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Yılmaz S, İba Yilmaz S, Alay H, Koşan Z, Eren Z. Temporal tendency, seasonality and relationship with climatic factors of Crimean-Congo Hemorrhagic Fever cases (East of Turkey: 2012-2021). Heliyon 2023; 9:e19593. [PMID: 37681169 PMCID: PMC10480645 DOI: 10.1016/j.heliyon.2023.e19593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
Crimean-Congo Hemorrhagic Fever continues to be an important public health problem by expanding its borders. To evaluate the temporal trend, seasonality, and relationship with the climatic factors of Crimean-Congo Hemorrhagic Fever. Study data included cases treated in two different tertiary healthcare institutions between 2012 and 2021. The demographic characteristics of the cases and the dates of admission to the hospital were determined, and they were matched with the average of the measurements (temperature, cumulative precipitation, relative humidity, wind speed) of two different meteorology stations in the study area. By calculating the crude incidence rates, the trend in years was investigated. Estimates were created by removing the incidence rates, seasonality, and trend components using the additive decomposition technique. The temporal relationship between incidence rates and climatic factors was evaluated with the help of the Autoregressive Distributed Lag Bound Test. Toda Yamamoto test was used for causality verification. The mean age of the cases (n = 974) included in the study was 47.6 ± 17.7 years, and the majority (57.3%) were in the group above 45 years of age. 56.6% of the cases were male and there was a male predominance in all age groups. Incidence rates ranged from 5.5 to 23.1/100,000 over the ten-year period and there was a significant upward trend (R2 = 0.691, p = 0.003). Cases of Crimean-Congo Hemorrhagic Fever that started in March, peaked in July and ended in October, showed a clear seasonality. A cointegration relationship was observed between case incidence rates and air temperature, cumulative precipitation, and relative humidity (p < 0.05 for all). Climatic factors can only indirectly affect the occurrence of Crimean-Congo Hemorrhagic Fever cases. However, climatic conditions that become progressively more favorable for vector ticks lead to the spread of the disease. The control measures to be taken should be prepared by considering the changing climatic conditions and prioritizing the risk groups. There is a need for information and awareness-raising studies about climate change and the growing dangers associated with it, also outside of endemic regions.
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Affiliation(s)
- Sinan Yılmaz
- Atatürk University Faculty of Medicine, Department of Public Health, Erzurum, Turkey
| | - Sibel İba Yilmaz
- Health Sciences University, Erzurum Faculty of Medicine, Clinic of Infectious Diseases, Erzurum, Turkey
| | - Handan Alay
- Atatürk University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
| | - Zahide Koşan
- Atatürk University Faculty of Medicine, Department of Public Health, Erzurum, Turkey
| | - Zeynep Eren
- Atatürk University, Faculty of Engineering, Department of Environmental Technologies, Erzurum, Turkey
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Motlogeloa O, Fitchett JM. Climate and human health: a review of publication trends in the International Journal of Biometeorology. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02466-8. [PMID: 37129619 PMCID: PMC10153057 DOI: 10.1007/s00484-023-02466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.
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Affiliation(s)
- Ogone Motlogeloa
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer M Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa.
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Javaid A, Ijaz A, Ashfaq UA, Arshad M, Irshad S, Saif S. An overview of chikungunya virus molecular biology, epidemiology, pathogenesis, treatment and prevention strategies. Future Virol 2022. [DOI: 10.2217/fvl-2019-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The chikungunya virus (CHIKV) causes a devastating musculoskeletal inflammatory disease with symptoms of headache, rash, polyarthralgia, fever and myalgia. CHIKV has appeared intermittently around the world and in different ecological zones of Pakistan. Aedes mosquito species are the main vectors of CHIKV transmission and cause high disease rates in the urban transmission cycle. Even though the CHIKV is responsible for many cases of disease, no authorized antibodies or antiviral treatments are available, and prevention is the primary countermeasure. This review describes an update on CHIKV molecular biology, replication cycle, epidemiology, ecological factors, clinical manifestations and treatment and suggests a way forward to control and prevent this infection strategically in the future.
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Affiliation(s)
- Anam Javaid
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
| | - Aroosa Ijaz
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
| | - Maham Arshad
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
| | - Shakeel Irshad
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
| | - Saira Saif
- Department of Bioinformatics & Biotechnology, Government College University, Faisalabad, Pakistan
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Ticks on the Run: A Mathematical Model of Crimean-Congo Haemorrhagic Fever (CCHF)-Key Factors for Transmission. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2022; 3:116-134. [PMID: 36417271 PMCID: PMC9620928 DOI: 10.3390/epidemiologia3010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/14/2022]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a zoonotic disease caused by the Crimean-Congo hemorrhagic fever virus (CCHFV). Ticks of the genus Hyalomma are the main vectors and represent a reservoir for the virus. CCHF is maintained in nature in an endemic vertebrate-tick-vertebrate cycle. The disease is prevalent in wide geographical areas including Asia, Africa, South-Eastern Europe and the Middle East. It is of great importance for the public health given its occasionally high case/fatality ratio of CCHFV in humans. Climate change and the detection of possible CCHFV vectors in Central Europe suggest that the establishment of the transmission in Central Europe may be possible in future. We have developed a compartment-based nonlinear Ordinary Differential Equation (ODE) system to model the disease transmission cycle including blood sucking ticks, livestock and human. Sensitivity analysis of the basic reproduction number R0 shows that decreasing the tick survival time is an efficient method to control the disease. The model supports us in understanding the influence of different model parameters on the spread of CCHFV. Tick-to-tick transmission through co-feeding and the CCHFV circulation through transstadial and transovarial transmission are important factors to sustain the disease cycle. The proposed model dynamics are calibrated through an empirical multi-country analysis and multidimensional plot reveals that the disease-parameter sets of different countries burdened with CCHF are different. This information may help decision makers to select efficient control strategies.
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Seroprevalence and Risk Factors of Crimean-Congo Hemorrhagic Fever in Cattle of Smallholder Farmers in Central Malawi. Pathogens 2021; 10:pathogens10121613. [PMID: 34959568 PMCID: PMC8709441 DOI: 10.3390/pathogens10121613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, Asia, and Eastern Europe where it circulates among animals and ticks causing sporadic outbreaks in humans. Although CCHF is endemic in sub-Saharan Africa, epidemiological information is lacking in many countries, including Malawi. To assess the risk of CCHF in Malawi, we conducted an epidemiological study in cattle reared by smallholder livestock farmers in central Malawi. A cross-sectional study was conducted in April 2020 involving seven districts, four from Kasungu and three from Lilongwe Agriculture Development Divisions. A structured questionnaire was administered to farmers to obtain demographic, animal management, and ecological risk factors data. Sera were collected from randomly selected cattle and screened for CCHF virus (CCHFV) specific antibodies using a commercial ELISA kit. Ticks were collected from cattle and classified morphologically to species level. An overall CCHFV seropositivity rate of 46.9% (n = 416; 95% CI: 42.0–51.8%) was observed. The seropositivity was significantly associated with the age of cattle (p < 0.001), sex (p < 0.001), presence of ticks in herds (p = 0.01), district (p = 0.025), and type of grazing lands (p = 0.013). Five species of ticks were identified, including Hyalomma truncatum, a known vector of CCHFV. Ticks of the species Hyalomma truncatum were not detected in two districts with the highest seroprevalence for CCHF and vector competency must be further explored in the study area. To our knowledge, this is the first report of serologic evidence of the presence of CCHV among smallholder cattle in central Malawi. This study emphasizes the need for continued monitoring of CCHFV infection among livestock, ticks, and humans for the development of data-based risk mitigation strategies.
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Nili S, Khanjani N, Jahani Y, Bakhtiari B. The effect of climate variables on the incidence of Crimean Congo Hemorrhagic Fever (CCHF) in Zahedan, Iran. BMC Public Health 2020; 20:1893. [PMID: 33298021 PMCID: PMC7726875 DOI: 10.1186/s12889-020-09989-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Crimean-Congo Hemorrhagic fever (CCHF) is endemic in Iran and has a high fatality rate. The aim of this study was to investigate the association between CCHF incidence and meteorological variables in Zahedan district, which has a high incidence of this disease. Methods Data about meteorological variables and CCHF incidence was inquired from 2010 to 2017 for Zahedan district. The analysis was performed using univariate and multivariate Seasonal Autoregressive Integrated Moving Average (SARIMA) models and Generalized Additive Models (GAM) using R software. AIC, BIC and residual tests were used to test the goodness of fit of SARIMA models, and R2 was used to select the best model in GAM/GAMM. Results During the years under study, 190 confirmed cases of CCHF were identified in Zahedan district. The fatality rate of the disease was 8.42%. The disease trend followed a seasonal pattern. The results of multivariate SARIMA showed the (0,1,1) (0,1,1)12 model with maximum monthly temperature lagged 5 months, forecasted the disease better than other models. In the GAM, monthly average temperature lagged 5 months, and the monthly minimum of relative humidity and total monthly rainfall without lag, had a nonlinear relation with the incidence of CCHF. Conclusions Meteorological variables can affect CCHF occurrence.
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Affiliation(s)
- Sairan Nili
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Yunes Jahani
- Modelling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bahram Bakhtiari
- Water Engineering Department, College of Agriculture, Shahid Bahonar University, Kerman, Iran
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Barr KL, Khan E, Farooqi JQ, Imtiaz K, Prakoso D, Malik F, Lednicky JA, Long MT. Evidence of Chikungunya Virus Disease in Pakistan Since 2015 With Patients Demonstrating Involvement of the Central Nervous System. Front Public Health 2018; 6:186. [PMID: 30042937 PMCID: PMC6048291 DOI: 10.3389/fpubh.2018.00186] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/12/2018] [Indexed: 11/18/2022] Open
Abstract
Several arboviruses are endemic to and co-circulate in Pakistan. In recent years, Pakistan has observed a rise in arboviral infections. A cross-sectional study for arboviral diseases, which included screening for Chikungunya virus (CHIKV), was initiated in 2015 to determine which pathogens were causing disease in patients presenting to health care services. Exposure to CHIKV was verified via detection of viral nucleic acids or virus-specific IgM with virus-specific neutralizing antibodies. Out of 997 enrolled patients presenting with clinical features suggestive of arboviral disease, 102 patients were positive for CHIKV IgM antibodies and 60 patients were positive for CHIKV nucleic acids or neutralizing antibodies. The data presented here show that CHIKV has been circulating in Pakistan since April of 2015. CHIKV infections were detected in study subjects up to the conclusion of our enrollment period in July 2017. Syndromic and clinical data show that arthralgia was associated with CHIKV as was rash, fever greater than 38°C, and lymphopenia. Neurological symptoms were reported in 49% of CHIKV suspect patients and in 46.6% of confirmed infections. Acute disseminated encephalomyelitis was diagnosed in 5% of confirmed infection and various manifestation of encephalitis diagnosed in an additional 16.6% of patients with confirmed CHIKV infections. CHIKV-exposed patients were just as likely to present with neurological symptoms and encephalitis as patients with West Nile Virus infections but were 4.57 times more likely to have lymphopenia. This proportion of neurological symptoms may be a complicating factor in countries where WNV and/or JEV co-circulate with CHIKV.
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Affiliation(s)
- Kelli L Barr
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, Gainesville, FL, United States
| | - Erum Khan
- Laboratory Medicine, Department of Pathology, Aga Khan University, Karachi, Pakistan
| | - Joveria Q Farooqi
- Laboratory Medicine, Department of Pathology, Aga Khan University, Karachi, Pakistan
| | - Kehkashan Imtiaz
- Laboratory Medicine, Department of Pathology, Aga Khan University, Karachi, Pakistan
| | - Dhani Prakoso
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, Gainesville, FL, United States
| | - Faisal Malik
- Laboratory Medicine, Department of Pathology, Aga Khan University, Karachi, Pakistan
| | - John A Lednicky
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, Gainesville, FL, United States
| | - Maureen T Long
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, Gainesville, FL, United States
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Abstract
Climate change is expected to impact across every domain of society, including health. The majority of the world's population is susceptible to pathological, infectious disease whose life cycles are sensitive to environmental factors across different physical phases including air, water and soil. Nearly all so-called neglected tropical diseases (NTDs) fall into this category, meaning that future geographic patterns of transmission of dozens of infections are likely to be affected by climate change over the short (seasonal), medium (annual) and long (decadal) term. This review offers an introduction into the terms and processes deployed in modelling climate change and reviews the state of the art in terms of research into how climate change may affect future transmission of NTDs. The 34 infections included in this chapter are drawn from the WHO NTD list and the WHO blueprint list of priority diseases. For the majority of infections, some evidence is available of which environmental factors contribute to the population biology of parasites, vectors and zoonotic hosts. There is a general paucity of published research on the potential effects of decadal climate change, with some exceptions, mainly in vector-borne diseases.
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Affiliation(s)
- Mark Booth
- Newcastle University, Institute of Health and Society, Newcastle upon Tyne, United Kingdom.
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Khan E, Barr KL, Farooqi JQ, Prakoso D, Abbas A, Khan ZY, Ashi S, Imtiaz K, Aziz Z, Malik F, Lednicky JA, Long MT. Human West Nile Virus Disease Outbreak in Pakistan, 2015-2016. Front Public Health 2018. [PMID: 29535994 PMCID: PMC5835076 DOI: 10.3389/fpubh.2018.00020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Like most of the world, Pakistan has seen an increase in mosquito-transmitted diseases in recent years. The magnitude and distribution of these diseases are poorly understood as Pakistan does not have a nation-wide system for reporting disease. A cross-sectional study to determine which flaviviruses were causing of arboviral disease in Pakistan was instituted. West Nile virus (WNV) is a cause of seasonal fever with neurotropic findings in countries that share borders with Pakistan. Here, we describe the active and persistent circulation of WNV in humans in the southern region of Pakistan. This is the first report of WNV causing neurological disease in human patients in this country. Of 997 enrolled patients presenting with clinical features suggestive of arboviral disease, 105 were positive for WNV IgM antibodies, and 71 of these patients possessed WNV-specific neutralizing antibodies. Cross-reactivity of WNV IgM antibodies with Japanese encephalitis virus (JEV) occurred in 75 of these 105 patients. WNV co-infections with Dengue viruses were not a contributing factor for the severity of disease. Nor did prior exposure to dengue virus contribute to incidence of neurological involvement in WNV-infected patients. Patients with WNV infections were more likely to present with altered mental status, seizures, and reduced Glasgow Coma scores when compared with JEV-infected patients. Human WNV cases and vector numbers exhibited a temporal correlation with climate.
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Affiliation(s)
- Erum Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kelli L Barr
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Joveria Qais Farooqi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Dhani Prakoso
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Alizeh Abbas
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Zain Yar Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Shanze Ashi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kehkashan Imtiaz
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Z Aziz
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Faisal Malik
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - John A Lednicky
- Department of Environmental and Global Health, Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Maureen T Long
- Department of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
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