Taenia solium Cysticercosis in the Democratic Republic of Congo: How Does Pork Trade Affect the Transmission of the Parasite?

Taenia solium is a parasite that can affect both humans and pigs, causing important economic losses in pig production and being the main cause of acquired epilepsy in endemic areas. However, the parasite has been neglected in many African countries and particularly in the Democratic Republic of Congo (DRC), where recent data are non-existent. The present study is part of a first initiative to assess whether cysticercosis is actually present in DRC and to estimate its potential economic and public health importance. Focusing our work on porcine cysticercosis, we demonstrated high prevalence figures of active infections in villages in a rural area of DRC and in markets in the city of Kinshasa. Moreover, the intensity of infection was higher in pigs sampled in villages as compared to pigs sampled on urban markets. Preliminary surveys conducted in parallel in both study sites suggest an effect of pork trade on the transmission of the parasite selecting highly infected pigs at village level

Contribution of PEPFAR-Supported HIV and TB Molecular Diagnostic Networks to COVID-19 Testing Preparedness in 16 Countries.

The US President's Emergency Plan for AIDS Relief (PEPFAR) supports molecular HIV and tuberculosis diagnostic networks and information management systems in low- and middle-income countries. We describe how national programs leveraged these PEPFAR-supported laboratory resources for SARS-CoV-2 testing during the COVID-19 pandemic. We sent a spreadsheet template consisting of 46 indicators for assessing the use of PEPFAR-supported diagnostic networks for COVID-19 pandemic response activities during April 1, 2020, to March 31, 2021, to 27 PEPFAR-supported countries or regions. A total of 109 PEPFAR-supported centralized HIV viral load and early infant diagnosis laboratories and 138 decentralized HIV and TB sites reported performing SARS-CoV-2 testing in 16 countries. Together, these sites contributed to >3.4 million SARS-CoV-2 tests during the 1-year period. Our findings illustrate that PEPFAR-supported diagnostic networks provided a wide range of resources to respond to emergency COVID-19 diagnostic testing in 16 low- and middle-income countries

Epidemiology of polyparasitism with Taenia solium, schistosomes and soil-transmitted helminths in the co-endemic village of Malanga, Democratic Republic of Congo.

Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD

Are the children with epilepsy treated traditionally a disadvantaged group? A pilot study

peer reviewedIntroduction: in sub-Saharan Africa, the proportion of persons with epilepsy who seek traditional treatment is estimated at 80%. Despite that children are the firsts concerned by epilepsy, the characteristics and particularities of the children with epilepsy (CWE) who resort to traditional treatment are not known. The aim of this pilot study was to identify clinical particularities of the CWE who resort to traditional treatment. Methods: CWE between 6 to 17 years were included in the study based on their histories of previous antiepileptic treatments. The CWE previously treated by traditional healers were compared to others CWE. Results: data from 140 CWE whose previous treatments had been documented were selected. The duration of epilepsy (7 [3.0-9.8] years versus 3 [1.0-7.0] years, p=0.013) was higher for the CWE traditionally treated compared to the CWE without any antiepileptic treatment. The seizure frequency (8.7 [1.5-91.3]/month versus 1 [3-30.4]/month, p=0.036) was higher for the CWE traditionally treated compared to the CWE without any antiepileptic treatment, but the p-value was under the Bonferroni correction (p=0.017). There was no differences between the CWE traditionally treated and the CWE previously treated with antiepileptic drugs. Conclusion: compared to others, the CWE who resort to traditional medicine spend much time before consulting health facilities and could have a more serious epilepsy. We have discussed on factors that could explain these differences

Origins of the pigs included in the market study.

<p>Origins of the pigs included in the market study.</p

Proportion of infected pigs in function of their intensity of infection as reflected by the value of the ratio resulting from the ELISA for detection of circulating antigens.

<p>Four classes have been arbitrarily defined: 1≤ratio<2 (low intensity), 2≤ratio<5 (medium intensity), 5≤ratio<10 (high intensity), ratio ≥10 (very high intensity).</p

Proportion of pigs with active cysticercosis as determined by antigen ELISA (white bars) and tongue inspection (grey bars).

<p>The proportions are presented per province for the pigs sold on the markets and as overall prevalence measured in the villages (BD  =  Bandundu, BC  =  Bas-Congo, EQ  =  Equateur and KN  =  Kinshasa). Upper and lower exact 95% binomial confidence intervals are represented through error bars.</p