Preliminary Evidence for the Absence of Cystic Echinococcosis in Gabon: A Cross-Sectional Pilot Survey in Humans and Definitive Hosts

Felix Lötsch Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;
Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;

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Ghyslain Mombo-Ngoma Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;

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Johannes Mischlinger Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;
Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;

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Mirjam Groger Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;
Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;

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Luzia Veletzky Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;
Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;

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Ayôla Akim Adegnika Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;
Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany;

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Bertrand Lell Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;
Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany;

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Selidji Todagbe Agnandji Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;
Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany;

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Marielle Bouyou-Akotet Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon;

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Markus Obermüller Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;

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Marion Wassermann Department of Parasitology, University of Hohenheim, Stuttgart, Germany;

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Renate Schneider Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria;

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Herbert Auer Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria;

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Michael Ramharter Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria;
Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon;
Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany;
Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany

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Cystic echinococcosis (CE) is a globally endemic zoonosis caused by the larval stage of the Echinococcus granulosus sensu lato (s.l.) complex. Although the disease is known to be highly prevalent in certain parts of North and East Africa, data on CE, both in humans and definitive hosts, are extremely scarce for Central Africa. The present study assessed the epidemiology of CE in humans and dogs in rural Gabon. An ultrasound and serologic survey was conducted in volunteers from rural villages in Gabon. A two-step approach was used for serological testing with an indirect hemagglutination assay as a screening test and Western Blot as a confirmatory test. Fecal dog samples were analyzed microscopically, and polymerase chain reaction (PCR) amplification of nad1 and cox1 genes was performed when taeniid eggs were visible. Regional hospitals and the national reference center for parasitology in Gabon were contacted for information about previous cases of CE. Randomly selected communities were invited to participate. Three hundred and forty-eight human volunteers from these communities were screened. No suspected cases of CE were detected. Definitive host screening was performed from 128 fecal samples from representative subregions, but no eggs from E. granulosus s.l. were found. No documented cases of echinococcosis were reported from the local health-care institutions and the national diagnostic reference center in Gabon. Cystic echinococcosis seems to be very rare or absent in Gabon. The reason for this lack of evidence for echinococcosis is unknown, but the absence of livestock may play a major role.

Author Notes

Financial support: We are grateful for the financial support of the Landsteiner Gesellschaft, Austria.

Authors’ addresses: Felix Lötsch, Mirjam Groger, and Markus Obermüller, Department of Infectious Diseases and Tropical Medicine, Medizinische Universitat Wien, Wien, Austria, E-mails: felix.loetsch@gmail.com, mirjam.groger@gmail.com, and markus.obermueller@meduniwien.ac.at. Ghyslain Mombo-Ngoma, Centre de Recherches Médicals de Lambaréné, Albert Schweitzer Hospital, Lambaréné, Gabon, E-mail: ghyslain.mombongoma@gmail.com. Johannes Mischlinger and Luzia Veletzky, Centre de Recherches Médicals de Lambaréné, Lambarene, Gabon, E-mails: hannes.mischlinger@gmail.com and luzia.veletzky@meduniwien.ac.at. Ayôla Akim Adegnika, Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon, and Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany, E-mail: aadegnika@gmail.com. Betrand Lell, Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon, E-mail: bertrand.lell@gmail.com. Selidji Todagbe Agnandji, Centre de Recherches Médicales de Lambaréné, Lambaréné, Moyen-Ogooué, Gabon, E-mail: agnandjis@lambarene.org. Marielle Bouyou-Akotet, Department of Parasitology Mycology, Université des Sciences de la Santé, Libreville, Gabon, and Malaria Clinical Research and Operational Unit, Centre Hospitalier de Libreville, Libreville, Gabon, E-mail: mariellebouyou@gmail.com. Marion Wassermann, Department of Zoology, Universitat Hohenheim, Stuttgart, Baden-Württemberg, Germany, E-mail: marion.wassermann@uni-hohenheim.de. Renate Schneider and Herbert Auer, Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Vienna, Austria, E-mails: renate.schneider@meduniwien.ac.at and herbert.auer@meduniwien.ac.at. Michael Ramharter, Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria, and Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany, and Bernhard Nocht Hospital for Tropical Diseases,Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, E-mail: ramharter@bnitm.de.

Address correspondence to Michael Ramharter, Bernhard Nocht Hospital for Tropical Diseases, Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany. E-mail: ramharter@bnitm.de

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