Epidemiology of Mansonella perstans in the middle belt of Ghana

Linda Batsa Debrah, Norman Nausch, Vera Serwaa Opoku, Wellington Owusu, Yusif Mubarik, Daniel Antwi Berko, Samuel Wanji, Laura E Layland, Achim Hoerauf, Marc Jacobsen, Alexander Yaw Debrah, Richard O Phillips, Linda Batsa Debrah, Norman Nausch, Vera Serwaa Opoku, Wellington Owusu, Yusif Mubarik, Daniel Antwi Berko, Samuel Wanji, Laura E Layland, Achim Hoerauf, Marc Jacobsen, Alexander Yaw Debrah, Richard O Phillips

Abstract

Background: Mansonellosis was first reported in Ghana by Awadzi in the 1990s. Co-infections of Mansonella perstans have also been reported in a small cohort of patients with Buruli ulcer and their contacts. However, no study has assessed the exact prevalence of the disease in a larger study population. This study therefore aimed to find out the prevalence of M. perstans infection in some districts in Ghana and to determine the diversity of Culicoides that could be potential vectors for transmission.

Methods: From each participant screened in the Asante Akim North (Ashanti Region), Sene West and Atebubu Amantin (Brong Ahafo Region) districts, a total of 70 μl of finger prick blood was collected for assessment of M. perstans microfilariae. Centre for Disease Control (CDC) light traps as well as the Human Landing Catch (HLC) method were used to assess the species diversity of Culicoides present in the study communities.

Results: From 2,247 participants, an overall prevalence of 32% was recorded although up to 75% prevalence was demonstrated in some of the communities. Culicoides inornatipennis was the only species of Culicoides caught with the HLC method. By contrast, C. imicola (47%), C. neavei (25%) and C. schultzei (15%) were caught by the CDC light trap method. A wide diversity of other Culicoides spp. was also identified but correlation was only found between the prevalence of C. inornatipennis and M. perstans during the dry season.

Conclusions: Here we demonstrate for the first time that M. perstans is highly prevalent in three districts in Ghana. We found a wide spectrum of Culicoides spp. Culicoides inornatipennis was the most anthropophilic and is therefore likely to be the species responsible for transmission of infection but formal proof has yet to be obtained.

Trial registration: NCT02281643 . Registered October 26, 2014. 'Retrospectively registered'.

Trial registry: ClinicalTrials.gov.

Keywords: Culicoides; Epidemiology; Mansonella perstans; Mansonellosis; Microfilariae.

Figures

Fig. 1
Fig. 1
Spatial-epidemiological map of study communities
Fig. 2
Fig. 2
Distribution of M. perstans microfilariae within age groups for Ashanti Akim North District (a), Sene West District (b), Atebubu Amantin District (c), as well as distribution within specific communities for Ashanti Akim North District (d), Sene West District (e) and Atebubu Amantin District (f). There were associations between microfilarial prevalence and age in the Ashanti Akim North District (χ2 = 24.3, df = 8, P = 0.0020; Fig. 2a), Sene West District (χ2 = 25.1, df = 8, P = 0.0015; Fig. 2b) and Atebubu Amantin District (χ2 = 28.3, df = 8, P = 0.0004; Fig. 2c). Green line depicts the community with co-infections of Wuchereria bancrofti. Red line shows the community with ongoing Mass Drug Administration Programmes
Fig. 3
Fig. 3
Overnight trap collection (a), evening trap collections (b) and human landing catch collections (c) Comparison of different Culicoides species obtained using light traps and human landing catch collections within the dry (black bars) or wet season (grey bars)

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