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Colebunders, R.

Publications and source records attributed to Colebunders, R..

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Cameroonian blackflies (Diptera: Simuliidae) harbour a plethora of (RNA) viruses

Strong epidemiological evidence suggests that onchocerciasis may be associated with epilepsy - hence the name onchocerciasis-associated epilepsy (OAE). However, the pathogenesis of OAE still needs to be elucidated, as recent studies failed to detect Onchocerca volvulus in the central nervous system of persons with OAE. Therefore, it was suggested that a potentially neurotropic virus transmitted by blackflies could play a role in triggering OAE. To investigate this hypothesis, adult blackflies were collected in an onchocerciasis-endemic area with a high OAE prevalence in the Ntui Health District, Cameroon. A whole-genome shotgun sequencing approach was used to detect viral sequences in fifty-five pools of ten blackflies. A very high abundance of viral reads was detected across multiple (novel) viral families, including viral families associated with human disease. Although, no genomes closely related to known neurotropic viruses were found in the blackfly virome, the plethora of novel viruses representing novel species, genera and even families, warrant further exploration for their potential to infect vertebrates. These results could serve as a first step for studying the viruses associated with the hematophagous blackfly, which also could be present in their nematode host O. volvulus. Exploring the diversity of viruses in blackflies should be included in the active surveillance of zoonotic diseases.

microbiology↗

Identification of the onchocerciasis vector in the Kakoi-Koda focus of the Democratic Republic of Congo

BackgroundThe objective of this study was to characterise the vector in a small hyper-endemic focus of onchocerciasis (the Kakoi-Koda focus) which has recently been discovered on the western slopes of the rift valley above Lake Albert. Methodology/Principal FindingsAquatic stages of blackflies were collected by hand from streams and rivers, and anthropophilic adult females were collected by human landing catches. Using a combination of morphotaxonomy and DNA barcoding, the blackflies collected biting humans within the focus were identified as Simulium dentulosum and S. vorax, which were also found breeding in local streams and rivers. Simulium damnosum s.l., S. neavei and S. albivirgulatum were not found (except for a single site in 2009 where crabs were carrying S. neavei). Anthropophilic specimens from the focus were screened for Onchocerca DNA using discriminant qualitative real-time triplex PCR. One specimen of S. vorax was positive for Onchocerca volvulus in the body, and out of 155 S. dentulosum, 30% and 11% were infected and infective (respectively). Conclusions/SignificanceSimulium dentulosum currently appears to be the main vector of human onchocerciasis within the Kakoi-Koda focus, and S. vorax may be a secondary vector. It remains possible that S. neavei was the main (or only) vector in the past having now become rare as a result of the removal of tree-cover and land-use changes. Simulium vorax has previously been shown to support the development of O. volvulus in the laboratory, but this is the first time that S. dentulosum has been implicated as a vector of onchocerciasis, and this raises the possibility that other blackfly species which are not generally considered to be anthropophilic vectors might become vectors under suitable conditions. Because S. dentulosum is not a vector in endemic areas surrounding the Kakoi-Koda focus, it is probable that the Kakoi-Koda focus is significantly isolated. AUTHOR SUMMARYRiver blindness (=onchocerciasis) is a severely debilitating disease caused by the nematode parasite Onchocerca volvulus, and in Africa it is known to be transmitted from person to person by blood-sucking blackflies (Diptera: Simuliidae) of the Simulium damnosum complex, the S. neavei group and (rarely) by S. albivirgulatum. Using classical morphological characteristics and DNA analysis we have unexpectedly identified the vector blackfly as S. dentulosum (and possibly S. vorax) in a small endemic area (the Kakoi-Koda focus) which has been recently discovered on the western slopes of the rift valley in the Democratic Republic of Congo above Lake Albert. In the surrounding endemic areas, the vectors are S. damnosum complex and/or S. neavei (as normally expected), and because S. dentulosum is not a vector in these surrounding areas, it follows that this focus is entomologically isolated from immigrant blackfly species which might otherwise have carried new infections into the Kakoi-Koda focus (and vice-versa). This is of local importance, because it makes elimination of the parasite easier, but our findings have wider significance across Africa, because they raise the possibility that under the right conditions, other common and widely-distributed blackfly species might unexpectedly become man-biters and significant vectors.

ecology↗

Onchocerciasis-associated epilepsy in the Democratic Republic of Congo: Clinical description and relationship with microfilarial density

Background: High epilepsy prevalence and incidence were observed in onchocerciasis-endemic villages in the Democratic Republic of Congo (DRC). We sought to investigate the clinical characteristics of onchocerciasis-associated epilepsy (OAE), and the relationship with microfilarial density. Methods: In October 2017, ivermectin-naive persons with epilepsy (PWE) were recruited from onchocerciasis-endemic areas in the Logo health zone in the DRC. Additional PWE were enrolled in the Aketi health zone, where ivermectin had been distributed annually for 14 years. Past medical history, clinical characteristics and skin snips for Onchocerca volvulus detection were obtained from participants. Bivariate and multivariable analyses were used to investigate associations with microfilarial density. Results: Of the 420 PWE in the Logo health zone, 392 were skin snipped (36.5% positive). Generalized motor seizures were most frequent (392 PWE, 93.3%), and nodding seizures were reported in 32 (7.6%) participants. Twelve PWE (3.1%) presented Nakalanga features. More skin snip-positive participants reported a family history of epilepsy (p=0.027). Eighty-one onchocerciasis-infected PWE were recruited in the Aketi health zone. Positive correlations between seizure frequency and microfilarial density were observed in Logo (Spearman-rho=0.181; p=0.0003) and Aketi (Spearman-rho=0.228; p=0.046). In the multivariable analysis which adjusted for age, gender and previous anti-epileptic drug use, factors associated with high seizure frequency included: high microfilarial density (RR=1.004, 95% CI: 1.002-1.007; p<0.001), history of nodding seizures (RR=3.852, 95% CI: 2.926-5.082; p<0.001) and shorter duration of epilepsy (RR=0.948, 95% CI: 0.928-0.968; p<0.001). In Aketi, previous ivermectin use was associated with reduced seizures (RR=0.69, 95% CI: 0.58-0.83; p<0.001). Conclusion: In onchocerciasis-endemic regions in the DRC, a wide spectrum of seizures was observed. Nodding seizures, Nakalanga features, and a positive association between microfilarial density and seizures suggest a high OAE prevalence in the study villages, requiring a double management strategy: treatment with anti-epileptic drugs and stronger onchocerciasis elimination programs.

neuroscience↗