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Ramphal Y, Tegally H, San JE, Reichmuth ML, Hofstra M, Wilkinson E, Baxter C, de Oliveira T, Moir M. Understanding the Transmission Dynamics of the Chikungunya Virus in Africa. Pathogens 2024; 13:605. [PMID: 39057831 PMCID: PMC11279734 DOI: 10.3390/pathogens13070605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
The Chikungunya virus (CHIKV) poses a significant global public health concern, especially in Africa. Since its first isolation in Tanzania in 1953, CHIKV has caused recurrent outbreaks, challenging healthcare systems in low-resource settings. Recent outbreaks in Africa highlight the dynamic nature of CHIKV transmission and the challenges of underreporting and underdiagnosis. Here, we review the literature and analyse publicly available cases, outbreaks, and genomic data, providing insights into the epidemiology, genetic diversity, and transmission dynamics of CHIKV in Africa. Our analyses reveal the circulation of geographically distinct CHIKV genotypes, with certain regions experiencing a disproportionate burden of disease. Phylogenetic analysis of sporadic outbreaks in West Africa suggests repeated emergence of the virus through enzootic spillover, which is markedly different from inferred transmission dynamics in East Africa, where the virus is often introduced from Asian outbreaks, including the recent reintroduction of the Indian Ocean lineage from the Indian subcontinent to East Africa. Furthermore, there is limited evidence of viral movement between these two regions. Understanding the history and transmission dynamics of outbreaks is crucial for effective public health planning. Despite advances in surveillance and research, diagnostic and surveillance challenges persist. This review and secondary analysis highlight the importance of ongoing surveillance, research, and collaboration to mitigate the burden of CHIKV in Africa and improve public health outcomes.
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Affiliation(s)
- Yajna Ramphal
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Houriiyah Tegally
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | | | | | - Marije Hofstra
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Eduan Wilkinson
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Cheryl Baxter
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | | | - Tulio de Oliveira
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, Durban 4001, South Africa
| | - Monika Moir
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
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2
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Abuelmaali SA, Mashlawi AM, Ishak IH, Wajidi MFF, Jaal Z, Avicor SW, Kassim NFA. Population genetic structure of Aedes aegypti subspecies in selected geographical locations in Sudan. Sci Rep 2024; 14:2978. [PMID: 38316804 PMCID: PMC10844603 DOI: 10.1038/s41598-024-52591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/20/2024] [Indexed: 02/07/2024] Open
Abstract
Although knowledge of the composition and genetic diversity of disease vectors is important for their management, this is limiting in many instances. In this study, the population structure and phylogenetic relationship of the two Aedes aegypti subspecies namely Aedes aegypti aegypti (Aaa) and Aedes aegypti formosus (Aaf) in eight geographical areas in Sudan were analyzed using seven microsatellite markers. Hardy-Weinberg Equilibrium (HWE) for the two subspecies revealed that Aaa deviated from HWE among the seven microsatellite loci, while Aaf exhibited departure in five loci and no departure in two loci (A10 and M201). The Factorial Correspondence Analysis (FCA) plots revealed that the Aaa populations from Port Sudan, Tokar, and Kassala clustered together (which is consistent with the unrooted phylogenetic tree), Aaf from Fasher and Nyala populations clustered together, and Gezira, Kadugli, and Junaynah populations also clustered together. The Bayesian cluster analysis structured the populations into two groups suggesting two genetically distinct groups (subspecies). Isolation by distance test revealed a moderate to strong significant correlation between geographical distance and genetic variations (p = 0.003, r = 0.391). The migration network created using divMigrate demonstrated that migration and gene exchange between subspecies populations appear to occur based on their geographical proximity. The genetic structure of the Ae. aegypti subspecies population and the gene flow among them, which may be interpreted as the mosquito vector's capacity for dispersal, were revealed in this study. These findings will help in the improvement of dengue epidemiology research including information on the identity of the target vector/subspecies and the arboviruses vector surveillance program.
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Affiliation(s)
- Sara A Abuelmaali
- 129 Medical Entomology Laboratory, School of Biological Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, 11115, Sudan
| | - Abadi M Mashlawi
- Department of Biology, College of Science, Jazan University, P.O. Box. 114, Jazan, 45142, Kingdom of Saudi Arabia
| | - Intan Haslina Ishak
- 129 Medical Entomology Laboratory, School of Biological Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.
- Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | | | - Zairi Jaal
- Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Silas Wintuma Avicor
- Molecular Entomology Research Group, Universiti Sains Malaysia, 11800, Penang, Malaysia
- Entomology Division, Cocoa Research Institute of Ghana, New Tafo-Akim, Ghana
| | - Nur Faeza Abu Kassim
- 129 Medical Entomology Laboratory, School of Biological Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.
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Stacey MJ, Brett S, Fitchett G, Hill NE, Woods D. What do environment-related illnesses tell us about the character of military medicine and future clinical requirements? BMJ Mil Health 2024; 170:43-46. [PMID: 34686561 DOI: 10.1136/bmjmilitary-2021-001934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 11/03/2022]
Abstract
Extreme environments present medical and occupational challenges that extend beyond generic resuscitation, to formulating bespoke diagnoses and prognoses and embarking on management pathways rarely encountered in civilian practice. Pathophysiological complexity and clinical uncertainty call for military physicians of all kinds to balance intuition with pragmatism, adapting according to the predominant patterns of care required. In an era of smaller operational footprints and less concentrated clinical experience, proposals aimed at improving the systematic care of Service Personnel incapacitated at environmental extremes must not be lost to corporate memory. These general issues are explored in the particular context of thermal stress and metabolic disruption. Specific focus is given to the accounts of military physicians who served on large-scale deployments into the heat of Iraq and Kuwait (Operation TELIC) and Oman (Exercise SAIF SAREEA). Generalisable insights into the enduring character of military medicine and future clinical requirements result.
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Affiliation(s)
- Michael John Stacey
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - S Brett
- Faculty of Medicine, Imperial College London, London, UK
| | - G Fitchett
- Blood Far Forward, British Army HQ, Andover, UK
| | - N E Hill
- Faculty of Medicine, Imperial College London, London, UK
| | - D Woods
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Kayange N, Hau DK, Pain K, Mshana SE, Peck R, Gehring S, Groendahl B, Koliopoulos P, Revocatus B, Msaki EB, Malande O. Seroprevalence of Dengue and Chikungunya Virus Infections in Children Living in Sub-Saharan Africa: Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1662. [PMID: 37892325 PMCID: PMC10605353 DOI: 10.3390/children10101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Dengue and chikungunya viruses are frequent causes of malarial-like febrile illness in children. The rapid increase in virus transmission by mosquitoes is a global health concern. This is the first systematic review and meta-analysis of the childhood prevalence of dengue and chikungunya in Sub-Saharan Africa (SSA). A comprehensive search of the MEDLINE (Ovid), Embase (Ovid), and Cochrane Library (Wiley) databases was conducted on 28 June 2019, and updated on 12 February 2022. The search strategy was designed to retrieve all articles pertaining to arboviruses in SSA children using both controlled vocabulary and keywords. The pooled (weighted) proportion of dengue and chikungunya was estimated using a random effect model. The overall pooled prevalence of dengue and chikungunya in SSA children was estimated to be 16% and 7%, respectively. Prevalence was slightly lower during the period 2010-2020 compared to 2000-2009. The study design varied depending on the healthcare facility reporting the disease outbreak. Importantly, laboratory methods used to detect arbovirus infections differed. The present review documents the prevalence of dengue and chikungunya in pediatric patients throughout SSA. The results provide unprecedented insight into the transmission of dengue and chikungunya viruses among these children and highlight the need for enhanced surveillance and controlled methodology.
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Affiliation(s)
- Neema Kayange
- Department of Pediatrics, Bugando Medical Centre, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Duncan K Hau
- Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA;
| | - Kevin Pain
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA;
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Robert Peck
- Department of Pediatrics, Bugando Medical Centre, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
- Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA;
- Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Stephan Gehring
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Britta Groendahl
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Philip Koliopoulos
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Baraka Revocatus
- Department of Data and Statistics, Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania;
| | - Evarist B Msaki
- Department of Epidemiology and Biostatistics, Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania;
| | - Ombeva Malande
- East Africa Centre for Vaccines and Immunization (ECAVI), Kampala P.O. Box 3040, Uganda;
- Department of Public Health Phamarmacy, Sefako Makgatho Health Sciences University, Pretoria P.O. Box 60, South Africa
- Department of Paediatrics & Child Health, Makerere University, Kampala P.O. Box 7072, Uganda
- Department of Public Health, UNICAF University, Lusaka P.O. Box 20842, Zambia
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5
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Su L, Lou X, Yan H, Yang Z, Mao H, Yao W, Sun Y, Pan J, Zhang Y. Importation of a novel Indian Ocean lineage carrying E1-K211E and E2-V264A of Chikungunya Virus in Zhejiang Province, China, in 2019. Virus Genes 2023; 59:693-702. [PMID: 37468826 PMCID: PMC10499945 DOI: 10.1007/s11262-023-02020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
The chikungunya virus (CHIKV) is widespread. In Zhejiang province, China, CHIKV infection is often associated with travelers from tropical and subtropical countries. In the present study, three CHIKV isolates from serum samples of travelers in Zhejiang province in 2019 were sequenced, and phylogenetically analyzed to study their molecular characteristics. Sequence analysis showed that the non-structural protein and the structural protein had 37 and 28 amino acid mutations, respectively; no mutation site was found at the E1-A226 residue, which could increase the adaptability of CHIKV to Aedes albopictus. All three samples carried two mutations, namely, E1-K211E and E2-V264A, which were introduced to Bangladesh around late 2015 and Thailand in early 2017. Phylogenetic analysis revealed that these three CHIKVs were Indian Ocean lineage of the East Africa/Central/South Africa genotype (ECSA) and that the MF773566 strain from Bangladesh (Australia/Bangladesh 2017) had the closest evolutionary relationship. The three CHICKs imported into Zhejiang province in 2019 belonged to the ECSA genotype and had multiple amino acid variation sites. The variation in the three samples provides a certain reference for the subsequent research on CHIKV evolution.
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Affiliation(s)
- Lingxuan Su
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Xiuyu Lou
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Hao Yan
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Zhangnv Yang
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Haiyan Mao
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Wenwu Yao
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Yi Sun
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Junhang Pan
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
| | - Yanjun Zhang
- Zhejiang Provincial Center of Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051 China
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Costa DMDN, Gouveia PADC, Silva GEDB, Neves PDMDM, Vajgel G, Cavalcante MAGDM, Oliveira CBLD, Valente LM, Silveira VMD. The relationship between chikungunya virus and the kidneys: A scoping review. Rev Med Virol 2023; 33:e2357. [PMID: 35521644 DOI: 10.1002/rmv.2357] [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: 12/07/2021] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 01/28/2023]
Abstract
Several atypical forms of chikungunya fever (CHIK) have been described, including neurological, cardiac and renal involvement. These forms may be related to high morbidity and mortality rates. This scoping review based on the PubMed, Scopus, and WOS databases aims to identify and summarise all the available evidence regarding the clinical and histopathological presentations and risk factors associated with kidney injury related to CHIK, as well as the clinical impact. Thus, a total of 54 papers were selected from 1606 initial references after applying the defined inclusion criteria. Data on the association between kidney injury and CHIK are scarce, with studies only conducted in the acute phase of the disease, lacking further characterisation. Kidney injury incidence in hospitalised patients using the Kidney Disease Improving Global Outcomes criteria varies from 21% to 45%, being higher among patients with atypical and severe manifestations. Although acute kidney injury does not seem to be related to viraemia, it may be related to higher mortality. Few studies have described the renal histopathological changes in the acute phase of CHIK, with prevalent findings of acute interstitial nephritis with mononuclear infiltrate, glomerular congestion and nephrosclerosis. Only one study assessed the kidney function of patients in the subacute and chronic phases of CHIK. Additionally, individuals with comorbidities, including chronic kidney disease, may be among those with a greater risk of presenting worse outcomes when affected by CHIK. The results described herein may contribute to better understand the relationship between the kidneys and chikungunya virus.
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Affiliation(s)
| | | | | | - Precil Diego Miranda de Menezes Neves
- Nephrology Division, University of São Paulo School of Medicine, São Paulo, Brazil.,Nephrology and Dialysis Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Gisele Vajgel
- Nephrology Division, Federal University of Pernambuco, Recife, Brazil
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Webb E, Michelen M, Rigby I, Dagens A, Dahmash D, Cheng V, Joseph R, Lipworth S, Harriss E, Cai E, Nartowski R, Januraga PP, Gedela K, Sukmaningrum E, Cevik M, Groves H, Hart P, Fletcher T, Blumberg L, Horby PW, Jacob ST, Sigfrid L. An evaluation of global Chikungunya clinical management guidelines: A systematic review. EClinicalMedicine 2022; 54:101672. [PMID: 36193172 PMCID: PMC9526181 DOI: 10.1016/j.eclinm.2022.101672] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) has expanded its geographical reach in recent decades and is an emerging global health threat. CHIKV can cause significant morbidity and lead to chronic, debilitating arthritis/arthralgia in up to 40% of infected individuals. Prevention, early identification, and clinical management are key for improving outcomes. The aim of this review is to evaluate the quality, availability, inclusivity, and scope of evidence-based clinical management guidelines (CMG) for CHIKV globally. METHODS We conducted a systematic review. Six databases were searched from Jan 1, 1989, to 14 Oct 2021 and grey literature until Sept 16, 2021, for CHIKV guidelines providing supportive care and treatment recommendations. Quality was assessed using the appraisal of Guidelines for Research and Evaluation tool. Findings are presented in a narrative synthesis. PROSPERO registration: CRD42020167361. FINDINGS 28 CMGs were included; 54% (15/28) were produced more than 5 years ago, and most were of low-quality (median score 2 out of 7 (range 1-7)). There were variations in the CMGs' guidance on the management of different at-risk populations, long-term sequelae, and the prevention of disease transmission. While 54% (15/28) of CMGs recommended hospitalisation for severe cases, only 39% (11/28) provided guidance for severe disease management. Further, 46% (13/28) advocated for steroids in the chronic phase, but 18% (5/28) advised against its use. INTERPRETATION There was a lack of high-quality CMGs that provided supportive care and treatment guidance, which may impact patient care and outcomes. It is essential that existing guidelines are updated and adapted to provide detailed evidence-based treatment guidelines for different at-risk populations. This study also highlights a need for more research into the management of the acute and chronic phases of CHIKV infection to inform evidence-based care. FUNDING The UK Foreign, Commonwealth and Development Office, Wellcome Trust [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135].
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Affiliation(s)
- Eika Webb
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Melina Michelen
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Ishmeala Rigby
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Andrew Dagens
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Dania Dahmash
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Vincent Cheng
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Samuel Lipworth
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Erhui Cai
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Robert Nartowski
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | | | | | - Evi Sukmaningrum
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
- HIV AIDS Research Centre-HPSI, AJCU, Jakarta, Indonesia
| | - Muge Cevik
- Department of Global Health and Infection Research, School of Medicine, University of St Andrews, Fife, Scotland, UK
| | | | | | - Tom Fletcher
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Lucille Blumberg
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Peter W. Horby
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Shevin T. Jacob
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Louise Sigfrid
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
- Corresponding author.
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8
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Inhibition of Chikungunya virus early replication by intracellular nanoantibodies targeting nsP2 Epitope Rich Region. Antiviral Res 2022; 208:105446. [DOI: 10.1016/j.antiviral.2022.105446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 11/21/2022]
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9
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Fang Y, Khater EIM, Xue JB, Ghallab EHS, Li YY, Jiang TG, Li SZ. Epidemiology of Mosquito-Borne Viruses in Egypt: A Systematic Review. Viruses 2022; 14:v14071577. [PMID: 35891557 PMCID: PMC9322113 DOI: 10.3390/v14071577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 12/21/2022] Open
Abstract
There are at least five common mosquito-borne viruses (MBVs) recorded in Egypt, including dengue virus (DENV), Rift Valley fever virus (RVFV), West Nile virus (WNV), Chikungunya virus, and Sindbis virus. Unexpected outbreaks caused by MBVs reflect the deficiencies of the MBV surveillance system in Egypt. This systematic review characterized the epidemiology of MBV prevalence in Egypt. Human, animal, and vector prevalence studies on MBVs in Egypt were retrieved from Web of Science, PubMed, and Bing Scholar, and 33 eligible studies were included for further analyses. The monophyletic characterization of the RVFV and WNV strains found in Egypt, which spans about half a century, suggests that both RVFV and WNV are widely transmitted in this nation. Moreover, the seropositive rates of DENV and WNV in hosts were on the rise in recent years, and spillover events of DENV and WNV to other countries from Egypt have been recorded. The common drawback for surveillance of MBVs in Egypt is the lack of seroprevalence studies on MBVs, especially in this century. It is necessary to evaluate endemic transmission risk, establish an early warning system for MBVs, and develop a sound joint system for medical care and public health for managing MBVs in Egypt.
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Affiliation(s)
- Yuan Fang
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China; (Y.F.); (J.-B.X.); (Y.-Y.L.)
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Emad I. M. Khater
- Department of Entomology, Faculty of Science, Ain Shams University, Abbasiah, Cairo 11566, Egypt; (E.I.M.K.); (E.H.S.G.)
| | - Jing-Bo Xue
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China; (Y.F.); (J.-B.X.); (Y.-Y.L.)
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Enas H. S. Ghallab
- Department of Entomology, Faculty of Science, Ain Shams University, Abbasiah, Cairo 11566, Egypt; (E.I.M.K.); (E.H.S.G.)
| | - Yuan-Yuan Li
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China; (Y.F.); (J.-B.X.); (Y.-Y.L.)
| | - Tian-Ge Jiang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Shi-Zhu Li
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China; (Y.F.); (J.-B.X.); (Y.-Y.L.)
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- Correspondence:
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10
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Spread of a Novel Indian Ocean Lineage Carrying E1-K211E/E2-V264A of Chikungunya Virus East/Central/South African Genotype across the Indian Subcontinent, Southeast Asia, and Eastern Africa. Microorganisms 2022; 10:microorganisms10020354. [PMID: 35208808 PMCID: PMC8878743 DOI: 10.3390/microorganisms10020354] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 01/27/2023] Open
Abstract
The Indian Ocean Lineage (IOL) of the chikungunya virus (CHIKV) East/Central/South African (ECSA) genotype, which originated in Kenya, spread to the Indian ocean and the Indian subcontinent, and then expanded through Southeast Asia in the previous decade. It carried an adaptive mutation E1-A226V, which enhances CHIKV replication in Aedes albopictus. However, the IOL CHIKV of the most recent outbreaks during 2016–2020 in India, Pakistan, Bangladesh, the Maldives, Myanmar, Thailand, and Kenya lacked E1-A226V but carried E1-K211E and E2-V264A. Recent CHIKV genome sequences of the Maldives and Thailand were determined, and their phylogenetic relationships were further investigated together with IOL sequences reported in 2004–2020 in the database. The results showed that the ancestral IOLs diverged to a sub-lineage E1-K211E/E2-V264A, probably in India around 2008, and caused sporadic outbreaks in India during 2010–2015 and in Kenya in 2016. The massive expansion of this new sub-lineage occurred after the acquisition of E1-I317V in other neighboring and remote regions in 2014–2020. Additionally, the phylogenetic tree indicated that independent clades formed according to the geographical regions and introduction timing. The present results using all available partial or full sequences of the recent CHIKVs emphasized the dynamics of the IOL sub-lineages in the Indian subcontinent, Southeast Asia, and Eastern Africa.
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De Weggheleire A, Nkuba-Ndaye A, Mbala-Kingebeni P, Mariën J, Kindombe-Luzolo E, Ilombe G, Mangala-Sonzi D, Binene-Mbuka G, De Smet B, Vogt F, Selhorst P, Matungala-Pafubel M, Nkawa F, Vulu F, Mossoko M, Pukuta-Simbu E, Kinganda-Lusamaki E, Van Bortel W, Wat’senga-Tezzo F, Makiala-Mandanda S, Ahuka-Mundeke S. A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo. Viruses 2021; 13:v13101988. [PMID: 34696418 PMCID: PMC8541179 DOI: 10.3390/v13101988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022] Open
Abstract
Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR/ELISA, malaria RDT), semi-structured interviews with patients/caregivers about perceptions and health seeking behavior, and mosquito sampling (adult/larvae) for CHIKV-PCR and estimation of infestation levels. The investigations confirmed a large CHIKV outbreak that lasted February–June 2019. The total caseload remained unknown due to a lack of systematic surveillance, but one of the two health zones of Matadi notified 2686 suspects. Of the clinical suspects we investigated (n = 220), 83.2% were CHIKV-PCR or IgM positive (acute infection). One patient had an isolated IgG-positive result (while PCR/IgM negative), suggestive of past infection. In total, 15% had acute CHIKV and malaria. Most adult mosquitoes and larvae (>95%) were Aedes albopictus. High infestation levels were noted. CHIKV was detected in 6/11 adult mosquito pools, and in 2/15 of the larvae pools. This latter and the fact that 2/6 of the CHIKV-positive adult pools contained only males suggests transovarial transmission. Interviews revealed that healthcare seeking shifted quickly toward the informal sector and self-medication. Caregivers reported difficulties to differentiate CHIKV, malaria, and other infectious diseases resulting in polypharmacy and high out-of-pocket expenditure. We confirmed a first major CHIKV outbreak in Matadi, with main vector Aedes albopictus. The health sector was ill-prepared for the information, surveillance, and treatment needs for such an explosive outbreak in a CHIKV-naïve population. Better surveillance systems (national level/sentinel sites) and point-of-care diagnostics for arboviruses are needed.
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Affiliation(s)
- Anja De Weggheleire
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
- Correspondence: ; Tel.: +32-494-368-535
| | - Antoine Nkuba-Ndaye
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier University, 34090 Montpellier, France
| | - Placide Mbala-Kingebeni
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Joachim Mariën
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Esaie Kindombe-Luzolo
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Gillon Ilombe
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
- Global Health Institute, Antwerp University, 2000 Antwerp, Belgium
| | - Donatien Mangala-Sonzi
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Guillaume Binene-Mbuka
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
| | - Birgit De Smet
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Florian Vogt
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia
| | - Philippe Selhorst
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Mathy Matungala-Pafubel
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Frida Nkawa
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Fabien Vulu
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Mathias Mossoko
- Direction de Lutte contre la Maladie, Ministry of Health, B.P. 3040 Kinshasa I, Democratic Republic of the Congo;
| | - Elisabeth Pukuta-Simbu
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Eddy Kinganda-Lusamaki
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Wim Van Bortel
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Francis Wat’senga-Tezzo
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
| | - Sheila Makiala-Mandanda
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Steve Ahuka-Mundeke
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
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Mala W, Wilairatana P, Kotepui KU, Kotepui M. Prevalence of Malaria and Chikungunya Co-Infection in Febrile Patients: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2021; 6:tropicalmed6030119. [PMID: 34209434 PMCID: PMC8293423 DOI: 10.3390/tropicalmed6030119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
Background: Co-infection with malaria and chikungunya could exert a significant public health impact with infection misdiagnosis. Therefore, this study aimed to collect qualitative and quantitative evidence of malaria and chikungunya co-infection among febrile patients. Methods: Potentially relevant studies were identified using PubMed, Web of Science, and Scopus. The bias risk of the included studies was assessed using the checklist for analytical cross-sectional studies developed by the Joanna Briggs Institute. The pooled prevalence of malaria and chikungunya co-infection among febrile patients and the pooled prevalence of chikungunya virus (CHIKV) infection among malaria patients were estimated with the random effect model. The odds of malaria and chikungunya co-infection among febrile patients were also estimated using a random effect model that presumed the heterogeneity of the outcomes of the included studies. The heterogeneity among the included studies was assessed using the Cochran Q test and I2 statistics. Publication bias was assessed using the funnel plot and Egger’s test. Results: Of the 1924 studies that were identified from the three databases, 10 fulfilled the eligibility criteria and were included in our study. The pooled prevalence of malaria and chikungunya co-infection (182 cases) among febrile patients (16,787 cases), stratified by diagnostic tests for CHIKV infection, was 10% (95% confidence interval (CI): 8–11%, I2: 99.5%) using RDT (IgM), 7% (95% CI: 4–10%) using the plaque reduction neutralization test (PRNT), 1% (95% CI: 0–2%, I2: 41.5%) using IgM and IgG ELISA, and 4% (95% CI: 2–6%) using real-time RT-PCR. When the prevalence was stratified by country, the prevalence of co-infection was 7% (95% CI: 5–10%, I2: 99.5%) in Nigeria, 1% (95% CI: 0–2%, I2: 99.5%) in Tanzania, 10% (95% CI: 8–11%) in Sierra Leone, 1% (95% CI: 0–4%) in Mozambique, and 4% (95% CI: 2–6%) in Kenya. The pooled prevalence of CHIKV infection (182 cases) among malaria patients (8317 cases), stratified by diagnostic tests for CHIKV infection, was 39% (95% CI: 34–44%, I2: 99.7%) using RDT (IgM), 43% (95% CI: 30–57%) using PRNT, 5% (95% CI: 3–7%, I2: 5.18%) using IgM and IgG ELISA, and 9% (95% CI: 6–15%) using real-time RT-PCR. The meta-analysis showed that malaria and chikungunya co-infection occurred by chance (p: 0.59, OR: 0.32, 95% CI: 0.6–1.07, I2: 78.5%). Conclusions: The prevalence of malaria and chikungunya co-infection varied from 0% to 10% as per the diagnostic test for CHIKV infection or the country where the co-infection was reported. Hence, the clinicians who diagnose patients with malaria infections in areas where two diseases are endemic should further investigate for chikungunya co-infection to prevent misdiagnosis or delayed treatment of concurrent infection.
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Affiliation(s)
- Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand; (W.M.); (K.U.K.)
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 73170, Thailand;
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand; (W.M.); (K.U.K.)
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand; (W.M.); (K.U.K.)
- Correspondence: ; Tel.: +66-954-392-469
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