onchocerciasis in guinea bissau, west africa · human onchocerciasi in guinesa bissa waus first...

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EPIDEMIOLOGY OF FILARIASIS CONCLUSION s more results from our ongoing studies in Cameroon and Nigeria become available, modifications and better adjustments of our model will be made. Rapid socio-econo- mic, ecological and cultural changes in rural areas of Africa influence the epidemiology of the major parasitic diseases in various ways. Some conclusions and recommendations may already be drawn from our work on onchocerciasis : - In the Cameroon Sudan savanna, where severe blinding onchocerciasis is hyperendemic, nomadic Bororo herdsmen nowadays increasingly come with their cattle into the rive- rine areas during the dry season, when the contrast bet- ween human and fly-population is closest, thus introducing a considerable effect of zooprophylaxis. - Keeping cattle throughout the year at strategic site bet- ween the village and the Simulium breeding river should afford the highest degree of protection. - The proportion of bloodmeals on the human population is very low at present (10 to 30 %). Individual protection from the bites of the flies must therefore not necessarily increase the risk for the non-protected part of the popula- tion, but on the other hand, the vectorial capacity of the local flies could increase considerably, if the availability of animal bloodhosts decreases or if the density of the human population increases. - The reservoir of O. ochengi in cattle could possibly be affected by anthelmintic treatment of cattle. Acaricide treat- ments (pour-on) repel biting Simulium flies thus increasing the proportion of bloodmeals on the human population and reducing the vaccination effect. - Mass distribution of ivermectin for treatment of human onchocerciasis will enhance the protective effects o f O. ocbengi L3 by reducing the proportion of O. volvulus L3 in the flies. Our present field-studies concentrate on the influence of cattle on the epidemiology of human onchocerciasis, but the way in which domestic animals influence other parasi- toses should also be considered. Investigations on the epi- demiological links between onchocerciasis, schistosomiasis and malaria are therefore suggested. REFERENCES DIETZ K. : The population dynamics of onchocerciasis. In : The population dynamics of infectious diseases : theory and applica- tions. R.M. Anderson ed. Chapman and Hall, London & New York, 1982, 209-241. DUKE B.O.L., MOORE P.J. & ANDERSON J. : A comparison of the Onchocerca volvulus transmission potentials of Simulium dam- nosum populations in four Cameroon rain-forest villages and the pattern of onchocerciasis associated therewith. Ann. Trap. Med. Parasitol, 1972, 66, 219-234. NELSON G. : Parasitic zoonoses. In : The biology of parasitism : a molecular and immunological approach. P.T. Englund and A. Sher (eds). New York : Alan R. Liss, MBL lectures in Biology, 1988, 9, 13-41. RATARD C. et al. • Human schistosomiasis in Cameroon. I. Distribution of schistosomiasis. Am. J. Trop. Med. Hyg., 1990, 42, 561-572. SOTA M.G. & MOGI M. : Effectiveness of zooprophylaxis in malaria control : a theoretical inquiry, with a model for mosquito popula- tions with two bloodmeal hosts. Med. Vet. Entomol., 1989, 3, 337-345. TAYLOR M.G., HUSSEIN M.F. & HARRISON RA. : Baboons, bovine and bilharzia vaccines. In :Parasitic helminths and zoonoses in Africa. C.N.L. Macpherson and P.S Craig (eds), London : Unwin Hyman, 1991, 237-259. ONCHOCERCIASIS IN GUINEA BISSAU, WEST AFRICA SANTOS GRACIO A.J.*, SHELLEY A.J.**, CHARALAMBOUS M.**, LOWRY C.A.**, GRACIO M.A.A.*, FORTE J.A.G.*, RAYBOULD J.**, MOLYNEUX D.*** AND NHAQUE A.T.**** KEY WORDS : onchocerciasis, simuliidae. Guinea Bissau INTRODUCTION uinea Bissau is a small country in West Africa with a population of about one million (130,000 in villages along the Geba river and 120,000 along the Corubal river). The country is divided into coastal lowlands of mangrove swamps, a high (200 m) plateau and hilly area in the south east and a lowland plateau area below 100 m altitude in the north east. The country is drained by four main rivers : the Geba, Corubal, Mansoa and Cacheu. The climate is charac- terised by a hot and rainy season from June to October and a dry season from November to May with annual rainfall varying between 1200 to 2750 mm and temperatures from 26° to 29° C. The vegetation in the north east of the coun- try is a mosaic of woodland and Sudan-Guinea savanna. Human onchocerciasis in Guinea Bissau was first recorded in 1956 by Lecuona at Paina Lenguer-Piche (close to the Corubal river). Later word (Lecuona, 1959) showed a preva- lence rate of 14.8 % in 2,585 persons examined at villages along the Corubal and Geba rivers and Simulium damno- sum s.l. was found naturally infected with filariae at two localities on the Corubal river. In I960 Lecuona presented a review of onchocerciasis and new data for the Sonaco region (Geba river) where he found Simulium damnosum s.l. Later, Tendeiro (1963) carried out an entomological sur- vey and found ten species of blackflies in the Geba and Corubal rivers : Simulium damnosum s.l., S. alcocki, S. garmsi (= 5. occidentale), S. diallonense, S. cervicornutum, S. unicornutum, S. ruficome, S. adersi and 5. hargreavesi. Most recently Abreu (1964) examined 482 persons and found 61.2 % positive for onchocerciasis in the Gabu region near the Corubal river and in 1965 found the same species of simuliids in the Corubal river as Tendeiro (1963). PARASITE PREVALENCE RATES sing weighed skin snips the prevalence of onchocer- L_J ciasis in Guinea Bissau was recorded between 1989 and 1993. Villages along the rivers Geba and Corubal were *Institutode Higiene e Medicina Tropical (Universidade Nova de Lisboa), Rua da Junqueira, 96 - 1300 Lisboa, Portugal. ** Medical and Veterinary Division, Entomology Department, The Natural History Museum, Cromwell Road, London SW7 5BD, U.K. *** Liverpool School of Tropical Medicine (formerly University of Salford), Pembroke Place, Liverpool L3 5QA, U.K. ***Centrode Medicina Tropical da Guine-Bissau, Guinea Bissau. 6 ito i OOA 1 1q Article available at http://www.parasite-journal.org or http://dx.doi.org/10.1051/parasite/199401s1006

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EPIDEMIOLOGY OF FILARIASIS

CONCLUSION

s more results from our ongoing studies in Cameroon and Nigeria b e c o m e available, modifications and better

adjustments o f our model will be made. Rapid soc io -econo­mic, ecological and cultural changes in rural areas o f Africa influence the epidemiology o f the major parasitic diseases in various ways. S o m e conclus ions and recommendat ions may already b e drawn from our work on onchocerc ias is :

- In the Cameroon Sudan savanna, where severe blinding onchocerc ias is is hyperendemic, nomadic Boro ro herdsmen nowadays increasingly c o m e with their cattle into the rive­rine areas during the dry season, w h e n the contrast bet­w e e n human and fly-population is closest , thus introducing a considerable effect o f zooprophylaxis . - Keeping cattle throughout the year at strategic site bet­w e e n the village and the Simulium breeding river should afford the highest degree o f protection. - T h e proportion o f b loodmeals on the human population is very low at present (10 to 30 % ) . Individual protection from the bites o f the flies must therefore not necessar i ly increase the risk for the non-protected part o f the popula­tion, but on the other hand, the vectorial capacity o f the local flies could increase considerably, if the availability o f animal bloodhosts decreases o r if the density o f the human population increases. - T h e reservoir o f O. ochengi in cattle could possibly b e affected by anthelmintic treatment o f cattle. Acaricide treat­ments (pour-on) repel biting Simulium flies thus increasing the propor t ion o f b loodmea l s on the h u m a n popula t ion and reducing the vaccination effect. - Mass distribution o f ivermectin for treatment o f human o n c h o c e r c i a s i s will e n h a n c e the protec t ive effects o f O. ocbengi L3 by reducing the proportion o f O. volvulus L3 in the flies.

Our present field-studies concent ra te on the influence o f cattle on the ep idemio logy o f human onchocerc ias i s , but the way in which domest ic animals influence other parasi­toses should also b e considered. Investigations on the epi­demiological links be tween onchocercias is , schistosomiasis and malaria are therefore suggested.

REFERENCES DIETZ K . : The population dynamics of onchocerciasis. In : The

population dynamics of infectious diseases : theory and applica­tions. R . M . Anderson ed. Chapman and Hall, London & New York, 1982, 209-241.

DUKE B.O.L., MOORE P.J. & ANDERSON J . : A comparison of the

Onchocerca volvulus transmission potentials of Simulium dam-nosum populations in four Cameroon rain-forest villages and the pattern of onchocerciasis associated therewith. Ann. Trap. Med. Parasitol, 1972, 66, 219-234.

NELSON G . : Parasitic zoonoses. In : The biology of parasitism : a molecular and immunological approach. P.T. Englund and A. Sher (eds). New York : Alan R. Liss, MBL lectures in Biology, 1988, 9, 13-41.

RATARD C. et al. • Human schis tosomias is in Cameroon. I. Distribution of schistosomiasis. Am. J. Trop. Med. Hyg., 1990, 42, 561-572.

SOTA M . G . & MOGI M. : Effectiveness of zooprophylaxis in malaria control : a theoretical inquiry, with a model for mosquito popula­

tions with two bloodmeal hosts. Med. Vet. Entomol., 1989, 3, 337-345.

TAYLOR M.G., HUSSEIN M.F. & HARRISON RA. : Baboons, bovine and

bilharzia vaccines. In :Parasitic helminths and zoonoses in Africa. C.N.L. Macpherson and P.S Craig (eds), London : Unwin Hyman, 1991, 237-259.

ONCHOCERCIASIS I N GUINEA B I S S A U , W E S T AFRICA SANTOS GRACIO A.J.*, SHELLEY A.J.**, CHARALAMBOUS M.**, LOWRY C.A.**, GRACIO M.A.A.*, FORTE J.A.G.*, RAYBOULD J.**, MOLYNEUX D.*** AND NHAQUE A.T.****

KEY WORDS : onchocerciasis, simuliidae. Guinea Bissau

INTRODUCTION

uinea Bissau is a small country in Wes t Africa with a populat ion o f about o n e million ( 1 3 0 , 0 0 0 in villages

along the G e b a river and 120 ,000 along the Corubal river). T h e country is divided into coastal lowlands o f mangrove swamps, a high ( 2 0 0 m) plateau and hilly area in the south east and a lowland plateau area b e l o w 100 m altitude in the north east. T h e country is drained by four main rivers : the Geba , Corubal, Mansoa and Cacheu. T h e climate is charac­terised by a hot and rainy season from J u n e to Oc tobe r and a dry season from November to May with annual rainfall varying be tween 1200 to 2 7 5 0 m m and temperatures from 26° to 29° C. T h e vegetation in the north east o f the coun­try is a mosa ic o f woodland and Sudan-Guinea savanna.

Human onchocerc ias is in Guinea Bissau was first recorded in 1956 by Lecuona at Paina Lenguer-Piche (c lose to the Corubal river). Later word (Lecuona, 1959) showed a preva­lence rate o f 14.8 % in 2,585 persons examined at villages along the Corubal and G e b a rivers and Simulium damno-sum s.l. was found naturally infected with filariae at two localities on the Corubal river. In I 9 6 0 Lecuona presented a r ev i ew o f o n c h o c e r c i a s i s and n e w data for the S o n a c o region ( G e b a river) where he found Simulium damnosum s.l. Later, Tendei ro ( 1 9 6 3 ) carried out an entomologica l sur­vey and found ten spec ies o f blackflies in the G e b a and Coruba l rivers : Simulium damnosum s.l., S. alcocki, S. garmsi (= 5. occidentale), S. diallonense, S. cervicornutum, S. unicornutum, S. ruficome, S. adersi and 5. hargreavesi. Most r ecen t ly Abreu ( 1 9 6 4 ) e x a m i n e d 4 8 2 p e r s o n s and found 61 .2 % positive for onchocerc ias i s in the Gabu region near the Corubal river and in 1965 found the same species o f simuliids in the Corubal river as Tende i ro ( 1 9 6 3 ) .

PARASITE PREVALENCE RATES

sing weighed skin snips the prevalence o f onchoce r -L _ J ciasis in Guinea Bissau was recorded b e t w e e n 1989

and 1993. Villages along the rivers G e b a and Corubal were

* Instituto de Higiene e Medicina Tropical (Universidade Nova de Lisboa), Rua da Junqueira, 96 - 1300 Lisboa, Portugal. ** Medical and Veterinary Division, Entomology Department, The Natural History Museum, Cromwell Road, London SW7 5BD, U.K. *** Liverpool School of Tropical Medicine (formerly University of Salford), Pembroke Place, Liverpool L3 5QA, U.K. *** Centro de Medicina Tropical da Guine-Bissau, Guinea Bissau.

6 ito i O O A 1 1 q

Article available at http://www.parasite-journal.org or http://dx.doi.org/10.1051/parasite/199401s1006

FPIDFMIOLOGY OF FILARIASIS

mainly investigated, a l though o ther parts o f the country

were visited to a lesser extent. Onchocerc ias i s was found

only in villages along the former two rivers. No infected

individuals w e r e r e c o r d e d from 9 8 7 p e o p l e s a m p l e d at

thirty-five loca l i t i es in the r eg ions o f C a c h e u , O i o and

Tombali outside the known foci.

O f 516 people examined in six villages along the Geba river

102 (19 % ) were infected with the disease. The data show

that the disease was more prevalent in the older age groups.

Skin densities were relatively low with the majority o f infec­

ted individuals having less than 15 mff/mg.

Investigations in villages along the Corubal river showed that

316 (37 % ) o f 833 individuals examined were infected. An

analysis o f the disease in relation to age and sex shows that

although larger numbers o f older people were infected the

disease was also significant in younger males. Skin densities

were also higher than for individuals from villages along the

G e b a river.

Typical symptoms o f onchocerciasis were seen in infected

individuals and 48 o f the infected people were blind (31

males and 17 females). In most cases this was due to the pre­

sence o f microfilariae in the eye.

The data presented indicate that the more important o f the

two foci is that o f the Corubal river. Irrigation schemes along

the upper reaches o f the Geba river have drastically reduced

water flow and transmission is bel ieved to be only sporadic

or even absent because o f the paucity o f S. damnosum s.l. in

this area.

SIMULIIDAE

' "TPhe distribution o f Simuliidae in Guinea Bissau was inves-

I tigated (Gracio et al., in press) and identification o f the

cytospecies o f the Simulium damnosum complex made at

l o c a l i t i e s w i t h i n a n d a d j a c e n t to t h e C o r u b a l f o c u s

(Charalambous et al., in press).

Only S. sirbanum and S. konkourense were found along the

Corubal river be tween March 1990 and November 1992. The

former species predominated at localities along the upper

reaches and the largely zoophil ic S. konkourense was the

m a i n c y t o f o r m a l o n g t he l o w e r r e a c h e s o f t he r iver .

Morphometric analysis o f cytotyped larvae showed these two

cytotaxa o f S. damnosum could be separated using the num­

ber o f rows o f hooks in the posterior circlet and the number

o f hypstomial setae. Unfortunately, this differentiation o f the

two cytotypes contained a large percentage o f overlap so

that unequivocal identifications could only be made for spe­

cimens in the extremes o f the combined range (Lowry et al.,

in prep.).

Entomological surveys showed the presence o f the following

simuliid species associated with the Geba and Corubal river

basins : Simulium alcocki, S. gartnsi, S. djallonense, S. cervi-

cornutum, S. unicornutum, S. ruficorne, S. adersi, S. tridens

and S. hargreavesi.

p a r e f i l a r i a l d e v e l o p m e n t in t h e t w o c y t o s p e c i e s .

Insufficient numbers o f S. konkourense precluded the com­

pletion o f the experiment .

REFERENCES

ABREU M.M. , MARINI A. : Contribuicäo para o estudo da oncocercose na Guiñé Portuguesa (Foco do Rio Corubal). Bol. Cult. Guiñé Port., 1964, 19, 433-453 (also published in Rev. Est. Ger. Univ. Mozambique, 1964, 1, 3-23.

ABREU M.M. , MARINI A. : Contribuicäo para o estudo dos Simuliidae (Díptera : Nematocera) da Guiñé Portuguesa. Estudo realizado na bacia hidrográfica do Rio Corubal. Bol. Cult. Guiñé Port., 1965, 20, 35-65.

CHARALAMBOUS M., SHELLEY A.J . & GRACIO A.J . dos Santos : Cytogene-

tical analysis of the Simulium damnosum complex (Diptera : Simuli idae) in Guinea Bissau. Medical and Veterinary Entomology, in press.

GRACIO A . J . dos Santos, SHELLEY A J . , RAYBOULD J . & NHAQUE A.T . :

The blackfl ies (Diptera : Simuli idae) o f Guinea Bissau. Systematics , distribution and b ioeco log ica l data. Acta Parasitológica Portuguesa. 1994, 2 (1), in press.

LECUONA M . O . : Nota previa sobre a existencia da oncocer-cose na Guiñé Portuguesa (primeiro caso registado). An. Inst. Med. trop., 1956. 13 (1/2), 83-87.

LECUONA M . O . : Primeiros dados sobre a distribuieäo da oncocer­cose na Guiñé Portuguesa. An. Inst. Med. trop., 1959, 16(1/4), 199-208.

LECUONA M . O . : A oncocercose e o seu interesse médico-social na Guiñé Portuguesa. Subsidios para o estudo epidemiológico do foco de Sonaco. Bol. Cult. Guiñé Port., I960, 15(58), 193-237.

LOWRY C.A., CHARALAMBOUS M., SHELLEY A.J . , GRACIO A.J . dos Santos

& HOWARD T.M. : Identification of larvae in the Simulium dam­nosum complex (Diptera : Simuliidae) from Guinea Bissau using multivariate morphometric analysis. In preparation.

TENDEIRO J . : Estudos sobre simúlios na Guiñé Portuguesa. García de Orta, 1963, 7 7 (2), 243-252.

TRANSMISSION OF ONCHOCERCA VOLVULUS, 0. OCHENGI AND TYPE D FILARIAE BY SIMULIUM DAMNOSUM S.L. IN NORTH CAMEROON AND ITS INFLUENCE ON THE EPIDEMIOLOGY OF HUMAN ONCHOCERCIASIS WAHL G.*, ENYONG P.**, SCHIESEL J.M.***, NGOSSO A.****, TUBBESING H.*****, MOYOU R.**, & RENZ A.******

KEY WORDS : Onchocerca volvulus. Onchocerca ochengi. Simulium damnusum. North Cameroon.

INTRODUCTION

E arlier studies in North-Cameroon showed that the pro­

portion o f non- Onchocerca volvulus filarial larvae in

the onchocerc ias i s vectors (Simulium damnosus s.l.) was

BITING BEHAVIOUR AND HOST CAPACITIES

dult S. sirbanum and S. konkourense were co l lec ted

biting man and large numbers o f the former cytospe­

cies were experimental ly infected with O. volvulus to com-

* Institut für Tropenmedizin, Universität Tübingen, Germany. ** Medical Research Station, Kumba, Cameroon. *** Lehrstuhl für Populationsgenetik, Universität Tübingen, Germany. **** Hôpital Central, Yaounde, Cameroon. ***** Hôpital Protestant, Ngaoundéré, Cameroon. ****** Fachgebiet Parasitologic Universität Hohenheim, Germany.

Parasite. 1994. ?. I S 7