Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo
Clinical observations and animal studies have suggested that Salmonella intestinal carriage is promoted by concurrent Schistosoma infection. The present study assessed association of Salmonella intestinal carriage and Schistosoma mansoni infection among individuals in a Schistosoma endemic area in s...
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Veröffentlicht in: | PLoS neglected tropical diseases 2020-02, Vol.14 (2), p.e0007875 |
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creator | Mbuyi-Kalonji, Lisette Barbé, Barbara Nkoji, Gaëlle Madinga, Joule Roucher, Clémentine Linsuke, Sylvie Hermy, Marie Heroes, Anne-Sophie Mattheus, Wesley Polman, Katja Lutumba, Pascal Phoba, Marie-France Lunguya, Octavie Jacobs, Jan |
description | Clinical observations and animal studies have suggested that Salmonella intestinal carriage is promoted by concurrent Schistosoma infection. The present study assessed association of Salmonella intestinal carriage and Schistosoma mansoni infection among individuals in a Schistosoma endemic area in sub-Saharan Africa.
From November 2015 to March 2016, a cross-sectional community-wide study was conducted in Kifua II, a rural village in Kongo Central Province, Democratic Republic of Congo. Stool samples were collected and analyzed for Salmonella intestinal carriage (culture) and Schistosoma mansoni infection (Kato Katz microscopy with determination of egg load). Salmonella Typhimurium and Enteritidis isolates were assessed for genetic similarity with blood culture isolates obtained during the same period in a neighboring hospital using multi-locus variable-numbers tandem repeat analysis (MLVA).
A total of 1,108 participants were included (median age 15 years (IQR: 7-36), male-to-female ratio of 1:1.1). The overall prevalence of Schistosoma mansoni infection and non-typhoidal Salmonella carriage was 51.2% (95% CI: 48.2-54.1) and 3.4% (95% CI: 2.5-4.7) respectively, with 2.2% (95% CI: 1.5-3.2) of participants coinfected. The proportion of Salmonella carriage tended to be higher among Schistosoma mansoni infected participants compared to non-infected participants but this difference did not reach statistical significance (4.2% versus 2.6%, p = 0.132). However, the proportion of Salmonella carriage among participants with a heavy Schistosoma mansoni infection was significantly higher compared to those with a light and moderate infection (8.7% versus 3.2%, p = 0.012) and compared to Schistosoma mansoni negatives (8.7% versus 2.6%, p = 0.002). The 38 Salmonella isolates comprised five and four Enteritidis and Typhimurium serotypes respectively, the majority of them had MLVA types identical or similar to those observed among blood culture isolates.
Salmonella intestinal carriage was associated with a heavy intensity of Schistosoma mansoni infection. Further studies are needed to address causation. |
doi_str_mv | 10.1371/journal.pntd.0007875 |
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From November 2015 to March 2016, a cross-sectional community-wide study was conducted in Kifua II, a rural village in Kongo Central Province, Democratic Republic of Congo. Stool samples were collected and analyzed for Salmonella intestinal carriage (culture) and Schistosoma mansoni infection (Kato Katz microscopy with determination of egg load). Salmonella Typhimurium and Enteritidis isolates were assessed for genetic similarity with blood culture isolates obtained during the same period in a neighboring hospital using multi-locus variable-numbers tandem repeat analysis (MLVA).
A total of 1,108 participants were included (median age 15 years (IQR: 7-36), male-to-female ratio of 1:1.1). The overall prevalence of Schistosoma mansoni infection and non-typhoidal Salmonella carriage was 51.2% (95% CI: 48.2-54.1) and 3.4% (95% CI: 2.5-4.7) respectively, with 2.2% (95% CI: 1.5-3.2) of participants coinfected. The proportion of Salmonella carriage tended to be higher among Schistosoma mansoni infected participants compared to non-infected participants but this difference did not reach statistical significance (4.2% versus 2.6%, p = 0.132). However, the proportion of Salmonella carriage among participants with a heavy Schistosoma mansoni infection was significantly higher compared to those with a light and moderate infection (8.7% versus 3.2%, p = 0.012) and compared to Schistosoma mansoni negatives (8.7% versus 2.6%, p = 0.002). The 38 Salmonella isolates comprised five and four Enteritidis and Typhimurium serotypes respectively, the majority of them had MLVA types identical or similar to those observed among blood culture isolates.
Salmonella intestinal carriage was associated with a heavy intensity of Schistosoma mansoni infection. Further studies are needed to address causation.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0007875</identifier><identifier>PMID: 32084128</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Animals ; Bacteria ; Biology ; Biology and Life Sciences ; Biomedical research ; Blood ; Blood culture ; Blood tests ; Carrier State - epidemiology ; Carrier State - microbiology ; Causation ; Child ; Coinfection - epidemiology ; Coinfection - microbiology ; Coinfection - parasitology ; Comorbidity ; Cross-Sectional Studies ; Democratic Republic of the Congo - epidemiology ; Endemic species ; Epidemiology ; Female ; Fever ; Funding ; Hospitals ; Humans ; Immunology ; Infections ; Intestine ; Intestines - microbiology ; Male ; Medical research ; Medicine ; Medicine and Health Sciences ; Microscopy ; Mortality ; Ova ; Rural areas ; Rural Population ; Salmonella ; Salmonella typhimurium ; Salmonella typhimurium - genetics ; Salmonella typhimurium - isolation & purification ; Schistosoma ; Schistosoma mansoni ; Schistosoma mansoni - genetics ; Schistosoma mansoni - isolation & purification ; Schistosoma mansoni - physiology ; Schistosomiasis mansoni - epidemiology ; Schistosomiasis mansoni - parasitology ; Serotypes ; Statistical methods ; Studies ; Supervision ; Tropical diseases ; Typhoid ; Vaccines ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2020-02, Vol.14 (2), p.e0007875</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Mbuyi-Kalonji et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Mbuyi-Kalonji et al 2020 Mbuyi-Kalonji et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-3428afd9aa319eae09483d9601cfc01e69ab2cb6e67271fa924271599bef656b3</citedby><cites>FETCH-LOGICAL-c624t-3428afd9aa319eae09483d9601cfc01e69ab2cb6e67271fa924271599bef656b3</cites><orcidid>0000-0002-5092-8689</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034803/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034803/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32084128$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lok, James B.</contributor><creatorcontrib>Mbuyi-Kalonji, Lisette</creatorcontrib><creatorcontrib>Barbé, Barbara</creatorcontrib><creatorcontrib>Nkoji, Gaëlle</creatorcontrib><creatorcontrib>Madinga, Joule</creatorcontrib><creatorcontrib>Roucher, Clémentine</creatorcontrib><creatorcontrib>Linsuke, Sylvie</creatorcontrib><creatorcontrib>Hermy, Marie</creatorcontrib><creatorcontrib>Heroes, Anne-Sophie</creatorcontrib><creatorcontrib>Mattheus, Wesley</creatorcontrib><creatorcontrib>Polman, Katja</creatorcontrib><creatorcontrib>Lutumba, Pascal</creatorcontrib><creatorcontrib>Phoba, Marie-France</creatorcontrib><creatorcontrib>Lunguya, Octavie</creatorcontrib><creatorcontrib>Jacobs, Jan</creatorcontrib><title>Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Clinical observations and animal studies have suggested that Salmonella intestinal carriage is promoted by concurrent Schistosoma infection. The present study assessed association of Salmonella intestinal carriage and Schistosoma mansoni infection among individuals in a Schistosoma endemic area in sub-Saharan Africa.
From November 2015 to March 2016, a cross-sectional community-wide study was conducted in Kifua II, a rural village in Kongo Central Province, Democratic Republic of Congo. Stool samples were collected and analyzed for Salmonella intestinal carriage (culture) and Schistosoma mansoni infection (Kato Katz microscopy with determination of egg load). Salmonella Typhimurium and Enteritidis isolates were assessed for genetic similarity with blood culture isolates obtained during the same period in a neighboring hospital using multi-locus variable-numbers tandem repeat analysis (MLVA).
A total of 1,108 participants were included (median age 15 years (IQR: 7-36), male-to-female ratio of 1:1.1). The overall prevalence of Schistosoma mansoni infection and non-typhoidal Salmonella carriage was 51.2% (95% CI: 48.2-54.1) and 3.4% (95% CI: 2.5-4.7) respectively, with 2.2% (95% CI: 1.5-3.2) of participants coinfected. The proportion of Salmonella carriage tended to be higher among Schistosoma mansoni infected participants compared to non-infected participants but this difference did not reach statistical significance (4.2% versus 2.6%, p = 0.132). However, the proportion of Salmonella carriage among participants with a heavy Schistosoma mansoni infection was significantly higher compared to those with a light and moderate infection (8.7% versus 3.2%, p = 0.012) and compared to Schistosoma mansoni negatives (8.7% versus 2.6%, p = 0.002). The 38 Salmonella isolates comprised five and four Enteritidis and Typhimurium serotypes respectively, the majority of them had MLVA types identical or similar to those observed among blood culture isolates.
Salmonella intestinal carriage was associated with a heavy intensity of Schistosoma mansoni infection. Further studies are needed to address causation.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Animals</subject><subject>Bacteria</subject><subject>Biology</subject><subject>Biology and Life Sciences</subject><subject>Biomedical research</subject><subject>Blood</subject><subject>Blood culture</subject><subject>Blood tests</subject><subject>Carrier State - epidemiology</subject><subject>Carrier State - microbiology</subject><subject>Causation</subject><subject>Child</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - microbiology</subject><subject>Coinfection - parasitology</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Democratic Republic of the Congo - epidemiology</subject><subject>Endemic species</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fever</subject><subject>Funding</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infections</subject><subject>Intestine</subject><subject>Intestines - microbiology</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Microscopy</subject><subject>Mortality</subject><subject>Ova</subject><subject>Rural areas</subject><subject>Rural Population</subject><subject>Salmonella</subject><subject>Salmonella typhimurium</subject><subject>Salmonella typhimurium - genetics</subject><subject>Salmonella typhimurium - isolation & purification</subject><subject>Schistosoma</subject><subject>Schistosoma mansoni</subject><subject>Schistosoma mansoni - genetics</subject><subject>Schistosoma mansoni - isolation & purification</subject><subject>Schistosoma mansoni - physiology</subject><subject>Schistosomiasis mansoni - epidemiology</subject><subject>Schistosomiasis mansoni - parasitology</subject><subject>Serotypes</subject><subject>Statistical methods</subject><subject>Studies</subject><subject>Supervision</subject><subject>Tropical diseases</subject><subject>Typhoid</subject><subject>Vaccines</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptkluL1DAUx4so7rr6DUQLgvgyYy5N0rwIy3hbWBRcfQ6naTrN0CZjkgrzGfzSZna6y4wseUg4-Z3_uRbFS4yWmAr8fuOn4GBYbl1qlwghUQv2qDjHkrIFEZQ9PnqfFc9i3CDEJKvx0-KMElRXmNTnxd9v3i3Sbtt728JQ3sAwemeGAUrrkonJ5hClhhAsrE22lVDe6N7G5KMfoRzBRe9saVxrRqtL7cdxcjbtDmiYQnaHYKD0XZl6U340o9cBUmZ_mO3UDPmRv1berf3z4kkHQzQv5vui-PX508_V18X19y9Xq8vrheakSgtakRq6VgJQLA0YJKuatpIjrDuNsOESGqIbbrggAncgSZVvJmVjOs54Qy-K1wfd7eCjmvsYFaFCCISlrDJxdSBaDxu1DXaEsFMerLo1-LBWEHINg1EM69xLzRqORNUwU3NiGKqoMLXkNe2y1oc52tSMptXGpdyUE9HTH2d7tfZ_lEC0qhHNAu9mgeB_T3kmarRR72fkjJ_2eXOCCSKMZfTNf-jD1c3UGnIB1nU-x9V7UXXJMWekkkRmavkAlc_tpPOSdDbbTxzeHjn0BobURz9MyXoXT8HqAOrgYwymu28GRmq_23dZq_1uq3m3s9ur40beO90tM_0H5T32rQ</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Mbuyi-Kalonji, Lisette</creator><creator>Barbé, Barbara</creator><creator>Nkoji, Gaëlle</creator><creator>Madinga, Joule</creator><creator>Roucher, Clémentine</creator><creator>Linsuke, Sylvie</creator><creator>Hermy, Marie</creator><creator>Heroes, Anne-Sophie</creator><creator>Mattheus, Wesley</creator><creator>Polman, Katja</creator><creator>Lutumba, Pascal</creator><creator>Phoba, Marie-France</creator><creator>Lunguya, Octavie</creator><creator>Jacobs, Jan</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5092-8689</orcidid></search><sort><creationdate>20200201</creationdate><title>Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo</title><author>Mbuyi-Kalonji, Lisette ; Barbé, Barbara ; Nkoji, Gaëlle ; Madinga, Joule ; Roucher, Clémentine ; Linsuke, Sylvie ; Hermy, Marie ; Heroes, Anne-Sophie ; Mattheus, Wesley ; Polman, Katja ; Lutumba, Pascal ; Phoba, Marie-France ; Lunguya, Octavie ; Jacobs, Jan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-3428afd9aa319eae09483d9601cfc01e69ab2cb6e67271fa924271599bef656b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Animals</topic><topic>Bacteria</topic><topic>Biology</topic><topic>Biology and Life Sciences</topic><topic>Biomedical research</topic><topic>Blood</topic><topic>Blood culture</topic><topic>Blood tests</topic><topic>Carrier State - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mbuyi-Kalonji, Lisette</au><au>Barbé, Barbara</au><au>Nkoji, Gaëlle</au><au>Madinga, Joule</au><au>Roucher, Clémentine</au><au>Linsuke, Sylvie</au><au>Hermy, Marie</au><au>Heroes, Anne-Sophie</au><au>Mattheus, Wesley</au><au>Polman, Katja</au><au>Lutumba, Pascal</au><au>Phoba, Marie-France</au><au>Lunguya, Octavie</au><au>Jacobs, Jan</au><au>Lok, James B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>14</volume><issue>2</issue><spage>e0007875</spage><pages>e0007875-</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Clinical observations and animal studies have suggested that Salmonella intestinal carriage is promoted by concurrent Schistosoma infection. The present study assessed association of Salmonella intestinal carriage and Schistosoma mansoni infection among individuals in a Schistosoma endemic area in sub-Saharan Africa.
From November 2015 to March 2016, a cross-sectional community-wide study was conducted in Kifua II, a rural village in Kongo Central Province, Democratic Republic of Congo. Stool samples were collected and analyzed for Salmonella intestinal carriage (culture) and Schistosoma mansoni infection (Kato Katz microscopy with determination of egg load). Salmonella Typhimurium and Enteritidis isolates were assessed for genetic similarity with blood culture isolates obtained during the same period in a neighboring hospital using multi-locus variable-numbers tandem repeat analysis (MLVA).
A total of 1,108 participants were included (median age 15 years (IQR: 7-36), male-to-female ratio of 1:1.1). The overall prevalence of Schistosoma mansoni infection and non-typhoidal Salmonella carriage was 51.2% (95% CI: 48.2-54.1) and 3.4% (95% CI: 2.5-4.7) respectively, with 2.2% (95% CI: 1.5-3.2) of participants coinfected. The proportion of Salmonella carriage tended to be higher among Schistosoma mansoni infected participants compared to non-infected participants but this difference did not reach statistical significance (4.2% versus 2.6%, p = 0.132). However, the proportion of Salmonella carriage among participants with a heavy Schistosoma mansoni infection was significantly higher compared to those with a light and moderate infection (8.7% versus 3.2%, p = 0.012) and compared to Schistosoma mansoni negatives (8.7% versus 2.6%, p = 0.002). The 38 Salmonella isolates comprised five and four Enteritidis and Typhimurium serotypes respectively, the majority of them had MLVA types identical or similar to those observed among blood culture isolates.
Salmonella intestinal carriage was associated with a heavy intensity of Schistosoma mansoni infection. Further studies are needed to address causation.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32084128</pmid><doi>10.1371/journal.pntd.0007875</doi><orcidid>https://orcid.org/0000-0002-5092-8689</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1935-2735 |
ispartof | PLoS neglected tropical diseases, 2020-02, Vol.14 (2), p.e0007875 |
issn | 1935-2735 1935-2727 1935-2735 |
language | eng |
recordid | cdi_plos_journals_2377701994 |
source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central |
subjects | Adolescent Adult Animals Bacteria Biology Biology and Life Sciences Biomedical research Blood Blood culture Blood tests Carrier State - epidemiology Carrier State - microbiology Causation Child Coinfection - epidemiology Coinfection - microbiology Coinfection - parasitology Comorbidity Cross-Sectional Studies Democratic Republic of the Congo - epidemiology Endemic species Epidemiology Female Fever Funding Hospitals Humans Immunology Infections Intestine Intestines - microbiology Male Medical research Medicine Medicine and Health Sciences Microscopy Mortality Ova Rural areas Rural Population Salmonella Salmonella typhimurium Salmonella typhimurium - genetics Salmonella typhimurium - isolation & purification Schistosoma Schistosoma mansoni Schistosoma mansoni - genetics Schistosoma mansoni - isolation & purification Schistosoma mansoni - physiology Schistosomiasis mansoni - epidemiology Schistosomiasis mansoni - parasitology Serotypes Statistical methods Studies Supervision Tropical diseases Typhoid Vaccines Young Adult |
title | Non-typhoidal Salmonella intestinal carriage in a Schistosoma mansoni endemic community in a rural area of the Democratic Republic of Congo |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T23%3A30%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Non-typhoidal%20Salmonella%20intestinal%20carriage%20in%20a%20Schistosoma%20mansoni%20endemic%20community%20in%20a%20rural%20area%20of%20the%20Democratic%20Republic%20of%20Congo&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Mbuyi-Kalonji,%20Lisette&rft.date=2020-02-01&rft.volume=14&rft.issue=2&rft.spage=e0007875&rft.pages=e0007875-&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0007875&rft_dat=%3Cgale_plos_%3EA616524929%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2377701994&rft_id=info:pmid/32084128&rft_galeid=A616524929&rft_doaj_id=oai_doaj_org_article_51c084c5b6074b5e862e50437e89683f&rfr_iscdi=true |