Entomological investigations carried out from 2002 to 2010 into the involvement of water bugs (Heteroptera - Hemiptera) in transmission of Mycobacterium ulcerans to humans in Côte d’Ivoire (West Africa)

Ulcer is a disease caused by a mycobacterium present in the environment: Mycobacterium ulcerans.This communicable disease occurs essentially in wet tropical regions, and in particular in west Africa where it is endemic. It is the third most common mycobacterial disease affecting humans after leprosy and tuberculosis, although it is more prevalent than either leprosy or tuberculosis in some rural areas of several countries (Benin, Côte d’Ivoire and Ghana). This has led WHO to act, and in 1998 to declare Buruli ulcer an « emerging disease » and to recognize it as a neglected tropical disease. Its development is a source of concern in Côte d’Ivoire, the country most affected in the world, with an aggregate number of 30 000 cases and more than 2000 cases detected each year. It particularly affects children living in isolated rural areas around bodies of stagnant or slowly flowing water.  In order to control the disease, it is essential fully to understand its epidemiology. In this connection, there are several hypotheses on the mode of transmission of M. ulcerans to humans. Since 1999, the involvement of water bugs belonging to the order of the hemiptera has been invoked by Portaels. In 2002, this hypothesis was confirmed by Marsollier et al. for water bugs of the genus Naucoris taken from the region of Daloa in Côte d’Ivoire, where the disease is endemic. In 2008, Portaels also found M. ulcerans in samples taken from the environment (Gerridae) in Ghana. In 2007, studies began in Côte d’Ivoire into the specific diversity, biology, ecology, ethology and role of aquatic heteroptera in the transmission of M. ulcerans to humans. Samples of aquatic heteroptera were collected each month from different aquatic environments in endemic areas of Côte d’Ivoire. The insects were identified by family, genus and occasionally species. Their distribution, population dynamics and ecological distribution in the water points investigated were correlated with human activities. Monospecific batches of water bugs were regularly composed in order to identify the molecular signatures of M. ulcerans using PCR at the bacteriology laboratory of the Institut Pasteur in Côte d’Ivoire and at the bacteriology laboratory of the Groupe d’Etudes des Interactions Hôtes-Pathogènes (Host-Pathogen Study Group) at the University Teaching hospital in Angers, France. Eighteen (18) species belonging to 8 families were identified. After the aquatic insects collected had been identified, 283 monospecific batches were composed and sent to the Institut Pasteur in Côte d’Ivoire (IPCI) for PCR. Twenty four (24) of the 283 batches i.e. 8,5% containing the following, 14 Diplonychus sp, 2 Naucoris sp, 3 Micronecta sp, 2 Ranatra fusca, 2 Anisops sp and 1 Laccotrephes ater, respectively belonging to the families Belostomatidae, Naucoridae, Corixidae, Ranatridae and Nepidae tested positive under PCR. Thirty five (35) samples of saliva were collected from specimens of the genus Diplonychus. Six of the samples (i.e. 17%) tested positive under PCR. Out of 109 other monospecific batches sent to the laboratory in Angers, France, 33 (i.e. 30%) tested positive under PCR. They comprised 11 batches of Diplonychus sp (Belostomatidae), 8 batches of Micronecta sp (Corixidae), 2 batches of Laccocoris sp (Naucoridae), 4 batches of Ranatra fusca (Ranatridae), 3 batches of Anisops sp, 1 lot de Anisops sardea et 1 lot de Enithares sp (Notonectidae), 2 batches of Plea pullula (Pleidae) and 1 batch of de Laccotrephes sp (Nepidae). Clearly, not only is Diplonychus sp the genus most commonly found, it is also that most affected by M. ulcerans. This justifies the decision to breed this genus in the laboratory since 2008, in order to improve our understanding of its biology and ethology and to standardize physical and chemical parameters so as to determine the best conditions for breeding the insect which would provide an animal model for experimental infections. We have now bred six successive generations in the laboratory. To conclude, although some aquatic heteroptera that host M. ulcerans are strictly phytophagous, (e.g. the Corixidae), the great majority of water bugs are carnivorous predators that are hosts and vectors of M. ulcerans. The absence of a reliable key for determining the family, genus and species in central and west Africa has led us to draw up an iconographic catalogue to determine the taxonomy of these insects

Biodiversity and implication of waters bugs in transmission of Mycobacterium ulcerans, etiological agent of Buruli ulcer in Côte d’Ivoire (West Africa)

Date du colloque&nbsp;: 04/2009</p

Biological diversity and the possible involvement of aquatic Hemiptera in the transmission of Mycobacterium ulcerans, an etiological agent of Buruli ulcer in Côte d’Ivoire (West Africa)

International audienc

The African Network for Improved Diagnostics, Epidemiology and Management of common infectious Agents

Background!#!In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa.!##!Methods!#!ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d'Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors.!##!Discussion!#!ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care