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Hill V, Cleemput S, Fonseca V, Tegally H, Brito AF, Gifford R, Tran VT, Kien DTH, Huynh T, Yacoub S, Dieng I, Ndiaye M, Balde D, Diagne MM, Faye O, Salvato R, Wallau GL, Gregianini TS, Godinho FMS, Vogels CBF, Breban MI, Leguia M, Jagtap S, Roy R, Hapuarachchi C, Mwanyika G, Giovanetti M, Alcantara LCJ, Faria NR, Carrington CVF, Hanley KA, Holmes EC, Dumon W, de Oliveira T, Grubaugh ND. A new lineage nomenclature to aid genomic surveillance of dengue virus. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.16.24307504. [PMID: 38798319 PMCID: PMC11118645 DOI: 10.1101/2024.05.16.24307504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Dengue virus (DENV) is currently causing epidemics of unprecedented scope in endemic settings and expanding to new geographical areas. It is therefore critical to track this virus using genomic surveillance. However, the complex patterns of viral genomic diversity make it challenging to use the existing genotype classification system. Here we propose adding two sub-genotypic levels of virus classification, named major and minor lineages. These lineages have high thresholds for phylogenetic distance and clade size, rendering them stable between phylogenetic studies. We present an assignment tool to show that the proposed lineages are useful for regional, national and sub-national discussions of relevant DENV diversity. Moreover, the proposed lineages are robust to classification using partial genome sequences. We provide a standardized neutral descriptor of DENV diversity with which we can identify and track lineages of potential epidemiological and/or clinical importance. Information about our lineage system, including methods to assign lineages to sequence data and propose new lineages, can be found at: dengue-lineages.org.
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Affiliation(s)
- Verity Hill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | | | - Vagner Fonseca
- Department of Exact and Earth Sciences, University of the State of Bahia, Salvador, Brazil
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
| | - Houriiyah Tegally
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Robert Gifford
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- MRC-University of Glasgow Centre for Virus Research, Bearsden, Glasgow, UK
| | - Vi Thuy Tran
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Tuyen Huynh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Sophie Yacoub
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Idrissa Dieng
- Arboviruses and Haemorrhagic Fever Viruses Unit, Virology Department, Institut Pasteur de Dakar, Dakar, Senegal
| | - Mignane Ndiaye
- Arboviruses and Haemorrhagic Fever Viruses Unit, Virology Department, Institut Pasteur de Dakar, Dakar, Senegal
| | - Diamilatou Balde
- Arboviruses and Haemorrhagic Fever Viruses Unit, Virology Department, Institut Pasteur de Dakar, Dakar, Senegal
| | - Moussa M Diagne
- Arboviruses and Haemorrhagic Fever Viruses Unit, Virology Department, Institut Pasteur de Dakar, Dakar, Senegal
| | - Oumar Faye
- Arboviruses and Haemorrhagic Fever Viruses Unit, Virology Department, Institut Pasteur de Dakar, Dakar, Senegal
| | - Richard Salvato
- Centro Estadual de Vigilância em Saúde da Secretaria de Saúde do Estado do Rio Grande do Sul (CDCT/CEVS/SES-RS), Rio Grande do Sul, Brazil
| | - Gabriel Luz Wallau
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM)-Fundação Oswaldo Cruz-FIOCRUZ, Recife, Brazil
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Center for Arbovirus and Hemorrhagic Fever Reference, Hamburg, Germany
- National Reference Center for Tropical Infectious Diseases. Bernhard, Hamburg, Germany
| | - Tatiana S Gregianini
- Centro Estadual de Vigilância em Saúde da Secretaria de Saúde do Estado do Rio Grande do Sul (CDCT/CEVS/SES-RS), Rio Grande do Sul, Brazil
| | - Fernanda M S Godinho
- Centro Estadual de Vigilância em Saúde da Secretaria de Saúde do Estado do Rio Grande do Sul (CDCT/CEVS/SES-RS), Rio Grande do Sul, Brazil
| | - Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Mallery I Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Mariana Leguia
- Genomics Laboratory, Pontificia Universidad Católica del Peru, Lima, Peru
| | - Suraj Jagtap
- Department of Chemical Engineering, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Rahul Roy
- Department of Chemical Engineering, Indian Institute of Science, Bengaluru, Karnataka, India
- Center for BioSystems Science and Engineering, Indian Institute of Science, Bengaluru, Karnataka, India
| | | | - Gaspary Mwanyika
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Department of Applied Sciences, Mbeya University of Science and Technology (MUST), Mbeya, Tanzania
| | - Marta Giovanetti
- Department of Sciences and Technologies for Sustainable Development and One Health, Universita Campus Bio-Medico di Roma, Italy
- Instituto René Rachou, Fundação Oswaldo Cruz, Minas Gerais, Brazil
- Climate Amplified Diseases and Epidemics (CLIMADE), Minas Gerais, Brazil
| | - Luiz C J Alcantara
- Instituto René Rachou, Fundação Oswaldo Cruz, Minas Gerais, Brazil
- Climate Amplified Diseases and Epidemics (CLIMADE), Minas Gerais, Brazil
| | - Nuno R Faria
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London, London, UK
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Christine V F Carrington
- Department of Preclinical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Kathryn A Hanley
- Department of Biology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Edward C Holmes
- Sydney Institute for Infectious Diseases, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | | | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
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2
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Bohm BC, Morais MHF, Cunha MDCM, Bruhn NCP, Caiaffa WT, Bruhn FRP. Determining the relationship between dengue and vulnerability in a Brazilian city: a spatial modeling analysis. Pathog Glob Health 2024; 118:120-130. [PMID: 37602571 PMCID: PMC11141313 DOI: 10.1080/20477724.2023.2247273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Dengue is a viral infection transmitted by the Aedes aegypti mosquito. This study aimed to assess the distribution of cases and deaths from dengue and severe dengue, and its relationship with social vulnerability in Belo Horizonte, State of Minas Gerais, Brazil, from 2010 to 2018. The incidence and lethality rates of dengue and their relationship with sex, age, education, skin color, and social vulnerability were studied using chi-square tests, Ordinary Least Squares (OLS), and Geographically Weighted Regression (GWR) analyses. The number of cases of dengue in Belo Horizonte during the study period was 324,044 dengue cases, with 1,334 cases of severe dengue and 88 deaths. During the past few decades, the incidence rate of both dengue and severe cases varied, with an average incidence rate of respectively 1515.5 and 6.2/100,000 inhabitants. The increase in dengue cases was directly related to areas with higher social vulnerability areas and more working-age people. Also, the disease is more severe in people self-declared as black, elderly, and male. The findings of this study might provide relevant information for health services in the organization of control and prevention policies for this problem, emphasizing the most vulnerable urban areas and categories.
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Affiliation(s)
- Bianca Conrad Bohm
- Veterinary Epidemiology Laboratory, Preventive Veterinary Department, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | | | | | - Waleska Teixeira Caiaffa
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Preventive Veterinary Department, Zoonoses Control Center (UFPel), Federal University of Pelotas, Pelotas, Brazil
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Recker M, Fleischmann WA, Nghia TH, Truong NV, Nam LV, Duc Anh D, Song LH, The NT, Anh CX, Hoang NV, My Truong N, Toan NL, Kremsner PG, Velavan TP. Markers of prolonged hospitalisation in severe dengue. PLoS Negl Trop Dis 2024; 18:e0011922. [PMID: 38289968 PMCID: PMC10857710 DOI: 10.1371/journal.pntd.0011922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/09/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Dengue is one of the most common diseases in the tropics and subtropics. Whilst mortality is a rare event when adequate supportive care can be provided, a large number of patients get hospitalised with dengue every year that places a heavy burden on local health systems. A better understanding of the support required at the time of hospitalisation is therefore of critical importance for healthcare planning, especially when resources are limited during major outbreaks. METHODS Here we performed a retrospective analysis of clinical data from over 1500 individuals hospitalised with dengue in Vietnam between 2017 and 2019. Using a broad panel of potential biomarkers, we sought to evaluate robust predictors of prolonged hospitalisation periods. RESULTS Our analyses revealed a lead-time bias, whereby early admission to hospital correlates with longer hospital stays - irrespective of disease severity. Importantly, taking into account the symptom duration prior to hospitalisation significantly affects observed associations between hospitalisation length and previously reported risk markers of prolonged stays, which themselves showed marked inter-annual variations. Once corrected for symptom duration, age, temperature at admission and elevated neutrophil-to-lymphocyte ratio were found predictive of longer hospitalisation periods. CONCLUSION This study demonstrates that the time since dengue symptom onset is one of the most significant predictors for the length of hospital stays, independent of the assigned severity score. Pre-hospital symptom durations need to be accounted for to evaluate clinically relevant biomarkers of dengue hospitalisation trajectories.
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Affiliation(s)
- Mario Recker
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Wim A. Fleischmann
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Trinh Huu Nghia
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Truong
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Van Nam
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Duc Anh
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Le Huu Song
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Trong The
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | | | | | - Nhat My Truong
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Peter G. Kremsner
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon
| | - Thirumalaisamy P. Velavan
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
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Lu P, Creagh AP, Lu HY, Hai HB, Thwaites L, Clifton DA. 2D-WinSpatt-Net: A Dual Spatial Self-Attention Vision Transformer Boosts Classification of Tetanus Severity for Patients Wearing ECG Sensors in Low- and Middle-Income Countries. SENSORS (BASEL, SWITZERLAND) 2023; 23:7705. [PMID: 37765761 PMCID: PMC10535235 DOI: 10.3390/s23187705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023]
Abstract
Tetanus is a life-threatening bacterial infection that is often prevalent in low- and middle-income countries (LMIC), Vietnam included. Tetanus affects the nervous system, leading to muscle stiffness and spasms. Moreover, severe tetanus is associated with autonomic nervous system (ANS) dysfunction. To ensure early detection and effective management of ANS dysfunction, patients require continuous monitoring of vital signs using bedside monitors. Wearable electrocardiogram (ECG) sensors offer a more cost-effective and user-friendly alternative to bedside monitors. Machine learning-based ECG analysis can be a valuable resource for classifying tetanus severity; however, using existing ECG signal analysis is excessively time-consuming. Due to the fixed-sized kernel filters used in traditional convolutional neural networks (CNNs), they are limited in their ability to capture global context information. In this work, we propose a 2D-WinSpatt-Net, which is a novel Vision Transformer that contains both local spatial window self-attention and global spatial self-attention mechanisms. The 2D-WinSpatt-Net boosts the classification of tetanus severity in intensive-care settings for LMIC using wearable ECG sensors. The time series imaging-continuous wavelet transforms-is transformed from a one-dimensional ECG signal and input to the proposed 2D-WinSpatt-Net. In the classification of tetanus severity levels, 2D-WinSpatt-Net surpasses state-of-the-art methods in terms of performance and accuracy. It achieves remarkable results with an F1 score of 0.88 ± 0.00, precision of 0.92 ± 0.02, recall of 0.85 ± 0.01, specificity of 0.96 ± 0.01, accuracy of 0.93 ± 0.02 and AUC of 0.90 ± 0.00.
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Affiliation(s)
- Ping Lu
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
| | - Andrew P. Creagh
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
| | - Huiqi Y. Lu
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
| | - Ho Bich Hai
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam
| | | | - Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam
| | - David A. Clifton
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, UK
- Oxford Suzhou Centre for Advanced Research, Suzhou 215123, China
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Rodriguez DM, Major CG, Sánchez-González L, Jones E, Delorey MJ, Alonso C, Rivera-Amill V, Paz-Bailey G, Adams LE. Dengue vaccine acceptability before and after the availability of COVID-19 vaccines in Puerto Rico. Vaccine 2023:S0264-410X(23)00516-9. [PMID: 37173267 PMCID: PMC10160531 DOI: 10.1016/j.vaccine.2023.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Dengue is a growing public health threat, causing approximately 400 million infections annually. In June 2021, the Advisory Committee on Immunization Practices recommended the first dengue vaccine (CYD-TDV) for children aged 9-16 years with a previous dengue infection, living in endemic areas, such as Puerto Rico (PR). As the COVID-19 pandemic affected vaccine intention worldwide, we assessed dengue vaccine intention before (pre-COVID) and after (post-COVID) COVID-19 vaccine availability among participants enrolled in the Communities Organized to Prevent Arboviruses (COPA) cohort to prepare for dengue vaccine implementation in PR. We used logistic regression models to evaluate changes in dengue vaccine intention by interview timing and participant characteristics. Among 2,513 participants pre-COVID, 2,512 answered the dengue vaccine intention question for themselves, and 1,564 answered relative to their children. Post-COVID, dengue vaccine intention in adults increased for themselves from 73.4% to 84.5% (adjusted odds ratio (aOR) = 2.27, 95%CI: 1.90-2.71) and relative to their children from 75.6% to 85.5% (aOR = 2.21, 95%CI: 1.75-2.78). Among all participants, groups with higher dengue vaccine intention included those who reported previous year influenza vaccine uptake and those who reported being frequently bitten by mosquitos, compared to those who did not. Adult males were also more likely to intend to vaccinate themselves than females. Respondents who were employed or in school were less likely to intend to vaccinate compared to those who were not working. The primary reasons for vaccine hesitancy were concerns with side effects and not believing in vaccines, which should be considered during educational strategies prior to dengue vaccine implementation. In general, dengue vaccine intention is high in PR and has increased after COVID-19 vaccine availability, potentially due to increased awareness of vaccine importance during the COVID-19 pandemic.
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Affiliation(s)
- Dania M Rodriguez
- Centers for Disease Control and Prevention, Dengue Branch, 1324 Calle Canada, San Juan 00920, Puerto Rico.
| | - Chelsea G Major
- Centers for Disease Control and Prevention, Dengue Branch, 1324 Calle Canada, San Juan 00920, Puerto Rico.
| | - Liliana Sánchez-González
- Centers for Disease Control and Prevention, Dengue Branch, 1324 Calle Canada, San Juan 00920, Puerto Rico.
| | - Emma Jones
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States.
| | - Mark J Delorey
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States.
| | - Claudia Alonso
- Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032, United States.
| | - Vanessa Rivera-Amill
- Ponce Health Sciences University/Ponce Research Institute, 395 Dr Luis F Sala Street, Ponce 00716, Puerto Rico.
| | - Gabriela Paz-Bailey
- Centers for Disease Control and Prevention, Dengue Branch, 1324 Calle Canada, San Juan 00920, Puerto Rico.
| | - Laura E Adams
- Centers for Disease Control and Prevention, Dengue Branch, 1324 Calle Canada, San Juan 00920, Puerto Rico.
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Turner HC, Quyen DL, Dias R, Huong PT, Simmons CP, Anders KL. An economic evaluation of Wolbachia deployments for dengue control in Vietnam. PLoS Negl Trop Dis 2023; 17:e0011356. [PMID: 37253037 PMCID: PMC10256143 DOI: 10.1371/journal.pntd.0011356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/09/2023] [Accepted: 05/06/2023] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Dengue is a major public health challenge and a growing problem due to climate change. The release of Aedes aegypti mosquitoes infected with the intracellular bacterium Wolbachia is a novel form of vector control against dengue. However, there remains a need to evaluate the benefits of such an intervention at a large scale. In this paper, we evaluate the potential economic impact and cost-effectiveness of scaled Wolbachia deployments as a form of dengue control in Vietnam-targeted at the highest burden urban areas. METHODS Ten settings within Vietnam were identified as priority locations for potential future Wolbachia deployments (using a population replacement strategy). The effectiveness of Wolbachia deployments in reducing the incidence of symptomatic dengue cases was assumed to be 75%. We assumed that the intervention would maintain this effectiveness for at least 20 years (but tested this assumption in the sensitivity analysis). A cost-utility analysis and cost-benefit analysis were conducted. RESULTS From the health sector perspective, the Wolbachia intervention was projected to cost US$420 per disability-adjusted life year (DALY) averted. From the societal perspective, the overall cost-effectiveness ratio was negative, i.e. the economic benefits outweighed the costs. These results are contingent on the long-term effectiveness of Wolbachia releases being sustained for 20 years. However, the intervention was still classed as cost-effective across the majority of the settings when assuming only 10 years of benefits. CONCLUSION Overall, we found that targeting high burden cities with Wolbachia deployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Reynold Dias
- World Mosquito Program, Monash University, Clayton, Australia
| | - Phan Thi Huong
- Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
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Thisyakorn U, Saokaew S, Gallagher E, Kastner R, Sruamsiri R, Oliver L, Hanley R. Epidemiology and costs of dengue in Thailand: A systematic literature review. PLoS Negl Trop Dis 2022; 16:e0010966. [PMID: 36534668 PMCID: PMC9810168 DOI: 10.1371/journal.pntd.0010966] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 01/03/2023] [Accepted: 11/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dengue is the fastest-spreading vector-borne viral disease worldwide. In Thailand, dengue is endemic and is associated with a high socioeconomic burden. A systematic literature review was conducted to assess and describe the epidemiological and economic burden of dengue in Thailand. METHODS Epidemiological and economic studies published in English and Thai between 2011-2019 and 2009-2019, respectively, were searched in MEDLINE, Embase, and Evidence-Based Medicines reviews databases. Reports published by the National Ministry of Public Health (MoPH) and other grey literature sources were also reviewed. Identified studies were screened according to predefined inclusion and exclusion criteria. Extracted data were descriptively summarised and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A total of 155 publications were included in the review (39 journal articles and 116 grey literature). Overall, dengue incidence varied yearly, with the highest rates per 100,000 population in 2013 (dengue fever (DF) 136.6, dengue haemorrhagic fever (DHF) 100.9, dengue shock syndrome (DSS) 3.58) and 2015 (DF 133.1, DHF 87.4, DSS 2.14). Peak incidence coincided with the monsoon season, and annual mortality was highest for DSS, particularly in the age group 15-24-year-olds. The highest dengue incidence rates were reported in children (10-14-year-olds) and young adults (15-24-year-olds), irrespective of dengue case definition. Economic and societal burdens are extensive, with the average cost per case ranging from USD 41 to USD 261, total cost per year estimated at USD 440.3 million, and an average of 7.6 workdays lost for DHF and 6.6 days for DF. CONCLUSIONS The epidemiological, economic, and societal burden of dengue in Thailand is high and underreported due to gaps in national surveillance data. The use of expansion factors (EFs) is recommended to understand the true incidence of dengue and cost-benefit of control measures. Furthermore, as dengue is often self-managed and underreported, lost school and workdays result in substantial underestimation of the true economic and societal burden of dengue. The implementation of integrated strategies, including vaccination, is critical to reduce the disease burden and may help alleviate health disparities and equity challenges posed by dengue.
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Affiliation(s)
- Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Surasak Saokaew
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
- Unit of Excellence on Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
- Division of Social and Administrative Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | | | - Randee Kastner
- Takeda Vaccines Inc., Cambridge, Massachusetts, United States of America
| | | | - Louisa Oliver
- Adelphi Values, Bollington, Macclesfield, United Kingdom
| | - Riona Hanley
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
- * E-mail:
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Duong CV, Kang JH, Nguyen VV, Bae YJ. Invasion Pattern of Aedes aegypti in the Native Range of Ae. albopictus in Vietnam Revealed by Biogeographic and Population Genetic Analysis. INSECTS 2022; 13:1079. [PMID: 36554989 PMCID: PMC9782358 DOI: 10.3390/insects13121079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/30/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
Since its introduction to Asia, Aedes aegypti has coexisted with the native species Ae. albopictus and has been reported to transmit several infectious diseases. However, the development of efficient disease prevention and vector control is hindered by the relatively poor understanding of the biogeography and the genetic diversity of Ae. aegypti in the region. This study aimed to determine the invasion patterns of Ae. aegypti by evaluating the distribution and abundance of Ae. aegypti and Ae. albopictus in different climatic regions (northern temperate and southern tropical regions) and habitats (domestic, peri-domestic, and natural). We further analyzed the genetic diversity and phylogenetic relationships of Ae. aegypti populations in Vietnam using mitochondrial COI gene sequences. Both Aedes species were observed at most of the study sites, but only Ae. albopictus thrived in northern mountainous areas. In sympatric ranges, the individual abundance of the species was influenced by regional climate and habitats. The tropical climate and availability of domestic containers facilitated the dominance of Ae. aegypti, whereas temperate climates and natural breeding sites facilitated that of Ae. albopictus. In addition, many genetic polymorphisms were detected in the Ae. aegypti populations, which formed two distinct genetic groups; however, this genetic diversity is unlikely to be relevant to the invasive success of Ae. aegypti. These findings provide insights into the mechanisms and patterns of Ae. Aegypti invasion, which depend on the climate and reproductive strategies in the native range of Ae. albopictus in Asia.
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Affiliation(s)
- Cuong Van Duong
- Department of Environmental Science and Ecological Engineering, College of Life Sciences, Korea University, Seoul 02841, Republic of Korea
- Department of Applied Zoology, Faculty of Biology, University of Science, Vietnam National University, Hanoi 100000, Vietnam
| | - Ji Hyoun Kang
- Korean Entomological Institute, College of Life Sciences, Korea University, Seoul 02841, Republic of Korea
| | - Van Vinh Nguyen
- Department of Applied Zoology, Faculty of Biology, University of Science, Vietnam National University, Hanoi 100000, Vietnam
| | - Yeon Jae Bae
- Department of Environmental Science and Ecological Engineering, College of Life Sciences, Korea University, Seoul 02841, Republic of Korea
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Hoi TM, Satyal P, Huong LT, Hau DV, Binh TD, Duyen DTH, Dai DN, Huy NG, Chinh HV, Hoa VV, Hung NH, Setzer WN. Essential Oils from Vietnamese Asteraceae for Environmentally Friendly Control of Aedes Mosquitoes. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27227961. [PMID: 36432060 PMCID: PMC9699393 DOI: 10.3390/molecules27227961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/27/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Mosquitoes, in addition to being a biting nuisance, are vectors of several pathogenic viruses and parasites. As a continuation of our work identifying abundant and/or invasive plant species in Vietnam for use as ecologically friendly pesticidal agents, we obtained the essential oils of Blumea lacera, Blumea sinuata, Emilia sonchifolia, Parthenium hysterophorus, and Sphaeranthus africanus; analyzed the essential oils using gas chromatographic techniques; and screened the essential oils for mosquito larvicidal activity against Aedes aegypti and Aedes albopictus. The most active larvicidal essential oils were B. sinuata, which was rich in thymohydroquinone dimethyl ether (29.4%), (E)-β-caryophyllene (19.7%), α-pinene (8.8%), germacrene D (7.8%), and α-humulene (4.3%), (24-h LC50 23.4 and 29.1 μg/mL) on Ae. aegypti and Ae. albopictus, respectively, and Emilia sonchifolia, dominated by 1-undecene (41.9%) and germacrene D (11.0%), (24-h LC50 30.1 and 29.6 μg/mL) on the two mosquito species. The essential oils of P. hysterophorus and S. africanus were also active against mosquito larvae. Notably, B. sinuata, P. hysterophorus, and S. africanus essential oils were not toxic to the non-target water bug, Diplonychus rusticus. However, E. sonchifolia essential oil showed insecticidal activity (24-h LC50 48.1 μg/mL) on D. rusticus. Based on these results, B. sinuata, P. hysterophorus, and S. africanus essential oils appear promising for further investigations.
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Affiliation(s)
- Tran Minh Hoi
- Department of Plant Resources, Institute of Ecology and Biological Resources, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam
| | | | - Le Thi Huong
- School of Natural Science Education, Vinh University, Vinh City 43000, Vietnam
| | - Dang Viet Hau
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam
| | - Tran Duc Binh
- Department of Plant Resources, Institute of Ecology and Biological Resources, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam
| | - Dang Thi Hong Duyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam
| | - Do Ngoc Dai
- Faculty of Agriculture, Forestry and Fishery, Nghe An College of Economics, Vinh City 43000, Vietnam
| | - Ngo Gia Huy
- Center for Advanced Chemistry, Institute of Research and Development, Duy Tan University, Da Nang 550000, Vietnam
| | - Hoang Van Chinh
- Faculty of Natural Sciences, Hong Duc University, Thanh Hoa 440000, Vietnam
| | - Vo Van Hoa
- Department of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
| | - Nguyen Huy Hung
- Center for Advanced Chemistry, Institute of Research and Development, Duy Tan University, Da Nang 550000, Vietnam
- Department of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: (N.H.H.); (W.N.S.)
| | - William N. Setzer
- Aromatic Plant Research Center, Lehi, UT 84043, USA
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL 35899, USA
- Correspondence: (N.H.H.); (W.N.S.)
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10
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Tran HTD, Schindler C, Pham TTT, Vien MQ, Do HM, Ngo QT, Nguyen TB, Hoang HTH, Vu LTH, Schelling E, Paris DH. Simple clinical and laboratory predictors to improve empirical treatment strategies in areas of high scrub typhus and dengue endemicity, central Vietnam. PLoS Negl Trop Dis 2022; 16:e0010281. [PMID: 35507541 PMCID: PMC9067661 DOI: 10.1371/journal.pntd.0010281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background Dengue fever is highly endemic in Vietnam, but scrub typhus—although recognized as an endemic disease—remains underappreciated. These diseases together are likely to account for more than half of the acute undifferentiated fever burden in Vietnam. Scrub typhus (ST) is a bacterial disease requiring antimicrobial treatment, while dengue fever (DF) is of viral etiology and does not. The access to adequate diagnostics and the current understanding of empirical treatment strategies for both illnesses remain limited. In this study we aimed to contribute to the clinical decision process in the management of these two important etiologies of febrile illness in Vietnam. Methods Using retrospective data from 221 PCR-confirmed scrub typhus cases and 387 NS1 protein positive dengue fever patients admitted to five hospitals in Khanh Hoa province (central Vietnam), we defined predictive characteristics for both diseases that support simple clinical decision making with potential to inform decision algorithms in future. We developed models to discriminate scrub typhus from dengue fever using multivariable logistic regression (M-LR) and classification and regression trees (CART). Regression trees were developed for the entire data set initially and pruned, based on cross-validation. Regression models were developed in a training data set involving 60% of the total sample and validated in the complementary subsample. Probability cut points for the distinction between scrub typhus and dengue fever were chosen to maximise the sum of sensitivity and specificity. Results Using M-LR, following seven predictors were identified, that reliably differentiate ST from DF; eschar, regional lymphadenopathy, an occupation in nature, increased days of fever on admission, increased neutrophil count, decreased ratio of neutrophils/lymphocytes, and age over 40. Sensitivity and specificity of predictions based on these seven factors reached 93.7% and 99.5%, respectively. When excluding the “eschar” variable, the values dropped to 76.3% and 92.3%, respectively. The CART model generated one further variable; increased days of fever on admission, when eschar was included, the sensitivity and specificity was 95% and 96.9%, respectively. The model without eschar involved the following six variables; regional lymphadenopathy, increased days of fever on admission, increased neutrophil count, increased lymphocyte count, platelet count ≥ 47 G/L and age over 28 years as predictors of ST and provided a sensitivity of 77.4% and a specificity of 90.7%. Conclusions The generated algorithms contribute to differentiating scrub typhus from dengue fever using basic clinical and laboratory parameters, supporting clinical decision making in areas where dengue and scrub typhus are co-endemic in Vietnam. Dengue fever is highly endemic in Vietnam, while scrub typhus is recognized as a re-emerging neglected disease. Both diseases are likely to account for more than half of the acute undifferentiated fever burden in Vietnam. However, scrub typhus is a bacterial disease requiring antimicrobial treatment, while dengue fever—of viral etiology—does not. Misdiagnosis and treatment delays cause potentially severe or fatal complications among scrub typhus patients, even though it is easily treatable. In this study, we used simple clinical and laboratory markers, which were identified upon admission of 221 PCR-confirmed scrub typhus cases and 387 NS1-positive dengue fever patients from Khanh Hoa province to identify the differences between scrub typhus and dengue. We found seven predictors that served to construct a simple clinical decision tree, holding great potential to distinguish scrub typhus from dengue using readily available clinical or laboratory findings. These predictors can strongly support medical staff in identifying scrub typhus cases from dengue, without using sophisticated diagnostic tests, and could improve the quality of diagnoses and appropriate treatment strategies at the primary health care level–especially in areas where scrub typhus and dengue fever are co-endemic in Vietnam and many parts of Asia and where diagnostic tests are not readily available.
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Affiliation(s)
- Hanh Thi Duc Tran
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Epidemiology, Hanoi University of Public Health, Hanoi, Vietnam
- University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Thuy Thi Thanh Pham
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam
- The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam
| | | | - Hung Manh Do
- Department for Infectious Disease Control and Prevention, Nha Trang Pasteur Institute, Khanh Hoa, Vietnam
| | - Quyet Thi Ngo
- Department of Microbiology and Immunology, Nha Trang Pasteur Institute, Khanh Hoa, Vietnam
| | - Trieu Bao Nguyen
- Department of Microbiology and Immunology, Nha Trang Pasteur Institute, Khanh Hoa, Vietnam
| | - Hang Thi Hai Hoang
- Department for Infectious Disease Control and Prevention, Nha Trang Pasteur Institute, Khanh Hoa, Vietnam
| | - Lan Thi Hoang Vu
- Department of Epidemiology, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Daniel H. Paris
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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11
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Hou J, Ye W, Chen J. Current Development and Challenges of Tetravalent Live-Attenuated Dengue Vaccines. Front Immunol 2022; 13:840104. [PMID: 35281026 PMCID: PMC8907379 DOI: 10.3389/fimmu.2022.840104] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/03/2022] [Indexed: 01/26/2023] Open
Abstract
Dengue is the most common arboviral disease caused by one of four distinct but closely related dengue viruses (DENV) and places significant economic and public health burdens in the endemic areas. A dengue vaccine will be important in advancing disease control. However, the effort has been challenged by the requirement to induce effective protection against all four DENV serotypes and the potential adverse effect due to the phenomenon that partial immunity to DENV may worsen the symptoms upon subsequent heterotypic infection. Currently, the most advanced dengue vaccines are all tetravalent and based on recombinant live attenuated viruses. CYD-TDV, developed by Sanofi Pasteur, has been approved but is limited for use in individuals with prior dengue infection. Two other tetravalent live attenuated vaccine candidates: TAK-003 by Takeda and TV003 by National Institute of Allergy and Infectious Diseases, have completed phase 3 and phase 2 clinical trials, respectively. This review focuses on the designs and evaluation of TAK-003 and TV003 vaccine candidates in humans in comparison to the licensed CYD-TDV vaccine. We highlight specific lessons from existing studies and challenges that must be overcome in order to develop a dengue vaccine that confers effective and balanced protection against all four DENV serotypes but with minimal adverse effects.
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Affiliation(s)
- Jue Hou
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology (SMART), Singapore, Singapore
| | - Weijian Ye
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology (SMART), Singapore, Singapore
| | - Jianzhu Chen
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology (SMART), Singapore, Singapore.,Department of Biology, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
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12
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Ming DK, Tuan NM, Hernandez B, Sangkaew S, Vuong NL, Chanh HQ, Chau NVV, Simmons CP, Wills B, Georgiou P, Holmes AH, Yacoub S. The Diagnosis of Dengue in Patients Presenting With Acute Febrile Illness Using Supervised Machine Learning and Impact of Seasonality. Front Digit Health 2022; 4:849641. [PMID: 35360365 PMCID: PMC8963938 DOI: 10.3389/fdgth.2022.849641] [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: 01/06/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Symptomatic dengue infection can result in a life-threatening shock syndrome and timely diagnosis is essential. Point-of-care tests for non-structural protein 1 and IgM are used widely but performance can be limited. We developed a supervised machine learning model to predict whether patients with acute febrile illnesses had a diagnosis of dengue or other febrile illnesses (OFI). The impact of seasonality on model performance over time was examined. Methods We analysed data from a prospective observational clinical study in Vietnam. Enrolled patients presented with an acute febrile illness of <72 h duration. A gradient boosting model (XGBoost) was used to predict final diagnosis using age, sex, haematocrit, platelet, white cell, and lymphocyte count collected on enrolment. Data was randomly split 80/20% into a training and hold-out set, respectively, with the latter not used in model development. Cross-validation and hold out set testing was used, with performance over time evaluated through a rolling window approach. Results We included 8,100 patients recruited between 16th October 2010 and 10th December 2014. In total 2,240 (27.7%) patients were diagnosed with dengue infection. The optimised model from training data had an overall median area under the receiver operator curve (AUROC) of 0.86 (interquartile range 0.84-0.86), specificity of 0.92, sensitivity of 0.56, positive predictive value of 0.73, negative predictive value (NPV) of 0.84, and Brier score of 0.13 in predicting the final diagnosis, with similar performances in hold-out set testing (AUROC of 0.86). Model performances varied significantly over time as a function of seasonality and other factors. Incorporation of a dynamic threshold which continuously learns from recent cases resulted in a more consistent performance throughout the year (NPV >90%). Conclusion Supervised machine learning models are able to discriminate between dengue and OFI diagnoses in patients presenting with an early undifferentiated febrile illness. These models could be of clinical utility in supporting healthcare decision-making and provide passive surveillance across dengue endemic regions. Effects of seasonality and changing disease prevalence must however be taken into account-this is of significant importance given unpredictable effects of human-induced climate change and the impact on health.
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Affiliation(s)
- Damien K. Ming
- Centre for Antimicrobial Optimisation, Imperial College London, London, United Kingdom
| | - Nguyen M. Tuan
- Children's Hospital 1, Ho Chi Minh City, Vietnam
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Bernard Hernandez
- Centre for BioInspired Technology, Imperial College London, London, United Kingdom
| | - Sorawat Sangkaew
- Centre for Antimicrobial Optimisation, Imperial College London, London, United Kingdom
| | - Nguyen L. Vuong
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ho Q. Chanh
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen V. V. Chau
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Cameron P. Simmons
- Institute of Vector Borne Disease, Monash University, Clayton, VIC, Australia
| | - Bridget Wills
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Pantelis Georgiou
- Centre for BioInspired Technology, Imperial College London, London, United Kingdom
| | - Alison H. Holmes
- Centre for Antimicrobial Optimisation, Imperial College London, London, United Kingdom
| | - Sophie Yacoub
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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13
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Hung TM, Van Hao N, Yen LM, McBride A, Dat VQ, van Doorn HR, Loan HT, Phong NT, Llewelyn MJ, Nadjm B, Yacoub S, Thwaites CL, Ahmed S, Van Vinh Chau N, Turner HC. Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam. Front Public Health 2022; 10:893200. [PMID: 35812512 PMCID: PMC9263973 DOI: 10.3389/fpubh.2022.893200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases. Methods We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. Results ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. Conclusion This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.
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Affiliation(s)
- Trinh Manh Hung
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Nguyen Van Hao
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.,Department of Infectious Diseases, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Lam Minh Yen
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Angela McBride
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hanoi, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Huynh Thi Loan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Martin J Llewelyn
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Behzad Nadjm
- Medical Research Council (MRC) Unit the Gambia at the London School of Hygiene & Tropical Medicine, Fajara, Gambia
| | - Sophie Yacoub
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - C Louise Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sayem Ahmed
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Hugo C Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, Norfolk Place, London, United Kingdom
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14
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Navarro Valencia V, Díaz Y, Pascale JM, Boni MF, Sanchez-Galan JE. Assessing the Effect of Climate Variables on the Incidence of Dengue Cases in the Metropolitan Region of Panama City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212108. [PMID: 34831862 PMCID: PMC8619576 DOI: 10.3390/ijerph182212108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/24/2022]
Abstract
The present analysis uses the data of confirmed incidence of dengue cases in the metropolitan region of Panama from 1999 to 2017 and climatic variables (air temperature, precipitation, and relative humidity) during the same period to determine if there exists a correlation between these variables. In addition, we compare the predictive performance of two regression models (SARIMA, SARIMAX) and a recurrent neural network model (RNN-LSTM) on the dengue incidence series. For this data from 1999–2014 was used for training and the three subsequent years of incidence 2015–2017 were used for prediction. The results show a correlation coefficient between the climatic variables and the incidence of dengue were low but statistical significant. The RMSE and MAPE obtained for the SARIMAX and RNN-LSTM models were 25.76, 108.44 and 26.16, 59.68, which suggest that any of these models can be used to predict new outbreaks. Although, it can be said that there is a limited role of climatic variables in the outputs the models. The value of this work is that it helps understand the behaviour of cases in a tropical setting as is the Metropolitan Region of Panama City, and provides the basis needed for a much needed early alert system for the region.
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Affiliation(s)
- Vicente Navarro Valencia
- Facultad de Ciencias y Tecnología, Universidad Tecnológica de Panamá (UTP), El Dorado 0819-07289, Panama;
| | - Yamilka Díaz
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Justo Arosemena Avenue and 35st Street, Panama 0816-02593, Panama;
| | - Juan Miguel Pascale
- Unit of Diagnosis, Clinical Research and Tropical Medicine, Gorgas Memorial Institute of Health Studies, Justo Arosemena Avenue and 35st Street, Panama 0816-02593, Panama;
- Sistema Nacional de Investigación (SNI) SENACYT, Panama 0816-02852, Panama
| | - Maciej F. Boni
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA 16802, USA;
| | - Javier E. Sanchez-Galan
- Facultad de Ciencias y Tecnología, Universidad Tecnológica de Panamá (UTP), El Dorado 0819-07289, Panama;
- Sistema Nacional de Investigación (SNI) SENACYT, Panama 0816-02852, Panama
- Grupo de Investigaciones en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Facultad de Ingenieria de Sistemas Computacionales, Universidad Tecnológica de Panamá (UTP), El Dorado 0819-07289, Panama
- Correspondence: ; Tel.: +507-560-3933
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15
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Sigera C, Rodrigo C, de Silva NL, Weeratunga P, Fernando D, Rajapakse S. Direct costs of managing in-ward dengue patients in Sri Lanka: A prospective study. PLoS One 2021; 16:e0258388. [PMID: 34624062 PMCID: PMC8500425 DOI: 10.1371/journal.pone.0258388] [Citation(s) in RCA: 2] [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: 05/07/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction The cost in managing hospitalised dengue patients varies across countries depending on access to healthcare, management guidelines, and state sponsored subsidies. For health budget planning, locally relevant, accurate costing data from prospective studies, is essential. Objective To characterise the direct costs of managing hospitalised patients with suspected dengue infection in Sri Lanka. Methods Colombo Dengue Study is a prospective single centre cohort study in Sri Lanka recruiting suspected hospitalised dengue fever patients in the first three days of fever and following them up until discharge. The diagnosis of dengue is retrospectively confirmed and the cohort therefore has a group of non-dengue fever patients with a phenotypically similar illness, managed as dengue while in hospital. The direct costs of hospital admission (base and investigation costs, excluding medication) were calculated for all recruited patients and compared between dengue and non-dengue categories as well as across subgroups (demographic, clinical or temporal) within each of these categories. We also explored if excluding dengue upfront, would lead to an overall cost saving in several hypothetical scenarios. Results From October 2017 to February 2020, 431 adult dengue patients and 256 non-dengue fever patients were recruited. The hospitalisation costs were USD 18.02 (SD: 4.42) and USD 17.55 (SD: 4.09) per patient per day for dengue and non-dengue patients respectively (p>0.05). Laboratory investigations (haematological, biochemical and imaging) accounted for more than 50% of the total cost. The costs were largely homogenous in all subgroups within or across dengue and non-dengue categories. Excluding dengue upfront by subsidised viral genomic testing may yield overall cost savings for non-dengue patients. Conclusion As non-dengue patients incur a similar cost per day as the dengue patients, confirming dengue diagnosis using subsidised tests for patients presenting in the first three days of fever may be cost-efficient.
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Affiliation(s)
- Chathurani Sigera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chaturaka Rodrigo
- Department of Pathology, School of Medical Sciences, Sydney, NSW, Australia
- * E-mail:
| | - Nipun L. de Silva
- Department of Clinical Sciences, Faculty of Medicine, Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Praveen Weeratunga
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Deepika Fernando
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Senaka Rajapakse
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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16
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Turner HC, Archer RA, Downey LE, Isaranuwatchai W, Chalkidou K, Jit M, Teerawattananon Y. An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations. Front Public Health 2021; 9:722927. [PMID: 34513790 PMCID: PMC8424074 DOI: 10.3389/fpubh.2021.722927] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
Economic evidence is increasingly being used for informing health policies. However, the underlining principles of health economic analyses are not always fully understood by non-health economists, and inappropriate types of analyses, as well as inconsistent methodologies, may be being used for informing health policy decisions. In addition, there is a lack of open access information and methodological guidance targeted to public health professionals, particularly those based in low- and middle-income country (LMIC) settings. The objective of this review is to provide a comprehensive and accessible introduction to economic evaluations for public health professionals with a focus on LMIC settings. We cover the main principles underlining the most common types of full economic evaluations used in healthcare decision making in the context of priority setting (namely cost-effectiveness/cost-utility analyses, cost-benefit analyses), and outline their key features, strengths and weaknesses. It is envisioned that this will help those conducting such analyses, as well as stakeholders that need to interpret their output, gain a greater understanding of these methods and help them select/distinguish between the different approaches. In particular, we highlight the need for greater awareness of the methods used to place a monetary value on the health benefits of interventions, and the potential for such estimates to be misinterpreted. Specifically, the economic benefits reported are typically an approximation, summarising the health benefits experienced by a population monetarily in terms of individual preferences or potential productivity gains, rather than actual realisable or fiscal monetary benefits to payers or society.
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Affiliation(s)
- Hugo C Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Rachel A Archer
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Laura E Downey
- School of Public Health, Imperial College London, London, United Kingdom
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Kalipso Chalkidou
- School of Public Health, Imperial College London, London, United Kingdom
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Modelling and Economics Unit, Public Health England, London, United Kingdom
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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17
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Chu CS, Tsai SJ, Cheng CM, Su TP, Chen TJ, Bai YM, Liang CS, Chen MH. Dengue and dementia risk: A nationwide longitudinal study. J Infect 2021; 83:601-606. [PMID: 34454958 DOI: 10.1016/j.jinf.2021.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Accumulating evidence suggests neurological manifestations after dengue infection. However, the relationship between dengue and long-term neurocognitive sequel remains unclear. METHODS We recruited 816 patients with dengue and 8,160 controls between 1997 and 2012 using data from Taiwan National Health Insurance Research Database and followed them up until the end of 2013. Individuals who exhibited any type of dementia were identified during the follow-up period. Cox regression analyses were performed with adjustments for demographic data and medical and mental comorbidities (cerebrovascular diseases, traumatic brain injury, hypertension, dyslipidemia, diabetes mellitus, depression, alcohol use disorder, and substance use disorder). The E-value for the causality of the evidence was calculated. Sensitivity analysis was conducted to exclude patients with prodromal dementia. RESULTS Patients with dengue were more likely to develop dementia (hazard ratio [HR]: 2.23, 95% confidence interval [CI]: 1.51-3.28), Alzheimer's disease (HR: 3.03, 95% CI: 1.08-8.45), and unspecified dementia (HR: 2.25, 95% CI: 1.43-3.53), but not vascular dementia compared to controls during the follow-up period. Sensitivity analyses after exclusion of the observation period over the first three years or first five years and after exclusion of patients' enrollment before 2010 or 2008 showed consistent findings. The E-values for the HR (range 3.62-5.51) supported the association between dengue and subsequent dementia among the whole population, men, and women. CONCLUSION The risk of dementia was 2.23-fold higher in patients diagnosed with dengue during the follow-up period than in the controls. Further studies are necessary to investigate the underlying pathophysiology of dengue and dementia.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Non-invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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18
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Huang Y, Williamson BD, Moodie Z, Carpp LN, Chambonneau L, DiazGranados CA, Gilbert PB. Analysis of Neutralizing Antibodies as a Correlate of Instantaneous Risk of Hospitalized Dengue in Placebo Recipients of Dengue Vaccine Efficacy Trials. J Infect Dis 2021; 225:332-340. [PMID: 34174082 DOI: 10.1093/infdis/jiab342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the CYD14 (NCT01373281) and CYD15 (NCT01374516) dengue vaccine efficacy trials, Month 13 neutralizing antibody (nAb) titers correlated inversely with risk of symptomatic, virologically confirmed dengue (VCD) between Month 13 (one month post-final-dose) and Month 25. We assessed nAb titer as a correlate of instantaneous risk of hospitalized VCD (HVCD), for which participants were continually surveilled for 72 months. METHODS Using longitudinal nAb titers from the per-protocol immunogenicity subsets, we estimated hazard ratios (HRs) of HVCD by current nAb titer value for three correlate/endpoint pairs: average titer across all four serotypes/HVCD of any serotype (HVCD-Any), serotype-specific titer/homologous HVCD, and serotype-specific titer/heterologous HVCD. RESULTS Baseline-seropositive placebo recipients with higher average titer had lower instantaneous risk of HVCD-Any in 2-16-year-olds and in 9-16-year-olds (HR 0.26 or 0.15 per 10-fold increase in average titer by two methods, 95% CIs 0.14 to 0.45 and 0.07 to 0.34, respectively) pooled across both trials. Results were similar for homologous HVCD. There was evidence suggesting increased HVCD-Any risk in participants with low average titer (1:10 to 1:100) compared to seronegative participants (HR 1.85, 95% CI 0.93 to 3.68). CONCLUSIONS Natural infection-induced nAbs were inversely associated with hospitalized dengue, upon exceeding a relatively low threshold.
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Affiliation(s)
- Ying Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 98109, United States of America.,Department of Biostatistics, University of Washington, Seattle, 98109, United States of America
| | - Brian D Williamson
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 98109, United States of America
| | - Zoe Moodie
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 98109, United States of America
| | - Lindsay N Carpp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 98109, United States of America
| | | | - Carlos A DiazGranados
- Clinical Sciences, Sanofi Pasteur, Swiftwater, Pennsylvania, United States of America
| | - Peter B Gilbert
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 98109, United States of America.,Department of Biostatistics, University of Washington, Seattle, 98109, United States of America
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19
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Schulte A, Weber I, Tiga-Loza DC, Amaya Larios IY, Shepard DS, Tschampl CA, Undurraga EA, Martínez-Vega RA, Fischer F, Chihu L, Ramos-Castañeda J. Health-Related Quality of Life after Dengue Fever, Morelos, Mexico, 2016-2017. Emerg Infect Dis 2021; 26:751-755. [PMID: 32186487 PMCID: PMC7101125 DOI: 10.3201/eid2604.190729] [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] [Indexed: 11/24/2022] Open
Abstract
We adapted the EQ-5D-3L questionnaire and visual analog scale to assess health-related quality of life (HRQOL) and persistent symptoms in 79 patients with laboratory-confirmed dengue in Morelos, Mexico. The lowest HRQOLs were 0.53 and 38.1 (febrile phase). Patients recovered baseline HRQOL in ≈2 months.
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20
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Thai PQ, Rabaa MA, Luong DH, Tan DQ, Quang TD, Quach HL, Hoang Thi NA, Dinh PC, Nghia ND, Tu TA, Quang LN, Phuc TM, Chau V, Khanh NC, Anh DD, Duong TN, Thwaites G, van Doorn HR, Choisy M. The First 100 Days of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Control in Vietnam. Clin Infect Dis 2021; 72:e334-e342. [PMID: 32738143 PMCID: PMC7454342 DOI: 10.1093/cid/ciaa1130] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
Background One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. Methods Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers. Results A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI, .·37–2.·36). No community transmission has been detected since 15 April. Conclusions Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission.
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Affiliation(s)
- Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maia A Rabaa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Duong Huy Luong
- Medical Services Administration, Ministry of Health, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Tran Dai Quang
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Ha-Linh Quach
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Ngoc-Anh Hoang Thi
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Phung Cong Dinh
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi, Vietnam
| | - Ngu Duy Nghia
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Anh Tu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Tran My Phuc
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Vinh Chau
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - H Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Marc Choisy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
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21
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Thai PQ, Rabaa MA, Luong DH, Tan DQ, Quang TD, Quach HL, Hoang Thi NA, Dinh PC, Nghia ND, Tu TA, Quang LN, Phuc TM, Chau V, Khanh NC, Anh DD, Duong TN, Thwaites G, van Doorn HR, Choisy M. The First 100 Days of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Control in Vietnam. Clin Infect Dis 2021. [PMID: 32738143 DOI: 10.1093/cid/ciaa1130/5879764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. METHODS Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers. RESULTS A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI, .·37-2.·36). No community transmission has been detected since 15 April. CONCLUSIONS Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission.
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Affiliation(s)
- Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maia A Rabaa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Duong Huy Luong
- Medical Services Administration, Ministry of Health, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Tran Dai Quang
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Ha-Linh Quach
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Ngoc-Anh Hoang Thi
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Phung Cong Dinh
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi, Vietnam
| | - Ngu Duy Nghia
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Anh Tu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Tran My Phuc
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Vinh Chau
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - H Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Marc Choisy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
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22
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Colón-González FJ, Soares Bastos L, Hofmann B, Hopkin A, Harpham Q, Crocker T, Amato R, Ferrario I, Moschini F, James S, Malde S, Ainscoe E, Sinh Nam V, Quang Tan D, Duc Khoa N, Harrison M, Tsarouchi G, Lumbroso D, Brady OJ, Lowe R. Probabilistic seasonal dengue forecasting in Vietnam: A modelling study using superensembles. PLoS Med 2021; 18:e1003542. [PMID: 33661904 PMCID: PMC7971894 DOI: 10.1371/journal.pmed.1003542] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/18/2021] [Accepted: 01/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND With enough advanced notice, dengue outbreaks can be mitigated. As a climate-sensitive disease, environmental conditions and past patterns of dengue can be used to make predictions about future outbreak risk. These predictions improve public health planning and decision-making to ultimately reduce the burden of disease. Past approaches to dengue forecasting have used seasonal climate forecasts, but the predictive ability of a system using different lead times in a year-round prediction system has been seldom explored. Moreover, the transition from theoretical to operational systems integrated with disease control activities is rare. METHODS AND FINDINGS We introduce an operational seasonal dengue forecasting system for Vietnam where Earth observations, seasonal climate forecasts, and lagged dengue cases are used to drive a superensemble of probabilistic dengue models to predict dengue risk up to 6 months ahead. Bayesian spatiotemporal models were fit to 19 years (2002-2020) of dengue data at the province level across Vietnam. A superensemble of these models then makes probabilistic predictions of dengue incidence at various future time points aligned with key Vietnamese decision and planning deadlines. We demonstrate that the superensemble generates more accurate predictions of dengue incidence than the individual models it incorporates across a suite of time horizons and transmission settings. Using historical data, the superensemble made slightly more accurate predictions (continuous rank probability score [CRPS] = 66.8, 95% CI 60.6-148.0) than a baseline model which forecasts the same incidence rate every month (CRPS = 79.4, 95% CI 78.5-80.5) at lead times of 1 to 3 months, albeit with larger uncertainty. The outbreak detection capability of the superensemble was considerably larger (69%) than that of the baseline model (54.5%). Predictions were most accurate in southern Vietnam, an area that experiences semi-regular seasonal dengue transmission. The system also demonstrated added value across multiple areas compared to previous practice of not using a forecast. We use the system to make a prospective prediction for dengue incidence in Vietnam for the period May to October 2020. Prospective predictions made with the superensemble were slightly more accurate (CRPS = 110, 95% CI 102-575) than those made with the baseline model (CRPS = 125, 95% CI 120-168) but had larger uncertainty. Finally, we propose a framework for the evaluation of probabilistic predictions. Despite the demonstrated value of our forecasting system, the approach is limited by the consistency of the dengue case data, as well as the lack of publicly available, continuous, and long-term data sets on mosquito control efforts and serotype-specific case data. CONCLUSIONS This study shows that by combining detailed Earth observation data, seasonal climate forecasts, and state-of-the-art models, dengue outbreaks can be predicted across a broad range of settings, with enough lead time to meaningfully inform dengue control. While our system omits some important variables not currently available at a subnational scale, the majority of past outbreaks could be predicted up to 3 months ahead. Over the next 2 years, the system will be prospectively evaluated and, if successful, potentially extended to other areas and other climate-sensitive disease systems.
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Affiliation(s)
- Felipe J. Colón-González
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Tyndall Centre for Climate Change Research, University of East Anglia, Norwich, United Kingdom
- * E-mail:
| | - Leonardo Soares Bastos
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Scientific Computing Programme, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro
| | | | - Alison Hopkin
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | | | | | | | | | - Samuel James
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | - Sajni Malde
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | - Vu Sinh Nam
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Hanoi, Vietnam
| | | | | | - Gina Tsarouchi
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | - Oliver J. Brady
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel Lowe
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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23
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Giang NT, van Tong H, Quyet D, Hoan NX, Nghia TH, Nam NM, Hung HV, Anh DT, Van Mao C, Son HA, Meyer CG, Velavan TP, Toan NL. Complement protein levels and MBL2 polymorphisms are associated with dengue and disease severity. Sci Rep 2020; 10:14923. [PMID: 32913345 PMCID: PMC7484760 DOI: 10.1038/s41598-020-71947-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023] Open
Abstract
The complement system may be crucial during dengue virus infection and progression to severe dengue. This study investigates the role of MBL2 genetic variants and levels of MBL in serum and complement proteins in Vietnamese dengue patients. MBL2 genotypes (- 550L/H, MBL2 codon 54), MBL2 diplotypes (XA/XO, YA/XO) and MBL2 haplotypes (LXPB, HXPA, XO) were associated with dengue in the study population. The levels of complement factors C2, C5, and C5a were higher in dengue and dengue with warning signs (DWS) patients compared to those in healthy controls, while factor D levels were decreased in dengue and DWS patients compared to the levels determined in healthy controls. C2 and C5a levels were associated with the levels of AST and ALT and with WBC counts. C9 levels were negatively correlated with ALT levels and WBC counts, and factor D levels were associated with AST and ALT levels and with platelet counts. In conclusions, MBL2 polymorphisms are associated with dengue in the Vietnamese study population. The levels of the complement proteins C2, C4b, C5, C5a, C9, factor D and factor I are modulated in dengue patients during the clinical course of dengue.
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Affiliation(s)
- Ngo Truong Giang
- Department of Pathophysiology, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Hanoi, Vietnam.,Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang van Tong
- Department of Pathophysiology, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Hanoi, Vietnam. .,Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222 Phung Hung, Ha Dong, Hanoi, Vietnam.
| | - Do Quyet
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222 Phung Hung, Ha Dong, Hanoi, Vietnam
| | - Nghiem Xuan Hoan
- 108 Military Central Hospital, Hanoi, Vietnam.,Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Trinh Huu Nghia
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Minh Nam
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang Vu Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Tuan Anh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Can Van Mao
- Department of Pathophysiology, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Hanoi, Vietnam
| | - Ho Anh Son
- Department of Pathophysiology, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Hanoi, Vietnam.,Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 222 Phung Hung, Ha Dong, Hanoi, Vietnam
| | - Christian G Meyer
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.,Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Duy Tan University, Faculty of Medicine, Da Nang, Vietnam
| | - Thirumalaisamy P Velavan
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam.,Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Duy Tan University, Faculty of Medicine, Da Nang, Vietnam
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Hanoi, Vietnam.
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24
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Lytton SD, Nematollahi G, van Tong H, Xuan Anh C, Hung HV, Hoan NX, Diez G, Schumacher T, Landt O, Melchior W, Fuchs D, Toan NL, Velavan TP, Song LH. Predominant secondary dengue infection among Vietnamese adults mostly without warning signs and severe disease. Int J Infect Dis 2020; 100:316-323. [PMID: 32896661 DOI: 10.1016/j.ijid.2020.08.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/27/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The morbidity in dengue fever is dependent on the dengue virus (DENV) serotypes, the patient age, predisposing immunogenic markers and the frequency of primary and secondary infections. This study aims to distinguish acute primary from secondary dengue infections of Vietnamese adults and to assess the association of viremia and anti-dengue immunoglobulin levels with clinical outcomes. STUDY DESIGN Viral RNA, dengue serotypes and levels of anti-dengue IgM and IgG of hospitalized adult cases were determined in EDTA-plasma samples prospectively collected during three consecutive years of dengue infection in Hanoi. Patients admitted to hospital within 7 days of their 1st reported fever were included. Primary infections were anti-dengue IgG enzyme-linked immunosorbent assay (ELISA) negative on both day of hospital entry (day 0) and day two or three of hospitalization (day 2 or 3) with a positive anti-dengue IgM on either day 0 or day 2 or 3 hospitalization. The secondary infections were anti-dengue IgG ELISA positive on both day 0 and day 2 or 3 with positive anti-dengue IgM ELISA on either day 0 or day 2 or 3. RESULTS The hospitalized dengue fever cases between October 2016 and March 2019 were predominantly secondary infections (74%, 68% and 77%, respectively) with DENV-1 (60% and 65%) and DENV-2 (22% and 26%) serotypes determined in the latter two years. The viremia in primary infection was significantly higher than that in secondary infection (P < 0.01) and positively correlated with the days of hospital stay. In secondary infections, platelet counts were lower than in primary infections (P = 0.04) and IgG levels in secondary infection negatively correlated with platelet counts (Spearman's r = -0.22, P < 0.01). CONCLUSIONS Our results indicate high rates of secondary infection with DENV1 and DENV2 serotypes. Anti-dengue immunoglobulins negatively correlate with hospital stay and platelet counts with few warning signs or severe disease. Further investigations of specific antibodies in adults which predict auto-inflammatory activity after the recovery from dengue infection are warranted.
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Affiliation(s)
| | | | - Hoang van Tong
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam.
| | | | - Hoang Vu Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Viet Nam.
| | | | - Gerold Diez
- Institut Virion\Serion GmbH, 97076 Würzburg, Germany.
| | | | - Offert Landt
- TIB MOLBIOL Syntheselabor GmbH D-12103 Berlin Germany.
| | | | - Dietmar Fuchs
- Division of Biological Chemistry, Innsbruck Medical University, Innsbruck, Austria.
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam.
| | - Thirumalaisamy P Velavan
- Vietnamese-GermanCenter for Medical Research, VG-CARE, Hanoi, Viet Nam; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
| | - Le Huu Song
- 108 Military Central Hospital, Hanoi, Viet Nam; Vietnamese-GermanCenter for Medical Research, VG-CARE, Hanoi, Viet Nam.
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25
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Tuyen TT, Viet NT, Hang NT, Giang NT, Anh DD, Anh DT, Hung HV, Quyet D, Toan NL, Cam TD, Van Tong H. Proinflammatory Cytokines Are Modulated in Vietnamese Patients with Dengue Fever. Viral Immunol 2020; 33:514-520. [DOI: 10.1089/vim.2020.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Tran Thi Tuyen
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
- Thai Binh Medical College, Thai Binh, Vietnam
| | - Nguyen Thanh Viet
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Ngo Thu Hang
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
- Ha Dong Medical College, Hanoi, Vietnam
| | - Ngo Truong Giang
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
- Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Duc Anh
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Tuan Anh
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang Vu Hung
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Quyet
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - Hoang Van Tong
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
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26
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Ngwe Tun MM, Nguyen TTT, Ando T, Dumre SP, Soe AM, Buerano CC, Nguyen MT, Le NTN, Pham VQ, Nguyen TH, Le TQM, Morita K, Hasebe F. Clinical, Virological, and Cytokine Profiles of Children Infected with Dengue Virus during the Outbreak in Southern Vietnam in 2017. Am J Trop Med Hyg 2020; 102:1217-1225. [PMID: 32189614 DOI: 10.4269/ajtmh.19-0607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Dengue virus (DENV) infection is a major cause of morbidity and mortality in Vietnam, and the incidence is higher and more consistent in the southern part of the country. This study investigated the circulation of DENV serotypes, viremia levels, immunological status, and cytokine levels, with disease severities among children infected in 2017 in Ho Chi Minh City, Southern Vietnam. Acute and convalescent serum samples were collected from clinically diagnosed dengue children. They were confirmed to have DENV infection by NS1 antigen, IgM and IgG ELISAs, virus isolation, and conventional and real-time RT-PCR. Measurement of 10 cytokine levels was performed in the serum samples. All the children were dengue IgM positive; 28% and 72% of them had primary and secondary DENV infections, respectively, whereas 54% of those with secondary infection were children with dengue with warning signs and with severe dengue. Any or mixed infection of the four serotypes of DENV RNA was detected in 58 children. Twenty DENV strains (DENV-1 = 16 and DENV-4 = 4) were isolated. Levels of IFN-γ, TNF-α, MCP-1, IL-10, and IL-6 were significantly higher in severe dengue cases. We report the predominance of DENV-1 over other serotypes in the 2017 dengue outbreak in Southern Vietnam. Our data showed that cytokine expressions were correlated with dengue pathogenesis and may help in identifying an effective therapeutic strategy.
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Affiliation(s)
- Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Thi Thu Thuy Nguyen
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tsuyoshi Ando
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shyam Prakash Dumre
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Aung Min Soe
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Corazon C Buerano
- Research and Biotechnology, St Luke's Medical Center, Quezon City, Philippines
| | - Minh Tuan Nguyen
- Dengue Department, Children Hospital No. (1), Ho Chi Minh, Vietnam
| | | | - Van Quang Pham
- ICU Department, Children Hospital No. (1), Ho Chi Minh, Vietnam
| | | | - Thi Quynh Mai Le
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Futoshi Hasebe
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Center of International Collaboration Research, Nagasaki University, Nagasaki, Japan
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27
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Saeung M, Ngoen-Klan R, Thanispong K, Muenworn V, Bangs MJ, Chareonviriyaphap T. Susceptibility of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) to Temephos in Thailand and Surrounding Countries. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:1207-1220. [PMID: 32159772 DOI: 10.1093/jme/tjaa035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Indexed: 06/10/2023]
Abstract
Aedes-borne virus disease control relies on insecticides to interrupt transmission. Temephos remains a key chemical for control of immature stage Aedes in Thailand and much of Southeast Asia. However, repeated use of insecticides may result in selection for resistance in vector populations, thus compromising operational intervention. Herein, the phenotypic response to temephos by Aedes aegypti (L.) and Aedes albopictus (Skuse) collected in Thailand and surrounding countries is presented. Data from 345 collection sites are included: 283 from literature review (244 sites with Ae. aegypti, 21 with Ae. albopictus, and 18 having both species sampled), plus 62 locations with Ae. aegypti in Thailand conducted between 2014 and 2018. Susceptibility assays followed WHO guidelines using the recommended discriminating dose of temephos (0.012 mg/liter) against late third to early fourth instar Ae. aegypti. Findings revealed 34 locations with susceptible Ae. aegypti, 13 with suspected resistance, and 15 indicating resistance. Published data between 1999 and 2019 in Thailand found Ae. aegypti resistant in 73 of 206 collection sites, whereas 3 locations from 11 sampled with low-level resistant in Ae. albopictus. From surrounding countries conducting temephos assays (Cambodia, Lao PDR, Myanmar, Malaysia, and Singapore), resistance is present in Ae. aegypti and Ae. albopictus from 27 of 56 and 19 of 28 locations, respectively. Routine insecticide susceptibility monitoring should be an operational requirement in vector control programs. Given the wide distribution and apparent increase in temephos-resistance, alternative larvicidal compounds must be considered if chemical control is to remain a viable vector control strategy.
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Affiliation(s)
- Manop Saeung
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Ratchadawan Ngoen-Klan
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Kanutcharee Thanispong
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Vithee Muenworn
- Department of Entomology and Plant Pathology, Faculty of Agriculture, Khon Kaen University, Khon Kaen, Thailand
| | - Michael J Bangs
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
- Public Health & Malaria Control Department, PT Freeport Indonesia/International SOS, Kuala Kencana, Papua, Indonesia
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28
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Hung TM, Shepard DS, Bettis AA, Nguyen HA, McBride A, Clapham HE, Turner HC. Productivity costs from a dengue episode in Asia: a systematic literature review. BMC Infect Dis 2020; 20:393. [PMID: 32493234 PMCID: PMC7268537 DOI: 10.1186/s12879-020-05109-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/20/2020] [Indexed: 01/22/2023] Open
Abstract
Background Dengue is a mosquito-borne viral infection which has been estimated to cause a global economic burden of US$8.9 billion per year. 40% of this estimate was due to what are known as productivity costs (the costs associated with productivity loss from both paid and unpaid work that results from illness, treatment or premature death). Although productivity costs account for a significant proportion of the estimated economic burden of dengue, the methods used to calculate them are often very variable within health economic studies. The aim of this review was to systematically examine the current estimates of the productivity costs associated with dengue episodes in Asia and to increase awareness surrounding how productivity costs are estimated. Method We searched PubMed and Web of Knowledge without date and language restrictions using terms related to dengue and cost and economics burden. The titles and abstracts of publications related to Asia were screened to identify relevant studies. The reported productivity losses and costs of non-fatal and fatal dengue episodes were then described and compared. Costs were adjusted for inflation to 2017 prices. Results We reviewed 33 relevant articles, of which 20 studies reported the productivity losses, and 31 studies reported productivity costs. The productivity costs varied between US$6.7–1445.9 and US$3.8–1332 for hospitalized and outpatient non-fatal episodes, respectively. The productivity cost associated with fatal dengue episodes varied between US$12,035-1,453,237. A large degree of this variation was due to the range of different countries being investigated and their corresponding economic status. However, estimates for a given country still showed notable variation. Conclusion We found that the estimated productivity costs associated with dengue episodes in Asia are notable. However, owing to the significant variation in methodology and approaches applied, the reported productivity costs of dengue episodes were often not directly comparable across studies. More consistent and transparent methodology regarding the estimation of productivity costs would help the estimates of the economic burden of dengue be more accurate and comparable across studies.
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Affiliation(s)
- Trinh Manh Hung
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.
| | - Donald S Shepard
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, USA
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, London, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, UK
| | - Huyen Anh Nguyen
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Angela McBride
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Department of Global Health and Infection, Brighton and Sussex Medical School, Falmer, Brighton, England
| | - Hannah E Clapham
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hugo C Turner
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
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29
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Nguyen CT, Moi ML, Le TQM, Nguyen TTT, Vu TBH, Nguyen HT, Pham TTH, Le THT, Nguyen LMH, Phu Ly MH, Ng CFS, Takemura T, Morita K, Hasebe F. Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey. BMC Infect Dis 2020; 20:332. [PMID: 32393198 PMCID: PMC7216417 DOI: 10.1186/s12879-020-05042-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/16/2020] [Indexed: 12/24/2022] Open
Abstract
Background Between 2016 and 2019, 265 cases of Zika virus (ZIKV) infection were reported in Vietnam, predominantly in southern Vietnam. In 2016, a case of ZIKV-associated microcephaly was confirmed in the Central Highlands, and several members of the infant’s family were confirmed to be infected with ZIKV. The study aims to determine the level of immunity to ZIKV in the general population of the ZIKV epidemic region. Methods A total of 879 serum samples were collected from 801 participants between January 2017 and July 2018, during and after the ZIKV epidemic in Vietnam. The samples were tested for anti-ZIKV immunoglobulin M (IgM) and immunoglobulin G (IgG), and anti-dengue virus (DENV) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Plaque-reduction neutralization test (PRNT) for ZIKV was performed on all samples, and for DENV on the samples that ZIKV neutralizing antibody positive. Results A total of 83 (10.3%) participants had anti-ZIKV IgM. Of the 83, 6 were confirmed to be ZIKV antibodies positive using PRNT and anti-ZIKV IgG ELISA. Of the 718 participants who were anti-ZIKV IgM negative, a further 3 cases were confirmed as positive for antibodies against ZIKV. Of the 9 participants with ZIKV infection, 5 lived in the same village as the infant with ZIKV-associated microcephaly and the other 4 lived in 2 neighboring communes. Repeat samples were collected from the 83 ZIKV IgM positive participants 1.5 years after the first collection. No new cases of ZIKV infection were detected. In addition, 2 of 3 participants with anti-ZIKV NS1 IgG demonstrated a 4- to 8-fold increase in ZIKV neutralizing antibody titer. Conclusions ZIKV was present in the area around Krong Buk, with the rate of ZIKV-specific antibodies was 1.1% in the community since at least 2016. While the low levels of circulation together with low seroprevalence suggests a limited outbreak in the region, the results also reflect on low levels of protective immunity to Zika within the population. These results provide a better understanding of the current ZIKV epidemic status in the region and demonstrate a need for implementation of more effective ZIKV infection control measures.
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Affiliation(s)
- Co Thach Nguyen
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.,Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan
| | - Meng Ling Moi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. .,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan. .,Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan.
| | | | | | - Thi Bich Hau Vu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hai Tuan Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Thi Hien Thu Le
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Le Manh Hung Nguyen
- Tay Nguyen Institute of Hygiene and Epidemiology, Tay Nguyen, Dak Lak, Vietnam
| | - Minh Huong Phu Ly
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Taichiro Takemura
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kouichi Morita
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.,Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan
| | - Futoshi Hasebe
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.,Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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30
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The Impact of Dengue on Economic Growth: The Case of Southern Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030750. [PMID: 31991624 PMCID: PMC7037327 DOI: 10.3390/ijerph17030750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 12/24/2022]
Abstract
Dengue has long been a public health problem in tropical and subtropical countries. In 2015, a dengue outbreak occurred in Taiwan, where 43,784 cases were reported. This study aims to assess the impact of dengue on Southern Taiwan’s economic growth according to the economic growth model-based regression approach recommended by the World Health Organization (WHO). Herein, annual data from Southern Taiwan on the number of dengue cases, income growth, and demographics from 2010–2015 were analyzed. The percentage of reduction of the average income per capita in 2015 due to the dengue outbreak was estimated. Dengue was determined to have a negative linear economic impact on Southern Taiwan’s economic growth. In particular, a reduction of 0.26% in the average income per capita was estimated in Southern Taiwan due to the 2015 outbreak. If the model is applied alongside other dengue outbreak forecast models, then the forecast for economic reduction due to a future dengue outbreak may also be estimated. Prevention and recovery policies may subsequently be decided upon based on not only the number of dengue cases but also the degree of economic burden resulting from an outbreak.
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31
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Rathnayake D, Clarke M, Jayasooriya L. Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemics – A systematic review. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1692517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mike Clarke
- Centre for Public Health, Institute of Clinical Sciences, Queens University, Belfast, UK
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32
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Kestelyn E, Le Phuong C, Ilo Van Nuil J, Dong Thi HT, Minh Nguyen N, Dinh The T, Chambers M, Simmons CP, Nguyen Trong T, Nguyen The D, Phuong LT, Do Van D, Duc Anh D, Nguyen Van VC, Baker S, Wills B. Expert voices and equal partnerships: establishing Controlled Human Infection Models (CHIMs) in Vietnam. Wellcome Open Res 2019; 4:143. [PMID: 31681857 PMCID: PMC6820821 DOI: 10.12688/wellcomeopenres.15337.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2019] [Indexed: 01/20/2023] Open
Abstract
The number of controlled human infection models (CHIMs) conducted worldwide has increased considerably in recent years, although few have been conducted in low and middle-income countries (LMICs), where infectious diseases have the greatest burden. Recently Oxford University Clinical Research Unit (OUCRU) in Ho Chi Minh City (HCMC) started developing CHIM research proposals motivated by the need to develop a clearer and more grounded understanding of the issues surrounding the conduct of CHIMs in LMICs. To explore initial perceptions and barriers to conducting CHIMs in Vietnam, OUCRU researchers conducted a set of key stakeholder interviews early in 2018 and held a CHIM workshop in HCMC in March 2018. This paper summarizes the discussions from the workshop and outlines a way forward for conducting CHIMs in Vietnam.
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Affiliation(s)
- Evelyne Kestelyn
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Chi Le Phuong
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Hoai Tam Dong Thi
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Nguyet Minh Nguyen
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Trung Dinh The
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam
| | - Mary Chambers
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Cameron P Simmons
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.,Institute for Vector-Borne Disease, Monash University, Clayton, VIC 3800, Australia
| | | | - Dung Nguyen The
- Department of Infectious Diseases, School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
| | | | - Dung Do Van
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Dung Duc Anh
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Vinh Chau Nguyen Van
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Bridget Wills
- Oxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.,Center for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
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33
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Nhan LNT, Turner HC, Khanh TH, Hung NT, Lien LB, Hong NTT, Nhu LNT, Ny NTH, Nguyet LA, Thanh TT, Van HMT, Viet HL, Tung TH, Phuong TTL, Devine A, Thwaites G, Chau NVV, Thwaites L, van Doorn HR, Tan LV. Economic Burden Attributed to Children Presenting to Hospitals With Hand, Foot, and Mouth Disease in Vietnam. Open Forum Infect Dis 2019; 6:5514500. [PMID: 31363772 PMCID: PMC6657964 DOI: 10.1093/ofid/ofz284] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) has become a major public health concern in the Asia-Pacific region. Knowledge of its economic burden is essential for policy makers in prioritizing the development and implementation of interventions. Methods A multi-hospital-based study was prospectively conducted at 3 major hospitals in Ho Chi Minh City, Vietnam, during 2016–2017. Data on direct and productivity costs were collected alongside clinical information and samples and demographic information from study participants. Results A total of 466 patients were enrolled. Two hundred three of 466 (43.6%) patients lived in Ho Chi Minh City, and 72/466 (15.5%) had severe HFMD. An enterovirus was identified in 74% of 466 patients, with EV-A71, CV-A6, CV-A10, and CV-A16 being the most common viruses identified (236/466, 50.6%). The mean economic burden per case was estimated at US$400.80 (95% confidence interval [CI], $353.80–$448.90), of which the total direct (medical) costs accounted for 69.7%. There were considerable differences in direct medical costs between groups of patients with different clinical severities and pathogens (ie, EV-A71 vs non-EV-A71). In Vietnam, during 2016–2017, the economic burden posed by HFMD was US$90 761 749 (95% CI, $79 033 973–$103 009 756). Conclusions Our findings are of public health significance because for the first time we demonstrate that HFMD causes a substantial economic burden in Vietnam, and although multivalent vaccines are required to control HFMD, effective EV-A71 vaccine could substantially reduce the burden posed by severe HFMD. The results will be helpful for health policy makers in prioritizing resources for the development and implementation of intervention strategies to reduce the burden of HFMD.
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Affiliation(s)
- Le Nguyen Thanh Nhan
- Children's Hospital 1, Ho Chi Minh City, Vietnam.,Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Hugo C Turner
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | | | - Le Bich Lien
- Children's Hospital 1, Ho Chi Minh City, Vietnam
| | | | | | | | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Ho Lu Viet
- Children's Hospital 2, Ho Chi Minh City, Vietnam
| | | | | | - Angela Devine
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Mahidol Oxford Tropical Research Unit, Bangkok, Thailand
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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