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Lin WZ, Hung CM, Lin IH, Sun YJ, Liao ZX, Wu CC, Hou SY. Enhancing antibody detection sensitivity in lateral flow immunoassays using endospores of Bacillus subtilis as signal amplifiers. Talanta 2024; 276:126215. [PMID: 38723474 DOI: 10.1016/j.talanta.2024.126215] [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] [Received: 09/08/2023] [Revised: 03/28/2024] [Accepted: 05/05/2024] [Indexed: 06/14/2024]
Abstract
Antibody detection is the critical first step for tracking the spread of many diseases including COVID-19. Lateral flow immunoassay (LFIA) is the most commonly used method for rapid antibody detection because it is easy-to-use and inexpensive. However, LFIA has limited sensitivity when gold nanoparticles (AuNPs) are used as the signals. In this study, the endospores of Bacillus subtilis were used in combination with AuNP in a LFIA to detect antibodies. The endospores serve as a signal amplifier. The detection limit was about 10-8 M for anti-beta galactosidase antibody detection whereas the detection limit of conventional LFIA is about 10-6 M. Furthermore, the proposed methods have no additional user steps compared with the traditional LFIA. This method, therefore, improved the sensitivity 100-fold without compromising any advantages of LFIA. We believe that the proposed method will be useful for detection of antibodies against HIV, Zika virus, SARS-CoV-2, and so on.
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Affiliation(s)
- Wen-Zhi Lin
- Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, 11490, Taiwan; Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, 23742, Taiwan; Department of Biology and Anatomy, National Defense Medical Center, Taipei, 11490, Taiwan.
| | - Chin-Mao Hung
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, 23742, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, 11490, Taiwan.
| | - I-Hsien Lin
- Graduate Institute of Chemical Engineering, Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, 10608, Taiwan.
| | - Yi-Jia Sun
- Graduate Institute of Biochemical and Biomedical Engineering, Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, 10608, Taiwan.
| | - Zheng-Xiu Liao
- Graduate Institute of Chemical Engineering, Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, 10608, Taiwan.
| | - Chia-Chun Wu
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, 23742, Taiwan; Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan.
| | - Shao-Yi Hou
- Graduate Institute of Biochemical and Biomedical Engineering, Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, 10608, Taiwan.
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Tian G, Tan J, Liu B, Xiao M, Xia Q. Field-deployable viral diagnostic tools for dengue virus based on Cas13a and Cas12a. Anal Chim Acta 2024; 1316:342838. [PMID: 38969428 DOI: 10.1016/j.aca.2024.342838] [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] [Received: 03/10/2024] [Revised: 05/20/2024] [Accepted: 06/05/2024] [Indexed: 07/07/2024]
Abstract
The diagnosis of dengue virus (DENV) has been challenging particularly in areas far from clinical laboratories. Early diagnosis of pathogens is a prerequisite for the timely treatment and pathogen control. An ideal diagnostic for viral infections should possess high sensitivity, specificity, and flexibility. In this study, we implemented dual amplification involving Cas13a and Cas12a, enabling sensitive and visually aided diagnostics for the dengue virus. Cas13a recognized the target RNA by crRNA and formed the assembly of the Cas13a/crRNA/RNA ternary complex, engaged in collateral cleavage of nearby crRNA of Cas12a. The Cas12a/crRNA/dsDNA activator ternary complex could not be assembled due to the absence of crRNA of Cas12a. Moreover, the probe, with 5' and 3' termini labeled with FAM and biotin, could not be separated. The probes labeled with FAM and biotin, combined the Anti-FAM and the Anti-Biotin Ab-coated gold nanoparticle, and conformed sandwich structure on the T-line. The red line on the paper strip caused by clumping of AuNPs on the T-line indicated the detection of dengue virus. This technique, utilizing an activated Cas13a system cleaving the crRNA of Cas12a, triggered a cascade that amplifies the virus signal, achieving a low detection limit of 190 fM with fluorescence. Moreover, even at 1 pM, the red color on the T-line was easily visible by naked eyes. The developed strategy, incorporating cascade enzymatic amplification, exhibited good sensitivity and may serve as a field-deployable diagnostic tool for dengue virus.
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Affiliation(s)
- Guozhen Tian
- Hainan Women and Children's Medical Center, Haikou, Hainan, 571199, China
| | - Jun Tan
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, 571199, China
| | - Biao Liu
- Hainan Women and Children's Medical Center, Haikou, Hainan, 571199, China
| | - Meifang Xiao
- Hainan Women and Children's Medical Center, Haikou, Hainan, 571199, China.
| | - Qianfeng Xia
- NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan, 571199, China.
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Tran PNT, Siranart N, Sukmark T, Limothai U, Tachaboon S, Tantawichien T, Thisyakorn C, Thisyakorn U, Srisawat N. A simple nomogram to predict dengue shock syndrome: A study of 4522 south east Asian children. J Med Virol 2024; 96:e29874. [PMID: 39165074 DOI: 10.1002/jmv.29874] [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] [Received: 05/21/2024] [Revised: 07/16/2024] [Accepted: 08/10/2024] [Indexed: 08/22/2024]
Abstract
Dengue shock syndrome (DSS) substantially worsens the prognosis of children with dengue infection. This study aimed to develop a simple clinical tool to predict the risk of DSS. A cohort of 2221 Thai children with a confirmed dengue infection who were admitted to King Chulalongkorn Memorial Hospital between 1987 and 2007 was conducted. Another data set from a previous publication comprising 2,301 Vietnamese children with dengue infection was employed to create a pooled data set, which was randomly split into training (n = 3182), testing (n = 697) and validating (n = 643) datasets. Logistic regression was compared to alternative machine learning algorithms to derive the most predictive model for DSS. 4522 children, including 899 DSS cases (758 Thai and 143 Vietnamese children) with a mean age of 9.8 ± 3.4 years, were analyzed. Among the 12 candidate clinical parameters, the Bayesian Model Averaging algorithm retained the most predictive subset of five covariates, including body weight, history of vomiting, liver size, hematocrit levels, and platelet counts. At an Area Under the Curve (AUC) value of 0.85 (95% CI: 0.81-0.90) in testing data set, logistic regression outperformed random forest, XGBoost and support vector machine algorithms, with AUC values being 0.82 (0.77-0.88), 0.82 (0.76-0.88), and 0.848 (0.81-0.89), respectively. At its optimal threshold, this model had a sensitivity of 0.71 (0.62-0.80), a specificity of 0.84 (0.81-0.88), and an accuracy of 0.82 (0.78-0.85) on validating data set with consistent performance across subgroup analyses by age and gender. A logistic regression-based nomogram was developed to facilitate the application of this model. This work introduces a simple and robust clinical model for DSS prediction that is well-tailored for children in resource-limited settings.
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Affiliation(s)
- Phu Nguyen Trong Tran
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Internal Medicine, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Noppachai Siranart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Umaporn Limothai
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Critical Care Nephrology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Sasipha Tachaboon
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Critical Care Nephrology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Terapong Tantawichien
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Chule Thisyakorn
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nattachai Srisawat
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Critical Care Nephrology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Critical Care Medicine, School of Medicine, Center for Critical Care Nephrology, The CRISMA Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand
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Kinanti DR, Ahmad I, Putra R, Yusmalinar S, Wibowo I, Anggraeni T, Dwiartama A, Tjia TOS, Destiani PC, Khoirunnisa K, Tu WC, Neoh KB, Apip RA, Raksanagara A, Dewi Jani I, Tisnawati Y, Warisman A, Rostiana T, Fibriani A. Evaluation of in-house dengue real-time PCR assays in West Java, Indonesia. PeerJ 2024; 12:e17758. [PMID: 39071132 PMCID: PMC11283174 DOI: 10.7717/peerj.17758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Dengue is an infectious disease caused by infection of dengue virus (DENV) transmitted by Aedes aegypti and Aedes albopictus. In Indonesia, dengue commonly occurs with an increasing incidence rate annually. It is known that early detection of dengue infection is one of the keys to controlling this disease outbreak. Rapid and accurate early detection to diagnose dengue can be achieved by molecular tests, one of which is through a real-time PCR method. However, real-time PCR assay for dengue developed based on Indonesian DENV sequences has not been available. Therefore, we developed in-house dengue real-time PCR (SYBR- and TaqMan-based) assays and evaluated those assays in routine clinical testing in the community. These assays target the 3' UTR region of the four DENV serotypes and was found to be specific for DENV. The most sensitive assay was the TaqMan assay with the LOD95% of 482 copy/ml, followed by the SYBR assay with the LOD95% of 14,398 copy/ml. We recruited dengue suspected patients from three primary health care services in West Java, Indonesia to represent the community testing setting. Dengue infection was examined using the two in-house real-time PCR assays along with NS1, IgM, and IgG rapid diagnostic tests (RDT). In total, as many as 74 clinical specimens of dengue suspected patients were included in this study. Among those patients, 21 were positive for TaqMan assay, 17 were positive for SYBR assay, nine were positive for NS1 test, six were positive for both IgG and IgM tests, and 22 were positive for IgG test only. Compared with our in-house TaqMan assay, the sensitivity of NS1 test, IgM test, and IgG test were 42.86%, 14.29%, and 28.57% respectively. Among these three RDT tests, NS1 showed 100% specificity. Thus, our study confirmed that NS1 test showed high specificity, indicating that a positive result of NS1 can be confidently considered a dengue case. However, NS1, IgM, and IgG tests with RDT are not enough to diagnose a dengue case. We suggest applying the high sensitivity and specificity rRT-PCR test as the gold standard for early detection and antibody test as a follow-up test for rRT-PCR negative cases.
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Affiliation(s)
- Denti R. Kinanti
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Intan Ahmad
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Ramadhani Putra
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Sri Yusmalinar
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Indra Wibowo
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Tjandra Anggraeni
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Angga Dwiartama
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | | | - Putri Cahya Destiani
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Karimatu Khoirunnisa
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
| | - Wu-Chun Tu
- Department of Entomology, National Chung Hsing University, Taichung, Taichung, Taiwan
| | - Kok-Boon Neoh
- Department of Entomology, National Chung Hsing University, Taichung, Taichung, Taiwan
| | | | | | - Ira Dewi Jani
- Bandung City Health Office, Bandung, West Java, Indonesia
| | | | - Aan Warisman
- Puskesmas Margahayu Raya, Bandung, West Java, Indonesia
| | - Tita Rostiana
- Puskesmas Cipamokolan, Bandung, West Java, Indonesia
| | - Azzania Fibriani
- School of Life Sciences and Technology, Institute of Technology Bandung, Bandung, West Java, Indonesia
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Abeygoonawardena H, Dassanayake K, Kariyawasam J, Chathuranga T, Sundralingam T, Gunasekara H, Wevita S, Premawansa G, Premawansa S, Wijewickrama A, Wijesinghe N, Navaratne V, Weiskopf D, Sette A, Punchihewa C, De Silva AD. Identifying the strains of dengue circulating in the western province of Sri Lanka during 2019-2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003150. [PMID: 39012856 PMCID: PMC11251588 DOI: 10.1371/journal.pgph.0003150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/23/2024] [Indexed: 07/18/2024]
Abstract
A study conducted from July 2019 to May 2022 at several hospitals in the Western Province, Sri Lanka, focused on dengue virus strains during the COVID-19 pandemic. Among 417 febrile patients, 47% were PCR-positive for dengue. Serotyping revealed DENV-1 (12.8%), DENV-2 (46.4%), DENV-3 (37.2%), and DENV-4 (3.6%). Sequencing identified two genotypically distinct variants of DENV-3 and two genotypically distinct variants of DENV-1, while DENV-2 showed a single genotype cluster. Notably, the study found concurrent circulation of two DENV-3 and two DENV-1 genotypes, along with DENV-2, during the pandemic in the area. This data suggests the presence of multiple dengue strains, including several DENV-1 and DENV-3 variants, without major epidemic outbreaks reported in the Western Province. Continuous monitoring and research are essential to understand the dynamics of these dengue strains in the context of the COVID-19 pandemic.
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Affiliation(s)
- Harshi Abeygoonawardena
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Kanchana Dassanayake
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Jayani Kariyawasam
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Teshan Chathuranga
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | | | - Hansani Gunasekara
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Sathyani Wevita
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | | | | | | | - Namal Wijesinghe
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Varuna Navaratne
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
| | - Daniela Weiskopf
- La Jolla Institute for Immunology, Center for Infectious Disease and Vaccine Research, La Jolla, California, United States of America
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, California, United States of America
| | - Alessandro Sette
- La Jolla Institute for Immunology, Center for Infectious Disease and Vaccine Research, La Jolla, California, United States of America
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, California, United States of America
| | | | - Aruna Dharshan De Silva
- Faculty of Medicine, General Sir John Kotelawala Defence University, Kandawala Estate Ratmalana, Sri Lanka
- La Jolla Institute for Immunology, Center for Infectious Disease and Vaccine Research, La Jolla, California, United States of America
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Hadpech S, Thongboonkerd V. Proteomic investigations of dengue virus infection: key discoveries over the last 10 years. Expert Rev Proteomics 2024; 21:281-295. [PMID: 39049185 DOI: 10.1080/14789450.2024.2383580] [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] [Received: 05/19/2023] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION Dengue virus (DENV) infection remains one of the most significant infectious diseases in humans. Several efforts have been made to address its molecular mechanisms. Over the last 10 years, proteomics has been widely applied to investigate various aspects of DENV infection. AREAS COVERED In this review, we briefly introduce common proteomics approaches using various mass spectrometric modalities followed by summarizing all the discoveries obtained from proteomic investigations of DENV infection over the last 10 years. These include the data on DENV-vector interactions and host responses to address the DENV biology and disease mechanisms. Moreover, applications of proteomics to disease prevention, diagnosis, vaccine design, development of anti-DENV agents and other new treatment strategies are discussed. EXPERT OPINION Despite efforts on disease prevention, DENV infection is still a significant global healthcare burden that affects the general population. As summarized herein, proteomic technologies with high-throughput capabilities have provided more in-depth details of protein dynamics during DENV infection. More extensive applications of proteomics and other powerful research tools would provide a promise to better cope and prevent this mosquito-borne infectious disease.
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Affiliation(s)
- Sudarat Hadpech
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Macêdo JVL, Júnior AGS, Oliveira MDL, Andrade CAS. Systematic review and meta-analysis: assessing the accuracy of rapid immunochromatographic tests in dengue diagnosis. Diagn Microbiol Infect Dis 2024; 109:116227. [PMID: 38503028 DOI: 10.1016/j.diagmicrobio.2024.116227] [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] [Received: 01/25/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
The objective of this systematic review is to analyze the diagnostic accuracy of rapid dengue diagnostic tests. The search was conducted in the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database and Google Scholar. ELISA and PCR assays were adopted as reference methods. Thirty-four articles were included in this systematic review. Receiver operating characteristic (ROC) and Forest Plot were performed to evaluate sensitivity and specificity for each parameter analyzed (NS1, IgM and IgG). The results revealed that the combined analysis of the IgM antibody with the NS1 antigen resulted in greater sensitivity than the isolated analysis of IgM. The three analytes together showed the best performance, with a combined sensitivity of 90 % (95 % CI: 89-92 %) using ELISA as a comparator. Thus, the present review provides relevant knowledge for decision-making between the available rapid diagnostic tests.
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Affiliation(s)
- Jéssica V L Macêdo
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - Alberto G S Júnior
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - Maria D L Oliveira
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil
| | - César A S Andrade
- Programa de Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Departamento de Bioquímica, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil; Núcleo de Pesquisa em Avaliação de Tecnologias em Saúde - NUPIATS, Universidade Federal de Pernambuco, 50670-901 Recife, PE, Brazil.
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Goyal PK, Hissaria K, Shekhawat C. Role of Serum Ferritin as a Predictor of Dengue Severity: A Prospective Observational Study From India. Cureus 2024; 16:e63503. [PMID: 39081444 PMCID: PMC11288214 DOI: 10.7759/cureus.63503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Early detection of dengue fever progression to severe form using simple measurable tests is crucial for initiating appropriate supportive therapy. This study aimed to assess whether serum ferritin is an indicator of severity in dengue patients. MATERIAL AND METHODS This hospital-based prospective observational study was done on 70 patients admitted in wards and intensive care unit (ICU) of Aditya Birla Memorial Hospital, Pune, India, and Jaipur Golden Hospital, Delhi, India, satisfying inclusion criteria during the study period. Dengue cases were classified as those who had non-structural protein 1 (NS1) positivity on days 2-8 and/or positive immunoglobulin M (IgM) on days 6-10, while those with other confirmed diagnoses were considered as other febrile illnesses. The outcome of this study was to see an association between serum ferritin levels and severity of illness, condition at the time of discharge/death, and the length of hospitalization. RESULTS Mean serum ferritin (ng/mL), platelet count (cells/mm3), and hospital stay (in days) were 1469.43±297.53, 17289.29±8254.47, and 6.01±3.90, respectively. Subjects with severe dengue had significantly higher mean serum ferritin levels and median hospital stays compared to those with non-severe dengue (p<0.05). A moderate (Pearson correlation coefficient ρ=-0.35, p=0.0027) negative correlation was found between serum ferritin level and platelet count whereas a moderate (ρ=0.50, p=0.0000) positive correlation was found between serum ferritin level and hospital stay. CONCLUSION Serum ferritin levels can be used as a tool to help differentiate between severe and non-severe dengue.
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Limothai U, Tachaboon S, Dinhuzen J, Singh J, Leewongworasingh A, Watanaboonyongcharoen P, Fernandez S, Hunsawong T, Farmer AR, Tantawichien T, Thisyakorn U, Srisawat N. Dengue virus transmission risk in blood donation: Evidence from Thailand. J Med Virol 2024; 96:e29689. [PMID: 38818789 DOI: 10.1002/jmv.29689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/28/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
Individuals infected with dengue virus (DENV) often show no symptoms, which raises the risk of DENV transfusion transmission (TT-DENV) in areas where the virus is prevalent. This study aimed to determine the evidence of DENV infection in blood donors from different geographic regions of Thailand. A cross-sectional study was conducted on blood donor samples collected from the Thai Red Cross National Blood Center and four regional blood centers between March and September 2020. Screening for DENV nonstructural protein 1 (NS1), anti-DENV immunoglobulin G (IgG), and IgM antibodies was performed on residual blood from 1053 donors using enzyme-linked immunosorbent assay kits. Positive NS1 and IgM samples indicating acute infection were verified using four different techniques, including quantitative real-time (q) RT-PCR, nested PCR, virus isolation in C6/36 cells, and mosquito amplification. DENV IgG seropositivity was identified in 89% (938/1053) of blood donors. Additionally, 0.4% (4/1053) and 2.1% (22/1053) of Thai blood donors tested positive for NS1 and IgM, respectively. The presence of asymptomatic dengue virus infection in healthy blood donors suggests a potential risk of transmission through blood transfusion, posing a concern for blood safety.
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Affiliation(s)
- Umaporn Limothai
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Sasipha Tachaboon
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Janejira Dinhuzen
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Jasleen Singh
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thailand Public Health Research Fellowship, Health Education England, London, UK
| | - Akarathep Leewongworasingh
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Phandee Watanaboonyongcharoen
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University and Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Taweewun Hunsawong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Aaron R Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Terapong Tantawichien
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nattachai Srisawat
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Critical Care Medicine, Center for Critical Care Nephrology, The CRISMA Center, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand
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10
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Raza S, Poria R, Kala D, Sharma N, Sharma AK, Florien N, Tuli HS, Kaushal A, Gupta S. Innovations in dengue virus detection: An overview of conventional and electrochemical biosensor approaches. Biotechnol Appl Biochem 2024; 71:481-500. [PMID: 38225854 DOI: 10.1002/bab.2553] [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] [Received: 05/22/2023] [Accepted: 12/27/2023] [Indexed: 01/17/2024]
Abstract
Globally, people are in great threat due to the highly spreading of viral infectious diseases. Every year like 100-300 million cases of infections are found, and among them, above 80% are not recognized and irrelevant. Dengue virus (DENV) is an arbovirus infection that currently infects people most frequently. DENV encompasses four viral serotypes, and they each express comparable sign. From a mild febrile sickness to a potentially fatal dengue hemorrhagic fever, dengue can induce a variety of symptoms. Presently, the globe is being challenged by the untimely identification of dengue infection. Therefore, this review summarizes advances in the detection of dengue from conventional methods (nucleic acid-based, polymerase chain reaction-based, and serological approaches) to novel biosensors. This work illustrates an extensive study of the current designs and fabrication approaches involved in the formation of electrochemical biosensors for untimely identifications of dengue. Additionally, in electrochemical sensing of DENV, we skimmed through significances of biorecognition molecules like lectins, nucleic acid, and antibodies. The introduction of emerging techniques such as the CRISPR/Cas' system and their integration with biosensing platforms has also been summarized. Furthermore, the review revealed the importance of electrochemical approach compared with traditional diagnostic methods.
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Affiliation(s)
- Shadan Raza
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Renu Poria
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Deepak Kala
- Centera Laboratories, Institute of High Pressure Physics PAS, Warsaw, Poland
| | - Nishant Sharma
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Anil K Sharma
- Department of Biotechnology, Amity University of Punjab, Mohali, Punjab, India
| | - Nkurunziza Florien
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Hardeep S Tuli
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Ankur Kaushal
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
| | - Shagun Gupta
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar (Deemed to Be) University, Mullana, Ambala, India
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11
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T AM, Singh B, Rupali P. Central nervous system infections in the tropics. Curr Opin Infect Dis 2024; 37:201-210. [PMID: 38529912 DOI: 10.1097/qco.0000000000001015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Emerging and re-emerging central nervous system (CNS) infections are a major public health concern in the tropics. The reasons for this are myriad; climate change, rainfall, deforestation, increased vector density combined with poverty, poor sanitation and hygiene. This review focuses on pathogens, which have emerged and re-emerged, with the potential for significant morbidity and mortality. RECENT FINDINGS In recent years, multiple acute encephalitis outbreaks have been caused by Nipah virus, which carries a high case fatality. Arboviral infections, predominantly dengue, chikungunya and Zika are re-emerging increasingly especially in urban areas due to changing human habitats, vector behaviour and viral evolution. Scrub typhus, another vector borne disease caused by the bacterium Orientia tsutsugamushi , is being established as a leading cause of CNS infections in the tropics. SUMMARY A syndromic and epidemiological approach to CNS infections in the tropics is essential to plan appropriate diagnostic tests and management. Rapid diagnostic tests facilitate early diagnosis and thus help prompt initiation and focusing of therapy to prevent adverse outcomes. Vector control, cautious urbanization and deforestation, and reducing disturbance of ecosystems can help prevent spread of vector-borne diseases. Regional diagnostic and treatment approaches and specific vaccines are required to avert morbidity and mortality.
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Affiliation(s)
| | - Bhagteshwar Singh
- Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; Institute of Infection Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom; Department of Infectious Diseases
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College, Vellore, India
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12
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Gonzales Y Tucker RD, Addepalli A. Fever and Rash. Emerg Med Clin North Am 2024; 42:303-334. [PMID: 38641393 DOI: 10.1016/j.emc.2024.01.005] [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: 04/21/2024]
Abstract
Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses. A provisional diagnosis and immediate treatment with antimicrobials and supportive care are usually required prior to the return of confirmatory laboratory testing.
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Affiliation(s)
- Richard Diego Gonzales Y Tucker
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Emergency Medicine, Alameda Health System - Wilma Chan Highland Hospital, 1411 E 31st Street, Oakland, CA 94602, USA.
| | - Aravind Addepalli
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA
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13
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Vogels CBF, Hill V, Breban MI, Chaguza C, Paul LM, Sodeinde A, Taylor-Salmon E, Ott IM, Petrone ME, Dijk D, Jonges M, Welkers MRA, Locksmith T, Dong Y, Tarigopula N, Tekin O, Schmedes S, Bunch S, Cano N, Jaber R, Panzera C, Stryker I, Vergara J, Zimler R, Kopp E, Heberlein L, Herzog KS, Fauver JR, Morrison AM, Michael SF, Grubaugh ND. DengueSeq: a pan-serotype whole genome amplicon sequencing protocol for dengue virus. BMC Genomics 2024; 25:433. [PMID: 38693476 PMCID: PMC11062901 DOI: 10.1186/s12864-024-10350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/25/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND The increasing burden of dengue virus on public health due to more explosive and frequent outbreaks highlights the need for improved surveillance and control. Genomic surveillance of dengue virus not only provides important insights into the emergence and spread of genetically diverse serotypes and genotypes, but it is also critical to monitor the effectiveness of newly implemented control strategies. Here, we present DengueSeq, an amplicon sequencing protocol, which enables whole-genome sequencing of all four dengue virus serotypes. RESULTS We developed primer schemes for the four dengue virus serotypes, which can be combined into a pan-serotype approach. We validated both approaches using genetically diverse virus stocks and clinical specimens that contained a range of virus copies. High genome coverage (>95%) was achieved for all genotypes, except DENV2 (genotype VI) and DENV 4 (genotype IV) sylvatics, with similar performance of the serotype-specific and pan-serotype approaches. The limit of detection to reach 70% coverage was 10-100 RNA copies/μL for all four serotypes, which is similar to other commonly used primer schemes. DengueSeq facilitates the sequencing of samples without known serotypes, allows the detection of multiple serotypes in the same sample, and can be used with a variety of library prep kits and sequencing instruments. CONCLUSIONS DengueSeq was systematically evaluated with virus stocks and clinical specimens spanning the genetic diversity within each of the four dengue virus serotypes. The primer schemes can be plugged into existing amplicon sequencing workflows to facilitate the global need for expanded dengue virus genomic surveillance.
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Affiliation(s)
- Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA.
| | - Verity Hill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Mallery I Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA
| | - Lauren M Paul
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida, USA
| | - Afeez Sodeinde
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Emma Taylor-Salmon
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Isabel M Ott
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Mary E Petrone
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Sydney Institute for Infectious Diseases, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Dennis Dijk
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Marcel Jonges
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Matthijs R A Welkers
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Timothy Locksmith
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Yibo Dong
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Namratha Tarigopula
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Omer Tekin
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Sarah Schmedes
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, USA
| | - Sylvia Bunch
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Natalia Cano
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Rayah Jaber
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Charles Panzera
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Ian Stryker
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Julieta Vergara
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Rebecca Zimler
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA
| | - Edgar Kopp
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Lea Heberlein
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, USA
| | - Kaylee S Herzog
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Joseph R Fauver
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andrea M Morrison
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA
| | - Scott F Michael
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA.
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut, USA.
- Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut, USA.
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14
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Hoyos W, Hoyos K, Ruíz R. Using Computational Simulations Based on Fuzzy Cognitive Maps to Detect Dengue Complications. Diagnostics (Basel) 2024; 14:533. [PMID: 38473004 PMCID: PMC10931136 DOI: 10.3390/diagnostics14050533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 03/14/2024] Open
Abstract
Dengue remains a globally prevalent and potentially fatal disease, affecting millions of people worldwide each year. Early and accurate detection of dengue complications is crucial to improving clinical outcomes and reducing the burden on healthcare systems. In this study, we explore the use of computational simulations based on fuzzy cognitive maps (FCMs) to improve the detection of dengue complications. We propose an innovative approach that integrates clinical data into a computational model that mimics the decision-making process of a medical expert. Our method uses FCMs to model complexity and uncertainty in dengue. The model was evaluated in simulated scenarios with each of the dengue classifications. These maps allow us to represent and process vague and fuzzy information effectively, capturing relationships that often go unnoticed in conventional approaches. The results of the simulations show the potential of our approach to detecting dengue complications. This innovative strategy has the potential to transform the way clinical management of dengue is approached. This research is a starting point for further development of complication detection approaches for events of public health concern, such as dengue.
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Affiliation(s)
- William Hoyos
- Grupo de Investigación en Ingeniería Sostenible e Inteligente, Universidad Cooperativa de Colombia, Montería 230002, Colombia
- Grupo de Investigación en I+D+I en TIC, Universidad EAFIT, Medellín 050022, Colombia
| | - Kenia Hoyos
- Laboratorio Clínico Humano, Clínica Salud Social, Sincelejo 700001, Colombia;
| | - Rander Ruíz
- Grupo de Investigación Interdisciplinario del Bajo Cauca y Sur de Córdoba, Universidad de Antioquia, Campus Caucasia, Caucasia 052410, Colombia;
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15
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Mohindra R, K D, Kalyan M, Bora I, Soni RK, Suri V, Behera A, Saini N, Sharma V, Zohmangaihi D. The continuum of liver injury with severity of dengue fever: A retrospective observational study. J R Coll Physicians Edinb 2024; 54:7-13. [PMID: 38112152 DOI: 10.1177/14782715231216157] [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: 12/20/2023] Open
Abstract
BACKGROUND Dengue is a major international health concern prevalent in tropical and sub-tropical countries. There are a paucity of studies on the relationship of hepatic complications with inflammatory parameters in dengue infection. METHODS Single-centre observational study was conducted at the tertiary care centre in North India. Patients (>12 years) diagnosed with dengue infection between August and November 2021 were enrolled in the study. The frequency of hepatic derangements and their associations with inflammatory severity was analysed. RESULTS Based on the clinical symptoms, 170 patients were classified into three categories, namely, dengue fever, warning dengue and severe dengue. Higher incidence of liver dysfunction was observed in severe dengue patients with median values of aspartate aminotransferase (AST) (3051 U/L, p < 0.001), alanine aminotransferase (ALT) (1792 U/L, p = 0.009), alkaline phosphatase (172 U/L, p = 0.001), T.Bil (34.2 µmol/L, p < 0.001), albumin (30 g/L, <0.001), and gamma-glutamyl transferase (152 U/L, p < 0.001) along with inflammatory marker C-reactive protein (CRP) (43 mg/dL, p < 0.001) highly deranged, in comparison to patients with/without warning signs. Median levels of CRP were found to be positively and significantly correlated with the median levels of AST and ALT (p < 0.05, r = 0.99) in all three categories of dengue patients. Liver injury was noted in 107 (63%) of the cohort, and mixed type of liver injury involving both hepatocellular and cholestatic patterns was observed as the most common type of injury (n = 50, 29.4%). Liver injury correlated with the severity of dengue illness as about 85% of severe dengue patients had significant liver injury (p = 0.014). CONCLUSION In dengue patients, the association of the liver injury with inflammatory severity suggests that the mechanism of liver injury may be related to inflammatory response apart from the hepatotropic nature of the virus.
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Affiliation(s)
- Ritin Mohindra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divyashree K
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhur Kalyan
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ishani Bora
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Roop Kishore Soni
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Suri
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Behera
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neha Saini
- University Institute of Agricultural Sciences (UIAS), Chandigarh University, Gharuan, Mohali, India
| | - Vishal Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepy Zohmangaihi
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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16
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Lim HJ, Saha T, Ooi CW. Site-specific imprinting of dengue virus non-structural 1 antigen on a polydopamine-based sensing film for early detection and prognosis of dengue. Talanta 2024; 268:125376. [PMID: 37951180 DOI: 10.1016/j.talanta.2023.125376] [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] [Received: 07/13/2023] [Revised: 10/06/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
Serum levels of dengue virus (DENV) non-structural 1 (NS1) antigen can serve as a valuable prognostic indicator of severe dengue infections. A quartz crystal microbalance (QCM)-based biosensor with a biomimetic recognition element was designed to quantitatively detect DENV NS1 as an early disease biomarker. To mitigate the reliance on costly viral antigens during the molecular imprinting process, a synthetic peptide mimicking a DENV NS1 epitope was used as a surrogate template for the synthesis of an epitope-imprinted polydopamine (EMIPDA) sensing film on the biosensor surface. The maximal frequency shift for DENV NS1 was obtained with an EMIPDA film synthesised using 5 mg mL-1 of dopamine monomer and 0.5 mg mL-1 of peptide template. The EMIPDA-QCM biosensor achieved low detection and quantitation limits of 0.091 μg mL-1 and 0.436 μg mL-1, respectively, allowing acute-phase detection of dengue and prognosis of the disease progression. The EMIPDA-QCM biosensor exhibited remarkable selectivity with up to 68-fold larger frequency responses towards DENV NS1 compared to a major serum protein. The site-specific imprinting approach not only enhanced the biosensing performance but also enabled a 26-fold cost reduction for biosensor functionalisation, providing a cost-effective strategy for label-free biosensing of the dengue biomarker via the biopolymer film.
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Affiliation(s)
- Hui Jean Lim
- Department of Chemical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Tridib Saha
- Department of Electrical and Robotics Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Chien Wei Ooi
- Department of Chemical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; Tropical Medicine and Biology Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
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17
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B A Seixas J, Giovanni Luz K, Pinto Junior V. [Clinical Update on Diagnosis, Treatment and Prevention of Dengue]. ACTA MEDICA PORT 2024; 37:126-135. [PMID: 38309298 DOI: 10.20344/amp.20569] [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] [Received: 08/18/2023] [Accepted: 11/07/2023] [Indexed: 02/05/2024]
Abstract
Dengue is a vector-borne disease that has a significant impact on global public health. The vector mosquito belongs to the genus Aedes. Two species play a key role in human transmission: Ae. aegypti, which has adapted to the urban environment of highly populated areas in tropical and subtropical countries, leading to a dramatic increase in dengue cases over the years, and Ae. albopictus, which poses a potential threat to temperate climate countries due to its ability to adapt to colder climates. The disease is widespread across the world, posing a risk to nearly half of the world's population. Although most cases are asymptomatic, dengue causes a burden on healthcare systems and mainly affects the younger population. The disease is also spreading to temperate climate countries, thus becoming a global threat. Vector control measures and vaccine development have been the main prevention strategies, as there is still no effective treatment for the disease.
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Affiliation(s)
- Jorge B A Seixas
- Unidade de Ensino e Investigação de Clínica Tropical. Instituto de Higiene e Medicina Tropical. Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Kleber Giovanni Luz
- Departamento de Infectologia. Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte. Hospital Giselda Trigueiro. Rio Grande do Norte. Portugal
| | - Vitor Pinto Junior
- Clínica Universitária de Doenças Infeciosas. Faculdade de Medicina. Universidade de Lisboa. Portugal
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18
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Farrukh AM, Ganipineni VDP, Jindal U, Chaudhary A, Puar RK, Ghazarian K, Corrales VV, Alarcón SE, Remala K, Thota N, Vijayan S, Rathore SS. Unveiling the Dual Threat: Myocarditis in the Spectrum of Dengue Fever. Curr Probl Cardiol 2024; 49:102029. [PMID: 37567490 DOI: 10.1016/j.cpcardiol.2023.102029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
This meta-analysis aims to systematically review and analyze available studies on the association between myocarditis and dengue viral fever. A comprehensive literature search was carried out using several databases. Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size using random effect models. Besides, random effects models were used to calculate the overall pooled prevalence. Data from 26 articles (6622 dengue patients) showed that pooled estimate of myocarditis in dengue fever was 12.4% (95% CI, 8.41-17.08). Higher prevalence was seen in reports from Asia (15.2%) compared to that from Latin America (3.6%). Besides, the pooled prevalence of severity and mortality was 34% (95% CI, 20.49-49.04) and 26.44% (95% CI, 18.07-35.78) respectively. Significantly higher prevalence rates of severe disease in the pediatric population (52.4%) and studies with a higher percentage of females (52.1%) were also observed. However, higher mortality rates were seen in the adult population (34.8%) compared with the pediatric age group. Further, myocarditis in dengue patients was associated with increased risk of severity (RR = 2.44, 95% CI 1.007-5.93, P = 0.048) and mortality (RR = 19.41, 95% CI 7.19-52.38, P < 0.001) compared with dengue patients without myocarditis. No significant publication bias was evident in the meta-analysis. The findings highlight the clinical significance of early identification and management of myocarditis in patients with dengue fever.
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Affiliation(s)
| | | | - Urmi Jindal
- KJ Somaiya Medical College and Research Centre, Mumbai, Maharashtra, India
| | | | | | | | | | | | - Kavya Remala
- Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
| | - Naganath Thota
- Department of Internal Medicine, Baptist Memorial Hospital, Memphis, TN
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19
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Tejo AM, Hamasaki DT, Menezes LM, Ho YL. Severe dengue in the intensive care unit. JOURNAL OF INTENSIVE MEDICINE 2024; 4:16-33. [PMID: 38263966 PMCID: PMC10800775 DOI: 10.1016/j.jointm.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 01/25/2024]
Abstract
Dengue fever is considered the most prolific vector-borne disease in the world, with its transmission rate increasing more than eight times in the last two decades. While most cases present mild to moderate symptoms, 5% of patients can develop severe disease. Although the mechanisms are yet not fully comprehended, immune-mediated activation leading to excessive cytokine expression is suggested as a cause of the two main findings in critical patients: increased vascular permeability that may shock and thrombocytopenia, and coagulopathy that can induce hemorrhage. The risk factors of severe disease include previous infection by a different serotype, specific genotypes associated with more efficient replication, certain genetic polymorphisms, and comorbidities such as diabetes, obesity, and cardiovascular disease. The World Health Organization recommends careful monitoring and prompt hospitalization of patients with warning signs or propensity for severe disease to reduce mortality. This review aims to update the diagnosis and management of patients with severe dengue in the intensive care unit.
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Affiliation(s)
- Alexandre Mestre Tejo
- Intensive Care Unit, Department of Intensive Medicine of the Cancer Institute of the State of São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Debora Toshie Hamasaki
- Transfusion Medicine and Cell Therapy Department, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Letícia Mattos Menezes
- Intensive Care Unit of Infectious Disease Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Yeh-Li Ho
- Intensive Care Unit of Infectious Disease Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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20
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Qin T, Wu P, Zhang Q, Kang K, Ma Y, Wang J. A functionalized Sup35NM nanofibril-assisted oriented antibody capture in lateral flow immunoassay for sensitive detection of dengue type II NS1. Mikrochim Acta 2023; 191:39. [PMID: 38110765 DOI: 10.1007/s00604-023-06109-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/19/2023] [Indexed: 12/20/2023]
Abstract
Rapid and sensitive dengue non-structural protein 1 (NS1) detection assay is essential for the treatment of disease and currently releases high medical cost burdens. To address the limitations of conventional LFIA strips, we have developed an improved Sup35NM-Z-based LFIA that immobilizes antibodies on cellulose membranes in an orientated manner to increase the sensitivity of LFIA strips. A dual-functional Sup35NM nanofibril was fabricated by fusion with the antibody binding domain; resultant nanofibril from the amyloid Sup35NM was sprayed on the T-line to orientate the capture antibody and produces fluorescence signals. Antibody binding analysis showed that self-assembly of the Sup35NM monomer does not affect the binding activity of the Z-domain with the antibody. The NS1 for DENV-2 infection was chosen as a model target antigen to assess the feasibility of the Sup35NM-Z-domain-based LFIA platform. Under optimal conditions, the Sup35NM-Z-domain-based LFIA detected NS1 within 15 min with a detection limit of 1.29 ng/ml, while the detection limit of traditional LFIA with the same concentration of anti-NS1-Ab1 on the T-line by conventional physical adsorption was 2.20 ng/ml, 1.7 times higher than that of Sup35NM-Z-domain-based LFIA. As compared to traditional LFIAs, the Sup35NM-Z-based LFIA had a wide detection range of 1.29-625 ng/mL. The LFIA's clinical performance in identifying NS1 was also assessed using 15 clinical samples. The LFIA accurately recognized positive and negative samples, equal to 86.7% accuracy. The developed Sup35NM-Z-domain-based LFIA in this study offers great potential for the identification of target markers because of its greatly improved sensitivity and wider detection range.
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Affiliation(s)
- Ting Qin
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Peidian Wu
- National Engineering Laboratory of Rapid Diagnostic Tests, Guangzhou Wondfo Biotech Co., Ltd., Guangzhou, 510663, China
| | - Qiankun Zhang
- National Engineering Laboratory of Rapid Diagnostic Tests, Guangzhou Wondfo Biotech Co., Ltd., Guangzhou, 510663, China
| | - Keren Kang
- National Engineering Laboratory of Rapid Diagnostic Tests, Guangzhou Wondfo Biotech Co., Ltd., Guangzhou, 510663, China
| | - Yi Ma
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
- Guangdong Provincial Key Laboratory of Fermentation and Enzyme Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Jufang Wang
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China.
- Guangdong Provincial Key Laboratory of Fermentation and Enzyme Engineering, South China University of Technology, Guangzhou, 510006, China.
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21
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Puccioni-Sohler M, Nascimento Soares C, Christo PP, Almeida SMD. Review of dengue, zika and chikungunya infections in nervous system in endemic areas. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1112-1124. [PMID: 38157877 PMCID: PMC10756841 DOI: 10.1055/s-0043-1777104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/15/2023] [Indexed: 01/03/2024]
Abstract
Dengue, zika, and chikungunya are arboviruses of great epidemiological relevance worldwide. The emergence and re-emergence of viral infections transmitted by mosquitoes constitute a serious human public health problem. The neurological manifestations caused by these viruses have a high potential for death or sequelae. The complications that occur in the nervous system associated with arboviruses can be a challenge for diagnosis and treatment. In endemic areas, suspected cases should include acute encephalitis, myelitis, encephalomyelitis, polyradiculoneuritis, and/or other syndromes of the central or peripheral nervous system, in the absence of a known explanation. The confirmation diagnosis is based on viral (isolation or RT-PCR) or antigens detection in tissues, blood, cerebrospinal fluid, or other body fluids, increase in IgG antibody titers between paired serum samples, specific IgM antibody in cerebrospinal fluid and serological conversion to IgM between paired serum samples (non-reactive in the acute phase and reactive in the convalescent). The cerebrospinal fluid examination can demonstrate: 1. etiological agent; 2. inflammatory reaction or protein-cytological dissociation depending on the neurological condition; 3. specific IgM, 4. intrathecal synthesis of specific IgG (dengue and chikungunya); 5. exclusion of other infectious agents. The treatment of neurological complications aims to improve the symptoms, while the vaccine represents the great hope for the control and prevention of neuroinvasive arboviruses. This narrative review summarizes the updated epidemiology, general features, neuropathogenesis, and neurological manifestations associated with dengue, zika, and chikungunya infection.
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Affiliation(s)
- Marzia Puccioni-Sohler
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Departamento de Medicina Geral, Rio de Janeiro RJ, Brazil.
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brazil.
| | | | - Paulo Pereira Christo
- Santa Casa BH, Faculdade de Saúde, Programa de Pós-Graduação Stricto Sensu em Medicina-Biomedicina, Belo Horizonte MG, Brazil.
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Neurologia, Belo Horizonte MG, Brazil.
| | - Sérgio Monteiro de Almeida
- Universidade Federal do Paraná, Faculdade de Medicina, Departamento de Patologia Médica, Curitiba PR, Brazil.
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22
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Wang K, Lu H, Zou M, Wang G, Zhao J, Huang X, Ren F, Hu H, Huang J, Min X. DegS protease regulates antioxidant capacity and adaptability to oxidative stress environment in Vibrio cholerae. Front Cell Infect Microbiol 2023; 13:1290508. [PMID: 38053530 PMCID: PMC10694293 DOI: 10.3389/fcimb.2023.1290508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Adaptation to oxidative stress is critical for survival of Vibrio cholerae in aquatic ecosystems and hosts. DegS activates the σE envelope stress response. We have previously revealed that DegS may be involved in regulating the oxidative stress response. In this study, we demonstrated that deletion of the degS gene attenuates the antioxidant capacity of V. cholerae. In addition, our results further revealed that the regulation of antioxidant capacity by DegS in V. cholerae could involve the cAMP-CRP complex, which regulates rpoS. XthA is an exonuclease that repairs oxidatively damaged cells and affects the bacterial antioxidant capacity. qRT-PCR showed that DegS, σE, cAMP, CRP, and RpoS positively regulate xthA gene transcription. XthA overexpression partially compensates for antioxidant deficiency in the degS mutant. These results suggest that DegS affects the antioxidant capacity of V.cholerae by regulating xthA expression via the cAMP-CRP-RpoS pathway. In a mouse intestinal colonization experiment, our data showed that V.cholerae degS, rpoE, and rpoS gene deletions were associated with significantly reduced resistance to oxidative stress and the ability to colonize the mouse intestine. In conclusion, these findings provide new insights into the regulation of antioxidant activity by V.cholerae DegS.
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Affiliation(s)
- Kaiying Wang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Huifang Lu
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Mei Zou
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Guangli Wang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiajun Zhao
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiaoyu Huang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Fangyu Ren
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Huaqin Hu
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jian Huang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xun Min
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China
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23
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Mustafa UK, Sauli E, Brinkel J, Kreppel KS. Health professionals' knowledge on dengue and health facility preparedness for case detection: A cross-sectional study in Dar es Salaam, Tanzania. PLoS Negl Trop Dis 2023; 17:e0011761. [PMID: 37988330 PMCID: PMC10662763 DOI: 10.1371/journal.pntd.0011761] [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: 05/05/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
Dengue presents a growing public health concern in the Dar es Salaam region of Tanzania, marked by the recurring incidence of outbreaks. Unfortunately, there is little information available on the region's preparedness in terms of health care workers' knowledge on dengue as well as the availability of reagents and equipment essential for diagnosing and monitoring of dengue infections. To elucidate this, 78 health facilities were visited in Temeke district and structured questionnaires were distributed to 324 health care workers. The aim was to evaluate health care workers' knowledge on dengue and to assess the availability of reagents and equipment essential for diagnosing and monitoring of dengue infections. Content validity of the questionnaire was achieved through extensive literature review and it exhibited high reliability (Cronbach Alpha coefficient = 0.813). Cumulative scores for responses on knowledge questions by health care workers were computed. Characteristics such as level of education, place of work and gender were tested for association with these scores using chi-square tests and logistics regression. Almost all health care workers (99.7%) were aware of dengue disease. However, less than half (46.9%) had knowledge scores of or over 40%. Clinicians had approximately four times higher knowledge scores than other cadres (AOR, 3.637; p-value≤ 0.0001), and those who worked in private facilities had twice the knowledge score than those working in government institutions (AOR, 2.071; p-value = 0.007). Only 8.6%, 35.6% and 14.7% of respondents reported the availability of dengue rapid tests, medical guidelines and refresher training respectively, showing a lack of health facilities readiness for the detection of dengue infections. Based on findings from this study, we recommend government authorities to build capacity of health care workers, to improve their understanding of dengue. We also urge the government and stakeholders to work together to ensure availability of diagnostic tests and other tools needed for diagnosis and surveillance of dengue.
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Affiliation(s)
- Ummul-khair Mustafa
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Elingarami Sauli
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Johanna Brinkel
- Department of Infectious Disease Epidemiology, Bernhard Nocht lnstitute for Tropical Medicine, Hamburg, Germany
| | - Katharina Sophia Kreppel
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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24
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Vogels CB, Hill V, Breban MI, Chaguza C, Paul LM, Sodeinde A, Taylor-Salmon E, Ott IM, Petrone ME, Dijk D, Jonges M, Welkers MR, Locksmith T, Dong Y, Tarigopula N, Tekin O, Schmedes S, Bunch S, Cano N, Jaber R, Panzera C, Stryker I, Vergara J, Zimler R, Kopp E, Heberlein L, Morrison AM, Michael SF, Grubaugh ND. DengueSeq: A pan-serotype whole genome amplicon sequencing protocol for dengue virus. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.13.23296997. [PMID: 37873191 PMCID: PMC10592998 DOI: 10.1101/2023.10.13.23296997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Background The increasing burden of dengue virus on public health due to more explosive and frequent outbreaks highlights the need for improved surveillance and control. Genomic surveillance of dengue virus not only provides important insights into the emergence and spread of genetically diverse serotypes and genotypes, but it is also critical to monitor the effectiveness of newly implemented control strategies. Here, we present DengueSeq, an amplicon sequencing protocol, which enables whole-genome sequencing of all four dengue virus serotypes. Results We developed primer schemes for the four dengue virus serotypes, which can be combined into a pan-serotype approach. We validated both approaches using genetically diverse virus stocks and clinical specimens that contained a range of virus copies. High genome coverage (>95%) was achieved for all genotypes, except DENV2 (genotype VI) and DENV 4 (genotype IV) sylvatics, with similar performance of the serotype-specific and pan-serotype approaches. The limit of detection to reach 70% coverage was 101-102 RNA copies/μL for all four serotypes, which is similar to other commonly used primer schemes. DengueSeq facilitates the sequencing of samples without known serotypes, allows the detection of multiple serotypes in the same sample, and can be used with a variety of library prep kits and sequencing instruments. Conclusions DengueSeq was systematically evaluated with virus stocks and clinical specimens spanning the genetic diversity within each of the four dengue virus serotypes. The primer schemes can be plugged into existing amplicon sequencing workflows to facilitate the global need for expanded dengue virus genomic surveillance.
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Affiliation(s)
- Chantal B.F. Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
| | - Verity Hill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Mallery I. Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
| | - Lauren M. Paul
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida, United States of America
| | - Afeez Sodeinde
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Emma Taylor-Salmon
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Isabel M. Ott
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Mary E. Petrone
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Sydney Institute for Infectious Diseases, School of Medical Sciences, University of Sydney, NSW, Australia
| | - Dennis Dijk
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC location AMC, Amsterdam, The Netherlands
| | - Marcel Jonges
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC location AMC, Amsterdam, The Netherlands
| | - Matthijs R.A. Welkers
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC location AMC, Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Timothy Locksmith
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Yibo Dong
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, United States of America
| | - Namratha Tarigopula
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, United States of America
| | - Omer Tekin
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, United States of America
| | - Sarah Schmedes
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Jacksonville, FL, United States of America
| | - Sylvia Bunch
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Natalia Cano
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Rayah Jaber
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Charles Panzera
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Ian Stryker
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Julieta Vergara
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Rebecca Zimler
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, United States of America
| | - Edgar Kopp
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Lea Heberlein
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, FL, United States of America
| | - Andrea M. Morrison
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, United States of America
| | - Scott F. Michael
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida, United States of America
| | - Nathan D. Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut, United States of America
- Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut, United States of America
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25
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Calderon-Ruiz P, Haist G, Mascus A, Holguin-Rocha AF, Koliopoulos P, Daniel T, Velez G, Londono-Renteria B, Gröndahl B, Tobon-Castano A, Gehring S. Multiplex Reverse Transcription Polymerase Chain Reaction Combined with a Microwell Hybridization Assay Screening for Arbovirus and Parasitic Infections in Febrile Patients Living in Endemic Regions of Colombia. Trop Med Infect Dis 2023; 8:466. [PMID: 37888594 PMCID: PMC10610613 DOI: 10.3390/tropicalmed8100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Acute febrile syndrome is a frequent reason for medical consultations in tropical and subtropical countries where the cause could have an infectious origin. Malaria and dengue are the primary etiologies in Colombia. As such, constant epidemiological surveillance and new diagnostic tools are required to identify the causative agents. A descriptive cross-sectional study was conducted to evaluate the circulation and differential diagnosis of six pathogens in two regions of Colombia. The results obtained via multiplex reverse transcription polymerase chain reaction combined with a microwell hybridization assay (m-RT-PCR-ELISA) were comparable to those obtained using rapid tests conducted at the time of patient enrollment. Of 155 patients evaluated, 25 (16.1%) and 16 (10.3%) were positive for malaria and dengue, respectively; no samples were positive for any of the other infectious agents tested. In most cases, m-RT-PCR-ELISA confirmed the results previously obtained through rapid testing.
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Affiliation(s)
- Paula Calderon-Ruiz
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
- Malaria Group, Lab 610, Faculty of Medicine, University of Antioquia, Medellin 050010, Colombia; (G.V.); (A.T.-C.)
| | - Gregor Haist
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
| | - Annina Mascus
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
| | - Andres F. Holguin-Rocha
- Department of Entomology, College of Agriculture, Kansas State University, Manhattan, KS 66506, USA;
| | - Philip Koliopoulos
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
| | - Tim Daniel
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
| | - Gabriel Velez
- Malaria Group, Lab 610, Faculty of Medicine, University of Antioquia, Medellin 050010, Colombia; (G.V.); (A.T.-C.)
| | - Berlin Londono-Renteria
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Britta Gröndahl
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
| | - Alberto Tobon-Castano
- Malaria Group, Lab 610, Faculty of Medicine, University of Antioquia, Medellin 050010, Colombia; (G.V.); (A.T.-C.)
| | - Stephan Gehring
- Center of Pediatric and Adolescent Medicine, University Medical Center, 55131 Mainz, Germany; (G.H.); (A.M.); (P.K.); (T.D.); (B.G.); (S.G.)
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26
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Tan H, Zhang S, Tan W, Hu T, He Y, Wu Z, Wang M, Jia R, Zhu D, Liu M, Zhao X, Yang Q, Wu Y, Zhang S, Huang J, Ou X, Gao Q, Sun D, Cheng A, Chen S. Linear epitope identification of monoclonal antibodies against the duck Tembusu virus NS1. Poult Sci 2023; 102:102926. [PMID: 37499611 PMCID: PMC10413195 DOI: 10.1016/j.psj.2023.102926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/25/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
Since 2010, the duck Tembusu virus (DTMUV) has caused a severe outbreak of egg drop syndrome in laying ducks in China, which has resulted in substantial financial losses in the poultry industry. DTMUV nonstructural protein 1 (NS1), as the only secreted protein, could aid in the development of therapeutic antibodies and diagnostic techniques; however, there are few studies on the preparation and epitope identification of monoclonal antibodies (mAbs) against DTMUV NS1. In this study, by indirect enzyme-linked immunosorbent assay (ELISA), Western blotting, and indirect immunofluorescence assay, we screened 6 mAbs (8A4, 8E6, 10F12, 1H11, 3D5, 5C11) that could specifically recognize DTMUV NS1. For epitope mapping of mAbs, a series of GST-tagged truncated fusion proteins of DTMUV NS1 were constructed by prokaryotic expression. Finally, the 4 shortest linear epitopes were identified by indirect ELISA and Western blotting. The epitope 133FVIDGPK139 was recognized by 8A4, the epitope 243IPKTLGGP250 was recognized by 8E6, the epitope 267PWDEK271 was recognized by 10F12, and 156EDFGFGVL163 was recognized by 1H11, 3D5, and 5C11. By sequence alignment and cross-reaction tests, we found that 8A4 and 8E6 had high specificity for DTMUV NS1 compared with that of other mAbs, but 10F12, 1H11, 3D5, and 5C11 exhibited a clear degree of cross-reaction with dengue virus (DENV), Japanese encephalitis virus (JEV), West Nile virus (WNV), and Zika virus (ZIKV) NS1. Finally, the predicted crystal structure analysis showed the approximate spatial positions of the 4 epitopes on the NS1 dimer. In summary, our study revealed 2 specific mAbs for DTMUV NS1 recognition and 4 multiflavivirus mAbs for DENV, JEV, WNV, and ZIKV NS1 recognition.
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Affiliation(s)
- Hantai Tan
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Senzhao Zhang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Wangyang Tan
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Tao Hu
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Yu He
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Zhen Wu
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Mingshu Wang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Renyong Jia
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Dekang Zhu
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Mafeng Liu
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Xinxin Zhao
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Qiao Yang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Ying Wu
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Shaqiu Zhang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Juan Huang
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Xumin Ou
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Qun Gao
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Di Sun
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Anchun Cheng
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China
| | - Shun Chen
- Institute of Preventive Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Research Center of Avian Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, China; Engineering Research Center of Southwest Animal Disease Prevention and Control Technology, Ministry of Education of the People's Republic of China, Chengdu 611130, China; Key Laboratory of Animal Disease and Human Health of Sichuan Province, Sichuan Agricultural University, Chengdu, Sichuan 611130, China.
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Khan MB, Yang ZS, Lin CY, Hsu MC, Urbina AN, Assavalapsakul W, Wang WH, Chen YH, Wang SF. Dengue overview: An updated systemic review. J Infect Public Health 2023; 16:1625-1642. [PMID: 37595484 DOI: 10.1016/j.jiph.2023.08.001] [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] [Received: 03/30/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023] Open
Abstract
Dengue is caused by the dengue virus (DENVs) infection and clinical manifestations include dengue fever (DF), dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS). Due to a lack of antiviral drugs and effective vaccines, several therapeutic and control strategies have been proposed. A systemic literature review was conducted according to PRISMA guidelines to select proper references to give an overview of DENV infection. Results indicate that understanding the virus characteristics and epidemiology are essential to gain the basic and clinical knowledge as well as dengue disseminated pattern and status. Different factors and mechanisms are thought to be involved in the presentation of DHF and DSS, including antibody-dependent enhancement, immune dysregulation, viral virulence, host genetic susceptibility, and preexisting dengue antibodies. This study suggests that dissecting pathogenesis and risk factors as well as developing different types of therapeutic and control strategies against DENV infection are urgently needed.
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Affiliation(s)
- Muhammad Bilal Khan
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Zih-Syuan Yang
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Yen Lin
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ming-Cheng Hsu
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Aspiro Nayim Urbina
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wanchai Assavalapsakul
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Wen-Hung Wang
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan
| | - Yen-Hsu Chen
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan; Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Sheng-Fan Wang
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
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28
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Pereira SS, Andreata-Santos R, de Castro-Amarante MF, Venceslau-Carvalho AA, Sales NS, Silva MDO, Alves RPDS, Jungmann P, Ferreira LCDS. Multi-epitope Antigen for Specific Serological Detection of Dengue Viruses. Viruses 2023; 15:1936. [PMID: 37766342 PMCID: PMC10535193 DOI: 10.3390/v15091936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Dengue is an infectious disease of global health concern that continues to require surveillance. Serological testing has been used to investigate dengue-infected patients, but specificity is affected by the co-circulation of ZIKA virus (ZIKV), which shares extensive antigen similarities. The goal of this study was the development of a specific dengue virus (DENV) IgG ELISA based on a multi-epitope NS1-based antigen for antibody detection. The multi-epitope protein (T-ΔNS1), derived from a fragment of the NS1-protein of the four DENV serotypes, was expressed in Escherichia coli and purified via affinity chromatography. The antigenicity and specificity were evaluated with sera of mice infected with DENV-1-4 or ZIKV or after immunization with the recombinant ΔNS1 proteins. The performance of the T-ΔNS1-based IgG ELISA was also determined with human serum samples. The results demonstrate that the DENV T-ΔNS1 was specifically recognized by the serum IgG of dengue-infected mice or humans but showed no or reduced reactivity with ZIKV-infected subjects. Based on the available set of clinical samples, the ELISA based on the DENV T-ΔNS1 achieved 77.42% sensitivity and 88.57% specificity. The results indicate that the T-ΔNS1 antigen is a promising candidate for the development of specific serological analysis.
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Affiliation(s)
- Samuel Santos Pereira
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
| | - Robert Andreata-Santos
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
| | - Maria Fernanda de Castro-Amarante
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
- Institut Pasteur de São Paulo, São Paulo 05508-020, Brazil
| | - Aléxia Adrianne Venceslau-Carvalho
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
- Institut Pasteur de São Paulo, São Paulo 05508-020, Brazil
| | - Natiely Silva Sales
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
| | - Mariângela de Oliveira Silva
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
| | - Rúbens Prince dos Santos Alves
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
| | - Patrícia Jungmann
- General Pathology, Universidade de Pernambuco, Recife 50100-130, Brazil;
| | - Luís Carlos de Souza Ferreira
- Laboratory of Vaccine Development, Institute of Biomedical Sciences, Department of Microbiology, University of São Paulo, São Paulo 05508-000, Brazil; (S.S.P.); (R.A.-S.); (M.F.d.C.-A.); (A.A.V.-C.); (N.S.S.); (M.d.O.S.); (R.P.d.S.A.)
- Institut Pasteur de São Paulo, São Paulo 05508-020, Brazil
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Chen PK, Chang JH, Ke LY, Kao JK, Chen CH, Yang RC, Yoshimura T, Ito E, Tsai JJ. Advanced Detection Method for Dengue NS1 Protein Using Ultrasensitive ELISA with Thio-NAD Cycling. Viruses 2023; 15:1894. [PMID: 37766300 PMCID: PMC10534902 DOI: 10.3390/v15091894] [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] [Received: 08/11/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Dengue fever, a mosquito-borne disease in tropical and subtropical climates caused by the dengue virus (DENV), has become a major social and economic burden in recent years. However, current primary detection methods are inadequate for early diagnosis of DENV because they are either time-consuming, expensive, or require training. Non-structural protein 1 (NS1) is secreted during DENV infection and is thus considered a suitable biomarker for the development of an early detection method. In the present study, we developed a detection method for the NS1 protein based on a previously reported thio-NAD cycling ELISA (i.e., ultrasensitive ELISA) and successfully achieved a LOD of 1.152 pg/mL. The clinical diagnosis potential of the detection system was also evaluated by using 85 patient specimens, inclusive of 60 DENV-positive and 25 DENV-negative specimens confirmed by the NAAT method. The results revealed 98.3% (59/60) sensitivity and 100% (25/25) specificity, which was in almost perfect agreement with the NAAT data with a kappa coefficient of 0.972. The present study demonstrates the diagnostic potential of using an ultrasensitive ELISA as a low-cost, easy-to-use method for the detection of DENV compared with NAAT and could be of great benefit in low-income countries.
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Affiliation(s)
- Po-Kai Chen
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (P.-K.C.); (J.-H.C.)
| | - Jyun-Hao Chang
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (P.-K.C.); (J.-H.C.)
| | - Liang-Yin Ke
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Jun-Kai Kao
- Frontier Molecular Medical Research Center in Children, Changhua Christian Children’s Hospital, Changhua 50006, Taiwan; (J.-K.K.); (R.-C.Y.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402204, Taiwan;
| | - Chang-Hua Chen
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402204, Taiwan;
- Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Rei-Cheng Yang
- Frontier Molecular Medical Research Center in Children, Changhua Christian Children’s Hospital, Changhua 50006, Taiwan; (J.-K.K.); (R.-C.Y.)
- Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
| | - Teruki Yoshimura
- School of Pharmaceutical Sciences, Health Science University of Hokkaido, Hokkaido 061-0293, Japan;
| | - Etsuro Ito
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (P.-K.C.); (J.-H.C.)
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
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Siahaan AMP, Tandean S, Nainggolan BWM, Tarigan J, Sitanggang JS. A Critical Analysis of Intracranial Hemorrhage as a Fatal Complication of Dengue Fever. J Korean Neurosurg Soc 2023; 66:494-502. [PMID: 36642946 PMCID: PMC10483153 DOI: 10.3340/jkns.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/21/2022] [Accepted: 01/12/2023] [Indexed: 01/17/2023] Open
Abstract
Dengue fever is the most rapidly spreading mosquito-borne virus in the world, infecting about 100 million individuals. A rare but possibly dangerous consequence of dengue illness is intracranial hemorrhage (ICH). Currently, the pathogenesis of ICH is unknown. A number of studies have found a variety of risk factors for ICH in dengue. In addition, studies have reported the use of emergency surgery while monitoring thrombocytopenia in the therapy of dengue ICH. This review enumerates the potential predictors of ICH in dengue, discusses the use of brain imaging, and mentions the possibility of emergency surgery.
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Affiliation(s)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Junita Tarigan
- Division of Infection and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Johan Samuel Sitanggang
- Undergraduate Program in Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Arkell P, Mairiang D, Songjaeng A, Malpartida-Cardenas K, Hill-Cawthorne K, Avirutnan P, Georgiou P, Holmes A, Rodriguez-Manzano J. Analytical and diagnostic performance characteristics of reverse-transcriptase loop-mediated isothermal amplification assays for dengue virus serotypes 1-4: A scoping review to inform potential use in portable molecular diagnostic devices. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002169. [PMID: 37552632 PMCID: PMC10409275 DOI: 10.1371/journal.pgph.0002169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 08/10/2023]
Abstract
Dengue is a mosquito-borne disease caused by dengue virus (DENV) serotypes 1-4 which affects 100-400 million adults and children each year. Reverse-transcriptase (RT) quantitative polymerase chain reaction (qPCR) assays are the current gold-standard in diagnosis and serotyping of infections, but their use in low-middle income countries (LMICs) has been limited by laboratory infrastructure requirements. Loop-mediated isothermal amplification (LAMP) assays do not require thermocycling equipment and therefore could potentially be deployed outside laboratories and/or miniaturised. This scoping literature review aimed to describe the analytical and diagnostic performance characteristics of previously developed serotype-specific dengue RT-LAMP assays and evaluate potential for use in portable molecular diagnostic devices. A literature search in Medline was conducted. Studies were included if they were listed before 4th May 2022 (no prior time limit set) and described the development of any serotype-specific DENV RT-LAMP assay ('original assays') or described the further evaluation, adaption or implementation of these assays. Technical features, analytical and diagnostic performance characteristics were collected for each assay. Eight original assays were identified. These were heterogenous in design and reporting. Assays' lower limit of detection (LLOD) and linear range of quantification were comparable to RT-qPCR (with lowest reported values 2.2x101 and 1.98x102 copies/ml, respectively, for studies which quantified target RNA copies) and analytical specificity was high. When evaluated, diagnostic performance was also high, though reference diagnostic criteria varied widely, prohibiting comparison between assays. Fourteen studies using previously described assays were identified, including those where reagents were lyophilised or 'printed' into microfluidic channels and where several novel detection methods were used. Serotype-specific DENV RT-LAMP assays are high-performing and have potential to be used in portable molecular diagnostic devices if they can be integrated with sample extraction and detection methods. Standardised reporting of assay validation and diagnostic accuracy studies would be beneficial.
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Affiliation(s)
- Paul Arkell
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Dumrong Mairiang
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens (SiCORE-Dengue), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Bangkok, Thailand
| | - Adisak Songjaeng
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens (SiCORE-Dengue), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kenny Malpartida-Cardenas
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Kerri Hill-Cawthorne
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Panisadee Avirutnan
- Siriraj Center of Research Excellence in Dengue and Emerging Pathogens (SiCORE-Dengue), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Bangkok, Thailand
- Division of Dengue Hemorrhagic Fever Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pantelis Georgiou
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
- Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
| | - Alison Holmes
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
- David Price Evans Global Health and Infectious Disease Research Group, University of Liverpool, Liverpool, United Kingdom
| | - Jesus Rodriguez-Manzano
- Centre for Antimicrobial Optimisation, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, United Kingdom
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Zhang Y, Wang L, Wang G, Xu J, Zhang T. An ecological assessment of the potential pandemic threat of Dengue Virus in Zhejiang province of China. BMC Infect Dis 2023; 23:473. [PMID: 37461015 DOI: 10.1186/s12879-023-08444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND AIM Dengue fever, transmitted by Aedes mosquitoes, is a significant public health concern in tropical and subtropical regions. With the end of the COVID-19 pandemic and the reopening of the borders, dengue fever remains a threat to mainland China, Zhejiang province of China is facing a huge risk of importing the dengue virus. This study aims to analyze and predict the current and future potential risk regions for Aedes vectors distribution and dengue prevalence in Zhejiang province of China. METHOD We collected occurrence records of DENV and DENV vectors globally from 2010 to 2022, along with historical and future climate data and human population density data. In order to predict the probability of DENV distribution in Zhejiang province of China under future conditions, the ecological niche of Ae. aegypti and Ae. albopictus was first performed with historical climate data based on MaxEnt. Then, predicted results along with a set of bioclimatic variables, elevation and human population density were included in MaxEnt model to analyze the risk region of DENV in Zhejiang province. Finally, the established model was utilized to predict the spatial pattern of DENV risk in the current and future scenarios in Zhejiang province of China. RESULTS Our findings indicated that approximately 89.2% (90,805.6 KM2) of Zhejiang province of China is under risk, within about 8.0% (8,144 KM2) classified as high risk area for DENV prevalence. Ae. albopictus were identified as the primary factor influencing the distribution of DENV. Future predictions suggest that sustainable and "green" development pathways may increase the risk of DENV prevalence in Zhejiang province of China. Conversely, Fossil-fueled development pathways may reduce the risk due to the unsuitable environment for vectors. CONCLUSIONS The implications of this research highlight the need for effective vector control measures, community engagement, health education, and environmental initiatives to mitigate the potential spread of dengue fever in high-risk regions of Zhejiang province of China.
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Affiliation(s)
- Yaxing Zhang
- Clinical Practice Teaching Center, Academic Affairs Office, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lei Wang
- College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Guozhen Wang
- College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Jiabao Xu
- College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Tianxing Zhang
- College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Soni S, Gill VJS, Anusheel, Singh J, Chhabra J, Gill GJS, Bakshi R. Dengue, Chikungunya, and Zika: The Causes and Threats of Emerging and Re-emerging Arboviral Diseases. Cureus 2023; 15:e41717. [PMID: 37575782 PMCID: PMC10422058 DOI: 10.7759/cureus.41717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
The recent emergence and re-emergence of viral infections transmitted by vectors, Zika, chikungunya, dengue, and others, is a cause for international concern. Here, we provide a summary of the current understanding of the transmission, clinical features, diagnosis, global burden, and the likelihood of future epidemics by these viruses. Arboviruses transmitted by mosquitoes are challenging to diagnose and can have surprising clinical complications. Dengue, chikungunya, and Zika are the most important diseases caused by arboviruses worldwide, especially in tropical and subtropical regions. These are transmitted to humans by day-biting Aedes aegypti and Aedes albopictus mosquitoes. In India, the increase in the incidence of dengue and chikungunya cases is primarily linked to the dissemination of Aedes aegypti. A rapid and accurate diagnosis is paramount for effectively controlling dengue outbreaks. As there is no vaccination or specific treatment available for these viruses, vector control is the only comprehensive solution available.
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Affiliation(s)
- Suha Soni
- Department of Public Health Sciences, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Anusheel
- Department of Internal Medicine, Shanti Gopal Hospital, Ghaziabad, IND
| | - Jugraj Singh
- Department of Internal Medicine, Punjab Institute of Medical Sciences, Jalandhar, IND
| | - Jayksh Chhabra
- Department of Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Gurparam Jeet Singh Gill
- Department of Otolaryngology, Head and Neck Surgery, Adesh Medical College and Hospital, Ambala, IND
| | - Rupinder Bakshi
- Department of Microbiology, Government Medical College, Patiala, IND
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Huits R, Angelo KM, Amatya B, Barkati S, Barnett ED, Bottieau E, Emetulu H, Epelboin L, Eperon G, Medebb L, Gobbi F, Grobusch MP, Itani O, Jordan S, Kelly P, Leder K, Díaz-Menéndez M, Okumura N, Rizwan A, Rothe C, Saio M, Waggoner J, Yoshimura Y, Libman M, Hamer DH, Schwartz E. Clinical Characteristics and Outcomes Among Travelers With Severe Dengue : A GeoSentinel Analysis. Ann Intern Med 2023; 176:940-948. [PMID: 37335991 PMCID: PMC10760980 DOI: 10.7326/m23-0721] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Dengue virus is a flavivirus transmitted by Aedes mosquitoes and is an important cause of illness worldwide. Data on the severity of travel-associated dengue illness are limited. OBJECTIVE To describe the epidemiology, clinical characteristics, and outcomes among international travelers with severe dengue or dengue with warning signs as defined by the 2009 World Health Organization classification (that is, complicated dengue). DESIGN Retrospective chart review and analysis of travelers with complicated dengue reported to GeoSentinel from January 2007 through July 2022. SETTING 20 of 71 international GeoSentinel sites. PATIENTS Returning travelers with complicated dengue. MEASUREMENTS Routinely collected surveillance data plus chart review with abstraction of clinical information using predefined grading criteria to characterize the manifestations of complicated dengue. RESULTS Of 5958 patients with dengue, 95 (2%) had complicated dengue. Eighty-six (91%) patients had a supplemental questionnaire completed. Eighty-five of 86 (99%) patients had warning signs, and 27 (31%) were classified as severe. Median age was 34 years (range, 8 to 91 years); 48 (56%) were female. Patients acquired dengue most frequently in the Caribbean (n = 27 [31%]) and Southeast Asia (n = 21 [24%]). Frequent reasons for travel were tourism (46%) and visiting friends and relatives (32%). Twenty-one of 84 (25%) patients had comorbidities. Seventy-eight (91%) patients were hospitalized. One patient died of nondengue-related illnesses. Common laboratory findings and signs were thrombocytopenia (78%), elevated aminotransferase (62%), bleeding (52%), and plasma leakage (20%). Among severe cases, ophthalmologic pathology (n = 3), severe liver disease (n = 3), myocarditis (n = 2), and neurologic symptoms (n = 2) were reported. Of 44 patients with serologic data, 32 confirmed cases were classified as primary dengue (IgM+/IgG-) and 12 as secondary (IgM-/IgG+) dengue. LIMITATIONS Data for some variables could not be retrieved by chart review for some patients. The generalizability of our observations may be limited. CONCLUSION Complicated dengue is relatively rare in travelers. Clinicians should monitor patients with dengue closely for warning signs that may indicate progression to severe disease. Risk factors for developing complications of dengue in travelers need further prospective study. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention, International Society of Travel Medicine, Public Health Agency of Canada, and GeoSentinel Foundation.
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Affiliation(s)
- Ralph Huits
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy (R.H.)
| | - Kristina M Angelo
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (K.M.A.)
| | - Bhawana Amatya
- CIWEC Hospital and Travel Medicine Center, Kathmandu, Nepal (B.A.)
| | - Sapha Barkati
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada (S.B.)
| | - Elizabeth D Barnett
- Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts (E.D.B., M.L.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (E.B.)
| | - Hannah Emetulu
- International Society of Travel Medicine, Atlanta, Georgia (H.E., A.R.)
| | - Loïc Epelboin
- Infectious and Tropical Diseases Unit and CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana (L.E.)
| | - Gilles Eperon
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland (G.E.)
| | - Line Medebb
- Aix Marseille University, AP-HM, IHU-Méditerranée Infection, Marseille, France (L.M.)
| | - Federico Gobbi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (F.G.)
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Center, Amsterdam, the Netherlands (M.P.G.)
| | - Oula Itani
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France (O.I.)
| | - Sabine Jordan
- Division of Tropical Medicine, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, and Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (S.J.)
| | - Paul Kelly
- BronxCare Hospital Center, Bronx, New York (P.K.)
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, and Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Victoria, Australia (K.L.)
| | - Marta Díaz-Menéndez
- Tropical Medicine Department, Hospital Universitario La Paz-Carlos III, IdIPAz, and CIBERINFECT, Madrid, Spain (M.D.)
| | - Nobumasa Okumura
- Center Hospital of the National Center for Global Health and Medicine, Shinjuku City, Tokyo, Japan (N.O.)
| | - Aisha Rizwan
- International Society of Travel Medicine, Atlanta, Georgia (H.E., A.R.)
| | - Camilla Rothe
- Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-Universität München, Munich, Germany (C.R.)
| | - Mauro Saio
- Doctor's Plaza, Nairobi Hospital, Nairobi, Kenya (M.S.)
| | - Jesse Waggoner
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia (J.W.)
| | | | - Michael Libman
- Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts (E.D.B., M.L.)
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Section of Infectious Diseases, Boston University School of Medicine, Center for Emerging Infectious Disease Policy and Research, Boston University, and National Emerging Infectious Disease Laboratory, Boston, Massachusetts (D.H.H.)
| | - Eli Schwartz
- The Center of Geographical Medicine and Tropical Diseases, Sheba Medical Center, Tel HaShomer, and Ramat Gan & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.S.)
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Hale GL. Flaviviruses and the Traveler: Around the World and to Your Stage. A Review of West Nile, Yellow Fever, Dengue, and Zika Viruses for the Practicing Pathologist. Mod Pathol 2023; 36:100188. [PMID: 37059228 DOI: 10.1016/j.modpat.2023.100188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/02/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
Flaviviruses are a genus of single-stranded RNA viruses that impose an important and growing burden to human health. There are over 3 billion individuals living in areas where flaviviruses are endemic. Flaviviruses and their arthropod vectors (which include mosquitoes and ticks) take advantage of global travel to expand their distribution and cause severe disease in humans, and they can be grouped according to their vector and pathogenicity. The mosquito-borne flaviviruses cause a spectrum of diseases from encephalitis to hepatitis and vascular shock syndrome, congenital abnormalities, and fetal death. Neurotropic infections such as Zika virus and West Nile virus cross the blood-brain barrier and infect neurons and other cells, leading to meningoencephalitis. In the hemorrhagic fever clade, there are yellow fever virus, the prototypical hemorrhagic fever virus that infects hepatocytes, and dengue virus, which infects cells of the reticuloendothelial system and can lead to a dramatic plasma cell leakage and shock syndrome. Zika virus also causes congenital infections and fetal death and is the first and only example of a teratogenic arbovirus in humans. Diagnostic testing for flaviviruses broadly includes the detection of viral RNA in serum (particularly within the first 10 days of symptoms), viral isolation by cell culture (rarely performed due to complexity and biosafety concerns), and histopathologic evaluation with immunohistochemistry and molecular testing on formalin-fixed paraffin-embedded tissue blocks. This review focuses on 4 mosquito-borne flaviviruses-West Nile, yellow fever, dengue, and Zika virus-and discusses the mechanisms of transmission, the role of travel in geographic distribution and epidemic emergence, and the clinical and histopathologic features of each. Finally, prevention strategies such as vector control and vaccination are discussed.
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Affiliation(s)
- Gillian L Hale
- Department of Pathology, University of Utah, Salt Lake City, Utah.
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Singh S, Alallah J, Amrit A, Maheshwari A, Boppana S. Neurological Manifestations of Perinatal Dengue. NEWBORN (CLARKSVILLE, MD.) 2023; 2:158-172. [PMID: 37559696 PMCID: PMC10411360 DOI: 10.5005/jp-journals-11002-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Dengue viruses (DENVs) are single-stranded RNA viruses belonging to the family Flaviviridae. There are four distinct antigenically related serotypes, DENVs types 1, 2, 3, and 4. These are all mosquito-borne human pathogens. Congenital dengue disease occurs when there is mother-to-fetus transmission of the virus and should be suspected in endemic regions in neonates presenting with fever, maculopapular rash, and thrombocytopenia. Although most of the infected infants remain asymptomatic, some can develop clinical manifestations such as sepsis-like illness, gastric bleeding, circulatory failure, and death. Neurological manifestations include intracerebral hemorrhages, neurological malformations, and acute focal/disseminated encephalitis/encephalomyelitis. Dengue NS1Ag, a highly conserved glycoprotein, can help the detection of cases in the viremic stage. We do not have proven specific therapies yet; management is largely supportive and is focused on close monitoring and maintaining adequate intravascular volume.
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Affiliation(s)
- Srijan Singh
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Jubara Alallah
- Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Astha Amrit
- Department of Neonatology, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Akhil Maheshwari
- Department of Pediatrics, Division of Neonatal Medicine, Louisiana State University – Shreveport, Shreveport, Louisiana; Global Newborn Society, Baltimore, Maryland, United States of America
| | - Suresh Boppana
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Tabassum S, Naeem A, Nazir A, Naeem F, Gill S, Tabassum S. Year-round dengue fever in Pakistan, highlighting the surge amidst ongoing flood havoc and the COVID-19 pandemic: a comprehensive review. Ann Med Surg (Lond) 2023; 85:908-912. [PMID: 37113909 PMCID: PMC10129218 DOI: 10.1097/ms9.0000000000000418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/12/2023] [Indexed: 04/29/2023] Open
Abstract
Dengue fever (DF) is an arthropod-borne viral infection caused by four serotypes of dengue virus (DENV 1-4) transmitted to the host by the vector mosquito Aedes, which causes fever, vomiting, headache, joint pain, muscle pain, and a distinctive itching and skin rash, ultimately leading to dengue hemorrhagic fever and dengue shock syndrome. The first case of DF in Pakistan was documented in 1994, but outbreak patterns began in 2005. As of 20 August 2022, Pakistan has 875 confirmed cases, raising alarming concerns. Misdiagnosis due to mutual symptoms, lack of an effective vaccine, the weakened and overburdened health system of Pakistan, irrational urbanization, climate change in Pakistan, insufficient waste management system, and a lack of awareness are the significant challenges Pakistan faces and result in recurrent dengue outbreaks every year. The recent flood in Pakistan has caused massive destruction, and stagnant dirty water has facilitated mosquito breeding. Sanitization and spraying, proper waste management, an adequate and advanced diagnostic system, control of population size, public awareness, and promotion of medical research and global collaboration, especially amidst flood devastation, are recommended to combat this deadly infection in Pakistan. This article aims to comprehensively review the year-round DF in Pakistan, highlighting the surge amidst ongoing flood havoc and the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Shehroze Tabassum
- King Edward Medical University, Lahore
- Corresponding author. Address: King Edward Medical University, Lahore 54000, Pakistan. Tel.: +92 333 1783344. E-mail address: (S. Tabassum)
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Ndiaye O, Woolston K, Gaye A, Loucoubar C, Cocozza M, Fall C, Dia F, Adams ER, Samb M, Camara D, Sadio BD, Diagne CT, Weidmann M, Faye O, Fitchett JRA, Sall AA, Diagne CT. Laboratory Evaluation and Field Testing of Dengue NS1 and IgM/IgG Rapid Diagnostic Tests in an Epidemic Context in Senegal. Viruses 2023; 15:v15040904. [PMID: 37112887 PMCID: PMC10143717 DOI: 10.3390/v15040904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
In Senegal, the burden of dengue is increasing and expanding. As case management and traditional diagnostic techniques can be difficult to implement, rapid diagnostic tests (RDTs) deployed at point of care are ideal for investigating active outbreaks. The aim of this study was to evaluate the diagnostic performance of the Dengue NS1 and Dengue IgM/IgG RDTs on the serum/plasma samples in a laboratory setting and in the field. During laboratory evaluation, performance of the NS1 RDT was assessed using NS1 ELISA as the gold standard. Sensitivity and specificity were 88% [75–95%] and 100% [97–100%], respectively. Performance of the IgM/IG RDT was assessed using the IgM Antibody Capture (MAC) ELISA, indirect IgG, and PRNT as gold standards. The IgM and IgG test lines respectively displayed sensitivities of 94% [83–99%] and 70% [59–79%] and specificities of 91% [84–95%] and 91% [79–98%]. In the field, the Dengue NS1 RDT sensitivity and specificity was 82% [60–95%] and 75% [53–90%], respectively. The IgM and IgG test lines displayed sensitivities of 86% [42–100%] and 78% [64–88%], specificities of 85% [76–92%] and 55% [36–73%], respectively. These results demonstrate that RDTs are ideal for use in a context of high prevalence or outbreak setting and can be implemented in the absence of a confirmatory test for acute and convalescent patients.
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Affiliation(s)
- Oumar Ndiaye
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Kevin Woolston
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Aboubacry Gaye
- Epidemiology Clinical Research and Data Science Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Cheikh Loucoubar
- Epidemiology Clinical Research and Data Science Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Michael Cocozza
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Cheikh Fall
- Microbiology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Fatou Dia
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Emily R. Adams
- Global Access Diagnostics, Bedford Technology Park, Bedford MK44 2YA, Bedfordshire, UK
| | - Marième Samb
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Diogop Camara
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | | | - Cheikh T. Diagne
- Mivegec Infectious Diseases and Vector: Ecology, Genetics, Evolution and Control, Université Montpellier, IRD, CNRS, 34394 Montpellier, France
| | - Manfred Weidmann
- Institute of Microbiology and Virology, Medical School Brandenburg Theodor Fontane, D-01968 Senftenberg, Germany
| | - Oumar Faye
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | | | - Amadou Alpha Sall
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
| | - Cheikh Tidiane Diagne
- Diatropix Unit, Institut Pasteur de Dakar, Dakar BP 220, Senegal
- Virology Department, Institut Pasteur de Dakar, Dakar BP 220, Senegal
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Coronel-Ruiz C, Velandia-Romero ML, Calvo E, Camacho-Ortega S, Parra-Alvarez S, Beltrán EO, Calderón-Pelaez MA, Porras-Ramírez A, Cortés-Muñoz F, Rojas-Hernandez JP, Velasco-Alvarez S, Pinzón-Junca A, Castellanos JE. Improving dengue diagnosis and case confirmation in children by combining rapid diagnostic tests, clinical, and laboratory variables. FRONTIERS IN TROPICAL DISEASES 2023. [DOI: 10.3389/fitd.2023.1118774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
BackgroundDengue is the most widely distributed arboviral disease in tropical and subtropical countries. Most suspected cases are diagnosed according to the clinical criteria, and early diagnosis is difficult. Moreover, in underdeveloped countries, several factors continue to challenge the diagnosis and surveillance of dengue cases. This study aimed to design a diagnostic algorithm using rapid diagnostic tests (RDTs), ELISA tests, and clinical and hematological variables to confirm dengue cases in febrile patients in Colombia.MethodsAltogether, 505 samples were collected. Serum samples were evaluated by RDTs (IgM and IgG antibodies and NS1 antigen), capture IgM and IgG ELISAs, and endpoint hemi-nested RT-PCR assay (qualitative). We statistically analyzed the performance of individual tests to determine the most useful ones to confirm dengue cases accurately.ResultsIndividual results for IgM, IgG, and NS1 RDTs yielded lower sensitivity and specificity values than the reference standard. High sensitivity and specificity were obtained after combining IgM and NS1 ELISA results (96.3% and 96.4%) and NS1 RDT plus IgM ELISA results (90.3% and 96.2%), respectively. Adjusted odds ratios (aORs) were calculated for clinical variables and laboratory tests to differentiate dengue from other febrile illnesses (OFI). This approach showed that myalgia, abdominal tenderness, and platelet count were identified with higher sensitivity to confirm dengue cases. IgM RDT and NS1 RDT differentiated dengue cases from OFI. A positive IgM RDT or a positive NS1 RDT combined with specific signs or symptoms confirmed 81.6% of dengue cases. A combination of clinical findings and a positive NS1 RDT or positive ELISA IgM confirmed 90.6% of the cases.ConclusionOur findings showed that clinical diagnoses in pediatric population alone cannot confirm true dengue cases and needs to be complemented by laboratory diagnostic tests. We also demonstrate the usefulness of combining clinical criteria with RDTs, suggesting that their implementation with the IgM ELISA test improves dengue case confirmation.
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Performance of VIDAS® Diagnostic Tests for the Automated Detection of Dengue Virus NS1 Antigen and of Anti-Dengue Virus IgM and IgG Antibodies: A Multicentre, International Study. Diagnostics (Basel) 2023; 13:diagnostics13061137. [PMID: 36980445 PMCID: PMC10047366 DOI: 10.3390/diagnostics13061137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Dengue is a serious mosquito-transmitted disease caused by the dengue virus (DENV). Rapid and reliable diagnosis of DENV infection is urgently needed in dengue-endemic regions. We describe here the performance evaluation of the CE-marked VIDAS® dengue immunoassays developed for the automated detection of DENV NS1 antigen and anti-DENV IgM and IgG antibodies. A multicenter concordance study was conducted in 1296 patients from dengue-endemic regions in Asia, Latin America, and Africa. VIDAS® dengue results were compared to those of competitor enzyme-linked immunosorbent assays (ELISA). The VIDAS® dengue assays showed high precision (CV ≤ 10.7%) and limited cross-reactivity (≤15.4%) with other infections. VIDAS® DENGUE NS1 Ag showed high positive and negative percent agreement (92.8% PPA and 91.7% NPA) in acute patients within 0–5 days of symptom onset. VIDAS® Anti-DENGUE IgM and IgG showed a moderate-to-high concordance with ELISA (74.8% to 90.6%) in post-acute and recovery patients. PPA was further improved in combined VIDAS® NS1/IgM (96.4% in 0–5 days acute patients) and IgM/IgG (91.9% in post-acute patients) tests. Altogether, the VIDAS® dengue NS1, IgM, and IgG assays performed well, either alone or in combination, and should be suitable for the accurate diagnosis of DENV infection in dengue-endemic regions.
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Machain-Williams C, Reyes-Solis GC, Blitvich BJ, Laredo-Tiscareño V, Dzul-Rosado AR, Kim S, AbuBakar S. Evaluation of an Immunoglobulin E Capture Enzyme-Linked Immunosorbent Assay for the Early Diagnosis of Dengue. Viral Immunol 2023; 36:101-109. [PMID: 36862827 DOI: 10.1089/vim.2022.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Dengue virus (DENV) is the etiological agent of dengue, the most important mosquito-transmitted viral disease of humans worldwide. Enzyme-linked immunosorbent assays (ELISAs) designed to detect DENV IgM are commonly used for dengue diagnosis. However, DENV IgM is not reliably detected until ≥4 days after illness onset. Reverse transcription-polymerase chain reaction (RT-PCR) can diagnose early dengue but requires specialized equipment, reagents, and trained personnel. Additional diagnostic tools are needed. Limited work has been performed to determine whether IgE-based assays can be used for the early detection of vector-borne viral diseases, including dengue. In this study, we determined the efficacy of a DENV IgE capture ELISA for the detection of early dengue. Sera were collected within the first 4 days of illness onset from 117 patients with laboratory-confirmed dengue, as determined by DENV-specific RT-PCR. The serotypes responsible for the infections were DENV-1 and DENV-2 (57 and 60 patients, respectively). Sera were also collected from 113 dengue-negative individuals with febrile illness of undetermined etiology and 30 healthy controls. The capture ELISA detected DENV IgE in 97 (82.9%) confirmed dengue patients and none of the healthy controls. There was a high false positivity rate (22.1%) among the febrile non-dengue patients. In conclusion, we provide evidence that IgE capture assays have the potential to be explored for early diagnosis of dengue, but further research is necessary to address the possible false positivity rate among patients with other febrile illnesses.
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Affiliation(s)
- Carlos Machain-Williams
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico
| | - Guadalupe C Reyes-Solis
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico
| | - Bradley J Blitvich
- Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Viridiana Laredo-Tiscareño
- Laboratorio de Arbovirologia, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatan, Merida, Yucatan, Mexico.,Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | | | - Sungmin Kim
- Department of Infectious Diseases in Internal Medicine, Sejong Chungnam National University Hospital, School of Medicine, Chungnam National University, Sejong, Korea
| | - Sazaly AbuBakar
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Higher Institution Center of Excellence (HICOE), Universiti Malaya, Kuala Lumpur, Malaysia
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Lucena-Neto FD, Falcão LFM, Moraes ECDS, David JPF, Vieira-Junior ADS, Silva CC, de Sousa JR, Duarte MIS, Vasconcelos PFDC, Quaresma JAS. Dengue fever ophthalmic manifestations: A review and update. Rev Med Virol 2023; 33:e2422. [PMID: 36658757 DOI: 10.1002/rmv.2422] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/23/2022] [Accepted: 01/08/2023] [Indexed: 01/21/2023]
Abstract
Dengue fever, the most common arbovirus disease, affects an estimated 390 million people annually. Dengue virus (DENV) is an RNA virus of the Flaviviridae family with four different serotypes. Dengue haemorrhagic fever is the deadliest form of dengue infection and is characterised by thrombocytopaenia, hypotension, and the possibility of multi-system organ failure. The mechanism hypothesised for DENV viral replication is intrinsic antibody-dependent enhancement, which refers to Fcγ receptor-mediated viral amplification. This hypothesis suggests that the internalisation of DENV through the Fcγ receptor inhibits antiviral genes by suppressing type-1 interferon-mediated antiviral responses. DENV NS1 antibodies can promote the release of various inflammatory mediators in the nuclear transcription factor pathway (NF-κB-dependent), including monocyte chemoattractant protein (MCP)-1, interleukin (IL)-6, and IL-8. As a result, MCP-1 increases ICAM-1 expression and facilitates leukocyte transmigration. In addition, anti-DENV NS1 antibodies induce endothelial cell apoptosis via a nitric oxide-regulated pathway. A chain reaction involving pre-existing DENV heterotypic antibodies and innate immune cells causes dysfunction in complement system activity and contributes to the action of autoantibodies and anti-endothelial cells, resulting in endothelial cell dysfunction, blood-retinal barrier breakdown, haemorrhage, and plasma leakage. A spectrum of ocular diseases associated with DENV infection, ranging from haemorrhagic to inflammatory manifestations, has been reported in the literature. Although rare, ophthalmic manifestations can occur in both the anterior and posterior segments and are usually associated with thrombocytopenia. The most common ocular complication is haemorrhage. However, ophthalmic complications, such as anterior uveitis and vasculitis, suggest an immune-mediated pathogenesis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Juarez Antônio Simões Quaresma
- State University of Pará, Belém, Pará, Brazil.,Federal University of Pará, Belém, Pará, Brazil.,School of Medicine, São Paulo University, São Paulo, São Paulo, Brazil.,Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
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Diagnosis of Dengue Virus Infections Imported to Hungary and Phylogenetic Analysis of Virus Isolates. Diagnostics (Basel) 2023; 13:diagnostics13050873. [PMID: 36900018 PMCID: PMC10001143 DOI: 10.3390/diagnostics13050873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Dengue virus is one of the most important arbovirus infections of public health concern. Between 2017 and June 2022, 75 imported dengue infections were confirmed by laboratory diagnostic methods in Hungary. Our study aimed to isolate the imported Dengue strains and characterize them by whole-genome sequencing. METHODS Laboratory diagnosis of imported infections was carried out using both serological and molecular methods. Virus isolation was attempted on Vero E6 cell lines. An in-house amplicon-based whole-genome sequencing method was applied for the detailed molecular characterization of the isolated virus strains. RESULTS From 75 confirmed Dengue infected patients, 68 samples were used for virus isolation. Isolation and whole-genome sequencing were successful in the case of eleven specimens. Isolated strains belonged to Dengue-1,-2,-3 serotypes. DISCUSSION The isolated strains corresponded to the circulating genotypes of the visited geographic area, and some of the genotypes were linked with more severe DENV cases in the literature. We found that multiple factors, including viral load, specimen type, and patient antibody status, influence the isolation efficacy. CONCLUSIONS Analysis of imported DENV strains can help estimate the outcomes of a possible local DENV transmission in Hungary, a threat from the near future.
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Maeki T, Tajima S, Ando N, Wakimoto Y, Hayakawa K, Kutsuna S, Kato F, Taniguchi S, Nakayama E, Lim CK, Saijo M. Analysis of cross-reactivity among flaviviruses using sera of patients with dengue showed the importance of neutralization tests with paired serum samples for the correct interpretations of serological test results for dengue. J Infect Chemother 2023; 29:469-474. [PMID: 36702208 DOI: 10.1016/j.jiac.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/12/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
Dengue is a febrile illness caused by the dengue virus (DENV) that belongs to the genus Flavivirus in the family Flaviviridae. Cross-reactivity between flaviviruses poses a challenge while interpreting serological test results. In the present study, the cross-reactivity of sera of the patients with dengue, who traveled from Japan to DENV-endemic countries, was analyzed by using an enzyme-linked immunosorbent assay (ELISA) and neutralization test (NT). Sixteen serum samples were collected from patients with dengue and were tested for: i) IgM antibodies against Zika virus (ZIKV), West Nile virus (WNV), Japanese encephalitis virus (JEV), and tick-borne encephalitis virus (TBEV) using IgM ELISA, ii) IgG antibody against TBEV using IgG ELISA, and iii) neutralizing antibody against ZIKV, WNV, TBEV, and JEV. Among the 16 samples tested using ELISA, seven samples were IgM-positive for at least one of the other flaviviruses, and nine samples were IgG-positive for TBEV. Neutralizing antibody titers (NATs) against ZIKV, WNV, and TBEV were one-fourth or lower than those against the causative DENV in all samples. The NATs against JEV were one-fourth or lower than those against the causative DENV in six convalescent-phase serum sample among the seven convalescent-phase serum samples. The NAT against DENV of the residual one convalescent-phase serum was similar to that against JEV and that against JEV of its relevant acute-phase serum sample. These results showed that NTs with paired serum samples are important to correctly interpret the serological test results for DENV.
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Affiliation(s)
- Takahiro Maeki
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan.
| | - Shigeru Tajima
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Naokatsu Ando
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Yuji Wakimoto
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Kayoko Hayakawa
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Satoshi Kutsuna
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Fumihiro Kato
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Satoshi Taniguchi
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Eri Nakayama
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Chang-Kweng Lim
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
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Wang J, Zhu Z. Novel paradigm of mosquito-borne disease control based on self-powered strategy. Front Public Health 2023; 11:1115000. [PMID: 36741958 PMCID: PMC9895093 DOI: 10.3389/fpubh.2023.1115000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Affiliation(s)
- Junhao Wang
- School of Electronic Information Engineering, Southwest University, Chongqing, China,State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China
| | - Zhiyuan Zhu
- School of Electronic Information Engineering, Southwest University, Chongqing, China,*Correspondence: Zhiyuan Zhu ✉
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Park G, Park H, Park SC, Jang M, Yoon J, Ahn JH, Lee T. Recent Developments in DNA-Nanotechnology-Powered Biosensors for Zika/Dengue Virus Molecular Diagnostics. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:361. [PMID: 36678114 PMCID: PMC9864780 DOI: 10.3390/nano13020361] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Zika virus (ZIKV) and dengue virus (DENV) are highly contagious and lethal mosquito-borne viruses. Global warming is steadily increasing the probability of ZIKV and DENV infection, and accurate diagnosis is required to control viral infections worldwide. Recently, research on biosensors for the accurate diagnosis of ZIKV and DENV has been actively conducted. Moreover, biosensor research using DNA nanotechnology is also increasing, and has many advantages compared to the existing diagnostic methods, such as polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). As a bioreceptor, DNA can easily introduce a functional group at the 5' or 3' end, and can also be used as a folded structure, such as a DNA aptamer and DNAzyme. Instead of using ZIKV and DENV antibodies, a bioreceptor that specifically binds to viral proteins or nucleic acids has been fabricated and introduced using DNA nanotechnology. Technologies for detecting ZIKV and DENV can be broadly divided into electrochemical, electrical, and optical. In this review, advances in DNA-nanotechnology-based ZIKV and DENV detection biosensors are discussed.
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Affiliation(s)
- Goeun Park
- Department of Chemical Engineering, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Hanbin Park
- Department of Chemical Engineering, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Sang-Chan Park
- Department of Electronics Engineering, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Moonbong Jang
- Department of Chemical Engineering, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Jinho Yoon
- Department of Biomedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si 14662, Gyeonggi-do, Republic of Korea
| | - Jae-Hyuk Ahn
- Department of Electronics Engineering, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Taek Lee
- Department of Chemical Engineering, Kwangwoon University, Seoul 01897, Republic of Korea
- TL Bioindustry, 20 Kwangwoon-ro, Nowon-gu, Seoul 01897, Republic of Korea
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47
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Dengue virus infection - a review of pathogenesis, vaccines, diagnosis and therapy. Virus Res 2023; 324:199018. [PMID: 36493993 DOI: 10.1016/j.virusres.2022.199018] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/19/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
The transmission of dengue virus (DENV) from an infected Aedes mosquito to a human, causes illness ranging from mild dengue fever to fatal dengue shock syndrome. The similar conserved structure and sequence among distinct DENV serotypes or different flaviviruses has resulted in the occurrence of cross reaction followed by antibody-dependent enhancement (ADE). Thus far, the vaccine which can provide effective protection against infection by different DENV serotypes remains the biggest hurdle to overcome. Therefore, deep investigation is crucial for the potent and effective therapeutic drugs development. In addition, the cross-reactivity of flaviviruses that leads to false diagnosis in clinical settings could result to delay proper intervention management. Thus, the accurate diagnostic with high specificity and sensitivity is highly required to provide prompt diagnosis in respect to render early treatment for DENV infected individuals. In this review, the recent development of neutralizing antibodies, antiviral agents, and vaccine candidates in therapeutic platform for DENV infection will be discussed. Moreover, the discovery of antigenic cryptic epitopes, principle of molecular mimicry, and application of single-chain or single-domain antibodies towards DENV will also be presented.
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Distinguishing SARS-CoV-2 Infection and Non-SARS-CoV-2 Viral Infections in Adult Patients through Clinical Score Tools. Trop Med Infect Dis 2023; 8:tropicalmed8010061. [PMID: 36668968 PMCID: PMC9860567 DOI: 10.3390/tropicalmed8010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
This study aimed to determine distinguishing predictors and develop a clinical score to differentiate COVID-19 and common viral infections (influenza, respiratory syncytial virus (RSV), dengue, chikungunya (CKV), and zika (ZKV)). This retrospective study enrolled 549 adults (100 COVID-19, 100 dengue, 100 influenza, 100 RSV, 100 CKV, and 49 ZKV) during the period 2017−2020. CKV and ZKV infections had specific clinical features (i.e., arthralgia and rash); therefore, these diseases were excluded. Multiple binary logistic regression models were fitted to identify significant predictors, and two scores were developed differentiating influenza/RSV from COVID-19 (Flu-RSV/COVID) and dengue from COVID-19 (Dengue/COVID). The five independent predictors of influenza/RSV were age > 50 years, the presence of underlying disease, rhinorrhea, productive sputum, and lymphocyte count < 1000 cell/mm3. Likewise, the five independent predictors of dengue were headache, myalgia, no cough, platelet count < 150,000/mm3, and lymphocyte count < 1000 cell/mm3. The Flu-RSV/COVID score (cut-off value of 4) demonstrated 88% sensitivity and specificity for predicting influenza/RSV (AUROC = 0.94). The Dengue/COVID score (cut-off value of 4) achieved 91% sensitivity and 94% specificity for differentiating dengue and COVID-19 (AUROC = 0.98). The Flu-RSV/COVID and Dengue/COVID scores had a high discriminative ability for differentiating influenza/RSV or dengue infection and COVID-19. The further validation of these scores is needed to ensure their utility in clinical practice.
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Mayrose H, Bairy GM, Sampathila N, Belurkar S, Saravu K. Machine Learning-Based Detection of Dengue from Blood Smear Images Utilizing Platelet and Lymphocyte Characteristics. Diagnostics (Basel) 2023; 13:diagnostics13020220. [PMID: 36673030 PMCID: PMC9857931 DOI: 10.3390/diagnostics13020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/04/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Dengue fever, also known as break-bone fever, can be life-threatening. Caused by DENV, an RNA virus from the Flaviviridae family, dengue is currently a globally important public health problem. The clinical methods available for dengue diagnosis require skilled supervision. They are manual, time-consuming, labor-intensive, and not affordable to common people. This paper describes a method that can support clinicians during dengue diagnosis. It is proposed to automate the peripheral blood smear (PBS) examination using Artificial Intelligence (AI) to aid dengue diagnosis. Nowadays, AI, especially Machine Learning (ML), is increasingly being explored for successful analyses in the biomedical field. Digital pathology coupled with AI holds great potential in developing healthcare services. The automation system developed incorporates a blob detection method to detect platelets and thrombocytopenia from the PBS images. The results achieved are clinically acceptable. Moreover, an ML-based technique is proposed to detect dengue from the images of PBS based on the lymphocyte nucleus. Ten features are extracted, including six morphological and four Gray Level Spatial Dependance Matrix (GLSDM) features, out of the lymphocyte nucleus of normal and dengue cases. Features are then subjected to various popular supervised classifiers built using a ten-fold cross-validation policy for automated dengue detection. Among all the classifiers, the best performance was achieved by Support Vector Machine (SVM) and Decision Tree (DT), each with an accuracy of 93.62%. Furthermore, 1000 deep features extracted using pre-trained MobileNetV2 and 177 textural features extracted using Local binary pattern (LBP) from the lymphocyte nucleus are subjected to feature selection. The ReliefF selected 100 most significant features are then fed to the classifiers. The best performance was attained using an SVM classifier with 95.74% accuracy. With the obtained results, it is evident that this proposed approach can efficiently contribute as an adjuvant tool for diagnosing dengue from the digital microscopic images of PBS.
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Affiliation(s)
- Hilda Mayrose
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - G. Muralidhar Bairy
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
- Correspondence: (G.M.B.); (N.S.)
| | - Niranjana Sampathila
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
- Correspondence: (G.M.B.); (N.S.)
| | - Sushma Belurkar
- Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Kavitha Saravu
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
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Maillard O, Hirschinger D, Bénéteau S, Koumar Y, Vague A, Girerd R, DiAscia L, Jabot J, Cousty J, Randrianjohany A, Bertolotti A, Raffray L. C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area. PLoS One 2023; 18:e0285900. [PMID: 37195992 DOI: 10.1371/journal.pone.0285900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/04/2023] [Indexed: 05/19/2023] Open
Abstract
In tropical regions, leptospirosis and dengue fever (DF) are infectious diseases of epidemiological importance and have overlapping symptomatic features. The objective of this study was to identify the factors associated to diagnosing leptospirosis that differentiate it to DF at the initial hospital evaluation. A multicenter retrospective study was conducted comparing confirmed leptospirosis to DF cases. Clinical/laboratory findings were compiled at hospital admission on Reunion Island between 2018 and 2019. Multivariable logistic regression was used to identify the predictors of leptospirosis. In total, 98 leptospirosis and 673 DF patients were included with a mean age of 47.8 (±17.1) and 48.9 (±23.3) years, respectively. In the multivariate analyses, the main parameters associated with leptospirosis were: i) increased neutrophil counts, ii) C-reactive protein values, iii) the absence of prolonged partial thromboplastin time, and iv) a decrease of platelets. The most discriminating parameter was C-reactive protein (CRP). With a threshold of 50mg/L, CRP taken alone had a sensitivity of 94% and a specificity of 93.5%. The positive and negative likelihood ratios were 14.5 and 0.06, respectively. In the setting of an early presumptive diagnosis, we found that an increased CRP value (>50 mg/L) could help diagnose leptospirosis and aid the decision process for hospital surveillance and/or a potential antibiotic treatment regimen.
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Affiliation(s)
- Olivier Maillard
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC 1410, CHU Réunion, Saint-Pierre, Reunion, France
| | - David Hirschinger
- Department of Emergency Medicine, CHU Réunion, Saint-Denis, Reunion, France
| | - Samuel Bénéteau
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
| | - Yatrika Koumar
- Department of Infectious Diseases, CHU Réunion, Saint-Pierre, Reunion, France
| | - Adrien Vague
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Rémi Girerd
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Laura DiAscia
- Department of Emergency Medicine, CHU Réunion, Saint-Denis, Reunion, France
| | - Julien Jabot
- Intensive Care Unit, CHU Réunion, Saint-Denis, Reunion, France
| | - Julien Cousty
- Intensive Care Unit, CHU Réunion, Saint-Pierre, Reunion, France
| | - Andry Randrianjohany
- Department of Internal Medicine, Groupe Hospitalier Est Réunion, Saint-Benoit, Reunion, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC 1410, CHU Réunion, Saint-Pierre, Reunion, France
- Department of Infectious Diseases, CHU Réunion, Saint-Pierre, Reunion, France
| | - Loïc Raffray
- Department of Internal Medicine, CHU Réunion, Saint-Denis, Reunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, Reunion, France
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