Co-circulation of Plasmodium and Bacterial DNAs in Blood of Febrile and Afebrile Children from Urban and Rural Areas in Gabon
Authors: Jean Bernard Lekana-Douki
Rella Zoleko Manego
Pierre Blaise Matsiegui
Alpha Kabinet Keïta
Angélique Ndjoyi-Mbiguino
Florence Fenollar
Irene Pegha Moukandja
Lady Charlène Kouna
Didier Raoult
Hervé Tissot-Dupont
Sydney Maghendji Nzondo
Gaël Mourembou
Journal: American Journal of Tropical Medicine and Hygiene (2016)
Discipline: CLINICAL MEDICINE
Keywords: Malaria; Bacteremias; Children; Gabon; DNA extracts
Affiliations: Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France. Ecole Doctorale Régionale d'Afrique Centrale, Franceville, Gabon., Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon., Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon., Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France., Département de Microbiologie, Laboratoire National de Référence IST/sida, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon., Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Sciences de la Santé, Libreville, Gabon.

Abstract:  Malaria is considered to be the most common etiology of fever in sub-Saharan Africa while bacteremias exist but are under assessed. This study aimed to assess bacteremias and malaria in children from urban and rural areas in Gabon. DNA extracts from blood samples of 410 febrile and 60 afebrile children were analyzed using quantitative polymerase chain reaction. Plasmodium spp. was the microorganism most frequently detected in febrile (78.8%, 323/410) and afebrile (13.3%, 8/60) children, (P &lt; 0.001). DNA from one or several bacteria were detected in 15 febrile patients (3.7%) but not in the controls (P = 0.1). This DNA was more frequently detected as co-infections among febrile children tested positive for Plasmodium (4.6%, 15/323) than in those tested negative for Plasmodium (0%, 0/87; P = 0.04). The bacteria detected were Streptococcus pneumoniae 2.4% (10/410), Staphylococcus aureus 1.7% (7/410), Salmonella spp. 0.7% (3/410), Streptococcus pyogenes 0.2% (1/410) and Tropheryma whipplei 0.2% (1/410) only in febrile children. Coxiella burnetii, Borrelia spp., Bartonella spp., Leptospira spp., and Mycobacterium tuberculosis were not observed. This paper reports the first detection of bacteremia related to T. whipplei in Gabon and shows that malaria decreases in urban areas but not in rural areas. Co-infections in febrile patients are common, highlighting the need to improve fever management strategies in Gabon. 

Retracted: No

PubPeer comments:
 This paper is part of a set of 9 papers. According to the authors, all papers are related to the same protocol approved under the number 0023 2013 SG CNE by the National Ethics Committee of Gabon. Some of the authors are mentioned in the 9 papers. This protocol seems to cover 2 types of different objectives: -t3 papers describe a study on malaria in children. -t9 papers describe studies dedicated to characterize different new bacteria. **Study on malaria in children:** - 3 papers describe a study in hundreds of febrile and afebriles children. -tBlood samples are taken. -tThe study is performed between 2013 and 2014. **Studies to characterize different new bacteria:** 6 papers describe different protocols done on different participants. -tStools samples have been taken. No blood samples. -t4 papers describe a protocol performed on 1 child only. This is a different child for each paper. All samples have been taken on January 2015. -t1 paper describes a protocol performed on 1 adult only on January 2015 -t1 paper describes a protocol performed on 3 children in Gabon and Senegal in 2016. Can the authors explain how a unique protocol cover 2 different types of studies with 2 objectives so different? -tStudy designs are very different. -tRecruitment periods are different. -tTypes of participants are different -tTypes of sample are different, etcu2026 It seems pretty unusual that a same protocol cover -tblood samples in children to study malaria in 2013. -tand also a stool sample in 1 adult only, 2 years after. Can the authors explain the scope of the protocol Nu00b00023 2013 SG CNE and the approval process by the National Ethics Committee of Gabon for this 2 different type of design ? **Malaria in children u2013 Blood samples (2013-2014)** 1.t[Emerging infectious diseases - Possible role of Rickettsia felis in acute febrile illness among children in Gabon] 2.t[Malaria journal - Malaria in urban, semi-urban and rural areas of southern of Gabon: comparison of the Pfmdr 1 and Pfcrt genotypes from symptomatic children] 3.t[The American journal of tropical medicine and hygiene - Co-circulation of Plasmodium and bacterial DNAs in blood of febrile and afebrile children from urban and rural areas in Gabon] **Description of new bacteria u2013 Stool samples in children (or 1 adult)** 4.t[Current microbiology - Description of Gabonibacter massiliensis gen. nov., sp. nov., a new member of the family porphyromonadaceae isolated from the human gut microbiota] 5.t[New Microbes and New Infections - Taxonogenomics description of Bacillus dakarensis sp. nov., Bacillus sinesaloumensis sp. nov. and Bacillus massiliogabonensis sp. nov., three new species isolated from human stools] 6.t[New microbes and new infections - Noncontiguous finished genome sequence and description of Gabonia massiliensis gen. nov., sp. nov.] 7.t[New microbes and new infections - u201cIntestinimonas gabonensisu201d sp. nov., a new bacterium detected from a Gabonese stool specimen] 8.t[New microbes and new infections - Noncontiguous finished genome sequence and description of Kallipyga gabonensis sp. nov.] 9.t[New microbes and new infections - Discovery of a new species within Bacillus genus in a stool sample from Gabon:u201cBacillus massiliogabonensisu201d sp. nov.] ,