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Martí MM, Castanha PMS, Barratt-Boyes SM. The Dynamic Relationship between Dengue Virus and the Human Cutaneous Innate Immune Response. Viruses 2024; 16:727. [PMID: 38793609 PMCID: PMC11125669 DOI: 10.3390/v16050727] [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: 04/11/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Dengue virus (DENV) is a continuing global threat that puts half of the world's population at risk for infection. This mosquito-transmitted virus is endemic in over 100 countries. When a mosquito takes a bloodmeal, virus is deposited into the epidermal and dermal layers of human skin, infecting a variety of permissive cells, including keratinocytes, Langerhans cells, macrophages, dermal dendritic cells, fibroblasts, and mast cells. In response to infection, the skin deploys an array of defense mechanisms to inhibit viral replication and prevent dissemination. Antimicrobial peptides, pattern recognition receptors, and cytokines induce a signaling cascade to increase transcription and translation of pro-inflammatory and antiviral genes. Paradoxically, this inflammatory environment recruits skin-resident mononuclear cells that become infected and migrate out of the skin, spreading virus throughout the host. The details of the viral-host interactions in the cutaneous microenvironment remain unclear, partly due to the limited body of research focusing on DENV in human skin. This review will summarize the functional role of human skin, the cutaneous innate immune response to DENV, the contribution of the arthropod vector, and the models used to study DENV interactions in the cutaneous environment.
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Affiliation(s)
- Michelle M. Martí
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.M.M.); (P.M.S.C.)
| | - Priscila M. S. Castanha
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.M.M.); (P.M.S.C.)
- Faculdade de Ciệncias Médicas, Universidade de Pernambuco, Recife 52171-011, Brazil
| | - Simon M. Barratt-Boyes
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.M.M.); (P.M.S.C.)
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2
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Paz-Bailey G, Adams LE, Deen J, Anderson KB, Katzelnick LC. Dengue. Lancet 2024; 403:667-682. [PMID: 38280388 DOI: 10.1016/s0140-6736(23)02576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 01/29/2024]
Abstract
Dengue, caused by four closely related viruses, is a growing global public health concern, with outbreaks capable of overwhelming health-care systems and disrupting economies. Dengue is endemic in more than 100 countries across tropical and subtropical regions worldwide, and the expanding range of the mosquito vector, affected in part by climate change, increases risk in new areas such as Spain, Portugal, and the southern USA, while emerging evidence points to silent epidemics in Africa. Substantial advances in our understanding of the virus, immune responses, and disease progression have been made within the past decade. Novel interventions have emerged, including partially effective vaccines and innovative mosquito control strategies, although a reliable immune correlate of protection remains a challenge for the assessment of vaccines. These developments mark the beginning of a new era in dengue prevention and control, offering promise in addressing this pressing global health issue.
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Affiliation(s)
| | - Laura E Adams
- Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jacqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Kathryn B Anderson
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Leah C Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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3
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Shafie AA, Moreira ED, Vidal G, Di Pasquale A, Green A, Tai R, Yoong J. Sustainable Dengue Prevention and Management: Integrating Dengue Vaccination Strategies with Population Perspectives. Vaccines (Basel) 2024; 12:184. [PMID: 38400167 PMCID: PMC10892244 DOI: 10.3390/vaccines12020184] [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: 12/26/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The GEMKAP study (2023) unveiled consistent knowledge, attitude, and practice (KAP) levels across Asia-Pacific (APAC) and Latin America (LATAM) countries regarding dengue, with variations in the willingness to vaccinate. Despite an overall KAP parity, the disparities within and between the countries indicated the need for both overarching and tailored strategies. Population-wide gaps in dengue awareness result in suboptimal vaccination priorities and preventive measures. This commentary delves into identifying the drivers and barriers for implementing a multi-pronged dengue prevention and management program, emphasizing the pivotal role of vaccination alongside education and vector control. Drawing on expert interviews in APAC and LATAM, informed by the Consolidated Framework for Implementation Research (CFIR), four key themes emerged: prioritizing and continuously advocating for dengue on national health agendas, fostering stakeholder collaboration, incorporating population perspectives for behavioral change, and designing sustainable dengue prevention and management programs. Successful implementation requires evidence-based decision making and a comprehensive understanding of population dynamics to design adaptive education tailored to diverse population views. This commentary provides actionable strategies for enhancing dengue prevention and management, with a pronounced emphasis on dengue vaccination, advocating for a holistic, population-centric approach for sustained effectiveness.
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Affiliation(s)
- Asrul Akmal Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Gelugor 11800, Malaysia;
| | - Edson Duarte Moreira
- Associação Obras Sociais Irmã Dulce Hospital Santo Antônio and Oswaldo Cruz Foundation, Bahia CEP 40.415-006, Brazil;
| | - Gabriela Vidal
- Argentinian Infectious Diseases Society, Buenos Aires C1085, Argentina;
| | - Alberta Di Pasquale
- Regional Medical Affairs Vaccines, Growth and Emerging Markets, Takeda Pharmaceuticals International AG Singapore Branch, Singapore 018981, Singapore; (A.D.P.); (A.G.)
| | - Andrew Green
- Regional Medical Affairs Vaccines, Growth and Emerging Markets, Takeda Pharmaceuticals International AG Singapore Branch, Singapore 018981, Singapore; (A.D.P.); (A.G.)
| | - Rie Tai
- Vista Health Pte Ltd., Singapore 059413, Singapore;
| | - Joanne Yoong
- Research For Impact, Singapore 159964, Singapore
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Golding MAJ, Noble SAA, Khouri NK, Layne-Yarde RNA, Ali I, Sandiford SL. Natural vertical transmission of dengue virus in Latin America and the Caribbean: highlighting its detection limitations and potential significance. Parasit Vectors 2023; 16:442. [PMID: 38017450 PMCID: PMC10685567 DOI: 10.1186/s13071-023-06043-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/04/2023] [Indexed: 11/30/2023] Open
Abstract
Dengue continues to be a major public health concern in Latin America and the Caribbean with many countries in the region having experienced drastic increases in the incidence of dengue over the past few years. Dengue virus is predominantly transmitted by the bite of an infected female Aedes aegypti mosquito via a process called horizontal transmission. However, the virus may also be transmitted from an infected female mosquito to her offspring by vertical transmission, which occurs via viral invasion of the ovary either at the time of fertilization or during oviposition. In this way, mosquitoes may become dengue virus infected before ever encountering a human host. While some researchers have reported this phenomenon and suggested it may serve as a reservoir for the dengue virus in nature, others have questioned its epidemiological significance because of the low frequency at which it has been observed. Several researchers have either altogether failed to detect it or observed its occurrence at low frequencies. However, some studies have attributed these failures to small sample sizes as well as poor sensitivities of screening methods employed. Therefore, an overview of the occurrence, significance and limitations of detection of vertical transmission of dengue virus in Aedes mosquitoes in nature within Latin America and the Caribbean will be the focus of this review.
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Affiliation(s)
- Mario A J Golding
- Department of Basic Medical Sciences, Pharmacology and Pharmacy Section, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
| | - Simmoy A A Noble
- Department of Microbiology, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
| | - Nadia K Khouri
- Department of Basic Medical Sciences, Pharmacology and Pharmacy Section, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
| | - Rhaheem N A Layne-Yarde
- Department of Basic Medical Sciences, Pharmacology and Pharmacy Section, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
| | - Inshan Ali
- College of Health and Wellness, Department of Health Sciences, Barry University, Miami Shores, FL, 33161, USA
- Microbiology Laboratory, Memorial Healthcare System, Hollywood, FL, 33021, USA
| | - Simone L Sandiford
- Department of Basic Medical Sciences, Pharmacology and Pharmacy Section, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica.
- Mosquito Control and Research Unit, The University of the West Indies, Mona, Kingston, Jamaica.
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de Arruda TB, Bavia L, Mosimann ALP, Aoki MN, Sarzi ML, Conchon-Costa I, Wowk PF, Duarte dos Santos CN, Pavanelli WR, Silveira GF, Bordignon J. Viremia and Inflammatory Cytokines in Dengue: Interleukin-2 as a Biomarker of Infection, and Interferon-α and -γ as Markers of Primary versus Secondary Infection. Pathogens 2023; 12:1362. [PMID: 38003826 PMCID: PMC10675515 DOI: 10.3390/pathogens12111362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
The pathogenesis of Dengue virus (DENV) infection is complex and involves viral replication that may trigger an inflammatory response leading to severe disease. Here, we investigated the correlation between viremia and cytokine levels in the serum of DENV-infected patients. Between 2013 and 2014, 138 patients with a diagnosis of acute-phase DENV infection and 22 patients with a non-dengue acute febrile illness (AFI) were enrolled. Through a focus-forming assay (FFU), we determined the viremia levels in DENV-infected patients and observed a peak in the first two days after the onset of symptoms. A higher level of viremia was observed in primary versus secondary DENV-infected patients. Furthermore, no correlation was observed between viremia and inflammatory cytokine levels in DENV-infected patients. Receiver operating characteristic (ROC) curve analysis revealed that IL-2 has the potential to act as a marker to distinguish dengue from other febrile illnesses and is positively correlated with Th1 cytokines. IFN-α and IFN-γ appear to be potential markers of primary versus secondary infection in DENV-infected patients, respectively. The results also indicate that viremia levels are not the main driving force behind inflammation in dengue and that cytokines could be used as infection biomarkers and for differentiation between primary versus secondary infection.
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Affiliation(s)
- Thaís Bonato de Arruda
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
| | - Lorena Bavia
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
- Departamento de Biologia Celular, Setor de Ciências Biológicas, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - Ana Luiza Pamplona Mosimann
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
| | - Mateus Nobrega Aoki
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
- Laboratório de Ciências & Tecnologias Aplicadas a Saúde, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil
| | - Maria Lo Sarzi
- Secretaria Municipal de Saúde de Cambé, Cambé 86057-970, Paraná, Brazil
| | - Ivete Conchon-Costa
- Laboratório de Protozoologia Experimental, Universidade Estadual de Londrina, Londrina 86057-970, Paraná, Brazil (W.R.P.)
| | - Pryscilla Fanini Wowk
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
| | - Claudia Nunes Duarte dos Santos
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
| | - Wander Rogério Pavanelli
- Laboratório de Protozoologia Experimental, Universidade Estadual de Londrina, Londrina 86057-970, Paraná, Brazil (W.R.P.)
| | | | - Juliano Bordignon
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba 81350-010, Paraná, Brazil; (T.B.d.A.); (A.L.P.M.)
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Annan E, Treviño J, Zhao B, Rodriguez-Morales AJ, Haque U. Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. PLoS Negl Trop Dis 2023; 17:e0011537. [PMID: 37556473 PMCID: PMC10441797 DOI: 10.1371/journal.pntd.0011537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 08/21/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and region. Further, we assessed the spatial clustering of dengue severity for individuals with primary and secondary infection across Mexican municipalities. Health data from 2012 to 2017 was retrieved from Mexico's Ministry of Health. A mediation analysis was performed using multiple logistic regression models based on a directed acyclic graph. The models were explored for the direct effect of age on dengue severity and its indirect impact through secondary infection. In addition, severe dengue clusters were determined in some Northeastern and Southeastern municipalities through spatial analysis. We observed a nonlinear trend between age and severe dengue. There was a downward trend of severe dengue for individuals between 0 and 10 years and an upward trend above 10 years. The effect of age on dengue severity was no longer significant for individuals between 10 and 60 years after introducing infectivity status into the model. The mediating role of infectivity status in the causal model was 17%. Clustering of severe dengue among individuals with primary infection in the Northeastern region may point to the high prevalence of DENV-3 in the region. Public health efforts may prevent secondary infection among infants and the aged. In addition, there should be a further investigation into the effect of DENV-3 in individuals with primary disease.
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Affiliation(s)
- Esther Annan
- Center for Health and Wellbeing, School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America
| | - Jesús Treviño
- Department of Urban Affairs at the School of Architecture, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo Léon, México
| | - Bingxin Zhao
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
| | - Ubydul Haque
- Rutgers Global Health Institute, New Brunswick, New Jersey, United States of America
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
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de Castro Poncio L, Apolinário dos Anjos F, de Oliveira DA, de Oliveira da Rosa A, Piraccini Silva B, Rebechi D, Pedrosa JM, da Costa Franciscato DA, de Souza C, Paldi N. Prevention of a dengue outbreak via the large-scale deployment of Sterile Insect Technology in a Brazilian city: a prospective study. LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100498. [PMID: 37187486 PMCID: PMC10176055 DOI: 10.1016/j.lana.2023.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/28/2022] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
Background Dengue is a global problem that seems to be worsening, as hyper-urbanization associated with climate change has led to a significant increase in the abundance and geographical spread of its principal vector, the Aedes aegypti mosquito. Currently available solutions have not been able to stop the spread of dengue which shows the urgent need to implement alternative technologies as practical solutions. In a previous pilot trial, we demonstrated the efficacy and safety of the method 'Natural Vector Control' (NVC) in suppressing the Ae. aegypti vector population and in blocking the occurrence of an outbreak of dengue in the treated areas. Here, we expand the use of the NVC program in a large-scale 20 months intervention period in an entire city in southern Brazil. Methods Sterile male mosquitoes were produced from locally sourced Ae. aegypti mosquitoes by using a treatment that includes double-stranded RNA and thiotepa. Weekly massive releases of sterile male mosquitoes were performed in predefined areas of Ortigueira city from November 2020 to July 2022. Mosquito monitoring was performed by using ovitraps during the entire intervention period. Dengue incidence data was obtained from the Brazilian National Disease Surveillance System. Findings During the two epidemiological seasons, the intervention in Ortigueira resulted in up to 98.7% suppression of live progeny of field Ae. aegypti mosquitoes recorded over time. More importantly, when comparing the 2020 and 2022 dengue outbreaks that occurred in the region, the post-intervention dengue incidence in Ortigueira was 97% lower compared to the control cities. Interpretation The NVC method was confirmed to be a safe and efficient way to suppress Ae. aegypti field populations and prevent the occurrence of a dengue outbreak. Importantly, it has been shown to be applicable in large-scale, real-world conditions. Funding This study was funded by Klabin S/A and Forrest Innovations Ltd.
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Affiliation(s)
| | | | | | | | | | - Débora Rebechi
- Forrest Brasil Tecnologia Ltda, São José dos Pinhais, PR, Brazil
| | | | | | | | - Nitzan Paldi
- Forrest Innovations Ltd, Rehovot, Israel
- Corresponding author. Forrest Innovations Ltd, 13 Gad Feinstein Street, Rehovot, Israel.
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Lessa CLS, Hodel KVS, Gonçalves MDS, Machado BAS. Dengue as a Disease Threatening Global Health: A Narrative Review Focusing on Latin America and Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8050241. [PMID: 37235289 DOI: 10.3390/tropicalmed8050241] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Arboviruses constitute the largest known group of viruses. These viruses are the etiological agents of pathologies known as arboviruses, with dengue being one of the most prevalent. Dengue has resulted in important socioeconomic burdens placed on different countries around the world, including those in Latin America, especially Brazil. Thus, this work intends to carry out a narrative-based review of the literature, conducted using a study of the secondary data developed through a survey of scientific literature databases, and to present the situation of dengue, particularly its distribution in these localities. Our findings from the literature demonstrate the difficulties that managers face in controlling the spread of and planning a response against dengue, pointing to the high cost of the disease for public coffers, rendering the resources that are already limited even scarcer. This can be associated with the different factors that affect the spread of the disease, including ecological, environmental, and social factors. Thus, in order to combat the disease, it is expected that targeted and properly coordinated public policies need to be adopted not only in specific localities, but also globally.
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Affiliation(s)
- Carlos Letacio Silveira Lessa
- Postgraduate Program in Industrial Management and Technology, SENAI CIMATEC University Center, Salvador 41650-010, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, Brazil
| | - Katharine Valéria Saraiva Hodel
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Brazil
| | - Marilda de Souza Gonçalves
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, Brazil
- Anemia Research Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador 40170-115, Brazil
| | - Bruna Aparecida Souza Machado
- Postgraduate Program in Industrial Management and Technology, SENAI CIMATEC University Center, Salvador 41650-010, Brazil
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Brazil
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Fernandez-Guzman D, Caira-Chuquineyra B, Calderon-Ramirez PM, Cisneros-Alcca S, Benito-Vargas RM. Sociodemographic factors associated to knowledge and attitudes towards dengue prevention among the Peruvian population: findings from a national survey. BMJ Open 2023; 13:e071236. [PMID: 36944464 PMCID: PMC10032396 DOI: 10.1136/bmjopen-2022-071236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES To evaluate the frequency of knowledge and attitudes towards dengue prevention among the Peruvian population, as well as the sociodemographic factors associated with reported knowledge and attitude outcomes. DESIGN/SETTING A cross-sectional study was conducted, based on information from the National Survey of Budget Programs of Peru, 2019. PARTICIPANTS We included 57 829 respondents with a mean age of 40.3±17.4 years, of whom 52.8% were women and 87.6% were from urban areas. PRIMARY AND SECONDARY OUTCOMES Knowledge about dengue infection (transmission, symptoms, importance of going to a health centre and not self-medicating) and preventive attitudes to avoid infection. RESULTS Of all the respondents, 36.2% (n=23 247) presented good knowledge about dengue and 11.6% (n=7890) had a higher number of preventive attitudes (≥3 attitudes). In the multivariate regression analysis, we found that being female (for knowledge: aPR (adjusted prevalence ratio): 1.03; 95% CI 1.02 to 1.03; and for attitude: aPR: 1.02; 95% CI 1.01 to 1.02), being married/cohabiting (for knowledge: aPR: 1.02; 95% CI 1.00 to 1.03; and for attitude: aPR: 1.01; 95% CI 1.00 to 1.02) and residing in the jungle (for knowledge: aPR: 1.14; 95% CI 1.12 to 1.16; and for attitude: aPR: 1.09; 95% CI 1.07 to 1.11) were associated with better knowledge and more preventive attitudes. In addition, we found that being an adolescent (for knowledge: aPR: 0.97; 95% CI 0.96 to 0.99; and for attitude: aPR: 0.99; 95% CI 0.97 to 0.99), and belonging to the Quechua ethnic group (for knowledge: aPR: 0.93; 95% CI 0.91 to 0.94; and for attitude: aPR: 0.98; 95% CI 0.97 to 0.99) were associated with a lower proportion of adequate knowledge and fewer preventive attitudes. CONCLUSIONS Our study found a high proportion of poor knowledge and few preventive attitudes towards dengue in the Peruvian population. That highlights the requirement to implement national strategies to educate people about dengue and promote preventive attitudes, considering the factors found.
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Affiliation(s)
| | | | | | - Shanelin Cisneros-Alcca
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Raysa M Benito-Vargas
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
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Al Noman A, Das D, Nesa Z, Tariquzzaman M, Sharzana F, Rakibul Hasan M, Khoorshid Riaz B, Sharower G, Meshbahur Rahman M. Importance of Wolbachia-mediated biocontrol to reduce dengue in Bangladesh and other dengue-endemic developing countries. BIOSAFETY AND HEALTH 2023. [DOI: 10.1016/j.bsheal.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
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Thommes E, Coudeville L, Muhammad R, Martin M, Nelson CB, Chit A. Public health impact and cost-effectiveness of implementing a 'pre-vaccination screening' strategy with the dengue vaccine in Puerto Rico. Vaccine 2022; 40:7343-7351. [PMID: 36347720 DOI: 10.1016/j.vaccine.2022.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommended 'pre-vaccination screening' as its preferred implementation strategy when using the licensed dengue vaccine (CYD-TDV; Dengvaxia, Sanofi), so that only individuals with previous dengue infection are vaccinated. The US Centers for Disease Control and Prevention (CDC) recommended use of CYD-TDV to prevent dengue in children with previous laboratory-confirmed dengue infection in regions where dengue is endemic. Here, we evaluate the public health impact and cost-effectiveness of a 'pre-vaccination screening' strategy in Puerto Rico. METHODS The current analysis builds upon a previously published transmission model used to assess the benefits/risks associated with dengue vaccination. For 'pre-vaccination screening', three alternative testing methods were assessed: one using an immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) dengue serotest, another with dengue serotesting using a rapid diagnostic test (RDT), and one using both sequentially (as recommended in Puerto Rico). The time horizon considered was 10 years. RESULTS In Puerto Rico, the disability-adjusted life years (DALYs) averted for 'pre-vaccination screening' with an ELISA-based program, RDT-based program, and both sequentially would be a median 1,192 (95% CI: 716-2,232), 2,812 (95% CI: 1,579-5,019), and 1,017 (95% CI: 561-1,738), respectively. These benefits would arise from the reduction in cases: median 24,961 (95% CI: 17,480-36,782), 58,273 (95% CI: 40,729-84,796), 20,775 (95% CI: 14,637-30,374) fewer cases, respectively. The cost per DALY averted from a payer perspective would be US$12,518 (95 %CI: US$4,749-26,922), US$10,047 (95% CI: US$3,350-23,852), and US$12,334 (95% CI: US$4,965-26,444), respectively. All three strategies would be cost saving from a societal perspective. CONCLUSIONS Our study supports the WHO and CDC 'pre-vaccination screening' guidance for CYD-TDV implementation. In Puerto Rico, regardless of the testing strategy and even with a relatively low rate of testing, it would be cost-effective from a payer perspective and cost saving from a societal perspective.
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Affiliation(s)
- Edward Thommes
- Sanofi, 1755 Steeles Avenue W, Toronto, Ontario M2R 3T4, Canada; University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada; York University, 4700 Keele St, Toronto, Ontario M3J 1P3, Canada.
| | | | | | - Maria Martin
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA.
| | | | - Ayman Chit
- Sanofi, 1 Discovery Drive, Swiftwater, PA 18370, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.
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Abud DA, Santos CY, Neto AAL, Senra JT, Tuboi S. Real world data study of prevalence and direct costs related to dengue management in Brazil's private healthcare from 2015 to 2020. Braz J Infect Dis 2022; 26:102718. [PMID: 36423695 PMCID: PMC9700264 DOI: 10.1016/j.bjid.2022.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/24/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The burden of dengue in Brazil is poorly documented and is based on data from the public health care setting. This study estimated the prevalence and costs of dengue management in the private health care system in Brazil from 2015 to 2020 using a large claims database from Orizon. METHODS We selected claims with dengue ICD codes (ICD-10 A90 or A91) from January 2015 to December 2020. Prevalence was estimated based on the population enrolled in health insurance plans in the given year. Costs were adjusted for the inflation up to December 2021 and evaluated by measures of central tendency and dispersion. RESULTS A total of 63,882 unique beneficiaries were included, with a total of 64,186 dengue cases. The year with the highest prevalence was 2015 (1.6% of patients who used health plans), and there was also an increase in cases in 2016 and 2019. The median cost per hospitalization in 2015 was US$486.17, and in 2020, it reached US$696.72. The median cost of a case seen at an emergency room ranged from US$ 97.78 in 2015 to US$ 118.16 in 2017. CONCLUSIONS The estimated prevalence of dengue in this population of private health-insured patients followed the epidemiological trends of the general population in Brazil, with the highest rates in 2015, 2016, and 2019. The cost of dengue management has increased in the private health care setting over the years.
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Gonçalves Maciel LH, Vieira da Rocha Neto C, Ferreira Martins Y, de Azevedo Furtado F, Cunha Teixeira P, Oliveira Dias MY, Batista Rodrigues YK, Ribeiro Piauilino IC, Damasceno Pinto S, Côrte Alencar AC, de Lima Gimaque JB, Gomes Mourão MP, Guimarães Lacerda MV, da Costa Castilho M, Bôtto-Menezes C. Prevalence of arboviruses and other infectious causes of skin rash in patients treated at a tertiary health unit in the Brazilian Amazon. PLoS Negl Trop Dis 2022; 16:e0010727. [PMID: 36228027 PMCID: PMC9560595 DOI: 10.1371/journal.pntd.0010727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the clinical course of diseases such as arboviruses, skin rashes may appear, as is often seen in other infectious diseases. The aim of this study was to estimate the prevalence of arboviruses and other infectious causes of skin rash in a tertiary health unit in Manaus, Amazonas state, Western Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS This was a cross-sectional study of patients presenting with rash who sought care at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD) from February 2018 to May 2019. Individuals of either gender, aged over 18 years, were invited to participate voluntarily. Infection by Zika virus (ZIKV), dengue virus (DENV), chikungunya virus (CHIKV), Mayaro virus (MAYV), Oropouche virus (OROV) and measles was evaluated using RT-qPCR (real-time polymerase chain reaction). Immunodiagnostic tests for EBV, CMV, HIV, syphilis, rubella and measles were also performed. A total of 340 participants were included, most were female (228, 67.1%) with an average age of 36.5 years (SD ± 12.2 years). The highest prevalence was of ZIKV monoinfections (65.3%, 222/340), followed by DENV (0.9%, 3/340) and CHIKV infection (0.3%, 1/340). No cases of MAYV, OROV or rubella were found. Other causes of skin rash were detected: measles (2.9%, 10/340), parvovirus B19 (0.9% 3/340), HIV (0.3%, 1/340) and syphilis 0.6% (2/340). The co-infections identified were ZIKV+HIV (0.3%, 1/340), ZIKV+measles (0.3%, 1/340), ZIKV+parvovirus B19 (0.3%, 1/340), ZIKV+EBV (0.3%, 1/340), EBV+parvovirus B19 (0.3%, 1/340), CMV+parvovirus B19 (0.6%, 2/340), CMV+syphilis (0.3%, 1/340), ZIKV+EBV+parvovirus B19 (0.3%, 1/340) and CMV+EBV+parvovirus B19 (0.9%, 3/340). Approximately one quarter of patients had no defined cause for their skin rash (25.3%, 86/340). CONCLUSIONS Despite the benign clinical evolution of most of the diseases diagnosed in this series of cases, syndromic surveillance of diseases such as syphilis and HIV are of utmost importance. Periodic serosurveillance might also aid in evaluating the trends of endemic diseases and eventual outbreaks.
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Affiliation(s)
| | - Cosmo Vieira da Rocha Neto
- Programa de Iniciação Científica, Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brasil
| | - Yasmin Ferreira Martins
- Programa de Iniciação Científica, Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brasil
| | | | - Pâmela Cunha Teixeira
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | - Maianne Yasmin Oliveira Dias
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
| | | | | | - Sérgio Damasceno Pinto
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | | | | | - Maria Paula Gomes Mourão
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
| | - Marcus Vinicius Guimarães Lacerda
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Instituto Leônidas e Maria Deane (ILMD–Fiocruz Amazônia), Manaus, Amazonas, Brazil
| | | | - Camila Bôtto-Menezes
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- * E-mail:
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Zaheer S, Tahir MJ, Ullah I, Ahmed A, Saleem SM, Shoib S, Asghar MS. Dengue outbreak in the times of COVID-19 pandemic: Common myths associated with the dengue. Ann Med Surg (Lond) 2022; 81:104535. [PMID: 36065431 PMCID: PMC9434948 DOI: 10.1016/j.amsu.2022.104535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 11/01/2022] Open
Abstract
With the sharp rise in dengue cases across the state and the ongoing COVID-19 pandemic, it is crucial to pay attention to the common misbelieves among the population about dengue. It should be considered to actively spread awareness about the disease to bust the common myths associated with it. A few common myths include that it is a contagious disease, or it is a milder infection than COVID-19, so it's not taken more seriously, or that one cannot be coinfected with both dengue and COVID-19 at one time. We propose that accurate information about dengue can be spread through community education through televisions and social media to cater to the targeted audience. In addition to that, awareness campaigns in rural areas should be planned to help the masses understand the pathogenesis of the diseases and play a role in limiting the transmission.
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Affiliation(s)
| | | | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, 25000, Pakistan
| | - Ali Ahmed
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Muhammad Sohaib Asghar
- Department of Internal Medicine, Dow University of Health Sciences-Ojha Campus, Karachi, Pakistan
- Corresponding author. B328, Block 6, Gulshan-e-Iqbal, Karachi, 75300, Pakistan.
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Junior JBS, Massad E, Lobao-Neto A, Kastner R, Oliver L, Gallagher E. Epidemiology and costs of dengue in Brazil: a systematic literature review. Int J Infect Dis 2022; 122:521-528. [DOI: 10.1016/j.ijid.2022.06.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
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Ferreira DTDO, Atanaka M, Martinez Espinosa M, Schuler-Faccini L, da Silva Caldeira A, da Silva JH, Vivi-Oliveira VK, de Castro da Paz R, do Nascimento VF, Terças-Trettel ACP. Recent dengue virus infection: epidemiological survey on risk factors associated with infection in a medium-sized city in Mato Grosso. SAO PAULO MED J 2022; 140:33-41. [PMID: 34852169 PMCID: PMC9623843 DOI: 10.1590/1516-3180.2020.0718.r1.18052021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/18/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dengue is considered to be the most important arbovirus worldwide, with important complications that increase its lethality. In Brazil, an endemic country, the disease reaches significant incidence levels, with occurrences of serious cases and high costs of hospitalizations for its treatment. OBJECTIVE To analyze risk factors among individuals with recent histories of dengue infection in a medium-sized city in Mato Grosso. DESIGN AND SETTING Descriptive cross-sectional study, of epidemiological-survey type, conducted among the urban population of a city located in mid-northern Mato Grosso. METHODS A seroepidemiological survey using questionnaires and collection of biological material was conducted among 596 adults aged ≥ 18 years who had been selected through a cluster sampling process. Positive dengue cases were those with positive results from anti-dengue immunoassays (ELISA). Statistical analyses with descriptive and inferential techniques were used, with 95% confidence intervals and a 5% significance level. RESULTS The seroepidemiological profile of the study participants was predominantly female, with ages between 18 and 39 years, self-declared non-white race/color, not more than eight years of education and not living with a companion. Among the sanitary factors analyzed, the following were risk factors for dengue virus infection: no running water at home; no water supply from the public piped network; no waste from drains or toilets sent to the sewage network; endemic disease combat agents visiting the home; and presence of mosquito breeding sites at home. CONCLUSION Low schooling levels and previous dengue virus infection were associated with current dengue virus infection.
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Affiliation(s)
- Dandára Thaís de Oliveira Ferreira
- MSc. Nutritionist and Public Manager, Storage and Distribution Center for Medicines and Supplies of the Municipal Health Department, Várzea Grande (MT), Brazil.
| | - Marina Atanaka
- PhD. Nurse and Associate Professor IV, Postgraduate Program on Collective Health, Universidade Federal de Mato Grosso (UFMT), Cuiabá campus, Cuiabá (MT), Brazil.
| | - Mariano Martinez Espinosa
- PhD. Statistician and Associate Professor IV, Postgraduate Program on Collective Health, Universidade Federal de Mato Grosso (UFMT), Cuiabá campus, Cuiabá (MT), Brazil.
| | - Lavinia Schuler-Faccini
- MD, PhD. Full Professor, Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre (RS), Brazil.
| | | | - Juliana Herrero da Silva
- MSc. Nurse and Technical Manager, Municipal Epidemiological Surveillance Department, Tangará da Serra (MT), Brazil.
| | | | - Rayana de Castro da Paz
- Specialist. Pharmacist, Biochemist and Technical Consultant, General Coordination Office for Health Laboratories, Health Surveillance Department, Ministry of Health, Brasília (DF), Brazil.
| | - Vagner Ferreira do Nascimento
- PhD. Nurse and Adjunct Professor II, Universidade do Estado de Mato Grosso (UNEMAT), Tangará da Serra campus, Tangará da Serra (MT), Brazil.
| | - Ana Cláudia Pereira Terças-Trettel
- PhD. Nurse and Adjunct Professor, Universidade do Estado de Mato Grosso (UNEMAT), Tangará da Serra campus, Tangará da Serra (MT), Brazil; and Permanent Professor, Postgraduate Program on Collective Health, Universidade Federal de Mato Grosso (UFMT), Cuiabá campus, Cuiabá (MT), Brazil.
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Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus. Viruses 2021; 13:v13091789. [PMID: 34578370 PMCID: PMC8473164 DOI: 10.3390/v13091789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 12/27/2022] Open
Abstract
The incidence of dengue in Latin America has increased dramatically during the last decade. Understanding the pathogenic mechanisms in dengue is crucial for the identification of biomarkers for the triage of patients. We aimed to characterize the profile of cytokines (IFN-γ, TNF-α, IL-1β, IL-6, IL-18 and IL-10), chemokines (CXCL8/IL-8, CCL2/MCP-1 and CXCL10/IP-10) and coagulation mediators (Fibrinogen, D-dimer, Tissue factor-TF, Tissue factor pathway inhibitor-TFPI and Thrombomodulin) during the dengue-4 epidemic in Brazil. Laboratory-confirmed dengue cases had higher levels of TNF-α (p < 0.001), IL-6 (p = 0.005), IL-10 (p < 0.001), IL-18 (p = 0.001), CXCL8/IL-8 (p < 0.001), CCL2/MCP-1 (p < 0.001), CXCL10/IP-10 (p = 0.001), fibrinogen (p = 0.037), D-dimer (p = 0.01) and TFPI (p = 0.042) and lower levels of TF (p = 0.042) compared to healthy controls. A principal component analysis (PCA) distinguished between two profiles of mediators of inflammation and coagulation: protective (TNF-α, IL-1β and CXCL8/IL-8) and pathological (IL-6, TF and TFPI). Lastly, multivariate logistic regression analysis identified high aspartate aminotransferase-to-platelet ratio index (APRI) as independent risk factors associated with severity (adjusted OR: 1.33; 95% CI 1.03–1.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681–0.869) and an optimal cutoff value was 1.4 (sensitivity: 76%; specificity: 79%), so it could be a useful marker for the triage of patients attending primary care centers.
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Byrne AB, García AG, Brahamian JM, Mauri A, Ferretti A, Polack FP, Talarico LB. A murine model of dengue virus infection in suckling C57BL/6 and BALB/c mice. Animal Model Exp Med 2021; 4:16-26. [PMID: 33738433 PMCID: PMC7954830 DOI: 10.1002/ame2.12145] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/01/2020] [Indexed: 12/20/2022] Open
Abstract
Dengue is a significant public health concern across tropical and subtropical regions worldwide, principally causing disease in children. Very young children are at increased risk of severe manifestations of dengue infection. The mechanism of dengue disease in this population is not fully understood. In this study, we present a murine model of dengue virus primary infection in suckling C57BL/6 and BALB/c mice in order to investigate disease pathogenesis. Three-day-old C57BL/6 mice intraperitoneally infected with DENV-2 NGC were more susceptible to infection than BALB/c mice, showing increased liver enzymes, extended viremia, dissemination to organs and histological alterations in liver and small intestine. Furthermore, the immune response in DENV-infected C57BL/6 mice exhibited a marked Th1 bias compared to BALB/c mice. These findings highlight the possibility of establishing an immunocompetent mouse model of DENV-2 infection in suckling mice that reproduces certain signs of disease observed in humans and that could be used to further study age-related mechanisms of dengue pathogenesis.
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Affiliation(s)
- Alana B. Byrne
- Fundación INFANTBuenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
- Present address:
Laboratorio de Investigaciones Infectológicas y Biología MolecularInfectologíaDepartamento de MedicinaHospital de Niños Ricardo GutiérrezBuenos AiresArgentina
| | - Ayelén G. García
- Fundación INFANTBuenos AiresArgentina
- Present address:
Instituto Nacional de Enfermedades Infecciosas (INEI) ‐ Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) “Dr Carlos Malbrán”Buenos AiresArgentina
| | - Jorge M. Brahamian
- Fundación INFANTBuenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
- Present address:
Departamento de Química Biológica‐IQUIBICEN (CONICET‐UBA)Facultad de Ciencias Exactas y NaturalesUniversidad de Buenos AiresBuenos AiresArgentina
| | | | | | | | - Laura B. Talarico
- Fundación INFANTBuenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Buenos AiresArgentina
- Present address:
Laboratorio de Investigaciones Infectológicas y Biología MolecularInfectologíaDepartamento de MedicinaHospital de Niños Ricardo GutiérrezBuenos AiresArgentina
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Ho TS, Weng TC, Wang JD, Han HC, Cheng HC, Yang CC, Yu CH, Liu YJ, Hu CH, Huang CY, Chen MH, King CC, Oyang YJ, Liu CC. Comparing machine learning with case-control models to identify confirmed dengue cases. PLoS Negl Trop Dis 2020; 14:e0008843. [PMID: 33170848 PMCID: PMC7654779 DOI: 10.1371/journal.pntd.0008843] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 10/01/2020] [Indexed: 01/10/2023] Open
Abstract
In recent decades, the global incidence of dengue has increased. Affected countries have responded with more effective surveillance strategies to detect outbreaks early, monitor the trends, and implement prevention and control measures. We have applied newly developed machine learning approaches to identify laboratory-confirmed dengue cases from 4,894 emergency department patients with dengue-like illness (DLI) who received laboratory tests. Among them, 60.11% (2942 cases) were confirmed to have dengue. Using just four input variables [age, body temperature, white blood cells counts (WBCs) and platelets], not only the state-of-the-art deep neural network (DNN) prediction models but also the conventional decision tree (DT) and logistic regression (LR) models delivered performances with receiver operating characteristic (ROC) curves areas under curves (AUCs) of the ranging from 83.75% to 85.87% [for DT, DNN and LR: 84.60% ± 0.03%, 85.87% ± 0.54%, 83.75% ± 0.17%, respectively]. Subgroup analyses found all the models were very sensitive particularly in the pre-epidemic period. Pre-peak sensitivities (<35 weeks) were 92.6%, 92.9%, and 93.1% in DT, DNN, and LR respectively. Adjusted odds ratios examined with LR for low WBCs [≤ 3.2 (x103/μL)], fever (≥38°C), low platelet counts [< 100 (x103/μL)], and elderly (≥ 65 years) were 5.17 [95% confidence interval (CI): 3.96-6.76], 3.17 [95%CI: 2.74-3.66], 3.10 [95%CI: 2.44-3.94], and 1.77 [95%CI: 1.50-2.10], respectively. Our prediction models can readily be used in resource-poor countries where viral/serologic tests are inconvenient and can also be applied for real-time syndromic surveillance to monitor trends of dengue cases and even be integrated with mosquito/environment surveillance for early warning and immediate prevention/control measures. In other words, a local community hospital/clinic with an instrument of complete blood counts (including platelets) can provide a sentinel screening during outbreaks. In conclusion, the machine learning approach can facilitate medical and public health efforts to minimize the health threat of dengue epidemics. However, laboratory confirmation remains the primary goal of surveillance and outbreak investigation.
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Affiliation(s)
- Tzong-Shiann Ho
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Ting-Chia Weng
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Jung-Der Wang
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Department of Public Heath, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Hsieh-Cheng Han
- Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Hao-Chien Cheng
- Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chun-Chieh Yang
- Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chih-Hen Yu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Yen-Jung Liu
- Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chien Hsiang Hu
- Department of Medical Informatics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Chun-Yu Huang
- Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Ming-Hong Chen
- Department of Medical Informatics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Chwan-Chuen King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yen-Jen Oyang
- Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan, Republic of China
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Castillo Signor LDC, Edwards T, Escobar LE, Mencos Y, Matope A, Castaneda-Guzman M, Adams ER, Cuevas LE. Epidemiology of dengue fever in Guatemala. PLoS Negl Trop Dis 2020; 14:e0008535. [PMID: 32813703 PMCID: PMC7458341 DOI: 10.1371/journal.pntd.0008535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/31/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022] Open
Abstract
Dengue fever occurs worldwide and about 1% of cases progress to severe haemorrhage and shock. Dengue is endemic in Guatemala and its surveillance system could document long term trends. We analysed 17 years of country-wide dengue surveillance data in Guatemala to describe epidemiological trends from 2000 to 2016.Data from the national dengue surveillance database were analysed to describe dengue serotype frequency, seasonality, and outbreaks. We used Poisson regression models to compare the number of cases each year with subsequent years and to estimate incidence ratios within serotype adjusted by age and gender. 91,554 samples were tested. Dengue was confirmed by RT-qPCR, culture or NS1-ELISA in 7097 (7.8%) cases and was IgM ELISA-positive in 19,290 (21.1%) cases. DENV1, DENV2, DENV3, and DENV4 were detected in 2218 (39.5%), 2580 (45.9%), 591 (10.5%), and 230 (4.1%) cases. DENV1 and DENV2 were the predominant serotypes, but all serotypes caused epidemics. The largest outbreak occurred in 2010 with 1080 DENV2 cases reported. The incidence was higher among adults during epidemic years, with significant increases in 2005, 2007, and 2013 DENV1 outbreaks, the 2010 DENV2 and 2003 DENV3 outbreaks. Adults had a lower incidence immediately after epidemics, which is likely linked to increased immunity. Dengue is the most common mosquito-borne virus, and a major cause of fever, with an estimated 390 million infections annually. Guatemala, in Central America, has had ongoing dengue transmission since the 1990s. Its national surveillance system monitors outbreaks and seasonal trends of infections to inform public health responses. We have analysed 17 years of surveillance data collected from 2000 to 2016, to describe seasonal trends, outbreak years, and the fluctuating prevalence of the four dengue serotypes. Laboratory data from 91,554 individual serum samples were included, of which 7.8% were positive for dengue. All four dengue serotypes circulate in the country, with dengue 1 and 2 being the predominant serotypes. This is important, as it increases the likelihood of dengue infections being followed by a new infection with a different serotype, which can lead to severe dengue. We also report that adults in Guatemala have a lower likelihood of infection the year after an epidemic, which might be linked to an increased immunity in the population.
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Affiliation(s)
| | - Thomas Edwards
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Luis E. Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, United States of America
| | - Yolanda Mencos
- Ministerio de Salud Publica y Asistencia Social de Guatemala, Guatemala City, Guatemala
| | - Agnes Matope
- Tropical Clinical Trials Unit. Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mariana Castaneda-Guzman
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, United States of America
| | - Emily R. Adams
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Luis E. Cuevas
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Tropical Clinical Trials Unit. Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
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21
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Análisis de costo-efectividad del uso del programa VECTOS en el control rutinario de enfermedades transmitidas por Aedes aegypti en dos municipios de Santander, Colombia. BIOMÉDICA 2020; 40:270-282. [PMID: 32673456 PMCID: PMC7505512 DOI: 10.7705/biomedica.4658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Indexed: 12/04/2022]
Abstract
Introducción. Las enfermedades transmitidas por Aedes aegypti son un problema de salud pública. VECTOS es un programa novedoso de integración de estrategias de control de vectores. Objetivo. Evaluar el costo-efectividad del uso del VECTOS en los programas de control rutinario de enfermedades transmitidas por el vector Aedes aegypti en el municipio de San Juan de Girón (Santander). Materiales y métodos. Se evaluó el costo-efectividad del programa empleando un modelo de análisis de decisiones desde la perspectiva de las autoridades locales de salud. Se estudió la integración de las estrategias de control de vectores mediante el programa VECTOS utilizado en el municipio de San Juan de Girón durante el 2016, con el control rutinario llevado a cabo sin VECTOS en el municipio de Floridablanca. Se calculó la razón incremental del costo-efectividad (RICE), usando como medida de efectividad los años de vida ajustados por discapacidad (AVAD). Resultados. El uso del programa VECTOS fue rentable a una tasa de ahorro de USD$ 660,4 por cada AVAD evitado en comparación con el control de rutina en Floridablanca. El modelo probabilístico indicó que el sistema fue costo-efectivo en el 70 % de las 10.000 iteraciones para un umbral entre 1 y 3 PIB per cápita. Conclusiones. El programa VECTOS fue muy costo-efectivo en el municipio de San Juan de Girón. Su uso puede adoptarse en otros municipios del país donde las enfermedades transmitidas por A. aegypti son endémicas.
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Rathnayake D, Clarke M, Jayasooriya L. Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemics – A systematic review. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1692517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mike Clarke
- Centre for Public Health, Institute of Clinical Sciences, Queens University, Belfast, UK
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