New geographical records for tick-borne pathogens in ticks collected from cattle in Benin and Togo.

BACKGROUND: Ticks are obligate hematophagous arthropods capable of transmitting a great variety of endemic and emerging pathogens causing diseases in animals and humans. OBJECTIVES: The aim of this study was to investigate the presence of Bartonella spp., Rickettsia spp., Borrelia burgdorferi sensu lato (s.l.) and Anaplasma phagocytophilum in ticks collected from cattle in Benin and Togo. METHODS: Overall, 396 (148 males, 205 females and 43 nymphs) ticks were collected from cattle in 17 districts (Benin and Togo) between 2019 and 2020. Ticks were pooled into groups of 2-6 ticks per pool according to individual host, location, species and developmental stage. The DNA of each pool was extracted for molecular screening. RESULTS: PCR results revealed that 20 tick pools were positive for Bartonella spp. (Benin and Togo) and 23 tick pools positive for Rickettsia spp. (Benin), while all pools were negative for A. phagocytophilum and B. burgdorferi s.l. Sequence analysis of positive Rickettsia samples revealed the presence of Rickettsia aeschlimannii. CONCLUSIONS: The present study highlights the presence of zoonotic agents in ticks collected from cattle in Benin and Togo. This information will raise awareness of tick-borne diseases among physicians and veterinarians, stimulate further studies to monitor these pathogens, and advise on necessary measures to control the spread of these zoonoses.

Molecular characterization of Rickettsia spp., Bartonella spp., and Anaplasma phagocytophilum in hard ticks collected from wild animals in Benin, West Africa.

Tick and tick-borne pathogens constitute a growing veterinary and public health concern around the world. Ticks are considered natural reservoirs for tick-borne related pathogens and are equally responsible for the spread of infections in animals as well as humans. In this study, the presence of Rickettsia, Bartonella, and Anaplasma phagocytophilum was investigated in hard ticks collected from reptiles, birds, and wild mammalian animals. The sample collection was carried out between December 2020 and September 2021. Adult ticks (male and female) were collected from wild animals in six districts of southern Benin. Molecular analysis was used to verify the presence of pathogens in all the ticks collected from wild animals. A total of 504 ticks were collected and grouped into 115 different tick pools. The PCR analysis detected 19 out of 115 tick pools which turn out positive for Rickettsia spp. and 9/115 tick pools positive for Bartonella spp., while Anaplasma phagocytophilum DNA was not detected in any tick. Several of the tick species collected from our studied reptiles/wild mammalian animals could be potential sources of zoonotic pathogens when subjected to further investigation. Therefore, stringent attention should be established for tick infestation of reptiles/wild mammalian animals in order to put in place proper control and prevention measures for tick-borne diseases in the wild, which could serve as reservoirs in the infestation of domestic animals/humans in the event of any possible contact.

Geographical distribution of hard ticks (Acari:Ixodidae) and tick-host associations in Benin, Burkina-Faso, Ivory-Coast and Togo.

Knowledge of ticks and associated pathogens is crucial to assess the risk of exposure of humans and animals to pathogens. For this review, we collected relevant data from published articles and field collections to provide an update on the biodiversity of ticks, and tick-host associations in four countries of West Africa: Benin, Burkina-Faso, Ivory-Coast, and Togo. The literature review was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was limited to literature published from 1953 to 2021 in English and French sources. Out of 104 articles retrieved, only 41 studies met the eligibility criteria and were included in the review. The final database included a total of 53,619 adults, nymphs and larval ticks belonging to 24 species and five genera (Amblyomma, Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus) that were collected from 23 different species of wild and domestic animals. This is the first record of Ixodes aulacodi and Rhipicephalus simpsoni in Benin, together with two new host records for A. latum. This checklist allows an update on tick-host associations and provides information on the diversity of ticks in West Africa.

Prevalence of Coxiella-infections in ticks - review and meta-analysis.

Q fever is a global zoonotic infection caused by the intracellular Gram-negative bacterium Coxiella burnetii. Historically, it is considered a vector-borne disease, but the role of ticks in transmission has not fully been elucidated yet. Excretion of C. burnetii in tick feces and saliva is well documented but the role of these findings or the epidemiological context is discussed controversially. Thus, the aim of this study was to determine the prevalence of C. burnetii DNA in ticks to clarify the potential role of tick species for maintenance of C. burnetii infection. A literature review was performed using Google scholar, Agora, Science Direct, PubMed and Scopus to identify original studies on C. burnetii DNA presence in ticks. The search was limited to literature published from 2009 to 2020 in English and French and focused on data obtained by molecular detection of C. burnetii DNA in ticks. Overall, the prevalence of C. burnetii in ticks collected in Africa varied from 2.91% to 13.97%, in Europe from 2.46% to 10.52% and the Middle East from 4.76% to 12.53%. Ticks collected from animals showed a prevalence of 8% (95% CI: 6%-10%), followed by ticks collected from the environment and animals of 7% (95% CI: 5%-10%). C. burnetii DNA has been found in samples of many tick species with the highest prevalence in Rhipicephalus evertsi and Amblyomma variegatum. However, most of these studies did not include a differentiation between C. burnetii and Coxiella-like endosymbionts making it finally difficult to estimate the potential role that ticks play in the epidemiology of Q fever. Therefore, it is necessary to analyze the vector competence of different tick species to transmit C. burnetii. Knowledge of the vector and reservoir competence of ticks is important for taking adequate preventive measures to limit infection risks.

Phenotypic and genotypic characterization of dog tick Rhipicephalus sanguineus sensu lato (Acari: Ixodidae) resistance to deltamethrin in Benin.

The aim of this study was to evaluate the phenotypic and genotypic resistance of Rhipicephalus sanguineus sensu lato to deltamethrin in dogs in the municipality of Natitingou in Benin. In this study, the collection and identification of ticks, Larval Packet Test and specific allele PCR were the main methods used. A total of 41 dogs were examined and 420 ticks were collected in six areas which includes: Tchrimina, Yokossi, Boriyoure, Berécingou, Péporiyakou and Perma. Three species of ticks were identified and they include: R. sanguineus s.l., Rhipicephalus microplus and Haemaphysalis spp. However, R. sanguineus s.l. was the most abundant tick species (9.85) and had the highest parasitic intensity (10.36). The results of the Larval Packet Test showed that the larvae of R. sanguineus s.l. developed a phenotypic resistance against deltamethrin, particularly in the Bérécingou area where resistance ratios of LC50 and LC95 of R. sanguineus s.l. compared to a susceptible strain were 1.591 (1.025-3.054) and 65.339 (20.235-579.825) respectively. The molecular study of the sodium channel gene revealed three genotypes namely the susceptible genotype (SS), the heterozygous genotype (SR) and the resistant genotype (RR), which correlates with the phenotypic results. This information is fundamental to improve monitoring and resistance management strategies of R. sanguineus s.l. ticks to pyrethroids.

Preliminary study on the tick population of Benin wildlife at the moment of its invasion by the Rhipicephalus microplus tick (Canestrini, 1888).

BACKGROUND AND AIM: Rhipicephalus microplus (Rm) is one of the most problematic livestock tick species in the world. Its rapid propagation and resistance to acaricides make it control difficult in the sub-region and Benin particularly. The aim of this work was to check its presence in wildlife and to confirm the possible role of reservoir wildlife may play in the propagation of the parasite. This will help to design more efficient control strategy. MATERIALS AND METHODS: This study was conducted from February to March 2017 in the National Parks of Benin (Pendjari and W Park) and wildfowl's assembly and selling point in Benin. Ticks were manually picked with forceps from each animal after slaughtering by hunters then stored in 70° ethanol. Collected ticks were counted and identified in the laboratory using the identification key as described by Walker. RESULTS: Overall, seven species of ticks (Amblyomma variegatum, Boophilus decoloratus, Rm, Boophilus spp., Hyalomma spp., Rhipicephalus sanguineus, Rhipicephalus spp.) were identified on nine wild animal species sampled (Cane rat, wildcat, Hare, Doe, Cricetoma, Buffalo, Buffon Cobe, and Bushbuck and Warthog). The average number of ticks varies from 3 to 6 between animal species, 3 to 7 between localities visited, and 2 to 5 between tick species. However, these differences are statistically significant only for localities. Considering tick species and animal species, the parasite load of Rm and Rhipicephalus spp. is higher; the buffalo being more infested. The analysis of deviance reveals that the abundance of ticks observed depends only on the observed localities (p>0.05). However, the interactions between animal species and localities on the one hand and between animal and tick species on the other hand, although not significant, have influenced the abundance of ticks as they reduce the residual deviance after their inclusion in the model. CONCLUSIONS: This study reported the presence of Rm in wildlife of Benin and confirmed its role in the maintenance and spread of the parasites. It is, therefore, an important risk factor that we must not neglect in the epidemiological surveillance and ticks control strategies in the West African sub-region and particularly in Benin.

Sensitivity of Different Cattle Breeds to the Infestation of Cattle Ticks Amblyomma variegatum, Rhipicephalus microplus, and Hyalomma spp. on the Natural Pastures of Opkara Farm, Benin.

A study was carried out on the Opkara (Benin) cattle farm on 64 cattle of four different breeds (16 individuals per breed) from June to December 2016. During this study, three tick species were found in different numbers, Amblyomma variegatum (732), Rhipicephalus microplus (8079), and Hyalomma spp. (208), with parasitic intensity of 11.90, 126.23, and 3.25, respectively. The interracial comparison of the tick infestation between the cattle showed a significant difference (P < 0.001). However, Girolando was more infested than all the cattle breeds. Infestation of A. variegatum, R. microplus, and Hyalomma spp. on the Girolando was, respectively, 19.43 ± 2.71, 171.25 ± 23.50, and 7.12 ± 0.63, but the Borgou were less infested. Borgou breed females were more infested by A. variegatum (4.41 ± 1.14) than females Girolando (4.20 ± 0.90). The Crossbred and Azawak females were less infested (P < 0.01). The mean of A. variegatum on Borgou, Azawak, Crossbred, and Girolando calves was 1.29 ± 0.35, 0.66 ± 0.26, 1.37 ± 0.37, and 2.25 ± 0.48 (P < 0.01), respectively. The results of this study can be exploited to include genetic and nongenetic approaches to tick control.

Evidence of multiple mechanisms of alphacypermethrin and deltamethrin resistance in ticks Rhipicephalus microplus in Benin, West Africa.

Ticks are obligate haematophagous arthropods, causing heavy losses in affected livestock. The objective of this study is to investigate phenotypic and genotypic resistance in Rhipicephalus microplus populations from Benin. Engorged female adult ticks were collected from cattle in two districts of Benin. Bioassays, biochemical and molecular tests were carried out on these ticks to determine the phenotypic, enzymatic and genetic status of resistance. Results of bioassays showed high resistance factors (RF > 41). The molecular tests showing the presence of the domain II mutation and absence of the domain III mutation in the voltage-gated sodium channel gene. Biochemical tests showed increased activity of esterases, multifunction oxidases and glutathione transferases in resistant samples. Genotyping the samples showed high levels of heterozygous genotypes (73.36% and 63.30%) as compared to homozygous susceptible and resistant genotypes (23.3% and 10%) respective at Samiondji and Betecoucou. A correlation between phenotype resistance and presence of the domain II mutation at the voltage gated sodium channel gene was observed suggesting that this could be associated with resistance. Target site mutation and metabolic detoxification are mechanisms of resistance to pyrethroids in R. microplus tick populations from Benin.

The cervicosternolaparotomy approach for the treatment of graft dysfunction after retrosternal esophageal reconstruction for caustic injuries.

OBJECTIVE: The study purpose was to report the indications, technical aspects, and outcomes of cervicosternolaparotomy during revision surgery after esophageal reconstruction for caustic injuries. METHODS: Patients who underwent cervicosternolaparotomy during revision surgery for graft dysfunction between 1999 and 2015 were included. Cervicosternolaparotomy was performed to mobilize and pull up the primary conduit during surgery for strictures (rescue cervicosternolaparotomy) or to allow retrosternal access for management of other graft-related complications (exposure cervicosternolaparotomy). Statistical tests were performed to identify factors associated with primary conduit preservation during rescue cervicosternolaparotomy. RESULTS: Fifty-five patients were included (28 men; median age, 43 years). Median delay between primary reconstruction and cervicosternolaparotomy was 15 months. Exposure cervicosternolaparotomy was performed in 12 patients (22%) for redundancy (n = 8), spontaneous perforation (n = 2), and caustic reingestion (n = 2). Rescue cervicosternolaparotomy was performed in 43 patients (78%) to treat supra-anastomotic (n = 11), anastomotic (n = 23), and diffuse (n = 9) stenosis. During rescue cervicosternolaparotomy, the primary conduit was preserved in 32 patients; median length gain obtained by transplant release was 8 cm. Failure to preserve the primary conduit was associated with previous surgical repair attempts (P = .003) and lack of initial concomitant pharyngeal reconstruction (P = .039). Two patients died (4%), and 35 patients (64%) experienced operative complications. Operative outcomes were similar after rescue and exposure cervicosternolaparotomy. With a median follow-up of 4.4 years, the functional success rate was 85%. CONCLUSIONS: Cervicosternolaparotomy during revision surgery for graft dysfunction is reliable, is associated with low morbidity and mortality, and has good results.

Computed Tomography Evaluation of Esophagogastric Necrosis After Caustic Ingestion.

BACKGROUND: Endoscopy is the standard of care for emergency patient evaluation after caustic ingestion. However, the inaccuracy of endoscopy in determining the depth of intramural necrosis may lead to inappropriate decision-making with devastating consequences. Our aim was to evaluate the use of computed tomography (CT) for the emergency diagnostic workup of patients with caustic injuries. METHODS: In a prospective study, we used a combined endoscopy-CT decision-making algorithm. The primary outcome was pathology-confirmed digestive necrosis. The respective utility of CT and endoscopy in the decision-making process were compared. Transmural endoscopic necrosis was defined as grade 3b injuries; signs of transmural CT necrosis included absence of postcontrast gastric/ esophageal-wall enhancement, esophageal-wall blurring, and periesophageal-fat blurring. RESULTS: We included 120 patients (59 men, median age 44 years). Emergency surgery was performed in 24 patients (20%) and digestive resection was completed in 16. Three patients (3%) died and 28 patients (23%) experienced complications. Pathology revealed transmural necrosis in 9/11 esophagectomy and 16/16 gastrectomy specimens. Severe oropharyngeal injuries (P = 0.015), increased levels of blood lactate (P = 0.007), alanine aminotransferase (P = 0.027), bilirubin (P = 0.005), and low platelet counts (P > 0.0001) were predictive of digestive necrosis. Decision-making relying on CT alone or on a combined CT-endoscopy algorithm was similar and would have spared 19 unnecessary esophagectomies and 16 explorative laparotomies compared with an endoscopy-alone algorithm. Endoscopy did never rectify a wrong CT decision. CONCLUSIONS: Emergency decision-making after caustic injuries can rely on CT alone.

System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives.

In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system.

Social marketing techniques for public health communication: a review of syphilis awareness campaigns in 8 US cities.

OBJECTIVES: To describe the social marketing approaches used to increase syphilis awareness in 8 US cities. METHODS: We reviewed the typical academic approach for developing social marketing campaigns and interviewed health department staff responsible for social marketing campaigns in each city. RESULTS: Using social marketing techniques such as target segmentation, concept testing of materials, and formative evaluation, campaign planners throughout the 8 cities developed a variety of approaches to reach their target audiences. Preliminary results suggest 71% to 80% of men who have sex with men interviewed were aware of the campaigns, and 45% to 53% of them reported they were tested due to the campaigns. CONCLUSIONS: Campaigns should address the local epidemic and target audience with culturally appropriate messages.

Interventions in the commercial sex industry during the rise in syphilis rates among men who have sex with men (MSM).

OBJECTIVE: Describe sexually transmitted disease/human immunodeficiency virus prevention interventions targeting men who have sex with men (MSM) in commercial sex venues (CSV). STUDY: Compilation of descriptive and evaluation data from the CDC 8-city MSM Syphilis Response on interventions conducted in bathhouses/sex clubs, circuit parties, the Internet, male sex workers, and the adult film industry. RESULTS: Interventions in the commercial sex industry (CSI) often involved multiple collaborative efforts between public health departments (PHD), community-based organizations (CBO), and CSV owners and managers. Education and condoms were provided at multiple venues, including circuit parties, bathhouses, and sex clubs. CBO staff reported one-on-one street and CSV outreach to engage MSM at risk. Evaluation data demonstrate that MSM exposed to media campaigns were more aware of syphilis and more likely to have been tested for syphilis than MSM who did not see the campaigns. CONCLUSIONS: PHD and CBO are using multiple means of reaching MSM in the CSI. Evaluations are needed to determine which of these efforts decreases syphilis transmission.

Internet-based health promotion and disease control in the 8 cities: successes, barriers, and future plans.

OBJECTIVES: The objective of this paper is to provide a detailed description of Internet-based sexually transmitted disease/human immunodeficiency virus prevention in the 8 US cities most affected by syphilis in men who have sex with men. GOAL: By reviewing the efforts under way in these 8 cities, we will understand the barriers and facilitators associated with Internet-based prevention efforts. STUDY: This is a review of Internet activities taking place in 8 major US cities. RESULTS: Efforts in the 8 cities vary, with some cities reporting little or no Internet-based prevention activities. Other cities have attempted banner advertising, online outreach, online partner notification, online laboratory slips for syphilis testing, and auditorium-style chat sessions. CONCLUSION: Though a number of policy-related barriers prevent some cities from engaging in Internet-based prevention, these activities are clearly important to the overall prevention effort. In order to surmount local policy barriers, it is essential to obtain evaluation data from the programs initiated.