Scholar, ainsi que sur certaines revues régionales et locales. Sur un total de 501 articles initialement récupérés et concernant la cysticercose à T. solium dans les pays d'Afrique de l'Ouest, seuls 120 articles étaient pertinents pour cet examen et ont donc finalement été retenus. Pour les porcs, seulement huit des seize pays de la région ont signalé une cysticercose porcine. L'examen post mortem des carcasses dans les abattoirs, l'inspection de la viande dans les boucheries ou l'inspection de la langue dans le troupeau ont été la principale source de données, mais peuvent ne pas refléter entièrement la répartition réelle des parasites. Pour l'homme, seuls cinq pays sur seize ont rapporté des données épidémiologiques sur la neurocysticercose. La plupart des données se référaient à la prévalence de la neurocysticercose chez les épileptiques ou les cas cliniques isolés. De plus, les données existantes sont souvent anciennes. Dans l'ensemble, la cysticercose à T. solium reste largement négligée en Afrique de l'Ouest et sa prévalence ne semble être affectée par aucune religion en particulier. Il est urgent de promouvoir et de mettre en œuvre des partenariats et des programmes de santé sur cette maladie afin de collecter davantage de données et d'identifier les populations sensibles dans les pays de la zone CEDEAO.

Emergence of Neisseria meningitidis W135 in Cote d'Ivoire: laboratory based-surveillance.

OBJECTIVES: To describe the emergence of Neisseria meningitidis (Nm) W135 in Côte d'Ivoire and its characteristics compared to NmA. METHODS: Data on Nm samples isolated at the National Reference Center for meningitis in Côte d'Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test. RESULTS: Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d'Ivoire (85.9 vs. 45.5%; p<0.001). No sample of NmA has been isolated since 2009, while 95% of the type W135 samples were isolated between 2010 and 2012. CONCLUSIONS: This study highlighted the emergence of NmW135 in Côte d'Ivoire, as well as the simultaneous disappearance of NmA. It is important to improve laboratory-based surveillance of meningitis to assess trends in the circulation of bacteria and to detect the emergence of new serogroups earlier.

The Chikungunya epidemic on La Réunion Island in 2005-2006: a cost-of-illness study.

BACKGROUND: This study was conducted to assess the impact of chikungunya on health costs during the epidemic that occurred on La Réunion in 2005-2006. METHODOLOGY/PRINCIPAL FINDINGS: From data collected from health agencies, the additional costs incurred by chikungunya in terms of consultations, drug consumption and absence from work were determined by a comparison with the expected costs outside the epidemic period. The cost of hospitalization was estimated from data provided by the national hospitalization database for short-term care by considering all hospital stays in which the ICD-10 code A92.0 appeared. A cost-of-illness study was conducted from the perspective of the third-party payer. Direct medical costs per outpatient and inpatient case were evaluated. The costs were estimated in Euros at 2006 values. Additional reimbursements for consultations with general practitioners and drugs were estimated as € 12.4 million (range: € 7.7 million-€ 17.1 million) and € 5 million (€ 1.9 million-€ 8.1 million), respectively, while the cost of hospitalization for chikungunya was estimated to be € 8.5 million (€ 5.8 million-€ 8.7 million). Productivity costs were estimated as € 17.4 million (€ 6 million-€ 28.9 million). The medical cost of the chikungunya epidemic was estimated as € 43.9 million, 60% due to direct medical costs and 40% to indirect costs (€ 26.5 million and € 17.4 million, respectively). The direct medical cost was assessed as € 90 for each outpatient and € 2,000 for each inpatient. CONCLUSIONS/SIGNIFICANCE: The medical management of chikungunya during the epidemic on La Réunion Island was associated with an important economic burden. The estimated cost of the reported disease can be used to evaluate the cost/efficacy and cost/benefit ratios for prevention and control programmes of emerging arboviruses.

Impact of Chikungunya virus infection on health status and quality of life: a retrospective cohort study.

BACKGROUND: Persistent symptoms, mainly joint and muscular pain and depression, have been reported several months after Chikungunya virus (CHIKV) infection. Their frequency and their impact on quality of life have not been compared with those of an unexposed population. In the present study, we aimed to describe the frequency of prolonged clinical manifestations of CHIKV infection and to measure the impact on quality of life and health care consumption in comparison with that of an unexposed population, more than one year after infection. METHODOLOGY/PRINCIPAL FINDINGS: In a retrospective cohort study, 199 subjects who had serologically confirmed CHIKV infection (CHIK+) were compared with 199 sero-negative subjects (CHIK-) matched for age, gender and area of residence in La Réunion Island. Following an average time of 17 months from the acute phase of infection, participants were interviewed by telephone about current symptoms, medical consumption during the last 12 months and quality of life assessed by the 12-items Short-Form Health Survey (SF-12) scale. At the time of study, 112 (56%) CHIK+ persons reported they were fully recovered. CHIK+ complained more frequently than CHIK- of arthralgia (relative risk = 1.9; 95% confidence interval: 1.6-2.2), myalgia (1.9; 1.5-2.3), fatigue (2.3; 1.8-3), depression (2.5; 1.5-4.1) and hair loss (3.8; 1.9-7.6). There was no significant difference between CHIK+ and CHIK- subjects regarding medical consumption in the past year. The mean (SD) score of the SF-12 Physical Component Summary was 46.4 (10.8) in CHIK+ versus 49.1 (9.3) in CHIK- (p = 0.04). There was no significant difference between the two groups for the Mental Component Summary. CONCLUSIONS/SIGNIFICANCE: More than one year following the acute phase of infection, CHIK+ subjects reported more disabilities than those who were CHIK-. These persistent disabilities, however, have no significant influence on medical consumption, and the impact on quality of life is moderate.