Helicobacter pylori in patients with gastritis in West Cameroon: prevalence and risk factors for infection.

OBJECTIVES: Helicobacter pylori is a pathogenic bacterium that parasitizes the gastric mucous layer and the epithelial lining of the stomach causing duodenal ulcers, gastric ulcers and cardiovascular disease amongst others. This study aimed at establishing the epidemiologic profile of H. pylori infection in gastritis patients presenting at the Melong District Hospital. RESULTS: Blood, stool and epidemiological data collected from 500 patients were analyzed for the presence of H. pylori antibody in serum, antigen in stool and elucidation of risk factors captured in questionnaires. Of 500 blood samples, 217 (43.4%) were seropositive with male and female seroprevalences of 45.5% (61/134) and 42.6% (156/366) respectively. Similarly, 47.4% (237/500) samples tested positive for stool antigen with prevalences of 47.0% (63/134) for males and 47.5% (174/366) for females. The antigen prevalence was higher (53.2%; 118/222) in older patients (> 50 years) than in younger patients (42.8%; 119/278; P = 0.021). The antigen test had a higher (47.4%) prevalence than the antibody test (43.4%). Educational level, source of income, source of drinking water, age of patients, and alcohol consumption had positive associations with H. pylori infection. These results have clinical and epidemiological significance and call for intervention to mitigate the situation.

Detection of Ehrlichia ruminantium infection in cattle in Cameroon.

OBJECTIVES: Ehrlichia ruminantium infection (heartwater) is a major constraint that impacts negatively on the cattle industry development in sub-Saharan Africa and so far, little is known of the presence of heartwater in cattle in Cameroon. This study sought to investigate the prevalence of E. ruminantium infection in cattle in Cameroon and to determine the predictors of infection. RESULTS: A species-specific semi-nested pCS20 polymerase chain reaction was used to screen the buffy coats from 182 cattle (comprising 82 cattle that received intensive tick control regimen and 100 cattle on strategic tick control) from two study sites in Cameroon for E. ruminantium DNA in a cross-sectional study. E. ruminantium infection was confirmed in 12 (6.6%) of the 182 cattle comprising 11 that received intensive tick control and one on strategic tick control. Of the 12 cattle detected, 11 were apparently healthy and one was clinically diagnosed of heartwater. All DNA sequences of pCS20 amplicons were identical to each other (a representative sequence deposited in GenBank under accession number JQ039939). These findings which have veterinary and epidemiological significance, suggest the need for further investigation to determine the extent and role of heartwater in cattle in Cameroon.

Genetic diversity of Ehrlichia ruminantium strains in Cameroon.

In order to investigate the extent of genetic diversity among Ehrlichia ruminantium strains in Cameroon, a partial fragment (800 bp) of the E. ruminantium map1 gene was amplified by nested polymerase chain reaction in 121 of 156 E. ruminantium pCS20-positive DNA samples extracted from ticks and cattle collected from two ranches. Deoxyribonucleic acid sequencing of the map1 gene products indicated the presence of at least 21 genotypes at the nucleotide level and 16 genotypes at the amino acid level circulating within the study sites. Some of the genotypes were identical to Antigua (U50830), Blaaukrans (AF368000) or UmBanein (U50835), whilst the others were new genotypes. Twenty-four representative sequences were deposited in GenBank and given accession numbers JX477663 - JX477674 (for sequences of tick origin) and JX486788 - JX486799 (for sequences of cattle origin). Knowledge of E. ruminantium strain diversity could be important in understanding the epidemiology of heartwater.

Prevalence of Ehrlichia ruminantium in adult Amblyomma variegatum collected from cattle in Cameroon.

Ehrlichia ruminantium, the etiologic agent of the economically important disease heartwater, is an obligate intracellular bacterium transmitted by ticks of the genus Amblyomma, particularly A. hebraeum and A. variegatum. Although serologic and microscopic evidence of the presence of heartwater have been reported in ruminants in Cameroon, knowledge of E. ruminantium infection in the tick vector, A. variegatum, is lacking. In order to determine the infectivity of A. variegatum ticks by E. ruminantium, we analysed 500 un-engorged A. variegatum ticks collected by hand-picking from predilection sites from 182 cattle [115 ticks from 82 cattle at Société de Développement et d'Exploitation des Productions Animales (SODEPA) Dumbo ranch (SDR) and 385 ticks from 100 cattle at the Upper Farms ranch (UFR)] by amplification of the open reading frame (ORF) 2 of the pCS20 region of E. ruminantium. PCR amplification of the 279 bp fragment of the pCS20 region detected E. ruminantium DNA in 142 (28.4 %) of the 500 ticks with a higher infection rate (47/115; 40.9 %) observed in ticks from SDR and 24.7 % (95/385) of ticks collected from cattle at UFR. Twenty five randomly selected PCR products were sequenced and results indicated that some of the isolates shared homology with one another and to sequences of E. ruminantium in the GenBank. This report represents the first molecular evidence of E. ruminantium infection in A. variegatum ticks in Cameroon and suggests possible exposure of cattle to this pathogen in our environment.

Ehrlichia species, probable emerging human pathogens in sub-Saharan Africa: environmental exacerbation.

Ehrlichiae are obligate intracellular Gram-negative tick-borne bacteria that are responsible for life-threatening emerging human zoonoses and diseases of veterinary importance worldwide, collectively called ehrlichioses. The genus Ehrlichia consists of five recognized species, including E. canis, E. chaffeensis, E. ewingii, E. muris, and E. ruminantium. The recent discoveries of Ehrlichia species in new areas and of tick species that were previously thought to be uninfected by these agents have suggested that these agents may have wider distribution than originally thought. Environmental factors like temperature, migration, control failure, and host population have been known to exacerbate the spread of Ehrlichia species. Human cases of moderate to severe disease caused by E. chaffeensis have been reported mainly in North America. In this article, we present an overview of ehrlichiae as emerging pathogens in sub-Saharan Africa, where E. ruminantium, the causative agent of heartwater, a disease of domestic and wild ruminants, is most established. Molecular evidence indicates that E. ruminantium may be an emerging pathogen of a life-threatening human disease. Ehrlichia ruminantium is considered an agricultural biothreat, with several strains reported throughout sub-Saharan Africa, where the infection is considered endemic. Understanding the diversity of E. ruminantium and other Ehrlichia species from all geographically distinct areas of sub-Saharan Africa may enhance our knowledge of the pathogenesis and epidemiology of these pathogens.

Predominance of Ehrlichia chaffeensis in Rhipicephalus sanguineus ticks from kennel-confined dogs in Limbe, Cameroon.

Rhipicephalus sanguineus ticks (n = 63) collected from five dogs (two adults and three puppies) housed in a kennel were screened for Ehrlichial agents (Ehrlichia canis, E. chaffeensis, and E. ewingii) using a species-specific multicolor real-time TaqMan PCR amplification of the disulphide bond formation protein (dsb) gene. Ehrlichia chaffeensis DNA was detected in 33 (56%) ticks, E. canis DNA was detected in four (6%) ticks, and one tick was coinfected. The E. chaffeensis and E. canis nucleotide sequences of the amplified dsb gene (374 bp) obtained from the Cameroonian R. sanguineus ticks were identical to the North American genotypes.