Home | Volume 19 | Article number 26

Original article

Enterohemorrhagic Escherichia coli O157 in North Africa region: a threat require advanced investigation

Enterohemorrhagic Escherichia coli O157 in North Africa region: a threat require advanced investigation

 

Mohamed Ahmed1,&, Jennifer Van Velkinburgh2

 

1Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya, 2Initiative for Collaboratory Biomedical Research, Santa Fe, New Mexico, USA

 

 

&Corresponding author
Mohamed Ahmed, Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya

 

 

To the editors of the Pan African Medical Journal

Several concerns exist regarding the prevalence, incidence, distribution and infectiousness of bacterial pathogen Enterohemorrhagic E. coli (EHEC) O157 in the North African region. EHEC O157 strains have been detected worldwide in animals as well as humans; the related infections have a complicated clinical course with occasionally fatal outcome, and the documented strains show remarkable variability between and within different countries [1-4]. Animals, cattle in particular, are a major reservoir and an important transmission vector of feacal E. coli O157 [5-7]. A limited amount of studies from Africa have reported diarrheagenic E. coli from human and non-human reservoirs but the true extent and burden E. coli 0157 is still unclear and possibly underestimated [5-8]. Below is a summary and comparison of recent published information on the status of E. coli 0157 in humans and animals in the North African region (Table 1).

 

Since the first reported outbreaks in Africa in the 1990s very limited information has been published regarding E. coli O157 and related outbreaks in humans [5,9]. In recent decades, few studies have investigated the prevalence of E. coli O157 in north African region, mostly focused on animals and food products (bovine-cattle and chicken) or/and from human stools (diarrheic and non diarrheic children) (Table 1). Most of North African studies have applied basic and recommended laboratory techniques with very limited application of PCR technology and absence of thorough epidemiological risk factors analysis [10]. The variation between different countries could be related to different risk factors which might have contributed to such variation even within countries and for both humans and animals in North Africa region. (Table 1). Cattle, especially under stress conditions, are a major reservoir of feacal E. coli O157, and an important environmental factor contributing to the zoonotic transmission of this bacterial pathogen in Africa by direct contact with feacal matter from shedding infected cattle or indirectly through ingestion of contaminated food products with faecal matters [5,7,11]. The North African countries share environmental, many economic and social features, which may have led to the close and lack documented status of E. coli O157 of some of these studies [12-17].

 

Most of data related to public health concerns from North Africa, are largely based on standard laboratory applications. This approach, with the exception of some researchers’ efforts has resulted in most publications neglecting the key importance of applying the data from epidemiological studies to identifying and resolving infections and outbreak [7]. PCR-based technology has become the gold standard for laboratory, diagnostics and epidemiological purposes across the globe; however, the standard and basic laboratory methods that have documented reliability are still recommended for use, especially in developing countries with insufficient accessibility to and expertise in the modern molecular technologies [2, 9, 10]. This letter has also brought forth a very important issue that also needs to be discussed: the traditional (and unfortunately regressive) mindset held by a portion of the scientific and medical community in some developing countries, especially developing countries, that is encumbering the overall efforts to advance these nations’ scientific and medical programs on a global scale. In order for the researchers of these countries to make meaningful contributions on a global scale, they must learn and employ the newest technologies and networking ability to the benefit of their national health and laboratory quality [18].

 

The current status of EHEC O157 in North African region is unclear and the public health risk concern remains uninvestigated. There is need to implement epidemiological researches and monitoring studies to determine the zoonotic risk of this pathogen from different animals, mainly in cattle. Such important investigations and interventions will provide health authorities with excellent data and important epidemiological information related to this pathogen. Developing countries should promote science and public health by setting up a sustainable future cadre of advanced thinking researchers who are willing and capable of embracing new technologies for the betterment of their societies.

 

 

Competing interests

The authors declare no competing interest.

 

 

Authors’ contributions

Authors have equally contributed in the preparation of this short article. All authors have read and agreed to the final version of this manuscript and have equally contributed to its content and to the management of the case.

 

 

Table

Table 1: summary of the prevalence and status of E. coli O157 in North African region

 

 

References

  1. CDC 2014. Multistate Outbreak of Shiga toxin-producing Escherichia coli O157:H7 Infections Linked to Ground Beef Posted May 19, 2014. Google Scholar

  2. Chahed A, China B, Mainil J, Daube G. Prevalence of enterohaemorrhagic Escherichia coli from serotype O157 and other attaching and effacing Escherichia coli on bovine carcasses in Algeria. J Appl Microbiol. 2006 Aug;101(2):361-368. PubMed | Google Scholar

  3. Gomez-Duarte OG, Arzuza O, Urbina D, Bai J, Guerra J, Montes O, et al. Detection of Escherichia coli enteropathogens by multiplex polymerase chain reaction from children's diarrheal stools in two Caribbean-Colombian cities. Foodborne Pathog Dis. 2010 Feb;7(2):199-206. PubMed | Google Scholar

  4. Sallam KI, Mohammed MA, Ahdy AM, Tamura T. Prevalence, genetic characterization and virulence genes of sorbitol-fermenting Escherichia coli O157:H- and E coli O157:H7 isolated from retail beef. Int J Food Microbiol. 2013 Aug 1;165(3):295-301. PubMed | Google Scholar

  5. Effler E, Isaacson M, Arntzen L, Heenan R, Canter P, Barrett T, et al. Factors contributing to the emergence of Escherichia coli O157 in Africa. Emerg Infect Dis. 2001 Sep;7(5):812-819. PubMed | Google Scholar

  6. Armstrong GL, Hollingsworth J, Morris JG, Jr. Emerging foodborne pathogens: Escherichia coli O157:H7 as a model of entry of a new pathogen into the food supply of the developed world. Epidemiol Rev. 1996;18(1):29-51. PubMed | Google Scholar

  7. Ahmed MO, Abouzeed YM. Enterohaemorrhagic Escherichia coli O157: a survey of dairy cattle in Tripoli, Libya. Libyan J Med. 2014;9:24409. PubMed | Google Scholar

  8. Okeke IN. Diarrheagenic Escherichia coli in sub-Saharan Africa: status, uncertainties and necessities. J Infect Dev Ctries. 2009;3(11):817-42. PubMed | Google Scholar

  9. Chigor VN, Umoh VJ, Smith SI, Igbinosa EO, Okoh AI. Multidrug resistance and plasmid patterns of Escherichia coli O157 and other E coli Isolated from diarrhoeal stools and surface waters from some selected sources in Zaria, Nigeria. Int J Environ Res Public Health. 2010 Oct;7(10):3831-41. PubMed | Google Scholar

  10. El Shrek YM, Ali MR. Microbiological study of spiced chicken burgers in Tripoli City, Libya. East Mediterr Health J. 2012 Jun;18(6):653-62. PubMed | Google Scholar

  11. El-Jakee JK, Mahmoud RM, Samy AA, El-Shabrawy MA, Effat MM and Gad El-Said WA. Molecular Characterization of E coli Isolated from Chicken, Cattle and Buffaloes. International Journal of Microbiological Research. 2012; 3 (1): 64-74. PubMed | Google Scholar

  12. Ghenghesh KS, Abeid SS, Bara F, and Bukris B. Aetiology of childhood diarrhoea in Tripoli-Libya. Jamahiriya Med J. 2001; 1(2): 23-29. PubMed | Google Scholar

  13. Ali MM, Mohamed ZK, Klena JD, Ahmed SF, Moussa TA, Ghenghesh KS. Molecular characterization of diarrheagenic Escherichia coli from Libya. Am J Trop Med Hyg. 2012 May;86(5):866-871. PubMed | Google Scholar

  14. Ahmed AM, Shimamoto T. Isolation and molecular characterization of Salmonella enterica, Escherichia coli O157:H7 and Shigella spp from meat and dairy products in Egypt. Int J Food Microbiol. 2014 Jan 3;168-169:57-62. PubMed | Google Scholar

  15. Al-Azeem MW, Hussein AA, Sultan S, Mohamed WK. Microbiological and Molecular Studies on E Coli O157:H7 as one of Important Food Borne Diseases XX. International Congress of Mediterranean Federation of Health and Production of Ruminants, 19-22 February (2013). Google Scholar

  16. Barka MS and Kihal M. Prevalence of Escherichia coli Enterohelorragic O157:H7 in frozen bovine meat in Algeria. World J of dairy and food sciences. 2010; 5(2):183-187. PubMed | Google Scholar

  17. Al-Gallas N, Bahri O, Bouratbeen A, Ben HA, Ben AR. Etiology of acute diarrhea in children and adults in Tunis, Tunisia, with emphasis on diarrheagenic Escherichia coli: prevalence, phenotyping, and molecular epidemiology. Am J Trop Med Hyg. 2007 Sep;77(3):571-82. PubMed | Google Scholar

  18. Arya SC, Agarwal N. Quality control inclinical diagnostic laboratories in remote and rural areas in Africa. Pan Afr Med J. 2012;13:76. PubMed | Google Scholar