Microfilariae Prevalence and its Association with Anemia Among First-time Blood Donors in Lambaréné, Gabon

Background: Anemia remains a significant public health concern in Gabon, particularly among children, adolescents, and females. Gabon is also home to two major species of filarial worms, Loa and Mansonella spp., which cause microfilaremia. The epidemiological nexus between hemoglobin (Hb) concentrations and microfilaremia in Gabonese first-time blood donors remains unknown. Aims: To understand better the epidemiological relationship between anemia and microfilaremia to improve donor selection and management protocols. Study Design: A retrospective cohort study. Methods: This study was conducted among first-time blood donors in Lambaréné between March 2018 and October 2019. Participants aged 16-65 years old and weighing a minimum of 50 kg were enrolled using standard donor selection criteria. An automatic hematological analyzer was used to quantify Hb concentrations, and microscopy techniques were used to detect the presence of microfilariae. Results: Microfilariae were found in 4.8% (35/723) of the 723 first-time blood donors from Lambaréné. Anemia was classified as mild in 35.5% (257/723) and moderate in 1% (7/723). No significant associations were found between the distribution of microfilariae and variables such as age, sex, socioprofessional classification, marital status, or residence. Blood group O donors had a higher prevalence of microfilariae (6%) than non-O donors (2.7%). However, the observed difference was not statistically significant (AOR =2.3, p = 0.052). Furthermore, microfilariae were associated with increased moderate anemia (3.7% vs. 29%, AOR =15.6, p = 0.003). Conclusion: Our findings highlight microfilaremia as a possible etiological cause of anemia among Gabonese blood donors, emphasizing the need for further research and a potential review of donor management strategies.

Distribution of Aedes mosquito species along the rural-urban gradient in Lambaréné and its surrounding.

BACKGROUND: Aedes albopictus and Aedes aegypti are known for their potential as vectors of dengue (DENV) and chikungunya (CHIKV) viruses. However, entomological surveys are mostly carried out during epidemics. In Gabon where outbreaks of both viruses have occurred, there is no vector control program targeting these arboviruses. Therefore, we assessed the presence of Aedes species along a rural-urban gradient in Lambaréné (Gabon) and its surroundings and determined ecological factors associated to their presence. METHODS: An entomological survey was conducted in Lambaréné and its surrounding rural areas. Mosquitoes were collected with aspirators around human dwellings, and ecological and environmental data were collected from each study area. Morphological identification keys were used to identify Aedes species. RNA was extracted from pools of female mosquitoes and amplified by RT-qPCR to detect the presence of DENV and CHIKV. RESULTS: Overall, the most common vector collected was Aedes albopictus (97%, 4236/4367 specimens), followed by Aedes aegypti (3%, 131/4367). Albopictus vectors was more abundant in the rural area (Wilcoxon signed-rank test, Z = 627, P = 0.043) than in the urban area. In the urban area, a higher number of mosquitoes (45%) were recorded in the economic zone (zone 3) than in the historical and administrative zones (zone 1 and 2). In the rural area, the proportions of species numbers were significantly higher along the south rural transect (92%) compared to the north rural transect (Wilcoxon signed-rank test, Z = 43, P ˂ 0.016). We also noted a high abundance of vectors in environments characterized by monocultures of Hevea brasiliensis (Hevea) and Manihot esculenta (cassava) (Kruskal-Wallis H-test, H = 25.7, df = 2, P < 0.001). Finally, no mosquito pools were positive for either DENV or CHIKV. CONCLUSION: Aedes albopictus was the dominant vector across the study sites due to its high invasiveness capacity. This presence re-affirms the potential for local transmission of both DENV and CHIKV, as indicated previously by serological surveys conducted in our study area, even though no transmission was detected during the current study. These findings underscore the need for regular arbovirus surveillance in the study region, with the aim of supporting vector control efforts in the event of outbreaks.