Seroprevalence of <scp>HTLV</scp>‐1 and HTLV‐2 amongst mothers and children in Malawi within the context of a systematic review and meta‐analysis of <scp>HTLV</scp> seroprevalence in Africa

Fox, James M.; Mutalima, Nora; Molyneux, Elizabeth; Carpenter, Lucy; Taylor, Graham P.; Bland, Martin; Newton, Robert; Martin, Fabiola

doi:10.1111/tmi.12659

Cited by 24 publications

(16 citation statements)

References 87 publications

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“…However, the situation of HTLV-1 in Africa is not well known. Indeed, the majority of previous studies have been carried out either on very specific populations such as pregnant women, blood donors or hospitalized patient series, or in heterogeneous and relatively small groups of rural or urban inhabitants of a specific town or village or area [ 5 , 13 ]. All these groups are far from being representative of the population of a given region or country.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for HTLV-1 infection in Central Africa: A rural population-based survey in Gabon

et al. 2018

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BackgroundHuman T-Lymphotropic Virus type 1 (HTLV-1) is a human oncoretrovirus that infects at least 5 to 10 million people worldwide and is associated with severe diseases. Africa appears as the largest HTLV-1 endemic area. However, the risk factors for the acquisition of HTLV-1 remain poorly understood in Central Africa.MethodsWe conducted an epidemiological survey between 2013 and 2017, in rural areas of 6 provinces of Gabon, in a rainforest environment. Epidemiological data were obtained and blood samples were collected after informed consent. Plasma were screened for HTLV-1 antibodies by ELISA and the positive samples were then tested by Western blot (WB). Genomic DNA derived from buffy-coat was subjected to two semi-nested PCRs amplifying either HTLV-1 env gene or LTR region fragments.ResultsWe recruited 2,060 individuals over 15 years old, including 1,205 men and 855 women (mean age: 49 years). Of these, 299 were found to be ELISA HTLV-1/2 seropositive. According to WB criteria, 136 were HTLV-1 (6.6%), 25 HTLV-1/2 (1.2%) and 9 HTLV seroreactive (0.4%). PCR results showed that 146 individuals were positive for at least one PCR: 104 for the env gene and 131 for the LTR region. Based on both serological and molecular results, 179 individuals were considered infected with HTLV-1, leading to an overall prevalence of 8.7%. The distribution of HTLV-1 infection was heterogeneous across the country. Based on multivariable analyses, female gender, increasing age, ethnicity (Pygmy) and multiple hospitalizations (more than 5 times) were found to be independent risk factors for HTLV-1 infection. Furthermore, a non-human primate bite appeared to be marginally associated with a higher risk of HTLV-1 infection.ConclusionBased on state-of-the-art serological and molecular methods, we have demonstrated that rural adult populations in Gabon are highly endemic for HTLV-1. Our results regarding risk factors should lead to public health actions aiming to reduce HTLV-1 transmission.

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Section: Introductionmentioning

confidence: 99%

Risk factors for HTLV-1 infection in Central Africa: A rural population-based survey in Gabon

et al. 2018

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“…Based on the regional prevalences of HTLV in adults from Fox et al . and assuming an annual incidence of ATLL among adult (40+) carriers of HTLV‐1 in Africa of 40 per 10 5 in males and 25 per 10 5 in females, about 1,400 cases of ATLL (all in SSA) would be caused by HTLV‐1 in Africa in 2018.…”

Section: Resultsmentioning

confidence: 99%

“…[101][102][103][104] A systematic review of studies in 25 African countries found the average seroprevalence of HTLV-1 in NA to be 0%, 1.2% in Eastern and Southern Africa and 3.2% in Western and Central Africa. 17 ATLL occurs in older adults in Japan, and is very rare under the age of 40, but seems to be more common among younger individual elsewhere. In a review of the incidence of ATLL among carriers of HTLV-1 in Japan, Iwanaga et al 105 found the rate to be about 60 per 100,000, 1.35 times higher in males than females.…”

Section: Htlv-imentioning

confidence: 99%

“…In the early 1980s, HTLV-1 was the first human retrovirus to be recognized as a carcinogenic agent and able to cause adult T-cell leukemia/lymphoma (ATLL). 13 Based on the regional prevalences of HTLV in adults from Fox et al 17 and assuming an annual incidence of ATLL among adult (40+) carriers of HTLV-1 in Africa of 40 per 10 5 in males and 25 per 10 5 in females, about 1,400 cases of ATLL (all in SSA) would be caused by HTLV-1 in Africa in 2018. ATLL has been rarely identified in Africa, probably due to lack of diagnostic facilities, although when series of lymphoma cases are reviewed, some 10-20% have characteristics of ATLL (with positivity for HTLV-1 18,19 ).…”

Section: Human T-cell Lymphotropic Virusmentioning

confidence: 99%

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Cancer in Africa 2018: The role of infections

Parkin

Hämmerl

Ferlay

et al. 2019

Intl Journal of Cancer

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We estimate the fractions of cancer attributed to infections in Africa in 2018. The number of new cancer cases occurring was taken from Globocan2018 with some additional estimations based on data from African population‐based registries. Population attributable fractions were calculated using prevalence of infection and relative risk in exposed vs. nonexposed. The greatest share of infection‐associated cancers is due to the human papillomaviruses (12.1% of all cancers in Africa and 15.4% in sub‐Saharan Africa [SSA]); of these, cervical cancer is by far the most common. Kaposi sarcoma‐associated herpesvirus is responsible for 3.1% of all cancers in Africa, the hepatitis viruses (B and C) for 2.9% and Helicobacter pylori for 2.7% (non‐Cardia Gastric cancer and primary gastric lymphomas). Two percent of cancers are attributable to the Epstein–Barr virus, Schistosoma haematobium increases the risk of bladder cancer resulting in 1.0% of all cancers. HIV‐related NHL and squamous cell carcinoma of the conjunctiva account for 0.6% of cancers. Altogether 24.5% of cancers in Africa and 28.7% in SSA are due to infectious agents. Infections are by far the most common cancer risk factor for cancer in Africa—the traditional risk factors (smoking, alcohol and unhealthy diet) probably cause only one in eight cancers in Africa. Prevention should focus on those infectious diseases preventable through vaccination (HPV and hepatitis B) which could reduce two‐thirds of the burden. Helicobacter pylori and schistosomiasis are treatable with antibiotics and praziquantel, with a potential reduction of one in eight infection‐associated cancers.

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“…48 Few prevalence data are available for HTLV1/2 in SSA; when available, estimates are frequently based on accessible populations (e.g., blood donors and pregnant women). 49 A review found that the HTLV1 prevalence in healthy volunteers ranged from 0% (Zambia) to 13.07% (Gabon) 50 ; more recently, a seroprevalence of 2.1% was reported among pregnant women in Gabon. 51 The epidemiology of transfusion-associated HTLV1/2 in SSA is uncertain.…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

Weimer

Tagny

Tapko³

et al. 2018

Transfusion

107

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BACKGROUND Access to a safe, adequate blood supply has proven challenging in sub‐Saharan Africa, where systemic deficiencies spanning policy, collections, testing, and posttransfusion surveillance have long been recognized. Progress in transfusion safety in the early 2000s was in large part due to intervention by the World Health Organization and other foreign governmental bodies, coupled with an influx of external funding. STUDY DESIGN AND METHODS A review of the literature was conducted to identify articles pertaining to blood safety in sub‐Saharan Africa from January 2009 to March 2018. The search was directed toward addressing the major elements of the blood safety chain, in the countries comprising the World Health Organization African region. Of 1380 articles, 531 met inclusion criteria and 136 articles were reviewed. RESULTS External support has been associated with increased recruitment of voluntary donors and expanded testing for the major transfusion‐transmitted infections (TTIs). However, the rates of TTIs among donors remain high. Regional education and training initiatives have been implemented, and a tiered accreditation process has been adopted. However, a general decline in funding for transfusion safety (2009 onwards) has strained the ability to maintain or improve transfusion‐related services. Critical areas of need include data collection and dissemination, epidemiological surveillance for TTIs, donor recruitment, quality assurance and oversight (notably laboratory testing), and hemovigilance. CONCLUSION Diminishing external support has been challenging for regional transfusion services. Critical areas of deficiency in regional blood transfusion safety remain. Nonetheless, substantive gains in education, training, and accreditation suggest durable gains in regional capacity.

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Seroprevalence of HTLV‐1 and HTLV‐2 amongst mothers and children in Malawi within the context of a systematic review and meta‐analysis of HTLV seroprevalence in Africa

Cited by 24 publications

References 87 publications

Risk factors for HTLV-1 infection in Central Africa: A rural population-based survey in Gabon

Risk factors for HTLV-1 infection in Central Africa: A rural population-based survey in Gabon

Cancer in Africa 2018: The role of infections

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

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