Mansonella ozzardi (Nematoda: Onchocercidae) is an understudied filarial nematode, originally described by Patrick Manson in 1897, that can be transmitted by two families of dipteran vectors, biting midges (most of them members of the genus Culicoides) and black flies (genus Simulium). With a patchy geographic distribution from southern Mexico to northwestern Argentina, human infection with M. ozzardi is highly prevalent in some of the Caribbean islands, along riverine communities in the Amazon Basin, and on both sides of the border between Bolivia and Argentina. There is no clinical entity unequivocally associated with M. ozzardi infection, although fever, arthralgia, headache, cold lower extremities, and itchy cutaneous rashes are occasionally mentioned in case report series. More recently, ocular manifestations (especially keratitis) have been associated with mansonelliasis, opening an important area of investigation. Here, we briefly review the biology, epidemiology, pathogenesis, and clinical aspects of M. ozzardi infection and point to some existing knowledge gaps, aiming to stimulate a research agenda to help filling them. IntroductionMansonella ozzardi (Nematoda: Onchocercidae) is one of the several filarial nematodes that infect humans. This relatively unknown parasite has a patchy geographic distribution across Latin America and the Caribbean, from southern Mexico to northwestern Argentina. Most infected people, regardless of the parasite density, are asymptomatic or have few symptoms. As a consequence, infections with M. ozzardi usually remain undiagnosed and untreated. Ill-defined and unspecific symptoms such as fever, arthralgia, headache, cold lower extremities, and itchy cutaneous rashes are occasionally reported by patients, but whether they are caused by M. ozzardi infection remains to be determined. Nevertheless, ocular manifestations potentially associated with mansonelliasis, especially keratitis, have attracted substantial interest from ophthalmologists in recent years. Here, we summarize key biological, epidemiological, and clinical aspects of M. ozzardi infection. We explore recent developments in pathogenesis, laboratory diagnosis, and chemotherapy and discuss the potential public health impact of this highly prevalent but largely neglected New World parasite. Biological featuresThree filarial nematodes of the genus Mansonella are known to cause human mansonelliasis: Mansonella streptocerca, which is endemic to Africa; Mansonella perstans, which is commonly found in Africa but also occurs in South America; and M. ozzardi, which is found exclusively in the Americas and the Caribbean islands.1 Only humans appear to be naturally infected with M. ozzardi; African patas monkeys (Erythrocebus patas), but not chimpanzees, rhesus, capuchin, or squirrel monkeys, are susceptible to experimental infection with this nematode. 4 Several decades later, Orihel and Eberhard described the elusive adult male and female worms recovered from experimentally infected patas monkeys. 2Natural infection with M. ...

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Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucumán Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female's oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease.

The species diversity and seasonal abundance of biting midges of the genus Culicoides (Diptera: Ceratopogonidae) were studied in northwestern Argentina during the period 2003-2005. A total of 5437 Culicoides specimens were collected using CDC light traps in three areas of the mountainous rainforest area. The most common species were Culicoides paraensis (Goeldi) and C. insignis Lutz, Culicoides lahillei (Iches), C. venezuelensis Ortiz & Mirsa, C. debilipalpis Lutz and C. crescentis Wirth & Blanton were also collected. Culicoides paraensis was abundant during the summer, and C. insignis and C. lahillei during late summer and early fall. Accumulated rainfall was the climatic variable most related to fluctuation in abundance of C. paraensis.

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The goal of this survey was to analyze the spatio-temporal distribution patterns of Culicoides Latreille species (Diptera: Ceratopogonidae) and their relationship with environmental variables in Salta, northwestern Argentina. Culicoides were collected monthly from January 2003 through December 2005. The influence of the climatic variables on population abundance was analyzed with a multilevel Poisson regression. A total of 918 specimens belonging to five species were collected. The most abundant species was Culicoides paraensis Goeldi (65.5%), followed by Culicoides lahillei Iches (14.6%) and Culicoides debilipalpis Lutz (7.6%). The highest seasonal abundance for C. paraensis, C. debilipalpis and C. lahillei occurred during the spring and summer. A Poisson regression analysis showed that the mean maximum and minimum temperature and the mean maximum and minimum humidity were the variables with the greatest influence on the population abundance of Culicoides species.

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A case of co-infection with Plasmodium vivax and Mansonella ozzardi was detected in a blood sample from a person who had shown symptoms of malaria and lived in a city that was close to the Argentina/Bolivia border. The case was detected during a random revision of thick and thin smears from patients diagnosed with malaria from various towns and cities located in north-western Argentina between 1983 and 2001. Trophozoites of P. vivax were observed in the thin blood smear along with M. ozzardi microfilaria (larval form), which presented a long, slender, pointed anucleate tail and the absence of the sheath. This last characteristic is shared with Mansonella perstans, Mansonella streptocerca and Onchocerca volvulus. More rigorously controlled studies to detect other co-infection cases in the area as well as the possibility of importation from Bolivia into Argentina are currently ongoing. The relationship between the malaria parasite and microfilaria, the potential effect of malaria treatment on the development of M. ozzardi, and the possible impact of this microfilaria on the immunity of a person against P. vivax are all still unknown. This contribution constitutes a point of focus for future studies involving the interaction between the parasites and the potential risk that humans are exposed to.