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Wongsawat J, Thamthitiwat S, Hicks VJ, Uttayamakul S, Teepruksa P, Sawatwong P, Skaggs B, Mock PA, MacArthur JR, Suya I, Sapchookul P, Kitsutani P, Lo TQ, Vachiraphan A, Kovavisarach E, Rhee C, Darun P, Saepueng K, Waisaen C, Jampan D, Sriboonrat P, Palanuwong B, Sukbut P, Areechokchai D, Pittayawonganon C, Iamsirithaworn S, Bloss E, Rao CY. Characteristics, risk factors, and outcomes related to Zika virus infection during pregnancy in Northeastern Thailand: A prospective pregnancy cohort study, 2018-2020. PLoS Negl Trop Dis 2024; 18:e0012176. [PMID: 38758964 PMCID: PMC11139345 DOI: 10.1371/journal.pntd.0012176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 05/30/2024] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In response to the 2015-2016 Zika virus (ZIKV) outbreak and the causal relationship established between maternal ZIKV infection and adverse infant outcomes, we conducted a cohort study to estimate the incidence of ZIKV infection in pregnancy and assess its impacts in women and infants. METHODOLOGY/PRINCIPAL FINDINGS From May 2018-January 2020, we prospectively followed pregnant women recruited from 134 participating hospitals in two non-adjacent provinces in northeastern Thailand. We collected demographic, clinical, and epidemiologic data and blood and urine at routine antenatal care visits until delivery. ZIKV infections were confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens with confirmed ZIKV underwent whole genome sequencing. Among 3,312 women enrolled, 12 (0.36%) had ZIKV infections, of which two (17%) were detected at enrollment. Ten (83%, 3 in 2nd and 7 in 3rd trimester) ZIKV infections were detected during study follow-up, resulting in an infection rate of 0.15 per 1,000 person-weeks (95% CI: 0.07-0.28). The majority (11/12, 91.7%) of infections occurred in one province. Persistent ZIKV viremia (42 days) was found in only one woman. Six women with confirmed ZIKV infections were asymptomatic until delivery. Sequencing of 8 ZIKV isolates revealed all were of Asian lineage. All 12 ZIKV infected women gave birth to live, full-term infants; the only observed adverse birth outcome was low birth weight in one (8%) infant. Pregnancies in 3,300 ZIKV-rRT-PCR-negative women were complicated by 101 (3%) fetal deaths, of which 67 (66%) had miscarriages and 34 (34%) had stillbirths. There were no differences between adverse fetal or birth outcomes of live infants born to ZIKV-rRT-PCR-positive mothers compared to live infants born to ZIKV-rRT-PCR-negative mothers. CONCLUSIONS/SIGNIFICANCE Confirmed ZIKV infections occurred infrequently in this large pregnancy cohort and observed adverse maternal and birth outcomes did not differ between mothers with and without confirmed infections.
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Affiliation(s)
- Jurai Wongsawat
- Thailand Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand
| | - Somsak Thamthitiwat
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Victoria J. Hicks
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Sumonmal Uttayamakul
- Thailand Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand
| | - Phanthaneeya Teepruksa
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Pongpun Sawatwong
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Beth Skaggs
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Philip A. Mock
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - John R. MacArthur
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Inthira Suya
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Patranuch Sapchookul
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Paul Kitsutani
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Terrence Q. Lo
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Apichart Vachiraphan
- Thailand Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand
| | - Ekachai Kovavisarach
- Thailand Ministry of Public Health, Department of Medical Services, Nonthaburi, Thailand
| | - Chulwoo Rhee
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Pamorn Darun
- Bueng Kan Provincial Public Health Office, Bueng Kan, Thailand
| | | | - Chamnan Waisaen
- Bueng Kan Provincial Public Health Office, Bueng Kan, Thailand
| | | | | | | | | | - Darin Areechokchai
- Thailand Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand
| | | | - Sopon Iamsirithaworn
- Thailand Ministry of Public Health, Department of Disease Control, Nonthaburi, Thailand
| | - Emily Bloss
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
| | - Carol Y. Rao
- Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- US Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, Georgia, United States of America
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Choyrum S, Wangsaeng N, Nechba A, Salvadori N, Saisom R, Achalapong J, Putiyanun C, Sabsanong P, Sangsawang S, Patamasingh Na Ayudhaya O, Jourdain G, Ngo-Giang-Huong N, Khamduang W. Zika Virus Immunoglobulin G Seroprevalence among Young Adults Living with HIV or without HIV in Thailand from 1997 to 2017. Viruses 2022; 14:v14020368. [PMID: 35215960 PMCID: PMC8878279 DOI: 10.3390/v14020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023] Open
Abstract
Zika virus (ZIKV) epidemiological data in Thailand are limited. We assessed ZIKV IgG seroprevalence among young adults during 1997–2017 and determined factors associated with ZIKV IgG seropositivity. This retrospective laboratory study included randomly selected subjects aged 18–25 years participating in large clinical studies conducted in Thailand during 1997–2017. Stored plasma samples were analyzed for ZIKV IgG using an ELISA test (Anti-Zika Virus IgG, EUROIMMUN, Lübeck, Germany). Sociodemographic, clinical and laboratory data were used in univariable and multivariable analyses to identify factors associated with ZIKV IgG positivity. Of the 1648 subjects included, 1259 were pregnant women, 844 were living with HIV and 111 were living with HBV. ZIKV IgG seroprevalence was similar among the HIV-infected and -uninfected pregnant women (22.8% vs. 25.8%, p-value = 0.335) and was overall stable among the pregnant women, with a 25.2% prevalence. Factors independently associated with ZIKV IgG positivity included an age of 23–25 years as compared to 18–20 years, an HIV RNA load below 3.88 log10 copies/mL and birth in regions outside northern Thailand. Our study shows that a large proportion of the population in Thailand probably remains susceptible to ZIKV infection, which could be the ground for future outbreaks. Continued surveillance of ZIKV spread in Thailand is needed to inform public health policies.
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Affiliation(s)
- Sirinath Choyrum
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.C.); (N.S.); (G.J.); (N.N.-G.-H.)
| | - Nantawan Wangsaeng
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
| | - Anouar Nechba
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
| | - Nicolas Salvadori
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.C.); (N.S.); (G.J.); (N.N.-G.-H.)
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
- Maladies Infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle (MIVEGEC), Agropolis University Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Recherche Pour le Développement (IRD), 34394 Montpellier, France
| | - Rumpaiphorn Saisom
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
| | | | | | | | | | | | - Gonzague Jourdain
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.C.); (N.S.); (G.J.); (N.N.-G.-H.)
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
- Maladies Infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle (MIVEGEC), Agropolis University Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Recherche Pour le Développement (IRD), 34394 Montpellier, France
| | - Nicole Ngo-Giang-Huong
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.C.); (N.S.); (G.J.); (N.N.-G.-H.)
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
- Maladies Infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle (MIVEGEC), Agropolis University Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Recherche Pour le Développement (IRD), 34394 Montpellier, France
| | - Woottichai Khamduang
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.C.); (N.S.); (G.J.); (N.N.-G.-H.)
- Associated Medical Sciences (AMS)-CMU IRD Research Collaboration, Chiang Mai 50200, Thailand; (N.W.); (A.N.); (R.S.)
- Correspondence: ; Tel.: +66-(0)-53-93-50-86
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