bims-mosdis Biomed News
on Mosquito distribution and disease
Issue of 2023–05–07
fourteen papers selected by
Richard Halfpenny, Staffordshire University
  1. Population structure and invasion history of Aedes aegypti (Diptera: Culicidae) in Southeast Asia and Australasia.
  2. Genetic structure of Aedes albopictus (Diptera: Culicidae) populations in China and relationship with the knockdown resistance mutations.
  3. Mosquito community composition in two major stopover aquatic ecosystems used by migratory birds in northern Spain.
  4. Understanding West Nile virus transmission: Mathematical modelling to quantify the most critical parameters to predict infection dynamics.
  5. Using community science data to assess the association between urbanization and the presence of invasive Aedes species in Hungary.
  6. Ťahyňa virus-A widespread, but neglected mosquito-borne virus in Europe.
  7. The epidemiology and evolutionary dynamics of massive dengue outbreak in China, 2019.
  8. Malaria, climate variability, and interventions: modelling transmission dynamics.
  9. Malaria surveillance reveals parasite relatedness, signatures of selection, and correlates of transmission across Senegal.
  10. Retrospective investigation of the origin and epidemiology of the dengue outbreak in Yunnan, China from 2017 to 2018.
  11. West Nile virus infections in Hungary: Epidemiological update and phylogenetic analysis of the Hungarian virus strains between 2015 and 2022.
  12. Malaria prevalence in Pakistan: A systematic review and meta-analysis (2006-2021).
  13. Malaria prevalence in Mauritania: a systematic review and meta-analysis.
  14. Combating West Nile Virus Disease - Time to Revisit Vaccination.
  1. Evol Appl. 2023 Apr;16(4): 849-862
    Population structure and invasion history of Aedes aegypti (Diptera: Culicidae) in Southeast Asia and Australasia.
    Andrew J Maynard, Luke Ambrose, Michael J Bangs, Rohani Ahmad, Charles Butafa, Nigel W Beebe.
      The dengue mosquito, Aedes aegypti (Linnaeus, 1762), is a highly invasive and medically significant vector of dengue, yellow fever, chikungunya and Zika viruses, whose global spread can be attributed to increased globalization in the 15th through 20th century. Records of the invasion history of Ae. aegypti across Southeast Asia are sparse and there is little knowledge regarding the invasion routes that the species exploited to gain a foothold in the Indo-Pacific. Likewise, a broad and geographically thorough investigation of Ae. aegypti population genetics in the Indo-Pacific is lacking, despite this region being highly impacted by diseases transmitted by this species. We assess 11 nuclear microsatellites and mitochondrial COI sequences, coupled with widespread sampling through the Indo-Pacific region to characterise population structure at a broad geographic scale. We also perform a comprehensive literature search to collate documentation of the first known records of Ae. aegypti at various locations in the Indo-Pacific. We revealed additional spatial population genetic structure of Ae. aegypti in Southeast Asia, the Indo-Pacific and Australasia compared with previous studies and find differentiation between multiple Queensland and Torres Strait Islands populations. We also detected additional genetic breaks within Australia, Indonesia and Malaysia. Characterising the structure of previously unexplored populations through this region enhances the understanding of the population structure of Ae. aegypti in Australasia and Southeast Asia and may assist predictions of future mosquito movement, informing control strategies as well as assessing the risk of new invasion pathways.
    Keywords:  Aedes aegypti; Indo‐Pacific; microsatellites; mtDNA; population genetics – empirical
    DOI:  https://doi.org/10.1111/eva.13541
  2. Infect Dis Poverty. 2023 May 05. 12(1): 46
    Genetic structure of Aedes albopictus (Diptera: Culicidae) populations in China and relationship with the knockdown resistance mutations.
    Wenqi Shan, Hao Yuan, Hanming Chen, Haowei Dong, Qiuming Zhou, Feng Tao, Jie Bai, Huiying Chen, Yajun Ma, Heng Peng.
       BACKGROUND: Mosquito control is needed to prevent dengue fever, which is mainly spread by Aedes albopictus in China. Application of insecticides is one of the main mosquito control methods; however, this approach can fail due to the knockdown resistance (kdr) gene mutation that causes decreased sensitivity to insecticides in Ae. albopictus. The kdr mutation patterns among different regions in China differ significantly. However, the underlying mechanism and factors that influence kdr mutation remain unclear. To explore the potential influence of genetic background on the development of insecticide resistance in Ae. albopictus, we analyzed the genetic structure of Ae. albopictus populations in China and its correlation with major kdr mutations.
    METHODS: We collected Ae. albopictus from 17 sites in 11 provinces (municipalities) across China from 2016 to 2021 and extracted the genomic DNA from individual adult mosquitoes. We selected eight microsatellite loci for genotyping, and based on microsatellite scores, we estimated intraspecific genetic diversity, population structure, and effective population size. The association between the intrapopulation genetic variation and F1534 mutation rate was evaluated by the Pearson correlation coefficient.
    RESULTS: Based on variation analysis of the microsatellite loci of 453 mosquitoes representing 17 populations throughout China, more than 90% of the variation occurred within individuals, whereas only about 9% of the variation occurred among populations, indicating that field populations of Ae. albopictus are highly polymorphic. The northern populations tended to belong to gene pool I (BJFT 60.4%, SXXA 58.4%, SDJN 56.1%, SXYC 46.8%), the eastern populations tended to belong to pool III (SH 49.5%, JZHZ 48.1%), and the southern populations tended to belong to three different gene pools. Moreover, we observed that the greater the fixation index (FST), the lower the wild-type frequency of F1534 of VSGC.
    CONCLUSIONS: The degree of genetic differentiation among Ae. albopictus populations in China was low. These populations were divided into three gene pools, in which the northern and eastern pools are relatively homogeneous, while the southern gene pool is heterogeneous. The possible correlation between its genetic variations and kdr mutations is also noteworthy.
    Keywords:  Aedes albopictus; China; Knockdown resistance; Microsatellite; Population structure
    DOI:  https://doi.org/10.1186/s40249-023-01096-x
  3. Med Vet Entomol. 2023 May 03.
    Mosquito community composition in two major stopover aquatic ecosystems used by migratory birds in northern Spain.
    Mikel A González, Fátima Goiri, Aitor Cevidanes, Luis M Hernández-Triana, Jesús F Barandika, Ana L García-Pérez.
      Mosquitoes (Diptera: Culicidae) are common bloodsucking Diptera frequently found in aquatic environments, which are valuable ecosystems for many animal species, particularly migrating birds. Therefore, interactions between these animal species and mosquitoes may play a critical role in pathogen transmission. During 2018-2019, mosquitoes were collected from two aquatic ecosystems in northern Spain using different methodologies and identified using classical morphology and molecular tools. A total of 1529 males and females of 22 native mosquito species (including eight new records for the region) were trapped using CO2 -baited Centers for Disease Control and Prevention (CDC) traps and sweep netting. Among the blood-fed female mosquitoes, 11 vertebrate host species-six mammals and five birds-were identified using DNA barcoding. The developmental sites of eight mosquito species were determined across nine microhabitats, and 11 mosquito species were caught landing on humans. The flight period varied among mosquito species, with some peaking in the spring and others in the summer. Our study highlights the advantages of mosquito sampling using various techniques to comprehensively characterise species composition and abundance. Information on the trophic preferences, biting behaviour and influence of climatic variables on the ecology of mosquitoes is also provided.
    Keywords:  aquatic ecosystems; blood-meals; diversity; flight activity; host feeding preferences; mosquitoes
    DOI:  https://doi.org/10.1111/mve.12661
  4. PLoS Negl Trop Dis. 2023 May 01. 17(5): e0010252
    Understanding West Nile virus transmission: Mathematical modelling to quantify the most critical parameters to predict infection dynamics.
    Elisa Fesce, Giovanni Marini, Roberto Rosà, Davide Lelli, Monica Pierangela Cerioli, Mario Chiari, Marco Farioli, Nicola Ferrari.
      West Nile disease is a vector-borne disease caused by West Nile virus (WNV), involving mosquitoes as vectors and birds as maintenance hosts. Humans and other mammals can be infected via mosquito bites, developing symptoms ranging from mild fever to severe neurological infection. Due to the worldwide spread of WNV, human infection risk is high in several countries. Nevertheless, there are still several knowledge gaps regarding WNV dynamics. Several aspects of transmission taking place between birds and mosquitoes, such as the length of the infectious period in birds or mosquito biting rates, are still not fully understood, and precise quantitative estimates are still lacking for the European species involved. This lack of knowledge affects the precision of parameter values when modelling the infection, consequently resulting in a potential impairment of the reliability of model simulations and predictions and in a lack of the overall understanding of WNV spread. Further investigations are thus needed to better understand these aspects, but field studies, especially those involving several wild species, such as in the case of WNV, can be challenging. Thus, it becomes crucial to identify which transmission processes most influence the dynamics of WNV. In the present work, we propose a sensitivity analysis to investigate which of the selected epidemiological parameters of WNV have the largest impact on the spread of the infection. Based on a mathematical model simulating WNV spread into the Lombardy region (northern Italy), the basic reproduction number of the infection was estimated and used to quantify infection spread into mosquitoes and birds. Then, we quantified how variations in four epidemiological parameters representing the duration of the infectious period in birds, the mosquito biting rate on birds, and the competence and susceptibility to infection of different bird species might affect WNV transmission. Our study highlights that knowledge gaps in WNV epidemiology affect the precision in several parameters. Although all investigated parameters affected the spread of WNV and the modelling precision, the duration of the infectious period in birds and mosquito biting rate are the most impactful, pointing out the need of focusing future studies on a better estimate of these parameters at first. In addition, our study suggests that a WNV outbreak is very likely to occur in all areas with suitable temperatures, highlighting the wide area where WNV represents a serious risk for public health.
    DOI:  https://doi.org/10.1371/journal.pntd.0010252
  5. Parasit Vectors. 2023 May 05. 16(1): 158
    Using community science data to assess the association between urbanization and the presence of invasive Aedes species in Hungary.
    László Zsolt Garamszegi, Zoltán Soltész, Kornélia Kurucz, Tamara Szentiványi.
       BACKGROUND: Urbanization can be a significant contributor to the spread of invasive mosquito vector species, and the diseases they carry, as urbanized habitats provide access to a great density of food resources (humans and domestic animals) and offer abundant breeding sites for these vectors. Although anthropogenic landscapes are often associated with the presence of invasive mosquito species, we still have little understanding about the relationships between some of these and the built environment.
    METHODS: This study explores the association between urbanization level and the occurrence of invasive Aedes species, specifically Aedes albopictus, Aedes japonicus, and Aedes koreicus, in Hungary, using data from a community (or citizen) science program undertaken between 2019 and 2022.
    RESULTS: The association between each of these species and urbanized landscapes within an extensive geographic area was found to differ. Using the same standardized approach, Ae. albopictus showed a statistically significant and positive relationship with urbanization, whereas Ae. japonicus and Ae. koreicus did not.
    CONCLUSIONS: The findings highlight the importance of community science to mosquito research, as the data gathered using this approach can be used to make qualitative comparisons between species to explore their ecological requirements.
    Keywords:  Citizen science; Disease vector; Habitat preference; Urbanization level
    DOI:  https://doi.org/10.1186/s13071-023-05780-7
  6. Zoonoses Public Health. 2023 May 02.
    Ťahyňa virus-A widespread, but neglected mosquito-borne virus in Europe.
    Kristína Mravcová, Jeremy V Camp, Zdeněk Hubálek, Silvie Šikutová, Alexander G C Vaux, Jolyon M Medlock, Ivo Rudolf.
      Ťahyňa virus (TAHV) is an orthobunyavirus and was the first arbovirus isolated from mosquitoes in Europe and is associated with floodplain areas as a characteristic biotope, hares as reservoir hosts and the mammal-feeding mosquitoes Aedes vexans as the main vector. The disease caused by TAHV ("Valtice fever") was detected in people with acute flu-like illness in the 1960s, and later the medical significance of TAHV became the subject of many studies. Although TAHV infections are widespread, the prevalence and number of actual cases, clinical manifestations in humans and animals and the ecology of transmission by mosquitoes and their vertebrate hosts are rarely reported. Despite its association with meningitis in humans, TAHV is a neglected human pathogen with unknown public health importance in Central Europe, and a potential emerging disease threat elsewhere in Europe due to extreme summer flooding events.
    Keywords:   Aedes ; Europe; Valtice fever; arboviruses; mosquito; vectors
    DOI:  https://doi.org/10.1111/zph.13042
  7. Front Microbiol. 2023 ;14 1156176
    The epidemiology and evolutionary dynamics of massive dengue outbreak in China, 2019.
    Shaowei Sang, Yujuan Yue, Yiguan Wang, Xiangwei Zhang.
       Introduction: In 2019, China experienced massive dengue outbreaks with high incidence and expanded outbreak areas. The study aims to depict dengue's epidemiology and evolutionary dynamics in China and explore the possible origin of these outbreaks.
    Methods: Records of confirmed dengue cases in 2019 were obtained from the China Notifiable Disease Surveillance System. The sequences of complete envelope gene detected from the outbreak provinces in China in 2019 were retrieved from GenBank. Maximum Likelihood trees were constructed to genotype the viruses. The median-joining network was used to visualize fine-scale genetic relationships. Four methods were used to estimate the selective pressure.
    Results: A total of 22,688 dengue cases were reported, 71.4% of which were indigenous cases and 28.6% were imported cases (including from abroad and from other domestic provinces). The abroad cases were predominantly imported from Southeast Asia countries (94.6%), with Cambodia (3,234 cases, 58.9%), and Myanmar (1,097 cases, 20.0%) ranked as the top two. A total of 11 provinces with dengue outbreaks were identified in the central-south of China, of which Yunnan and Guangdong provinces had the highest number of imported and indigenous cases. The primary source of imported cases in Yunnan was from Myanmar, while in the other ten provinces, the majority of imported cases were from Cambodia. Guangdong, Yunnan and Guangxi provinces were China's primary sources of domestically imported cases. Phylogenetic analysis of the viruses in outbreak provinces revealed three genotypes: (I, IV, and V) in DENV 1, Cosmopolitan and Asian I genotypes in DENV 2, and two genotypes (I and III) in DENV 3. Some genotypes concurrently circulated in different outbreak provinces. Most of the viruses were clustered with those from Southeast Asia. Haplotype network analysis showed that Southeast Asia, possibly Cambodia and Thailand, was the respective origin of the viruses in clade 1 and 4 for DENV 1. Positive selection was detected at codon 386 in clade 1.
    Conclusion: Dengue importation from abroad, especially from Southeast Asia, resulted in the dengue epidemic in China in 2019. Domestic transmission between provinces and positive selection on virus evolution may contribute to the massive dengue outbreaks.
    Keywords:  China; dengue; epidemiology; evolution; imported
    DOI:  https://doi.org/10.3389/fmicb.2023.1156176
  8. Sci Rep. 2023 May 05. 13(1): 7367
    Malaria, climate variability, and interventions: modelling transmission dynamics.
    Anton Beloconi, Bryan O Nyawanda, Godfrey Bigogo, Sammy Khagayi, David Obor, Ina Danquah, Simon Kariuki, Stephen Munga, Penelope Vounatsou.
      Assessment of the relative impact of climate change on malaria dynamics is a complex problem. Climate is a well-known factor that plays a crucial role in driving malaria outbreaks in epidemic transmission areas. However, its influence in endemic environments with intensive malaria control interventions is not fully understood, mainly due to the scarcity of high-quality, long-term malaria data. The demographic surveillance systems in Africa offer unique platforms for quantifying the relative effects of weather variability on the burden of malaria. Here, using a process-based stochastic transmission model, we show that in the lowlands of malaria endemic western Kenya, variations in climatic factors played a key role in driving malaria incidence during 2008-2019, despite high bed net coverage and use among the population. The model captures some of the main mechanisms of human, parasite, and vector dynamics, and opens the possibility to forecast malaria in endemic regions, taking into account the interaction between future climatic conditions and intervention scenarios.
    DOI:  https://doi.org/10.1038/s41598-023-33868-8
  9. medRxiv. 2023 Apr 17. pii: 2023.04.11.23288401. [Epub ahead of print]
    Malaria surveillance reveals parasite relatedness, signatures of selection, and correlates of transmission across Senegal.
    Stephen F Schaffner, Aida Badiane, Akanksha Khorgade, Medoune Ndiop, Jules Gomis, Wesley Wong, Yaye Die Ndiaye, Younouss Diedhiou, Julie Thwing, Mame Cheikh Seck, Angela Early, Mouhamad Sy, Awa Deme, Mamadou Alpha Diallo, Ngayo Sy, Aita Sene, Tolla Ndiaye, Djiby Sow, Baba Dieye, Ibrahima Mbaye Ndiaye, Amy Gaye, Aliou Ndiaye, Katherine E Battle, Joshua L Proctor, Caitlin Bever, Fatou Ba Fall, Ibrahima Diallo, Seynabou Gaye, Doudou Sene, Daniel L Hartl, Dyann F Wirth, Bronwyn MacInnis, Daouda Ndiaye, Sarah K Volkman.
      Parasite genetic surveillance has the potential to play an important role in malaria control. We describe here an analysis of data from the first year of an ongoing, nationwide program of genetic surveillance of Plasmodium falciparum parasites in Senegal, intended to provide actionable information for malaria control efforts. Looking for a good proxy for local malaria incidence, we found that the best predictor was the proportion of polygenomic infections (those with multiple genetically distinct parasites), although that relationship broke down at very low incidence. The proportion of closely related parasites in a site was more weakly correlated with incidence while the local genetic diversity was uninformative. Study of related parasites indicated their potential for discriminating local transmission patterns: two nearby study areas had similarly high fractions of relatives, but one area was dominated by clones and the other by outcrossed relatives. Throughout the country, most related parasites proved to belong to a single network of relatives, within which parasites were enriched for shared haplotypes at known and suspected drug resistance loci as well as at one novel locus, reflective of ongoing selection pressure.
    DOI:  https://doi.org/10.1101/2023.04.11.23288401
  10. Front Vet Sci. 2023 ;10 1137392
    Retrospective investigation of the origin and epidemiology of the dengue outbreak in Yunnan, China from 2017 to 2018.
    Liang Cao, Ziping Yu, Haiqiang He, Xiaofang Guo, Chun Wei, Xuancheng Zhang, Junduo Bao, Chenghui Li, Hongning Zhou, Jialiang Xin, Fulong Nan.
      Since 2013, a dengue epidemic has broken out in Yunnan, China and neighboring countries. However, after the COVID-19 pandemic in 2019, the number of dengue cases decreased significantly. In this retrospective study, epidemiological and genetic diversity characterizations of dengue viruses (DENV) isolated in Yunnan between 2017 and 2018 were performed. The results showed that the dengue outbreak in Yunnan from 2017 to 2018 was mainly caused by DENV1 (genotype I and genotype V) and DENV2 (Asia I, Asia II, and Cosmopolitan). Furthermore, correlation analysis indicated a significant positive correlation between the number of imported and local cases (correlation coefficient = 0.936). Multiple sequence alignment and phylogenetic divergence analysis revealed that the local isolates are closely related to the isolates from Myanmar and Laos. Interestingly, recombination analysis found that the DENV1 and DENV2 isolates in this study had widespread intra-serotype recombination. Taken together, the results of the epidemiological investigation imply that the dengue outbreak in Yunnan was primarily due to imported cases. This study provides a new reference for further investigations on the prevalence and molecular epidemiology of DENV in Yunnan, China.
    Keywords:  2017–2018; Yunnan; dengue virus; epidemiology; phylogenetic analysis
    DOI:  https://doi.org/10.3389/fvets.2023.1137392
  11. Acta Microbiol Immunol Hung. 2023 May 02.
    West Nile virus infections in Hungary: Epidemiological update and phylogenetic analysis of the Hungarian virus strains between 2015 and 2022.
    Anna Nagy, András Horváth, Eszter Mezei, Judit Henczkó, Nóra Magyar, Orsolya Nagy, Anita Koroknai, Nikolett Csonka, Mária Takács.
      Following the introduction of the West Nile virus (WNV) into Hungary in 2004, it has shortly become one of the most important human arbovirus infections, with a gradually increasing number of cases. The study aimed to summarize the current epidemiological situation in Hungary and sequence the WNV PCR-positive clinical specimens and virus isolates by next-generation whole genome sequencing (NGS) to obtain a detailed phylogenetic analysis of the circulating virus strains. Whole blood and urine samples from confirmed WNV-infected patients and WNV isolates were investigated by reverse transcription PCR assays. Genome sequencing was carried out by Sanger-method, followed by NGS on the Illumina MiSeq platform. Altogether 499 human infections were diagnosed between 2004 and 2022. A particularly remarkable increase in human WNV infections was observed in 2018, while the number of reported cases significantly decreased during the COVID-19 pandemic. Between 2015 and 2022, 15 WNV isolates, and 10 PCR-positive clinical specimens were investigated by NGS. Phylogenetic analysis revealed that the major European WNV lineage 2 clades, namely the Eastern European (or Russian) and the Central European (or Hungarian) clades, are presented in Hungary. Strains of the Balkan and other European clusters within the Central European clade are co-circulating in the country, following a characteristic geographical distribution. In Hungary, the presence and co-circulation of multiple lineage 2 WNV strains could be identified in the last few years. Therefore, in light of the 2018 WNV outbreak, sequence-based typing of the currently circulating strains could highly support outbreak investigations.
    Keywords:  West Nile virus; arboviruses; emerging pathogens; lineage 2; next-generation sequencing; phylogeny; zoonotic infections
    DOI:  https://doi.org/10.1556/030.2023.02040
  12. Heliyon. 2023 Apr;9(4): e15373
    Malaria prevalence in Pakistan: A systematic review and meta-analysis (2006-2021).
    Muhammad Imran Khan, Humera Qureshi, Suk Joo Bae, Aamer Ali Khattak, Muhammad Shahid Anwar, Sadique Ahmad, Fazal Hassan, Shabir Ahmad.
      Malaria is one of the major public health issues globally. Malaria infection spreads through mosquito bites from infected female Anopheles mosquitoes. This study aims to conduct a systematic review and meta-analysis on malaria prevalence in Pakistan from 2006 to 2021. We searched PubMed, Science Direct, EMBASE, EMCare, and Google Scholar to acquire data on the prevalence of malaria infections. We performed a meta-analysis with a random-effects model to obtain the pooled prevalence of malaria, Plasmodium vivax, and Plasmodium falciparum. Meta-analysis was computed using R 4.1.2 Version statistical software. I2 and time series analysis were performed to identify a possible source of heterogeneity across studies. A funnel plot and the Freeman-Tukey Double Arcsine Transformed Proportion were used to evaluate the presence of publication bias. Out of the 315 studies collected, only 45 full-text articles were screened and included in the final measurable meta-analysis. Pooled malaria prevalence in Pakistan was 23.3%, with Plasmodium vivax, Plasmodium falciparum, and mixed infection rates of 79.13%, 16.29%, and 3.98%, respectively. Similarly, the analysis revealed that the maximum malaria prevalence was 99.79% in Karachi and the minimum was 1.68% in the Larkana district. Amazingly, this systematic review and meta-analysis detected a wide variation in malaria prevalence in Pakistan. Pakistan's public health department and other competent authorities should pay close attention to the large decrease in mosquito populations to curb the infection rate.
    Keywords:  Malaria; Meta-analysis; Pakistan; Plasmodium falciparum; Plasmodium vivax
    DOI:  https://doi.org/10.1016/j.heliyon.2023.e15373
  13. Malar J. 2023 May 02. 22(1): 146
    Malaria prevalence in Mauritania: a systematic review and meta-analysis.
    Inejih El Moustapha, Mohamed Ouldabdallahi Moukah, Mohamed Salem Ould Ahmedou Salem, Khyarhoum Brahim, Sébastien Briolant, Leonardo Basco, Ali Ould Mohamed Salem Boukhary.
       BACKGROUND: Understanding malaria epidemiology is a critical step toward efficient malaria control and elimination. The objective of this meta-analysis was to derive robust estimates of malaria prevalence and Plasmodium species from studies conducted in Mauritania and published since 2000.
    METHODS: The present review followed the PRISMA guidelines. Searches were conducted in various electronic databases such as PubMed, Web of Science, and Scopus. To obtain pooled prevalence of malaria, meta-analysis was performed using the DerSimonian-Laird random-effects model. Methodological quality of eligible prevalence studies was assessed using Joanna Briggs Institute tool. Inconsistency and heterogeneity between studies were quantified by the I2 index and Cochran's Q test. Publication bias was assessed with funnel plots and Egger's regression tests.
    RESULTS: A total of 16 studies with a good individual methodological quality were included and analysed in this study. The overall random effects pooled prevalence of malaria infection (symptomatic and asymptomatic) across all included studies was 14.9% (95% confidence interval [95% CI]: 6.64, 25.80, I2 = 99.8%, P < 0.0001) by microscopy, 25.6% (95% CI: 8.74, 47.62, I2 = 99.6%, P < 0.0001) by PCR and 24.3% (95% CI: 12.05 to 39.14, I2 = 99.7%, P < 0.0001) by rapid diagnostic test. Using microscopy, the prevalence of asymptomatic malaria was 1.0% (95% CI: 0.00, 3.48) against 21.46% (95% CI: 11.03, 34.21) in symptomatic malaria. The overall prevalence of Plasmodium falciparum and Plasmodium vivax was 51.14% and 37.55%, respectively. Subgroup analysis showed significant variation (P = 0.039) in the prevalence of malaria between asymptomatic and symptomatic cases.
    CONCLUSION: Plasmodium falciparum and P. vivax are widespread in Mauritania. Results of this meta-analysis implies that distinct intervention measures including accurate parasite-based diagnosis and appropriate treatment of confirmed malaria cases are critical for a successful malaria control and elimination programme in Mauritania.
    Keywords:  Malaria; Mauritania; Meta-analysis; Plasmodium falciparum; Plasmodium vivax; Prevalence; Systematic review
    DOI:  https://doi.org/10.1186/s12936-023-04569-4
  14. N Engl J Med. 2023 May 04. 388(18): 1633-1636
    Combating West Nile Virus Disease - Time to Revisit Vaccination.
    Carolyn V Gould, J Erin Staples, Claire Y-H Huang, Aaron C Brault, Randall J Nett.
      
    DOI:  https://doi.org/10.1056/NEJMp2301816
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