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The relationship between microfilaraemic and amicrofilaraemic loiasis involving co-infection with Mansonella perstans and clinical symptoms in an exposed population from Gabon

Published online by Cambridge University Press:  13 August 2015

M.K. Bouyou Akotet ,
M. Owono-Medang ,
D.P. Mawili-Mboumba ,
M.N. Moussavou-Boussougou ,
S. Nzenze Afène ,
E. Kendjo  and
M. Kombila
M.K. Bouyou Akotet*
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
M. Owono-Medang
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
D.P. Mawili-Mboumba
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
M.N. Moussavou-Boussougou
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
S. Nzenze Afène
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
E. Kendjo
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
M. Kombila
Affiliation:
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon
*
*Fax: 00 241 01 70 48 96 E-mail: [email protected]
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Abstract

The relationship between the frequency of loiasis objective symptoms and microfilaraemic or amicrofilaraemic infection was assessed in 1148 exposed patients also infected, or not, with Mansonella perstans. Filarial infections were detected by direct microscopy, leucoconcentration and serology, with prevalence values of 39.5% Loa loa, 5.6% M. perstans and 3.4% co-infection with both filarial species. Amicrofilaraemic or occult loiasis (OL) predominated among L. loa-infected individuals, with a prevalence of 58.2%. Hypermicrofilaraemia (>8000 microfilariae (mf)/ml) was found in 18.4% of L. loa microfilaraemic patients, with 25.7% of them harbouring more than 30,000 mf/ml. Up to 34% of patients with OL showed evidence of Calabar swelling, compared with 26.3% of microfilaraemic patients (P= 0.03). Overall 5.3% of patients presented with adult worm migration across the eye, representing 16.3% of microfilaraemic individuals and 11.4% of amicrofilaraemic patients (P= 0.13). This symptom was similarly found in patients with more than 30,000 mf/ml (22%), those with microfilaraemia between 8 and 30,000 mf/ml (15.4%) and also in individuals with low or without microfilaraemia (16.1%) (P= 0.7). Five (14.3%) hypermicrofilaraemic patients did not present any L. loa-specific objective symptoms, as well as all the patients with single M. perstans infection. The presence of adult eye worm migration as a strong predictor of high microfilaraemia density would obscure the real burden of L. loa hypermicrofilaraemia in exposed individuals. For epidemiological purposes and control strategies, the mapping of L. loa in endemic areas should also take into account the group of patients with occult loiasis.

Type
Research Papers
Information
Journal of Helminthology , Volume 90 , Issue 4 , July 2016 , pp. 469 - 475
Copyright
Copyright © Cambridge University Press 2015 

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References

Agbolade, M. & Akinboye, D.O. (2001) Loa loa and Mansonella perstans infections in Ijebu north, western Nigeria, a parasitological study. Japanese Journal of Infectious Diseases 54, 108–110.Google ScholarPubMed
Akué, J.P., Nkoghe, D., Padilla, C., Moussavou, G., Moukana, H., Mbou, R.A., Ollomo, B. & Leroy, E.M. (2011) Epidemiology of concomitant infection due to Loa loa and Mansonella perstans in Gabon. PLoS Neglected Tropical Diseases 5, e1329.CrossRefGoogle ScholarPubMed
Anosike, J.C., Dozie, I.N., Onwuliri, C.O., Nwoke, B.E. & Onwuliri, V.A. (2005) Prevalence of Mansonella perstans infections among the nomadic Fulanis of northern Nigeria. Annals of Agriculture and Environmental Medicine 12, 35–38.Google ScholarPubMed
Asio, S.M., Simonsen, P.E. & Onapa, A.W. (2009) Mansonella perstans filariasis in Uganda, patterns of microfilaraemia and clinical manifestations in two endemic communities. Transactions of the Royal Society of Tropical Medicine and Hygiene 103, 266–273.Google Scholar
Boussinesq, M., Gardon, J., Gardon-Wendel, N., Kamgno, J., Ngoumou, P. & Chippaux, J.P. (1998) Three probable cases of Loa loa encephalopathy following ivermectin treatment for onchocerciasis. American Journal of Tropical Medicine and Hygiene 58, 461–469.CrossRefGoogle ScholarPubMed
Bouyou-Akotet, M.K., Moussavou Boussougou, M.N., Ovono-Abessolo, F., Owono-Medang, M. & Kombila, M. (2014) Influence of Mansonella perstans microfilaraemia on total IgE levels in Gabonese patients co-infected with Loa loa . Acta Tropica 31, 11–15.CrossRefGoogle Scholar
Bregani, E.R., Tantardini, F. & Rovellini, A. (2007) Mansonella perstans filariasis. Parassitologia 49, 23–26.Google Scholar
Carme, B., Mamboueni, J.P., Copin, N. & Noireau, F. (1989) Clinical and biological study of Loa loa filariasis in Congolese. American Journal of Tropical Medicine and Hygiene 41, 331–337.Google Scholar
Chippaux, J.P., Boussinesq, M., Gardon, J., Gardon-Wendel, N. & Ernould, J.C. (1996) Severe adverse reaction risks during mass treatment with ivermectin in loiasis-endemic areas. Parasitology Today 12, 448–450.CrossRefGoogle ScholarPubMed
Deluol, A.M. (2004) Colour atlas of parasitology. Helminths. Vol.4. 2nd edn. Saint Maur, France, Eds Varia, .Google Scholar
Dolo, H., Coulibaly, Y.I., Dembele, B., Konate, S., Coulibaly, S.Y., Doumbia, S.S., Diallo, A.A., Soumaoro, L., Coulibaly, M.E., Diakite, S.A., Guindo, A., Fay, M.P., Metenou, S., Nutman, T.B. & Klion, A.D. (2013) Filariasis attenuates anemia and proinflammatory responses associated with clinical malaria, a matched prospective study in children and young adults. PLoS Neglected Tropical Diseases 6, e1890.Google Scholar
Dupont, A., Zue-N'dong, J. & Pinder, M. (1998) Common occurrence of amicrofilaraemic Loa loa filariasis within the endemic region. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 730–735.Google Scholar
Fernández-Soto, P., Mvoulouga, P.O., Akue, J.P., Abán, J.L., Santiago, B.V., Sánchez, M.C. & Muro, A. (2014) Development of a highly sensitive loop-mediated isothermal amplification (LAMP) method for the detection of Loa loa . PLoS One 9, e94664.Google Scholar
Fink, D.L., Kamgno, J. & Nutman, T.B. (2011) Rapid molecular assays for specific detection and quantitation of Loa loa microfilaremia. PLoS Neglected Tropical Diseases 5, e1299.CrossRefGoogle ScholarPubMed
Gardon, J., Gardon-Wendel, N., Demanga-Ngangue, Kamgno, J., Chippaux, J.P. & Boussinesq, M. (1997) Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350, 18–22.Google Scholar
Gobbi, F., Boussinesq, M., Mascarello, M., Angheben, A., Gobbo, M., Rossanese, A., Corachán, M. & Bisoffi, Z. (2011) Case report, loiasis with peripheral nerve involvement and spleen lesions. American Journal of Tropical Medicine and Hygiene 84, 733–737.CrossRefGoogle ScholarPubMed
Ho Thi Sang, & Petithory, J. (1963) Techniques de concentration des microfilaires sanguicoles. Bulletin de la Société de Pathologie Exotique, Filiales 56, 197–206.Google Scholar
Hotez, P. (2011) Enlarging the ‘Audacious Goal’, elimination of the world's high prevalence neglected tropical diseases. Vaccine 29, 104–110.Google Scholar
Klion, A.D., Massougbodji, A., Sadeler, B.C., Ottesen, E.A. & Nutman, T.B. (1991) Loiasis in endemic and nonendemic populations, immunologically mediated differences in clinical presentation. Journal of Infectious Diseases 163, 1318–1325.Google Scholar
Kombila, M. & Richard-Lenoble, D. (1998) Programme de donation Mectizan® au Gabon, évolution et perspectives de la distribution dans les foyers d'onchocercose (1991–1997). Sante 8, 53–57.Google Scholar
Li, X.X. & Zhou, X.N. (2013) Co-infection of tuberculosis and parasitic diseases in humans, a systematic review. Parasites and Vectors 6, 79–86.CrossRefGoogle ScholarPubMed
Mackenzie, C., Geary, T., Prichard, R. & Boussinesq, M. (2007) Where next with Loa loa encephalopathy? Data are badly needed. Trends in Parasitology 23, 237–238.Google Scholar
Metenou, S., Babu, S. & Nutman, T.B. (2012) Impact of filarial infections on coincident intracellular pathogens, Mycobacterium tuberculosis and Plasmodium falciparum . Current Opinion in HIV and AIDS 7, 231–238.Google Scholar
Muhangi, L., Woodburn, P., Omara, M., Omoding, N., Kizito, D., Mpairwe, H., Nabulime, J., Ameke, C., Morison, L.A. & Elliott, A.M. (2007) Associations between mild-to-moderate anaemia in pregnancy and helminth, malaria and HIV infection in Entebbe, Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene 101, 899–907.Google Scholar
Ndibazza, J., Webb, E.L., Lule, S., Mpairwe, H., Akello, M., Oduru, G., Kizza, M., Akurut, H., Muhangi, L., Magnussen, P., Vennervald, B. & Elliott, A. (2013) Associations between maternal helminth and malaria infections in pregnancy and clinical malaria in the offspring, a birth cohort in Entebbe, Uganda. Journal of Infectious Diseases 208, 207–216.Google Scholar
Nutman, T.B., Miller, K.D., Mulligan, M. & Ottesen, E.A. (1986) Loa loa infection in temporary residents of endemic regions, recognition of a hyperresponsive syndrome with characteristic clinical manifestations. Journal of Infectious Diseases 154, 10–18.CrossRefGoogle ScholarPubMed
Pinder, M., Leclerc, A. & Everaere, S. (1992) Antibody-dependent cell-mediated immune reactions to Loa loa microfilariae in amicrofilaraemic subjects. Parasite Immunology 14, 541–556.Google Scholar
Pion, S.D., Demanou, M., Oudin, B. & Boussinesq, M. (2005) Loiasis, the individual factors associated with the presence of microfilaraemia. Annals of Tropical Medicine and Parasitology 99, 491–500.Google Scholar
Simonsen, P.E., Onapa, A.W. & Asio, S.M. (2011) Mansonella perstans filariasis in Africa. Acta Tropica 120, S109–S120.Google Scholar
Takougang, I., Meremikwu, M., Wandji, S., Yenshu, E.V., Aripko, B., Lamlenn, S.B., Eka, B.L., Enyong, P., Meli, J., Kale, O. & Remme, J.H. (2002) Rapid assessment method for prevalence and intensity of Loa loa infection. Bulletin of the World Health Organization 80, 852–858.Google Scholar
Toure, F.S., Bain, O., Nerrienet, E., Millet, P., Wahl, G., Toure, Y., Doumbo, O., Nicolas, L., Georges, A.J., McReynolds, L.A. & Egwang, T.G. (1997) Detection of Loa loa-specific DNA in blood from occult-infected individuals. Experimental Parasitology 86, 163–170.Google Scholar
Twum-Danso, N.A. (2003) Loa loa encephalopathy temporally related to ivermectin administration reported from onchocerciasis mass treatment programs from 1989 to 2001, implications for the future. Filaria Journal 2, S7.Google Scholar
Van Hoegaerden, M., Chabaud, B., Akue, J.P. & Ivanoff, B. (1987) Filariasis due to Loa loa and Mansonella perstans, distribution in the region of Okondja, Haut-Ogooué Province, Gabon, with parasitological and serological follow-up over one year. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 441–446.Google Scholar
Walker-Deemin, A., Ferrer, A., Gauthier, F., Kombila, M. & Richard-Lenoble, D. (2004) Identification and specificity of a 38 kDa Loa loa antigenic fraction in sera from high microfilaraemic Gabonese patients. Parasitology Research 92, 128–132.CrossRefGoogle ScholarPubMed
Wanji, S., Akotshi, D.O., Mutro, M.N., Tepage, F., Ukety, T.O., Diggle, P.J. & Remme, J.H. (2012) Validation of the rapid assessment procedure for loiasis (RAPLOA) in the Democratic Republic of Congo. Parasites and Vectors 5, 25.Google Scholar
Zouré, H.G., Wanji, S., Noma, M., Amazigo, U.V., Diggle, P.J., Tekle, A.H. & Remme, J.H. (2011) The geographic distribution of Loa loa in Africa, results of large-scale implementation of the Rapid Assessment Procedure for Loiasis (RAPLOA). PLoS Neglected Tropical Diseases 5, e1210.Google Scholar