Low-cost adaptation options to support green growth in agriculture, water resources, and coastal zones.

The regional climate as it is now and in the future will put pressure on investments in sub-Saharan Africa in water resource management, fisheries, and other crop and livestock production systems. Changes in oceanic characteristics across the Atlantic Ocean will result in remarkable vulnerability of coastal ecology, littorals, and mangroves in the middle of the twenty-first century and beyond. In line with the countries' objectives of creating a green economy that allows reduced greenhouse gas emissions, improved resource efficiency, and prevention of biodiversity loss, we identify the most pressing needs for adaptation and the best adaptation choices that are also clean and affordable. According to empirical data from the field and customized model simulation designs, the cost of these adaptation measures will likely decrease and benefit sustainable green growth in agriculture, water resource management, and coastal ecosystems, as hydroclimatic hazards such as pluviometric and thermal extremes become more common in West Africa. Most of these adaptation options are local and need to be scaled up and operationalized for sustainable development. Governmental sovereign wealth funds, investments from the private sector, and funding from global climate funds can be used to operationalize these adaptation measures. Effective legislation, knowledge transfer, and pertinent collaborations are necessary for their success.

Phenotypic and genotypic analysis of enterotoxigenic Escherichia coli in samples obtained from Egyptian children presenting to referral hospitals.

Hospital surveillance was established in the Nile River Delta to increase the understanding of the epidemiology of diarrheal disease among Egyptian children. Between September 2000 and August 2003, samples obtained from children less than 5 years of age who had diarrhea and who were seeking hospital care were cultured for enteric bacteria. Colonies from each culture with a morphology typical of that of Escherichia coli were tested for the heat-labile (LT) and heat-stable (ST) toxins by a GM-1-specific enzyme-linked immunosorbent assay and colonization factor (CF) antigens by an immunodot blot assay. Enterotoxigenic E. coli (ETEC) isolates were recovered from 320/1,540 (20.7%) children, and ETEC isolates expressing a known CF were identified in 151/320 (47%) samples. ST CFA/I, ST CS6, ST CS14, and LT and ST CS5 plus CS6 represented 75% of the CFs expressed by ETEC isolates expressing a detectable CF. Year-to-year variability in the proportion of ETEC isolates that expressed a detectable CF was observed (e.g., the proportion that expressed CFA/I ranged from 10% in year 1 to 21% in year 3); however, the relative proportions of ETEC isolates expressing a CF were similar over the reporting period. The proportion of CF-positive ETEC isolates was higher among isolates that expressed ST. ETEC isolates expressing CS6 were isolated significantly less often (P < 0.001) than isolates expressing CFA/I in children less than 1 year of age. Macrorestriction profiling of CFA/I-expressing ETEC isolates by using the restriction enzyme XbaI and pulsed-field gel electrophoresis demonstrated a wide genetic diversity among the isolates that did not directly correlate with the virulence of the pathogen. The genome plasticity demonstrated in the ETEC isolates collected in this work suggests an additional challenge to the development of a globally effective vaccine for ETEC.

Phenotypic diversity of enterotoxigenic Escherichia coli strains from a community-based study of pediatric diarrhea in periurban Egypt.

No past studies of diarrhea in children of the Middle East have examined in detail the phenotypes of enterotoxigenic Escherichia coli (ETEC) strains, which are important pathogens in this setting. During a prospective study conducted from November 1993 to September 1995 with 242 children under 3 years of age with diarrhea living near Alexandria, Egypt, 125 episodes of diarrhea were positive for ETEC. ETEC strains were available for 98 of these episodes, from which 100 ETEC strains were selected and characterized on the basis of enterotoxins, colonization factors (CFs), and O:H serotypes. Of these representative isolates, 57 produced heat-stable toxin (ST) only, 34 produced heat-labile toxin (LT) only, and 9 produced both LT and ST. Twenty-three ETEC strains expressed a CF, with the specific factors being CF antigen IV (CFA/IV; 10 of 23; 43%), CFA/II (5 of 23; 22%), CFA/I (3 of 23; 13%), PCFO166 (3 of 23; 13%), and CS7 (2 of 23; 9%). No ETEC strains appeared to express CFA/III, CS17, or PCFO159. Among the 100 ETEC strains, 47 O groups and 20 H groups were represented, with 59 O:H serotypes. The most common O serogroups were O159 (13 strains) and O43 (10 strains). O148 and O21 were each detected in five individual strains, O7 and O56 were each detected in four individual strains, O73, O20, O86, and O114 were each detected in three individual strains, and O23, O78, O91, O103, O128, and O132 were each detected in two individual strains. The most common H serogroups were H4 (16 strains), 12 of which were of serogroup O159; H2 (9 strains), all of which were O43; H18 (6 strains); H30 (6 strains); and H28 (5 strains); strains of the last three H serogroups were all O148. Cumulatively, our results suggest a high degree of clonal diversity of disease-associated ETEC strains in this region. As a low percentage of these strains expressed a CF, it remains possible that other adhesins for which we either did not assay or that are as yet undiscovered are prevalent in this region. Our findings point out some potential barriers to effective immunization against ETEC diarrhea in this population and emphasize the need to identify additional protective antigens commonly expressed by ETEC for inclusion in future vaccine candidates.

Characterization of an enterotoxigenic Escherichia coli strain from Africa expressing a putative colonization factor.

An enterotoxigenic Escherichia coli (ETEC) strain of serotype O114:H- that expressed both heat-labile and heat-stable enterotoxins and tested negative for colonization factors (CF) was isolated from a child with diarrhea in Egypt. This strain, WS0115A, induced hemagglutination of bovine erythrocytes and adhered to the enterocyte-like cell line Caco-2, suggesting that it may elaborate novel fimbriae. Surface-expressed antigen purified by differential ammonium sulfate precipitation and column chromatography yielded a single protein band with M(r) 14,800 when resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (16% polyacrylamide). A monoclonal antibody against this putative fimbrial antigen was generated and reacted with strain WS0115A and also with CS1-, CS17-, and CS19-positive strains in a dot blot assay. Reactivity was temperature dependent, with cells displaying reactivity when grown at 37 degrees C but not when grown at 22 degrees C. Immunoblot analysis of a fimbrial preparation from strain WS0115A showed that the monoclonal antibody reacted with a single protein band. Electron microscopy and immunoelectron microscopy revealed fimbria-like structures on the surface of strain WS0115A. These structures were rigid and measured 6.8 to 7.4 nm in diameter. Electrospray mass-spectrometric analysis showed that the mass of the purified fimbria was 14,965 Da. The N-terminal sequence of the fimbria established that it was a member of the CFA/I family, with sequence identity to the amino terminus of CS19, a new CF recently identified in India. Cumulatively, our results suggest that this fimbria is CS19. Screening of a collection of ETEC strains isolated from children with diarrhea in Egypt found that 4.2% of strains originally reported as CF negative were positive for this CF, suggesting that it is biologically relevant in the pathogenesis of ETEC.

Biological and biochemical comparative studies on Schistosoma mansoni from two localities in Egypt where S. haematobium is endemic.

The changing pattern of Schistosoma mansoni and S. haematobium distribution in Egypt is generally attributed to ecological changes caused by the construction of the Aswan High Dam. Although S. mansoni was previously restricted to Lower Egypt, it is now found at certain foci in Upper Egypt. In areas of Lower Egypt where S. mansoni and S. haematobium are sympatric, S. mansoni eggs are shed almost exclusively in the stools of patients, whereas in Upper Egypt they are more frequently shed in the urine. In spite of this difference, the eggs and adult worms obtained from hamsters infected with S. mansoni strains from each of these areas proved to be morphologically identical. Protein patterns and isoenzyme profiles of male or female adult worms of each of the two isolates, obtained from infected hamsters, also proved virtually identical. In hamsters with mixed infections of S. mansoni and S. haematobium, some S. mansoni females cross-mated with S. haematobium males and they then developed ovaries and laid eggs which were typical of S. mansoni and which were excreted from the urinary bladder. In Upper Egypt, which is predominantly a S. haematobium area, patients with established infections may have a preponderance of S. haematobium males associated with S. mansoni females. These females may then migrate to the vesicular plexus and deposit S. mansoni eggs in the urinary bladder, to be shed subsequently in the urine. The observations appear to be better explained by the phenomenon of parthenogenesis than by the production of true genetic hybrids.

Worm development in hamsters infected with unisex and cross-mated Schistosoma mansoni and Schistosoma haematobium.

Schistosoma mansoni and Schistosoma haematobium coexist in Egypt and in other areas in Africa, and people frequently are infected with parasites of both species. The effects of the interactions between worms of both sexes of the 2 species on development and egg laying were evaluated in vivo by infecting hamsters with cercariae from Biomphalaria alexandrina and Bulinus truncatus snails infected with single miracidia. In hamsters with unisex infections, male worms of both species were small. Schistosoma mansoni females were stunted and partially mature but did not contain eggs. Schistosoma haematobium females, though stunted, sometimes contained and laid small eggs, which were deposited in the liver, but few of which contained motile embryos. This suggests that unisexual infection with S. haematobium female worms produces a risk for liver damage due to egg deposition in tissues. Both S. mansoni and S. haematobium females that mated with males of the heterologous species were significantly larger than females from unisexual infections; they were sexually mature and possessed eggs in the uterus. The eggs in the liver homogenates of cross-specific infected hamsters contained fully developed miracidia that hatched in filtered pond water.