Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review

Background: Q fever is a common cause of febrile illness and community-acquired pneumonia in resource-limited settings. Coxiella burnetii, the causative pathogen, is transmitted among varied host species, but the epidemiology of the organism in Africa is poorly understood. We conducted a systematic review of C. burnetii epidemiology in Africa from a “One Health” perspective to synthesize the published data and identify knowledge gaps.<p></p> Methods/Principal Findings: We searched nine databases to identify articles relevant to four key aspects of C. burnetii epidemiology in human and animal populations in Africa: infection prevalence; disease incidence; transmission risk factors; and infection control efforts. We identified 929 unique articles, 100 of which remained after full-text review. Of these, 41 articles describing 51 studies qualified for data extraction. Animal seroprevalence studies revealed infection by C. burnetii (≤13%) among cattle except for studies in Western and Middle Africa (18–55%). Small ruminant seroprevalence ranged from 11–33%. Human seroprevalence was <8% with the exception of studies among children and in Egypt (10–32%). Close contact with camels and rural residence were associated with increased seropositivity among humans. C. burnetii infection has been associated with livestock abortion. In human cohort studies, Q fever accounted for 2–9% of febrile illness hospitalizations and 1–3% of infective endocarditis cases. We found no studies of disease incidence estimates or disease control efforts.<p></p> Conclusions/Significance: C. burnetii infection is detected in humans and in a wide range of animal species across Africa, but seroprevalence varies widely by species and location. Risk factors underlying this variability are poorly understood as is the role of C. burnetii in livestock abortion. Q fever consistently accounts for a notable proportion of undifferentiated human febrile illness and infective endocarditis in cohort studies, but incidence estimates are lacking. C. burnetii presents a real yet underappreciated threat to human and animal health throughout Africa.<p></p&gt

The optimization of epoxide-based tannage systems: an initial study

Liquid epoxide resins have an obvious potential as collagen crosslinkers, in particular as alternatives to the aldehydic-types used. In the work reported here, some conditions for the effective use of epoxides in tanning systems have been studied and identified based on hide powder trials. Few commercial aromatic epoxides are found to be water-soluble, and also have relatively low reaction rates, proving another disadvantage. In a series of screening tests, it has been found that an epoxide with aromatic groups in its backbone, used to treat collagen, produces higher hydrothermal stability than that treated with aliphatic epoxide. However, of the commercial aliphatic epoxide resins examined in this research, the water-soluble, tetra-functional pentaerythritol polyglycidyl ether, (e.g. Denacol EX 411), has been shown to be suitable for the leather tannage applications. Different types of waterborne epoxide resins, including emulsion and emulsifiable resins based on BDEGA (bisphenol A diglycidyl ether), have been examined but gave disappointing results. It is thought that difficulties here lie in trying to achieve good penetration into the collagen’s fibrous structure, of the particles that make up such emulsions. Late stage tannage, giving a leather product with high shrinkage temperature (Ts = 85ºC) has been achieved; here the system required catalyst to produce acceptable conversion within 3 hr at 50ºC. The important factors influencing the effectiveness of a particular tannage, are discussed

Epoxide tannage : a way forward

An understanding of both the reactive functions of epoxide resins and collagen, suggests that some epoxides could be effectively used in organic tannage systems. As such epoxides may be regarded as alternatives to aldehydic tanning systems, having lower toxicity combined with specific polymerization ability. The commercial and technical potential of epoxides as tanning agents are assessed in this review paper. To this end, an introduction to epoxide chemistry is provided based on the tanning chemist’s viewpoint. The literature survey describes epoxide-protein/collagen addition reaction mechanisms and their kinetics, which in turn are discussed with respect to the potential for future work, where these resins will be utilised in novel tanning technology. The potential risks associated with epoxides and modifications to conventional techniques of tanning, are also discussed

Isolation of Oropouche Virus from Febrile Patient, Ecuador.

We report identification of an Oropouche virus strain in a febrile patient from Ecuador by using metagenomic sequencing and real-time reverse transcription PCR. Virus was isolated from patient serum by using Vero cells. Phylogenetic analysis of the whole-genome sequence showed the virus to be similar to a strain from Peru

The impact of Loa loa microfilaraemia on research subject retention during a whole sporozoite malaria vaccine trial in Equatorial Guinea

Loa loa microfilariae were found on thick blood smears (TBSs) from 8 of 300 (2.7%) residents of Bioko Island, Equatorial Guinea, during a Plasmodium falciparum sporozoite malaria vaccine clinical trial. Only one subject was found to have microfilaraemia on his first exam; parasites were not discovered in the other seven until subsequent TBSs were performed, at times many weeks into the study. All infected individuals were asymptomatic, and were offered treatment with diethylcarbamazine, per national guidelines. L. loa microfilaraemia complicated the enrolment or continued participation of these eight trial subjects, and only one was able to complete all study procedures. If ruling out loiasis is deemed to be important during clinical trials, tests that are more sensitive than TBSs should be performed

Teaching emergency and disaster management in Australia: standards for higher education providers

The need for emergency and disaster professionals with multidisciplinary knowledge and holistic understanding is widely recognised. Despite this, there is currently no international nor an Australian consensus on a set of common standards for higher education that could ensure graduates possess knowledge and skills with sufficient commonality to facilitate interoperability in all facets of disaster management cycle. Thus, this research project aimed to develop a standards and an associated conceptual framework for higher education programs in emergency and disaster management. The Generic Emergency and Disaster Management Standards (GEDMS) were developed through a mixed qualitative research approach involving a systematic literature review, mapping of current course content offered in Australia and New Zealand, focus groups of experts and consultation with policy makers, industry representatives and other relevant stakeholders. The Standards consist of three main domains: knowledge, skills and application. Governance and policy frameworks, theoretical and conceptual basis for practice, and contemporary disaster management were identified as underlying themes for the knowledge domain. Leadership, communication, and collaboration were fitted under the skills domain. The professional practice, together with critical thinking, were considered the means by which knowledge and skills are applied

Infectious Etiologies of Acute Febrile Illness among Patients Seeking Health Care in South-Central Cambodia

The agents of human febrile illness can vary by region and country suggesting that diagnosis, treatment, and control programs need to be based on a methodical evaluation of area-specific etiologies. From December 2006 to December 2009, 9,997 individuals presenting with acute febrile illness at nine health care clinics in south-central Cambodia were enrolled in a study to elucidate the etiologies. Upon enrollment, respiratory specimens, whole blood, and serum were collected. Testing was performed for viral, bacterial, and parasitic pathogens. Etiologies were identified in 38.0% of patients. Influenza was the most frequent pathogen, followed by dengue, malaria, and bacterial pathogens isolated from blood culture. In addition, 3.5% of enrolled patients were infected with more than one pathogen. Our data provide the first systematic assessment of the etiologies of acute febrile illness in south-central Cambodia. Data from syndromic-based surveillance studies can help guide public health responses in developing nations

Genetic Characterization of Venezuelan Equine Encephalitis Virus from Bolivia, Ecuador and Peru: Identification of a New Subtype ID Lineage

Venezuelan equine encephalitis virus (VEEV) has been responsible for hundreds of thousands of human and equine cases of severe disease in the Americas. A passive surveillance study was conducted in Peru, Bolivia and Ecuador to determine the arboviral etiology of febrile illness. Patients with suspected viral-associated, acute, undifferentiated febrile illness of <7 days duration were enrolled in the study and blood samples were obtained from each patient and assayed by virus isolation. Demographic and clinical information from each patient was also obtained at the time of voluntary enrollment. In 2005–2007, cases of Venezuelan equine encephalitis (VEE) were diagnosed for the first time in residents of Bolivia; the patients did not report traveling, suggesting endemic circulation of VEEV in Bolivia. In 2001 and 2003, VEE cases were also identified in Ecuador. Since 1993, VEEV has been continuously isolated from patients in Loreto, Peru, and more recently (2005), in Madre de Dios, Peru. We performed phylogenetic analyses with VEEV from Bolivia, Ecuador and Peru and compared their relationships to strains from other parts of South America. We found that VEEV subtype ID Panama/Peru genotype is the predominant one circulating in Peru. We also demonstrated that VEEV subtype ID strains circulating in Ecuador belong to the Colombia/Venezuela genotype and VEEV from Madre de Dios, Peru and Cochabamba, Bolivia belong to a new ID genotype. In summary, we identified a new major lineage of enzootic VEEV subtype ID, information that could aid in the understanding of the emergence and evolution of VEEV in South America