Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence,Distribution, and Disease Burden

The neglected tropical diseases (NTDs) are the most common conditions affecting the poorest 500 million people living in sub-Saharan Africa (SSA), and together produce a burden of disease that may be equivalent to up to one-half of SSA''s malaria disease burden and more than double that caused by tuberculosis. Approximately 85% of the NTD disease burden results from helminth infections. Hookworm infection occurs in almost half of SSA''s poorest people, including 40–50 million school-aged children and 7 million pregnant women in whom it is a leading cause of anemia. Schistosomiasis is the second most prevalent NTD after hookworm (192 million cases), accounting for 93% of the world''s number of cases and possibly associated with increased horizontal transmission of HIV/AIDS. Lymphatic filariasis (46–51 million cases) and onchocerciasis (37 million cases) are also widespread in SSA, each disease representing a significant cause of disability and reduction in the region''s agricultural productivity. There is a dearth of information on Africa''s non-helminth NTDs. The protozoan infections, human African trypanosomiasis and visceral leishmaniasis, affect almost 100,000 people, primarily in areas of conflict in SSA where they cause high mortality, and where trachoma is the most prevalent bacterial NTD (30 million cases). However, there are little or no data on some very important protozoan infections, e.g., amebiasis and toxoplasmosis; bacterial infections, e.g., typhoid fever and non-typhoidal salmonellosis, the tick-borne bacterial zoonoses, and non-tuberculosis mycobaterial infections; and arboviral infections. Thus, the overall burden of Africa''s NTDs may be severely underestimated. A full assessment is an important step for disease control priorities, particularly in Nigeria and the Democratic Republic of Congo, where the greatest number of NTDs may occur.     

Climatic changes and the distribution of forest vertebrates in West Africa

Breaks in the distribution of forest mammals (of which the best data are for the primates), frogs and cyprinodont fishes and their subspeciations have been attributed by authors to the barriers presumably presented by a savanna gap formed by past extension of the Baoule V in the Côte d'Ivoire, by the present Dahomey Gap and by the course of the lower Niger. The potentials of these three features are considered and their history is discussed in the light of up-to-date geological and palaeo-climatological information. As part of the back-ground, evidence for the rate at which evolution can occur is summarized. The distributional data for each of the three classes and also for birds are then set out. Each class of animal is found to show different problems at taxonomic levels from the subspecies upwards.     

Aquatic Macroinvertebrate Assemblages of Ghana,West Africa: Understanding the Ecology of a Neglected Tropical Disease

Buruli ulcer (BU) is an emerging, but neglected tropical disease, where there has been a reported association with disturbed aquatic habitats and proposed aquatic macroinvertebrate vectors such as biting Hemiptera. An initial step in understanding the potential role of macroinvertebrates in the ecology of BU is to better understand the entire community, not just one or two taxa, in relation to the pathogen, Mycobacterium ulcerans, at a large spatial scale. For the first time at a country-wide scale this research documents that M. ulcerans was frequently detected from environmental samples taken from BU endemic regions, but was not present in 30 waterbodies of a non-endemic region. There were significant differences in macroinvertebrate community structure and identified potential indicator taxa in relation to pathogen presence. These results suggest that specific macroinvertebrate taxa or functional metrics may potentially be used as aquatic biological indicators of M. ulcerans. Developing ecological indicators of this pathogen is a first step for understanding the disease ecology of BU and should assist future studies of transmission.     

Zooplankton Spatial and Temporal Distribution in a Tropical Oceanic Area off West Africa

Tropical instability vortices are believed to modify the trophic food web by affecting plankton production. Such instabilities have been evidenced in a tuna fishing area of the Atlantic (10°–20° W and 2°–5° N). However, the origin of the tuna abundance remains uncertain as no data on zooplankton communities on which tuna preys are supposed to fed upon are available. This study was focused on short term spatial and diel variations of mesozooplankton communities sampled at 2° N during and after the passage of an instability wave evidenced from satellite imagery, at 4° N and at 0°, i.e. in the Equatorial divergence. Samples were collected with an opening–closing multisampler and with a WP2 net (200 μm). Copepods prevailed (86–92% of the total zooplankton) with Clausocalanidae, Oncaeidae, Corycaeidae, Calanidae, Eucalanidae as dominant families. At 0° and at 2° N during the wave, large-sized organisms constituted over 50% of total dry weight (DW). These percentages decreased after the wave and at 4° N. Zooplankton DW and densities were highest at 0° and lowest at 4° N. At 2° N after the wave, we observed a strong increase in the abundance of zooplankton which surpassed that at 0°. This increase mainly resulted from an increase in small copepods and copepodites. Our results suggest that the high production linked to the upwelling of nutrients caused by the geostrophic divergence is partly advected northward by the instability wave. The advection did not reach 4° N which displayed the characteristics of a typical tropical structure.     

First record of Melampodium divaricatum (Asteraceae) in West Tropical Africa

A plant that showed morphological closeness to Aspilia africana (Pers) C. D. Adams (Asteraceae) was spotted and collected in 2015 along Afe Babalola University road, Ado‐Ekiti, Ekiti State, Nigeria with coordinates 7°36′59.99″N, 5°12′60.00″E. However, upon closer observation some distinct and peculiar characteristics that clearly distinguished it from Aspilia africana were revealed, e.g. sterility of the disc florets and production of achenes by ray florets only. Another striking character of the plant was total emptying of the capitulum after achene maturation, leaving an empty capitulum cup on the plant. Literature and herbarium searches revealed that the plant had neither been reported from West Tropical Africa nor collected in any herbarium in Nigeria before. The plant was eventually identified as Melampodium divaricatum (L.) which is an annual erect herb, distributed in tropical and subtropical regions but mostly restricted to Mexico, North America and Central America. Morphological, reproductive and cytological studies carried out on the plant revealed it to possess a highly branched erect pigmented stem, simple opposite sub sessile leaves with acute apex and distantly serrated margins, capitula with yellow unisexual disc and ray florets, sterile disc florets, fertile ray florets, relatively high pollen fertility (92.85%), a somatic chromosome number of 2n = 24 and regular formation of 12 bivalents, indicating the plant to be a diploid species. Further studies on Melampodium in Nigeria and a general revision of the flora of West Tropical Africa is suggested as well as the need to monitor M. divaricatum in the region since it appears to have the capacity to become invasive.     

Association of Anaplasma marginale Strain Superinfection with Infection Prevalence within Tropical Regions

Strain superinfection occurs when a second strain infects a host already infected with and having mounted an immune response to a primary strain. The incidence of superinfection with Anaplasma marginale, a tick-borne rickettsial pathogen of domestic and wild ruminants, has been shown to be higher in tropical versus temperate regions. This has been attributed to the higher prevalence of infection, with consequent immunity against primary strains and thus greater selective pressure for superinfection with antigenically distinct strains. However an alternative explanation would be the differences in the transmitting vector, Dermacentor andersoni in the studied temperate regions and Rhipicephalus microplus in the studied tropical regions. To address this question, we examined two tropical populations sharing the same vector, R. microplus, but with significantly different infection prevalence. Using two separate markers, msp1α (one allele per genome) and msp2 (multiple alleles per genome), there were higher levels of multiple strain infections in the high infection prevalence as compared to the low prevalence population. The association of higher strain diversity with infection prevalence supports the hypothesis that high levels of infection prevalence and consequent population immunity is the predominant driver of strain superinfection.     

Impact of Climate Variability on Infectious Disease in West Africa

The importance of infectious disease as a determinant (as well as an outcome) of poverty has recently become a prominent argument for international and national investment in the control of infectious disease, as can be seen in the recently articulated United Nations (UN) Millennium Development Goals (MDGs). Climate variability and land use change have an enormous impact on health in West Africa, and may yet undermine the potential for achieving the MDGs, in certain economic-ecological zones. However, their underlying role in determining the burden of disease in the region on a yearly or decadal basis has never been systematically studied. In order to improve our understanding of the future impacts of climate change, it may be more effective to start by investigating the impact of inter-annual climate variability, and short-term shifts in climate (e.g., decadal), on disease transmission dynamics. This information may inform both current and future policy decisions with regard to prediction, prevention, and management of adverse climate-related health outcomes. This article reviews current knowledge of changes in the epidemiology of infectious diseases associated with climate variability in West Africa over the last 40 years. Selected examples are considered from bacterial (meningococcal meningitis), protozoan (malaria), and filarial (onchocerciasis and lymphatic filariasis) infections where spatial and temporal disease patterns have been directly influenced by seasonal, inter-annual, or decadal changes in climate.The views expressed herein are those of the authors and do not necessarily reflect the views of the National Oceanic and Atmospheric Administration (NOAA) or any of its sub-agencies.     

Zooplankton Variability in 49 Shallow Tropical Reservoirs of Ivory Coast (West Africa)

Zooplankton samples were collected from 49 small reservoirs of northern Ivory Coast in April 1997. Thirty taxa were identified, including 20 rotifers, 3 copepods and 6 cladocerans. The number of taxa per lake ranged between 12 to 22 and decreased with the total abundance of zooplankton. Copepods dominated standing biomass. Coinertia analysis suggested the role of seston food abundance, oxygen depletion and turbidity for zooplankton abundance and community structure. Rotifers, and particularly Brachionus angularis, Polyarthra and Filinia, were more abundant than copepods in the most eutrophic, turbid and deoxygenated reservoirs. The role of oxygen as a determinant of community structure is probably linked to the specific tolerance of taxa, but turbidity role could not be evaluated with certainty in the absence of information on visual predators.     

Additions to the foliicolous lichen flora of the Ivory Coast and Guinea (Tropical West Africa)

Four new foliicolous lichen species are described from the Ivory Coast (Tropical West Africa): Bapalmuia ivoriensis sp. nov., Chroodiscus africanus sp. nov., C. verrucosus sp. nov., and Lasioloma inexspectatum sp. nov. In addition, the new combination Calenia inconspicua comb, nova [Bas.: Heterothecium inconspicuum] is introduced. Lasioloma inexspectatum is the first species in the genus characterized by transversely septate ascospores and provides additional evidence for phylogenetic lines regarding the evolution of ascospore types in the lichen family Ectolechiaceae. In addition, 61 new records for the Ivory Coast and seven for Guinea are presented, increasing the number of species known in these areas to 161 and 124, respectively. Five species are new for tropical Africa, and six new for the Paleotropics. Further taxonomical and ecogeographical notes on the foliicolous lichen flora of tropical West Africa are provided.     

Genetic Diversity of Newcastle Disease Virus in Wild Birds and Pigeons in West Africa

In West and Central Africa, virulent Newcastle disease virus (NDV) strains of the recently identified genotypes XIV, XVII, and XVIII are enzootic in poultry, representing a considerable threat to the sector. The increasing number of reports of virulent strains in wild birds at least in other parts of the world raised the question of a potential role of wild birds in the spread of virulent NDV in sub-Saharan Africa as well. We investigated 1,723 asymptomatic birds sampled at live-bird markets and sites important for wild-bird conservation in Nigeria and 19 sick or dead wild birds in Côte d''Ivoire for NDV class I and II. Typical avirulent wild-type genotype I strains were found in wild waterfowl in wetlands in northeastern Nigeria. They were unrelated to vaccine strains, and the involvement of inter- or intracontinental migratory birds in their circulation in the region is suggested. Phylogenetic analyses also revealed that genotype VI strains found in pigeons, including some putative new subgenotype VIh and VIi strains, were introduced on multiple separate occasions in Nigeria. A single virulent genotype XVIII strain was found in a dead wild bird in Côte d''Ivoire, probably as a result of spillover from sick poultry. In conclusion, screening of wild birds and pigeons for NDV revealed the presence a variety of virulent and avirulent strains in West Africa but did not provide strong evidence that wild birds play an important role in the spread of virulent strains in the region.     

High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal,West Africa

Background

Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes.

Methods

We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review.

Results

One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01).

Conclusions

Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population.