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High prevalence and diversity of species D adenoviruses (HAdV-D) in human populations of four Sub-Saharan countries

Maude Pauly12, Eileen Hoppe2, Lawrence Mugisha34, Klara Petrzelkova56, Chantal Akoua-Koffi7, Emmanuel Couacy-Hymann8, Augustin Etile Anoh7, Arsène Mossoun8, Grit Schubert1, Lidewij Wiersma10, Sabwe Pascale9, Jean-Jacques Muyembe9, Stomy Karhemere9, Sabrina Weiss1, Siv Aina Leendertz1, Sébastien Calvignac-Spencer1, Fabian H Leendertz1 and Bernhard Ehlers2*

Author Affiliations

1 Project group “Epidemiology of Highly Pathogenic Microorganisms”, Robert Koch Institute, Berlin 13353, Germany

2 Division 12 “Measles, Mumps, Rubella and Viruses affecting immunocompromised patients”, Robert Koch Institute, Berlin 13353, Germany

3 Department of Wildlife and Animal Resource Management, Makerere University, Kampala 7062, Uganda

4 Conservation & Ecosystem Health Alliance (CEHA), Kampala 34153, Uganda

5 Institute of Vertebrate Biology, Academy of Sciences, Brno 60365, Czech Republic

6 Department of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences, Brno 61242, Czech Republic

7 Centre de Recherche pour le Developpement, University Alassane Ouattara of Bouake, Bouake 01 BP V18, Côte d’Ivoire

8 LANADA/Laboratoire Central de Pathologie Animale, Bingerville 206, Côte d’Ivoire

9 Institut National de Recherche Biomédicale, Kinshasa 1197, Democratic Republic of Congo

10 ViroscienceLab, Erasmus Medical Centre, Rotterdam 3015, The Netherlands

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Virology Journal 2014, 11:25  doi:10.1186/1743-422X-11-25

Published: 11 February 2014



Human adenoviruses of species D (HAdV-D) can be associated with acute respiratory illness, epidemic keratoconjunctivitis, and gastroenteritis, but subclinical HAdV-D infections with prolonged shedding have also been observed, particularly in immunocompromised hosts. To expand knowledge on HAdV-D in Sub-Saharan Africa, we investigated the prevalence, epidemiology and pathogenic potential of HAdV-D in humans from rural areas of 4 Sub-Saharan countries, Côte d’Ivoire (CI), Democratic Republic of the Congo (DRC), Central African Republic (CAR) and Uganda (UG).


Stool samples were collected from 287 people living in rural regions in CI, DRC, CAR and UG. HAdV-D prevalence and diversity were determined by PCR and sequencing. A gene block, spanning the genes pV to hexon, was used for analysis of genetic distance. Correlation between adenovirus infection and disease symptoms, prevalence differences, and the effect of age and gender on infection status were analyzed with cross tables and logistic regression models.


The prevalence of HAdV-D in the investigated sites was estimated to be 66% in CI, 48% in DRC, 28% in CAR (adults only) and 65% in UG (adults only). Younger individuals were more frequently infected than adults; there was no difference in HAdV-D occurrence between genders. No correlation could be found between HAdV-D infection and clinical symptoms. Highly diverse HAdV-D sequences were identified, among which a number are likely to stand for novel types.


HAdV-D was detected with a high prevalence in study populations of 4 Sub-Saharan countries. The genetic diversity of the virus was high and further investigations are needed to pinpoint pathological potential of each of the viruses. High diversity may also favor the emergence of recombinants with altered tropism and pathogenic properties.

Adenoviridae; Human adenovirus D; Genotype; Sub-Saharan Africa; PCR