A case-control study was carried out in 3 highly endemic regions of Cote d’Ivoire to study risk factors for Buruli ulcer. A case was defined as a Buruli ulcer occurring less than one year before the date of survey, resident in one of the regions investigated and there was no history of Buruli ulcer illness. Controls were selected from the general population by a two stage cluster sampling method. A total of 116 cases and 116 controls were included. For the cases, the male/female sex ratio was 0.84, the median age was 19.5 years and 40.5% were children 15 years. Biological results were obtained for 86 (74%) cases using skin exudate samples. Positive rates were 22.0, 22.1 and 27.9% respectively for smear examination, culture and PCR IS2404, respectively. After adjusting for possible confounders, no history of BCG vaccination (ORa = 5.0, CI 1.7 - 14.3), presence of a case 15 years (ORa = 8.3, CI 2.8 -24.1), having a river/lake/dam near the housing (ORa = 4.4, CI 1.6 - 12.2) and the type of place for fishing (p = 0.001) were associated with illness. Young children and women having daily water related activities were most at risk. Swab samples were not sensitive enough for Buruli ulcer diagnosis. There is an urgent need for a rapid field test to diagnosis Buruli Ulcer as PCR IS2404 remains expensive for most of the endemic countries.
Pathogens often encounter stressful conditions inside their hosts. In the attempt to characterize the stress response in Brucella suis, a gene highly homologous to Escherichia coli clpB was isolated from Brucella suis, and the deduced amino acid sequence showed features typical of the ClpB ATPase family of stress response proteins. Under high-temperature stress conditions, ClpB of B. suis was induced, and an isogenic B. suis clpB mutant showed increased sensitivity to high temperature, but also to ethanol stress and acid pH. The effects were reversible by complementation. Simultaneous inactivation of clpA and clpB resulted in a mutant that was sensitive to oxidative stress. In B. suis expressing gfp, ClpA but not ClpB participated in degradation of the green fluorescent protein at 42 degrees C. We concluded that ClpB was responsible for tolerance to several stresses and that the lethality caused by harsh environmental conditions may have similar molecular origins.
Detection of circulating influenza strains is a key public health concern especially in limited-resource settings where diagnosis capabilities remain a challenge. As part of multi-site surveillance in Côte d'Ivoire during the 2009 influenza A(H1N1) pandemic, we had the opportunity to test respiratory specimens collected from patients with acute respiratory illness (ARI). We analyzed and compared the percentage of specimens testing positive using three laboratory methods (rtRT-PCR, ELISA, viral culture). From January to October 2009, 1,356 respiratory specimens were collected from patients with acute respiratory illness and shipped at the WHO NIC (Institut Pasteur) Cote d'Ivoire, and 453 (33%) tested positive for influenza by one or more laboratory methods. The proportion of positive influenza tests did not differ by the sex or age of the patient or presenting symptoms, but did differ depending on the timing and site of specimen collection. Of the 453 positive specimens, 424 (93.6%) were detected by PCR, 199 (43.9%) by ELISA and 40 (8.8%) by viral culture. While seasonal influenza A(H1N1) virus strains were prominent, only four 2009 pandemic influenza A(H1N1) cases were detected. Use of molecular biology method (rtRT-PCR) increased sensitivity and diagnosis capabilities. Among all three methods used, rRT-PCR was the most sensitive and rapid method. More capacity building is still required for viral culture. Need to collect denominator data in order to have an accurate estimate of the burden of influenza. There was delayed introduction of pandemic influenza A(H1N1)2009 in Cote d'Ivoire.
Introduction: Buruli ulcer, caused by Mycobacterium ulcerans, is endemic in more than 30 countries worldwide, with Côte d'Ivoire being among the most affected countries. Methodology: We used seven variable number of tandem repeats (VNTR) markers and analyzed 114 samples from 11 Ivorian localities consisting of 33 bacterial strains and 81 clinical samples. Complete data sets at loci 1, 6, 9 and 33 were obtained for 18 of these strains (n = 15) and samples (n = 3) collected in each of the localities. Results: All the strains had allelic profile [3113], corresponding to the previously described Atlantic Africa genotype. Conclusion: Sequencing of PCR products at all loci showed no variation in sequence or repeat number, underlining the genetic monomorphism of M. ulcerans in Côte d'Ivoire.
Background Many countries in Africa have lacked sentinel surveillance systems for influenza and are under-represented in data used for global vaccine strain selection. Objectives We describe 8 years of sentinel surveillance data and the contribution of influenza and other viruses to medically attended influenza-like illness (ILI) in Côte d'Ivoire. Methods Sentinel surveillance was established in 2003. Nasopharyngeal (NP) specimens and epidemiologic data are collected from persons of all ages presenting with ILI at sentinel sites. Respiratory specimens have been tested for influenza using various viral and molecular diagnostic methods. A subset of 470 specimens collected from children aged 0–5 years were tested for multiple respiratory viruses using RT-PCR. Results From 2003 to 2010, 5074 NP specimens were collected from patients with ILI. Overall, 969/5074 (19%) of these specimens tested positive for influenza. Seasonal influenza A(H1N1) viruses predominated during 5 years and influenza A(H3N2) viruses predominated during 3 years. Influenza B viruses cocirculated with influenza A viruses during each year from 2004 to 2010. Seasonal peaks in influenza circulation were observed during the months of May, June, and October, with the largest peak corresponding with the primary rainfall season. Of 470 specimens collected from children under aged 5 who were tested for multiple respiratory viruses, a viral respiratory pathogen was detected in 401/470 (85%) of specimens. Commonly detected viruses were RSV (113 of 470 specimens, 24%), rhinoviruses (85/470, 18%), influenza (77/470, 16%), and parainfluenza (75/470, 16%). Conclusion In Côte d'Ivoire, there is a significant annual contribution of influenza and other respiratory viruses to medically attended ILI.
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