T. Marcotty

Spatial targeted vector control in the highlands of Burundi and its impact on malaria transmission.

BackgroundPrevention of malaria epidemics is a priority for African countries. The 2000 malaria epidemic in Burundi prompted the government to implement measures for preventing future outbreaks. Case management with artemisinin-based combination therapy and malaria surveillance were nationally improved. A vector control programme was initiated in one of the most affected highland provinces. The focal distribution of malaria vectors in the highlands was the starting point for designing a targeted vector control strategy. The objective of this study was to present the results of this strategy on malaria transmission in an African highland region.MethodsIn Karuzi, in 2002–2005, vector control activities combining indoor residual spraying and long-lasting insecticidal nets were implemented. The interventions were done before the expected malaria transmission period and targeted the valleys between hills, with the expectation that this would also protect the populations living at higher altitudes. The impact on the Anopheles population and on malaria transmission was determined by nine cross-sectional surveys carried out at regular intervals throughout the study period.ResultsAnopheles gambiae s.l. and Anopheles funestus represented 95% of the collected anopheline species. In the valleys, where the vector control activities were implemented, Anopheles density was reduced by 82% (95% CI: 69–90). Similarly, transmission was decreased by 90% (95% CI: 63%–97%, p = 0.001). In the sprayed valleys, Anopheles density was further reduced by 79.5% (95% CI: 51.7–91.3, p < 0.001) in the houses with nets as compared to houses without them. No significant impact on vector density and malaria transmission was observed in the hill tops. However, the intervention focused on the high risk areas near the valley floor, where 93% of the vectors are found and 90% of the transmission occurs.ConclusionSpatial targeted vector control effectively reduced Anopheles density and transmission in this highland district. Bed nets have an additional effect on Anopheles density though this did not translate in an additional impact on transmission. Though no impact was observed in the hilltops, the programme successfully covered the areas most at risk. Such a targeted strategy could prevent the emergence and spread of an epidemic from these high risk foci.

A significant increase in kdr in Anopheles gambiae is associated with an intensive vector control intervention in Burundi highlands

Objectives and Methods  In Burundi, the occurrence of the knock down resistance (kdr) mutation in Anopheles gambiae sensu lato (s.l.) was determined for six consecutive years within the framework of a vector control programme. Findings were also linked with the insecticide resistance status observed with bioassay in An. gambiae s.l. and An. funestus.

The effect of starvation on the susceptibility of teneral and non-teneral tsetse flies to trypanosome infection

Abstract Transmission of vector‐borne diseases depends largely on the ability of the insect vector to become infected with the parasite. In tsetse flies, newly emerged or teneral flies are considered the most likely to develop a mature, infective trypanosome infection. This was confirmed during experimental infections where laboratory‐reared Glossina morsitans morsitans Westwood (Diptera: Glossinidae) were infected with Trypanosoma congolense or T. brucei brucei. The ability of mature adult tsetse flies to become infected with trypanosomes was significantly lower than that of newly emerged flies for both parasites. However, the nutritional status of the tsetse at the time of the infective bloodmeal affected its ability to acquire either a T. congolense or T. b. brucei infection. Indeed, an extreme period of starvation (3–4 days for teneral flies, 7 days for adult flies) lowers the developmental barrier for a trypanosome infection, especially at the midgut level of the tsetse fly. Adult G. m. morsitans became at least as susceptible as newly emerged flies to infection with T. congolense. Moreover, the susceptibility of adult flies, starved for 7 days, to an infection with T. b. brucei was also significantly increased, but only at the level of maturation of an established midgut infection to a salivary gland infection. The outcome of these experimental infections clearly suggests that, under natural conditions, nutritional stress in adult tsetse flies could contribute substantially to the epidemiology of tsetse‐transmitted trypanosomiasis.

High prevalence of drug resistance in animal trypanosomes without a history of drug exposure.

Background Trypanosomosis caused by Trypanosoma congolense is a major constraint to animal health in sub-Saharan Africa. Unfortunately, the treatment of the disease is impaired by the spread of drug resistance. Resistance to diminazene aceturate (DA) in T. congolense is linked to a mutation modifying the functioning of a P2-type purine-transporter responsible for the uptake of the drug. Our objective was to verify if the mutation was linked or not to drug pressure. Methodology/Principal Findings Thirty-four T. congolense isolates sampled from tsetse or wildlife were screened for the DA-resistance linked mutation using DpnII-PCR-RFLP. The results showed 1 sensitive, 12 resistant and 21 mixed DpnII-PCR-RFLP profiles. This suggests that the mutation is present on at least one allele of each of the 33 isolates. For twelve of the isolates, a standard screening method in mice was used by (i) microscopic examination, (ii) trypanosome-specific 18S-PCR after 2 months of observation and (iii) weekly trypanosome-specific 18S-PCR for 8 weeks. The results showed that all mice remained microscopically trypanosome-positive after treatment with 5 mg/kg DA. With 10 and 20 mg/kg, 8.3% (n = 72) and 0% (n = 72) of the mice became parasitologically positive after treatment. However, in these latter groups the trypanosome-specific 18S-PCR indicated a higher degree of trypanosome-positivity, i.e., with a unique test, 51.4% (n = 72) and 38.9% (n = 72) and with the weekly tests 79.2% (n = 24) and 66.7% (n = 24) for 10 and 20 mg/kg respectively. Conclusion/Significance The widespread presence of the DA-resistance linked mutation in T. congolense isolated from wildlife suggests that this mutation is favourable to parasite survival and/or its dissemination in the host population independent from the presence of drug. After treatment with DA, those T. congolense isolates cause persisting low parasitaemias even after complete elimination of the drug and with little impact on the hosts health.

Evaluating the use of packed cell volume as an indicator of trypanosomal infections in cattle in eastern Zambia

In this study, packed cell volume-values (PCV) are evaluated as indicator of trypanosomiasis infections in cattle. A total of 734 blood samples were collected in 11 different sampling sites in eastern Zambia: 84 calves (< 1 year), 52 young females and 40 young males (between 1 and 3 years), 228 cows, 317 oxen and 13 bulls (> 3 years). All samples were subjected to three diagnostic tests: parasitological examination using the buffy coat method, PCR/RFLP and PCV determination. The results were compared and analysed in a Bayesian model, which allowed the estimation of the infection prevalence and the respective test sensitivities and specificities. The presence of a trypanosomal infection significantly reduced the PCV, independently of the age and sex of the infected animal. The estimated prevalence of trypanosomal infections in the study area was 34% (95% credibility interval: 30-38%). While the specificity of both the parasitological and the PCR/RFLP tests were set to 1, the parasitological diagnosis had a low sensitivity (37%) compared to the PCR/RFLP (96%). When using a cut-off value of 24, the PCV had a high specificity (98%) but a rather low sensitivity (53%) for identifying trypanosomiasis infections. Using 26% as a cut-off increased the sensitivity to 76% without much affecting the specificity (94%). A parallel combination of the parasitological diagnosis and the PCV improved the diagnostic sensitivity (74% and 89% for PCV cut-off values of 24% or 26%, respectively) while specificity remained high (98% and 94% for PCV cut-off values of 24% or 26%, respectively). These results suggest that such a combination could advantageously be used for the diagnosis of cattle trypanosomiasis in the field: it is much more sensitive than parasitological examination alone and it is much cheaper than molecular tests. However, the value of this approach depends largely on the determination of an appropriate cut-off value to consider a sample positive, depending on the required test sensitivities and specificities.

Transmissibility of Trypanosoma brucei during its development in cattle

Recent outbreaks of Trypanosoma brucei rhodesiense sleeping sickness in Soroti District of eastern Uganda have demonstrated the important role cattle can play as reservoirs of this parasite. To clarify the epidemiological importance of the cattle reservoir, experiments were conducted to determine the ease with which T. brucei is transmitted during the course of its development in Friesian cattle. The development of T. brucei in cattle is characterized by an acute phase with high levels of parasitaemia and a decline in PCV. The acute phase is followed by a chronic phase during which the PCV remains low but stable and the parasitaemia is low. Parasites are often difficult to detect using parasitological diagnostic tools during this chronic phase. Challenge of chronically infected cattle with T. congolense results in a sudden increase in the T. brucei parasitaemia. Despite significant differences in parasitaemia, the proportion of tsetse flies that developed metacyclic infections after a first bloodmeal on the infected cattle did not differ significantly between the acute and chronic phases or the phase of mixed T. b. brucei/T. congolense infection. This suggests that, throughout the observation period, the parasitaemia was above the threshold above which infection rates of tsetse are independent of the parasitaemia. The repercussions of the research findings for the understanding of the epidemiology, spread and the control of T. b. rhodesiense sleeping sickness are discussed.

Personal protection by long-lasting insecticidal hammocks against the bites of forest malaria vectors

Objective  In Southeast Asia, malaria vectors bite outside the houses before bedtime, and forest dwellers rarely use insecticide‐treated nets (ITNs). Thus, we tested the protection of long‐lasting insecticidal hammocks (LLIH) using Olyset™ technology against exophagic vectors in two forest villages of Cambodia.

A cross-sectional study on bovine tuberculosis in Hawassa town and its surroundings, Southern Ethiopia

A cross-sectional study was conducted in Hawassa town and its surroundings from October 2007 to May 2008 to estimate the prevalence of bovine tuberculosis (BTB) based on comparative interadermal tuberculin test (CIDT) and abattoir survey. Accordingly, 39 herds comprising 413 cattle were subjected to CIDT, and the herd and individual animal prevalence were 48.7% (19/39) and 11.6% (48/413), respectively. One of the 16 milk samples collected from tuberculin-positive cows was culture positive. The prevalence significantly differed among the age group (P = 0.001) and management system (P = 0.001). Thus, age group over four (OR = 7.9) and animal with poor management system (OR = 4.1) had a higher odds for tuberculin reactivity compared to those with age group under four and cattle with good management system, respectively. Of the total 1,023 cattle subjected to postmortem examination, 11 (1.1%) were found to be positive for gross tuberculous lesions. Larger proportion (50%) of TB lesion was recorded in the respiratory pathway followed by digestive system (28.6%) and prescapular lymph nodes (21.4%). Of 14 tissue specimens collected from the gross lesions, four (28.6%) were positive for histopathological TB lesions. In conclusion, this study revealed the importance of BTB in the study area in particular and the region in general.

Nutritional stress affects the tsetse fly's immune gene expression.

Tsetse‐transmitted trypanosomiasis poses a serious threat to human and animal health in sub‐Saharan Africa. The majority of tsetse flies (Glossina spp.) in a natural population will not develop a mature infection of either Trypanosoma congolense or Trypanosoma brucei sp. because of refractoriness, a phenomenon that is affected by different factors, including the tsetse flys immune defence. Starvation of tsetse flies significantly increases their susceptibility to the establishment of a trypanosome infection. This paper reports the effects of nutritional stress (starvation) on (a) uninduced baseline levels of gene expression of the antimicrobial peptides attacin, defensin and cecropin in the tsetse fly, and (b) levels of expression induced in response to bacterial (Escherichia coli) or trypanosomal challenge. In newly emerged, unfed tsetse flies, starvation significantly lowers baseline levels of antimicrobial peptide gene expression, especially for attacin and cecropin. In response to trypanosome challenge, only non‐starved older flies showed a significant increase in antimicrobial peptide gene expression within 5 days of ingestion of a trypanosome‐containing bloodmeal, especially with T. brucei bloodstream forms. These data suggest that a decreased expression of immune genes in newly hatched flies or a lack of immune responsiveness to trypanosomes in older flies, both occurring as a result of fly starvation, may be among the factors contributing to the increased susceptibility of nutritionally stressed tsetse flies to trypanosome infection.

Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia

Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people’s approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective.