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Riaz M, Harun SNB, Mallhi TH, Khan YH, Butt MH, Husain A, Khan MM, Khan AH. Evaluation of clinical and laboratory characteristics of dengue viral infection and risk factors of dengue hemorrhagic fever: a multi-center retrospective analysis. BMC Infect Dis 2024; 24:500. [PMID: 38760732 PMCID: PMC11102246 DOI: 10.1186/s12879-024-09384-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: 10/25/2023] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dengue Viral Infection (DVI) has become endemic in Pakistan since the first major outbreak in Karachi in 1996. Despite aggressive measures taken by relevant authorities, Pakistan has been dealing with a worsening dengue crisis for the past two decades. DHF is severe form of dengue infection which is linked with significant morbidity and mortality. Early identification of severe dengue infections can reduce the morbidity and mortality. In this context we planned current study in which we find out the different factors related with DHF as well as clinical laboratory features of DHF and compare them to DF so that patients can be best evaluated for DHF and managed accordingly at admission. METHODS Retrospective study conducted over a period of 6 years (2013-2018) in two tertiary care hospitals in Pakistan. Data were collected by using a pre-structured data collection form. Data were statistically analyzed to determine the clinical and laboratory characteristics of DVI and risk factors of dengue hemorrhagic fever (DHF). RESULTS A total 512 dengue cases (34.05 ± 15.08 years; Male 69.53%) were reviewed. Most common clinical manifestations of DVI were fever (99.60%), headache (89.1%), chills (86.5%), rigors (86.5%), myalgia (72.3%). Less common clinical manifestations were vomiting (52.5%), arthralgia (50.2%) and skin rashes (47.5%). Furthermore, nasal bleeding (44.1%), gum bleeding (32.6%), pleural effusion (13.9%) and hematuria (13.1%) were more profound clinical presentations among DHF patients. Mortality rate was 1.5% in this study. Logistic regression analysis indicated that delayed hospitalization (OR: 2.30) and diabetes mellitus (OR:2.71), shortness of breath (OR:2.21), association with risk groups i.e., living near stagnant water, travelling to endemic areas, living in endemic regions (OR:1.95), and presence of warning signs (OR:2.18) were identified as risk factors of DHF. Statistically we found that there is strong association of diabetes mellitus (DM) with DHF while the patient suffering from DM individually had higher odds (2.71) of developing DHF than patients without disease. CONCLUSIONS The current study demonstrated that the clinical and laboratory profiles of DF and DHF are significantly distinct. Significant predictors of DHF were advanced age, diabetes mellitus, ascites, pleural effusion, thick gallbladder and delayed hospitalization. The identification of these factors at early stage provides opportunities for the clinicians to identify high risk patients and to reduce dengue-related morbidity and mortality.
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Affiliation(s)
- Muhammad Riaz
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Palau Penang, Malaysia
- Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sabriah Noor Binti Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Palau Penang, Malaysia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakakah, Al-Jouf, Kingdom of Saudi Arabia
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakakah, Al-Jouf, Kingdom of Saudi Arabia
| | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, Uppsala, 75123, Sweden.
| | - Aamir Husain
- Department of Medicine, Faisalabad Medical University, Faisalabad, Pakistan
| | - Muhammad Mujeeb Khan
- Department of Infectious Diseases, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Palau Penang, Malaysia
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Lim HJ, Saha T, Ooi CW. Site-specific imprinting of dengue virus non-structural 1 antigen on a polydopamine-based sensing film for early detection and prognosis of dengue. Talanta 2024; 268:125376. [PMID: 37951180 DOI: 10.1016/j.talanta.2023.125376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/06/2023] [Accepted: 10/30/2023] [Indexed: 11/13/2023]
Abstract
Serum levels of dengue virus (DENV) non-structural 1 (NS1) antigen can serve as a valuable prognostic indicator of severe dengue infections. A quartz crystal microbalance (QCM)-based biosensor with a biomimetic recognition element was designed to quantitatively detect DENV NS1 as an early disease biomarker. To mitigate the reliance on costly viral antigens during the molecular imprinting process, a synthetic peptide mimicking a DENV NS1 epitope was used as a surrogate template for the synthesis of an epitope-imprinted polydopamine (EMIPDA) sensing film on the biosensor surface. The maximal frequency shift for DENV NS1 was obtained with an EMIPDA film synthesised using 5 mg mL-1 of dopamine monomer and 0.5 mg mL-1 of peptide template. The EMIPDA-QCM biosensor achieved low detection and quantitation limits of 0.091 μg mL-1 and 0.436 μg mL-1, respectively, allowing acute-phase detection of dengue and prognosis of the disease progression. The EMIPDA-QCM biosensor exhibited remarkable selectivity with up to 68-fold larger frequency responses towards DENV NS1 compared to a major serum protein. The site-specific imprinting approach not only enhanced the biosensing performance but also enabled a 26-fold cost reduction for biosensor functionalisation, providing a cost-effective strategy for label-free biosensing of the dengue biomarker via the biopolymer film.
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Affiliation(s)
- Hui Jean Lim
- Department of Chemical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Tridib Saha
- Department of Electrical and Robotics Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Chien Wei Ooi
- Department of Chemical Engineering, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; Tropical Medicine and Biology Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
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Low GKK, Jiee SF, Masilamani R, Shanmuganathan S, Rai P, Manda M, Omosumwen OF, Kagize J, Gavino AI, Azahar A, Jabbar MA. Routine blood parameters of dengue infected children and adults. A meta-analysis. Pathog Glob Health 2023; 117:565-589. [PMID: 36593636 PMCID: PMC10392251 DOI: 10.1080/20477724.2022.2161864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The World Health Organization (WHO) has revised dengue case classification in 2009 to better reflect the severity of the disease. However, there was no comprehensive meta-analysis of pooled routine blood parameters according to the age or the categories of the 2009 WHO classification. This study aimed to meta-analyze the routine blood parameters of dengue infected children and adults. Electronic search was performed with eligible articles included for review. Meta-analysis was conducted for six blood parameters stratified into children, adults and all ages, which were further grouped into the three 2009 WHO case classifications (dengue without warning signs, DwoWS; dengue with warning signs, DwWS; severe dengue, SD), non-severe dengue (non-SD) and 'All' cases. A total of 55 articles were included in the meta-analysis. Fifteen studies were conducted in the children's age category, 31 studies in the adult category and nine studies in all ages. The four selected pooled blood parameters for children were white blood cell (WBC) (×103/L) with 5.11 (SD), 5.64 (DwWS), 5.52 (DwoWS) and 4.68 (Non-SD) hematocrit (HCT) (%) with 36.78 (SD), 40.70 (DwWS), 35.00 (DwoWS) and 29.78 (Non-SD) platelet (PLT) (×103/µL) with 78.66 (SD), 108.01 (DwWS), 153.47 (DwoWS) and 108.29 (non-SD); and aspartate aminotransferase (AST) (/µL) with 248.88 (SD), 170.83 (DwWS), 83.24 (DwoWS) and 102.99 (non-SD). For adult, WBC were 4.96 (SD), 6.44 (DwWS), 7.74 (DwoWS) and 3.61 (non-SD); HCT were 39.50 (SD), 39.00 (DwWS), 37.45 (DwoWS) and 41.68 (non-SD); PLT were 49.62 (SD), 96.60 (DwWS), 114.37 (DwoWS) and 71.13 (non-SD); and AST were 399.50 (SD), 141.01 (DwWS), 96.19 (DwoWS) and 118.13 (non-SD). These blood parameters could not differentiate between each dengue severity according to the WHO 2009 classification, SD, DwoWS, DwWS and non-SD, because the timing of blood drawing was not known and there was an overlapping confidence interval among the clinical classification. Hence, these pooled blood parameter values could not be used to guide clinicians in management and did not correlate with severity as in previous scientific literatures and guidelines.
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Affiliation(s)
- Gary KK Low
- Research Operations, Nepean Hospital, Kingswood, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sam Froze Jiee
- Sarawak State Health Department, Ministry of Health Malaysia, Sri Aman District Health Office, Sri Aman, Sarawak, Malaysia
| | - Retneswari Masilamani
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Selvanaayagam Shanmuganathan
- Quality Unit, Hospital Kulim, Kulim, Kedah, Malaysia
- Menzies Centre Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Health Vertical, Torrens University Australia, Sydney, New South Wales, Australia
| | - Pramila Rai
- Health Vertical, Torrens University Australia, Sydney, New South Wales, Australia
| | - Mitali Manda
- Hammondcare Neringah Hospital, Wahroonga,New South Wales, Australia
| | - Osamudiamen Favour Omosumwen
- Department of Addiction and Community Health Professional, Faculty of Health and Social Science, Sundance College Edmonton, Edmonton, Alberta, Canada
| | - Jackob Kagize
- Health Vertical, Torrens University Australia, Sydney, New South Wales, Australia
| | - Alex I. Gavino
- Centre for Health Futures, Torrens University Australia, Sydney, New South Wales, Australia
- Public Health Department, Torrens University Australia, Sydney, New South Wales, Australia
| | - Aizad Azahar
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mohammed Abdulrazzaq Jabbar
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
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Suppiah J, Ali EZ, Mohd Khalid MKN, Mohd Ghazali S, Tee KK, Zulkifli MMS, Ramli N, Adiee AH, Ramly MN, Robert F, Lakha Singh SS, Mohd Zain R, Thayan R. Resurgence of Dengue Virus Serotype 4 in Malaysia: A Comprehensive Clinicodemographic and Genomic Analysis. Trop Med Infect Dis 2023; 8:409. [PMID: 37624348 PMCID: PMC10458033 DOI: 10.3390/tropicalmed8080409] [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: 07/07/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Dengue virus serotype 4 (DENV-4) has been the rarest circulating serotype in Malaysia, resulting in it being an understudied area. A recent observation from institutional surveillance data indicated a rapid increase in DENV-4-infected cases. The present study aimed to investigate the resurgence of DENV-4 in relation to the demographic, clinical and genomic profiles of 75 retrospective dengue samples. First, the demographic and clinical profiles obtained between 2017 and July 2022 were statistically assessed. Samples with good quality were subjected to full genome sequencing on the Illumina Next Seq 500 platform and the genome data were analysed for the presence of mutations. The effect of the mutations of interest was studied via an in silico computational approach using SWISS-MODEL and AlphaFold2 programs. The predominance of DENV-4 was discovered from 2021 to 2022, with a prevalence of 64.3% (n = 9/14) and 89.2% (n = 33/37), respectively. Two clades with a genetic divergence of 2.8% were observed within the dominant genotype IIa. The majority of DENV-4-infected patients presented with gastrointestinal symptoms, such as vomiting (46.7%), persistent diarrhoea (30.7%) and abdominal pain (13.3%). Two mutations, His50Tyr and Pro144Ser, located at the wing domain of the NS1 protein were discovered to be unique to the recently sequenced DENV-4.
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Affiliation(s)
- Jeyanthi Suppiah
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Ernie Zuraida Ali
- Inborn Error of Metabolism and Genetic Unit, Nutrition, Metabolic & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Mohd Khairul Nizam Mohd Khalid
- Inborn Error of Metabolism and Genetic Unit, Nutrition, Metabolic & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Kok Keng Tee
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Murni Maya Sari Zulkifli
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Nuraisyah Ramli
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Amir Hussin Adiee
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Muhamad Nurrani Ramly
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Fionie Robert
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Sarbhan Singh Lakha Singh
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Rozainanee Mohd Zain
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Ravindran Thayan
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
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Hu TY, Chow JC, Chien TW, Chou W. Detecting dengue fever in children using online Rasch analysis to develop algorithms for parents: An APP development and usability study. Medicine (Baltimore) 2023; 102:e33296. [PMID: 37000053 PMCID: PMC10063317 DOI: 10.1097/md.0000000000033296] [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] [Received: 01/13/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Dengue fever (DF) is a significant public health concern in Asia. However, detecting the disease using traditional dichotomous criteria (i.e., absent vs present) can be extremely difficult. Convolutional neural networks (CNNs) and artificial neural networks (ANNs), due to their use of a large number of parameters for modeling, have shown the potential to improve prediction accuracy (ACC). To date, there has been no research conducted to understand item features and responses using online Rasch analysis. To verify the hypothesis that a combination of CNN, ANN, K-nearest-neighbor algorithm (KNN), and logistic regression (LR) can improve the ACC of DF prediction for children, further research is required. METHODS We extracted 19 feature variables related to DF symptoms from 177 pediatric patients, of whom 69 were diagnosed with DF. Using the RaschOnline technique for Rasch analysis, we examined 11 variables for their statistical significance in predicting the risk of DF. Based on 2 sets of data, 1 for training (80%) and the other for testing (20%), we calculated the prediction ACC by comparing the areas under the receiver operating characteristic curve (AUCs) between DF + and DF- in both sets. In the training set, we compared 2 scenarios: the combined scheme and individual algorithms. RESULTS Our findings indicate that visual displays of DF data are easily interpreted using Rasch analysis; the k-nearest neighbors algorithm has a lower AUC (<0.50); LR has a relatively higher AUC (0.70); all 3 algorithms have an almost equal AUC (=0.68), which is smaller than the individual algorithms of Naive Bayes, LR in raw data, and Naive Bayes in normalized data; and we developed an app to assist parents in detecting DF in children during the dengue season. CONCLUSION The development of an LR-based APP for the detection of DF in children has been completed. To help patients, family members, and clinicians differentiate DF from other febrile illnesses at an early stage, an 11-item model is proposed for developing the APP.
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Affiliation(s)
- Ting-Yun Hu
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Julie Chi Chow
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsair-Wei Chien
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chung San Medical University Hospital, Taichung, Taiwan
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Dafalla O, Abdulhaq AA, Almutairi H, Noureldin E, Ghzwani J, Mashi O, Shrwani KJ, Hobani Y, Sufyani O, Ayed R, Alamri A, Al-Mekhlafi HM, Eisa ZM. The emergence of an imported variant of dengue virus serotype 2 in the Jazan region, southwestern Saudi Arabia. Trop Dis Travel Med Vaccines 2023; 9:5. [PMID: 36922890 PMCID: PMC10018863 DOI: 10.1186/s40794-023-00188-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/30/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Dengue virus (DENV) infection is a global economic and public health concern, particularly in tropical and subtropical countries where it is endemic. Saudi Arabia has seen an increase in DENV infections, especially in the western and southwestern regions. This study aims to investigate the genetic variants of DENV-2 that were circulating during a serious outbreak in Jazan region in 2019. METHODS A total of 482 serum samples collected during 2019 from Jazan region were tested with reverse transcription-polymerase chain reaction (RT-PCR) to detect and classify DENV; positive samples underwent sequencing and bioinformatics analyses. RESULTS Out of 294 positive samples, type-specific RT-PCR identified 58.8% as DENV-2 but could not identify 41.2%. Based on sequencing and bioinformatics analyses, the samples tested PCR positive in the first round but PCR negative in the second round were found to be imported genetic variant of DENV-2. The identified DENV-2 imported variant showed similarities to DENV-2 sequences reported in Malaysia, Singapore, Korea and China. The results revealed the imported genetic variant of DENV-2 was circulating in Jazan region that was highly prevalent and it was likely a major factor in this outbreak. CONCLUSIONS The emergence of imported DENV variants is a serious challenge for the dengue fever surveillance and control programmes in endemic areas. Therefore, further investigations and continuous surveillance of existing and new viral strains in the region are warranted.
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Affiliation(s)
- Ommer Dafalla
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia.
| | | | - Hatim Almutairi
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia.
| | | | - Jaber Ghzwani
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | - Omar Mashi
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | | | - Yahya Hobani
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | - Ohood Sufyani
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | - Reem Ayed
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | - Abdullah Alamri
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
| | | | - Zaki M Eisa
- Saudi Public Health Authority, Jazan, Kingdom of Saudi Arabia
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Genomic Characterization of Dengue Virus Outbreak in 2022 from Pakistan. Vaccines (Basel) 2023; 11:vaccines11010163. [PMID: 36680008 PMCID: PMC9867254 DOI: 10.3390/vaccines11010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Pakistan, a dengue-endemic country, has encountered several outbreaks during the past decade. The current study aimed to explore the serotype and genomic diversity of dengue virus responsible for the 2022 outbreak in Pakistan. From August to October 2022, NS-1 positive blood samples (n = 343) were collected from dengue patients, among which, (85%; n = 293) were positive based on RT-PCR. In terms of gender and age, dengue infection was more prevalent in male patients (63%; n = 184), with more adults (21-30 years; n = 94) being infected. The serotyping results revealed DENV-2 to be the most predominant serotype (62%; n = 183), followed by DENV-1 (37%; n = 109) and DENV-3 (0.32%; n = 1). Moreover, a total of 10 samples (DENV-2; n = 8, DENV-1; n = 2) were subjected to whole-genome sequencing. Among these, four were collected in early 2022, and six were collected between August and October 2022. Phylogenetic analysis of DENV-2 sequenced samples (n = 8) revealed a monophyletic clade of cosmopolitan genotype IVA, which is closely related to sequences from China and Singapore 2018, and DENV-1 samples (n = 2) show genotype III, which is closely related to Pakistan isolates from 2019. We also reported the first whole genome sequence of a coinfection case (DENV1-DENV2) in Pakistan detected through a meta-genome approach. Thus, dengue virus dynamics reported in the current study warrant large-scale genomic surveillance to better respond to future outbreaks.
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Khan MA, Imtiaz K, Shafaq H, Farooqi J, Hassan M, Zafar A, Long MT, Barr KL, Khan E. Screening for Arboviruses in Healthy Blood Donors: Experience from Karachi, Pakistan (Jul-Dec 2018). Virol Sin 2022; 37:774-777. [PMID: 35863605 PMCID: PMC9583101 DOI: 10.1016/j.virs.2022.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/13/2022] [Indexed: 11/29/2022] Open
Abstract
DENV, WNV and JEV status was investigated in healthy blood donors at the Aga Khan University July to December 2018. ELISA for IgM antibodies and RT-PCR for viral RNA detection were performed. IgM antibodies for DENV and WNV were positive in 3.9% and JEV in 0.28% of the blood donors. Blood donors aged 19 and 30 years and residents of urban areas, of Karachi City were most frequent. DENV and WNV seropositivity were significantly associated with residence in Malir District of Karachi.
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Affiliation(s)
- Moiz Ahmed Khan
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Kehkashan Imtiaz
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Humaira Shafaq
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Joveria Farooqi
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Mohammad Hassan
- Blood Bank, Haematology & Transfusion Medicine, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Afia Zafar
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan
| | - Maureen T Long
- Comparative Diagnostic and Population Medicine, University of Florida, Gainesville FL32611, USA
| | - Kelli L Barr
- Center for Global Health and Infectious Disease Research, University of South Florida, Tampa FL33620, USA
| | - Erum Khan
- Clinical Microbiology Laboratory, Department of Pathology & Lab Medicine, Aga Khan University, Karachi 74800, Pakistan.
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Jayadas TTP, Kumanan T, Gomes L, Jeewandara C, Malavige GN, Ranasinghe D, Jadi RS, Ramasamy R, Surendran SN. Regional Variation in Dengue Virus Serotypes in Sri Lanka and Its Clinical and Epidemiological Relevance. Diagnostics (Basel) 2021; 11:2084. [PMID: 34829432 PMCID: PMC8618005 DOI: 10.3390/diagnostics11112084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 01/19/2023] Open
Abstract
Dengue is a significant health concern in Sri Lanka, but diagnosis of the infecting dengue virus (DENV) serotype has hitherto been largely restricted to the Colombo district in the western province. Salinity tolerant Aedes vectors are present in the island's northern Jaffna peninsula, which is undergoing rapid groundwater salinization. Virus serotypes were determined by RT-qPCR in 107 and 112 patients diagnosed by NS1 antigen positivity from the Jaffna district in 2018 and 2019, respectively, and related to clinical characteristics. DENV1 and DENV2 were the most common serotypes in both years. Infections with multiple serotypes were not detected. DENV1 was significantly more prevalent in 2019 than 2018, while DENV3 was significantly more prevalent in 2018 than 2019 among the Jaffna patients. Limited genomic sequencing identified DENV1 genotype-I and DENV3 genotype-I in Jaffna patients in 2018. Dengue was more prevalent in working age persons and males among the serotyped Jaffna patients. DENV1 and DENV2 were the predominant serotypes in 2019 in the Colombo district. However, DENV1 and DENV3 were significantly more prevalent in Colombo compared with Jaffna in 2019. The differences in the prevalence of DENV1 and DENV3 between the Jaffna and Colombo districts in 2019 have implications for dengue epidemiology and vaccination. Salinity-tolerant Aedes vector strains, widespread in the Jaffna peninsula, may have contributed to differences in serotype prevalence compared with the Colombo district in 2019. Significant associations were not identified between virus serotypes and clinical characteristics among Jaffna patients.
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Affiliation(s)
| | | | - Laksiri Gomes
- Centre for Dengue Research, Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (L.G.); (C.J.); (G.N.M.); (D.R.)
| | - Chandima Jeewandara
- Centre for Dengue Research, Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (L.G.); (C.J.); (G.N.M.); (D.R.)
| | - Gathsaurie N. Malavige
- Centre for Dengue Research, Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (L.G.); (C.J.); (G.N.M.); (D.R.)
| | - Diyanath Ranasinghe
- Centre for Dengue Research, Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (L.G.); (C.J.); (G.N.M.); (D.R.)
| | - Ramesh S. Jadi
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7290, USA;
| | - Ranjan Ramasamy
- Department of Zoology, University of Jaffna, Jaffna 40000, Sri Lanka;
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10
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Sirisena P, Mahilkar S, Sharma C, Jain J, Sunil S. Concurrent dengue infections: Epidemiology & clinical implications. Indian J Med Res 2021; 154:669-679. [PMID: 35532585 PMCID: PMC9210535 DOI: 10.4103/ijmr.ijmr_1219_18] [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] [Indexed: 01/09/2023] Open
Abstract
Multiple dengue virus (DENV) serotypes circulating in a geographical area most often lead to simultaneous infection of two or more serotypes in a single individual. The occurrence of such concurrent infections ranges from 2.5 to 30 per cent, reaching as high as 40-50 per cent in certain dengue hyper-endemic areas. Concurrent dengue manifests itself differently than mono-infected patients, and it becomes even more important to understand the effects of co-infecting serotypes in concurrent infections to ascertain the clinical outcomes of the disease progression and transmission. In addition, there have also been reports of concurrent DENV infections in the presence of other arboviral infections. In this review, we provide a comprehensive breakdown of concurrent dengue infections globally. Furthermore, this review also touches upon the clinical presentations during those concurrent infections categorized as mild or severe forms of disease presentation. Another aspect of this review was aimed at providing insight into the concurrent dengue incidences in the presence of other arboviruses.
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Affiliation(s)
- P.D.N.N. Sirisena
- ImmunifyMe Healthcare Technologies Pvt. Ltd., Altrade Business Centre, Gurugram, Haryana, India
| | - Shakuntala Mahilkar
- Vector Borne Diseases Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Chetan Sharma
- Vector Borne Diseases Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Jaspreet Jain
- Human Retrovirology Laboratory, Montreal Clinical Research Institute (IRCM), Montreal, Quebec H2W 1R7, Canada
| | - Sujatha Sunil
- Vector Borne Diseases Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India,For correspondence: Dr Sujatha Sunil, Vector Borne Diseases Group, International Centre for Genetic Engineering & Biotechnology, Aruna Asaf Ali Marg, New Delhi 110 067, India e-mail:
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11
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Acklin JA, Cattle JD, Moss AS, Brown JA, Foster GA, Krysztof D, Stramer SL, Lim JK. Evaluating the Safety of West Nile Virus Immunity During Congenital Zika Virus Infection in Mice. Front Immunol 2021; 12:686411. [PMID: 34220838 PMCID: PMC8250419 DOI: 10.3389/fimmu.2021.686411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/24/2021] [Indexed: 12/19/2022] Open
Abstract
Antibody-dependent enhancement (ADE) is a phenomenon that occurs when cross-reactive antibodies generated from a previous flaviviral infection increase the pathogenesis of a related virus. Zika virus (ZIKV) is the most recent flavivirus introduced to the Western Hemisphere and has become a significant public health threat due to the unanticipated impact on the developing fetus. West Nile virus (WNV) is the primary flavivirus that circulates in North America, and we and others have shown that antibodies against WNV are cross-reactive to ZIKV. Thus, there is concern that WNV immunity could increase the risk of severe ZIKV infection, particularly during pregnancy. In this study, we examined the extent to which WNV antibodies could impact ZIKV pathogenesis in a murine pregnancy model. To test this, we passively transferred WNV antibodies into pregnant Stat2-/- mice on E6.5 prior to infection with ZIKV. Evaluation of pregnant dams showed weight loss following ZIKV infection; however, no differences in maternal weights or viral loads in the maternal brain, spleen, or spinal cord were observed in the presence of WNV antibodies. Resorption rates, and other fetal parameters, including fetal and placental size, were similarly unaffected. Further, the presence of WNV antibodies did not significantly alter the viral load or the inflammatory response in the placenta or the fetus in response to ZIKV. Our data suggest that pre-existing WNV immunity may not significantly impact the pathogenesis of ZIKV infection during pregnancy. Our findings are promising for the safety of implementing WNV vaccines in the continental US.
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Affiliation(s)
- Joshua A Acklin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Javier D Cattle
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Arianna S Moss
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Julia A Brown
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Gregory A Foster
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - David Krysztof
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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