Background Recently, arboviruses have been of concern as pathogens for emerging and re-emerging infectious diseases. In Ghana, yellow fever outbreak occurred in Savannah Region in the year 2021. A team from different institutions, organisations, and stakeholders of health with varying vital expertise was assembled to respond to this national emergency to assess, contain and/or control the rapid spread of the disease. This paper presents findings from the entomological investigations conducted during the yellow fever outbreak. Methods Immature stages of Aedes mosquitoes were collected from breeding containers in and around houses, and adult mosquitoes sampled using BG-Sentinel traps, human landing catches and Prokopack collections. After morphological identification of these mosquitoes, they were screened for Chikungunya, Dengue Fever, Yellow Fever, and Zika viruses using real time reverse-transcription polymerase chain reaction. Results In all, 12,264 breeding containers were examined. A total of 3,885 larvae and 1,186 pupae were obtained from 173 containers. Out of 1,001 houses surveyed, 130 were positive for larvae and/or pupae. The breeding receptacles included plastic (6,529), metallic (6,024), clay jar (753), tire (565), and well (34). The WHO thresholds for arboviruses larval indices were used to assess risk. A total of 1571 adults identified [ Aedes aegypti aegypti (35), Aedes aegypti formosus (619), and Culex (917)] were collected with adult mosquito sampling methods or emerged from immature mosquitoes stages. None of the arboviruses were detected using qPCR. Conclusion Vectors had no yellow fever infections. There was a high risk of arbovirus transmission in the study areas although mosquito vectors were not positive for arboviruses. Aedes aegypti formosus was the dominant Aedes species. They might be drivers for yellow fever transmission during outbreak. Generally, arboviral transmission was high in all study districts. Although yellow fever virus was not detected, Aedes aegypti populations and transmission risk in study districts was high. Author summary In 2021, Savannah Region of Ghana experienced yellow fever outbreak. This spread quickly to adjoining regions. The disease is transmitted by some female mosquitoes infected with yellow fever virus. These same mosquitoes can transmit other viral infections resulting in disease outcomes such as chikungunya, dengue, and zika. A team of experts from stakeholders of health were mobilised to control and/or contain the spread of the disease to other parts of Ghana. The team carried out several activities and assessments to stop the spread of yellow fever. Notably is the investigation to determine different types of mosquitoes involved in transmitting the disease. We collected some mosquitoes and processed them for vital information that could prevent future outbreaks of the aforementioned diseases. There is no surveillance system in Ghana to pick up early warnings regarding potential viral disease outbreaks. Therefore, there is scanty information on these type of mosquitoes and viruses found in different places. We used standard procedures to assess the risk of these mosquitoes in causing future disease outbreaks. Our findings suggested a high risk of future outbreaks for any of the viral diseases tested. We therefore recommended the implementation of a mosquito surveillance system to prevent future outbreaks. ### Competing Interest Statement The authors have declared no competing interest.

ABSTRACT. The threats from vector-borne pathogens transmitted by ticks place people (including deployed troops) at increased risk for infection, frequently contributing to undifferentiated febrile illness syndromes. Wild and domesticated animals are critical to the transmission cycle of many tick-borne diseases. Livestock can be infected by ticks, and serve as hosts to tick-borne diseases such as rickettsiosis. Thus, it is necessary to identify the tick species and determine their potential to transmit pathogens. A total of 1,493 adult ticks from three genera— Amblyomma , Hyalomma , and Rhipicephalus —were identified using available morphological keys and were pooled ( n = 541) by sex and species. Rickettsia species were detected in 308 of 541 (56.9%) pools by genus-specific quantitative polymerase chain reaction assay (Rick17b). Furthermore, sequencing of the outer membrane protein A and B genes ( ompA and ompB ) of random samples of Rickettsia -positive samples led to the identification of Rickettsia aeschlimannii and Rickettsia africae with most R. africae DNA (80.2%) detected in pools of Amblyomma variegatum . We report the first molecular detection and identification of the rickettsial pathogens R. africae and R. aeschlimannii in ticks from Ghana. Our findings suggest there is a need to use control measures to prevent infections from occurring among human populations in endemic areas in Ghana. This study underscores the importance of determining which vector-borne pathogens are in circulation in Ghana. Further clinical and prevalence studies are needed to understand more comprehensively the clinical impact of these rickettsial pathogens contributing to human disease and morbidity in Ghana.

Background: Leishmaniasis is a parasitic disease that mostly affects populations in tropical and subtropical countries. In Ghana, cutaneous leishmaniasis (CL) is the most common form of the disease affecting communities of the Volta Region. Conventional parasitological method (microscopy) is the commonly used test for CL diagnosis in many endemic countries, but has low sensitivity in chronic cases. Therefore, there is a clear need for a sensitive and easy-to-use point-of-care diagnostic method like an isothermal recombinase polymerase amplification-lateral flow (RPA-LF) test, suitable for use in austere and low-resource settings for the identification of CL cases. This study compared the efficacy of RPA-LF test with quantitative PCR (qPCR) in detecting Leishmania in suspected CL cases from the Volta Region. Methods: Twenty-five participants between 5 and 14 years were enrolled in the study from whom a total of 26 samples were obtained. Lesion samples were collected using FTA® filter papers applied to ulcerated lesions for molecular diagnosis. DNA isolated from filter papers was used for both the RPA-LF test and qPCR. Results: Twenty-two participants (88%) presented with one or two ulcerated active lesions per individual, while the rest of them had plaques or dried lesions. Among the 26 samples, 19/26 (73%) had concordant results when comparing the two diagnostic methods. Conclusion: Data from this study suggest that the RPA-LF test can be used in addition to a conventional parasitological diagnostic test (microscopy) to detect CL cases in communities of the Volta Region.

ABSTRACTDengue fever is expanding as a global public health threat including countries within Africa. For the past few decades, Cameroon has experienced sporadic cases of arboviral infections including dengue fever. Here, we conducted genomic analyses to investigate the origin and phylogenetic profile of Cameroon DENV-1 outbreak strains and predict the impact of emerging therapeutics on these strains. Bayesian and maximum-likelihood phylogenetic inference approaches were employed in virus evolutionary analyses. An in silico analysis was performed to assess the divergence in immunotherapeutic and vaccine targets in the new genomes. Six complete DENV-1 genomes were generated from 50 samples that met a clinical definition for DENV infection. Phylogenetic analyses revealed that the strains from the current study belong to a sub-lineage of DENV-1 genotype V and form a monophyletic taxon with a 2012 strain from Gabon. The most recent common ancestor (TMRCA) of the Cameroon and Gabon strains was estimated to have existed around 2008. Comparing our sequences to the vaccine strains, 19 and 15 amino acid (aa) substitutions were observed in the immuno-protective prM-E protein segments of the Dengvaxia® and TetraVax-DV-TV003 vaccines, respectively. Epitope mapping revealed mismatches in aa residues at positions E155 and E161 located in the epitope of the human anti-DENV-1 monoclonal antibody HMAb 1F4. The new DENV strains constitute a conserved genomic pool of viruses endemic to the Central African region that needs prospective monitoring to track local viral evolution. Further work is needed to ascertain the performance of emerging therapeutics in DENV strains from the African region.

Ticks are important vectors of various pathogenic protozoa, bacteria and viruses that cause serious and life-threatening illnesses in humans and animals worldwide. Estimating tick-borne pathogen prevalence in tick populations is necessary to delineate how geographical differences, environmental variability and host factors influence pathogen prevalence and transmission. This study identified ticks and tick-borne pathogens in samples collected from June 2016 to December 2017 at seven sites within the Coastal, Sudan and Guinea savanna ecological zones of Ghana. A total of 2016 ticks were collected from domestic animals including cattle, goats and dogs. Ticks were morphologically identified and analysed for pathogens such as Crimean-Congo haemorrhagic fever virus (CCHFV), Alkhurma haemorrhagic fever virus (AHFV), Rickettsia spp. and Coxiella burnetii using polymerase chain reaction assays (PCR) and sequence analysis. Seven species were identified, with Amblyomma variegatum (60%) most frequently found, followed by Rhipicephalus sanguineus sensu lato (21%), Rhipicephalus spp. (9%), Hyalomma truncatum (6%), Hyalomma rufipes (3%), Rhipicephalus evertsi (1%) and Rhipicephalus (Boophilus) sp. (0.1%). Out of 912 pools of ticks tested, Rickettsia spp. and Coxiella burnetii DNA was found in 45.6% and 16.7% of pools, respectively, whereas no CCHFV or AHFV RNA were detected. Co-infection of bacterial DNA was identified in 9.6% of tick pools, with no statistical difference among the ecozones studied. Based on these data, humans and animals in these ecological zones are likely at the highest risk of exposure to rickettsiosis, since ticks infected with Rickettsia spp. displayed the highest rates of infection and co-infection with C. burnetii, compared to other tick-borne pathogens in Ghana.

BackgroundChikungunya virus (CHIKV) is a re-emerging arbovirus associated with sporadic outbreaks in Cameroon since 2006. Viral whole genomes were generated to analyze the origins of evolutionary lineages, the potential of emergence/re-emergence, and to infer transmission dynamics of recent Cameroon CHIKV outbreak strains.MethodsSamples collected between 2016 and 2019 during CHIKV outbreaks in Cameroon were screened for CHIKV using reverse transcription PCR (RT-PCR), followed by whole genome sequencing of positive samples.ResultsThree coding-complete CHIKV genomes were obtained from samples, which belong to an emerging sub-lineage of the East/Central/South African genotype and formed a monophyletic taxon with previous Central African strains. This clade, which we have named the new Central African clade, appears to be evolving at 3.0 × 10−4 nucleotide substitutions per site per year (95% highest posterior density (HPD) interval of 1.94 × 10−4 to 4.1 × 10−4). Notably, mutations in the envelope proteins (E1-A226V, E2-L210Q, and E2-I211T), which are known to enhance CHIKV adaptability and infectious potential in Aedes albopictus, were present in all strains and mapped to established high-density Ae. albopictus populations.ConclusionsThese new CHIKV strains constitute a conserved genomic pool of an emerging sub-lineage, reflecting a putative vector host adaptation to Ae. albopictus, which has practically displaced Aedes aegypti from select regions of Cameroon.