In response to increasing resistance to anti-malarial drugs, Senegal adopted artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria in 2006. However, resistance of Plasmodium falciparum parasites to artemisinin derivatives, characterized by delayed parasite clearance after treatment with ACT or artesunate monotherapy, has recently emerged and rapidly spread in Southeast Asia. After 10 years of stability with rates ranging from 5.6 to 11.8%, the prevalence of parasites with reduced susceptibility in vitro to monodesethylamodiaquine, the active metabolite of an ACT partner drug, increased to 30.6% in 2014 in Dakar. Additionally, after a decrease of the in vitro chloroquine resistance in Dakar in 2009–2011, the prevalence of parasites that showed in vitro chloroquine resistance increased again to approximately 50% in Dakar since 2013. The aim of this study was to follow the evolution of the susceptibility to ACT partners and other anti-malarial drugs in 2015 in Dakar. An in vitro test is the only method currently available to provide an early indication of resistance to ACT partners. Thirty-two P. falciparum isolates collected in 2015 in Dakar were analysed using a standard ex vivo assay based on an HRP2 ELISA. The prevalence of P. falciparum parasites with reduced susceptibility in vitro to monodesethylamodiaquine, chloroquine, mefloquine, doxycycline and quinine was 28.1, 46.9, 45.2, 31.2 and 9.7%, respectively. None of the parasites were resistant to lumefantrine, piperaquine, pyronaridine, dihydroartemisinin and artesunate. These results confirm an increase in the reduced susceptibility to monodesethylamodiaquine observed in 2014 in Dakar and the chloroquine resistance observed in 2013. The in vitro resistance seems to be established in Dakar. Additionally, the prevalence of parasites with reduced susceptibility to doxycycline has increased two-fold compared to 2014. The establishment of a reduced susceptibility to monodesethylamodiaquine as well as chloroquine resistance, and the emergence of a reduced susceptibility to doxycycline are disturbing. The in vitro and in vivo surveillance of anti-malarial drugs must be implemented in Senegal.
In West Africa, research on the hepatitis E virus (HEV) is barely covered, despite the recorded outbreaks. The low level of access to safe water and adequate sanitation is still one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Herein, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A consecutive and non-redundant recruitment of participants was carried out over the period of 5 months, from March to July 2021. A total of 1227 consenting participants attending antenatal clinics responded to a standard questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. The overall HEV seroprevalence was 7.8% (n = 96), with 0.5% (n = 6) and 7.4% (n = 91) for HEV IgM and HEV IgG, respectively. One of the participant samples was IgM/IgG-positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer’s instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p < 0.0001), by the regularity of income (p = 0.0043), and by access to sanitation services (p = 0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental, and behavioral aspects for a better management of HEV infection in Senegal.
Hepatitis B virus (HBV) classification comprises up to 10 genotypes with specific geographical distribution worldwide, further subdivided into 40 subgenotypes, which have different impacts on liver disease outcome. Though extensively studied, the classification of subgenotype A sequences remains ambiguous. This study aimed to characterize HBV isolates from West African patients and propose a more advanced classification of subgenotype A. Fourteen HBV full-length genome sequences isolated from patients from The Gambia and Senegal were obtained and phylogenetically analyzed. Phylogenetic analysis of HBV genotype A sequences isolated from Senegalese and Gambian patients exhibited separate clusters from the other known and confirmed subgenotypes A (A1, A2, A6). Most of the sequences (10/14) clustered with an isolate from Cuba, reported as subgenotype A4 (supported by maximal bootstrap value). Four isolates from The Gambia and Senegal clustered separately from all other subgenotypes and samples sequenced in the study. Three of which from The Gambia, designated as an expanding clade of subgenotype A4, exhibited a mean inter-subgenotypic nucleotide divergence over the entire genome sequence higher than 4% in comparison with the other subgenotypes and the other isolates sequenced in the study, except with subgenotype A4 isolates (3.9%), and this was supported by a maximal bootstrap value. The last one from Senegal seemed to be an expanding subgenotype close to the new clade of A4. Amino acid analysis unveiled a novel motif specific to these isolates. This study revealed an expanding evolution of HBV subgenotype A and novel amino acid motifs. It also highlighted the need for a consensus regarding the analysis and classification of HBV sequences.
We used whole genome sequencing to identify and analyze mutations in SARS-CoV-2 in urban settings during the deadliest wave of the COVID-19 epidemic—from March to April 2021—in Senegal. Nasopharyngeal samples testing positive for SARS-CoV-2 were sequenced on the Illumina NovaSeq 6000 sequencing system using the COVIDSeq protocol. A total of 291 genotypable consensus genome sequences were obtained. Phylogenetic analyses grouped the genomes into 16 distinct PANGOLIN lineages. The major lineage was B.1.1.420, despite circulation of the Alpha variant of concern (VOC). A total of 1125 different SNPs, identified relative to the Wuhan reference genome, were detected. These included 13 SNPs in non-coding regions. An average density of 37.2 SNPs per 1000 nucleotides was found, with the highest density occurring in ORF10. This analysis allowed, for the first time, the detection of a Senegalese SARS-CoV-2 strain belonging to the P.1.14 (GR/20J, Gamma V3) sublineage of the Brazilian P.1 lineage (or Gamma VOC). Overall, our results highlight substantial SARS-CoV-2 diversification in Senegal during the study period.
Chronic hepatitis is a major public health problem. Hepatitis B virus is the primary cause, and Hepatitis B and C together are responsible for 60% of cirrhosis and 80% of hepatocellular carcinomas. This study measured the prevalence of HBsAg among Senegalese military to develop an appropriate strategy to prevent cirrhosis and hepatocellular carcinoma. We conducted a descriptive cross-sectional study among Senegalese military aged 25 to 60 years. A sample of 1224 participants was selected following a two-level-stratification. The mark of surface HBs antigen using chemiluminescence concerned 1195 participants. The presence of HBsAg was analyzed according to age, marital status, alcohol consumption and glomerular filtration rate. Epi-info6fr and R software were used, respectively, for data capture and analyses. A Chi-square test was performed to compare proportions considering a significance level of 5% and a confidence interval of 95%. The average age was 39.8 ± 9.2 years. Participants in the age groups of 25–34 years, 45–60 years and 35–44 years were respectively 30.7%, 34.4% and 34.9% of the sample. Married persons represented 82.6% of participants and 17.08% were single. Most participants were educated (99%), and 56% had reached at least secondary school level. Alcohol consumption was at 11.5%. The HBsAg prevalence rate was 10.8% [9.1% to 12.7%] with a significant difference between age groups (P < 0.001), which ranged from 5.6% for 45–60 years, 9.62% for 25–34 years to 16.9% for 35–44 years. Marital status and alcohol consumption did not affect the carriage of HBsAg. HBsAg prevalence was more common among participants who had a glomerular filtration rate greater than 90 ml/min. Transaminases rate exceeded the normal threshold for 43 participants (3.6%); the increase was 6.6% [2.7% to 11.8%] for HBsAg carriers and 3.2% [1.2% to 6.7%] for alcohol users. The high prevalence of HBsAg in the military requires the implementation of an effective prevention and care program to reduce the risk of cirrhosis and hepatocellular carcinoma and contribute to reducing the burden of communicable diseases, such as hepatitis and HIV/AIDS, and non-communicable diseases.
23 March 2022 in Journal of Advances in Microbiology
Background: The emergence and spread of carbapenem-resistant Acinetobacter baumannii are critical in hospitals, particularly in intensive care units (ICUs), which represents a public health concern worldwide. In this study, we investigated the molecular epidemiology of multi-drug resistant A. baumannii (MDR-AB) in Dakar, Senegal. Methods. The A. baumannii was isolated from Eosin Methylene Blue Agar culture and identified using API 20NE strip test and MALDI-TOF. The antimicrobial susceptibility testing was performed using the disk diffusion method. Simplex and multiplex-polymerase chain reactions with appropriate primers were used to detect and sequence the following β-lactamase genes: Two class D carbapenem hydrolyzing oxacillinases (blaOXA-51 and blaOXA-23), three class B metallo-β-lactamase genes (blaIMP, blaVIM and blaNDM), and five class A β-lactamase genes (blaPER, blaSHV, blaVEB, blaTEM, andblaGES). Results: A total of 29 strains of MDR-AB were isolated from patients hospitalized at Aristide Le Dantec University teaching hospital in Dakar, Senegal. Among the 29 MDR-AB strains isolated, 11 (37.9%) were isolated from ICUs, 5 (17.2%) from pediatric surgery, and 13 (44.8%) from other departments. The MDR strains were isolated from urine and pus samples with 12 (41.4%) and 9 (31.0%), respectively. All isolates were positive for the A. baumannii specific gene blaOXA-51. The blaOXA-51 and blaOXA-23 genes coexisted in 26 (89.65%) of the strains. The blaIMP and blaVIM genes were not detected among the selected strains. Moreover1 (3.4%) strain elicited the gene coding for metallo-β-lactamase NDM-1. 2 (6.9%) isolates turned out to produce the penicillinase TEM-2. Conclusions: Carbapenem resistance in Senegalese strains of A. baumannii is predominantly due to the worldwide disseminated gene blaOXA-23, with a subset of strains due to NDM-1 and TEM-2. Systemic molecular surveillance network should be established for further efficient monitoring of MDR strains in Senegal.