African Journal of Parasitology, Mycology and Entomology

Introduction: Malaria is one of the strongest known forces of evolutionary selection in the recent history of the human genome, having had important implications in human adaptation and in the response to its infections. The objective of this systematic review was to provide an update on human genetics that have been described as affecting the human susceptibility to malaria around the world and particularly in Africa. Methods: Through world wide web research vectors and using PubMed and Google Scholar, we reviewed relevant original articles, review papers, short reports, and peer-reviewed papers on human genetics factors described as related to human susceptibility to malaria. Here, we reviewed the literature on human genetic polymorphisms associated with protection from Plasmodium infections and/or disease. Results: After reviewing and summarizing 140 manuscripts, we found that several factors appeared to hamper an effective control of malaria, including the complex biology of Plasmodium parasites, parasite genetic diversity, environmental factors, resistance to antimalarial drugs, and the lack of a highly effective vaccine for public health use. Although the cellular and molecular regulatory mechanisms underlying the pathogenesis of disease are still not fully understood, it is well-established that genetic determinants of the host play an important role in the outcome of infection and the severity of the disease. Conclusions: The interaction between malaria parasites and humans has led to the selection of several inherited traits conferring protection against malaria, such as hemoglobinopathies, enzymopathies, and immunogenetic variation, whilst others’ polymorphism describes susceptibility to the infection. Full article

Introduction: The incidence of Candida infections is increasing worldwide. In clinical laboratories of resource-constrained countries, Candida speciation is commonly limited to germ tube tests and culture onto a chromogenic medium. In this study, we evaluated the diagnostic performance of Chromogenic Candida Lab-Agar^® (CCL) in identifying Candida species from clinical samples. Methods: We evaluated the diagnostic performance of CCL with 83 yeast isolates collected from 73 clinical samples at the laboratory department of Sourô Sanou University Hospital of Bobo-Dioulasso, Burkina Faso. Clinical specimens included vaginal swabs, urine, and blood cultures. After preliminary isolation on Sabouraud chloramphenicol agar, yeast isolates were inoculated onto the CCL medium and incubated at 35 °C for 48 h. Matrix-assisted laser desorption/ionisation time of flight mass spectrometry (MALDI-TOF MS) and ribosomal DNA internal transcribed spacer (ITS) sequencing were used as reference methods. Results: Among yeast species, Candida albicans was the most prevalent (43.4%), followed by C. krusei (13.3%), C. glabrata (12.0%), C. kefyr (8.4%), and C. tropicalis (7.2%). The overall agreement rate of CCL was 56.6% and varied across Candida species; it was 94.4% for C. albicans, 50% for C. glabrata, 18.2% for C. krusei, and 33.3% for C. tropicalis. Conclusions: This study showed that CCL had moderate accuracy in identifying Candida at the species level from clinical specimens in a routine laboratory in Burkina Faso. The misidentification of non-albicans species may expose patients to inadequate antifungal treatment. Therefore, identifying yeast in a routine based on CCL is not enough and should be associated with more accurate methods. Full article

Background—Mali was one of the first countries in sub-Saharan Africa to initiate a National Schistosomiasis Control Program (NSCP) in 1982. The WHO’s 2021–30 roadmap sets out the criteria for eliminating and controlling schistosomiasis as a public health problem. Our study aimed to assess the impact of annual mass drug distribution (MDD) of praziquantel (PZQ) on the prevalence and intensity in school-aged children (SAC) at NSCP sentinel sites (SSs). Methods—This study took place at twelve SSs in the Kayes and Koulikoro regions. Two-round cross-sectional studies were carried out in December 2014–2015 and in April 2018 after four to five years of annual MDD. Our sample size was 2439 schoolchildren aged 7 to 14 years, i.e., 485 in the first round (2014), 246 in the second round (2015) and 1708 in the third round (2018). Urine filtration and the Kato–Katz method were used for determining Schistosoma haematobium and S. mansoni eggs, respectively. Results—A total of 1708 samples were successfully examined. Of the twelve SSs treated from 2014–2015, one met the criterion for elimination of S. haematobium as a public health problem (prevalence of heavy-intensity infections (PHI) < 1%) (i.e., ≥50 S. haematobium eggs per 10 mL of urine or ≥400 S. mansoni eggs per g of stool) and four met the morbidity control criterion (PHI < 5%), while two sites remained below the morbidity control criterion (PHI > 5%). Five SSs had no heavy-intensity infections. The prevalence of S. mansoni was less than 1%. Conclusion—The impact of MDD of praziquantel in the SSs of the NSCP highlights that it has significantly reduced the PHI of schistosomiasis. However, the high prevalence of schistosomiasis or its increase in some sites requires in-depth studies. Full article

Introduction. In Côte d’Ivoire, current policy recommends the introduction of rapid diagnostic tests (RDTs) for malaria, including in the private sector, to facilitate effective case management. The main objective of the study was to examine the impact of introducing RDTs in private pharmacies with regard to national recommendations. Patients and methods. In order to assess knowledge, attitudes and practices after a few years of practice, a cross-sectional study was carried out from August to December 2015 among 300 professionals from private pharmacies (PPs) in the northern zone of the city of Abidjan. Results. Overall, PPs performing RDTs accounted for 25.1%. Fever (63.3%), headache (17.7%) and body aches (16.1%) were the main signs that led pharmacists to perform the test. The main criteria determining the choice of RDT are good sensitivity and specificity (45.6%), easy handling (42.6%) and lowest cost (11.8%). In 57.4% of cases, pharmacists performing RDTs said that the cost of the test (CFA 2000 or EUR 3 on average) is the main reason for non-acceptance by customers. In 97.1% of cases, the measures taken in the event of negative results were symptomatic treatment counselling followed by a medical consultation. In 2.9% of cases, some pharmacists recommended an antimalarial. On the other hand, in 92.6% of cases, the measures taken in the event of a positive result were antimalarial treatment with artemisinin-based combination therapies (ACTs). For pharmacies that did not carry out RDTs (74.9%), low customer demand was cited in 56.1% of cases. Conclusion. It would be appropriate for private pharmacy outlets to comply with the legislation by not carrying out RDTs within their pharmacies. Pending the implementation of these texts, it is imperative to improve on the shortcomings revealed. Full article

Introduction: Trichomonas vaginalis and Mycoplasma are common causes of sexually transmitted infections, but limited prevalence data are available in Senegal. This study aimed to determine the prevalence of T. vaginalis and genital mycoplasma infection among women in Dakar. Materials and Methods: A retrospective study was carried out between 2016 and 2021 among women referred to the microbiology laboratory of the Military Hospital of Ouakam for vaginal discharge. Mycoplasma was detected by a commercial Mycoplasma EIS Kit using the endocervical swab. A wet mount smear and Gram staining were performed to detect T. vaginalis. Results: We analyzed a group of 1889 women, ranging in age from 14 to 81, with a mean age of 32.5 years (+/− 8.3 years). Our findings showed that 18.5% (95% CI (16–20)) of the women were infected with Mycoplasma hominis, while 50.5% (95% CI (48–53)) had Ureaplasma urealyticum. Trichomonas vaginitis was found in 3.5% (95% CI (2.7–4.5)) of the women. Out of the 66 patients with trichomoniasis, 68.2% were also infected with Mycoplasma hominis and 36.4% with U. urealyticum. We also observed that 88% of the women with M. homininis infection had U. urealyticum. Conclusion: Our study revealed a significant co-infection rate between Trichomonas vaginalis and Mycoplasma. This highlights the need for systematic mycoplasma screening in patients with urogenital trichomoniasis. Full article

Background: In Mali, Chloroquine has been abandoned in 2005 because of the high in vivo and in vitro resistance rate of Plasmodium falciparum to this molecule. Artemisinin-based combination therapies (ACT) are currently recommended to treat uncomplicated malaria. Few antimalarials are in development. Assessing the prevalence of known antimalarial drug resistance markers might help in designing new combination regimens. This study aims to measure the dynamics of molecular markers of chloroquine in Kolle before, during and after chloroquine withdrawal. Method: Dried blood spot samples collected from previous drug efficacy studies conducted in Kolle between 2001 and 2015 were selected and Pfcrt and Pfmdr genes were genotyped for SNPs conferring resistance to chloroquine. Results: A total of 652 samples were analyzed. The overall prevalences of the mutant alleles Pfcrt 76T and Pfmdr1 86Y were 72.9% and 20%, respectively. The yearly prevalence rate for both mutant alleles remained constant from 2001 to 2015 (p > 0.05). Conclusion: The prevalence of the Pfcrt mutant allele remained high from 2001 to 2015 in Mali, although the prevalence of the Pfmdr1 mutant allele was low. Full article

Introduction: Schistosomiasis is classically described as a rural parasitic infection affecting deprived communities. In Mali, where Schistosoma haematobium and S. mansoni are endemic, the disease is also spreading to urban areas. Our study aimed to describe the prevalence and schistosomiasis maintenance factors in the district of Bamako. Materials and methods: An observational cross-sectional study was carried out in April 2023 involving schoolchildren randomly selected aged 6 to 14 years from Taliko (a peri-urban area crossed by the Woyowayanko river known as an important breeding and infestation habitat of snails) and Missabougou (an area subjected to social and environmental changes, including the development of the canal serving the district). Data on sociodemographics, symptoms, and human–water contact activities were recorded through a structured questionnaire. Filtration and Kato–Katz techniques were used for S. haematobium and S. mansoni diagnosis. Overall, 736 urine samples and 668 stool samples were examined. Multivariate logistic analysis was employed to test for associations between variables. Results: The prevalence of S. haematobium was 18.2% [95% CI: 14.5–21.8%] and that of S. mansoni was 8.1% [95% CI: 4.2–11.9%]. This prevalence was significantly higher in Taliko than in Missabougou: 34.4% [95% CI: 29.1–39.6%] versus 2.4% [95% CI: 0–8.0%] (p = 0.001) for S. haematobium and 12.1% versus 4.3% for S. mansoni (p = 0.001). In Taliko, children frequenting the river were significantly more affected with S. haematobium and hematuria and had higher parasite intensity (p < 0.05). Children with macroscopic hematuria who attended a school close to the river (p = 0.018) in Taliko, as well as children who used to urinate in water, were more infected (p < 0.05). In Missabougou, no significant variation in human–water contact activities was recorded. Conclusion: Our results show that S. haematobium and S. mansoni were still rampant in the district of Bamako; they also highlight that the use of water from the Woyowayanko river appears to be the major risk factor for the maintenance of schistosomiasis in the district of Bamako. Full article

Introduction: Human filariasis causes high morbidity and severe illness. There is a link between helminth infection and anemia. The objective of this study was to estimate the prevalence of blood-dwelling microfilariae among pregnant women in Burkina Faso using a molecular technique and attempt to find an association between anemia and filarial infection. Methods: A total of 1018 dried blood spot samples (DBS) were collected from pregnant women at the Health District of Nanoro. The DNA was isolated from DBS samples using a rapid and simple method. Afterward, the isolated DNA was assayed using the Filaria real-time PCR (F-RT-PCR) method. Results: Ten F-RT-PCR-positive samples were obtained as follows: two W. bancrofti (0.2%), four L. loa (0.39%), and four M. perstans (0.39%). No concomitant filarial infections were detected, as well as no coinfections between filarial disease and malaria. There was no link between the presence of W. bancrofti, L. loa, or M. perstans and anemia in pregnant women. Conclusions: The prevalence and intensity of human filariasis in this study were low for all of the samples in which microfilariae were detected. The F-RT-PCR can be a confirmatory test for diagnosis in remote areas due to its effectiveness in detecting and differentiating, both sensitively and specifically, a wide range of filarial parasites. Full article

Background: Malaria control in Senegal relies on antimalarial drugs like sulfadoxine–pyrimethamine (SP) for treatment and chemoprevention. Monitoring drug resistance markers is vital to ensure these interventions’ effectiveness. This study assessed the prevalence of SP resistance markers among pregnant women attending antenatal clinics in Senegal in 2019. Methods: Cross-sectional surveys were conducted during the high-transmission period of 2019 among pregnant women in low- and high-transmission areas. After obtaining consent, three dry blood spots on Whatman paper were collected. Samples were analyzed by real-time Polymerase Chain Reaction (RT-PCR) to detect the Plasmodium falciparum VarATS gene. Positive samples were genotyped by High-Resolution Melting for mutations in the dihydrofolate reductase and dihydropteroate synthase genes. Results: Six hundred samples positive for P. falciparum were analyzed. The population was predominantly young and resided in high-transmission areas. Key resistance mutations were detected at the following rates: PfdhfrII164L (11.7%), PfdhpsS436A (14.8%), PfdhpsA437G (19.0%), PfdhpsA581G (15.2%) and PfdhpsA613S (15.5%). The PfdhpsK540E mutation was not detected. The prevalence of these mutations was significantly higher in high-transmission areas. No significant differences in resistance markers were observed based on SP intake or gravidity. Conclusions: The low frequencies of SP resistance markers and the absence of the Pfdhps K540E mutation suggest that SP remains effective for malaria chemoprevention in Senegal. However, regular surveillance is crucial to monitor and contain any potential resistance of P. falciparum to SP and to track the evolution and spread of resistant parasites within malaria control areas. Surveys in antenatal clinics could be a good strategy for monitoring at low cost the emergence of resistance to SP. Full article

Introduction. Due to the lack of systemic antifungals (SAs), many invasive fungal infections (IFIs) do not yet benefit from effective treatment in Africa. Yet, fungi are a major threat to human health. This study aimed to assess the availability of SAs and compare this availability between West Africa (WA) and North Africa (NA). Materials and methods. The information processed was obtained during the same period between February and June 2021 in Senegal, Mauritania, and Côte d’Ivoire as well as in Morocco and Tunisia. In WA, data were received from wholesale drug suppliers and private pharmacies while in NA, the data were those available on the websites of the pharmacy and drug directorates. Results. All classes of SAs were available. However, this availability was not uniform depending on location, whether in WA or NA. Fluconazole and itraconazole were the only SA available in WA. In NA, all classes of SAs have been found, particularly in Morocco, while flucytosine was the only molecule absent in Tunisia. Conclusion. NA is ahead of WA as regards the burden of IFIs both diagnostically and in the availability of SAs. Studies on the epidemiology of IFIs in Africa, particularly in WA, are limited. The partial data available highlight that IFIs are not negligible, though these may be underestimated. Thus, a network based on the directory of African pharmacy and drug directorates must be set up and run in collaboration with the national laboratory directorates for the harmonization of procedures in order to reduce morbidity and mortality related to IFIs. Full article

Introduction: Microbial bioaerosols in indoor hospital air are one of the main potential sources of nosocomial infections. This study aimed to assess the composition of fungal bioaerosols in the indoor air of the Sourô Sanou University Hospital Center (SSUHC) in Burkina Faso. Methods: This study was carried out in two departments of the SSUHC. The indoor air sampling was carried out from August to December 2019. Sample collection was performed using the passive sedimentation method and incubated at 30 °C for 48 to 96 h. A total of 267 samples were analysed. Fungal identification was conducted based on the macroscopic and microscopic features of fungi. Results: Of the 267 samples analysed, 369 isolates belonging to 12 genera were identified. Aspergillus spp. was the most frequently isolated fungal agent with 64%, followed by Rhizopus spp. and Mucor spp. with 19.5% and 5.7%, respectively. Cladosporium spp., Penicillium spp., and Rhizomucor spp. accounted for 2.7%, 2.7%, and 1.9%, respectively. Among the genus Aspergillus spp., the most frequently isolated was A. niger (34.3%), followed by A. flavus (30.9%) and A. fumigatus (19.9%). Conclusions: This study showed that Aspergillus spp. is the most common fungal bioaerosol isolated in the indoor air of the SSUHC in Burkina Faso. Full article

Introduction : Le praziquantel est le seul médicament recommandé par l'Organisation Mondiale de la Santé pour traiter la schistosomose et cela suscite une inquiétude quant à une éventuelle résistance au médicament. Cette revue a pour objectif de faire la situation du praziquantel dans le traitement de la schistosomose chez les enfants d’âge scolaire en Afrique Sub-saharienne. Méthode : Cette revue a été réalisée en utilisant PubMed et Google Scholar. La revue incluait, les études de terrain portant sur l'efficacité du traitement de Schistosoma haematobium à base de praziquantel chez les enfants d’âge scolaire au niveau communautaire et/ou scolaire de 2005 en 2020 en Afrique Sub-saharienne. Les études exclues étaient celles qui ne répondaient pas aux critères d’inclusion. Résultats : Au total 11 articles inclus. Le praziquantel a montré des taux de guérison et une réduction de la prévalence chez les enfants jusqu’à 12 semaines après traitement. D’autres résultats, ont montré que des enfants traités sept semaines après l'administration du praziquantel continuaient d’expulser des œufs dans l'urine, aucun de ces œufs n'était viable. Le praziquantel à dose répétée de 40 mg/kg était plus efficace que la dose unique de 40 mg/kg. Conclusion : Un traitement de deux doses par an dans les zones à transmission élevée et une fois par an dans les zones à faible transmission, pourrait minimiser le risque de réinfection. Full article

Background: Malaria during pregnancy has adverse effects on both mothers and their offspring. To tackle this, the WHO proposed rapid case management and preventive measures delivered through ANC channels. However, a large proportion of pregnant women remain unprotected due to no or late attendance. In this context, our study aimed to assess the prevalence of malaria and associated risk factors in pregnant women receiving ANC for the first time. Methods: A total of 418 pregnant women who attended an ANC clinic in Nanoro, Burkina Faso were recruited. Venous blood (2 mL) was collected for study-associated investigations. Malaria microscopy was used as gold standard and hemoglobin was measured using Hemocue^®. Data analysis was performed using R Studio interface version 4.3.1. Results: The overall malaria prevalence was 20.4% (95% CI 18.5–22.4%). The geometric mean of parasite density was 442 parasites/μL (95% CI 380–515). In the univariate analysis, lower educational level, younger age, and lower parity were significant risk factors for malaria, while older age (≥25 years, OR 0.57, 95% CI 0.41–0.79) and multiparity (OR 0.50, 95% CI 0.33–0.74) were associated with a reduced risk of malaria parasitemia. Only 32/118 (27.1%) of the infections were associated with overt clinical symptoms such as fever. The prevalence of anemia (hemoglobin < 11.0 g/dL) was 60.8%. Malaria was significantly associated with increased odds of developing anemia. Conclusion: One out of five pregnant women attending their first ANC clinic visit in this high-transmission area had Plasmodium falciparum infection. Most infections were below 1000 asexual stage parasites/µL, without signs and symptoms suggestive of malaria, but were associated with anemia. There is a need to increase early ANC clinic attendance so mothers fully benefit from the existing malaria prevention strategies and to prevent unfavorable maternal and fetal birth outcomes in this population. Full article

Background: Artemisinin and its derivatives are key for the treatment of malaria (severe and uncomplicated). They are generally safe and well tolerated. However, some cases of hematological toxicity have been reported. In this study, we assessed hematological toxicity using new parameters derived from hematology analyzer, the XN-31. Methods: Data from prospective study which aims to assess the diagnostic accuracy of new hematology analyzer (the Sysmex XN-31) to detect malaria parasitemia were used. Data including the previous treatment and biological tests, including full blood count and malaria microscopy were recorded. Participants were divided into three groups based on malaria test result and treatment with artemisinin derivatives in: (i) malaria negative with no artemisinin treatment (Mal-/ACT-), (ii) malaria negative with artemisinin treatment (Mal-/ACT+) and (iii) malaria positive with artemisinin treatment (Mal+/ACT+). Erythropoiesis was assessed using reticulocytes absolutes count (Ret-Ab) and reticulocytes production index (RPI), and free hemoglobin level for hemolysis. Results: A total of 292 (31.0%) participants enrolled in the main diagnostic accuracy study were enrolled in this study; 140 (47.9%) received artemisinin derivatives treatment at admission and 93 (31.8%) had positive malaria smear. After multivariable analysis and adjustment for hemoglobin, age and C reactive protein (CRP), the delta Ret-Ab (measuring the baseline and follow-up levels) did not significantly differ in the Mal+/ACT+ (β=1.1, se(β)=5.4, p=0.8) and Mal-/ACT+ groups (β=5.1, se(β)=5.5, P=0.4) compared to Mal-/ACT- group. The same hold for the delta RPI. Free-Hb levels were elevated in the groups treated with ACT (Mal-/ACT+ and Mal+/ACT+) compared to Mal-/ACT-. However, this difference remains significant after adjustment for parasite density for only Mal+/ACT+ group with a median delta free hemoglobin of 0.4g/dl. Conclusion: Our study did not provide evidence of reticulocytopenia. However, post-treatment hemolysis with limited impact was observed. Artemisinin and its derivatives remain, therefore a well-tolerated potent antimalarial drug. Full article

Background Little data on malaria morbidity among African adults exposed since birth to intense malaria transmission are available. This study aimed to investigate malaria morbidity determinants among adults living in Dielmo village, Senegal, where a longitudinal epidemiological study was carried out over an 18-year period before the introduction of insecticide treated nets. Methods Between July 1990 and June 2008, a longitudinal study was carried out in Dielmo, a Senegalese village, among adults aged at least 15 years to evaluate determinants of P. falciparum clinical malaria attacks. Malaria diagnosis was confirmed by thick blood smear. Data were analyzed using a random-effect negative binomial regression. Results Of a total of 12,253 person-trimester observations, 768 P. falciparum uncomplicated clinical malaria attacks, and a series of biological and epidemiological parameters were analyzed. To be aged 30 years or more, combination therapy treatment period, and being born in the village of Dielmo were significantly associated with a lower risk of clinical malaria; while the third trimester of the year (rainy season) and pregnancy were significantly associated with an increased risk of clinical malaria. None of the biological parameters investigated were associated with the occurrence of malaria attacks. Conclusion This study provides longitudinal data on malaria among adults exposed to intense perennial transmission. It shows that the incidence of the disease among adults decreased first rapidly then progressively with age during the different treatment policies periods, with pregnancy as only individual major factor of increased risk of clinical malaria among those investigated in our study. Full article

Introduction: Mosquitoes and ticks are arthropods and are considered to be the main vectors of human and animal diseases worldwide. The aim of this study was to use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to identify ticks and mosquitoes in Côte d’Ivoire. Methods: Ticks were collected from sheep reared at the Institut Pasteur and mosquitoes from the institute's courtyard. Specimens were then identified using morphological and molecular techniques, before MALDI- TOF identification was attempted by testing the obtained spectra against those from an in-house MS arthropod spectra database. Tick-associated bacteria were also identified using molecular tools. Results: 16 and 47 mosquito and tick specimens were used, respectively. Morphologically, mosquitoes were identified to the Culex genus only and ticks were identified as Amblyomma variegatum (n=36; 76.60%) and Rhipicephalus (Boophilus) microplus (n=11; 23.43%) species. MALDI-TOF MS combined with molecular biology showed that 14 of the mosquitoes were Culex quinquefasciatus and the 36 tick specimens were confirmed to be A. variegatum and nine R. (B.) microplus. Tick screening showed the presence of DNA of Rickettsia africae in A. variegatum, and of Ehrlichia canis and Ehrlichia ruminantium in R. (B.) microplus. Conclusion: MALDI-TOF MS is a fast and efficient tool for identifying arthropods. The transfer of MALDI-TOF MS technology and staff training should be encouraged in African countries for use in medical entomology and microbiology. The detection of pathogen DNA in ticks is evidence of the existence and circulation of tick-borne diseases in humans and animals. Full article

Introduction: The onset of Plasmodium falciparum (P. falciparum) resistance to antimalarial drugs requires the careful surveillance of African parasite populations. Genomic tools are implemented to detect evolutionary changes that could impact malaria control and elimination strategies. Here, we evaluate the genome-wide pattern of selection and sequence variation in P. falciparum populations in Abidjan, Côte d’Ivoire. Methods: The study was conducted in three localities of Abidjan from 2013 to 2014. We collected 70 blood samples after receiving written informed consent from patients above two years of age. After extracting P. falciparum and human DNA from isolates, we performed whole-genome sequencing and used population genomics approaches to investigate the genetic diversity and complexity of infections and identify loci under positive directional selection. Results: We observed an excess of rare variants in the population, showing a clear mutation process in the isolates. Moderate Fst estimates (0.3) was detected for surfin, an immune invasion gene family. Seven iHS regions that had at least two SNPs with a score > 3.2 were identified. These regions code for genes that have been under strong directional selection. Two of these genes were the chloroquine resistance transporter (crt) on chromosome 7 and the dihydropteroate reductase (dhps) on chromosome 8. Our analyses showed that a recent selective sweep occurred for the erythrocyte membrane protein (Pfemp1). Conclusion: Our analyses identified genes under selective drug pressure and balancing selection on protective immune-specific genes. These findings demonstrate the effectiveness of genomics analyses to follow the evolution of malaria parasites and adopt appropriate strategies to eliminate malaria in Côte d’Ivoire. Full article

Introduction: Blastocystis sp. is an intestinal protozoan that is commonly reported, but whose clinical significance remains controversial. Clinical forms of this infection range from asymptomatic carriage to clinical signs, specifically gastrointestinal ones. There is a lack of data on the epidemiology of this protist in Gabon. This study was carried out to provide data on the frequency of Blastocystis sp. infection and its association with clinical signs and the haemoglobin rate. Methods: A cross-sectional study was conducted between September 2018 and November 2019. Stool samples were collected in five of the nine provinces of Gabon from children and adults. Sociodemographic and clinical data were recorded using a standardised pre-tested questionnaire. Haematological parameters and temperature were reported in a laboratory register. Parasitological diagnosis was performed using stool direct examination and a Merthiolate-Iodine-Formaldehyde (M.I.F) concentration to detect Blastocystis sp. Results: In total, 843 participants were interviewed and examined; 414 brought back stool samples. The frequency of Blastocystis sp. infection was 45.2% (n = 187/414), and it increased with age: from 20.0% in young children to 49.5% in adults (P = 0.0057). Being a male (P = 0.08) tended to be associated with Blastocystis sp. carriage. In the multivariate logistic regression, only males were associated with Blastocystis sp. infection and had a 4.3-fold higher risk of being infected than females did (adjusted odds ratio = 4.3; 95% CI = 1.2–15.6; P = 0.03). Diarrhoea, abdominal pain and colitis were observed in some patients with Blastocystis sp. monoinfection. No relation between Blastocystis sp. carriage and anaemia was found. Conclusion: The frequency of Blastocystis sp. infection was high. Males were more at risk of being infected. Blastocystis sp. could be used as indicator in the improvement of environmental sanitation and hygiene, coupled with improved housing. Additional investigations in a population with clinical symptoms should be performed. Full article

Background: Vulvovaginal infections are common in women. In Togo’s medical biology laboratories, routine diagnosis is often limited to filamentation testing, and the identification of fungal species is rarely performed. The aim of this study was to update the spectrum of Candida species isolated in vulvovaginitis and to determine their antifungal susceptibility profiles. Methods: Cross-sectional analytical study was carried out in women presenting leukorrhea received in two public laboratories in Lomé from June 2015 to October 2015. Socio-demographic and clinical data were collected through a structured questionnaire during an individual interview. Vulvovaginal samples were cultured in Sabouraud dextrose agar with chloramphenicol. Identification of fungi was determined by filamentation test and API 20C AUX^® gallery. The antifungal susceptibility profile was performed on five antifungal agents by a semi-solid medium microdilution technique of the ATB Fungus 3^® gallery. Results: Candida albicans/dubliniensis/africana complex was isolated in 51.6% of cases by API 20C AUX^® gallery. The same species were isolated by filamentation test in 12.3% of cases. All Candida species identified were sensitive to Voriconazole, whereas four species including Candida albicans/dubliniensis/africana complex had variable sensitivities compared to the five antifungal agents tested. Conclusions: This study demonstrated a high distribution of non-albicans species of Candida in Togo. Empirical treatment of candidiasis could contribute to increasing antifungal resistance. Routine fungi identification, at least by using an auxanogram test, could be instituted in medical laboratories to improve the therapeutic management of these diseases. Full article

Introduction: The Grand Magal de Touba (GMT) is the largest Muslim mass gathering in Senegal with a potential for infectious disease transmission. The objective of this study was to investigate pilgrims participating in this event for the presence of intestinal parasites, including soil-transmitted helminths (STHs). Method: The carriage of gastrointestinal STHs was assessed on rectal swabs (n = 513) taken with their consent, from cohorts of GMT pilgrims from two villages located in southern Senegal (2017–2022), and from patients consulting at the Mbacké health center in 2018 to 2021. RT-qPCR identification was performed to detect the presence of Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Ancylostoma duodenale and Stongyloides stercoralis. Result: Among cohort participants, only one pilgrim was positive for Entomoeba histolytica in a pre-Magal sample, and an acquisition rate of 2.8% for Giardia lamblia was noted. Among Mbacké patients suffering from diarrhea, 9.2% were positive for G. lamblia, 5.1% for Cryptosporidum sp. and 2.0% for E. histolytica. No samples tested positive for any helminths, either in the cohorts or in patients at the Mbacké health center. Conclusion: Our results confirm that STHs appear to have been eliminated in Diourbel. Empirical treatment of patients suffering from diarrhea at the GMT should not be based on drugs that are only active on helminths in the absence of obvious signs of helminthic infestation. However, infections with protozoa and notably with G. lamblia are still prevalent, both in asymptomatic pilgrims and in those suffering from diarrhea. Full article

Introduction: Severe anemia caused by severe malaria remains concentrated in children under 5 years old in Africa. In addition to blood-transfusion-related infections that pose a health concern, transfusion of severely anemic blood to a patient with severe anemia is another important concern. Method: Following the observation of a case of severe anemia in a blood donor, we conducted a secondary data analysis from a previous study to assess the frequency of anemia in blood donors in San, Mali. Results: In total, out of 140 volunteers, 13 (9%, 95% CI: 5.43–15.41) blood donors had moderate to severe anemia, based on Mali hemoglobin (Hb) normal values (10.5–16.5 g/dL, MRTC-GLP laboratory). In particular, we observed one case of severe anemia with an Hb level of 6.5 g/dL. Conclusions: To the best of our knowledge, this is the first report of severe anemia in blood donors in a malaria endemic area in Mali. Full article