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Roiz D, Pontifes PA, Jourdain F, Diagne C, Leroy B, Vaissière AC, Tolsá-García MJ, Salles JM, Simard F, Courchamp F. The rising global economic costs of invasive Aedes mosquitoes and Aedes-borne diseases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 933:173054. [PMID: 38729373 DOI: 10.1016/j.scitotenv.2024.173054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/05/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
Invasive Aedes aegypti and Aedes albopictus mosquitoes transmit viruses such as dengue, chikungunya and Zika, posing a huge public health burden as well as having a less well understood economic impact. We present a comprehensive, global-scale synthesis of studies reporting these economic costs, spanning 166 countries and territories over 45 years. The minimum cumulative reported cost estimate expressed in 2022 US$ was 94.7 billion, although this figure reflects considerable underreporting and underestimation. The analysis suggests a 14-fold increase in costs, with an average annual expenditure of US$ 3.1 billion, and a maximum of US$ 20.3 billion in 2013. Damage and losses were an order of magnitude higher than investment in management, with only a modest portion allocated to prevention. Effective control measures are urgently needed to safeguard global health and well-being, and to reduce the economic burden on human societies. This study fills a critical gap by addressing the increasing economic costs of Aedes and Aedes-borne diseases and offers insights to inform evidence-based policy.
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Affiliation(s)
- David Roiz
- MIVEGEC, Univ. Montpellier, IRD, CNRS, Montpellier, France; International Joint Laboratory ELDORADO, IRD/UNAM, Mexico.
| | - Paulina A Pontifes
- MIVEGEC, Univ. Montpellier, IRD, CNRS, Montpellier, France; International Joint Laboratory ELDORADO, IRD/UNAM, Mexico
| | - Fréderic Jourdain
- MIVEGEC, Univ. Montpellier, IRD, CNRS, Montpellier, France; Santé Publique France (French National Public Health Agency), Montpellier, France
| | - Christophe Diagne
- CBGP, Université de Montpellier, IRD, CIRAD, INRAE, Institut Agro, 34988 Montferrier-sur-Lez, France
| | - Boris Leroy
- Unité Biologie des Organismes et Écosystèmes Aquatiques (BOREA, UMR 7208), Muséum national d'Histoire naturelle, Sorbonne Université, Université de Caen Normandie, CNRS, IRD, Université des Antilles, Paris, France
| | - Anne-Charlotte Vaissière
- CNRS, AgroParisTech, Écologie Systématique et Évolution, Université Paris-Saclay, Gif-sur-Yvette, 91190, France; ECOBIO (écosystèmes, biodiversité, évolution) - UMR 6553, CNRS, Université de Rennes, 263 Avenue du Général Leclerc, 35042 Rennes, France
| | - María José Tolsá-García
- MIVEGEC, Univ. Montpellier, IRD, CNRS, Montpellier, France; International Joint Laboratory ELDORADO, IRD/UNAM, Mexico
| | - Jean-Michel Salles
- CEE-M, Univ. Montpellier, CNRS, INRAE, Institut Agro, Montpellier, France
| | | | - Franck Courchamp
- CNRS, AgroParisTech, Écologie Systématique et Évolution, Université Paris-Saclay, Gif-sur-Yvette, 91190, France
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Ting R, Dickens BL, Hanley R, Cook AR, Ismail E. The epidemiologic and economic burden of dengue in Singapore: A systematic review. PLoS Negl Trop Dis 2024; 18:e0012240. [PMID: 38857260 PMCID: PMC11192419 DOI: 10.1371/journal.pntd.0012240] [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: 12/11/2023] [Revised: 06/21/2024] [Accepted: 05/22/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize current data on the epidemiologic and economic burden of dengue in Singapore. METHODOLOGY We used multiple databases (PubMed, Embase, Cochrane, international/national repositories, surveillance) to search for published and gray literature (2000-2022). We included observational and cost studies, and two interventional studies, reporting Singapore-specific data on our co-primary outcomes, dengue incidence and dengue-related costs. Quality was assessed using the Newcastle-Ottawa Scale and an adapted cost-of-illness evaluation checklist. We performed a narrative synthesis and grouped studies according to reported outcomes and available stratified analyses. FINDINGS In total, 333 reports (330 epidemiological, 3 economic) were included. Most published epidemiological studies (89%) and all economic studies were of good quality. All gray literature reports were from the Ministry of Health or National Environment Agency. Based predominantly on surveillance data, Singapore experienced multiple outbreaks in 2000-2021, attaining peak incidence rate in 2020 (621.1 cases/100,000 person-years). Stratified analyses revealed the highest incidence rates in DENV-2 and DENV-3 serotypes and the 15-44 age group. Among dengue cases, the risk of hospitalization has been highest in the ≥45-year-old age groups while the risks of dengue hemorrhagic fever and death have generally been low (both <1%) for the last decade. Our search yielded limited data on deaths by age, severity, and infection type (primary, secondary, post-secondary). Seroprevalence (dengue immunoglobulin G) increases with age but has remained <50% in the general population. Comprising 21-63% indirect costs, dengue-related total costs were higher in 2010-2020 (SGD 148 million) versus the preceding decade (SGD 58-110 million). CONCLUSION Despite abundant passive surveillance data, more stratified and up-to-date data on the epidemiologic and economic burden of dengue are warranted in Singapore to continuously assess prevention and management strategies.
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Affiliation(s)
- Rita Ting
- Takeda Malaysia Sdn Bhd, Selangor, Malaysia
| | - Borame L. Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Riona Hanley
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Chowdhury R, Faria S, Chowdhury V, Islam MS, Akther S, Akter S. Bamboo stumps that are artificially in use put pressure on dengue and chikungunya vector control in Dhaka city, Bangladesh. J Vector Borne Dis 2024; 61:227-235. [PMID: 38922657 DOI: 10.4103/jvbd.jvbd_152_23] [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: 09/09/2023] [Accepted: 11/17/2023] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND OBJECTIVES Aedes aegypti and Ae. albopictus mosquitoes breed in natural and artificial containers, and they transmit dengue and chikungunya. A study was conducted to identify the contribution of bamboo stumps to these disease vectors that were used in the flower garden as pillars to hold the bamboo flex fence. METHODS Two sizes of whole bamboo were used to hold fences around gardens at Dhaka University, Bangladesh, and were painted red and green. Mosquito larvae and pupae were collected from bamboo stumps between July and August, and vectors were identified up to the species level. The data were analyzed using the STATA/MP 14.2 version. RESULTS 83.5% and 0.2% were Ae. albopictus and Ae. aegypti, respectively, and the remaining were Culex and Ar-migeres species. Ae. albopictus, Ae. aegypti, and both species-positive bamboo stumps were 46.9, 0.7, and 47.1%, respectively. 54.5% of the bamboo stumps had at least one mosquito species. The average stump depth for Aedes positive stumps (mean=11.7 cm, SE = 0.5) was significantly (p <0.001) higher than the Aedes negative stumps (mean = 9.5 cm, SE = 0.4). 53.8% and 38.0% stumps were found Aedes positive on the ground and upper sides of fences, respectively, and found significant (p<0.01) differences between both sides. A zero-inflated negative binomial count model is significant at a 5% level of significance, χ2(4) = 11.8, p = 0.019 (<0.05) for Ae. albopictus. Stump depth is found to have a significant positive effect on the number of Aedes-positive stumps. INTERPRETATION CONCLUSION Artificially used natural containers are adding pressure to current mosquito control activities as mosquitoes are breeding on them, which needs additional attention.
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Affiliation(s)
- Rajib Chowdhury
- Department of Public Health, Independent University Bangladesh (IUB), Dhaka, Bangladesh
| | - Shyla Faria
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | | | - Md Sahidul Islam
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Shireen Akther
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh
| | - Sakila Akter
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh
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Basheer A, Jamal SB, Alzahrani B, Faheem M. Development of a tetravalent subunit vaccine against dengue virus through a vaccinomics approach. Front Immunol 2023; 14:1273838. [PMID: 38045699 PMCID: PMC10690774 DOI: 10.3389/fimmu.2023.1273838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Dengue virus infection (DVI) is a mosquito-borne disease that can lead to serious morbidity and mortality. Dengue fever (DF) is a major public health concern that affects approximately 3.9 billion people each year globally. However, there is no vaccine or drug available to deal with DVI. Dengue virus consists of four distinct serotypes (DENV1-4), each raising a different immunological response. In the present study, we designed a tetravalent subunit multi-epitope vaccine, targeting proteins including the structural protein envelope domain III (EDIII), precursor membrane proteins (prM), and a non-structural protein (NS1) from each serotype by employing an immunoinformatic approach. Only conserved sequences obtained through a multiple sequence alignment were used for epitope mapping to ensure efficacy against all serotypes. The epitopes were shortlisted based on an IC50 value <50, antigenicity, allergenicity, and a toxicity analysis. In the final vaccine construct, overall, 11 B-cell epitopes, 10 HTL epitopes, and 10 CTL epitopes from EDIII, prM, and NS1 proteins targeting all serotypes were selected and joined via KK, AAY, and GGGS linkers, respectively. We incorporated a 45-amino-acid-long B-defensins adjuvant in the final vaccine construct for a better immunogenic response. The vaccine construct has an antigenic score of 0.79 via VaxiJen and is non-toxic and non-allergenic. Our refined vaccine structure has a Ramachandran score of 96.4%. The vaccine has shown stable interaction with TLR3, which has been validated by 50 ns of molecular dynamics (MD) simulation. Our findings propose that a designed multi-epitope vaccine has substantial potential to elicit a strong immune response against all dengue serotypes without causing any adverse effects. Furthermore, the proposed vaccine can be experimentally validated as a probable vaccine, suggesting it may serve as an effective preventative measure against dengue virus infection.
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Affiliation(s)
- Amina Basheer
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
| | - Syed Babar Jamal
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
| | - Badr Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia
| | - Muhammad Faheem
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
- Department of Biomedical Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
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Shepard DS, Agarwal‐Harding P, Jiamton S, Undurraga EA, Kongsin S. Enrollment of dengue patients in a prospective cohort study in Umphang District, Thailand, during the COVID-19 pandemic: Implications for research and policy. Health Sci Rep 2023; 6:e1657. [PMID: 38028707 PMCID: PMC10630743 DOI: 10.1002/hsr2.1657] [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: 07/26/2023] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Dengue is endemic in Thailand and imposes a high burden on the health system and society. We conducted a prospective cohort study in Umphang District, Tak Province, Thailand, to investigate the share of dengue cases with long symptoms and their duration. Here we present the results of the enrollment process during the COVID-19 pandemic with implications and challenges for research and policy. Methods In a prospective cohort study conducted in Umphang District, Thailand, we examined the prevalence of persistent symptoms in dengue cases. Clinically diagnosed cases were offered free laboratory testing, We enrolled ambulatory dengue patients regardless of age who were confirmed through a highly sensitive laboratory strategy (positive NS1 and/or IgM), agreed to follow-up visits, and gave informed consent. We used multivariate logistic regressions to assess the probability of clinical dengue being laboratory confirmed. To determine the factors associated with study enrollment, we analyzed the relationship of patient characteristics and month of screening to the likelihood of participation. To identify underrepresented groups, we compared the enrolled cohort to external data sources. Results The 150 clinical cases ranged from 1 to 85 years old. Most clinical cases (78%) were confirmed by a positive laboratory test, but only 19% of those confirmed enrolled in the cohort study. Women, who were half as likely to enroll as men, were underrepresented in the cohort. Conclusions The Thai physicians' clinical diagnoses at this rural district hospital had good agreement with laboratory diagnoses. By identifying underrepresented groups and disparities, future studies can ensure the creation of statistically representative cohorts to maximize their scientific value. This involves recruiting and retaining underrepresented groups in health research, such as women in this study. Promising strategies for meaningful inclusion include multi-site enrollment, offering in-home or virtual services, and providing in-kind benefits like childcare for underrepresented groups.
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Affiliation(s)
- Donald S. Shepard
- Schneider Institutes for Health PolicyHeller School for Social Policy and Management, Brandeis UniversityWalthamMassachusettsUSA
| | - Priya Agarwal‐Harding
- Schneider Institutes for Health PolicyHeller School for Social Policy and Management, Brandeis UniversityWalthamMassachusettsUSA
| | - Sukhum Jiamton
- Research Centre for Health Economics and Evaluation, Faculty of Public HealthMahidol UniversityBangkokThailand
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Eduardo A. Undurraga
- Escuela de GobiernoPontificia Universidad Católica de ChileSantiagoChile
- Research Center for Integrated Disaster Risk Management (CIGIDEN)SantiagoChile
- CIFAR Azrieli Global Scholars ProgramTorontoOntarioCanada
| | - Sukhontha Kongsin
- Research Centre for Health Economics and Evaluation, Faculty of Public HealthMahidol UniversityBangkokThailand
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Wang Q, Yang J, Li X, Wang W, Wu Y, Li Z, Huang X. HSPA13 modulates type I interferon antiviral pathway and NLRP3 inflammasome to restrict dengue virus infection in macrophages. Int Immunopharmacol 2023; 124:110988. [PMID: 37776769 DOI: 10.1016/j.intimp.2023.110988] [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: 06/15/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Dengue virus (DENV) is a type of arthropod-borne Flavivirus, which leads to a series of serious diseases like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). DENV has a devastating health and economic impact worldwide. However, there are no suitable drugs to combat the virus. Here we reported that HSPA13, also known as stress chaperone (STCH), is a member of the HSP70 family and is a key regulator of type I interferon (IFN-I) and pro-inflammatory responses during DENV infection. HSPA13 expression was increased in macrophages infected with DENV or other Flaviviruses like Zika virus (ZIKV), Yellow fever virus (YFV) and Japanese encephalitis virus (JEV). Further, HSPA13 suppressed the replication of DENV and other Flaviviruses (ZIKV, JEV, YFV), which exhibited broad-spectrum antiviral effects. On the one hand, HSPA13 promoted production of IFN-β and interferon-stimulated genes (ISGs, such as ISG15, OAS and IFIT3) by interacting with RIG-I and up-regulating RIG-I expression during DENV infection. On the other hand, HSPA13 enhanced NLRP3 inflammasome activation and IL-1β secretion by interacting with ASC in DENV infection. We identified HSPA13 as a potential anti-DENV target. Our results provide clues for the development of antiviral drugs against DENV based on HSPA13 and reveal novel drug target against Flaviviruses.
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Affiliation(s)
- Qiaohua Wang
- Foshan Fourth People's Hospital, Foshan, China; Center for Infection and Immunity and Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jingwen Yang
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, China
| | - Xingyu Li
- Center for Infection and Immunity and Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wei Wang
- Foshan Fourth People's Hospital, Foshan, China
| | - Yongjian Wu
- Center for Infection and Immunity and Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhijian Li
- Foshan Fourth People's Hospital, Foshan, China.
| | - Xi Huang
- Foshan Fourth People's Hospital, Foshan, China; Center for Infection and Immunity and Guangdong Provincial Engineering Research Center of Molecular Imaging, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China; The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, China.
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Gyasi P, Bright Yakass M, Quaye O. Analysis of dengue fever disease in West Africa. Exp Biol Med (Maywood) 2023; 248:1850-1863. [PMID: 37452719 PMCID: PMC10792414 DOI: 10.1177/15353702231181356] [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: 07/18/2023] Open
Abstract
Dengue fever disease (DFD) which is caused by four antigenically distinct dengue viruses (DENV) presents a global health threat, with tropical and subtropical regions at a greater risk. The paucity of epidemiological data on dengue in West African subregion endangers efforts geared toward disease control and prevention. A systematic search of DFD prevalence, incidence, and DENV-infected Aedes in West Africa was conducted in PubMed, Scopus, African Index Medicus, and Google Scholar in line with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. A total of 58 human prevalence studies involving 35,748 people from 8 countries were identified. Two incidence and six DENV-infected studies were also reviewed. Nigeria and Burkina Faso contributed the majority of the prevalence studies which spanned between 1968 and 2018, with a considerable variation in coverage among the countries reviewed in this study. An average prevalence of 20.97% was observed across both general prevalence and acute DENV infection study categories, ranging between 0.02% and 93%. The majority of these studies were conducted in acute febrile patients with a prevalence range of 0.02-93% while 19% (n = 11) of all studies were general population-based studies and reported a prevalence range of 17.2-75.8%. DENV-infected Aedes aegypti were reported in four out of the five countries with published reports; with DENV-2 found circulating in Cape Verde, Senegal, and Burkina Faso while DENV-3 and DENV-4 were also reported in Senegal and Cape Verde, respectively. High prevalence of DFD in human populations and the occurrence of DENV-infected A. aegypti have been reported in West Africa, even though weaknesses in study design were identified. Epidemiological data from most countries and population in the subregion were scarce or non-existent. This study highlights the epidemic risk of DFD in West Africa, and the need for research and surveillance to be prioritized to fill the data gap required to enact effective control measures.
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Affiliation(s)
- Prince Gyasi
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra 00233, Ghana
| | - Michael Bright Yakass
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra 00233, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra 00233, Ghana
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Zaw W, Lin Z, Ko Ko J, Rotejanaprasert C, Pantanilla N, Ebener S, Maude RJ. Dengue in Myanmar: Spatiotemporal epidemiology, association with climate and short-term prediction. PLoS Negl Trop Dis 2023; 17:e0011331. [PMID: 37276226 PMCID: PMC10270578 DOI: 10.1371/journal.pntd.0011331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 06/15/2023] [Accepted: 04/24/2023] [Indexed: 06/07/2023] Open
Abstract
Dengue is a major public health problem in Myanmar. The country aims to reduce morbidity by 50% and mortality by 90% by 2025 based on 2015 data. To support efforts to reach these goals it is important to have a detailed picture of the epidemiology of dengue, its relationship to meteorological factors and ideally to predict ahead of time numbers of cases to plan resource allocations and control efforts. Health facility-level data on numbers of dengue cases from 2012 to 2017 were obtained from the Vector Borne Disease Control Unit, Department of Public Health, Myanmar. A detailed analysis of routine dengue and dengue hemorrhagic fever (DHF) incidence was conducted to examine the spatial and temporal epidemiology. Incidence was compared to climate data over the same period. Dengue was found to be widespread across the country with an increase in spatial extent over time. The temporal pattern of dengue cases and fatalities was episodic with annual outbreaks and no clear longitudinal trend. There were 127,912 reported cases and 632 deaths from 2012 and 2017 with peaks in 2013, 2015 and 2017. The case fatality rate was around 0.5% throughout. The peak season of dengue cases was from May to August in the wet season but in 2014 peak dengue season continued until November. The strength of correlation of dengue incidence with different climate factors (total rainfall, maximum, mean and minimum temperature and absolute humidity) varied between different States and Regions. Monthly incidence was forecasted 1 month ahead using the Auto Regressive Integrated Moving Average (ARIMA) method at country and subnational levels. With further development and validation, this may be a simple way to quickly generate short-term predictions at subnational scales with sufficient certainty to use for intervention planning.
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Affiliation(s)
- Win Zaw
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Zaw Lin
- Vector Borne Disease Control, Department of Public Health, Ministry of Health, Nay Pyi Taw, Myanmar
| | - July Ko Ko
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chawarat Rotejanaprasert
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Neriza Pantanilla
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Steeve Ebener
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Richard James Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- The Open University, Milton Keynes, United Kingdom
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Turner HC, Quyen DL, Dias R, Huong PT, Simmons CP, Anders KL. An economic evaluation of Wolbachia deployments for dengue control in Vietnam. PLoS Negl Trop Dis 2023; 17:e0011356. [PMID: 37253037 PMCID: PMC10256143 DOI: 10.1371/journal.pntd.0011356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/09/2023] [Accepted: 05/06/2023] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Dengue is a major public health challenge and a growing problem due to climate change. The release of Aedes aegypti mosquitoes infected with the intracellular bacterium Wolbachia is a novel form of vector control against dengue. However, there remains a need to evaluate the benefits of such an intervention at a large scale. In this paper, we evaluate the potential economic impact and cost-effectiveness of scaled Wolbachia deployments as a form of dengue control in Vietnam-targeted at the highest burden urban areas. METHODS Ten settings within Vietnam were identified as priority locations for potential future Wolbachia deployments (using a population replacement strategy). The effectiveness of Wolbachia deployments in reducing the incidence of symptomatic dengue cases was assumed to be 75%. We assumed that the intervention would maintain this effectiveness for at least 20 years (but tested this assumption in the sensitivity analysis). A cost-utility analysis and cost-benefit analysis were conducted. RESULTS From the health sector perspective, the Wolbachia intervention was projected to cost US$420 per disability-adjusted life year (DALY) averted. From the societal perspective, the overall cost-effectiveness ratio was negative, i.e. the economic benefits outweighed the costs. These results are contingent on the long-term effectiveness of Wolbachia releases being sustained for 20 years. However, the intervention was still classed as cost-effective across the majority of the settings when assuming only 10 years of benefits. CONCLUSION Overall, we found that targeting high burden cities with Wolbachia deployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Reynold Dias
- World Mosquito Program, Monash University, Clayton, Australia
| | - Phan Thi Huong
- Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
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Bellotti E, Voros A, Passah M, Nongrum QD, Nengnong CB, Khongwir C, van Eijk A, Kessler A, Sarkar R, Carlton JM, Albert S. Social network and household exposure explain the use of malaria prevention measures in rural communities of Meghalaya, India. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.23.23288997. [PMID: 37162984 PMCID: PMC10168486 DOI: 10.1101/2023.04.23.23288997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Malaria remains a global concern despite substantial reduction in incidence over the past twenty years. Public health interventions to increase the uptake of preventive measures have contributed to this decline but their impact has not been uniform. To date, we know little about what determines the use of preventive measures in rural, hard-to-reach populations, which are crucial contexts for malaria eradication. We collected detailed interview data on the use of malaria preventive measures, health-related discussion networks, individual characteristics, and household composition in ten tribal, malaria-endemic villages in Meghalaya, India in 2020-2021 (n=1,530). Employing standard and network statistical models, we found that social network and household exposure were consistently positively associated with preventive measure use across villages. Network and household exposure were also the most important factors explaining behaviour, outweighing individual characteristics, opinion leaders, and network size. These results suggest that real-life data on social networks and household composition should be considered in studies of health-behaviour change.
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Affiliation(s)
- Elisa Bellotti
- Department of Sociology, University of Manchester, Manchester, UK
| | - Andras Voros
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Mattimi Passah
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
| | | | | | | | - Annemieke van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, USA
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, USA
| | - Rajiv Sarkar
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
| | - Jane M. Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, USA
| | - Sandra Albert
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
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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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12
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Khader Y, Cécilia-Joseph E, Bouzillé G, Najioullah F, Etienne M, Malouines F, Rosine J, Julié S, Cabié A, Cuggia M. The Role of Heterogenous Real-world Data for Dengue Surveillance in Martinique: Observational Retrospective Study. JMIR Public Health Surveill 2022; 8:e37122. [PMID: 36548023 PMCID: PMC9816958 DOI: 10.2196/37122] [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: 02/08/2022] [Revised: 06/30/2022] [Accepted: 10/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Traditionally, dengue prevention and control rely on vector control programs and reporting of symptomatic cases to a central health agency. However, case reporting is often delayed, and the true burden of dengue disease is often underestimated. Moreover, some countries do not have routine control measures for vector control. Therefore, researchers are constantly assessing novel data sources to improve traditional surveillance systems. These studies are mostly carried out in big territories and rarely in smaller endemic regions, such as Martinique and the Lesser Antilles. OBJECTIVE The aim of this study was to determine whether heterogeneous real-world data sources could help reduce reporting delays and improve dengue monitoring in Martinique island, a small endemic region. METHODS Heterogenous data sources (hospitalization data, entomological data, and Google Trends) and dengue surveillance reports for the last 14 years (January 2007 to February 2021) were analyzed to identify associations with dengue outbreaks and their time lags. RESULTS The dengue hospitalization rate was the variable most strongly correlated with the increase in dengue positivity rate by real-time reverse transcription polymerase chain reaction (Pearson correlation coefficient=0.70) with a time lag of -3 weeks. Weekly entomological interventions were also correlated with the increase in dengue positivity rate by real-time reverse transcription polymerase chain reaction (Pearson correlation coefficient=0.59) with a time lag of -2 weeks. The most correlated query from Google Trends was the "Dengue" topic restricted to the Martinique region (Pearson correlation coefficient=0.637) with a time lag of -3 weeks. CONCLUSIONS Real-word data are valuable data sources for dengue surveillance in smaller territories. Many of these sources precede the increase in dengue cases by several weeks, and therefore can help to improve the ability of traditional surveillance systems to provide an early response in dengue outbreaks. All these sources should be better integrated to improve the early response to dengue outbreaks and vector-borne diseases in smaller endemic territories.
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Affiliation(s)
| | - Elsa Cécilia-Joseph
- Centre de Données Cliniques, Centre Hospitalier Universitaire Martinique, Fort-de-France, Martinique
| | - Guillaume Bouzillé
- Laboratoire de Traitement du Signal et de l'Image (LTSI) - Unité Mixte de Recherche (UMR) 1099, Université de Rennes, Centre Hospitalier Universitaire Rennes, Institut national de la santé et de la recherche médicale (INSERM), Rennes, France
| | - Fatiha Najioullah
- Laboratoire de Virologie, Centre Hospitalier Universitaire Martinique, Fort-de-France, Martinique
| | - Manuel Etienne
- Centre de Démoustication et de Recherche Entomologique, Collectivité Territoriale de la Martinique - Agence Régionale de Santé, Fort-de-France, Martinique
| | - Fabrice Malouines
- Centre de Démoustication et de Recherche Entomologique, Collectivité Territoriale de la Martinique - Agence Régionale de Santé, Fort-de-France, Martinique
| | - Jacques Rosine
- Cellule Martinique, Santé Publique France, Saint-Maurice, France
| | - Sandrine Julié
- Département d'Information Médicale, Service de Santé Publique, Centre Hospitalier Universitaire Martinique, Fort-de-France, Martinique
| | - André Cabié
- Infectious and Tropical Diseases Unit, Centre Hospitalier Universitaire Martinique, Fort-de-France, Martinique.,Centre d'Investigation Clinique (CIC)-1424, Centre Hospitalier Universitaire Martinique, Institut national de la santé et de la recherche médicale (INSERM), Fort-de-France, Martinique.,Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Université de Montpellier - Université des Antilles, Institut national de la santé et de la recherche médicale (INSERM) - Etablissement Français du Sang (EFS), Montpellier, France
| | - Marc Cuggia
- Laboratoire de Traitement du Signal et de l'Image (LTSI) - Unité Mixte de Recherche (UMR) 1099, Université de Rennes, Centre Hospitalier Universitaire Rennes, Institut national de la santé et de la recherche médicale (INSERM), Rennes, France
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13
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Yu X, Cheng G. Contribution of phylogenetics to understanding the evolution and epidemiology of dengue virus. Animal Model Exp Med 2022; 5:410-417. [PMID: 36245335 PMCID: PMC9610151 DOI: 10.1002/ame2.12283] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/05/2022] [Indexed: 11/18/2022] Open
Abstract
Dengue virus (DENV) is one of the most important arboviral pathogens in the tropics and subtropics, and nearly one‐third of the world's population is at risk of infection. The transmission of DENV involves a sylvatic cycle between nonhuman primates (NHP) and Aedes genus mosquitoes, and an endemic cycle between human hosts and predominantly Aedes aegypti. DENV belongs to the genus Flavivirus of the family Flaviviridae and consists of four antigenically distinct serotypes (DENV‐1‐4). Phylogenetic analyses of DENV have revealed its origin, epidemiology, and the drivers that determine its molecular evolution in nature. This review discusses how phylogenetic research has improved our understanding of DENV evolution and how it affects viral ecology and improved our ability to analyze and predict future DENV emergence.
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Affiliation(s)
- Xi Yu
- Tsinghua-Peking Center for Life Sciences, School of Medicine, Tsinghua University, Beijing, China.,Institute of Infectious Diseases, Shenzhen Bay Laboratory, Shenzhen, China.,Institute of Pathogenic Organisms, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Life Sciences, Tsinghua University, Beijing, China
| | - Gong Cheng
- Tsinghua-Peking Center for Life Sciences, School of Medicine, Tsinghua University, Beijing, China.,Institute of Infectious Diseases, Shenzhen Bay Laboratory, Shenzhen, China.,Institute of Pathogenic Organisms, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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14
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Girón-Pérez DA, Hermosillo-Escobedo AT, Macias-Garrigos K, Díaz-Resendiz KJG, Toledo-Ibarra GA, Ventura-Ramón GH, Girón-Pérez MI. Altered phagocytic capacity due to acute exposure and long-term post-exposure to pesticides used for vector-borne disease as dengue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:455-462. [PMID: 32490699 DOI: 10.1080/09603123.2020.1773413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
Spinosad and temefos are widely used pesticides for chemical control of dengue vector-borne disease (Aedes aegypti). The aim of this study was to compare the effect of acute exposure (7 days) to spinosad (0.5 mg A.I. L-1) and temefos (10 mg A.I. L-1), concentrations used by the Mexican Ministry of Health, on phagocytic capacity (PC) of mononuclear cells of guppies fish (Poecilia reticulata), as well as to assess PC in fish, at 96 days after exposure to those pesticides. Obtained results indicated that spinosad did not alter PC, while an acute exposure to temefos significantly affected phagocytosis and this parameter was maintained downed even 96 days after the acute exposure, suggesting that the immunotoxic effects of temefos may be chronic.
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Affiliation(s)
- D A Girón-Pérez
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C., Unidad Especializada Laboratorio Nacional de Investigación Para la Inocuidad Alimentaria (Laniia)-unidad Nayarit, Tepic, México
| | | | - K Macias-Garrigos
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
| | - K J G Díaz-Resendiz
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C., Unidad Especializada Laboratorio Nacional de Investigación Para la Inocuidad Alimentaria (Laniia)-unidad Nayarit, Tepic, México
| | - G A Toledo-Ibarra
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C., Unidad Especializada Laboratorio Nacional de Investigación Para la Inocuidad Alimentaria (Laniia)-unidad Nayarit, Tepic, México
| | - G H Ventura-Ramón
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C., Unidad Especializada Laboratorio Nacional de Investigación Para la Inocuidad Alimentaria (Laniia)-unidad Nayarit, Tepic, México
| | - M I Girón-Pérez
- Laboratorio de Inmunotoxicología, Universidad Autónoma de Nayarit, Tepic Nayarit, México
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C., Unidad Especializada Laboratorio Nacional de Investigación Para la Inocuidad Alimentaria (Laniia)-unidad Nayarit, Tepic, México
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15
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Sondo AK, Diendéré EA, Meda BI, Diallo I, Zoungrana J, Poda A, Manga NM, Bicaba B, Gnamou A, Kagoné CJ, Sawadogo G, Yaméogo I, Benzekri NA, Tarnagda Z, Kouanda S, Ouédraogo-Traoré R, Ouédraogo MS, Seydi M. Severe dengue in adults and children, Ouagadougou (Burkina Faso), West Africa, October 2015–January 2017. IJID REGIONS 2021; 1:53-59. [PMID: 35757818 PMCID: PMC9216438 DOI: 10.1016/j.ijregi.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
Severe dengue was common in this sudy. In contrast to multiple prior studies, the risk of severe dengue was greater for patients with primary dengue compared to those with secondary infection. Additional risk factors for severe dengue included age, male sex, haemoglobin S, diabetes, and hypertension. Case mapping showed that dengue cases were more concentrated in sectors located in the centre of the city and close to the health centres.
Introduction Although dengue is the most common arbovirus infection worldwide, studies of severe dengue in Africa are lacking, and risk factors for severe dengue have been insufficiently described. This study was conducted in the context of the 2016 dengue epidemic in Burkina Faso to determine the prevalence of severe dengue, identify factors associated with severe dengue, and perform mapping of dengue cases in the country's capital, Ouagadougou. Methods This cross-sectional study was conducted from November 2015 to January 2017. Data were collected in 15 public and private health centres, and included sociodemographic, clinical and patient outcome variables. Dengue was diagnosed using SD Bioline Dengue Duo rapid diagnostic tests. Data were analysed using Epi-Info Version 7. Logistic regression was used to identify predictors of severe dengue. P<0.05 was considered significant. Dengue case mapping was performed using Geographic Information System software (ArcGIS). Results Of the 811 patients who tested positive for dengue, 609 (75%) had early dengue (AgNS1 positive) and 272 (33.5%) had severe dengue. Patient age ranged from 1 to 83 years (median 30.5 years) and 393 (48.3%) were female. Renal failure (13.1%) and severe bleeding (10.6%) were the most common signs of severe dengue. Risk factors for severe dengue included age, male sex, haemoglobin S, diabetes, hypertension, and primary dengue. Dengue cases were more concentrated in sectors located in the centre of the city and close to the health centres. Conclusion Dengue is increasingly common in Africa and factors associated with severity should be sought systematically as soon as a patient tests positive. Additional studies are needed to determine if the factors found to be associated with severity can be used to identify patients at risk for dengue-related complications, and to provide early and specialized management to reduce morbidity and mortality related to dengue in Africa.
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Affiliation(s)
- Apoline Kongnimissom Sondo
- Department of Infectious and Tropical Diseases, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
- Joseph Ki-Zerbo University, Health Sciences and Research Training Unit, Ouagadougou, Burkina Faso
- Corresponding author. Address: Department of Infectious and Tropical Diseases, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso. Tel.: +226 70077198.
| | - Eric Arnaud Diendéré
- Department of Infectious and Tropical Diseases, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
| | | | - Ismaèl Diallo
- Joseph Ki-Zerbo University, Health Sciences and Research Training Unit, Ouagadougou, Burkina Faso
| | | | - Armel Poda
- National Institute of Health Sciences, Bobo-Dioulasso. Burkina Faso
| | - Noel Magloire Manga
- Unit of Training and Research in Health Sciences, Assane Seck University, Ziguinchor, Senegal
| | - Brice Bicaba
- Ministry of Health, Directorate of Disease Control, Ouagadougou, Burkina Faso
| | - Arouna Gnamou
- Department of Infectious and Tropical Diseases, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
| | - Charles Joel Kagoné
- Department of Infectious and Tropical Diseases, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
| | - Guetawendé Sawadogo
- Ministry of Health, Directorate of Disease Control, Ouagadougou, Burkina Faso
| | - Issaka Yaméogo
- Ministry of Health, Directorate of Disease Control, Ouagadougou, Burkina Faso
| | - Noelle A. Benzekri
- University of Washington, Department of Medicine, Division of Infectious Diseases, Seattle, WA, USA
| | - Zekiba Tarnagda
- Health Science Research Institute, Bio-Medical Department, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Health Science Research Institute, Bio-Medical Department, Ouagadougou, Burkina Faso
| | - Ramata Ouédraogo-Traoré
- Joseph Ki-Zerbo University, Health Sciences and Research Training Unit, Ouagadougou, Burkina Faso
| | | | - Moussa Seydi
- Infectious and Tropical Diseases Clinics, Fann University Hospital, Dakar, Senegal
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16
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Capeding MR, de Boer M, Damaso S, Guignard A. Assessing the burden of dengue among household members in Alaminos, Laguna, the Philippines: a prospective cohort study. ASIAN BIOMED 2021; 15:213-222. [PMID: 37551324 PMCID: PMC10388797 DOI: 10.2478/abm-2021-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The incidence of dengue is increasing rapidly and is a challenging health issue in the Philippines. Epidemiological data are largely based on a passive-surveillance reporting system, which leads to substantial under-reporting of cases. Objectives To estimate dengue infection and disease incidence prospectively at the community level in an endemic area of the Philippines using an active surveillance strategy. Methods We implemented active surveillance in the highly endemic community of Alaminos, Laguna. The study consisted of a 1-year follow-up with 2 visits scheduled at the start and end of the study, as well as regular active surveillance in between and unscheduled visits for suspected cases. Blood samples were collected and analyzed to detect dengue during the first scheduled visit and all unscheduled visits, and clinical examination was performed at all visits (registered at clinicaltrials.gov NCT02766088). Results We enrolled 500 participants, aged from 6 months to 50 years; 76.2% were found positive for immunoglobulin G (95% confidence interval [CI], 71.9-80.0), with 92.0% among those aged 9-17 years. Active (weekly) surveillance identified 4 virologically confirmed cases of dengue (incidence proportion 0.8; 95% CI 0.3-2.1); all in participants aged ≤14 years. Conclusions Routine surveillance programs such as sentinel sites are needed to characterize the entire clinical spectrum of symptomatic dengue, disease incidence, and transmission in the community.
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Affiliation(s)
- Maria Rosario Capeding
- Department of Microbiology, Research Institute for Tropical Medicine, Muntinlupa, 1781Metro Manila, Philippines
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17
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Current Trends and Limitations in Dengue Antiviral Research. Trop Med Infect Dis 2021; 6:tropicalmed6040180. [PMID: 34698303 PMCID: PMC8544673 DOI: 10.3390/tropicalmed6040180] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/13/2022] Open
Abstract
Dengue is the most prevalent arthropod-borne viral disease worldwide and affects approximately 2.5 billion people living in over 100 countries. Increasing geographic expansion of Aedes aegypti mosquitoes (which transmit the virus) has made dengue a global health concern. There are currently no approved antivirals available to treat dengue, and the only approved vaccine used in some countries is limited to seropositive patients. Treatment of dengue, therefore, remains largely supportive to date; hence, research efforts are being intensified for the development of antivirals. The nonstructural proteins, 3 and 5 (NS3 and NS5), have been the major targets for dengue antiviral development due to their indispensable enzymatic and biological functions in the viral replication process. NS5 is the largest and most conserved nonstructural protein encoded by flaviviruses. Its multifunctionality makes it an attractive target for antiviral development, but research efforts have, this far, not resulted in the successful development of an antiviral targeting NS5. Increase in structural insights into the dengue NS5 protein will accelerate drug discovery efforts focused on NS5 as an antiviral target. In this review, we will give an overview of the current state of therapeutic development, with a focus on NS5 as a therapeutic target against dengue.
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18
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Tiga-Loza DC, Martínez-Vega RA, Undurraga EA, Tschampl CA, Shepard DS, Ramos-Castañeda J. Persistence of symptoms in dengue patients: a clinical cohort study. Trans R Soc Trop Med Hyg 2021; 114:355-364. [PMID: 32125417 DOI: 10.1093/trstmh/traa007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dengue is commonly considered an acute illness and follows three phases: febrile, critical in some cases and recovery. However, a number of studies have described a continuation of dengue symptoms for weeks or months, extending the recovery phase. Here we evaluate this persistence of dengue symptoms during convalescence. METHODS Our clinical cohort study included patients who sought medical services 48 to 144 h from the onset of fever at seven hospitals or ambulatory centers in Morelos, Mexico. Seventy-nine laboratory-confirmed dengue patients were followed up regularly using clinic and/or home visits and telephone calls for as long as symptoms persisted or up to 6 mo. RESULTS In total, 55.7% of patients had dengue-related symptoms 1 mo after the onset of fever; pain and dermatological manifestations were the most common persistent symptoms. Prognostic factors for symptom persistence were: ≥4 d of fever (RR 1.72; 95% CI 1.35 to 2.19), platelet count ≤100 000/mm3 (RR 1.20; 95% CI 1.20 to 2.20), petechiae/bruises (RR 1.97; 95% CI 1.56 to 2.48) and abdominal pain/hepatomegaly (RR 1.79; 95% CI 1.41 to 2.28). CONCLUSIONS Persistence of dengue symptoms were common in laboratory-confirmed dengue patients. Manifestations related to tissue damage were associated with persistence after 30 d; host characteristics, such as age and health status before infection, were associated with prolonged persistence (>60 d). The burden of dengue may be higher than previously estimated.
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Affiliation(s)
- Diana Carolina Tiga-Loza
- Programa de enfermería, Universidad Manuela Beltrán, Bucaramanga, Santander, Colombia.,Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Ruth A Martínez-Vega
- Escuela de Microbiología, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - Eduardo A Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
| | - Cynthia A Tschampl
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Donald S Shepard
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - José Ramos-Castañeda
- Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.,Universidad Anahuac, Centro de Investigación en Ciencias de la Salud. México
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19
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Sonali Fernando E, Headley TY, Tissera H, Wilder-Smith A, De Silva A, Tozan Y. Household and Hospitalization Costs of Pediatric Dengue Illness in Colombo, Sri Lanka. Am J Trop Med Hyg 2021; 105:110-116. [PMID: 33999848 DOI: 10.4269/ajtmh.20-1179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/02/2021] [Indexed: 01/31/2023] Open
Abstract
Dengue, a mosquito-borne viral infection that affects millions around the world, poses a substantial economic burden in endemic countries. We conducted a prospective costing study in hospitalized pediatric dengue patients at the Lady Ridgeway Hospital for Children (LRHC), a public pediatric hospital in Colombo district, Sri Lanka, to assess household out-of-pocket and hospitalization costs of dengue in pediatric patients during peak dengue transmission season. Between August and October 2013, we recruited 216 hospitalized patients (aged 0-3 years, 27%; 4-7 years, 29%; 8-12 years, 42%) who were clinically or laboratory diagnosed with dengue. Using 2013 US dollars, household out-of-pocket spending, on average, was US$59 (SD 49) per episode and increased with disease severity (DF, US$52; DHF/DSS, US$78). Pediatric dengue patients received free-of-charge medical care during hospitalization at LRHC, and this places a high financial burden on hospitals. The direct medical cost of hospitalization was US$68.0 (SD 31.4) for DF episode, and US$122.7 (SD 65.2) for DHF/DSS episode. Yet a hospitalized dengue illness episode still accounted for 20% to 35% of household monthly income due to direct and indirect costs. Additionally, a majority of caregivers (70%) sought outpatient care before hospitalization, most of whom (81%) visited private health facilities. Our findings indicate that hospitalized pediatric dengue illness poses a nontrivial cost burden to households and healthcare systems, emphasizing the importance of preventing and controlling the transmission of dengue in endemic countries.
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Affiliation(s)
| | - Tyler Y Headley
- 2Department of Political Science, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Annelies Wilder-Smith
- 4Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,5Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.,6Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Amala De Silva
- 7Department of Economics, University of Colombo, Colombo, Sri Lanka
| | - Yesim Tozan
- 2Department of Political Science, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.,8School of Global Public Health, New York University, New York, New York
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20
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de Aguiar DF, de Barros ENC, Ribeiro GS, Brasil P, Mourao MPG, Luz K, Aoki FH, Freitas ARR, Calvet GA, Oliveira E, Branco BF, Abreu A, Cheuvart B, Guignard A, de Boer M, Duarte AC, Borges MB, de Noronha TG. A prospective, multicentre, cohort study to assess the incidence of dengue illness in households from selected communities in Brazil (2014-2018). Int J Infect Dis 2021; 108:443-453. [PMID: 33894353 DOI: 10.1016/j.ijid.2021.04.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To estimate the incidence of dengue infection across geographically distinct areas of Brazil. METHODS This prospective, household-based, cohort study enrolled participants in five areas and followed them up for up to 4 years (2014-2018). Dengue seroprevalence was assessed at each scheduled visit. Suspected dengue cases were identified through enhanced passive and active surveillance. Acute symptomatic dengue infection was confirmed through reverse-transcriptase quantitative polymerase chain reaction in combination with an antigenic assay (non-structural protein 1) and serology. RESULTS Among 3300 participants enrolled, baseline seroprevalence was 76.2%, although only 23.3% of participants reported a history of dengue. Of 1284 suspected symptomatic dengue cases detected, 50 (3.9%) were laboratory-confirmed. Based on 8166.5 person-years (PY) of follow-up, the incidence of laboratory-confirmed symptomatic infection (primary endpoint) was 6.1 per 1000 PY (95% confidence interval [CI]: 4.5, 8.1). Incidence varied substantially in different years (1.8-7.4 per 1000 PY). The incidence of inapparent primary dengue infection was substantially higher: 41.7 per 1000 PY (95% CI: 31.1, 54.6). CONCLUSIONS Our findings, highlighting that the incidence of dengue infection is underestimated in Brazil, will inform the design and implementation of future dengue vaccine trials. CLINICAL TRIAL REGISTRATION NCT01751139.
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Affiliation(s)
- Daniele Fernandes de Aguiar
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
| | | | - Guilherme Sousa Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Avenida Waldemar Falcão, 121, Candeal, Salvador - BA, 40296-710, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Avenida Adhemar de Barros, s/nº - Ondina, Salvador - BA, 40170-110, Brazil
| | - Patricia Brasil
- Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz), Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
| | | | - Kleber Luz
- Centro de Pesquisas Clínicas de Natal, Rua Dr. Ponciano Barbosa, 282, Cidade Alta, Natal - RN, 59025-050, Brazil
| | - Francisco Hideo Aoki
- Universidade Estadual de Campinas, Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas - SP, 13083-970, Brazil
| | - Andre Ricardo Ribas Freitas
- São Leopoldo Mandic College, Rua Dr. José Rocha Junqueira, 13 - Pte. Preta, Campinas - SP, 13045-755, Brazil
| | - Guilherme Amaral Calvet
- Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz), Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
| | - Eduardo Oliveira
- GSK, Estrada dos Bandeirantes, 8464, Jacarepaguá, Rio de Janeiro - RJ, 22775-610, Brazil
| | - Bianca F Branco
- GSK, Estrada dos Bandeirantes, 8464, Jacarepaguá, Rio de Janeiro - RJ, 22775-610, Brazil
| | - Ariane Abreu
- GSK, Estrada dos Bandeirantes, 8464, Jacarepaguá, Rio de Janeiro - RJ, 22775-610, Brazil
| | | | | | | | - Ana Claudia Duarte
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
| | - Maria Beatriz Borges
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
| | - Tatiana Guimarães de Noronha
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil
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21
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Archuleta S, Chia PY, Wei Y, Syed-Omar SF, Low JG, Oh HM, Fisher D, Ponnampalavanar SSL, Wijaya L, Kamarulzaman A, Lum LCS, Tambyah PA, Leo YS, Lye DC. Predictors and Clinical Outcomes of Poor Platelet Recovery in Adult Dengue With Thrombocytopenia: A Multicenter, Prospective Study. Clin Infect Dis 2021; 71:383-389. [PMID: 31626692 DOI: 10.1093/cid/ciz850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 09/15/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Platelet transfusion is common in dengue patients with thrombocytopenia. We previously showed in a randomized clinical trial that prophylactic platelet transfusion did not reduce clinical bleeding. In this study, we aimed to characterize the predictors and clinical outcomes of poor platelet recovery in transfused and nontransfused participants. METHODS We analyzed patients from the Adult Dengue Platelet Study with laboratory-confirmed dengue with ≤20 000 platelets/μL and without persistent mild bleeding or any severe bleeding in a post hoc analysis. Poor platelet recovery was defined as a platelet count of ≤20 000/μL on Day 2. We recruited 372 participants from 5 acute care hospitals located in Singapore and Malaysia between 29 April 2010 and 9 December 2014. Of these, 188 were randomly assigned to the transfusion group and 184 to the control group. RESULTS Of 360 patients, 158 had poor platelet recovery. Age, white cell count, and day of illness at study enrollment were significant predictors of poor platelet recovery after adjustment for baseline characteristics and platelet transfusion. Patients with poor platelet recovery had longer hospitalizations but no significant difference in other clinical outcomes, regardless of transfusion. We found a significant interaction between platelet recovery and transfusion; patients with poor platelet recovery were more likely to bleed if given a prophylactic platelet transfusion (odds ratio 2.34, 95% confidence interval 1.18-4.63). CONCLUSIONS Dengue patients with thrombocytopenia who were older or presented earlier and with lower white cell counts were more likely to have poor platelet recovery. In patients with poor platelet recovery, platelet transfusion does not improve outcomes and may actually increase the risk of bleeding. The mechanisms of poor platelet recovery need to be determined. CLINICAL TRIALS REGISTRATION NCT01030211.
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Affiliation(s)
- Sophia Archuleta
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Po Ying Chia
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - Yuan Wei
- Singapore Clinical Research Institute, Singapore
| | | | - Jenny G Low
- Singapore General Hospital, Singapore.,Duke-NUS Graduate Medical School, Singapore
| | - Helen M Oh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Changi General Hospital, Singapore; and
| | - Dale Fisher
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | | | - Lucy C S Lum
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Paul A Tambyah
- Division of Infectious Diseases, National University Hospital, National University Health System, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yee-Sin Leo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - David C Lye
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Singapore
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22
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Colón-González FJ, Soares Bastos L, Hofmann B, Hopkin A, Harpham Q, Crocker T, Amato R, Ferrario I, Moschini F, James S, Malde S, Ainscoe E, Sinh Nam V, Quang Tan D, Duc Khoa N, Harrison M, Tsarouchi G, Lumbroso D, Brady OJ, Lowe R. Probabilistic seasonal dengue forecasting in Vietnam: A modelling study using superensembles. PLoS Med 2021; 18:e1003542. [PMID: 33661904 PMCID: PMC7971894 DOI: 10.1371/journal.pmed.1003542] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/18/2021] [Accepted: 01/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND With enough advanced notice, dengue outbreaks can be mitigated. As a climate-sensitive disease, environmental conditions and past patterns of dengue can be used to make predictions about future outbreak risk. These predictions improve public health planning and decision-making to ultimately reduce the burden of disease. Past approaches to dengue forecasting have used seasonal climate forecasts, but the predictive ability of a system using different lead times in a year-round prediction system has been seldom explored. Moreover, the transition from theoretical to operational systems integrated with disease control activities is rare. METHODS AND FINDINGS We introduce an operational seasonal dengue forecasting system for Vietnam where Earth observations, seasonal climate forecasts, and lagged dengue cases are used to drive a superensemble of probabilistic dengue models to predict dengue risk up to 6 months ahead. Bayesian spatiotemporal models were fit to 19 years (2002-2020) of dengue data at the province level across Vietnam. A superensemble of these models then makes probabilistic predictions of dengue incidence at various future time points aligned with key Vietnamese decision and planning deadlines. We demonstrate that the superensemble generates more accurate predictions of dengue incidence than the individual models it incorporates across a suite of time horizons and transmission settings. Using historical data, the superensemble made slightly more accurate predictions (continuous rank probability score [CRPS] = 66.8, 95% CI 60.6-148.0) than a baseline model which forecasts the same incidence rate every month (CRPS = 79.4, 95% CI 78.5-80.5) at lead times of 1 to 3 months, albeit with larger uncertainty. The outbreak detection capability of the superensemble was considerably larger (69%) than that of the baseline model (54.5%). Predictions were most accurate in southern Vietnam, an area that experiences semi-regular seasonal dengue transmission. The system also demonstrated added value across multiple areas compared to previous practice of not using a forecast. We use the system to make a prospective prediction for dengue incidence in Vietnam for the period May to October 2020. Prospective predictions made with the superensemble were slightly more accurate (CRPS = 110, 95% CI 102-575) than those made with the baseline model (CRPS = 125, 95% CI 120-168) but had larger uncertainty. Finally, we propose a framework for the evaluation of probabilistic predictions. Despite the demonstrated value of our forecasting system, the approach is limited by the consistency of the dengue case data, as well as the lack of publicly available, continuous, and long-term data sets on mosquito control efforts and serotype-specific case data. CONCLUSIONS This study shows that by combining detailed Earth observation data, seasonal climate forecasts, and state-of-the-art models, dengue outbreaks can be predicted across a broad range of settings, with enough lead time to meaningfully inform dengue control. While our system omits some important variables not currently available at a subnational scale, the majority of past outbreaks could be predicted up to 3 months ahead. Over the next 2 years, the system will be prospectively evaluated and, if successful, potentially extended to other areas and other climate-sensitive disease systems.
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Affiliation(s)
- Felipe J. Colón-González
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Tyndall Centre for Climate Change Research, University of East Anglia, Norwich, United Kingdom
- * E-mail:
| | - Leonardo Soares Bastos
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Scientific Computing Programme, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro
| | | | - Alison Hopkin
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | | | | | | | | | - Samuel James
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | - Sajni Malde
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | - Vu Sinh Nam
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Hanoi, Vietnam
| | | | | | - Gina Tsarouchi
- HR Wallingford, Wallingford, Oxfordshire, United Kingdom
| | | | - Oliver J. Brady
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel Lowe
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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23
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Koliopoulos P, Kayange NM, Daniel T, Huth F, Gröndahl B, Medina-Montaño GC, Pretsch L, Klüber J, Schmidt C, Züchner A, Ulbert S, Mshana SE, Addo M, Gehring S. Multiplex-RT-PCR-ELISA panel for detecting mosquito-borne pathogens: Plasmodium sp. preserved and eluted from dried blood spots on sample cards. Malar J 2021; 20:66. [PMID: 33526038 PMCID: PMC7851927 DOI: 10.1186/s12936-021-03595-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/15/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Children are the most vulnerable group affected by malaria and other tropical, vector-borne diseases in low-resource countries. Infants presenting with acute onset fever represent a major sector of outpatient care in the Lake Victoria region. Misclassification and overuse of antibiotics and anti-malarial medications are consistent problems. Identifying the prevalent mosquito-borne pathogens in the region will reduce the prescription of non-indicated medicines. METHODS The literature was reviewed focusing on the mosquito-borne pathogens most prevalent in sub-Saharan Africa. Accordingly, an assay comprised of a multiplex-reverse transcriptase-polymerase chain reaction and an enzyme-linked immunosorbent assay (multiplex-RT-PCR-ELISA) was designed and validated in its ability to identify and differentiate nine human mosquito-borne pathogens including eight arboviruses and Plasmodium sp., the aetiologic agents of malaria. Blood samples obtained from 132 children suspected of having malaria were spotted and preserved on Whatman® 903 protein sample cards. Multiplex-RT-PCR-ELISA analysis was assessed and compared to results obtained by blood smear microscopy and the malaria rapid diagnostic test (RDT). RESULTS Nine out of nine pathogens were amplified specifically by the multiplex-RT-PCR-ELISA panel. Twenty-seven out of 132 paediatric patients presenting with acute fever were infected with Plasmodium sp., confirmed by multiplex-RT-PCR. The results of blood smear microscopy were only 40% sensitive and 92.8% specific. The malaria RDT, on the other hand, detected acute Plasmodium infections with 96.3% sensitivity and 98.1% specificity. The preservation of Plasmodium sp. in clinical sera and whole blood samples spotted on sample cards was evaluated. The duration of successful, sample card storage was 186 to 312 days. CONCLUSIONS Reliable, easy-to-use point of care diagnostic tests are a powerful alternative to laboratory-dependent gold standard tests. The multiplex-RT-PCR-ELISA amplified and identified nine vector-borne pathogens including Plasmodium sp. with great accuracy. Translation of improved diagnostic approaches, i.e., multiplex-RT-PCR-ELISA, into effective treatment options promises to reduce childhood mortality and non-indicated prescriptions.
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Affiliation(s)
- Philip Koliopoulos
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
| | - Neema Mathias Kayange
- Department of Pediatric and Adolescent Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | - Tim Daniel
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
| | - Florian Huth
- Department of Infectiology and Tropical Medicine, University Medical Center Hamburg-Eppendorf, Eppendorf, Germany
| | - Britta Gröndahl
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany.
| | | | - Leah Pretsch
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
| | - Julia Klüber
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany.,Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Christian Schmidt
- Department of Pediatric and Adolescent Medicine, St. Vinzenz-Hospital, Dinslaken, Germany
| | - Antke Züchner
- Department of Pediatric and Adolescent Medicine, Bugando Medical Centre, Mwanza, Tanzania
| | - Sebastian Ulbert
- Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Steven E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Marylyn Addo
- Department of Infectiology and Tropical Medicine, University Medical Center Hamburg-Eppendorf, Eppendorf, Germany
| | - Stephan Gehring
- Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
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24
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Augustinos AA, Misbah-Ul-Haq M, Carvalho DO, de la Fuente LD, Koskinioti P, Bourtzis K. Irradiation induced inversions suppress recombination between the M locus and morphological markers in Aedes aegypti. BMC Genet 2020; 21:142. [PMID: 33339503 PMCID: PMC7747368 DOI: 10.1186/s12863-020-00949-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Aedes aegypti is the primary vector of arthropod-borne viruses and one of the most widespread and invasive mosquito species. Due to the lack of efficient specific drugs or vaccination strategies, vector population control methods, such as the sterile insect technique, are receiving renewed interest. However, availability of a reliable genetic sexing strategy is crucial, since there is almost zero tolerance for accidentally released females. Development of genetic sexing strains through classical genetics is hindered by genetic recombination that is not suppressed in males as is the case in many Diptera. Isolation of naturally-occurring or irradiation-induced inversions can enhance the genetic stability of genetic sexing strains developed through genetically linking desirable phenotypes with the male determining region. RESULTS For the induction and isolation of inversions through irradiation, 200 male pupae of the 'BRA' wild type strain were irradiated at 30 Gy and 100 isomale lines were set up by crossing with homozygous 'red-eye' (re) mutant females. Recombination between re and the M locus and the white (w) gene (causing a recessive white eye phenotype when mutated) and the M locus was tested in 45 and 32 lines, respectively. One inversion (Inv35) reduced recombination between both re and the M locus, and wand the M locus, consistent with the presence of a rather extended inversion between the two morphological mutations, that includes the M locus. Another inversion (Inv5) reduced recombination only between w and the M locus. In search of naturally-occurring, recombination-suppressing inversions, homozygous females from the red eye and the white eye strains were crossed with seventeen and fourteen wild type strains collected worldwide, representing either recently colonized or long-established laboratory populations. Despite evidence of varying frequencies of recombination, no combination led to the elimination or substantial reduction of recombination. CONCLUSION Inducing inversions through irradiation is a feasible strategy to isolate recombination suppressors either on the M or the m chromosome for Aedes aegypti. Such inversions can be incorporated in genetic sexing strains developed through classical genetics to enhance their genetic stability and support SIT or other approaches that aim to population suppression through male-delivered sterility.
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Affiliation(s)
- Antonios A Augustinos
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria.
- Present address: Department of Plant Protection, Hellenic Agricultural Organization-Demeter, Institute of Industrial and Forage Crops, 26442, Patras, Greece.
| | - Muhammad Misbah-Ul-Haq
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria
- Present address: Nuclear Institute for Food and Agriculture (NIFA), Peshawar, Pakistan
| | - Danilo O Carvalho
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria
| | - Lucia Duran de la Fuente
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria
| | - Panagiota Koskinioti
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis, 41500, Larissa, Greece
| | - Kostas Bourtzis
- Insect Pest Control Laboratory, Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, A-1400, Vienna, Austria.
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25
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Akbar NA, Assiri AM, Shabouni OI, Alwafi OM, Al-Raddadi R, H. Alzahrani M, Azhar EI, Amir A, Aljiffri AM, Althaqafi AO. The economic burden of dengue fever in the Kingdom of Saudi Arabia. PLoS Negl Trop Dis 2020; 14:e0008847. [PMID: 33253181 PMCID: PMC7728199 DOI: 10.1371/journal.pntd.0008847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/10/2020] [Accepted: 10/01/2020] [Indexed: 12/01/2022] Open
Abstract
Rapid urbanization, global trade, and the exceptionally great numbers of worldwide visitors during Hajj and Umrah have all placed the Kingdom of Saudi Arabia at a significant risk of introducing several vector-borne tropical diseases, such as dengue fever virus (DENV) infection. In this study we estimated DENV infection cost of illness (COI) in Saudi Arabia in the period 2013–2017, by processing national data including all declared cases recorded in referral centers in the western region, being the endemic region of the country. Using a statistically validated predictive model that was built on a representative sample of 717 laboratory-confirmed cases of DENV infection, direct costs, due to care-related expenditures, were estimated by applying the predictive equation to national data. However, indirect costs, which are due to productivity loss, were estimated using the human capital model based on gross domestic product adjusted for invalidity duration. Further, under-reporting was adjusted by using an expansion factor EF = 3. We observed highest estimated costs in 2016 with over US$168.5 Million total costs, including direct (US$29.0 Million) and indirect (US$139.5 Million) costs, for a total 4415 confirmed cases. The total DENV COI for the five years was estimated as US$551.0 Million for a total 15,369 patients (59.7%) out of 25,745 declared cases, resulting in an average cost of US$11 947.6 by patient. Depending on the year, productivity years loss costs accounted for 63.3% to 83.8% of the estimated total costs. Dengue has a substantial local economic burden that costs US$110.2 Million per year, stressing the urgent need for an effective national prevention strategy to perform considerable cost-savings besides reducing morbidity. The global incidence of DENV infection has evidenced a dramatic increase in the recent two decades with a great number of cases that are misclassified or underreported. These epidemiological characteristics generate high economic costs, especially in endemic regions and countries such as Saudi Arabia. This two-phase study aimed at providing economic data that helps political efficiency and resource prioritization for dengue prevention programs, by assessing the economic burden of disease over the last five years 2013–2017. A double-method used to estimate direct costs due to care expenses and indirect costs due to productivity loss, by using a predictive and an economic model, respectively. Assuming an expansion factor of 3 to correct under-reporting, the average estimated costs of dengue illness per year in the current study was US$117.87 million. Comparison of these findings with international reports emphasized the substantial disease burden of dengue fever in Saudi Arabia. Despite some limitations, this study provided the first economic data of dengue fever infection burden in Saudi Arabia.
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Affiliation(s)
- Naeema A. Akbar
- Preventive medicine, Public Health MOH, Jeddah, Saudi Arabia
- * E-mail:
| | | | | | - Osama M. Alwafi
- Preventive medicine department, Public Health MOH, Makkah, Saudi Arabia
| | - Rajaa Al-Raddadi
- King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia
| | | | - Esam I. Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center & Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ashraf Amir
- Chief Medical Officer, International Medical center, Jeddah, Saudi Arabia
| | - Abdullah M. Aljiffri
- Infection Control Consultant, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulhakeem O. Althaqafi
- Department of medicine, King Abdulaziz Medical city- Jeddah, King Saud bin Abdulaziz university for Health Sciences, King Abdullah Medical center, Saudi Arabia
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26
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A Targeted Computational Screen of the SWEETLEAD Database Reveals FDA-Approved Compounds with Anti-Dengue Viral Activity. mBio 2020; 11:mBio.02839-20. [PMID: 33173007 PMCID: PMC7667029 DOI: 10.1128/mbio.02839-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Affordable and effective antiviral therapies are needed worldwide, especially against agents such as dengue virus that are endemic in underserved regions. Many antiviral compounds have been studied in cultured cells but are unsuitable for clinical applications due to pharmacokinetic profiles, side effects, or inconsistent efficacy across dengue serotypes. Such tool compounds can, however, aid in identifying clinically useful treatments. Here, computational screening (Rapid Overlay of Chemical Structures) was used to identify entries in an in silico database of safe-in-human compounds (SWEETLEAD) that display high chemical similarities to known inhibitors of dengue virus. Inhibitors of the dengue proteinase NS2B/3, the dengue capsid, and the host autophagy pathway were used as query compounds. Three FDA-approved compounds that resemble the tool molecules structurally, cause little toxicity, and display strong antiviral activity in cultured cells were selected for further analysis. Pyrimethamine (50% inhibitory concentration [IC50] = 1.2 μM), like the dengue proteinase inhibitor ARDP0006 to which it shows structural similarity, inhibited intramolecular NS2B/3 cleavage. Lack of toxicity early in infection allowed testing in mice, in which pyrimethamine also reduced viral loads. Niclosamide (IC50 = 0.28 μM), like dengue core inhibitor ST-148, affected structural components of the virion and inhibited early processes during infection. Vandetanib (IC50 = 1.6 μM), like cellular autophagy inhibitor spautin-1, blocked viral exit from cells and could be shown to extend survival in vivo Thus, three FDA-approved compounds with promising utility for repurposing to treat dengue virus infections and their potential mechanisms were identified using computational tools and minimal phenotypic screening.IMPORTANCE No antiviral therapeutics are currently available for dengue virus infections. By computationally overlaying the three-dimensional (3D) chemical structures of compounds known to inhibit dengue virus over those of compounds known to be safe in humans, we identified three FDA-approved compounds that are attractive candidates for repurposing as antivirals. We identified targets for two previously identified antiviral compounds and revealed a previously unknown potential anti-dengue compound, vandetanib. This computational approach to analyze a highly curated library of structures has the benefits of speed and cost efficiency. It also leverages mechanistic work with query compounds used in biomedical research to provide strong hypotheses for the antiviral mechanisms of the safer hit compounds. This workflow to identify compounds with known safety profiles can be expanded to any biological activity for which a small-molecule query compound has been identified, potentially expediting the translation of basic research to clinical interventions.
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27
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Del Valle-Mendoza J, Vasquez-Achaya F, Aguilar-Luis MA, Martins-Luna J, Bazán-Mayra J, Zavaleta-Gavidia V, Silva-Caso W, Carrillo-Ng H, Tarazona-Castro Y, Aquino-Ortega R, Del Valle LJ. Unidentified dengue serotypes in DENV positive samples and detection of other pathogens responsible for an acute febrile illness outbreak 2016 in Cajamarca, Peru. BMC Res Notes 2020; 13:467. [PMID: 33023645 PMCID: PMC7541171 DOI: 10.1186/s13104-020-05318-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023] Open
Abstract
Objective To describe the prevalence of dengue virus serotypes, as well as other viral and bacterial pathogens that cause acute febrile illness during an outbreak in Cajamarca in 2016. Results Dengue virus (DENV) was the most frequent etiologic agent detected in 25.8% of samples (32/124), followed by Rickettsia spp. in 8.1% (10/124), Zika virus in 4.8% (6/124), Chikungunya virus 2.4% (3/124) and Bartonella bacilliformis 1.6% (2/124) cases. No positive cases were detected of Oropouche virus and Leptospira spp. DENV serotypes identification was only achieved in 23% of the total positive for DENV, two samples for DENV-2 and four samples for DENV-4. During the 2016 outbreak in Cajamarca—Peru, it was observed that in a large percentage of positive samples for DENV, the infecting serotype could not be determined by conventional detection assays. This represents a problem for the national surveillance system and for public health due to its epidemiological and clinical implications. Other viral and bacterial pathogens responsible for acute febrile syndrome were less frequently identified.
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Affiliation(s)
- Juana Del Valle-Mendoza
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru. .,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.
| | - Fernando Vasquez-Achaya
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Johanna Martins-Luna
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Jorge Bazán-Mayra
- Laboratorio Regional de Cajamarca, Dirección Regional de Salud de Cajamarca (DIRESA), Cajamarca, Peru
| | - Victor Zavaleta-Gavidia
- Laboratorio Regional de Cajamarca, Dirección Regional de Salud de Cajamarca (DIRESA), Cajamarca, Peru
| | - Wilmer Silva-Caso
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Hugo Carrillo-Ng
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Yordi Tarazona-Castro
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.,Escuela Profesional de Genética y Biotecnología. Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Ronald Aquino-Ortega
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Luis J Del Valle
- Barcelona Research Center for Multiscale Science and Engineering, Departament D'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain.
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Kazazian L, Lima Neto AS, Sousa GS, do Nascimento OJ, Castro MC. Spatiotemporal transmission dynamics of co-circulating dengue, Zika, and chikungunya viruses in Fortaleza, Brazil: 2011-2017. PLoS Negl Trop Dis 2020; 14:e0008760. [PMID: 33104708 PMCID: PMC7644107 DOI: 10.1371/journal.pntd.0008760] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/05/2020] [Accepted: 08/30/2020] [Indexed: 12/16/2022] Open
Abstract
The mosquito-borne viruses dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV), now co-endemic in the Americas, pose growing threats to health worldwide. However, it remains unclear whether there exist interactions between these viruses that could shape their epidemiology. This study advances knowledge by assessing the transmission dynamics of co-circulating DENV, ZIKV, and CHIKV in the city of Fortaleza, Brazil. Spatiotemporal transmission dynamics of DENV, ZIKV, and CHIKV were analyzed using georeferenced data on over 210,000 reported cases from 2011 to 2017 in Fortaleza, Brazil. Local spatial clustering tests and space-time scan statistics were used to compare transmission dynamics across all years. The transmission of co-circulating viruses in 2016 and 2017 was evaluated at fine spatial and temporal scales using a measure of spatiotemporal dependence, the τ-statistic. Results revealed differences in the diffusion of CHIKV compared to previous DENV epidemics and spatially distinct transmission of DENV/ZIKV and CHIKV during the period of their co-circulation. Significant spatial clustering of viruses of the same type was observed within 14-day time intervals at distances of up to 6.8 km (p<0.05). These results suggest that arbovirus risk is not uniformly distributed within cities during co-circulation. Findings may guide outbreak preparedness and response efforts by highlighting the clustered nature of transmission of co-circulating arboviruses at the neighborhood level. The potential for competitive interactions between the arboviruses should be further investigated.
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Affiliation(s)
- Lilit Kazazian
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Antonio S. Lima Neto
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Health Surveillance Department, Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Joaquim Távora, Fortaleza, Ceará, Brazil
- Health Sciences Center, University of Fortaleza (UNIFOR), Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Geziel S. Sousa
- Health Surveillance Department, Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Joaquim Távora, Fortaleza, Ceará, Brazil
| | - Osmar José do Nascimento
- Health Surveillance Department, Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Joaquim Távora, Fortaleza, Ceará, Brazil
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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29
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Hashan MR, Ghozy S, El-Qushayri AE, Pial RH, Hossain MA, Al Kibria GM. Association of dengue disease severity and blood group: A systematic review and meta-analysis. Rev Med Virol 2020; 31:1-9. [PMID: 32776660 DOI: 10.1002/rmv.2147] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 12/28/2022]
Abstract
Dengue disease encompasses various clinical manifestations including dengue fever (DF) and dengue hemorrhagic fever (DHF). In this article, we aimed to systematically review and analyze the association between different blood groups and severity of dengue. We searched nine databases for eligible papers reporting prevalence, distribution, and frequency of blood group type among dengue patients. Network meta-analysis using R software was used to analyze the data. Of a total of 63 reports screened, we included 10 studies with total sample size 1977 patients (1382 DF and 595 DHF). Blood group O was found to have the worst outcome with the highest risk of developing DF (P-score = 0.01) followed by group B (P-score = 0.34), group A (P-score = 0.64), and group AB (P-score = 1), respectively. Blood group O also had the worst outcome with highest risk of developing DHF (P-score = 0.1) followed by group B (P-score = 0.29), group A (P-score = 0.61), and group AB (P-score = 1), respectively. There was a significant increase (P-value <.001) in the overall odds risk of dengue infection among patients with Rhesus-positive blood groups [OR = 540.03; (95% CI = 151.48-1925.18)]. However, there was no significant difference in the odds risk of DF when compared to DHF according to Rhesus status (P-value = .954). This study identified the O blood group as a potential risk factor in predicting clinical severity in dengue patients which may be helpful in evaluating patients for their likely need for critical care.
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Affiliation(s)
- Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Sherief Ghozy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Rejwana Haque Pial
- Infectious Disease Division, International Center for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Md Anwar Hossain
- Infectious Disease Division, International Center for Diarrheal Disease Research, Dhaka, Bangladesh
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30
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Sulistyawati S, Nilsson M, Ekasari MP, Mulasari SA, Sukesi TW, Padmawati RS, Holmner Å. Untapped Potential: A Qualitative Study of a Hospital-Based Dengue Surveillance System. Am J Trop Med Hyg 2020; 103:120-131. [PMID: 32394883 PMCID: PMC7356460 DOI: 10.4269/ajtmh.19-0719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The incidence and geographical distribution of dengue fever has increased in recent decades. The actual disease burden is unknown owing to frequent underreporting and misclassification of cases. A well-functioning system for diagnosing, treating, and reporting cases is of prime importance as disease statistics is the foundation for decisions aiming to control the disease. This study aimed to explore the hospital-based disease surveillance system in Yogyakarta, a dengue-endemic region on Java, Indonesia. Semi-structured interviews were performed with 16 informants from four hospitals, including five general practitioners, three internists, four pediatricians, and four administrative staff working with administration relating to dengue diagnostics and reporting. Data were analyzed using content analysis. A theme arose from the analysis “Dengue surveillance stands and falls by the rigor of the health system.” The theme, and underlying categories and subcategories, describes a surveillance system that in the best-case scenario works well and is likely to produce reliable dengue case data. However, there is a lack of synchronization between regulations and guidelines in different hospitals and some friction between regulatory bodies and the care provider. Knowledge among the staff appears to vary, and many clinical and financial decisions are made rather arbitrarily, which ultimately might lead to unequal health service delivery. In conclusion, the dengue surveillance system under study could improve further, particularly by ensuring that all regulations and recommended procedures are standardized and that all staff are given the best opportunity to stay updated on dengue-related matters, clinical as well as regulatory, on a regular basis.
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Affiliation(s)
- Sulistyawati Sulistyawati
- Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Marlita Putri Ekasari
- Laboratory of Pharmacy Management and Community Pharmacy, Department of Pharmaceutics, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Tri Wahyuni Sukesi
- Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Retna Siwi Padmawati
- Department of Health Behaviour, Environmental, and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Center of Health Behavior and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Åsa Holmner
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Department of Radiation Sciences, Umeå University, Umeå, Sweden
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31
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Thompson R, Martin Del Campo J, Constenla D. A review of the economic evidence of Aedes-borne arboviruses and Aedes-borne arboviral disease prevention and control strategies. Expert Rev Vaccines 2020; 19:143-162. [PMID: 32077343 DOI: 10.1080/14760584.2020.1733419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Aedes-borne arboviruses contributes substantially to the disease and cost burden.Areas covered: We performed a systematic review of the economic evidence surrounding aedes-borne arboviruses and strategies to prevent and control these diseases to inform disease control policy decisions and research directions. We searched four databases covering an 18-year period (2000-2018) to identify arboviral disease-related cost of illness studies, cost studies of vector control and prevention strategies, cost-effectiveness analyses and cost-benefit analyses. We identified 74 published studies that revealed substantial global total costs in yellow fever virus and dengue virus ranging from 2.1 to 57.3 billion USD. Cost studies of vector control and surveillance programs are limited, but a few studies found that costs of vector control programs ranged from 5.62 to 73.5 million USD. Cost-effectiveness evidence was limited across Aedes-borne diseases, but generally found targeted dengue vaccination programs cost-effective. This review revealed insufficient economic evidence for vaccine introduction and implementation of surveillance and vector control programs.Expert opinion: Evidence of the economic burden of aedes-borne arboviruses and the economic impact of strategies for arboviral disease prevention and control is critical to inform policy decisions and to secure continued financial support for these preventive and control measures.
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Affiliation(s)
- Ryan Thompson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHBSPH), International Vaccine Access Center (IVAC), Baltimore, MD, USA
| | | | - Dagna Constenla
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHBSPH), International Vaccine Access Center (IVAC), Baltimore, MD, USA
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32
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Ahmed AM, Mohammed AT, Vu TT, Khattab M, Doheim MF, Ashraf Mohamed A, Abdelhamed MM, Shamandy BE, Dawod MT, Alesaei WA, Kassem MA, Mattar OM, Smith C, Hirayama K, Huy NT. Prevalence and burden of dengue infection in Europe: A systematic review and meta‐analysis. Rev Med Virol 2019; 30:e2093. [DOI: 10.1002/rmv.2093] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Affiliation(s)
| | | | - Thao T. Vu
- School of Health and Biomedical SciencesRMIT University Melbourne Victoria Australia
| | | | | | | | | | | | | | - Wafaa Ali Alesaei
- Faculty of MedicineMisr University for Science and Technology Giza Egypt
| | - Mahmoud Attia Kassem
- Medical Oncology DepartmentThe Ohio State University Wexner Medical Center Columbus Ohio USA
| | | | - Chris Smith
- School of Tropical Medicine and Global HealthNagasaki University Nagasaki Japan
- Department of Clinical ResearchLondon School of Hygiene and Tropical Medicine London UK
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global HealthNagasaki University Nagasaki Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research GroupTon Duc Thang University Ho Chi Minh City Vietnam
- Faculty of Applied SciencesTon Duc Thang University Ho Chi Minh City Vietnam
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33
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Liao F, Chen H, Xie J, Zhan S, Pan P, Lao Z, Fan Y, Lin L, Lai Y, Lin S, Wu J, Liu X, Li G. Molecular epidemiological characteristics of dengue virus carried by 34 patients in Guangzhou in 2018. PLoS One 2019; 14:e0224676. [PMID: 31725752 PMCID: PMC6855448 DOI: 10.1371/journal.pone.0224676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/19/2019] [Indexed: 11/18/2022] Open
Abstract
Dengue fever is a major worldwide public health problem that, as estimated by the WHO, causes epidemics in over 100 countries, resulting in hundreds of millions of dengue virus (DENV) infections every year. In China, dengue fever mainly occurs in coastal areas. Recurring dengue outbreaks were reported by Guangdong Province almost every year since the first epidemic in 1978. DENV infections persisted in Guangzhou in consecutive years since 2000, with the dengue epidemic reaching a historical peak in 2014. Because Guangzhou is one of the largest cities for opening up in China, understanding the epidemiological characteristics of dengue fever in the city can hopefully provide a significant basis for developing effective dengue prevention strategies. In this study, a total of 34 DENV strains, including 29 DENV-1 strains and 5 DENV-2 strains, were isolated from a blood samples drawn from patients who were diagnosed with dengue fever by hospitals in Guangzhou during 2018. To explore the epidemiological characteristics of dengue fever, the envelope (E) gene obtained from the isolates was amplified for phylogenetic analysis. The results from the phylogenetic analysis showed that DENV in Guangzhou was mainly imported from Southeast Asian countries. Additionally, propagation paths based on phylogeographical analysis suggested potential local dengue transmission in Guangzhou.
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Affiliation(s)
- Feng Liao
- Laboratory Animal Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huini Chen
- Institute of Medical Microbiology, Jinan University, Guangzhou, China
| | - Jieliang Xie
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shaofeng Zhan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pan Pan
- College of Life Sciences, WuHan university, Wuhan, China
| | - Zizhao Lao
- Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yaohua Fan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lupin Lin
- Guangzhou eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yanni Lai
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuangfeng Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianguo Wu
- Institute of Medical Microbiology, Jinan University, Guangzhou, China
| | - Xiaohong Liu
- Laboratory Animal Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Geng Li
- Laboratory Animal Center, Guangzhou University of Chinese Medicine, Guangzhou, China
- * E-mail:
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34
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Torres JR, Falleiros-Arlant LH, Gessner BD, Delrieu I, Avila-Aguero ML, Giambernardino HIG, Mascareñas A, Brea J, Torres CN, Castellanos-Martinez JM. Updated recommendations of the International Dengue Initiative expert group for CYD-TDV vaccine implementation in Latin America. Vaccine 2019; 37:6291-6298. [PMID: 31515144 DOI: 10.1016/j.vaccine.2019.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/25/2019] [Accepted: 09/02/2019] [Indexed: 11/17/2022]
Abstract
Dengue disease represents a large and growing global threat to public health, causing a significant burden to health systems of endemic countries. For countries considering vaccination as part of their Integrated Management Strategy for Prevention and Control of Dengue, the World Health Organization currently recommends the first licensed dengue vaccine, CYD-TDV for: individuals aged 9 years or above from populations with high transmission rates, based on either seroprevalence criteria or pre-vaccination screening strategies, and for persons with confirmed prior exposure to infection in moderate to lower transmission settings. This paper describes the main conclusions of the Sixth Meeting of the International Dengue Initiative (IDI) held in June 2018, following release of a new product label by the manufacturer, updated WHO-SAGE recommendations, additional scientific evidence on vaccine performance, and reports of experiences by implementing countries. Considerations were made regarding the need for improving the quality of epidemiological and surveillance data in the region to help define the convenience of either of the two vaccination strategies recommended by WHO-SAGE. Extensive discussion was dedicated to the pros and cons of implementing either of such strategies in Latin America. Although, in general, a seroprevalence-based approach was preferred in high transmission settings, when cost-effectivity is favorable pre-vaccination screening is a convenient alternative. Cost-effectiveness evaluations can assist with the decisions by public health authorities of whether to introduce a vaccine. Where implemented, vaccine introduction should be part of a public health strategy that includes the participation of multiple sectors of society, incorporating input from scientific societies, ministries of heath, and civil society, while ensuring a robust communication program.
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Affiliation(s)
- J R Torres
- Infectious Diseases Section, Tropical Medicine Institute, Universidad Central de Venezuela, Caracas, Venezuela.
| | - L H Falleiros-Arlant
- Departamento de Salud de los Niños, Facultad de Medicina, Universidad Metropolitana de Santos, Brazil.
| | - B D Gessner
- Agence de Médecine Préventive, Ferney-Voltaire, France
| | - I Delrieu
- Sciences and Technologies for Health EpiLinks, Saint-Genis-Pouilly, France.
| | - M L Avila-Aguero
- Servicio de Infectología, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica; Affiliated Researcher Center for Infectious Disease Modeling and Analysis (CIDMA) at Yale University, New Haven, CT, USA
| | - H I G Giambernardino
- Departamento de Inmunizaciones y de Control de Infección, Hospital Pequeño Principe, Curitiba, PR, Brazil.
| | - A Mascareñas
- Department of Pediatric Infectious Diseases, Hospital Universitario "José E. Gonzalez", Universidad Autónoma de Nuevo Leon, Mexico
| | - J Brea
- Centro Médico UCE, Santo Domingo, Dominican Republic
| | - C N Torres
- Director Cafettor Medical, Universidad del Bosque, Bogotá, Colombia.
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35
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Mello-Román JD, Mello-Román JC, Gómez-Guerrero S, García-Torres M. Predictive Models for the Medical Diagnosis of Dengue: A Case Study in Paraguay. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2019; 2019:7307803. [PMID: 31485259 PMCID: PMC6702853 DOI: 10.1155/2019/7307803] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 05/26/2019] [Indexed: 01/22/2023]
Abstract
Early diagnosis of dengue continues to be a concern for public health in countries with a high incidence of this disease. In this work, we compared two machine learning techniques: artificial neural networks (ANN) and support vector machines (SVM) as assistance tools for medical diagnosis. The performance of classification models was evaluated in a real dataset of patients with a previous diagnosis of dengue extracted from the public health system of Paraguay during the period 2012-2016. The ANN multilayer perceptron achieved better results with an average of 96% accuracy, 96% sensitivity, and 97% specificity, with low variation in thirty different partitions of the dataset. In comparison, SVM polynomial obtained results above 90% for accuracy, sensitivity, and specificity.
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36
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Moradi-Asl E, Vatandoost H, Adham D, Emdadi D, Moosa-Kazemi H. Investigation on the Occurrence of Aedes Species in Borderline of Iran and Azerbaijan for Control of Arboviral Diseases. J Arthropod Borne Dis 2019; 13:191-197. [PMID: 31803780 PMCID: PMC6885136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 05/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To investigate the diversity of the genus Aedes present in the natural areas of Ardabil Province, north-west of Iran. METHODS This cross-sectional study was carried out from Apr to Oct 2016 in North-western of Iran. Thirty-three areas of 10 cities which are border areas were selected randomly. The larvae were collected 2 times in each month during the seasonal activities of mosquitoes and the larvae were identified morphologically according to the appropriate identification keys. RESULTS Overall, 694 larvae were collected from four counties, from which only 7.2% were Aedes larvae. Three species of Aedes were identified which include Ae. caspius, Ae. vexans and Ae. flavescens. Aedes flavescens is reported from Ardabil Province for the first time. CONCLUSION Aedes species were a high density in borderline of Iran and Azerbaijan. Therefore, the north parts of Ardabil Province are a suitable habitat for Aedes species mosquitoes. Care should be taken for vector control in the case of occurrence of any arboviruses transmitted by Aedes mosquitoes.
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Affiliation(s)
- Eslam Moradi-Asl
- Department of Public Health, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hassan Vatandoost
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Department of Environmental Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Prof Hassan Vatandoost, E-mail:
| | - Davod Adham
- Department of Public Health, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Daryosh Emdadi
- Center for Disease Control, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hassan Moosa-Kazemi
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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38
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Sanyaolu A, Ayodele O, Likaj L, Marinkovic A, Locke J, Ahmed M, Akanbi O, Orish V, Okorie C, Badaru O. Changing Epidemiology, Treatment, and Vaccine Update on Chikungunya, Dengue, and Zika Viruses. CURRENT TROPICAL MEDICINE REPORTS 2019. [DOI: 10.1007/s40475-019-00181-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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39
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Seixas G, Paul REL, Pires B, Alves G, de Jesus A, Silva AC, Devine GJ, Sousa CA. An evaluation of efficacy of the auto-dissemination technique as a tool for Aedes aegypti control in Madeira, Portugal. Parasit Vectors 2019; 12:202. [PMID: 31053095 PMCID: PMC6499953 DOI: 10.1186/s13071-019-3454-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/22/2019] [Indexed: 01/10/2023] Open
Abstract
Background The frequency and intensity of arboviral epidemics is steadily increasing and posing an intractable public health burden. Current vector control methods are proving ineffectual and despite progress in the development of high technology approaches, there is an urgent need for the development of tools for immediate implementation. Several studies suggest that the auto-dissemination of pyriproxyfen (PPF) is a promising new approach to larviciding although there is little detail on the conditions under which it is optimally effective. Here, we evaluate the efficacy of the approach in urban and rural sites in Madeira, Portugal. Results Auto-dissemination of PPF through adapted Biogents Sentinel traps (BGSTs) resulted in a modest but consistent impact on both juvenile and adult mosquito populations, but with considerable spatial heterogeneity. This heterogeneity was related to the distance from the BGST dissemination station as well as the local density of adult mosquitoes. There was evidence that the impact of PPF was cumulative over time both locally and with gradual spatial expansion. Conclusions The density of adult mosquitoes and the spatial distribution of dissemination devices are key factors in mediating efficacy. In addition, urban topography may affect the efficiency of auto-dissemination by impeding adult mosquito dispersal. Further studies in a range of urban landscapes are necessary to guide optimal strategies for the implementation of this potentially efficacious and cost-effective approach to larviciding.
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Affiliation(s)
- Gonçalo Seixas
- UEI Parasitologia Médica, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal
| | - Richard E L Paul
- Functional Genetics of Infectious Diseases Unit, Department of Genomes and Genetics, Institut Pasteur, 75015, Paris, France.,Centre National de la Recherche Scientifique (CNRS), Génomique évolutive, modélisation et santé UMR 2000, 75724, Paris Cedex 15, France
| | - Bianca Pires
- UEI Parasitologia Médica, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal
| | - Gonçalo Alves
- UEI Parasitologia Médica, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal
| | - Ana de Jesus
- UEI Parasitologia Médica, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal
| | - Ana-Clara Silva
- Unidade de Engenharia Sanitária, Departamento de Promoção e Proteção da Saúde, Instituto de Administração da Saúde e Assuntos Sociais, IP-RAM, Funchal, Madeira, Portugal
| | - Gregor J Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Carla A Sousa
- UEI Parasitologia Médica, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisbon, Portugal.
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Liyanage P, Rocklöv J, Tissera H, Palihawadana P, Wilder-Smith A, Tozan Y. Evaluation of intensified dengue control measures with interrupted time series analysis in the Panadura Medical Officer of Health division in Sri Lanka: a case study and cost-effectiveness analysis. Lancet Planet Health 2019; 3:e211-e218. [PMID: 31128766 DOI: 10.1016/s2542-5196(19)30057-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/25/2019] [Accepted: 03/15/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND Dengue has become a major public health problem in Sri Lanka with a considerable economic burden. As a response, in June, 2014, the Ministry of Health initiated a proactive vector control programme in partnership with military and police forces, known as the Civil-Military Cooperation (CIMIC) programme, that was targeted at high-risk Medical Officer of Health (MOH) divisions in the country. Evaluating the effectiveness and cost-effectiveness of population-level interventions is essential to guide public health planning and resource allocation decisions, particularly in resource-limited health-care settings. METHODS Using an interrupted time series design with a non-linear extension, we evaluated the impact of vector control interventions from June 22, 2014, to Dec 29, 2016, in Panadura, a high-risk MOH division in Western Province, Sri Lanka. We used dengue notification and larval survey data to estimate the reduction in Breteau index and dengue incidence before and after the intervention using two separate models, adjusting for time-varying confounding variables (ie, rainfall, temperature, and the Oceanic Niño Index). We also assessed the cost and cost-effectiveness of the CIMIC programme from the perspective of the National Dengue Control Unit under the scenarios of different levels of hospitalisation of dengue cases (low [25%], medium [50%], and high [75%]) in terms of cost per disability-adjusted life-year averted (DALY). FINDINGS Vector control interventions had a significant impact on combined Breteau index (relative risk reduction 0·43, 95% CI 0·26 to 0·70) and on dengue incidence (0·43, 0·28 to 0·67), the latter becoming prominent 2 months after the intervention onset. The mean number of averted dengue cases was estimated at 2192 (95% CI 1741 to 2643), and the total cost of the CIMIC programme at 2016 US$271 615. Personnel costs accounted for about 89% of the total cost. In the base-case scenario of moderate level of hospitalisation, the CIMIC programme was cost-saving with a probability of 70% under both the lowest ($453) and highest ($1686) cost-effectiveness thresholds, resulting in a net saving of $20 247 (95% CI -57 266 to 97 790) and averting 176 DALYs (133 to 226), leading to a cost of -$98 (-497 to 395) per DALY averted. This was also the case for the scenario with high hospitalisation levels (cost per DALY averted -$512, 95% CI -872 to -115) but with a higher probability of 99%. In the scenario with low hospitalisation levels (cost per DALY averted $690, 143 to 1379), although the CIMIC programme was cost-ineffective at the lowest threshold with a probability of 77%, it was cost-effective at the highest threshold with a probability of 99%. INTERPRETATION This study suggests that communities affected by dengue can benefit from investments in vector control if interventions are implemented rigorously and coordinated well across sectors. By doing so, it is possible to reduce the disease and economic burden of dengue in endemic settings. FUNDING None.
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Affiliation(s)
- Prasad Liyanage
- Ministry of Health, Colombo, Sri Lanka; Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, SE-901 87, Umeå, Sweden
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, SE-901 87, Umeå, Sweden
| | | | | | - Annelies Wilder-Smith
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, SE-901 87, Umeå, Sweden; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Yesim Tozan
- Global Health and Environmental Public Health Sciences Program, College of Global Public Health, New York University, New York, NY, USA.
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MacCormack-Gelles B, Lima Neto AS, Sousa GS, Nascimento OJ, Machado MMT, Wilson ME, Castro MC. Epidemiological characteristics and determinants of dengue transmission during epidemic and non-epidemic years in Fortaleza, Brazil: 2011-2015. PLoS Negl Trop Dis 2018; 12:e0006990. [PMID: 30507968 PMCID: PMC6292645 DOI: 10.1371/journal.pntd.0006990] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 12/13/2018] [Accepted: 11/12/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND After being eliminated during the 1950s, dengue reemerged in Brazil in the 1980s. Since then, incidence of the disease has increased, as serotypes move within and between cities. The co-circulation of multiple serotypes contributes to cycles of epidemic and interepidemic years, and a seasonal pattern of transmission is observed annually. Little is known regarding possible differences in the epidemiology of dengue under epidemic and interepidemic scenarios. This study addresses this gap and aims to assess the epidemiological characteristics and determinants of epidemic and interepidemic dengue transmission, utilizing data from the 5th largest city in Brazil (Fortaleza), at fine spatial and temporal scales. METHODS/PRINCIPAL FINDINGS Longitudinal models of monthly rates of confirmed dengue cases were used to estimate the differential contribution of contextual factors to dengue transmission in Fortaleza between 2011 and 2015. Models were stratified by annual climatological schedules and periods of interepidemic and epidemic transmission, controlling for social, economic, structural, entomological, and environmental factors. Results revealed distinct seasonal patterns between interepidemic and epidemic years, with persistent transmission after June in interepidemic years. Dengue was strongly associated with violence across strata, and with poverty and irregular garbage collection during periods of low transmission, but not with other indicators of public service provision or structural deprivation. Scrapyards and sites associated with tire storage were linked to incidence differentially between seasons, with the strongest associations during transitional precipitation periods. Hierarchical clustering analysis suggests that the dengue burden concentrates in the southern periphery of the city, particularly during periods of minimal transmission. CONCLUSIONS/SIGNIFICANCE Our findings have direct programmatic implications. Vector control operations must be sustained after June even in non-epidemic years. More specifically, scrapyards and sites associated with tires (strongly associated with incidence during periods of minimal transmission), require sustained entomological surveillance, particularly during interepidemic intervals and in the urban periphery. Intersectoral collaborations that address urban violence are critical for facilitating the regular activities of vector control agents.
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Affiliation(s)
- Benjamin MacCormack-Gelles
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Antonio S. Lima Neto
- Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
| | - Geziel S. Sousa
- Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Fortaleza, Ceará, Brazil
| | - Osmar J. Nascimento
- Fortaleza Municipal Health Secretariat (SMS-Fortaleza), Fortaleza, Ceará, Brazil
| | | | - Mary E. Wilson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- School of Medicine, University of California, San Francisco, California, United States of America
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Jairaj A, Shirisha P, Abdul MSM, Fatima U, Tiwari RVC, Moothedath M. Adult Immunization - Need of the Hour. J Int Soc Prev Community Dent 2018; 8:475-481. [PMID: 30596036 PMCID: PMC6280562 DOI: 10.4103/jispcd.jispcd_347_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/16/2018] [Indexed: 11/15/2022] Open
Abstract
Immunization is the process of making individuals immune. Childhood immunization is a common process for various aliments, but adult immunization in the Indian scenario is obscure. Officially, India has been declared polio-free, which is an achievement despite cultural, political, economic, geographic, and so many other factors. The changing demographics of adult, geriatric population and growing cost of health-care maintenance are a concern in developing countries like India. Thus, promoting healthy lifestyle needs prevention, early detection, and management of various diseases and disorders. Certainly, prevention in adults is yet to be tapped completely, so that goal of 100% prevention can be achieved. Various fraternities of medical association have come up with guidelines for adult immunization schedules in India. The present paper reviews infectious diseases such as anthrax, chikungunya, cholera, dengue, influenza, and malaria in this section of the review. We humbly request all health-care professionals and educators to educate the mass for adult immunization. So that, cost involved for treatment and workforce for the management of diseases can be better utilized in some other needed areas.
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Affiliation(s)
| | - P Shirisha
- Department of Humanities and Social Sciences, IIT Madras, Chennai, Tamil Nadu, India
| | | | - Urooj Fatima
- Skin and Laser Care Centre, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia
| | - Rahul Vinay Chandra Tiwari
- Department of Oral and Maxillofacial Surgery and Dentistry, Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala, India
| | - Muhamood Moothedath
- Department of Public Health Dentistry, College of Applied Health Sciences in Ar Rass, Qassim University, Buraydah, Saudi Arabia
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Solimini AG, Manica M, Rosà R, Della Torre A, Caputo B. Estimating the risk of Dengue, Chikungunya and Zika outbreaks in a large European city. Sci Rep 2018; 8:16435. [PMID: 30401870 PMCID: PMC6219586 DOI: 10.1038/s41598-018-34664-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022] Open
Abstract
Outbreaks of arbovirus infections vectored by invasive Aedes albopictus have already occurred and are predicted to become increasingly frequent in Southern Europe. We present a probabilistic model to assess risk of arbovirus outbreaks based on incident cases worldwide, on the probability of arrival of infected travelers, and on the abundance of the vector species. Our results show a significant risk of Chikungunya outbreak in Rome from mid June to October in simulations with high human biting rates (i.e. when ≥50% of the population is bitten every day). The outbreak risk is predicted to be highest for Chikungunya and null for Zika. Simulated increase of incident cases in selected endemic countries has no major impact on the outbreak risk. The model correctly estimated the number of imported cases and can be easily adapted to other urban areas where Ae. albopictus is the only potential vector present.
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Affiliation(s)
- Angelo G Solimini
- Department of Public Health and Infectious Diseases, Universita' La Sapienza, Rome, Italy.
| | - Mattia Manica
- Department of Public Health and Infectious Diseases, Universita' La Sapienza, Rome, Italy
- Department of Biodiversity and Molecular Ecology, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, TN, Italy
| | - Roberto Rosà
- Department of Biodiversity and Molecular Ecology, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all'Adige, TN, Italy
| | - Alessandra Della Torre
- Department of Public Health and Infectious Diseases, Universita' La Sapienza, Rome, Italy
| | - Beniamino Caputo
- Department of Public Health and Infectious Diseases, Universita' La Sapienza, Rome, Italy
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Hung TM, Clapham HE, Bettis AA, Cuong HQ, Thwaites GE, Wills BA, Boni MF, Turner HC. The Estimates of the Health and Economic Burden of Dengue in Vietnam. Trends Parasitol 2018; 34:904-918. [PMID: 30100203 PMCID: PMC6192036 DOI: 10.1016/j.pt.2018.07.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022]
Abstract
Dengue has been estimated to cause a substantial health and economic burden in Vietnam. The most recent studies have estimated that it is responsible for 39884 disability-adjusted life years (DALYs) annually, representing an economic burden of US$94.87 million per year (in 2016 prices). However, there are alternative burden estimates that are notably lower. This variation is predominantly due to differences in how the number of symptomatic dengue cases is estimated. Understanding the methodology of these burden calculations is vital when interpreting health economic analyses of dengue. This review aims to provide an overview of the health and economic burden estimates of dengue in Vietnam. We also highlight important research gaps for future studies.
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Affiliation(s)
- Trinh Manh Hung
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Hannah E Clapham
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, London, UK; Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London W2 1 PG, UK
| | | | - Guy E Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Bridget A Wills
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Maciej F Boni
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Hugo C Turner
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Desjardins MR, Whiteman A, Casas I, Delmelle E. Space-time clusters and co-occurrence of chikungunya and dengue fever in Colombia from 2015 to 2016. Acta Trop 2018; 185:77-85. [PMID: 29709630 DOI: 10.1016/j.actatropica.2018.04.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/19/2018] [Accepted: 04/22/2018] [Indexed: 12/29/2022]
Abstract
Vector-borne diseases (VBDs) infect over one billion people and are responsible for over one million deaths each year, globally. Chikungunya (CHIK) and Dengue Fever (DENF) are emerging VBDs due to overpopulation, increases in urbanization, climate change, and other factors. Colombia has recently experienced severe outbreaks of CHIK AND DENF. Both viruses are transmitted by the Aedes mosquitoes and are preventable with a variety of surveillance and vector control measures (e.g. insecticides, reduction of open containers, etc.). Spatiotemporal statistics can facilitate the surveillance of VBD outbreaks by informing public health officials where to allocate resources to mitigate future outbreaks. We utilize the univariate Kulldorff space-time scan statistic (STSS) to identify and compare statistically significant space-time clusters of CHIK and DENF in Colombia during the outbreaks of 2015 and 2016. We also utilize the multivariate STSS to examine co-occurrences (simultaneous excess incidences) of DENF and CHIK, which is critical to identify regions that may have experienced the greatest burden of VBDs. The relative risk of CHIK and DENF for each Colombian municipality belonging to a univariate and multivariate cluster is reported to facilitate targeted interventions. Finally, we visualize the results in a three-dimensional environment to examine the size and duration of the clusters. Our approach is the first of its kind to examine multiple VBDs in Colombia simultaneously, while the 3D visualizations are a novel way of illustrating the dynamics of space-time clusters of disease.
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Affiliation(s)
- M R Desjardins
- Department of Geography and Earth Sciences and Center for Applied Geographic Information Science, University of North Carolina at Charlotte, 2901 University City Blvd, Charlotte, NC, 28223, United States
| | - A Whiteman
- Department of Geography and Earth Sciences and Center for Applied Geographic Information Science, University of North Carolina at Charlotte, 2901 University City Blvd, Charlotte, NC, 28223, United States
| | - I Casas
- School of History and Social Sciences, Louisiana Tech University, 305 Wisteria St, Ruston, LA, 71272, United States
| | - E Delmelle
- Department of Geography and Earth Sciences and Center for Applied Geographic Information Science, University of North Carolina at Charlotte, 2901 University City Blvd, Charlotte, NC, 28223, United States.
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Woon YL, Hor CP, Lee KY, Mohd Anuar SFZ, Mudin RN, Sheikh Ahmad MK, Komari S, Amin F, Jamal R, Chen WS, Goh PP, Yeap L, Lim ZR, Lim TO. Estimating dengue incidence and hospitalization in Malaysia, 2001 to 2013. BMC Public Health 2018; 18:946. [PMID: 30068318 PMCID: PMC6090758 DOI: 10.1186/s12889-018-5849-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/13/2018] [Indexed: 01/09/2023] Open
Abstract
Background Epidemiologic measures of the dengue burden such as prevalence and incidence are important for policy-making and monitoring the progress of disease control. It is a common practice where epidemiologic and economic research estimate dengue burden based on notification data. However, a basic challenge in estimating the incidence of dengue is that a significant proportion of infected population are asymptomatic. It can be overcome by using mathematical models that relate observed prevalence and mortality to incidence. In this study, we estimate the trend of dengue incidence and hospitalization in Malaysia. Methods This study is based entirely on the available secondary data sources on dengue in Malaysia. The age-specific incidence of dengue between 2001 and 2013 was estimated using the prevalence and mortality estimates in an incidence-prevalence-mortality (IPM) model. Data on dengue prevalence were extracted from six sero-surveys conducted in Malaysia between 2001 and 2013; while statistics on dengue notification and Case Fatality Rate were derived from National Dengue Surveillance System. Dengue hospitalization data for the years 2009 to 2013 were extracted from the Health Informatics Centre and the volumes of dengue hospitalization for hospitals with missing data were estimated with Poisson models. Results The dengue incidence in Malaysia varied from 69.9 to 93.4 per 1000 population (pkp) between 2001 and 2013.The temporal trend in incidence rate was decreasing since 2001. It has been reducing at an average rate of 2.57 pkp per year from 2001 to 2013 (p = 0.011). The age-specific incidence of dengue decreased steadily with dengue incidence reaching zero by age > 70 years. Dengue notification rate has remained stable since 2001 and the number of notified cases each year was only a small fraction of the incident cases (0.7 to 2.3%). Similarly, the dengue hospitalization was larger but still a small fraction of the incident cases (3.0 to 5.6%). Conclusion Dengue incidence can be estimated with the use of sero-prevalence surveys and mortality data. This study highlights a reducing trend of dengue incidence in Malaysia and demonstrates the discrepancy between true dengue disease burden and cases reported by national surveillance system. Sero-prevalence studies with representative samples should be conducted regularly to allow better estimation of dengue burden in Malaysia.
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Affiliation(s)
- Yuan Liang Woon
- Clinical Research Centre, Ministry of Health Malaysia, c/o Third Floor, Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - Chee Peng Hor
- Kepala Batas Hospital, Ministry of Health Malaysia, Jalan Bertam 2, 13200 Kepala Batas, Penang, Malaysia
| | - Keng Yee Lee
- Clinical Research Centre, Ministry of Health Malaysia, c/o Third Floor, Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - Siti Fatimah Zahra Mohd Anuar
- Clinical Research Centre, Ministry of Health Malaysia, c/o Third Floor, Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - Rose Nani Mudin
- Sector of Vector-Borne Disease, Disease Control Division, Ministry of Health Malaysia, 62590, Putrajaya, Malaysia
| | - Mohd Khadzir Sheikh Ahmad
- Health Informatic Centre, Planning Division, Ministry of Health Malaysia, 62590, Putrajaya, Malaysia
| | - Suhaya Komari
- Health Informatic Centre, Planning Division, Ministry of Health Malaysia, 62590, Putrajaya, Malaysia
| | - Faridah Amin
- National Public Health Laboratory, Lot 1853, Kg, Melayu, 47000, Sungai Buloh, Selangor, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute, UKM Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Wei Seng Chen
- Klinik Alam Medic, 41, Jalan Perdana 3/4, Taman Puchong Perdana, 47100, Puchong, Selangor, Malaysia
| | - Pik Pin Goh
- Clinical Research Centre, Ministry of Health Malaysia, c/o Third Floor, Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia
| | - Lena Yeap
- Stats Consulting Pte Ltd, D7-3-1, Block D7, Pusat Perdagangan Dana 1, Jalan PJU 1A/46, PJU 1A, 47301, Petaling Jaya, Selangor, Malaysia
| | - Zhuo Ren Lim
- Stats Consulting Pte Ltd, D7-3-1, Block D7, Pusat Perdagangan Dana 1, Jalan PJU 1A/46, PJU 1A, 47301, Petaling Jaya, Selangor, Malaysia
| | - Teck Onn Lim
- ClinResearch Pte Ltd, D7-3-1, Block D7, Pusat Perdagangan Dana 1, Jalan PJU 1A/46, PJU 1A, 47301, Petaling Jaya, Selangor, Malaysia.
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Targeting vaccinations for the licensed dengue vaccine: Considerations for serosurvey design. PLoS One 2018; 13:e0199450. [PMID: 29944696 PMCID: PMC6019750 DOI: 10.1371/journal.pone.0199450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 06/07/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The CYD-TDV vaccine was unusual in that the recommended target population for vaccination was originally defined not only by age, but also by transmission setting as defined by seroprevalence. WHO originally recommended countries consider vaccination against dengue with CYD-TDV vaccine in geographic settings only where prior infection with any dengue serotype, as measured by seroprevalence, was >170% in the target age group. Vaccine was not recommended in settings where seroprevalence was <50%. Test-and-vaccinate strategies suggested following new analysis by Sanofi will still require age-stratified seroprevalence surveys to optimise age-group targeting. Here we address considerations for serosurvey design in the context of vaccination program planning. METHODS To explore how the design of seroprevalence surveys affects estimates of transmission intensity, 100 age-specific seroprevalence surveys were simulated using a beta-binomial distribution and a simple catalytic model for different combinations of age-range, survey size, transmission setting, and test sensitivity/specificity. We then used a Metropolis-Hastings Markov Chain Monte-Carlo algorithm to estimate the force of infection from each simulated dataset. RESULTS Sampling from a wide age-range led to more accurate estimates than merely increasing sample size in a narrow age-range. This finding was consistent across all transmission settings. The optimum test sensitivity and specificity given an imperfect test differed by setting with high sensitivity being important in high transmission settings and high specificity important in low transmission settings. CONCLUSIONS When assessing vaccination suitability by seroprevalence surveys, countries should ensure an appropriate age-range is sampled, considering epidemiological evidence about the local burden of disease.
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Bygbjerg IC, Simonsen L, Schiøler KL. Elimination of Falciparum Malaria and Emergence of Severe Dengue: An Independent or Interdependent Phenomenon? Front Microbiol 2018; 9:1120. [PMID: 29899735 PMCID: PMC5989664 DOI: 10.3389/fmicb.2018.01120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/11/2018] [Indexed: 11/23/2022] Open
Abstract
The global malaria burden, including falciparum malaria, has been reduced by 50% since 2000, though less so in Sub-Saharan Africa. Regional malaria elimination campaigns beginning in the 1940s, up-scaled in the 1950s, succeeded in the 1970s in eliminating malaria from Europe, North America, the Caribbean (except Haiti), and parts of Asia and South- and Central America. Dengue has grown dramatically throughout the pantropical regions since the 1950s, first in Southeast Asia in the form of large-scale epidemics including severe dengue, though mostly sparing Sub-Saharan Africa. Globally, the WHO estimates 50 million dengue infections every year, while others estimate almost 400 million infections, including 100 million clinical cases. Curiously, despite wide geographic overlap between malaria and dengue-endemic areas, published reports of co-infections have been scarce until recently. Superimposed acute dengue infection might be expected to result in more severe combined disease because both pathogens can induce shock and hemorrhage. However, a recent review found no reports on more severe morbidity or higher mortality associated with co-infections. Cases of severe dual infections have almost exclusively been reported from South America, and predominantly in persons infected by Plasmodium vivax. We hypothesize that malaria infection may partially protect against dengue – in particular falciparum malaria against severe dengue – and that this inter-species cross-protection may explain the near absence of severe dengue from the Sub-Saharan region and parts of South Asia until recently. We speculate that malaria infection elicits cross-reactive antibodies or other immune responses that infer cross-protection, or at least partial cross-protection, against symptomatic and severe dengue. Plasmodia have been shown to give rise to polyclonal B-cell activation and to heterophilic antibodies, while some anti-dengue IgM tests have high degree of cross-reactivity with sera from malaria patients. In the following, the historical evolution of falciparum malaria and dengue is briefly reviewed, and we explore early evidence of subclinical dengue in high-transmission malaria areas as well as conflicting reports on severity of co-morbidity. We also discuss examples of other interspecies interactions.
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Affiliation(s)
- Ib C Bygbjerg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Simonsen
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Karin L Schiøler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Limiting global-mean temperature increase to 1.5-2 °C could reduce the incidence and spatial spread of dengue fever in Latin America. Proc Natl Acad Sci U S A 2018; 115:6243-6248. [PMID: 29844166 PMCID: PMC6004471 DOI: 10.1073/pnas.1718945115] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study is a multigeneral circulation model, multiscenario modeling exercise developed to quantify the dengue-related health benefits of limiting global warming to 1.5–2.0 °C above preindustrial levels in Latin America and the Caribbean. We estimate the impact of future climate change and population growth on the additional number of dengue cases and provide insights about the regions and periods most likely affected by changes in the length of the transmission season. Here, we show that future climate change may amplify dengue transmission and that significant impacts could be avoided by constraining global warming to 1.5 °C above preindustrial levels. Our work could be a starting point for future risk assessments incorporating other important drivers of disease such as urbanization and international traveling. The Paris Climate Agreement aims to hold global-mean temperature well below 2 °C and to pursue efforts to limit it to 1.5 °C above preindustrial levels. While it is recognized that there are benefits for human health in limiting global warming to 1.5 °C, the magnitude with which those societal benefits will be accrued remains unquantified. Crucial to public health preparedness and response is the understanding and quantification of such impacts at different levels of warming. Using dengue in Latin America as a study case, a climate-driven dengue generalized additive mixed model was developed to predict global warming impacts using five different global circulation models, all scaled to represent multiple global-mean temperature assumptions. We show that policies to limit global warming to 2 °C could reduce dengue cases by about 2.8 (0.8–7.4) million cases per year by the end of the century compared with a no-policy scenario that warms by 3.7 °C. Limiting warming further to 1.5 °C produces an additional drop in cases of about 0.5 (0.2–1.1) million per year. Furthermore, we found that by limiting global warming we can limit the expansion of the disease toward areas where incidence is currently low. We anticipate our study to be a starting point for more comprehensive studies incorporating socioeconomic scenarios and how they may further impact dengue incidence. Our results demonstrate that although future climate change may amplify dengue transmission in the region, impacts may be avoided by constraining the level of warming.
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Pollett S, Melendrez MC, Maljkovic Berry I, Duchêne S, Salje H, Cummings DAT, Jarman RG. Understanding dengue virus evolution to support epidemic surveillance and counter-measure development. INFECTION GENETICS AND EVOLUTION 2018; 62:279-295. [PMID: 29704626 DOI: 10.1016/j.meegid.2018.04.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022]
Abstract
Dengue virus (DENV) causes a profound burden of morbidity and mortality, and its global burden is rising due to the co-circulation of four divergent DENV serotypes in the ecological context of globalization, travel, climate change, urbanization, and expansion of the geographic range of the Ae.aegypti and Ae.albopictus vectors. Understanding DENV evolution offers valuable opportunities to enhance surveillance and response to DENV epidemics via advances in RNA virus sequencing, bioinformatics, phylogenetic and other computational biology methods. Here we provide a scoping overview of the evolution and molecular epidemiology of DENV and the range of ways that evolutionary analyses can be applied as a public health tool against this arboviral pathogen.
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Affiliation(s)
- S Pollett
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Marie Bashir Institute, University of Sydney, NSW, Australia; Institute for Global Health Sciences, University of California at San Francisco, CA, USA.
| | - M C Melendrez
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - I Maljkovic Berry
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - S Duchêne
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Australia
| | - H Salje
- Institut Pasteur, Paris, France; Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - D A T Cummings
- Johns Hopkins School of Public Health, Baltimore, MD, USA; University of Florida, FL, USA
| | - R G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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