Molecular characterization of filarial infections and their associated risk factors in rural community of Southeastern Gabon

Background Filarial infections continue to represent a considerable public health challenge in resource-limited communities in sub-Saharan Africa. In Gabon, the implementation of effective control strategies, such as mass drug administration (MDA), is hindered by a lack of contemporary data on the local distribution, molecular diversity, and associated risk factors of these infections, particularly in rural areas where Loa loa co-endemicity poses a risk of severe adverse events. This study aimed to molecularly characterize filarial species and determine the prevalence, associated risk factors, and community knowledge of filarial infections in the rural village of Dienga, southeastern Gabon.Methods A cross-sectional survey was conducted in August 2021 among 90 volunteers from Dienga, southeastern Gabon. Blood samples were analyzed by microscopy and quantitative PCR (qPCR) targeting the 28S rRNA gene and sequencing. Sociodemographic, clinical, and knowledge data were collected via standardized questionnaires. Statistical analyses employed chi-square tests and logistic regression.Results The overall filarial qPCR (23.33%) prevalence was 1.75-fold higher than microscopy (13.33%), confirming the superior sensitivity of qPCR for detecting sub-microscopic infections. Loa loa was the predominant species compared to Mansonella pestans (1.11%). Infection rates were significantlyInfection rates were significantly higher in men (40.5%) than women (11.32%, p = 0.002) and peaked in individuals over 61 years (38.8%). Phylogenetic analysis confirmed the circulation of L. loa and M. perstans and identity and explore genetic diversity. The concurrent presence of pruritus, Calabar swelling, and eyeworm was a strong predictor of microfilaremia (p = 0.0007). Knowledge assessment revealed critical gaps showing that only 10% of participants knew the disease vector, and among infected individuals, only 16.66% were aware of the transmission.Conclusion This study provides the first molecular evidence of a high prevalence of Loa loa in southeastern Gabon, revealing a substantial hidden burden of infection. The findings emphasize the pressing necessity for integrated, evidence-based control strategies that encompass sensitive molecular diagnostics, risk-stratified MDA, and robust community health education within a One Health framework.