Taenia solium taeniosis/cysticercosis in Africa: risk factors, epidemiology and prospects for control using vaccination.

Poor sanitary conditions, free-roaming of domestic pigs and lack of awareness of the disease play an important role in the perpetuation of the Taenia solium taeniosis and cysticercosis in Africa. Traditional pig production systems known as the source of T. solium taeniosis/cysticercosis complex are predominant in the continent, representing 60-90% of pig production in rural areas. It has been reported that T. solium cysticercosis is the main cause of acquired epilepsy in human population and results in considerable public health problems and economic costs to the endemic countries. Although the socioeconomic impact and public health burden of cysticercosis have been demonstrated, up to now no large-scale control programme has been undertaken in Africa. Most disease control trials reported in the literature have been located in Latin America and Asia. This review discusses the risk factors and epidemiology of T. solium cysticercosis in Africa and critically analyzes the options available for implementing control of this zoonotic disease in the continent.

Characterisation of novel strains of multiply antibiotic-resistant Salmonella recovered from poultry in Southern Senegal.

INTRODUCTION: Non-typhoidal Salmonella (NTS) contamination in poultry and poultry products is a major cause of food-borne disease in humans. This study presents the molecular epidemiology of NTS isolated from poultry in Senegal. METHODOLOGY: A total of 261 NTS recovered from broiler farms, chicken carcasses and street vendors were characterized using random amplification of polymorphic DNA (RAPD) and multilocus sequence typing (MLST) techniques. RESULTS: We observed 20 distinct RAPD profiles corresponding to 18 different serotypes. Strains from each of these 20 groups were further analysed using MLST. Consequently, 12 new MLST alleles and 17 new sequence types were discovered. Three sequence types (S. Kentucky ST198, S. Agona ST13 and S. Istanbul ST33) have previously been described in Senegal and other countries, suggesting that these clones are geographically widely distributed and are circulating in a wide range of hosts. Nine clones showed multi-resistance to the most commonly used antibiotics in both humans and animals. However, a novel multi-resistant clone of S. Kentucky ST832 was found. CONCLUSION: This study gives new insights into the genetic diversity of NTS in Senegal. Molecular tools remain essential to improve our understanding of the epidemiology of NTS by tracking the sources of infection and/or contamination.

Validation of an immunohistochemical assay for bovine cysticercosis, with comparison to a standard histological method.

The larval stage (syn Cysticercus bovis) of the human tapeworm Taenia saginata causes cysticercosis in cattle, which has both aesthetic and food safety implications to consumers of beef. A monoclonal antibody-based immunohistochemical (IHC) assay developed to improve postmortem diagnosis of this parasite and a standard histological method were assessed to determine their fitness for intended use. Sections from 169 known-positive specimens of T. saginata from experimentally or naturally infected cattle, and from 30 known-negative specimens and lesions of various etiologies from non-infected cattle, were tested. The IHC assay identified significantly more known positive bovine cysticerci than the histological method (91.7% and 38.5%, respectively). Positive IHC staining occurred on sections from other cestode species, but should not affect the diagnostic specificity of this assay for bovine cysticercosis, due to the different host and/or tissue preferences amongst these parasites. Use of the IHC assay should improve the reliability of diagnosing lesions caused by degenerated cysticerci, facilitating more effective and efficient control of bovine cysticercosis.

Antimicrobial resistance and virulence genes of non-typhoidal Salmonella isolates in The Gambia and Senegal.

INTRODUCTION: The prevalence of virulence genes in non-typhoidal Salmonella (NTS) and its association with commonly used antibiotics in West Africa is unknown. METHODOLOGY: We tested 185 NTS isolates from children, animals, and food products for the presence of twelve virulence genes by PCR. Ten of the virulence genes tested belonged to the five Salmonella pathogenicity islands implicated in its pathogenesis. RESULTS: Ten of twelve virulence genes except sopE and pefA were present in at least 70% of the isolates tested; sopE and pefA were observed in 33% and 44% of the isolates, respectively. The most prevalent gene was invA (99.5%), which is an invasion gene conserved within the Salmonella enterica. pipD and sopB genes, which were associated with serovar Enteritidis, were detected in 92.4% and 94.1% of isolates respectively. S. Istanbul and S. Javiana, which were isolated from chicken-serving restaurants, carried all the virulence genes of the five pathogenicity islands. There was significant association between sopB, sitC, orfLC, pipD and pefA virulence genes and resistance to commonly used antibiotics in Senegal and The Gambia, namely amoxicillin, ticarcillin, trimethoprim plus sulfamethoxazole, tetracycline, trimethoprim, spectinomycin, streptomycin, sulfonamides and nitrofurantoin. CONCLUSIONS: This study shows that virulence genes are present in NTS strains isolated from various sources. The significant association between some virulence genes and antibiotic resistance may have important implications with regard to the spread and persistence of resistance and virulence genes in Salmonella and to the prudent use of antimicrobial agents in humans and animals in West Africa.

Clonal differences between Non-Typhoidal Salmonella (NTS) recovered from children and animals living in close contact in the Gambia.

BACKGROUND: Non-Typhoidal Salmonella (NTS) is an important cause of invasive bacterial disease and associated with mortality in Africa. However, little is known about the environmental reservoirs and predominant modes of transmission. Our study aimed to study the role of domestic animals in the transmission of NTS to humans in rural area of The Gambia. METHODOLOGY: Human NTS isolates were obtained through an active population-based case-control surveillance study designated to determine the aetiology and epidemiology of enteric infections covering 27,567 Gambian children less than five years of age in the surveillance area. Fourteen children infected with NTS were traced back to their family compounds and anal swabs collected from 210 domestic animals present in their households. Identified NTSs were serotyped and genotyped by multi-locus sequencing typing. PRINCIPAL FINDINGS: NTS was identified from 21/210 animal sources in the households of the 14 infected children. Chickens carried NTS more frequently than sheep and goats; 66.6%, 28.6% and 4.8% respectively. The most common NTS serovars were S. Colindale in humans (21.42%) and S. Poona in animals (14.28%). MLST on the 35 NTS revealed four new alleles and 24 sequence types (ST) of which 18 (75%) STs were novel. There was no overlap in serovars or genotypes of NTS recovered from humans or animal sources in the same household. CONCLUSION: Our results do not support the hypothesis that humans and animals in close contact in the same household carry genotypically similar Salmonella serovars. These findings form an important baseline for future studies of transmission of NTS in humans and animals in Africa.

Old focus of cysticercosis in a senegalese village revisited after half a century.

The objective of this epidemiological study was to determine whether cysticercosis and especially neurocysticercosis is endemic in Soutou village about half a century after the 1962 outbreak. This study was carried out from September 2009 to February 2010. It involved a questionnaire administration, serology, treatment, coproscopy and neuro-imaging. Four hundred and three serum samples were collected from the village people, which covered 94% of the village population. By using a parallel combination of the antigen-detection ELISA and the enzyme-linked immunoelectrotransfer blot (EITB) a cysticercosis seroprevalence of 11.9% (95% CI: 8.9-15.4%) was found. Cerebral CT-scans showed that 23.3% (10/43) of the seropositives were affected by neurocysticercosis. Four out of these 43 (9.3%) were tapeworm carriers. Seropositivity was significantly associated to older age groups (41-60 years old; p=0.001 and 61-91 years old; p=0.028) and absence of a household toilet (p=0.001). It can be concluded that Soutou village is an active focus of Taenia solium cysticercosis about 50 years after the first reported epidemic outbreak.

Chemosensitization of Trypanosoma congolense strains resistant to isometamidium chloride by tetracyclines and enrofloxacin.

BACKGROUND: Because of the development of resistance in trypanosomes to trypanocidal drugs, the livelihood of millions of livestock keepers in sub-Saharan Africa is threatened now more than ever. The existing compounds have become virtually useless and pharmaceutical companies are not keen on investing in the development of new trypanocides. We may have found a breakthrough in the treatment of resistant trypanosomal infections, through the combination of the trypanocide isometamidium chloride (ISM) with two affordable veterinary antibiotics. METHODOLOGY/PRINCIPAL FINDINGS: In a first experiment, groups of mice were inoculated with Trypanosoma congolense strains resistant to ISM and either left untreated or treated with (i) tetracycline, (ii) ISM or (iii) the combination of the antibiotic and the trypanocide. Survival analysis showed that there was a significant effect of treatment and resistance to treatment on the survival time. The groups treated with ISM (with or without antibiotic) survived significantly longer than the groups that were not treated with ISM (P<0.01). The group treated with the combination trypanocide/antibiotic survived significantly longer than the group treated with ISM (P<0.01). In a second experiment, groups of cattle were inoculated with the same resistant trypanosome strain and treated with (i) ISM, (ii) ISM associated with oxytetracycline or (iii) ISM associated with enrofloxacine. All animals treated with ISM became parasitaemic. In the groups treated with ISM-oxytetracycline and ISM-enrofloxacine, 50% of the animals were cured. Animals from the groups treated with a combination trypanocide/antibiotic presented a significantly longer prepatent period than animals treated with ISM (p<0.001). The impact of the disease on the haematocrit was low in all ISM treated groups. Yet, it was lower in the groups treated with the combination trypanocide/antibiotic (p<0.01). CONCLUSIONS/SIGNIFICANCE: After optimization of the administration protocol, this new therapeutic combination could constitute a promising treatment for livestock infected with drug resistant T. congolense.

Porcine cysticercosis and risk factors in the gambia and senegal.

During a stratified cross-sectional survey, 1705 pigs were sampled from 279 randomly selected households, 63 randomly selected communities and villages, from four study areas in The Gambia and Senegal during the period October 2007 to January 2008. Porcine cysticercosis prevalence detected by tongue inspection at animal level per study area ranged from 0.1% to 1.0%. Using an antigen-detection ELISA the seroprevalence of cysticercosis at both community/village and animal levels for the four selected study areas is: Western region 80.0% (95%CI: 52.4%-93.6%) and 4.8% (95%CI: 3.4%-6.5%), Bignona 86.7% (95%CI: 59.8%-96.6%) and 8.9% (95%CI: 5.0%-15.5%), Kolda 82.4% (95%CI: 46.8%-96.1%) and 13.2% (95%CI: 10.8%-16.0%), and Ziguinchor 81.3% (95%CI: 43.5%-96.1%) and 6.4% (95%CI: 4.0%-10.1%), respectively. No risk factors for cysticercosis were found significant in this study. This study proved that porcine cysticercosis is endemic and distributed widely in the study areas though its incidence might be suppressed by the generalised use of toilets and latrines in the study areas.

Elimination of Taenia solium transmission to pigs in a field trial of the TSOL18 vaccine in Cameroon.

A pilot field trial of the TSOL18 vaccine was undertaken in Cameroon. Two hundred and forty, 2-3 month-old piglets were distributed to 114 individual households in pairs. Vaccinated animals received three immunisations with 200 microg TSOL18 plus 5 mg Quil A and 30 mg/kg oxfendazole at the time of the second immunisation. Necropsies were undertaken when the pigs were approximately 12 months of age. Viable Taenia solium cysticerci were identified in 20 control pigs (prevalence 19.6%); no cysticerci were found in any of the vaccinated animals (P<0.0001). Combined application of TSOL18 vaccination and a single oxfendazole treatment in pigs may be a relatively simple and sustainable procedure that has the potential to control T. solium transmission in endemic areas and, indirectly, reduce the number of new cases of neurocysticercosis in humans.

Prevalence and antimicrobial resistance of Salmonella isolated from broiler farms, chicken carcasses, and street-vended restaurants in Casamance, Senegal.

This study was undertaken to determine the prevalence and distribution of Salmonella on 57 randomly selected broiler farms at the end of the rearing period and in chicken products in urban and periurban areas in Casamance, Senegal, and to evaluate the antimicrobial resistance profiles of the Salmonella serovars. Salmonella was detected in chicken feces, on carcass skin, and in muscle on 35.1, 38.6, and 29.8% of farms, respectively. Salmonella was found in chicken meat servings from 14.3% of the 42 street restaurants and in 40.4% of the 285 chicken carcasses examined. The prevalence on skin and in muscle was significantly associated with the detection of Salmonella in feces (P

The disease burden of Taenia solium cysticercosis in Cameroon.

BACKGROUND: Taenia solium cysticercosis is an important zoonosis in many developing countries. Human neurocysticercosis is recognised as an important cause of epilepsy in regions where the parasite occurs. However, it is largely underreported and there is a lack of data about the disease burden. Because a body of information on human and porcine cysticercosis in Cameroon is becoming available, the present study was undertaken to calculate the impact of this neglected zoonosis. METHODS: Both the cost and Disability Adjusted Life Year (DALY) estimations were applied. All necessary parameters were collected and imported in R software. Different distributions were used according to the type of information available for each of the parameters. FINDINGS: Based on a prevalence of epilepsy of 3.6%, the number of people with neurocysticercosis-associated epilepsy was estimated at 50,326 (95% CR 37,299-65,924), representing 1.0% of the local population, whereas the number of pigs diagnosed with cysticercosis was estimated at 15,961 (95% CR 12,320-20,044), which corresponds to 5.6% of the local pig population. The total annual costs due to T. solium cysticercosis in West Cameroon were estimated at 10,255,202 Euro (95% CR 6,889,048-14,754,044), of which 4.7% were due to losses in pig husbandry and 95.3% to direct and indirect losses caused by human cysticercosis. The monetary burden per case of cysticercosis amounts to 194 Euro (95% CR 147-253). The average number of DALYs lost was 9.0 per thousand persons per year (95% CR 2.8-20.4). INTERPRETATION: This study provides an estimation of the costs due to T. solium cysticercosis using country-specific parameters and including the human as well as the animal burden of the zoonotic disease. A comparison with a study in South Africa indicates that the cost of inactivity, influenced by salaries, plays a predominant role in the monetary burden of T. solium cysticercosis. Therefore, knowing the salary levels and the prevalence of the disease might allow a rapid indication of the total cost of T. solium cysticercosis in a country. Ascertaining this finding with additional studies in cysticercosis-endemic countries could eventually allow the estimation of the global disease burden of cysticercosis. The estimated number of DALYs lost due to the disease was higher than estimates already available for some other neglected tropical diseases. The total estimated cost and number of DALYs lost probably underestimate the real values because the estimations have been based on epilepsy as the only symptom of cysticercosis.

Trypanotolerance in small ruminants of sub-Saharan Africa.

Although a lot of information is currently available on trypanotolerance in cattle, until recently the trypanotolerant nature of small ruminants was not well known. Trypanotolerance in small ruminants is less pronounced than in cattle and should be considered as resilience rather than resistance. West African Dwarf (WAD) goats seem to be less trypanotolerant than Djallonke sheep. However, recent studies have shown that there is an important introgression of genes of trypanosusceptible breeds into WAD goat populations, which possibly explains the loss of trypanotolerance in these animals. Measures need to be taken to safeguard and upgrade the genetic purity of trypanotolerant goat and sheep breeds in Africa.

Five-fold increase in Trypanosoma congolense isolates resistant to diminazene aceturate over a seven-year period in Eastern Zambia.

Two groups of Trypanosoma congolense isolates collected from cattle in 1996 (n=39) and 2003 (n=38) in the Eastern Province of Zambia were analyzed by BclI-PCR-RFLP to assess the evolution of diminazene aceturate (DA) resistance over a period of seven years. The results show a significant increase of DA resistance in this relatively short period of time. In 1996, among the 39 isolates, 61.5% were found sensitive, 12.8% resistant and 25.7% had a mixed BclI-PCR-RFLP profile. In 2004, among the 38 isolates, 10.5% were found sensitive, 63.2% were resistant and 26.3% showed a mixed BclI-PCR-RFLP profile. In vivo tests in mice showed that isolates with a sensitive or mixed RFLP profile were sensitive to DA whereas isolates with a resistant RFLP profile were resistant. Since there are no indications that the drug pressure has increased between 1996 and 2003, it is suggested that genetic exchange of resistance genes might explain the increased frequency of resistance to DA.

Molecular tools for the rapid detection of drug resistance in animal trypanosomes.

There are currently 17 African countries in which animal trypanocidal drug resistance has been reported. Large-scale surveys were carried out in only ten of them. The lack of baseline information is mainly due to the fact that the methods currently available for the detection of drug resistance are laborious, expensive and time consuming. In this review the mechanisms involved in resistance to isometamidium and diminazene will be discussed, together with some new molecular detection tools that have been developed recently enabling faster diagnosis of drug resistance than conventional laboratory or field tests.

Energy metabolism of bloodstream form Trypanosoma theileri.

Bloodstream form Trypanosoma theileri degrades glucose to acetate (47%) and succinate (45%) and, therefore, does not solely rely on glycolysis for ATP production. This trypanosomatid does not use amino acids for energy metabolism. These results refute the prevailing hypothesis that substrate availability determines the type of energy metabolism of trypanosomatids.

Sewage sludge or cattle slurry as pasture fertilisers: comparative cysticercosis and trichostrongylosis risk for grazing cattle.

Sewage sludge and slurry are used as fertilisers on pastures grazed by ruminants. The former may be a source of Taenia saginata, which causes cysticercosis in cattle and taeniosis in man. The latter is a source of digestive tract-strongyles, a major helminth infection in cattle. The interest of application on pastures of these two biowastes is environmental (optimal recycling of biowastes) and agronomic (fertilisation). The parasitic risk and the fertilisation value of such applications on pastures were evaluated during one grazing season. Liquid sewage sludge did induce higher herbage biomass, which corresponded to higher liveweight gains during the first 2 months of grazing, compared to slurry spread pastures and calves grazing them. The sludge group of calves did not acquire live cysticerci and thus the risk was nil under the conditions of the study (delay of 6 weeks between application and grazing). The slurry group of calves did become lightly infected with digestive-tract strongyles, mostly Ostertagia ostertagi. Under the conditions of this experiment, a 6-week delay between application and grazing strongly reduced the risk of infection: it renders compatible the agronomic use and requirements of public or animal health.

Influence of an experimental Trypanosoma congolense infection and plane of nutrition on milk production and some biochemical parameters in West African Dwarf goats.

The interactions of trypanosomosis and plane of nutrition on health and productivity of multiparous and primiparous West African Dwarf (WAD) does were studied in a multi-factorial experiment including diet (supplementation or basal diet) and infection (infected or control). Experimental does were infected with Trypanosoma congolense at the beginning of the second week post-kidding and monitored for 16 weeks after infection. Trypanosome infection significantly reduced packed cell volume (PCV) (control: 30.1+/-0.3% versus infected: 22.2+/-0.3%; P<0.0001). Regardless of infection, the drop in PCV from the pre-infection period to the end of the experiment was more severe in animals under restricted diet (interaction dietxperiod, P<0.001). Trypanosome parasitaemia tended to be higher in the supplemented group than in the basal diet group (P>0.05) and multiparous animals had a higher parasitaemia (score: 2.6+/-0.1) than primiparous animals (score: 2.2+/-0.1) (P<0.05). Trypanosome infection as well as dietary supplement had a significant effect on lactation length. Milk off-take from trypanosome-infected does was significantly lower than that from the uninfected control group (17.5+/-3.2l versus 35.5+/-3.2l, P<0.001) and there was a positive effect of plane of nutrition (supplemented: 32.8+/-3.2l and basal diet: 20.2+/-3.5l, P=0.01). The drop in milk off-take due to trypanosome infection was more severe in the supplemented group (control: 46.7+/-4.7l versus infected: 18.9+/-4.2l) than in the group receiving a basal diet (control: 24.2+/-5.0l versus infected: 16.1+/-4.7l) (interaction infectionxdiet, P=0.04) due to the number of does from the supplemented group that were withdrawn from the experiment. The effect of trypanosome infection on doe's live-weight was only noticeable during the first 8 weeks of lactation and there was no significant effect on offspring growth rate unless the mother died. Plasma total protein (TP), albumin and cholesterol concentrations were significantly reduced by the infection but were significantly increased by supplementation. Supplemented does had a higher level of cholesterol and a tendency for a higher parasitaemia. Does of high parity also had a higher cholesterol level than primiparous does and, based on the number of animals that were withdrawn from the experiment, they showed a lower resistance to the infection.

Bovine cysticercosis: preliminary observations on the immunohistochemical detection of Taenia saginata antigens in lymph nodes of an experimentally infected calf.

A newly developed immunohistochemical test was used for the first time to demonstrate the presence of Taenia saginata (Cysticercus bovis) antigens in the lymph nodes of a heifer calf experimentally inoculated with Taenia saginata eggs. The new test should aid in the differential diagnosis of eosinophilic lymphadenitis in cattle.

Diagnosis of taenia saginata cysticercosis by immunohistochemical test on formalin-fixed and paraffin-embedded bovine lesions.

A new method of diagnosing cysticercus or larval stage of the human tapeworm, Taenia saginata, also known as Cysticercus bovis, in formalin-fixed bovine tissue was developed using a monoclonal antibody to T. saginata and avidin-biotin complex immunohistochemistry. Grossly recognizable viable and degenerate cysts were identifiable after immunohistochemical staining and could be differentiated from Sarcocystis, Actinobacillus, or non-cyst, normal bovine structures. Thenew test should permit laboratory confirmation of suspected T. saginata cysticercus lesions.

Effects of an experimental Trypanosoma congolense infection on the reproductive performance of West African Dwarf goats.

Thirty-six West African Dwarf (WAD) goats were used to assess the effects of an experimental Trypanosoma congolense infection on their reproductive system. Estrous cycles were synchronised and when confirmed pregnant (n = 31), the does were randomly allocated into control and trypanosome-infected groups. After infection, the animals were carefully observed till parturition. Trypanosome infection caused an increase of rectal temperature, a significant drop in PCV (infected: 23.3 +/- 0.3%; control: 28.5 +/- 0.4%; P < 0.0001) and abortions in 27.8% of the infected does. Kids born from infected does had a lower birth weight than kids born from control goats (0.9 +/- 0.1 kg versus 1.6 +/- 0.1 kg; P < 0.0001). Eight out of 13 kids (61.5%) that were born alive from infected does died during their first week of life. Plasma pregnancy-associated glycoprotein (PAG) and progesterone concentrations were lower in the infected animals than in the controls. In general, PAG concentration in does which aborted dropped before abortion. Our results revealed that artificial T. congolense infection affected reproductive performance of WAD goats with abortions, premature births and perinatal losses being observed. Neither transplacental transmission of T. congolense nor histopathological lesions of the placenta could be demonstrated.