Thirty-Seven Human Cases of Sparganosis from Ethiopia and South Sudan Caused by Spirometra Spp.
Bottom Line: All 37 specimens were identified on microscopic study as larval tapeworms of the spargana type, and DNA sequence analysis of seven confirmed the identification of Spirometra sp.Age of cases ranged between 7 and 70 years (mean 25 years); 21 (57%) patients were male and 16 were female.The presence of spargana in open skin lesions is somewhat atypical, but does confirm the fact that populations living in these remote areas are either ingesting infected copepods in unsafe drinking water or, more likely, eating poorly cooked paratenic hosts harboring the parasite.
Affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Ethiopia Dracunculiasis Eradication Program, Federal Ministry of Health, Addis Ababa, Ethiopia; South Sudan Guinea Worm Eradication Program, Ministry of Health, Juba, Republic of South Sudan; The Carter Center, Atlanta, Georgia email@example.com.Show MeSH
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Mentions: Genetic distances (Kimura 2-parameter model, bootstrap N = 1,000) and phylogenetic trees (maximum-likelihood using a GTR+G+I substitution model) were calculated and inferred, respectively, in MEGA v6.012 (freely available at http://www.megasoftware.net) to further investigate the taxonomic relationship among the African spargana, Spirometra erinaceieuropaei, and other diphyllobothriid and Echinococcus species known or previously reported to occur in humans. Representative CO1 gene sequences of Spirometra erinaceieuropaei (AB015754), Sparganum proliferum (AB015753), Diphyllobothrium ditremum (FM209182), D. nihonkaiense (AB268585), D. latum (AB269325), D. dendriticum (KC812048), Diplogonoporus balaenopterae (AB425839), Dg. grandis (AB425840), Echinococcus canadensis (AB745463), E. multilocularis (AB510023), and E. granulosus (GQ168812) were obtained from GenBank, with the cestodarian species Gyrocotyle urna (JQ268546) serving as the out-group. Homology of all alignments was supported with amino acid translation before analysis. Average genetic divergence within the African spargana was quite low (d = 0.004 ± 0.001) compared with divergence between African spargana and Spirometra erinaceieuropaei (d = 0.107 ± 0.012) and all other interspecies and intergenus comparisons (d ≥ 0.075). Similarly, the inferred phylogenetic tree grouped the seven African spargana into a distinct clade, sister to Spirometra erinaceieuropaei within the larger diphyllobothriid clade (Figure 6Figure 6.
Affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Ethiopia Dracunculiasis Eradication Program, Federal Ministry of Health, Addis Ababa, Ethiopia; South Sudan Guinea Worm Eradication Program, Ministry of Health, Juba, Republic of South Sudan; The Carter Center, Atlanta, Georgia firstname.lastname@example.org.