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Davids M, Johnstone S, Mendes A, Brecht G, Avenant T, du Plessis N, de Villiers M, Page N, Venter M. Changes in Prevalence and Seasonality of Pathogens Identified in Acute Respiratory Tract Infections in Hospitalised Individuals in Rural and Urban Settings in South Africa; 2018-2022. Viruses 2024; 16:404. [PMID: 38543769 PMCID: PMC10974059 DOI: 10.3390/v16030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 05/23/2024] Open
Abstract
Severe acute respiratory tract infections (SARIs) has been well described in South Africa with seasonal patterns described for influenza and respiratory syncytial virus (RSV), while others occur year-round (rhinovirus and adenovirus). This prospective syndromic hospital-based surveillance study describes the prevalence and impact of public interventions on the seasonality of other respiratory pathogens during the coronavirus disease-19 (COVID-19) pandemic. This occurred from August 2018 to April 2022, with 2595 patients who met the SARS case definition and 442 controls, from three sentinel urban and rural hospital sites in South Africa. Naso/oro-pharyngeal (NP/OP) swabs were tested using the FastTrack Diagnostics® Respiratory pathogens 33 (RUO) kit. Descriptive statistics, odds ratios, and univariate/multivariate analyses were used. Rhinovirus (14.80%, 228/1540) and Streptococcus pneumoniae (28.50%, 439/1540) were most frequently detected in NP/OP swabs and in children <1 years old (35%, 648/1876). Among others, pathogens associated with SARI cases causing disease were influenza A&B, HRV, RSV, hCoV 229e, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. Pre-COVID-19, seasonal trends of these pathogens correlated with previous years, with RSV and influenza A seasons only resuming after the national lockdown (2021). It is evident that stringent lockdown conditions have severe impacts on the prevalence of respiratory tract infections.
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Affiliation(s)
- Michaela Davids
- Centre for Emerging Respiratory and Arbovirus Research, Department of Medical Virology, University of Pretoria, Pretoria 0084, South Africa
| | - Siobhan Johnstone
- Centre for Enteric Diseases, Virology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa; (S.J.); (N.P.)
| | - Adriano Mendes
- Centre for Emerging Respiratory and Arbovirus Research, Department of Medical Virology, University of Pretoria, Pretoria 0084, South Africa
| | - Gadean Brecht
- Centre for Emerging Respiratory and Arbovirus Research, Department of Medical Virology, University of Pretoria, Pretoria 0084, South Africa
| | - Theunis Avenant
- Department of Paediatrics, Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria 0084, South Africa
| | - Nicolette du Plessis
- Department of Paediatrics, Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria 0084, South Africa
| | - Maryke de Villiers
- Department of Internal Medicine, Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria 0084, South Africa
| | - Nicola Page
- Centre for Enteric Diseases, Virology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa; (S.J.); (N.P.)
- Centre of Enteric Diseases, Department of Medical Virology, University of Pretoria, Pretoria 0084, South Africa
| | - Marietjie Venter
- Centre for Emerging Respiratory and Arbovirus Research, Department of Medical Virology, University of Pretoria, Pretoria 0084, South Africa
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Rodríguez-Sabogal IA, Cabrera R, Marin D, Lopez L, Aguilar Y, Gomez G, Peña-Valencia K, Riaño W, Vélez L, Keynan Y, Rueda ZV. Does the Recovery of Respiratory Viruses Impact Pulmonary Function at Baseline and 1-, 6-, and 12-Month Follow-Up in People Living with HIV and Pneumonia? Viruses 2024; 16:344. [PMID: 38543710 PMCID: PMC10974101 DOI: 10.3390/v16030344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/10/2024] [Accepted: 02/21/2024] [Indexed: 05/23/2024] Open
Abstract
The frequency of respiratory viruses in people living with HIV (PLHIV) and their impact on lung function remain unclear. We aimed to determine the frequency of respiratory viruses in bronchoalveolar lavage and induced sputum samples in PLHIV and correlate their presence with lung function. A prospective cohort of adults hospitalized in Medellín between September 2016 and December 2018 included three groups: group 1 = people diagnosed with HIV and a diagnosis of community-acquired pneumonia (CAP), group 2 = HIV, and group 3 = CAP. People were followed up with at months 1, 6, and 12. Clinical, microbiological, and spirometric data were collected. Respiratory viruses were detected by multiplex RT-PCR. Sixty-five patients were included. At least 1 respiratory virus was identified in 51.9%, 45.1%, and 57.1% of groups 1, 2 and 3, respectively. Among these, 89% of respiratory viruses were detected with another pathogen, mainly Mycobacterium tuberculosis (40.7%) and Pneumocystis jirovecii (22.2%). The most frequent respiratory virus was rhinovirus (24/65, 37%). On admission, 30.4% of group 1, 16.6% of group 2, and 50% of group 3 had airflow limitation, with alteration in forced expiratory volume at first second in both groups with pneumonia compared to HIV. Respiratory viruses are frequent in people diagnosed with HIV, generally coexisting with other pathogens. Pulmonary function on admission was affected in patients with pneumonia, improving significantly in the 1st, 6th, and 12th months after CAP onset.
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Affiliation(s)
- Iván Arturo Rodríguez-Sabogal
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
| | - Ruth Cabrera
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo Biología de Sistemas, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia
| | - Diana Marin
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Lucelly Lopez
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Yudy Aguilar
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo Investigador de Problemas en Enfermedades Infecciosas—GRIPE, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia
| | - Gustavo Gomez
- Pulmonologist Section, Hospital Universitario San Vicente Fundacion, Medellin 050010, Colombia;
| | - Katherine Peña-Valencia
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
- Escuela de Microbiología, Universidad de Antioquia, Medellín 050010, Colombia
- Grupo Bacterias & Cancer, School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia
| | - Will Riaño
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Lázaro Vélez
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
- Grupo Investigador de Problemas en Enfermedades Infecciosas—GRIPE, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | - Zulma Vanessa Rueda
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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Vink E, Banda L, Amoah AS, Kasenda S, Read JM, Jewell C, Denis B, Mwale AC, Crampin A, Anscombe C, Menyere M, Ho A. Prevalence of Endemic Respiratory Viruses During the COVID-19 Pandemic in Urban and Rural Malawi. Open Forum Infect Dis 2024; 11:ofad643. [PMID: 38312213 PMCID: PMC10836885 DOI: 10.1093/ofid/ofad643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Background We investigated endemic respiratory virus circulation patterns in Malawi, where no lockdown was imposed, during the COVID-19 pandemic. Methods Within a prospective household cohort in urban and rural Malawi, adult participants provided upper respiratory tract (URT) samples at 4 time points between February 2021 and April 2022. Polymerase chain reaction (PCR) was performed for SARS-CoV-2, influenza, and other endemic respiratory viruses. Results 1626 URT samples from 945 participants in 542 households were included. Overall, 7.6% (n = 123) samples were PCR- positive for >1 respiratory virus; SARS-CoV-2 (4.4%) and rhinovirus (2.0%) were most common. No influenza A virus was detected. Influenza B and respiratory syncytial virus (RSV) were rare. Higher virus positivity were detected in the rural setting and at earlier time points. Coinfections were infrequent. Conclusions Endemic respiratory viruses circulated in the community in Malawi during the pandemic, though influenza and RSV were rarely detected. Distinct differences in virus positivity and demographics were observed between urban and rural cohorts.
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Affiliation(s)
- Elen Vink
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Louis Banda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
| | - Abena S Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Leiden University Medical Center, Leiden, the Netherlands
| | - Stephen Kasenda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
| | - Jonathan M Read
- Centre for Health Information Computation and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Chris Jewell
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | | | - Amelia Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine Anscombe
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
- Liverpool School of Tropical Medicine, University of Liverpool, Liverpool, UK
| | - Mavis Menyere
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Antonia Ho
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
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Moyes J, Tempia S, Walaza S, McMorrow ML, Cohen AL, Treurnicht F, Hellferscee O, Wolter N, Von Gottberg A, Dawood H, Variava E, Kahn K, Madhi SA, Cohen C. The attributable fraction of respiratory syncytial virus among patients of different ages with influenza-like illness and severe acute respiratory illness in a high HIV prevalence setting, South Africa, 2012-2016. Int J Infect Dis 2023; 134:71-77. [PMID: 37211271 PMCID: PMC10675839 DOI: 10.1016/j.ijid.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/05/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVES The detection of respiratory syncytial virus (RSV) in upper airway samples does not necessarily infer causality of illness. We aimed to calculate the attributable fraction (AF) of RSV in clinical syndromes across age groups. METHODS Using unconditional logistic regression models, we estimated the AF of RSV-associated influenza-like illness (ILI) and severe acute respiratory illness (SARI) cases by comparing RSV detection prevalence among ILI and SARI cases to those of healthy controls in South Africa, 2012-2016. The analysis, stratified by HIV serostatus, was conducted in the age categories <1, 1-4, 5-24, 25-44, 45-64, and ≥65 years. RESULTS We included 12,048 individuals: 2687 controls, 5449 ILI cases, and 5449 SARI cases. RSV-AFs for ILI were significant in <1, 1-4, 5-and 24, 25-44-year age groups: 84.9% (95% confidence interval [CI] 69.3-92.6%), 74.6% (95% CI 53.6-86.0%), 60.8% (95% CI 21.4-80.5%) and 64.1% (95% CI 14.9-84.9%), respectively. Similarly, significant RSV-AFs for SARI were 95.3% (95% CI 91.1-97.5) and 83.4% (95% CI 70.9-90.5) in the <1 and 1-4-year age groups respectively. In HIV-infected persons, RSV was significantly associated with ILI cases vs controls in individuals aged 5-44 years. CONCLUSION High RSV-AFs in young children confirm RSV detection is associated with severe respiratory illness in South African children, specifically infants. These estimates will assist with refining burden estimates and cost-effectiveness models.
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Affiliation(s)
- Jocelyn Moyes
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Stefano Tempia
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; MassGenics, Atlanta, Georgia, United States of America and Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Sibongile Walaza
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America and Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Adam L Cohen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America and Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Global Immunization Monitoring and Surveillance, Expanded Programme on Immunization Department of Immunization, Vaccines and Biologicals World Health Organization, Geneva, Switzerland
| | - Florette Treurnicht
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Orienka Hellferscee
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Nicole Wolter
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne Von Gottberg
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Halima Dawood
- Department of Medicine, Greys Hospital, Pietermaritzburg, South Africa; Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Ebrahim Variava
- Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa; Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- Medical Research Council of South Africa/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Epidemiology and Global Health Unit, Johannesburg, South Africa
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytical Research Unit, University of the Witwatersrand, Johannesburg, South Africa; African Leadership in Vaccinology Expertise, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Regassa BT, Gebrewold LA, Mekuria WT, Kassa NA. Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis. J Glob Health 2023; 13:04001. [PMID: 36637855 PMCID: PMC9840062 DOI: 10.7189/jogh.13.04001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Globally, the respiratory syncytial virus (RSV) is the most common etiologic agent of acute respiratory illnesses in children. However, its burden has not been well addressed in developing countries. We aimed to estimate the molecular epidemiology of RSV in children less than 18 years of age with acute respiratory infections in Africa by conducting a systematic review and meta-analysis. Methods We systematically searched PubMed, Scopus, CINAHL, and Global Index Medicus databases to identify studies published from January 1, 2002, to April 27, 2022, following the PRISMA 2020 guideline. We assessed the study quality using the Joanna Brigg's Institute (JBI) critical appraisal checklists. We conducted a qualitative synthesis by describing the characteristics of included studies and performed the quantitative synthesis with random effects model using STATA-14. We checked for heterogeneity with Q statistics, quantified by I2, and determined the prediction interval. We performed subgroup analyses to explain the sources of heterogeneity and assessed publication biases by funnel plots augmented with Egger's test. Results Eighty-eight studies with 105 139 participants were included in the review. The overall pooled prevalence of RSV in children <18 years of age was 23% (95% confidence interval (CI) = 20, 25%). Considerable heterogeneity was present across the included studies. The adjusted prediction interval was found to be 19%-27%. Heterogeneities were explained by subgroups analyses. The highest prevalence of RSV was found among inpatients, 28% (95% CI = 25, 31%) compared with inpatients/outpatients and outpatients, with statistically significant differences (P < 0.01). The RSV estimate was also highest among those with acute lower respiratory tract illnesses (ALRTIs), 28% (95% CI = 25, 31%) compared with acute upper respiratory tract illnesses (AURTIs) and both acute upper/lower respiratory manifestations, with statistically different prevalence (P < 0.01). RSV infection estimates in each sub-region of Africa were statistically different (P < 0.01). There were no statistically significant differences in RSV infections by designs, specimen types, and specimen conditions, despite them contributing to heterogeneity. Conclusions We found a high prevalence of RSV in pediatric populations with acute respiratory tract illnesses in Africa, highlighting that the prevention and control of RSV infections in children deserve more attention. Registration PROSPERO CRD42022327054.
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Affiliation(s)
- Belay Tafa Regassa
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Lami Abebe Gebrewold
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Wagi Tosisa Mekuria
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Nega Assefa Kassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia
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Jones RP, Ponomarenko A. Roles for Pathogen Interference in Influenza Vaccination, with Implications to Vaccine Effectiveness (VE) and Attribution of Influenza Deaths. Infect Dis Rep 2022; 14:710-758. [PMID: 36286197 PMCID: PMC9602062 DOI: 10.3390/idr14050076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 08/29/2023] Open
Abstract
Pathogen interference is the ability of one pathogen to alter the course and clinical outcomes of infection by another. With up to 3000 species of human pathogens the potential combinations are vast. These combinations operate within further immune complexity induced by infection with multiple persistent pathogens, and by the role which the human microbiome plays in maintaining health, immune function, and resistance to infection. All the above are further complicated by malnutrition in children and the elderly. Influenza vaccination offers a measure of protection for elderly individuals subsequently infected with influenza. However, all vaccines induce both specific and non-specific effects. The specific effects involve stimulation of humoral and cellular immunity, while the nonspecific effects are far more nuanced including changes in gene expression patterns and production of small RNAs which contribute to pathogen interference. Little is known about the outcomes of vaccinated elderly not subsequently infected with influenza but infected with multiple other non-influenza winter pathogens. In this review we propose that in certain years the specific antigen mix in the seasonal influenza vaccine inadvertently increases the risk of infection from other non-influenza pathogens. The possibility that vaccination could upset the pathogen balance, and that the timing of vaccination relative to the pathogen balance was critical to success, was proposed in 2010 but was seemingly ignored. Persons vaccinated early in the winter are more likely to experience higher pathogen interference. Implications to the estimation of vaccine effectiveness and influenza deaths are discussed.
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Affiliation(s)
- Rodney P Jones
- Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
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Nasal-spraying Bacillus spores as an effective symptomatic treatment for children with acute respiratory syncytial virus infection. Sci Rep 2022; 12:12402. [PMID: 35858943 PMCID: PMC9297280 DOI: 10.1038/s41598-022-16136-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 07/05/2022] [Indexed: 01/30/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of Acute Respiratory Tract Infections (ARTIs) in young children. However, there is currently no vaccine or treatment available for children. Here, we demonstrated that nasal-spraying probiotics containing 5 billion of Bacillus spores (LiveSpo Navax) is an effective symptomatic treatment in a 6-day randomized controlled clinical study for RSV-infected children (n = 40–46/group). Navax treatment resulted in 1-day faster recovery-time and 10–50% better efficacy in relieving ARTI symptoms. At day 3, RSV load and level of pro-inflammatory cytokines in nasopharyngeal samples was reduced by 630 folds and 2.7–12.7 folds respectively. This showed 53-fold and 1.8–3.6-fold more effective than those in the control-standard of care-group. In summary, nasal-spraying Bacillus spores can rapidly and effectively relieve symptoms of RSV-induced ARTIs while exhibit strong impacts in reducing viral load and inflammation. Our nasal-spraying probiotics may provide a basis for simple-to-use, low-cost, and effective treatment against viral infection in general.
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Moleleki M, du Plessis M, Ndlangisa K, Reddy C, Hellferscee O, Mekgoe O, McMorrow M, Walaza S, Cohen C, Tempia S, von Gottberg A, Wolter N. Pathogens detected using a syndromic molecular diagnostic platform in patients hospitalized with severe respiratory illness in South Africa in 2017. Int J Infect Dis 2022; 122:389-397. [PMID: 35700877 DOI: 10.1016/j.ijid.2022.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES We describe the use of a multi-pathogen platform, TaqMan array card (TAC) real-time PCR, for the detection of pathogens in patients hospitalized with severe respiratory illness (SRI). METHODS Prospective hospital-based syndromic surveillance for acute and chronic SRI was carried out at two sentinel sites in South Africa between January and December 2017. We tested respiratory specimens for 21 respiratory pathogens and blood samples for nine bacteria using TAC. Pathogen detection was compared by age group and HIV status using the chi-squared test. RESULTS During 2017, 956 patients of all ages were enrolled in the SRI surveillance, and of these, 637 (67%) patients were included in this study (637 blood, 487 naso- and oro-pharyngeal swabs and 411 sputum specimens tested). At least one pathogen was detected in 83% (527/637) of patients. Common pathogens detected included H. influenzae (225/637; 35%), S. pneumoniae (224/637; 35%), rhinovirus (144/637; 23%), S. aureus (129/637; 20%), K. pneumoniae (85/637; 13%), M. tuberculosis (75/637; 12%), and respiratory syncytial virus (57/637; 9%). Multiple pathogens (≥2) were co-detected in 57% (364/637) of patients. CONCLUSION While use of a multi-pathogen platform improved pathogen yield, pathogen co-detections were common and would need clinical assessment for usefulness in individual-level treatment and management decisions.
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Affiliation(s)
- Malefu Moleleki
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Mignon du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kedibone Ndlangisa
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cayla Reddy
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Medical Virology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Omphe Mekgoe
- Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meredith McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; MassGenics, Duluth, Georgia, United States of America
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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9
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Valley‐Omar Z, Tempia S, Hellferscee O, Walaza S, Variava E, Dawood H, Kahn K, McMorrow M, Pretorius M, Mtshali S, Mamorobela E, Wolter N, Venter M, von Gottberg A, Cohen C, Treurnicht FK. Human respiratory syncytial virus diversity and epidemiology among patients hospitalized with severe respiratory illness in South Africa, 2012-2015. Influenza Other Respir Viruses 2022; 16:222-235. [PMID: 34528769 PMCID: PMC8818822 DOI: 10.1111/irv.12905] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We aimed to describe the prevalence of human respiratory syncytial virus (HRSV) and evaluate associations between HRSV subgroups and/or genotypes and epidemiologic characteristics and clinical outcomes in patients hospitalized with severe respiratory illness (SRI). METHODS Between January 2012 and December 2015, we enrolled patients of all ages admitted to two South African hospitals with SRI in prospective hospital-based syndromic surveillance. We collected respiratory specimens and clinical and epidemiological data. Unconditional random effect multivariable logistic regression was used to assess factors associated with HRSV infection. RESULTS HRSV was detected in 11.2% (772/6908) of enrolled patients of which 47.0% (363/772) were under the age of 6 months. There were no differences in clinical outcomes of HRSV subgroup A-infected patients compared with HRSV subgroup B-infected patients but among patients aged <5 years, children with HRSV subgroup A were more likely be coinfected with Streptococcus pneumoniae (23/208, 11.0% vs. 2/90, 2.0%; adjusted odds ratio 5.7). No significant associations of HRSV A genotypes NA1 and ON1 with specific clinical outcomes were observed. CONCLUSIONS While HRSV subgroup and genotype dominance shifted between seasons, we showed similar genotype diversity as noted worldwide. We found no association between clinical outcomes and HRSV subgroups or genotypes.
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Affiliation(s)
- Ziyaad Valley‐Omar
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of Cape TownCape TownSouth Africa
| | - Stefano Tempia
- Centers for Disease Control and PreventionPretoriaSouth Africa
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
- MassGenicsDuluthGeorgiaUSA
- University of the WitwatersrandJohannesburgSouth Africa
| | - Orienka Hellferscee
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Sibongile Walaza
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | | | - Halima Dawood
- University of KwaZulu‐NatalKwaZulu‐NatalSouth Africa
- Greys hospitalPietermaritzburgSouth Africa
| | - Kathleen Kahn
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Meredith McMorrow
- Centers for Disease Control and PreventionPretoriaSouth Africa
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Marthi Pretorius
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Novartis Pharma AGBaselSwitzerland
| | - Senzo Mtshali
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Ernest Mamorobela
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Nicole Wolter
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Marietjie Venter
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of PretoriaPretoriaSouth Africa
| | - Anne von Gottberg
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Florette K. Treurnicht
- University of the WitwatersrandJohannesburgSouth Africa
- National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic HospitalJohannesburgSouth Africa
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10
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Tempia S, Moyes J, Cohen AL, Walaza S, McMorrow ML, Treurnicht FK, Hellferscee O, Wolter N, von Gottberg A, Dawood H, Variava E, Cohen C. The national burden of influenza-like illness and severe respiratory illness overall and associated with nine respiratory viruses in South Africa, 2013-2015. Influenza Other Respir Viruses 2022; 16:438-451. [PMID: 35150059 PMCID: PMC8983907 DOI: 10.1111/irv.12949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Estimates of the disease burden associated with different respiratory viruses are severely limited in low- and middle-income countries, especially in Africa. METHODS We estimated age-specific numbers and rates of medically and non-medically attended influenza-like illness (ILI) and severe respiratory illness (SRI) that were associated with influenza, respiratory syncytial virus (RSV), rhinovirus, human metapneumovirus, adenovirus, enterovirus and parainfluenza virus types 1-3 after adjusting for the attributable fraction (AF) of virus detection to illness in South Africa during 2013-2015. The base rates were estimated from five surveillance sites and extrapolated nationally. RESULTS The mean annual rates per 100,000 population were 51,383 and 4196 for ILI and SRI, respectively. Of these, 26% (for ILI) and 46% (for SRI) were medically attended. Among outpatients with ILI, rhinovirus had the highest AF-adjusted rate (7221), followed by influenza (6443) and adenovirus (1364); whereas, among inpatients with SRI, rhinovirus had the highest AF-adjusted rate (400), followed by RSV (247) and influenza (130). Rhinovirus (9424) and RSV (2026) had the highest AF-adjusted rates among children aged <5 years with ILI or SRI, respectively, whereas rhinovirus (757) and influenza (306) had the highest AF-adjusted rates among individuals aged ≥65 years with ILI or SRI, respectively. CONCLUSIONS There was a substantial burden of ILI and SRI in South Africa during 2013-2015. Rhinovirus and influenza had a prominent disease burden among patients with ILI. RSV and influenza were the most prominent causes of SRI in children and the elderly, respectively.
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Affiliation(s)
- Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,MassGenics, Duluth, GA, USA.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam L Cohen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Global Immunization Monitoring and Surveillance Team, Expanded Programme on Immunization, Department of Immunization, Vaccines and Biological, World Health Organization, Geneva, Switzerland
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,Division of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Halima Dawood
- Department of Medicine, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa.,Department of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Ebrahim Variava
- Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa.,Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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11
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Awori JO, Kamau A, Morpeth S, Kazungu S, Silaba M, Sande J, Karani A, Nyongesa S, Mwarumba S, Musyimi R, Bett A, Wande S, Shebe M, Ngama M, Munywoki PK, Muturi N, Nokes DJ, Feikin DR, Murdoch DR, Prosperi C, O’Brien KL, Deloria Knoll M, Hammitt LL, Scott JAG. The Etiology of Pneumonia in HIV-uninfected Children in Kilifi, Kenya: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study. Pediatr Infect Dis J 2021; 40:S29-S39. [PMID: 34448742 PMCID: PMC8448399 DOI: 10.1097/inf.0000000000002653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND In the 1980s, Streptococcus pneumoniae and Haemophilus influenzae were identified as the principal causes of severe pneumonia in children. We investigated the etiology of severe childhood pneumonia in Kenya after introduction of conjugate vaccines against H. influenzae type b, in 2001, and S. pneumoniae, in 2011. METHODS We conducted a case-control study between August 2011 and November 2013 among residents of the Kilifi Health and Demographic Surveillance System 28 days to 59 months of age. Cases were hospitalized at Kilifi County Hospital with severe or very severe pneumonia according to the 2005 World Health Organization definition. Controls were randomly selected from the community and frequency matched to cases on age and season. We tested nasal and oropharyngeal samples, sputum, pleural fluid, and blood specimens and used the Pneumonia Etiology Research for Child Health Integrated Analysis, combining latent class analysis and Bayesian methods, to attribute etiology. RESULTS We enrolled 630 and 863 HIV-uninfected cases and controls, respectively. Among the cases, 282 (44%) had abnormal chest radiographs (CXR positive), 33 (5%) died in hospital, and 177 (28%) had diagnoses other than pneumonia at discharge. Among CXR-positive pneumonia cases, viruses and bacteria accounted for 77% (95% CrI: 67%-85%) and 16% (95% CrI: 10%-26%) of pneumonia attribution, respectively. Respiratory syncytial virus, S. pneumoniae and H. influenza, accounted for 37% (95% CrI: 31%-44%), 5% (95% CrI: 3%-9%), and 6% (95% CrI: 2%-11%), respectively. CONCLUSIONS Respiratory syncytial virus was the main cause of CXR-positive pneumonia. The small contribution of H. influenzae type b and pneumococcus to pneumonia may reflect the impact of vaccine introductions in this population.
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Affiliation(s)
- Juliet O. Awori
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Alice Kamau
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Susan Morpeth
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Sidi Kazungu
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Micah Silaba
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | | | - Angela Karani
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Sammy Nyongesa
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Salim Mwarumba
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Robert Musyimi
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Anne Bett
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Siti Wande
- Clinical Sciences Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Mohammed Shebe
- Clinical Sciences Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Mwanajuma Ngama
- Clinical Sciences Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Patrick K. Munywoki
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - Neema Muturi
- Clinical Sciences Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
| | - D. James Nokes
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
- School of Life Sciences and WIDER, University of Warwick, Coventry, United Kingdom
| | - Daniel R. Feikin
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David R. Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
- Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Katherine L. O’Brien
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Laura L. Hammitt
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - J. Anthony G. Scott
- From the Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, CGMR-Coast, Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Nuffield Department of Tropical Medicine, Oxford University, Oxford, United Kingdom
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12
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Hellferscee O, Treurnicht F, Gaelejwe L, Moerdyk A, Reubenson G, McMorrow M, Tempia S, McAnerney J, Walaza S, Wolter N, von Gottberg A, Cohen C. Detection of Victoria lineage influenza B viruses with K162 and N163 deletions in the hemagglutinin gene, South Africa, 2018. Health Sci Rep 2021; 4:e367. [PMID: 34557595 PMCID: PMC8448392 DOI: 10.1002/hsr2.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 07/29/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A group of Victoria lineage influenza B viruses with a two amino acid deletion in the hemagglutinin (HA) at residues K162 and N163, was detected during the 2016 to 2017 Northern Hemisphere influenza season and continues to spread geographically. We describe the first identification of viruses with these deletions from South Africa in 2018. METHODS Nasopharyngeal samples were obtained from the syndromic surveillance programs. Real-time reverse transcription-polymerase chain reaction was used for virus detection and lineage determination. Influenza genetic characterization was done using next-generation sequencing on the MiSeq platform. The duration of virus circulation was determined using thresholds calculated using the Moving Epidemic Method; duration was used as an indicator of disease transmissibility and impact. RESULTS In 2018, 42% (426/1015) of influenza-positive specimens were influenza B viruses. Of 426 influenza B-positive samples, 376 (88%) had the lineage determined of which 75% (283/376) were Victoria lineage. The transmissibility of the 2018 South African influenza season was high for a few weeks, although the severity remained moderate through most of the season. The sequenced 2018 South African Victoria lineage influenza B viruses clustered in sub-clade V1A.1 with the 162-163 deletions. CONCLUSIONS We report the first detection of the 162-163 deletion variant of influenza B/Victoria viruses from South Africa in 2018, and suggest that this deletion variant replaced the previous circulating influenza B/Victoria viruses. These deletions putatively affect the antigenic properties of the viruses because they border an immune-dominant region at the tip of the HA. Therefore, close monitoring of these newly emerging viruses is essential.
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Affiliation(s)
- Orienka Hellferscee
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Department of Medical Virology, School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Florette Treurnicht
- Department of Medical Virology, School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Lucinda Gaelejwe
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Alexandra Moerdyk
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Gary Reubenson
- Department of Paediatrics & Child Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Meredith McMorrow
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
- MassGenicsDuluthGeorgiaUSA
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Johanna McAnerney
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
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13
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Baillie VL, Moore DP, Mathunjwa A, Park DE, Thea DM, Kwenda G, Mwananyanda L, Madhi SA. Epidemiology and Seasonality of Endemic Human Coronaviruses in South African and Zambian Children: A Case-Control Pneumonia Study. Viruses 2021; 13:v13081513. [PMID: 34452378 PMCID: PMC8402793 DOI: 10.3390/v13081513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/22/2023] Open
Abstract
Endemic human coronaviruses (HCoV) are capable of causing a range of diseases from the common cold to pneumonia. We evaluated the epidemiology and seasonality of endemic HCoVs in children hospitalized with clinical pneumonia and among community controls living in countries with a high HIV burden, namely South Africa and Zambia, between August 2011 to October 2013. Nasopharyngeal/oropharyngeal swabs were collected from all cases and controls and tested for endemic HCoV species and 12 other respiratory viruses using a multiplex real-time PCR assay. We found that the likelihood of detecting endemic HCoV species was higher among asymptomatic controls than cases (11% vs. 7.2%; 95% CI: 1.2–2.0). This was however only observed among children > 6 months and was mainly driven by the Betacoronavirus endemic species (HCoV-OC43 and –HKU1). Endemic HCoV species were detected through the year; however, in Zambia, the endemic Betacoronavirus species tended to peak during the winter months (May–August). There was no association between HIV status and endemic HCoV detection.
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Affiliation(s)
- Vicky L. Baillie
- Medical Research Council: Vaccines and Infectious Diseases Analytics, University of the Witwatersrand, Johannesburg 2050, South Africa; (D.P.M.); (A.M.); (S.A.M.)
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
- Correspondence: ; Tel.: +27-11-983-4283
| | - David P. Moore
- Medical Research Council: Vaccines and Infectious Diseases Analytics, University of the Witwatersrand, Johannesburg 2050, South Africa; (D.P.M.); (A.M.); (S.A.M.)
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
- Department of Paediatrics & Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg 1864, South Africa
| | - Azwifarwi Mathunjwa
- Medical Research Council: Vaccines and Infectious Diseases Analytics, University of the Witwatersrand, Johannesburg 2050, South Africa; (D.P.M.); (A.M.); (S.A.M.)
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Daniel E. Park
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Milken Institute School of Public Health, Department of Epidemiology, George Washington University, Washington, DC 20052, USA
| | - Donald M. Thea
- Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA;
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka 50110, Zambia;
| | - Lawrence Mwananyanda
- Right to Care-Zambia, Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA;
| | - Shabir A. Madhi
- Medical Research Council: Vaccines and Infectious Diseases Analytics, University of the Witwatersrand, Johannesburg 2050, South Africa; (D.P.M.); (A.M.); (S.A.M.)
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
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14
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Tempia S, Walaza S, Bhiman JN, McMorrow ML, Moyes J, Mkhencele T, Meiring S, Quan V, Bishop K, McAnerney JM, von Gottberg A, Wolter N, Du Plessis M, Treurnicht FK, Hellferscee O, Dawood H, Naby F, Variava E, Siwele C, Baute N, Nel J, Reubenson G, Zar HJ, Cohen C. Decline of influenza and respiratory syncytial virus detection in facility-based surveillance during the COVID-19 pandemic, South Africa, January to October 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 34296675 PMCID: PMC8299743 DOI: 10.2807/1560-7917.es.2021.26.29.2001600] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background In South Africa, COVID-19 control measures to prevent SARS-CoV-2 spread were initiated on 16 March 2020. Such measures may also impact the spread of other pathogens, including influenza virus and respiratory syncytial virus (RSV) with implications for future annual epidemics and expectations for the subsequent northern hemisphere winter. Methods We assessed the detection of influenza and RSV through facility-based syndromic surveillance of adults and children with mild or severe respiratory illness in South Africa from January to October 2020, and compared this with surveillance data from 2013 to 2019. Results Facility-based surveillance revealed a decline in influenza virus detection during the regular season compared with previous years. This was observed throughout the implementation of COVID-19 control measures. RSV detection decreased soon after the most stringent COVID-19 control measures commenced; however, an increase in RSV detection was observed after the typical season, following the re-opening of schools and the easing of measures. Conclusion COVID-19 non-pharmaceutical interventions led to reduced circulation of influenza and RSV in South Africa. This has limited the country’s ability to provide influenza virus strains for the selection of the annual influenza vaccine. Delayed increases in RSV case numbers may reflect the easing of COVID-19 control measures. An increase in influenza virus detection was not observed, suggesting that the measures may have impacted the two pathogens differently. The impact that lowered and/or delayed influenza and RSV circulation in 2020 will have on the intensity and severity of subsequent annual epidemics is unknown and warrants close monitoring.
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Affiliation(s)
- Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.,MassGenics, Duluth, Georgia, United States.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Sibongile Walaza
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jinal N Bhiman
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Jocelyn Moyes
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Thulisa Mkhencele
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Vanessa Quan
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Kate Bishop
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Johanna M McAnerney
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mignon Du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,Division of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Halima Dawood
- Department of Medicine, Greys Hospital, Pietermaritzburg, South Africa.,Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Fathima Naby
- Department of Paediatrics, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa.,Department of Paediatrics, University of KwaZulu Natal, Durban, South Africa
| | - Ebrahim Variava
- Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa.,Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Comfort Siwele
- Department of Paediatrics, Matikwana Hospital, Mkhuhlu, South Africa
| | - Neydis Baute
- Department of Paediatrics, Mapulaneng Hospital, Bushbuckridge, South Africa
| | - Jeremy Nel
- Department of Medicine, Helen Joseph Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Gary Reubenson
- Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa
| | - Heather J Zar
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Cheryl Cohen
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
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15
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Epidemiology of Human Metapneumovirus-associated Lower Respiratory Tract Infections in African Children: Systematic Review and Meta-analysis. Pediatr Infect Dis J 2021; 40:479-485. [PMID: 33480663 DOI: 10.1097/inf.0000000000003041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Human metapneumovirus (hMPV) has been associated with upper and lower respiratory tract infections (LRTI) in children and adults. This systematic review evaluated the epidemiology of hMPV-associated LRTI, including severe acute respiratory infection (SARI) hospitalization or clinically diagnosed severe pneumonia, in African children under 5 years of age. METHODS We searched Science Direct, PubMed, Cochrane Central, Scopus, and WHO regional databases using the terms "("Human metapneumovirus" AND "Africa") OR ("hMPV" AND "Africa")" up to September 17, 2020. Other sources included ClinicalTrials.gov to obtain unpublished data. Studies were included if children were less than 5 years of age and hospitalized with hMPV-associated LRTI, SARI or if clinically diagnosed with severe pneumonia in the community. The main outcomes were prevalence of hMPV identified among children with hospitalized LRTI or SARI. We further calculated odds ratios for hMPV in cases with LRTI compared with non-LRTI controls. Pooled results were calculated using a random-effects model. RESULTS Thirty studies were eligible for inclusion in the review. The prevalence of hMPV-LRTI/SARI among hospitalized and severe pneumonia cases was 4.7% [95% confidence interval (CI): 3.9-5.6, I2 = 95.0]. The case-control studies indicated that hMPV was 2.0-fold (95% CI: 0.9-4.4) more likely to be identified in LRTI cases (10.3%) than controls (6.0%). Three of 5 studies reported hMPV-associated LRTI case fatality risk, with a pooled estimate of 1.3% (95% CI: 0.3-2.9; I2 = 49). CONCLUSIONS hMPV was associated with approximately 5% of LRTI/SARI hospitalizations or severe pneumonia cases in Africa.
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16
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Brouwer L, Moreni G, Wolthers KC, Pajkrt D. World-Wide Prevalence and Genotype Distribution of Enteroviruses. Viruses 2021; 13:v13030434. [PMID: 33800518 PMCID: PMC7999254 DOI: 10.3390/v13030434] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022] Open
Abstract
Enteroviruses (EVs) are highly prevalent viruses world-wide, causing a wide range of diseases in both children and adults. Insight in the global prevalence of EVs is important to define their clinical significance and total disease burden, and assists in making therapeutic decisions. While many studies have been conducted to describe epidemiology of EVs in specific (sub)populations and patient cohorts, little effort has been made to aggregate the available evidence. In the current study, we conducted a search in the PubMed and Embase (Ovid) databases to identify articles reporting EV prevalence and type distribution. We summarized the findings of 153 included studies. We found that EVs are highly prevalent viruses in all continents. Enterovirus B was the most detected species worldwide, while the other species showed continent-specific differences, with Enterovirus C more detected in Africa and Enterovirus A more detected in Asia. Echovirus 30 was by far the most detected type, especially in studies conducted in Europe. EV types in species Enterovirus B-including echovirus 30-were often detected in patient groups with neurological infections and in cerebrospinal fluid, while Enterovirus C types were often found in stool samples.
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Affiliation(s)
- Lieke Brouwer
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Correspondence:
| | - Giulia Moreni
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Katja C. Wolthers
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
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17
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Lagare A, Rajatonirina S, Testa J, Mamadou S. The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review. Afr Health Sci 2020; 20:1514-1536. [PMID: 34394213 PMCID: PMC8351825 DOI: 10.4314/ahs.v20i4.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Influenza infection is a serious public health problem that causes an estimated 3 to 5 million cases and 250,000 deaths worldwide every year. The epidemiology of influenza is well-documented in high- and middle-income countries, however minimal effort had been made to understand the epidemiology, burden and seasonality of influenza in Africa. This study aims to assess the state of knowledge of seasonal influenza epidemiology in Africa and identify potential data gaps for policy formulation following the 2009 pandemic. Method We reviewed articles from Africa published into four databases namely: MEDLINE (PubMed), Google Scholar, Cochrane Library and Scientific Research Publishing from 2010 to 2019. Results We screened titles and abstracts of 2070 studies of which 311 were selected for full content evaluation and 199 studies were considered. Selected articles varied substantially on the basis of the topics they addressed covering the field of influenza surveillance (n=80); influenza risk factors and co-morbidities (n=15); influenza burden (n=37); influenza vaccination (n=40); influenza and other respiratory pathogens (n=22) and influenza diagnosis (n=5). Conclusion Significant progress has been made since the last pandemic in understanding the influenza epidemiology in Africa. However, efforts still remain for most countries to have sufficient data to allow countries to prioritize strategies for influenza prevention and control.
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Affiliation(s)
- Adamou Lagare
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
| | | | - Jean Testa
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
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18
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Loevinsohn G, Hardick J, Sinywimaanzi P, Fenstermacher KZJ, Shaw-Saliba K, Monze M, Gaydos CA, Rothman RE, Pekosz A, Thuma PE, Sutcliffe CG. Respiratory pathogen diversity and co-infections in rural Zambia. Int J Infect Dis 2020; 102:291-298. [PMID: 33127501 PMCID: PMC7817328 DOI: 10.1016/j.ijid.2020.10.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives: The role of respiratory co-infections in modulating disease severity remains understudied in southern Africa, particularly in rural areas. This study was performed to characterize the spectrum of respiratory pathogens in rural southern Zambia and the prognostic impact of co-infections. Methods: Respiratory specimens collected from inpatient and outpatient participants in a viral surveillance program in 2018–2019 were tested for selected viruses and a typical bacteria using the Xpert Xpress Flu/RSV assay and FilmArray Respiratory Panel EZ. Participants were followed for 3–5 weeks to assess their clinical course. Multivariable regression was used to examine the role of co-infections in influencing disease severity. Results: A respiratory pathogen was detected in 63.2% of samples from 671 participants who presented with influenza-like illness. Common pathogens identified included influenza virus (18.2% of samples), respiratory syncytial virus (RSV) (11.8%), rhinovirus (26.4%), and coronavirus (6.0%). Overall, 6.4% of participants were co-infected with multiple respiratory pathogens. Compared to mono-infections, co-infections were found not to be associated with severe clinical illness either overall (relative risk (RR) 0.72, 95% confidence interval (CI) 0.39–1.32) or specifically with influenza virus (RR 0.80, 95% CI 0.14–4.46) or RSV infections (RR 0.44, 95% CI 0.17–1.11). Conclusions: Respiratory infections in rural southern Zambia were associated with a wide range of viruses. Respiratory co-infections in this population were not associated with clinical severity.
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Affiliation(s)
- Gideon Loevinsohn
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Justin Hardick
- Division of Infectious Diseases, Department of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Philip E Thuma
- Macha Research Trust, Macha, Zambia; Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Catherine G Sutcliffe
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
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19
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Althaus T, Thaipadungpanit J, Greer RC, Swe MMM, Dittrich S, Peerawaranun P, Smit PW, Wangrangsimakul T, Blacksell S, Winchell JM, Diaz MH, Day NPJ, Smithuis F, Turner P, Lubell Y. Causes of fever in primary care in Southeast Asia and the performance of C-reactive protein in discriminating bacterial from viral pathogens. Int J Infect Dis 2020; 96:334-342. [PMID: 32437937 PMCID: PMC7211754 DOI: 10.1016/j.ijid.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This study investigated causes of fever in the primary levels of care in Southeast Asia, and evaluated whether C-reactive protein (CRP) could distinguish bacterial from viral pathogens. METHODS Blood and nasopharyngeal swab specimens were taken from children and adults with fever (>37.5 °C) or history of fever (<14 days) in Thailand and Myanmar. RESULTS Of 773 patients with at least one blood or nasopharyngeal swab specimen collected, 227 (29.4%) had a target organism detected. Influenza virus type A was detected in 85/227 cases (37.5%), followed by dengue virus (30 cases, 13.2%), respiratory syncytial virus (24 cases, 10.6%) and Leptospira spp. (nine cases, 4.0%). Clinical outcomes were similar between patients with a bacterial or a viral organism, regardless of antibiotic prescription. CRP was higher among patients with a bacterial organism compared with those with a viral organism (median 18 mg/L, interquartile range [10-49] versus 10 mg/L [≤8-22], p = 0.003), with an area under the curve of 0.65 (95% CI 0.55-0.75). CONCLUSIONS Serious bacterial infections requiring antibiotics are an exception rather than the rule in the first line of care. CRP testing could assist in ruling out such cases in settings where diagnostic uncertainty is high and routine antibiotic prescription is common. The original CRP randomised controlled trial was registered with ClinicalTrials.gov, number NCT02758821.
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Affiliation(s)
- Thomas Althaus
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
| | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rachel C Greer
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Myo Maung Maung Swe
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Myanmar-Oxford Clinical Research Unit (MOCRU), Medical Action Myanmar (MAM), Yangon, Myanmar
| | - Sabine Dittrich
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Pimnara Peerawaranun
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pieter W Smit
- Maasstad Ziekenhuis Hospital, Department of Medical Microbiology, Rotterdam, The Netherlands; Public Health Laboratory (GGD), Amsterdam, The Netherlands
| | - Tri Wangrangsimakul
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Stuart Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Jonas M Winchell
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maureen H Diaz
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Frank Smithuis
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Myanmar-Oxford Clinical Research Unit (MOCRU), Medical Action Myanmar (MAM), Yangon, Myanmar
| | - Paul Turner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Cambodia-Oxford Medical Research Unit (COMRU), Angkor Hospital for Children, Siem Reap, Cambodia
| | - Yoel Lubell
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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20
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Razanajatovo Rahombanjanahary NH, Rybkina K, Randriambolamanantsoa TH, Razafimanjato H, Heraud JM. Genetic diversity and molecular epidemiology of respiratory syncytial virus circulated in Antananarivo, Madagascar, from 2011 to 2017: Predominance of ON1 and BA9 genotypes. J Clin Virol 2020; 129:104506. [PMID: 32585620 DOI: 10.1016/j.jcv.2020.104506] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Respiratory syncytial virus is the main cause of acute respiratory infections leading to a considerable morbidity and mortality among under-5 years children. A comprehensive scheme of RSV virus evolution is of great value in implementing effective universal RSV vaccine. OBJECTIVE We investigated the clinical spectrum and molecular characteristics of detected RSV over a period of seven years (January 2011 to June 2017) in Antananarivo, the capital city of Madagascar. STUDY DESIGN 671 nasopharyngeal samples taken from children aged less than 5 years suffered from ARI were screened for RSV by real-time PCR. Clinical data were retrieved from case report forms. Genotype identification was performed by reverse-transcription PCR and sequencing of the second hyper variable region (HVR2) of the G glycoprotein. RESULTS Amongst samples tested, 292 (43.5 %) were found positive for RSV. RSV A predominated during the study period which accounted for 62.3 % (182/292) of positive samples while RSV B represented 37.0 % (108/292). Phylogenetic analyses identified NA1 and ON1 genotypes among RSV A. Though NA1 widespread from 2011 to 2013, ON1 became prevalent during the following years. Among RSV B, THB, CB1 and BA9 genotypes were detected. A co-circulation of THB and CB1 strains occurred during the 2011 season that was substituted by the BA9 from 2012. Malagasy ON1 strains carried some characteristic amino acid substitutions that distinguish them from the worldwide ON1 strains. By analyzing clinical spectrum, ON1 and BA genotypes seemed to prevail in mild infections compared to NA1. CONCLUSION Results obtained here will have its implication in predicting temporal evolution of RSV at the local level. Considering the insularity of the country, information obtained should help in comparative analysis with global RSV strains to optimize vaccine efficacy.
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Affiliation(s)
| | - Ksenia Rybkina
- National Influenza Center, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Helisoa Razafimanjato
- National Influenza Center, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Jean-Michel Heraud
- National Influenza Center, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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21
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Community-acquired pneumonia: The need to broaden our diagnostic armamentarium. Afr J Thorac Crit Care Med 2020; 26. [PMID: 34240019 PMCID: PMC8203090 DOI: 10.7196/ajtccm.2020.v26i1.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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22
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Hellferscee O, Treurnicht FK, Walaza S, Du Plessis M, Von Gottberg A, Wolter N, Moyes J, Dawood H, Variava E, Pretorius M, Venter M, Cohen C, Tempia S. The Fraction of Rhinovirus Detections Attributable to Mild and Severe Respiratory Illness in a Setting of High Human Immunodeficiency Virus Prevalence, South Africa, 2013-2015. J Infect Dis 2020; 219:1697-1704. [PMID: 30590585 DOI: 10.1093/infdis/jiy725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/20/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The association of rhinovirus (RV) detection to illness is poorly understood. METHODS We enrolled case patients hospitalized with severe respiratory illness (SRI) at 2 hospitals and outpatients with influenza-like illness (ILI) and asymptomatic individuals (controls) from 2 affiliated clinics during 2013-2015. We compared the RV prevalence among ILI and SRI cases to those of controls stratified by human immunodeficiency virus (HIV) serostatus using penalized logistic regression. The attributable fraction (AF) was calculated. RESULTS During 2013-2015, RV was detected in 17.4% (368/2120), 26.8% (979/3654), and 23.0% (1003/4360) of controls, ILI cases, and SRI cases, respectively. The RV AF (95% confidence interval) was statistically significant among children aged <5 years (ILI: 44.6% [30.7%-55.7%] and SRI: 50.3% [38.6%-59.9%]; P < .001) and individuals aged ≥5 years (ILI: 62.9% [54.4%-69.8%] and SRI: 51.3% [38.7%-61.3%]; P < .001) as well as among HIV-infected (ILI: 59.9% [45.8%-70.3%] and SRI: 39.8% [22.3%-53.3%]; P < .001) and HIV-uninfected (ILI: 53.6% [44.7%-61.1%] and SRI: 55.3% [45.6%-63.2%]; P < .001) individuals. CONCLUSIONS Although RV detection was common among controls, it was also associated with a substantial proportion of clinical illness across age groups, irrespective of HIV status.
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Affiliation(s)
- Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Mignon Du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg
| | - Anne Von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Halima Dawood
- Department of Medicine, Pietermaritzburg Metropolitan Hospital.,Department of Medicine, University of KwaZulu-Natal, Pietermaritzburg
| | - Ebrahim Variava
- Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp.,Department of Medicine, Faculty of Health Sciences, Johannesburg, South Africa.,Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Marthi Pretorius
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,Technical Research and Development, Novartis Pharma AG, Basel, Switzerland
| | - Marietjie Venter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,Center for Viral Zoonoses, Department of Medical Virology, University of Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
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23
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Pecego AC, Amâncio RT, Costa DM, Bozza FA, Siqueira MM, Oliveira ML, Cerbino-Neto J, Japiassu A. Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV. Int J STD AIDS 2020; 31:100-108. [PMID: 31969059 PMCID: PMC7206327 DOI: 10.1177/0956462419882587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11–30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm3, median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p = 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p = 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.
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Affiliation(s)
- AC Pecego
- Instituto Nacional de Infectologia – Fundação Oswaldo Cruz (Fiocruz) – Laboratório de Medicina Intensiva, Rio de Janeiro, Brazil
- AC Pecego, Instituto Nacional de Infectologia (INI), FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - RT Amâncio
- Instituto Nacional de Infectologia – Fundação Oswaldo Cruz (Fiocruz) – Laboratório de Medicina Intensiva, Rio de Janeiro, Brazil
| | - DM Costa
- Instituto Nacional de Infectologia – Fundação Oswaldo Cruz (Fiocruz) – Laboratório de Medicina Intensiva, Rio de Janeiro, Brazil
| | - FA Bozza
- Instituto Nacional de Infectologia – Fundação Oswaldo Cruz (Fiocruz) – Laboratório de Medicina Intensiva, Rio de Janeiro, Brazil
- Instituto D’Or de Pesquisa e Ensino, Rio de Janeiro, Brazil
| | - MM Siqueira
- Instituto Oswaldo Cruz – Fiocruz – Laboratório de Vírus Respiratório, do IOC/FIOCRUZ, Rio de Janeiro, Brazil
| | - ML Oliveira
- Instituto Oswaldo Cruz – Fiocruz – Laboratório de Vírus Respiratório, do IOC/FIOCRUZ, Rio de Janeiro, Brazil
| | - J Cerbino-Neto
- Laboratório de Pesquisa em Imunização e Vigilância em Saúde, Rio de Janeiro, Brazil
| | - A Japiassu
- Instituto Nacional de Infectologia – Fundação Oswaldo Cruz (Fiocruz) – Laboratório de Medicina Intensiva, Rio de Janeiro, Brazil
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Kozhikhova KV, Shilovskiy IP, Shatilov AA, Timofeeva AV, Turetskiy EA, Vishniakova LI, Nikolskii AA, Barvinskaya ED, Karthikeyan S, Smirnov VV, Kudlay DA, Andreev SM, Khaitov MR. Linear and dendrimeric antiviral peptides: design, chemical synthesis and activity against human respiratory syncytial virus. J Mater Chem B 2020; 8:2607-2617. [DOI: 10.1039/c9tb02485a] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Novel artificial peptides possess anti-RSV activity through a combination of two mechanisms: direct nonspecific destabilization of the viral envelope and competitive interaction with the RSV cellular receptor.
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Affiliation(s)
| | | | - Artem A. Shatilov
- NRC Institute Immunology FMBA
- Moscow
- Russian Federation
- Sechenov First Moscow State Medical University
- Moscow
| | - Anastasiia V. Timofeeva
- NRC Institute Immunology FMBA
- Moscow
- Russian Federation
- Sechenov First Moscow State Medical University
- Moscow
| | - Evgeny A. Turetskiy
- NRC Institute Immunology FMBA
- Moscow
- Russian Federation
- Sechenov First Moscow State Medical University
- Moscow
| | | | | | | | | | - Valeriy V. Smirnov
- NRC Institute Immunology FMBA
- Moscow
- Russian Federation
- Sechenov First Moscow State Medical University
- Moscow
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25
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Wang X, Li Y, Nair H. The Role of Attributable Fraction in the Exposed in Assessing the Association of Microorganisms With Pneumonia. Clin Infect Dis 2019; 68:1067-1068. [PMID: 30252022 DOI: 10.1093/cid/ciy815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xin Wang
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
| | - You Li
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
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O'Brien KL, Baggett HC, Brooks WA, Feikin DR, Hammitt LL, Higdon MM, Howie SR, Deloria Knoll M, Kotloff KL, Levine OS, Madhi SA, Murdoch DR, Prosperi C, Scott JAG, Shi Q, Thea DM, Wu Z, Zeger SL, Adrian PV, Akarasewi P, Anderson TP, Antonio M, Awori JO, Baillie VL, Bunthi C, Chipeta J, Chisti MJ, Crawley J, DeLuca AN, Driscoll AJ, Ebruke BE, Endtz HP, Fancourt N, Fu W, Goswami D, Groome MJ, Haddix M, Hossain L, Jahan Y, Kagucia EW, Kamau A, Karron RA, Kazungu S, Kourouma N, Kuwanda L, Kwenda G, Li M, Machuka EM, Mackenzie G, Mahomed N, Maloney SA, McLellan JL, Mitchell JL, Moore DP, Morpeth SC, Mudau A, Mwananyanda L, Mwansa J, Silaba Ominde M, Onwuchekwa U, Park DE, Rhodes J, Sawatwong P, Seidenberg P, Shamsul A, Simões EA, Sissoko S, Wa Somwe S, Sow SO, Sylla M, Tamboura B, Tapia MD, Thamthitiwat S, Toure A, Watson NL, Zaman K, Zaman SM. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Lancet 2019; 394:757-779. [PMID: 31257127 PMCID: PMC6727070 DOI: 10.1016/s0140-6736(19)30721-4] [Citation(s) in RCA: 484] [Impact Index Per Article: 96.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. METHODS We did a multi-site, international case-control study in nine study sites in seven countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted to cases without HIV infection and with abnormal chest x-rays and to controls without HIV infection. We applied a Bayesian, partial latent class analysis to estimate probabilities of aetiological agents at the individual and population level, incorporating case and control data. FINDINGS Between Aug 15, 2011, and Jan 30, 2014, we enrolled 4232 cases and 5119 community controls. The primary analysis group was comprised of 1769 (41·8% of 4232) cases without HIV infection and with positive chest x-rays and 5102 (99·7% of 5119) community controls without HIV infection. Wheezing was present in 555 (31·7%) of 1752 cases (range by site 10·6-97·3%). 30-day case-fatality ratio was 6·4% (114 of 1769 cases). Blood cultures were positive in 56 (3·2%) of 1749 cases, and Streptococcus pneumoniae was the most common bacteria isolated (19 [33·9%] of 56). Almost all cases (98·9%) and controls (98·0%) had at least one pathogen detected by PCR in the NP-OP specimen. The detection of respiratory syncytial virus (RSV), parainfluenza virus, human metapneumovirus, influenza virus, S pneumoniae, Haemophilus influenzae type b (Hib), H influenzae non-type b, and Pneumocystis jirovecii in NP-OP specimens was associated with case status. The aetiology analysis estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3-65·6) of causes, whereas bacteria accounted for 27·3% (23·3-31·6) and Mycobacterium tuberculosis for 5·9% (3·9-8·3). Viruses were less common (54·5%, 95% CrI 47·4-61·5 vs 68·0%, 62·7-72·7) and bacteria more common (33·7%, 27·2-40·8 vs 22·8%, 18·3-27·6) in very severe pneumonia cases than in severe cases. RSV had the greatest aetiological fraction (31·1%, 95% CrI 28·4-34·2) of all pathogens. Human rhinovirus, human metapneumovirus A or B, human parainfluenza virus, S pneumoniae, M tuberculosis, and H influenzae each accounted for 5% or more of the aetiological distribution. We observed differences in aetiological fraction by age for Bordetella pertussis, parainfluenza types 1 and 3, parechovirus-enterovirus, P jirovecii, RSV, rhinovirus, Staphylococcus aureus, and S pneumoniae, and differences by severity for RSV, S aureus, S pneumoniae, and parainfluenza type 3. The leading ten pathogens of each site accounted for 79% or more of the site's aetiological fraction. INTERPRETATION In our study, a small set of pathogens accounted for most cases of pneumonia requiring hospital admission. Preventing and treating a subset of pathogens could substantially affect childhood pneumonia outcomes. FUNDING Bill & Melinda Gates Foundation.
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Cohen R, Babushkin F, Geller K, Finn T. Characteristics of hospitalized adult patients with laboratory documented Influenza A, B and Respiratory Syncytial Virus - A single center retrospective observational study. PLoS One 2019; 14:e0214517. [PMID: 30921408 PMCID: PMC6438521 DOI: 10.1371/journal.pone.0214517] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/15/2019] [Indexed: 01/20/2023] Open
Abstract
Introduction The epidemiology, clinical features and outcomes of hospitalized adult patients with Influenza A (FluA), Influenza B (FluB) and Respiratory Syncytial Virus (RSV) have not been thoroughly compared. The aim of this study was to describe the differences between these viruses during 3 winter seasons. Methods A retrospective observational study was conducted consisting of all the polymerase chain reaction (PCR)-based diagnoses of FluA, FluB and RSV among adults during 2015–2018, in one regional hospital. Epidemiology, clinical symptoms and outcome-related data were comparatively analyzed. Results Between November 2015 and April 2018, 759 patients were diagnosed with FluA, FluB or RSV. Study cohort included 539 adult patients (306 FluA, 148 FluB and 85 RSV). FluB was predominant during the winter of 2017–18. RSV caused 15.7% of hospitalizations with diagnosed viral infection and in comparison to influenza, had distinct epidemiological, clinical features and outcomes, including older age (74.2 vs 66.2, p = 0.001) and higher rates of co-morbidities; complications including bacterial pneumonia (31 vs 18%, p = 0.02), mechanical ventilation (20 vs 7%, p = 0.001), and viral-related death (13 vs 6.6%, p = 0.04). FluA and FluB had similar epidemiology, clinical symptoms and outcomes, but vaccinated patients were less prone to be hospitalized with FluB as compared with FluA (3 vs 14%, p = 0.001). Paroxysmal atrial fibrillation and falls were common (8.7 and 8.5% respectively). Conclusions FluA and FluB had similar epidemiological, clinical features and contributed equally to hospitalization burden and complications. RSV had a major impact on hospitalizations, occurring among the more elderly and sick populations and causing significantly worse outcomes, when compared to influenza patients. Vaccination appeared as a protective factor against hospitalizations with FluB as compared with FluA.
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Affiliation(s)
- Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- * E-mail: ,
| | - Frida Babushkin
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Keren Geller
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Talya Finn
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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28
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Kamau E, Onyango CO, Otieno GP, Kiyuka PK, Agoti CN, Medley GF, Cane PA, Nokes DJ, Munywoki PK. An Intensive, Active Surveillance Reveals Continuous Invasion and High Diversity of Rhinovirus in Households. J Infect Dis 2019; 219:1049-1057. [PMID: 30576538 PMCID: PMC6420174 DOI: 10.1093/infdis/jiy621] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/21/2018] [Indexed: 11/14/2022] Open
Abstract
We report on infection patterns in 5 households (78 participants) delineating the natural history of human rhinovirus (HRV). Nasopharyngeal collections were obtained every 3-4 days irrespective of symptoms, over a 6-month period, with molecular screening for HRV and typing by sequencing VP4/VP2 junction. Overall, 311/3468 (8.9%) collections were HRV positive: 256 were classified into 3 species: 104 (40.6%) HRV-A; 14 (5.5%) HRV-B, and 138 (53.9%) HRV-C. Twenty-six known HRV types (13 HRV-A, 3 HRV-B, and 10 HRV-C) were identified (A75, C1, and C35 being most frequent). We observed continuous invasion and temporal clustering of HRV types in households (range 5-13 over 6 months). Intrahousehold transmission was independent of clinical status but influenced by age. Most (89.0%) of HRV infection episodes were limited to <14 days. Individual repeat infections were frequent (range 1-7 over 6 months), decreasing with age, and almost invariably heterotypic, indicative of lasting type-specific immunity and low cross-type protection.
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Affiliation(s)
- Everlyn Kamau
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
| | - Clayton O Onyango
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
- Centers for Disease Control and Prevention, Nairobi
| | - Grieven P Otieno
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
| | - Patience K Kiyuka
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
| | - Charles N Agoti
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
- School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Salisbury
| | | | - D James Nokes
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
- School of Life Sciences and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Patrick K Munywoki
- Epidemiology and Demography Department, Kenya Medical Research Institute – Wellcome Trust Research Programme, Kilifi
- School of Health and Human Sciences, Pwani University, Kilifi, Kenya
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Razanajatovo NH, Guillebaud J, Harimanana A, Rajatonirina S, Ratsima EH, Andrianirina ZZ, Rakotoariniaina H, Andriatahina T, Orelle A, Ratovoson R, Irinantenaina J, Rakotonanahary DA, Ramparany L, Randrianirina F, Richard V, Heraud JM. Epidemiology of severe acute respiratory infections from hospital-based surveillance in Madagascar, November 2010 to July 2013. PLoS One 2018; 13:e0205124. [PMID: 30462659 PMCID: PMC6248916 DOI: 10.1371/journal.pone.0205124] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/19/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Few comprehensive data exist regarding the epidemiology of severe acute respiratory infections (SARI) in low income countries. This study aimed at identifying etiologies and describing clinical features of SARI-associated hospitalization in Madagascar. METHODS It is a prospective surveillance of SARI in 2 hospitals for 3 years. Nasopharyngeal swabs, sputum, and blood were collected from SARI patients enrolled and tested for viruses and bacteria. Epidemiological and clinical information were obtained from case report forms. RESULTS Overall, 876 patients were enrolled in the study, of which 83.1% (728/876) were tested positive for at least one pathogen. Viral and bacterial infections occurred in 76.1% (667/876) and 35.8% (314/876) of tested samples, respectively. Among all detected viruses, respiratory syncytial virus (RSV) was the most common (37.7%; 348/924) followed by influenza virus A (FLUA, 18.4%; 170/924), rhinovirus (RV, 13.5%; 125/924), and adenovirus (ADV, 8.3%; 77/924). Among bacteria, Streptococcus pneumoniae (S. pneumoniae, 50.3%, 189/370) was the most detected followed by Haemophilus influenzae type b (Hib, 21.4%; 79/370), and Klebsiella (4.6%; 17/370). Other Streptococcus species were found in 8.1% (30/370) of samples. Compared to patients aged less than 5 years, older age groups were significantly less infected with RSV. On the other hand, patients aged more than 64 years (OR = 3.66) were at higher risk to be infected with FLUA, while those aged 15-29 years (OR = 3.22) and 30-64 years (OR = 2.39) were more likely to be infected with FLUB (influenza virus B). CONCLUSION The frequency of influenza viruses detected among SARI patients aged 65 years and more highlights the need for health authorities to develop strategies to reduce morbidity amongst at-risk population through vaccine recommendation. Amongst young children, the demonstrated burden of RSV should guide clinicians for a better case management of children. These findings reveal the need to develop point-of-care tests to avoid overuse of antibiotics and to promote vaccine that could reduce drastically the RSV hospitalizations.
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Affiliation(s)
| | - Julia Guillebaud
- National Influenza Centre, Virology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | - Aina Harimanana
- Epidemiology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | | | | | | | | | | | - Arnaud Orelle
- National Influenza Centre, Virology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | - Rila Ratovoson
- Epidemiology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | | | | | - Lovasoa Ramparany
- Center for Biological Analysis, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | | | - Vincent Richard
- Epidemiology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | - Jean-Michel Heraud
- National Influenza Centre, Virology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
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Kenmoe S, Bigna JJ, Well EA, Simo FBN, Penlap VB, Vabret A, Njouom R. Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: A systematic review and meta-analysis. Influenza Other Respir Viruses 2018; 12:793-803. [PMID: 29908103 PMCID: PMC6185896 DOI: 10.1111/irv.12584] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 12/31/2022] Open
Abstract
AIM The epidemiology of human respiratory syncytial virus (HRSV) infection has not yet been systematically investigated in Africa. This systematic review and meta-analysis are to estimate the prevalence of HRSV infections in people with acute respiratory tract infections (ARTI) in Africa. METHOD We searched PubMed, EMBASE, Africa Journal Online, and Global Index Medicus to identify observational studies published from January 1, 2000, to August 1, 2017. We used a random-effects model to estimate the prevalence across studies. Heterogeneity (I2 ) was assessed via the chi-square test on Cochran's Q statistic. Review registration: PROSPERO CRD42017076352. RESULTS A total of 67 studies (154 000 participants) were included. Sixty (90%), seven (10%), and no studies had low, moderate, and high risk of bias, respectively. The prevalence of HRSV infection varied widely (range 0.4%-60.4%). The pooled prevalence was 14.6% (95% CI 13.0-16.4, I2 = 98.8%). The prevalence was higher in children (18.5%; 95% CI 15.8-21.5) compared to adults (4.0%; 95% CI 2.2-6.1) and in people with severe respiratory tract infections (17.9%; 95% CI 15.8-20.1) compared to those with benign forms (9.4%; 95% CI 7.4-11.5); P-values <0.0001. The HRSV prevalence was not associated with sex, subregion in Africa, setting, altitude, latitude, longitude, and seasonality. CONCLUSION This study suggests a high prevalence of HRSV in people with ARTI in Africa, particularly among children and people with severe clinical form. All innovative strategies to curb the burden should first focus on children which present the highest HRSV-related burden.
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Affiliation(s)
- Sebastien Kenmoe
- Department of VirologyNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
| | - Jean Joel Bigna
- Department of Epidemiology and Public HealthNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
- School of Public HealthFaculty of MedicineUniversity of Paris SudLe Kremlin‐BicêtreFrance
| | | | - Fredy Brice N. Simo
- Department of BiochemistryFaculty of SciencesUniversity of Yaoundé 1YaoundéCameroon
| | - Véronique B. Penlap
- Department of BiochemistryFaculty of SciencesUniversity of Yaoundé 1YaoundéCameroon
| | - Astrid Vabret
- Normandie UniversitéCaenFrance
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM)Université de CaenCaenFrance
- Laboratoire de VirologieCentre Hospitalo‐Universitaire de CaenCaenFrance
| | - Richard Njouom
- Department of VirologyNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
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Bigna JJ, Kenmoe S, Well EA, Simo FBN, Penlap VB, Vabret A, Njouom R. Contemporaneous data on the prevalence of Human Respiratory Syncytial Virus infection in people with acute respiratory tract infections in Africa (2000-2017). Data Brief 2018; 20:940-947. [PMID: 30225305 PMCID: PMC6138983 DOI: 10.1016/j.dib.2018.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/24/2018] [Accepted: 08/15/2018] [Indexed: 11/28/2022] Open
Abstract
Availability of accurate data on the burden of the Human Respiratory Syncytial Virus (HRSV) can help to implement better strategies to curb this burden in Africa continent among people with acute respiratory tract infections (ARTI). We summarize here available contemporaneous data published from January 1, 2000 to August 31, 2017 on the prevalence of HSRV infection among people with ARTI in the continent.
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Affiliation(s)
- Jean Joel Bigna
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Sebastien Kenmoe
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Estelle Amandine Well
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon
| | - Fredy Brice N. Simo
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Véronique B. Penlap
- Department of Biochemistry, Faculty of Sciences, University of Yaoundé 1, P.O. Box 337, Yaoundé, Cameroon
| | - Astrid Vabret
- Normandie Université, 14032 Caen, France
- Université de Caen, Groupe de Recherche sur l’Adaptation Microbienne (GRAM), F-14000 Caen, France
- Laboratoire de Virologie, Centre Hospitalo-Universitaire de Caen, F-14033 Caen, France
| | - Richard Njouom
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
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Ho A, Mallewa J, Peterson I, SanJoaquin M, Garg S, Bar-Zeev N, Menyere M, Alaerts M, Mapurisa G, Chilombe M, Nyirenda M, Lalloo DG, Rothe C, Widdowson MA, McMorrow M, French N, Everett D, Heyderman RS. Epidemiology of Severe Acute Respiratory Illness and Risk Factors for Influenza Infection and Clinical Severity among Adults in Malawi, 2011-2013. Am J Trop Med Hyg 2018; 99:772-779. [PMID: 30039785 PMCID: PMC6169174 DOI: 10.4269/ajtmh.17-0905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Data on the epidemiology of severe acute respiratory illness (SARI) in adults from low-income, high human immunodeficiency virus (HIV) prevalence African settings are scarce. We conducted adult SARI surveillance in Blantyre, Malawi. From January 2011 to December 2013, individuals aged ≥ 15 years with SARI (both inpatients and outpatients) were enrolled at a large teaching hospital in Blantyre, Malawi. Nasopharyngeal aspirates were tested for influenza and other respiratory viruses by polymerase chain reaction. We estimated hospital-attended influenza-positive SARI incidence rates and assessed factors associated with influenza positivity and clinical severity (Modified Early Warning Score > 4). We enrolled 1,126 SARI cases; 163 (14.5%) were positive for influenza. Human immunodeficiency virus prevalence was 50.3%. Annual incidence of hospital-attended influenza-associated SARI was 9.7–16.8 cases per 100,000 population. Human immunodeficiency virus was associated with a 5-fold greater incidence (incidence rate ratio 4.91, 95% confidence interval [CI]: 3.83–6.32). On multivariable analysis, female gender, as well as recruitment in hot, rainy season (December to March; adjusted odds ratios (aOR): 2.82, 95% CI: 1.57–5.06) and cool, dry season (April to August; aOR: 2.47, 95% CI: 1.35–4.15), was associated with influenza positivity, whereas influenza-positive patients were less likely to be HIV-infected (aOR: 0.59, 95% CI: 0.43–0.80) or have viral coinfection (aOR: 0.51, 95% CI: 0.36–0.73). Human immunodeficiency virus infection (aOR: 1.86; 95% CI: 1.35–2.56) and recruitment in hot, rainy season (aOR: 4.98, 95% CI: 3.17–7.81) were independently associated with clinical severity. In this high HIV prevalence population, influenza was associated with nearly 15% of hospital-attended SARI. Human immunodeficiency virus infection is an important risk factor for clinical severity in all-cause and influenza-associated SARI. Expanded access to HIV testing and antiretroviral treatment, as well as targeted influenza vaccination, may reduce the burden of SARI in Malawi and other high HIV prevalence settings.
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Affiliation(s)
- Antonia Ho
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Jane Mallewa
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Ingrid Peterson
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Naor Bar-Zeev
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Mavis Menyere
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Maaike Alaerts
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Gugulethu Mapurisa
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Moses Chilombe
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Mulinda Nyirenda
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - David G Lalloo
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Marc-Alain Widdowson
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Meredith McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Pretoria, South Africa.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Neil French
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Dean Everett
- University of Edinburgh, Edinburgh, United Kingdom.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Robert S Heyderman
- Division of Infection and Immunity, University College London, London, United Kingdom
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Rao CY, Goryoka GW, Henao OL, Clarke KR, Salyer SJ, Montgomery JM. Global Disease Detection-Achievements in Applied Public Health Research, Capacity Building, and Public Health Diplomacy, 2001-2016. Emerg Infect Dis 2018; 23. [PMID: 29155662 PMCID: PMC5711302 DOI: 10.3201/eid2313.170859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015-2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human-animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.
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Tempia S, Walaza S, Moyes J, Cohen AL, von Mollendorf C, McMorrow ML, Mhlanga S, Treurnicht FK, Venter M, Pretorius M, Hellferscee O, Wolter N, von Gottberg A, Nguweneza A, McAnerney JM, Dawood H, Variava E, Madhi SA, Cohen C. The effects of the attributable fraction and the duration of symptoms on burden estimates of influenza-associated respiratory illnesses in a high HIV prevalence setting, South Africa, 2013-2015. Influenza Other Respir Viruses 2018; 12:360-373. [PMID: 29210203 PMCID: PMC5907815 DOI: 10.1111/irv.12529] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The attributable fraction of influenza virus detection to illness (INF-AF) and the duration of symptoms as a surveillance inclusion criterion could potentially have substantial effects on influenza disease burden estimates. METHODS We estimated rates of influenza-associated influenza-like illness (ILI) and severe acute (SARI-10) or chronic (SCRI-10) respiratory illness (using a symptom duration cutoff of ≤10 days) among HIV-infected and HIV-uninfected patients attending 3 hospitals and 2 affiliated clinics in South Africa during 2013-2015. We calculated the unadjusted and INF-AF-adjusted rates and relative risk (RR) due to HIV infection. Rates were expressed per 100 000 population. RESULTS The estimated mean annual unadjusted rates of influenza-associated illness were 1467.7, 50.3, and 27.4 among patients with ILI, SARI-10, and SCRI-10, respectively. After adjusting for the INF-AF, the percent reduction in the estimated rates was 8.9% (rate: 1336.9), 11.0% (rate: 44.8), and 16.3% (rate: 22.9) among patients with ILI, SARI-10, and SCRI-10, respectively. HIV-infected compared to HIV-uninfected individuals experienced a 2.3 (95% CI: 2.2-2.4)-, 9.7 (95% CI: 8.0-11.8)-, and 10.0 (95% CI: 7.9-12.7)-fold increased risk of influenza-associated illness among patients with ILI, SARI-10, and SCRI-10, respectively. Overall 34% of the estimated influenza-associated hospitalizations had symptom duration of >10 days; 8% and 44% among individuals aged <5 and ≥5 years, respectively. CONCLUSION The marginal differences between unadjusted and INF-AF-adjusted rates are unlikely to affect policies on prioritization of interventions. HIV-infected individuals experienced an increased risk of influenza-associated illness and may benefit more from annual influenza immunization. The use of a symptom duration cutoff of ≤10 days may underestimate influenza-associated disease burden, especially in older individuals.
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Affiliation(s)
- Stefano Tempia
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGAUSA
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Adam L. Cohen
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGAUSA
- Global Immunization Monitoring and Surveillance Team, Expanded Programme on ImmunizationDepartment of Immunization, Vaccines and BiologicalWorld Health OrganizationGenevaSwitzerland
| | - Claire von Mollendorf
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Meredith L. McMorrow
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGAUSA
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
| | - Sarona Mhlanga
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Florette K. Treurnicht
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Marietjie Venter
- Centre for Viral ZoonosesDepartment of Medical VirologyUniversity of PretoriaPretoriaSouth Africa
| | - Marthi Pretorius
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Centre for Viral ZoonosesDepartment of Medical VirologyUniversity of PretoriaPretoriaSouth Africa
- Tshwane Academic DivisionNational Health Laboratory ServicePretoriaSouth Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of PathologyFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of PathologyFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of PathologyFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Arthemon Nguweneza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Johanna M. McAnerney
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
| | - Halima Dawood
- Department of MedicinePietermaritzburg Metropolitan HospitalPietermaritzburgSouth Africa
- Department of MedicineUniversity of KwaZulu‐NatalPietermaritzburgSouth Africa
| | - Ebrahim Variava
- Department of MedicineKlerksdorp‐Tshepong Hospital ComplexKlerksdorpSouth Africa
- Department of MedicineFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Perinatal HIV Research UnitUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Shabir A. Madhi
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Medical Research CouncilRespiratory and Meningeal Pathogens Research UnitUniversity of the WitwatersrandJohannesburgSouth Africa
- Department of Science and Technology/National Research Foundation: Vaccine Preventable DiseasesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
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Nguenha N, Tivane A, Pale M, Machalele L, Nacoto A, Pires G, Mationane E, Salência J, Gundane F, Muteto D, Chilundo J, Mavale S, Adamo N, Semá-Baltazar C, Augusto O, Gudo E, Mussá T. Clinical and epidemiological characterization of influenza virus infections in children with severe acute respiratory infection in Maputo, Mozambique: Results from the implementation of sentinel surveillance, 2014 - 2016. PLoS One 2018; 13:e0194138. [PMID: 29590162 PMCID: PMC5874022 DOI: 10.1371/journal.pone.0194138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 02/11/2018] [Indexed: 11/16/2022] Open
Abstract
In Sub-Saharan Africa, where burden, impact, and incidence of acute respiratory infections (ARI) are the highest in the world, conversely, the epidemiology of influenza-associated severe acute respiratory infections (SARI) is incompletely known. The aim of this study was to describe the clinical and epidemiological features of influenza-associated SARI in hospitalized children in Maputo city, Mozambique. Nasopharyngeal and oropharyngeal swabs were collected from children aged 0-14 years old who met the case definition for SARI in two hospitals in Maputo city after their parents or legal representative consented to participate. A structured questionnaire was used to collect clinical and demographic data. Typing and subtyping of influenza were performed by real-time PCR. From January 2014 to December 2016, a total of 2,007 eligible children were recruited, of whom 1,997 (99.5%) were screened for influenza by real-time PCR. The median age of participants was 16.9 months (IQR: 7.0-38.9 months) and 53.9% (1076/1991) were male. A total of 77 were positive for influenza, yielding a frequency of 3.9% (77/1,991), with the highest frequency being reported in the age group 1-5 years old. Cases of influenza peaked twice each year, during which, its frequency reached up to 60%-80%. Among all influenza confirmed cases, 33.7% (26/77), 35.1% (27/77) and 28.6% (22/77) were typed as influenza A/H3N2, A/H1N1pdm09, and B, respectively. This represents the first report of influenza in urban/sub urban setting in Mozambique and the first evidence of distribution of strains of influenza in the country. Our data showed that frequency of influenza was lower than reported in a rural setting in Mozambique and the frequency of seasonal (A/H1N1pdm09) and (A/H3N2) subtypes were similar in children with SARI.
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Affiliation(s)
- Neuza Nguenha
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Almiro Tivane
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Mirela Pale
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Loira Machalele
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Afonso Nacoto
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Germano Pires
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Edirsse Mationane
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Judite Salência
- National Institute of Health, Ministry of Health, Maputo, Mozambique
- Pediatric Departament, Hospital Geral de Mavalane, Maputo, Mozambique
| | - Félix Gundane
- National Institute of Health, Ministry of Health, Maputo, Mozambique
- Pediatric Departament, Hospital Geral de Mavalane, Maputo, Mozambique
| | - Délcio Muteto
- Pediatric Departament, Hospital Central de Maputo, Maputo, Mozambique
| | - Josina Chilundo
- Pediatric Departament, Hospital Central de Maputo, Maputo, Mozambique
| | - Sandra Mavale
- Pediatric Departament, Hospital Central de Maputo, Maputo, Mozambique
| | - Noorbebi Adamo
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | | | - Orvalho Augusto
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Eduardo Gudo
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Tufária Mussá
- National Institute of Health, Ministry of Health, Maputo, Mozambique
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
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36
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Tempia S, Walaza S, Moyes J, Cohen AL, von Mollendorf C, McMorrow ML, Treurnicht FK, Venter M, Pretorius M, Hellferscee O, Wolter N, von Gottberg A, Nguweneza A, McAnerney JM, Dawood H, Variava E, Madhi SA, Cohen C. Attributable Fraction of Influenza Virus Detection to Mild and Severe Respiratory Illnesses in HIV-Infected and HIV-Uninfected Patients, South Africa, 2012-2016. Emerg Infect Dis 2018. [PMID: 28628462 PMCID: PMC5512492 DOI: 10.3201/eid2307.161959] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The attributable fraction (AF) of influenza virus detection to illness has not been described for patients in different age groups or with different HIV infection statuses. We compared the age group–specific prevalence of influenza virus infection among patients with influenza-like illness (ILI) or severe acute or chronic respiratory illness (SARI and SCRI, respectively) with that among controls, stratified by HIV serostatus. The overall AF for influenza virus detection to illness was 92.6% for ILI, 87.4% for SARI, and 86.2% for SCRI. Among HIV-uninfected patients, the AF for all syndromes was highest among persons <1 and >65 years of age and lowest among persons 25–44 years of age; this trend was not observed among HIV-infected patients. Overall, influenza viruses when detected in patients with ILI, SARI, or SCRI are likely attributable to illness. This finding is particularly likely among children and the elderly irrespective of HIV serostatus and among HIV-infected persons irrespective of age.
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Kabego L, Balol'Ebwami S, Kasengi JB, Miyanga S, Bahati YL, Kambale R, de Beer C. Human respiratory syncytial virus: prevalence, viral co-infections and risk factors for lower respiratory tract infections in children under 5 years of age at a general hospital in the Democratic Republic of Congo. J Med Microbiol 2018; 67:514-522. [PMID: 29509134 DOI: 10.1099/jmm.0.000713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This study aimed to determine the prevalence of human respiratory syncytial virus (HRSV) acute respiratory infection (ARI) in children under the age of 5 years at the Provincial General Hospital of Bukavu (PGHB), and to analyse factors associated with the risk of ARI being diagnosed as lower respiratory tract infection (LRTI). METHODOLOGY A total of 146 children under 5 years visiting the PGHB for ARI between August and December 2016 were recruited, and socio-demographic information, clinical data and nasopharyngeal swabs were collected. The samples were analysed by a multiplex reverse transcriptase polymerase chain reaction targeting 15 different viruses. RESULTS Of 146 samples collected, 84 (57.5 %) displayed a positive result of at least one of the 15 viruses. The overall prevalence of HRSV was 21.2 %. HRSV A (30, 20.5 %) was the virus the most detected, followed by HRV (24, 16.4 %), PIV3 (20, 16.6) and ADV (7, 4.79 %). The other viruses were detected in three or fewer cases. There were only 11 (7.5 %) cases of co-infection. HRSV infection, malnutrition, younger age, rural settings, low income and mother illiteracy were associated with the risk of ARI being diagnosed as LRTI in bivariate analyses but, after adjusting for the confounding factors, only HRSV infection and younger age were independently associated with LRTI. CONCLUSION The prevalence of HRSV is high among children visiting the PGHB for ARI. HRSV infection and lower age are independently associated with the risk of ARI being diagnosed as LRTI.
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Affiliation(s)
- Landry Kabego
- Division of Medical Virology, Department of Pathology, University of Stellenbosch, Tygerberg 7505, South Africa.,Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo.,Infection Control Africa Network, South Africa
| | - Serge Balol'Ebwami
- Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo
| | - Joe Bwija Kasengi
- Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo
| | - Serge Miyanga
- Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo
| | - Yvette Lufungulo Bahati
- Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo
| | - Richard Kambale
- Hopital Provincial Général de Référence de Bukavu/ Université Catholique de Bukavu, Democratic Republic of Congo
| | - Corena de Beer
- Division of Medical Virology, Department of Pathology, University of Stellenbosch, Tygerberg 7505, South Africa
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38
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Affiliation(s)
- Aubree Gordon
- 1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
| | - Arthur Reingold
- 2Division of Epidemiology, School of Public Health, University of California, 101 Haviland Hall, Berkeley, CA 94720 USA
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39
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Sarna M, Lambert SB, Sloots TP, Whiley DM, Alsaleh A, Mhango L, Bialasiewicz S, Wang D, Nissen MD, Grimwood K, Ware RS. Viruses causing lower respiratory symptoms in young children: findings from the ORChID birth cohort. Thorax 2017; 73:969-979. [PMID: 29247051 PMCID: PMC6166599 DOI: 10.1136/thoraxjnl-2017-210233] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 10/26/2017] [Accepted: 11/20/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Viral acute respiratory infections (ARIs) cause substantial child morbidity. Sensitive molecular-based assays aid virus detection, but the clinical significance of positive tests remains uncertain as some viruses may be found in both acutely ill and healthy children. We describe disease-pathogen associations of respiratory viruses and quantify virus-specific attributable risk of ARIs in healthy children during the first 2 years of life. METHODS One hundred fifty-eight term newborn babies in Brisbane, Australia, were recruited progressively into a longitudinal, community-based, birth cohort study conducted between September 2010 and October 2014. A daily tick-box diary captured predefined respiratory symptoms from birth until their second birthday. Weekly parent-collected nasal swabs were batch-tested for 17 respiratory viruses by PCR assays, allowing calculation of virus-specific attributable fractions in the exposed (AFE) to determine the proportion of virus-positive children whose ARI symptoms could be attributed to that particular virus. RESULTS Of 8100 nasal swabs analysed, 2646 (32.7%) were virus-positive (275 virus codetections, 3.4%), with human rhinoviruses accounting for 2058/2646 (77.8%) positive swabs. Viruses were detected in 1154/1530 (75.4%) ARI episodes and in 984/4308 (22.8%) swabs from asymptomatic periods. Respiratory syncytial virus (AFE: 68% (95% CI 45% to 82%)) and human metapneumovirus (AFE: 69% (95% CI 43% to 83%)) were strongly associated with higher risk of lower respiratory symptoms. DISCUSSION The strong association of respiratory syncytial virus and human metapneumovirus with ARIs and lower respiratory symptoms in young children managed within the community indicates successful development of vaccines against these two viruses should provide substantial health benefits.
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Affiliation(s)
- Mohinder Sarna
- School of Public Health, The University of Queensland, Brisbane, Australia.,UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Stephen B Lambert
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Brisbane, Australia
| | - Theo P Sloots
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Brisbane, Australia
| | - David M Whiley
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Asma Alsaleh
- Department of Botany and Microbiology, King Saud University, Riyadh, Saudi Arabia
| | - Lebogang Mhango
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Brisbane, Australia
| | - Seweryn Bialasiewicz
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Brisbane, Australia
| | - David Wang
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Michael D Nissen
- UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Brisbane, Australia
| | - Keith Grimwood
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.,Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Gold Coast, Australia
| | - Robert S Ware
- School of Public Health, The University of Queensland, Brisbane, Australia.,UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Song J, Wang H, Shi J, Cui A, Huang Y, Sun L, Xiang X, Ma C, Yu P, Yang Z, Li Q, Ng TI, Zhang Y, Zhang R, Xu W. Emergence of BA9 genotype of human respiratory syncytial virus subgroup B in China from 2006 to 2014. Sci Rep 2017; 7:16765. [PMID: 29196726 PMCID: PMC5711796 DOI: 10.1038/s41598-017-17055-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/21/2017] [Indexed: 01/10/2023] Open
Abstract
A study was conducted to investigate the circulation of HRSV subgroup B (HRSVB) in China in recent years. HRSVB sequences from 365 samples collected in 1991, 2004 and 2008-2014 in China, together with 332 Chinese HRSVB sequences obtained from GenBank were analyzed to determine the geographic and yearly distribution of HRSVB. Phylogenetic analysis revealed these HRSVB sequences clustered into 4 genotypes with different frequencies: BA (83%), CB1 (11%), SAB (3.0%) and GB3 (0.7%). Between 2005 and 2013, there was a co-circulation of BA and non-BA genotypes in China. Genotypes BA9 and BA10 were two of the main BA genotypes detected in this study. Genotype BA9 was first detected in China in 2006 and became the predominant HRSVB genotype circulating in China from 2008 to 2014. Three different lineages were detected for both genotypes BA9 and BA10. Time to the most recent common ancestor for genotypes BA9 and BA10 was estimated for years 1997 and 1996, respectively. Results of this study not only contribute to the understanding of the circulation pattern, but also the phylogenetic pattern and evolution of HRSVB in China from 1991 to 2014.
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Affiliation(s)
- Jinhua Song
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Huiling Wang
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jing Shi
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China.,Lu Juan Community Health Center of Daxing region, Beijing, People's Republic of China
| | - Aili Cui
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Yanzhi Huang
- Jilin Children's Medical Center, Children's Hospital of Changchun, Changchun, People's Republic of China
| | - Liwei Sun
- Jilin Children's Medical Center, Children's Hospital of Changchun, Changchun, People's Republic of China
| | - Xingyu Xiang
- Hunan Provincial Centers for Disease Control and Prevention, Changsha, People's Republic of China
| | - Chaofeng Ma
- Xian Center for Disease Control and Prevention, Xian, People's Republic of China
| | - Pengbo Yu
- Shaanxi Provincial Centers for Disease Control and Prevention, Xian, People's Republic of China
| | - Zifeng Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Qi Li
- Hebei Provincial Centers for Disease Control and Prevention, Shijiazhuang, People's Republic of China
| | | | - Yan Zhang
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China.
| | - Rongbo Zhang
- Medical College, Anhui University of Science & Technology, Huainan, People's Republic of China.
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles/Rubella Laboratory and Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China. .,Medical College, Anhui University of Science & Technology, Huainan, People's Republic of China.
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Hellferscee O, Tempia S, Walaza S, Variava E, Dawood H, Wolter N, Madhi SA, du Plessis M, Cohen C, Treurnicht FK. Enterovirus genotypes among patients with severe acute respiratory illness, influenza-like illness, and asymptomatic individuals in South Africa, 2012-2014. J Med Virol 2017; 89:1759-1767. [PMID: 28574589 PMCID: PMC5714810 DOI: 10.1002/jmv.24869] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/14/2017] [Indexed: 01/26/2023]
Abstract
Enteroviruses can cause outbreaks of severe acute respiratory illness (SARI) and EV-A, -B, -C, and -D species have different pathogenic profiles and circulation patterns. We aimed to characterize and determine the prevalence of enterovirus genotypes among South African patients with respiratory illness and controls during June 2012 to July 2014. Syndromic SARI and influenza-like illness (ILI) surveillance was performed at two sentinel sites. At each site nasopharyngeal/oropharyngeal specimens were collected from SARI and ILI patients as well as controls. Specimens were tested for enterovirus by real-time PCR. Positive specimens were further genotyped by sequencing a region of the VP1 gene. The prevalence of enterovirus was 5.8% (87/1494), 3.4% (103/3079), and 3.4% (46/1367) among SARI, ILI, and controls, respectively (SARI/controls, P = 0.002 and ILI/control, P = 0.973). Among the 101/236 (42.8%) enterovirus-positive specimens that could be genotyped, we observed a high diversity of circulating enterovirus genotypes (a total of 33 genotypes) from all four human enterovirus species with high prevalence of Enterovirus-B (60.4%; 61/101) and Enterovirus-A (21.8%; 22/101) compared to Enterovirus-C (10.9%; 11/101) and Enterovirus-D (6.9%; 7/101) (P = 0.477). Of the enterovirus genotypes identified, Echovirus 30 (9.9%, 10/101), Coxsackie virus B5 (7.9%, 8/101) and Enterovirus-D68 (6.9%, 7/101) were most prevalent. There was no difference in disease severity (SARI or ILI compared to controls) between the different enterovirus species (P = 0.167). We observed a high number of enterovirus genotypes in patients with respiratory illness and in controls from South Africa with no disease association of EV species with disease severity.
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Affiliation(s)
- Orienka Hellferscee
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Stefano Tempia
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- Centres for Disease Control and PreventionAtlantaGeorgia
| | - Sibongile Walaza
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Ebrahim Variava
- University of the WitwatersrandJohannesburgSouth Africa
- Department of MedicineKlerksdorp‐Tshepong Hospital ComplexKlerksdorpSouth Africa
| | - Halima Dawood
- Pietermaritzburg Metropolitan HospitalPietermaritzburgSouth Africa
- CaprisaUniversity of KwaZulu‐NatalSouth Africa
| | - Nicole Wolter
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Shabir A. Madhi
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Mignon du Plessis
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
- University of the WitwatersrandJohannesburgSouth Africa
| | - Florette K. Treurnicht
- National Institute for Communicable Diseases of the National Health Laboratory ServiceJohannesburgSouth Africa
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Emergence of ON1 genotype of human respiratory syncytial virus subgroup A in China between 2011 and 2015. Sci Rep 2017; 7:5501. [PMID: 28710393 PMCID: PMC5511225 DOI: 10.1038/s41598-017-04824-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/22/2017] [Indexed: 11/23/2022] Open
Abstract
A molecular epidemiological study of human respiratory syncytial virus (HRSV) was conducted to examine the distribution of its subgroups and genotypes, as well as to identify its transmission pattern in China. A total of 705 samples collected from 9 provinces in China between January 2008 and February 2015 were identified as HRSV-positive and were subsequently sequenced. Of these, 336 samples were HRSV subgroup A (HRSVA), 368 samples were HRSV subgroup B (HRSVB), and 1 sample contained both HRSVA and HRSVB. These 705 HRSV sequences, together with 766 HRSV sequences downloaded from GenBank, were analyzed to understand the recent circulation patterns of HRSV in China. HRSVB predominated in the 2008/2009 and 2009/2010 seasons, whereas HRSVA predominated in the 2010/2011 and 2011/2012 seasons; HRSVA and HRSVB co-circulated during 2012/2013 and 2014/2015. Phylogenetic analysis showed most of the HRSVA sequences clustered into 2 genotypes, namely, NA1 and ON1. The ON1 genotype was first detected in China in 2011, and it quickly replaced the NA1 genotype to become the most prevalent HRSVA genotype circulating in China between 2013 and 2015. Continuous epidemiological surveillance and molecular characterization of HRSV should be conducted to monitor the evolution of HRSV in China.
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43
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Boyles TH, Brink A, Calligaro GL, Cohen C, Dheda K, Maartens G, Richards GA, van Zyl Smit R, Smith C, Wasserman S, Whitelaw AC, Feldman C. South African guideline for the management of community-acquired pneumonia in adults. J Thorac Dis 2017; 9:1469-1502. [PMID: 28740661 DOI: 10.21037/jtd.2017.05.31] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Tom H Boyles
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Adrian Brink
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.,Ampath National Laboratory Services, Milpark Hospital, Johannesburg, South Africa
| | - Greg L Calligaro
- Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Keertan Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Guy A Richards
- Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard van Zyl Smit
- Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa
| | | | - Sean Wasserman
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Andrew C Whitelaw
- Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Charles Feldman
- Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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44
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Seleka M, Treurnicht FK, Tempia S, Hellferscee O, Mtshali S, Cohen AL, Buys A, McAnerney JM, Besselaar TG, Pretorius M, von Gottberg A, Walaza S, Cohen C, Madhi SA, Venter M. Epidemiology of influenza B/Yamagata and B/Victoria lineages in South Africa, 2005-2014. PLoS One 2017; 12:e0177655. [PMID: 28542324 PMCID: PMC5444647 DOI: 10.1371/journal.pone.0177655] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/01/2017] [Indexed: 12/29/2022] Open
Abstract
Background Studies describing the epidemiology of influenza B lineages in South Africa are lacking. Methods We conducted a prospective study to describe the circulation of influenza B/Victoria and B/Yamagata lineages among patients of all ages enrolled in South Africa through three respiratory illness surveillance systems between 2005 and 2014: (i) the Viral Watch (VW) program enrolled outpatients with influenza-like illness (ILI) from private healthcare facilities during 2005–2014; (ii) the influenza-like illnesses program enrolled outpatients in public healthcare clinics (ILI/PHC) during 2012–2014; and (iii) the severe acute respiratory illnesses (SARI) program enrolled inpatients from public hospitals during 2009–2014. Influenza B viruses were detected by virus isolation during 2005 to 2009 and by real-time reverse transcription polymerase chain reaction from 2009–2014. Clinical and epidemiological characteristics of patients hospitalized with SARI and infected with different influenza B lineages were also compared using unconditional logistic regression. Results Influenza viruses were detected in 22% (8,706/39,804) of specimens from patients with ILI or SARI during 2005–2014, of which 24% (2,087) were positive for influenza B. Influenza B viruses predominated in all three surveillance systems in 2010. B/Victoria predominated prior to 2011 (except 2008) whereas B/Yamagata predominated thereafter (except 2012). B lineages co-circulated in all seasons, except in 2013 and 2014 for SARI and ILI/PHC surveillance. Among influenza B-positive SARI cases, the detection of influenza B/Yamagata compared to influenza B/Victoria was significantly higher in individuals aged 45–64 years (adjusted odds ratio [aOR]: 4.2; 95% confidence interval [CI]: 1.1–16.5) and ≥65 years (aOR: 12.2; 95% CI: 2.3–64.4) compared to children aged 0–4 years, but was significantly lower in HIV-infected patients (aOR: 0.4; 95% CI: 0.2–0.9). Conclusion B lineages co-circulated in most seasons except in 2013 and 2014. Hospitalized SARI cases display differential susceptibility for the two influenza B lineages, with B/Victoria being more prevalent among children and HIV-infected persons.
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Affiliation(s)
- Mpho Seleka
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
| | - Florette K. Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- * E-mail:
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johanneburg, South Africa
| | - Senzo Mtshali
- Sequencing Core Facility, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
| | - Adam L. Cohen
- Global Influenza Program, World Health Organization (WHO), Geneva, Switzerland
| | - Amelia Buys
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
| | - Johanna M. McAnerney
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
| | - Terry G. Besselaar
- Global Influenza Program, World Health Organization (WHO), Geneva, Switzerland
| | - Marthi Pretorius
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johanneburg, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A. Madhi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Services (NHLS), Johannesburg, South Africa
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Marietjie Venter
- Zoonoses Research Unit, Department of Medical Virology, University of Pretoria, Pretoria, South Africa
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45
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Mazur NI, Bont L, Cohen AL, Cohen C, von Gottberg A, Groome MJ, Hellferscee O, Klipstein-Grobusch K, Mekgoe O, Naby F, Moyes J, Tempia S, Treurnicht FK, Venter M, Walaza S, Wolter N, Madhi SA. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children. Clin Infect Dis 2017; 64:443-450. [PMID: 27927871 PMCID: PMC5712444 DOI: 10.1093/cid/ciw756] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/20/2016] [Indexed: 12/21/2022] Open
Abstract
Background. Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. Methods. Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009–December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death. Results. Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)–associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39–1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6–7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0–4.5; P = .05) compared with RSV monoinfection. Conclusions. RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.
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Affiliation(s)
- Natalie I Mazur
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Wilhelmina Children's Hospital, Utrecht, The Netherlands.,Julius Global Health Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Louis Bont
- Wilhelmina Children's Hospital, Utrecht, The Netherlands.,Respiratory Syncytial Virus Network (ReSViNET) Ultrecht, The Netherlands
| | - Adam L Cohen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Influenza Program, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
| | - Cheryl Cohen
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle J Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kerstin Klipstein-Grobusch
- Julius Global Health Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Omphile Mekgoe
- Klerksdorp Hospital, Klerksdorp, North West Province, South Africa
| | - Fathima Naby
- Department of Pediatrics, Pietermaritzburg Metropolitan Hospital, University of KwaZulu-Natal, KwaZulu-Natal South Africa
| | - Jocelyn Moyes
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Stefano Tempia
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Influenza Program, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Marietje Venter
- Global Disease Detection Center South Africa, Division of Global Health Protection, Centers for Disease Control and Prevention, Pretoria, South Africa.,Department of Medical Virology, University of Pretoria, South Africa
| | - Sibongile Walaza
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
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Hellferscee O, Treurnicht FK, Tempia S, Variava E, Dawood H, Kahn K, Cohen AL, Pretorius M, Cohen C, Madhi SA, Venter M. Enterovirus D68 and other enterovirus serotypes identified in South African patients with severe acute respiratory illness, 2009-2011. Influenza Other Respir Viruses 2017; 11:211-219. [PMID: 28122175 PMCID: PMC5410726 DOI: 10.1111/irv.12444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 12/03/2022] Open
Abstract
Background Human enteroviruses (EV) have been associated with severe acute respiratory illness (SARI) in South Africa. Objectives We aimed to describe the molecular epidemiology of EV serotypes among patients hospitalized with SARI during 2009‐2011. Patients/Methods Study samples from patients were tested for the presence of enterovirus using a polymerase chain reaction assay. Results 8.2% (842/10 260) of SARI cases tested positive for enterovirus; 16% (7/45) were species EV‐A, 44% (20/45) EV‐B, 18% (8/45) EV‐C and 22% (10/45) EV‐D. Seventeen different EV serotypes were identified within EV‐A to EV‐D, of which EV‐D68 (22%; 10/45) and Echovirus 3 (11%; 5/45) were the most prevalent. Conclusions EV‐D68 should be monitored in South Africa to assess the emergence of highly pathogenic strains.
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Affiliation(s)
- Orienka Hellferscee
- National Institute for Communicable Diseases of the National Health Laboratory Service; Johannesburg South Africa
- University of the Witwatersrand; Johannesburg South Africa
| | - Florette K. Treurnicht
- National Institute for Communicable Diseases of the National Health Laboratory Service; Johannesburg South Africa
| | - Stefano Tempia
- National Institute for Communicable Diseases of the National Health Laboratory Service; Johannesburg South Africa
- Centres for Disease Control and Prevention; Atlanta Georgia USA
| | - Ebrahim Variava
- University of the Witwatersrand; Johannesburg South Africa
- Pietermaritzburg Metropolitan Hospital; Pietermaritzburg South Africa
| | - Halima Dawood
- Pietermaritzburg Metropolitan Hospital; Pietermaritzburg South Africa
- Caprisa; University of KwaZulu-Natal; Pietermaritzburg South Africa
| | - Kathleen Kahn
- University of the Witwatersrand; Johannesburg South Africa
| | - Adam L. Cohen
- Centres for Disease Control and Prevention; Atlanta Georgia USA
| | | | - Cheryl Cohen
- National Institute for Communicable Diseases of the National Health Laboratory Service; Johannesburg South Africa
- University of the Witwatersrand; Johannesburg South Africa
| | - Shabir A. Madhi
- National Institute for Communicable Diseases of the National Health Laboratory Service; Johannesburg South Africa
- University of the Witwatersrand; Johannesburg South Africa
| | - Marietjie Venter
- Centres for Disease Control and Prevention; Atlanta Georgia USA
- University of Pretoria; Pretoria South Africa
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47
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Abstract
Accurate diagnosis of viral infections enhances the ability of the clinician to make decisions on appropriate treatment of patients, evaluate disease progression and prevent misuse of antibiotics. Knowledge of the pathogen involved also allow implementation of infection control and monitoring of success of antiviral treatments that may affect the prognosis of patients. Epidemiological data collected through accurate diagnostics play an important role in public health through identification and control of outbreaks, implementation of appropriate diagnostic tests, vaccination programs and treatment but also to recognize common and emerging pathogens in a community. It is key that the clinician have an understanding of appropriate specimens to send to the laboratory and the value of specific nucleic acid and serological testing for different viral pathogens. Molecular techniques have revolutionized viral diagnoses over the past decade and enhanced both the sensitivity and specificity of tests and the speed by which a diagnosis can be made and new tests be developed. The continued use of serology for viruses with a short viremia, or for chronic infections should however complement these tests. This chapter aims to provide an overview of the available tests, the principles of testing and appropriate tests to select for different viruses and syndromes. Also provided is a glimpse of new developments in diagnostics that may further enhance the capacity to make a conclusive diagnosis in the near future.
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Affiliation(s)
- Robin J. Green
- Department of Paediatrics and Child Health, University of Pretoria, School of Medicine, Pretoria, ZA, South Africa
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48
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Abstract
Primer-independent agnostic deep sequencing was used to generate three human rhinovirus (HRV) B genomes and one HRV C genome from samples collected in a household respiratory survey in rural coastal Kenya. The study provides the first rhinovirus genomes from Kenya and will help improve the sensitivity of local molecular diagnostics.
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