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Simple Summary: Mosquito surveys conducted in the Democratic Republic of Sao Tome and Principe during 2000 to 2016 as a part of anti-malaria programs found the presence of four species of mosquitoes in the nation including Culex (Culex) poicilipes, Mansonia (Coquillettidia) annetti, Uranotaenia (Uranotaenia) alboabdominalis, and Uranotaenia (Uranotaenia) fraseri for the first time. Aedes albopictus (Skuse, 1894) was identified in 2015, and the follow-up survey confirmed that Aedes albopictus has become widespread across the nation. The larvae were predominant in artificial water-holding containers, with a positive rate up to 45.6% in used tires in Príncipe, while the native species, Aedes aegypti, preferred natural breeding sources. Phylogenetic analysis based on mitochondrial DNA revealed the introduced populations belonged to a clade involved in the worldwide spread of the species. Aedes albopictus is a public health threat due to its vectorial capacity for various arboviruses. Continuous vector surveillance and implication of interventions, such as source reduction to remove used tires, environmental management, and use of larvicides, were suggested. Aedes albopictus (Skuse, 1894), a mosquito originating in Asia, has been introduced to Africa since the 2000s. The mosquito is not only a nuisance but is capable of transmitting various arboviruses. The current study summarized our entomological surveys in the Democratic Republic of Sao Tome and Principe during 2000 to 2016. Adult mosquitoes were collected by sweep nets, human landing catches, and Centers for Disease Control (CDC) light traps, and the immatures were collected from water-filled habitats at 15 sentinel sites and reared to adulthood. Species identification was performed based on morphologic characteristics. Fragments of the cytochrome C oxidase subunit I (COI) and the Wolbachia surface protein (wsp) genes were amplified for mosquitoes collected in Principe. New records of four mosquito species were reported. Aedes albopictus was identified in 2015. The larvae were found distributed over the nation and were predominately in artificial water-holding containers (488/2698, 18.1%). The highest positive rate was observed in used tires in Príncipe (114/250, 45.6%). Mitochondrial DNA analysis revealed low genetic diversity among the invasive populations, but all tested specimens were superinfected by Wolbachia. The ability of Ae. albopictus to adapt to new environments and its involvement in disease transmission make the surveillance and control of this species particularly important. [ABSTRACT FROM AUTHOR]

Rickettsia felis is an obligate intracellular Gram‐negative bacterium which causes flea‐borne spotted fever in humans. In the past decades, R. felis has been detected worldwide in Ctenocephalides felis fleas and various other arthropods. However, due to its shared symptoms with other common vector‐borne diseases, human infection is prone to be underestimated or misdiagnosed, especially in the malaria‐endemic areas including sub‐Saharan Africa, where confirmatory laboratory diagnoses are not usually available. In this study, a 'One Health' approach was adopted to explore potential vector‐borne and zoonotic pathogens in the Democratic Republic of Sao Tome and Principe (DRSTP), an island nation in the Gulf of Guinea. By collaborating with local veterinarians, 1,187 fleas were collected from 95 domestic dogs across the country and later identified as Ct. felis using taxonomic keys. A cytochrome oxidase gene‐based phylogenetic analysis revealed that all collected fleas belonged to a single haplotype and were identical to isolates from Ivory Coast and Brazil that clustered into a clade of tropical distribution. Additional samples of 14 chigoe fleas (Tunga penetrans) were collected from the surrounding environment of the dogs' resting spots. Rickettsia felis infection in fleas was examined by molecular methods targeting the citrate synthase (gltA)‐ and outer membrane protein A (ompA)‐coding genes as well as the R. felis‐specific pRF plasmid. The bacterial DNA was detected in 21.01% (146/695) of cat fleas but none of the chigoe fleas. Microimmunofluorescence assay was then performed to assess pathogen exposure of the residents. Of 240 dried blood spots from participants with dog contacts, 8 (3.33%) exhibited R. felis antibodies. Our findings demonstrated the presence of R. felis in DRSTP. Further extensive epidemiological studies regarding its prevalence and its role in causing febrile illness while the nation is entering pre‐elimination stage of malaria will be carried out. [ABSTRACT FROM AUTHOR]

Spotted fever group rickettsiae (SFGR) and Coxiella burnetii are intracellular bacteria that cause potentially life‐threatening tick‐borne rickettsioses and Q fever respectively. Sao Tome and Principe (STP), small islands located in the Gulf of Guinea, recently experienced a dramatic reduction in the incidence of malaria owing to international collaborative efforts. However, unexplained febrile illnesses persist. A One Health approach was adopted to investigate exposure to SFGR and C. burnetii in humans and examine the diversity of these bacteria in ticks parasitizing domestic ruminants. A cross‐sectional human serological study was conducted in Agua Grande district in Sao Tome Island from January to March 2016, and ticks were collected from farmed domestic ruminants in 2012 and 2016. In total, 240 individuals varying in age were randomly screened for exposure to SFGR and C. burnetii by indirect immunofluorescence assay. Twenty of 240 individuals (8.3%) were seropositive for SFGR (4 for Rickettsia africae and 16 for R. conorii) and 16 (6.7%) were seropositive for C. burnetii. Amblyomma astrion were collected exclusively in 2012, as were A. variegatum in 2016 and Rickettsia spp. were detected in 22/42 (52.4%) and 49/60 (81.7%) respectively. Sequence analysis of multiple gene targets from Rickettsia spp. detected in ticks suggests the presence of a single divergent R. africae strain (Sao Tome). While no ticks were found positive for C. burnetii, Coxiella‐like endosymbionts were detected in nearly all ticks. This is the first study in STP to provide serological evidence in humans of SFGR and C. burnetii and additional molecular evidence in ticks for SFGR, which may be responsible for some of the unexplained febrile illnesses that persist despite the control of malaria. Future epidemiological studies are needed to confirm the occurrence and risk factors associated with SFG rickettsioses and Q fever in both humans and animals. [ABSTRACT FROM AUTHOR]

Orientia tsutsugamushi is an obligate intracellular bacterium that causes scrub typhus in humans. Formerly thought to be confined to the "tsutsugamushi triangle" within the Asia-Pacific region, scrub typhus was recently identified in the Western Hemisphere. Moreover, a new species of Orientia bacterial genus was isolated from a patient in Dubai. This study investigated Orientia exposure in an African country, the Democratic Republic of Sao Tome and Principe. Two sets of samples were analyzed in the study: 240 dried blood spots (DBSs) collected in 2016 and 863 serum samples from 570 pregnant women in 2003. Antibodies against O. tsutsugamushi were examined by immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA). The positive samples were further confirmed by Western blot. The results of IFA showed that 5.8% (14/240) of DBSs and 20.4% (116/570) of the serum samples contained reactive antibodies, whereas IgG ELISA yielded a positive rate of 15.4% (88/570) for the serum samples. These findings provided serologic evidence of potential Orientia exposure even though case of scrub typhus has never been diagnosed in the nation. Further studies are needed to determine the epidemiology and the burden of this neglected tropical disease in Africa.