Discovery of a novel albendazole-ivermectin refractoryTrichurisspecies,T. hominis, in Côte d’Ivoire patients through fecal DNA metabarcoding

Abstract

AbstractAlbendazole-ivermectin combination therapy is a promising alternative to benzimidazole monotherapy forTrichuris trichiuracontrol. We used fecal DNA metabarcoding to genetically characterizeTrichurispopulations in patients from a clinical trial showing lower albendazole-ivermectin efficacy in Côte d’Ivoire (ERR below 70%) than in Lao PDR and Tanzania (ERR above 98%). ITS-1 and ITS-2 rDNA metabarcoding revealed the entire Côte d’IvoireTrichurispopulation was phylogenetically distinct fromT. trichiurain Lao PDR and Tanzania, and more closely related to the porcine parasiteTrichuris suis. Complete mitogenomes of eight adultTrichurisfrom Côte d’Ivoire confirmed their species-level differentiation. CorrespondingTrichurisITS-1 and ITS-2 sequences in NCBI from individual human patients in Cameroon and Uganda and three captive non-human primates suggest this newly recognized species,T. hominis, is distributed beyond Côte d’Ivoire and has zoonotic potential. Further work is needed to assess the impact of thisTrichurisspecies on soil transmitted helminth control programs.