Detection of Trypanozoon trypanosomes infections on Glossina fuscipes fuscipes (Diptera: Glossinidae) using polymerase chain reaction (PCR) technique in the Blue Nile State, Sudan

Tsetse flies transmit many species of trypanosomes in Africa, some of which are human and livestock pathogens of major medical and socio-economic impact. Identification of trypanosomes is essential to assess the disease risk imposed by particular tsetse populations. The present study was carried out to determine the trypanosomal infection rate of tsetse flies (Glossina fuscipes fuscipes) in the Blue Nile State of Sudan. A polymerase chain reaction (PCR) assay was used because of the inherent difficulty of speciating trypanosomal parasites in the fly. Our results show that 4.44% (8/180) of the flies were positive for a Trypanosoma brucei group. Three of eight positive flies reacted with primers for Trypanosoma b. rhodesiense. We did not detect flies infected with T. b. gambiense. Thus, the burden of flies harboring T. b. rhodesiense and T. b. brucei trypanosomes were 1.67 and 2.78%, respectively. This is the first evidence of T. b. rhodesiense in the Yabus District. Thus, HAT case-detection active surveillance and tsetse fly control campaigns should be conducted before the establishment of human settlement, investment of natural resources into agricultural and animal husbandry.Key words: Glossina fuscipes fuscipes, Trypanosoma brucei, T. b. gambiense, T. b. rhodesiense, infection rate, PCR technique, Blue Nile State

Tsetse Fly Infection Dynamics and its Implications with Control of Trypanosomiasis in Kajo-Keji County, South Sudan

A two-year study was conducted in Kajo-keji County South Sudan to evaluate tsetse fly infection dynamics which implicate the control of trypanosomiasis in the study area.Infection dynamics ofthe flieswas assessed and monitored using biconical traps.Captured flies were identified, segregated into sexes and age examined using wing fray and ovarian techniques for males and females, respectively. RIME-LAMP test was used to detectTrypanosome species in the midguts of wild tsetse flies.The non-parametric Wilcoxon Signed Rank Test was used to assess the difference in the number of the infected flies between the dry and the wet season counts.The mean infected G.f. fuscipes were: male 6 ±1.4, female 3 ± 1.0 and male 10 ± 2.0, female 3 ± 0.7 in the dry and wet seasons of the year 2011; male,6 ± 1.4,female 6 ±1.4 and male,10 ± 2, female3 ± 0.8 in the dry and wet seasons of 2012.Infection showed significant differences (Z=-2.03,  P = 0.04) with both seasons in 2011 and no significant differences (Z=-1.41, P = 0.16) in 2012. Number of infected male and female flies was positively correlated with the fly age in the dry (Male, R2=0.94; female, R2=0.86) and wet (Male, R2=0.97; female, R2=1) seasons in 2011 and (Male, R2=0.90; female, R2=0.94) in the dry and wet (Male, R2= 0.97 female, R2=1) seasons in 2012.These results showed thatG. f.fuscipeswere  infected with T.brucei gambiense and  they were proved  to be potential vectors for HAT in the study area. Hence, the implications of Tsetse fly infection dynamics in the control of trypanosomiasis need development of further control strategies for sustainable development of livestock and human resources in Kajo-keji County.

Phylogeography and Population Structure of Glossina fuscipes fuscipes in Uganda: Implications for Control of Tsetse

Glossina fuscipes fuscipes is the most common species of tsetse in Uganda, where it transmits human sleeping sickness and nagana, a related disease of cattle. A consortium of African countries dedicated to controlling these diseases is poised to begin area wide control of tsetse, but a critical question remains: What is the most appropriate geographical scale for these activities? To address this question, we used population genetics to determine the extent of linkage between populations of tsetse confined to discrete patches of riverine habitat. Our results suggest that Uganda was colonized by two distinct lineages of G. f. fuscipes, which now co-occur only in a narrow band across central Uganda. Evidence for interbreeding at the zone of contact and movement of genes from the south to the north suggest that this historical genetic structure may dissolve in the future. At smaller scales, we have demonstrated that exchange of genes among neighboring populations via dispersal is at equilibrium with the differentiating force of genetic drift. Our results highlight the need for investment in vector control programs that account for the linkage observed among tsetse populations. Given its genetic isolation and its location at the far edge of G. fuscipes' range, the Lake Victoria region appears to be an appropriate target for area wide control

Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically