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Schuab G, Tosta S, Moreno K, Fonseca V, Santos LA, Slavov SN, Kashima S, Ciccozzi M, Lourenço J, Cella E, de Oliveira C, Cavalcanti AC, Junior Alcantara LC, de Bruycker-Nogueira F, Bispo de Filippis AM, Giovanetti M. Exploring the urban arbovirus landscape in Rio de Janeiro, Brazil: transmission dynamics and patterns of disease spread. LANCET REGIONAL HEALTH. AMERICAS 2024; 35:100786. [PMID: 38846808 PMCID: PMC11152967 DOI: 10.1016/j.lana.2024.100786] [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: 02/01/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024]
Abstract
Background This study focuses on urban arboviruses, specifically dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV), which pose a significant public health challenge in Rio de Janeiro state, Southeast Brazil. In our research, we highlight critical findings on the transmission dynamics of these arboviruses in Rio de Janeiro, identifying distinct patterns of disease spread. Methods By combining genomic data with case reports from the Brazilian Ministry of Health, we have analysed the phylogenetics, prevalence and spatial distribution of these endemic viruses within the state. Findings Our results revealed sustained DENV transmission primarily in the northern part of the state, a significant ZIKV epidemic in 2016 affecting all mesoregions, and two major CHIKV outbreaks in 2018 and 2019, predominantly impacting the northern and southern areas. Our analysis suggests an inverse relationship between arboviral case incidence and urban density, with less populous regions experiencing higher transmission rates, potentially attributed to a complex interplay of factors such as the efficacy of vector control measures, environmental conditions, local immunity levels, and human mobility. Furthermore, our investigation unveiled distinct age and gender trends among affected individuals. Notably, dengue cases were predominantly observed in young adults aged 32, while chikungunya cases were more prevalent among individuals over 41. In contrast, cases of ZIKV were concentrated around the 33-year age group. Intriguingly, females accounted for nearly 60% of the cases, suggesting a potential gender-based difference in infection rates. Interpretation Our findings underscore the complexity of arbovirus transmission and the need for interventions tailored to different geographical mesoregions. Enhanced surveillance and genomic sequencing will be essential for a deeper, more nuanced understanding of regional arbovirus dynamics. Identifying potential blind spots within the state will be pivotal for developing and implementing more effective public health strategies, specifically designed to address the unique challenges posed by these viruses throughout the state. Funding This study was supported by the National Institutes of Health USA grant U01 AI151698 for the United World Arbovirus Research Network (UWARN) and the CRP-ICGEB RESEARCH GRANT 2020 Project CRP/BRA20-03.
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Affiliation(s)
- Gabriel Schuab
- Universidade Federal do Rio de Janeiro, Duque de Caxias, Rio de Janeiro, Brazil
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Stephane Tosta
- Programa Interunidades de Pós-Graduação em Bioinformática, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Keldenn Moreno
- Programa Interunidades de Pós-Graduação em Bioinformática, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vagner Fonseca
- Department of Exact and Earth Sciences, University of the State of Bahia, Salvador, Brazil
| | | | - Svetoslav Nanev Slavov
- Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Butantan Institute, São Paulo, Brazil
| | - Simone Kashima
- Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - José Lourenço
- Universidade Católica Portuguesa, Faculdade de Medicina, Biomedical Research Center, Lisboa, Portugal
- Climate Amplified Diseases and Epidemics (CLIMADE), Portugal, Europe
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, 32827, USA
| | - Carla de Oliveira
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Ana Maria Bispo de Filippis
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marta Giovanetti
- Department of Science and Technology for Humans and the Environment, University of Campus Bio-Medico di Roma, Rome, Italy
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Puccioni-Sohler M, Nascimento Soares C, Christo PP, Almeida SMD. Review of dengue, zika and chikungunya infections in nervous system in endemic areas. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1112-1124. [PMID: 38157877 PMCID: PMC10756841 DOI: 10.1055/s-0043-1777104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/15/2023] [Indexed: 01/03/2024]
Abstract
Dengue, zika, and chikungunya are arboviruses of great epidemiological relevance worldwide. The emergence and re-emergence of viral infections transmitted by mosquitoes constitute a serious human public health problem. The neurological manifestations caused by these viruses have a high potential for death or sequelae. The complications that occur in the nervous system associated with arboviruses can be a challenge for diagnosis and treatment. In endemic areas, suspected cases should include acute encephalitis, myelitis, encephalomyelitis, polyradiculoneuritis, and/or other syndromes of the central or peripheral nervous system, in the absence of a known explanation. The confirmation diagnosis is based on viral (isolation or RT-PCR) or antigens detection in tissues, blood, cerebrospinal fluid, or other body fluids, increase in IgG antibody titers between paired serum samples, specific IgM antibody in cerebrospinal fluid and serological conversion to IgM between paired serum samples (non-reactive in the acute phase and reactive in the convalescent). The cerebrospinal fluid examination can demonstrate: 1. etiological agent; 2. inflammatory reaction or protein-cytological dissociation depending on the neurological condition; 3. specific IgM, 4. intrathecal synthesis of specific IgG (dengue and chikungunya); 5. exclusion of other infectious agents. The treatment of neurological complications aims to improve the symptoms, while the vaccine represents the great hope for the control and prevention of neuroinvasive arboviruses. This narrative review summarizes the updated epidemiology, general features, neuropathogenesis, and neurological manifestations associated with dengue, zika, and chikungunya infection.
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Affiliation(s)
- Marzia Puccioni-Sohler
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Departamento de Medicina Geral, Rio de Janeiro RJ, Brazil.
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brazil.
| | | | - Paulo Pereira Christo
- Santa Casa BH, Faculdade de Saúde, Programa de Pós-Graduação Stricto Sensu em Medicina-Biomedicina, Belo Horizonte MG, Brazil.
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Neurologia, Belo Horizonte MG, Brazil.
| | - Sérgio Monteiro de Almeida
- Universidade Federal do Paraná, Faculdade de Medicina, Departamento de Patologia Médica, Curitiba PR, Brazil.
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Sekendiz Z, Clouston SAP, Morozova O, Carr MA, Fontana A, Mehta N, Ali A, Jiang E, Luft B. ASSESSMENT AND CHARACTERIZATION OF COVID-19 RELATED COGNITIVE DECLINE: RESULTS FROM A NATURAL EXPERIMENT. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.06.23298101. [PMID: 37986906 PMCID: PMC10659478 DOI: 10.1101/2023.11.06.23298101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Cognitive impairment is the most common and disabling manifestation of post-acute sequelae of SARS-CoV-2. There is an urgent need for the application of more stringent methods for evaluating cognitive outcomes in research studies. Objective To determine whether cognitive decline emerges with the onset of COVID-19 and whether it is more pronounced in patients with Post-Acute Sequelae of SARS-CoV-2 or severe COVID-19. Methods This longitudinal cohort study compared the cognitive performance of 276 patients with COVID-19 to that of 217 controls across four neuroinflammation or vascular disease-sensitive domains of cognition using data collected both before and after the pandemic starting in 2015. Results The mean age of the COVID-19 group was 56.04±6.6 years, while that of the control group was 58.1±7.3 years. Longitudinal models indicated a significant decline in cognitive throughput ((β=-0.168, P=.001) following COVID-19, after adjustment for pre-COVID-19 functioning, demographics, and medical factors. The effect sizes were large; the observed changes in throughput were equivalent to 10.6 years of normal aging and a 59.8% increase in the burden of mild cognitive impairment. Cognitive decline worsened with coronavirus disease 2019 severity and was concentrated in participants reporting post-acute sequelae of SARS-CoV-2. Conclusion COVID-19 was most likely associated with the observed cognitive decline, which was worse among patients with PASC or severe COVID-19. Monitoring patients with post-acute sequelae of SARS-CoV-2 for declines in the domains of processing speed and visual working memory and determining the long-term prognosis of this decline are therefore warranted.
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Affiliation(s)
- Zennur Sekendiz
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Sean A P Clouston
- Stony Brook University, Family, Population and Preventive Medicine, Program in Public Health
| | - Olga Morozova
- The University of Chicago, Department of Public Health Sciences
| | - Melissa A Carr
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Ashley Fontana
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Nikhil Mehta
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Alina Ali
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Eugene Jiang
- Stony Brook University, Department of Medicine-World Trade Center Health Program
| | - Benjamin Luft
- Stony Brook University, Department of Medicine-World Trade Center Health Program
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de Lima Cavalcanti TYV, Azevedo EDAN, Lima MC, Saraiva KLA, Franca RFO. Chikungunya virus infection induces ultrastructural changes and impaired neuronal differentiation of human neurospheres. Front Microbiol 2023; 14:1152480. [PMID: 37250062 PMCID: PMC10213924 DOI: 10.3389/fmicb.2023.1152480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Chikungunya virus (CHIKV) is an arthropod-borne virus recently associated with large outbreaks in many parts of the world. Infection is typically manifested as a febrile and self-limited illness, characterized by joint pain and myalgia, albeit severe neurological manifestations are also reported. Although CHIKV is not recognized as a truly neurotropic virus, neurons, astrocytes, and oligodendrocytes are susceptible to infection in vitro. Here we employed a model of 3D cell culture to obtain neurospheres from ATRA/BNDF differentiated human neuroblastoma cells. We demonstrate that CHIKV is able to establish a productive infection, resulting in ultrastructural changes in cell morphology and impaired neuronal differentiation. Ultrastructural analysis of neurospheres infected with CHIKV during neuronal differentiation revealed diminished neuron dendrite formation, accumulation of viral particles associated with the plasma membrane, numerous cell vacuoles, and swollen mitochondria. Apoptotic cells were significantly increased at 72 h post-infection. Compared to Zika virus, a well-characterized neurotropic arbovirus, CHIKV infection resulted in a more discrete, albeit detectable upregulation of IL-6 levels. Finally, we found that CHIKV infection resulted in an altered profile expression, mainly downregulation, of a group of transcription factors named Hox genes. Altogether our findings highlight important features of CHIKV in the CNS, as well as the feasibility of neurospheres as robust experimental models that can support further studies for novel pharmacological interventions.
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Affiliation(s)
| | - Elisa de Almeida Neves Azevedo
- Department of Virology and Experimental Therapy, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz/Fiocruz, Recife, Brazil
| | - Morganna Costa Lima
- Department of Virology and Experimental Therapy, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz/Fiocruz, Recife, Brazil
| | | | - Rafael Freitas Oliveira Franca
- Department of Virology and Experimental Therapy, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz/Fiocruz, Recife, Brazil
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Benyumiza D, Kumakech E, Gutu J, Banihani J, Mandap J, Talib ZM, Wakida EK, Maling S, Obua C. Caregiver's perspectives on the Central Nervous System infection illness trajectory among older persons with dementia in Northern Uganda-a qualitative community-based study. BMC Geriatr 2022; 22:825. [PMID: 36303115 PMCID: PMC9609188 DOI: 10.1186/s12877-022-03499-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Few studies have explored the Central Nervous System (CNS) infection illness trajectory among older persons with dementia in sub-Saharan African (SSA) settings. This study explored the Caregiver’s perspectives on the Central Nervous System infection illness trajectory among the older persons with dementia in Northern Uganda. Methods This was a qualitative study conducted in Lira District northern Uganda in March 2022 amongst purposively selected 20 caregivers of the older persons aged 50 + years with a positive history of CNS infection and later life dementia. Data were collected using an in-depth interview guide. Audio recordings and field notes of the interviews were undertaken. The interviews generated data on the CNS infection illness trajectory from onset to the current demented state of the older persons. The audio-recorded interviews were transcribed verbatim before manual reflective thematic analysis. Results Older persons with a positive history of CNS infection illness and later life dementia in rural northern Uganda presented with symptoms of early life CNS infection illness ranging from neck pain, back pain, chronic headache, and fatigue. There were also manifestations of comorbidities particularly road traffic accidents involving traumatic injury to the head, neck, and spine, high blood pressure, chronic headache, and or their medications in the older person’s trajectory to later life dementia. A plurality of healthcare which included both formal and informal healthcare medicines was sought and utilized for the treatment and care of the CNS infection illness and dementia by the older persons amidst improper diagnosis and mismanagement. Conclusions and recommendations Older persons with early-life CNS infections illness and later-life dementia were reported to present with symptoms including neck pain, back pain, chronic headache, high blood pressure, and fatigue. The reported symptoms of CNS infection illness may be intertwined with co-morbidities particularly traumatic injury involving the head, neck, and spine, high blood pressure, and chronic headache. Healthcare professionals should integrate routine screening of older persons for the history of CNS infections, chronic headache, high blood pressure, trauma to the head, neck, and spine, and dementia and early treatment.
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Affiliation(s)
- Deo Benyumiza
- Department of Nursing and Midwifery, Faculty of Health Science, Lira University, P.O. Box 1035, Lira City, Uganda
| | - Edward Kumakech
- Department of Nursing and Midwifery, Faculty of Health Science, Lira University, P.O. Box 1035, Lira City, Uganda
| | - Jastine Gutu
- Office of the Health Professional Education Partnership Initiative – Transforming Ugandan Institution’s Training Against HIV/AIDS (HEPI-TUITAH) Program Administration, Faculty of Health Science, Lira University, Lira, Uganda
| | - Jude Banihani
- grid.514026.40000 0004 6484 7120Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
| | - Joshua Mandap
- grid.514026.40000 0004 6484 7120Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
| | - Zohray M. Talib
- grid.514026.40000 0004 6484 7120Department of Medicine, California University of Science and Medicine, San Bernadinio, USA ,grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
| | - Edith K. Wakida
- grid.514026.40000 0004 6484 7120Department of Medicine, California University of Science and Medicine, San Bernadinio, USA ,grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
| | - Samuel Maling
- grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda ,grid.33440.300000 0001 0232 6272Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- grid.33440.300000 0001 0232 6272Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda ,grid.33440.300000 0001 0232 6272Office of the Vice Chancellor, Mbarara University of Science and Technology, Mbarara, Uganda
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