Integrated risk mapping and landscape characterisation of lymphatic filariasis and loiasis in South West Nigeria.

Nigeria has the heaviest burden of lymphatic filariasis (LF) in sub-Saharan Africa, which is caused by the parasite Wuchereria bancrofti and transmitted by Anopheles mosquitoes. LF is targeted for elimination and the national programme is scaling up mass drug administration (MDA) across the country to interrupt transmission. However, in some regions the co-endemicity of the filarial parasite Loa loa (loiasis) is an impediment due to the risk of severe adverse events (SAEs) associated with the drug ivermectin. To better understand factors influencing LF elimination in loiasis areas, this study conducted a cross-sectional survey on the prevalence and co-distribution of the two infections, and the potential demographic, landscape, human movement, and intervention-related risk factors at a micro-level in the South West zone of Nigeria. In total, 870 participants from 10 communities on the fringe of a meso-endemic loiasis area of Osun State were selected. LF prevalence was measured by clinical assessment and using the rapid immunochromatographic test (ICT) to detect W. bancrofti antigen. Overall LF prevalence was low with ICT positivity ranging from 0 to 4.7%, with only 1 hydrocoele case identified. Males had significantly higher ICT positivity than females (3.2% vs 0.8%). Participants who did not sleep under a bed net had higher ICT positivity (4.0%) than those who did (1.3%). ICT positivity was also higher in communities with less tree coverage/canopy height (2.5-2.8%) than more forested areas with greater tree coverage/canopy height (0.9-1.0%). In comparison, loiasis was determined using the rapid assessment procedure for loiasis (RAPLOA), and found in all 10 communities with prevalence ranging from 1.4% to 11.2%. No significant difference was found by participants' age or sex. However, communities with predominately shrub land (10.4%) or forested land cover (6.2%) had higher prevalence than those with mosaic vegetation/croplands (2.5%). Satellite imagery showed denser forested areas in higher loiasis prevalence communities, and where low or no ICT positivity was found. Only one individual was found to be co-infected. GPS tracking of loiasis positive cases and controls also highlighted denser forested areas within higher loiasis risk communities and the sparser land cover in lower-risk communities. Mapping LF-loiasis distributions against landscape characteristics helped to highlight the micro-heterogeneity, identify potential SAE hotspots, and determine the safest and most appropriate treatment strategy.

Antioxidant and antimicrobial activities of solvent fractions of Vernonia cinerea (L.) Less leaf extract.

BACKGROUND: Vernonia cinerea (L.) Less is used in folk medicine as a remedy for various diseases. OBJECTIVES: The present study reports antioxidant and antimicrobial activities of solvent fractions of Vernonia cinerea. METHODS: The antioxidant properties of solvent fractions of V. cinerea were evaluated by determining radicals scavenging activity, total flavonoid and phenolic contents measured with the 2,2-diphenyl-1-picryl hydrazyl (DPPH) test, the aluminum chloride and the Folin-ciocalteau methods, respectively. Antimicrobial activities were tested against human pathogenic microorganisms using agar diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of each active extract were determined. RESULTS: The ethyl acetate fraction having the IC50 value of 6.50 µg/mL demonstrated comparable DPPH radical-scavenging activity with standard antioxidants, gallic acid and quercetin included in the study. All fractions displayed moderate antimicrobial potential against the tested pathogens with the zone of inhibition that ranged from 9.0 to 13.5 mm. The MIC (1.56 mg/mL) and MBC (3.13 mg/mL) indicated highest susceptibility of Candida albicans in all fractions. CONCLUSION: The results of this study showed that the solvent fractions of V. cinerea possess antioxidant and antimicrobial activities, hence justifying the folkloric use of the plant for the treatment of various ailments in traditional medicine.

Prospects, drawbacks and future needs of xenomonitoring for the endpoint evaluation of lymphatic filariasis elimination programs in Africa.

Lymphatic filariasis (LF) is a debilitating disease caused by Wuchereria bancrofti, Brugia malayi and B. timori parasitic worms and transmitted by Culex, Anopheles, Aedes and Mansonia mosquitoes. Mass drug administration (MDA) to reduce the infection levels in the human population is the key component of LF elimination programs. However, the potential of the use of vector control is gaining recognition as a tool that can complement MDA. The method of monitoring the parasites in mosquito vectors is known as xenomonitoring. Monitoring of vectors for filarial larvae is an important assessment tool for LF elimination programs. Xenomonitoring has the advantage of giving a real-time estimate of disease, because the pre-patent period may take months after infection in humans. It is a non-invasive sensitive tool for assessing the presence of LF in endemic areas. The aim of this review is to discuss the prospects, challenges and needs of xenomonitoring as a public health tool, in the post-MDA evaluation activities of national LF elimination programs.

An investigation of the disparity in estimates of microfilaraemia and antigenaemia in lymphatic filariasis surveys.

BACKGROUND: The diagnosis of lymphatic filariasis (LF) is based typically on either microfilaraemia as assessed by microscopy or filarial antigenaemia using an immuno-chromatographic test. While it is known that estimates of antigenaemia are generally higher than estimates of microfilaraemia, the extent of the difference is not known. METHODS: This paper presents the results of an extensive literature search for surveys that estimated both microfilaraemia and antigenaemia in order to better understand the disparity between the two measures. RESULTS AND CONCLUSIONS: In some settings there was a very large disparity, up to 40-70%, between estimates of microfilaraemia and antigenaemia. Regression analysis was unable to identify any predictable relationship between the two measures. The implications of findings for risk mapping and surveillance of LF are discussed.

Species composition and temporal distribution of mosquito populations in Ibadan, Southwestern Nigeria.

Nigeria has a high burden of vector borne diseases such as malaria and lymphatic filariasis (LF). This study aimed to determine the species composition of mosquitoes in Ibadan, Southwest Nigeria as well as determine their role in malaria and LF transmission. Adult mosquitoes were collected by Pyrethrum Spray Catch (PSC) and identified and graded according to their abdominal conditions. The mosquitoes were dissected to determine the parity status and to check for microfilariae of Wuchereria bancrofti. The presence of circumsporozoite protein of Plasmodium falciparum was examined using ELISA. A total of 1600 mosquitoes were collected of which 31 (1.9%) were Anopheles gambiae s.l. while 1756 (98%) were Culex sp. None of the mosquitoes examined was positive for Plasmodium falciparum and Wuchereria bancrofti. The lack of adequate sanitary conditions in the area could be responsible for the large number of mosquitoes collected. Health education could help in sensitizing the inhabitants.

Neglected tropical diseases: a systematic evaluation of research capacity in Nigeria.

BACKGROUND: Nigeria carries the highest burden and diversity of neglected tropical diseases (NTDs) in sub-Saharan Africa and is preparing to scale up its efforts to control/eliminate these diseases. To achieve this it will require a range of internal technical support and expertise for mapping, monitoring and evaluating, operational research and documenting its success. In order to begin to evaluate this potential in Nigeria, this study collated and analysed information for lymphatic filariasis (LF), onchocerciasis, schistosomiasis and soil-transmitted helminths (STH), which are currently being targeted with preventive chemotherapy through mass drug administration (MDA). METHODOLOGY/PRINCIPAL FINDINGS: Information from 299 scientific articles published on the selected NTDs in 179 journals between January 2008 and September 2013 was extracted and systematically compiled into a geo-referenced database for analysis and mapping. The highest number of articles was from the southern geo-political zones of the country. The majority of articles focused on one specific disease, and schistosomiasis and STH were found to have the highest and most wide ranging research output. The main type of study was parasitological, and the least was biotechnological. Nigerian authors were mostly affiliated with universities, and there was a wide range of international co-authors from Africa and other regions, especially the USA and UK. The majority of articles were published in journals with no known impact factor. CONCLUSIONS/SIGNIFICANCE: The extensive database and series of maps on the research capacity within Nigeria produced in this study highlights the current potential that exists, and needs to be fully maximized for the control/elimination of NTDs in the country. This study provides an important model approach that can be applied to other low and middle income countries where NTDs are endemic, and NTD programmes require support from the expertise within their own country, as well as internationally, to help raise their profile and importance.

Perceptions and recommendations by scientists for a potential release of genetically modified mosquitoes in Nigeria.

BACKGROUND: The use of genetically modified mosquitoes (GMMs) for the control of malaria and other mosquito-borne diseases has been proposed in malaria-endemic countries, such as Nigeria, which has the largest burden in Africa. Scientists are major stakeholders whose opinions and perceptions can adversely affect the success of the trials of GMMs if they are not involved early. Unfortunately, information on the awareness of Nigerians scientists and their overall perception of the GMMs is practically non-existent in the literature. Therefore, this study aimed at understanding how receptive Nigerian scientists are to a potential release of GMMs for the control of malaria. METHODS: The sample consisted of 164 scientists selected from academic and research institutions in Nigeria. Data were collected from participants using a semi-structured, self-administered questionnaire. Questions were asked about the cause and prevention of malaria, genetic modification and biotechnology. Specific questions on perception and acceptable conditions for the potential release of GM mosquitoes in Nigeria were also covered. RESULTS: All participants cited mosquitoes as one of several causes of malaria and used various methods for household control of mosquitoes. The main concerns expressed by the scientists were that GMMs can spread in an uncontrolled way beyond their release sites (89%) and will mate with other mosquito species to produce hybrids with unknown consequences (94.5%). Most participants (92.7%) agreed that it was important that before approving the release of GMMs in Nigeria, there had to be evidence of contingency measures available to remove the GMMs should a hazard become evident during the course of the release. In general, a majority (83.5%) of scientists who participated in this study were sceptical about a potential release in Nigeria, while 16.5% of the participants were in support. CONCLUSIONS: Although a majority of the participants are sceptical about GMMs generally, most encourage the use of genetic modification techniques to make mosquitoes incapable of spreading diseases provided that there are contingency measures to remove GMMs if a hazard becomes evident during the course of the release.

Lymphatic filariasis in Nigeria; micro-stratification overlap mapping (MOM) as a prerequisite for cost-effective resource utilization in control and surveillance.

BACKGROUND: Nigeria has a significant burden of lymphatic filariasis (LF) caused by the parasite Wuchereria bancrofti. A major concern to the expansion of the LF elimination programme is the risk of serious adverse events (SAEs) associated with the use of ivermectin in areas co-endemic with Loa filariasis. To better understand this, as well as other factors that may impact on LF elimination, we used Micro-stratification Overlap Mapping (MOM) to highlight the distribution and potential impact of multiple disease interventions that geographically coincide in LF endemic areas and which will impact on LF and vice versa. METHODOLOGY/PRINCIPAL FINDINGS: LF data from the literature and Federal Ministry of Health (FMoH) were collated into a database. LF prevalence distributions; predicted prevalence of loiasis; ongoing onchocerciasis community-directed treatment with ivermectin (CDTi); and long-lasting insecticidal mosquito net (LLIN) distributions for malaria were incorporated into overlay maps using geographical information system (GIS) software. LF was prevalent across most regions of the country. The mean prevalence determined by circulating filarial antigen (CFA) was 14.0% (n = 134 locations), and by microfilaria (Mf) was 8.2% (n = 162 locations). Overall, LF endemic areas geographically coincided with CDTi priority areas, however, LLIN coverage was generally low (<50%) in areas where LF prevalence was high or co-endemic with L. loa. CONCLUSIONS/SIGNIFICANCE: The extensive database and series of maps produced in this study provide an important overview for the LF Programme and will assist to maximize existing interventions, ensuring cost effective use of resources as the programme scales up. Such information is a prerequisite for the LF programme, and will allow for other factors to be included into planning, as well as monitoring and evaluation activities given the broad spectrum impact of the drugs used.