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Gómez G, Hufstedler H, Montenegro Morales C, Roell Y, Lozano-Parra A, Tami A, Magalhaes T, Marques ETA, Balmaseda A, Calvet G, Harris E, Brasil P, Herrera V, Villar L, Maxwell L, Jaenisch T. Pooled Cohort Profile: ReCoDID Consortium's Harmonized Acute Febrile Illness Arbovirus Meta-Cohort. JMIR Public Health Surveill 2024; 10:e54281. [PMID: 39042429 DOI: 10.2196/54281] [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: 11/06/2023] [Revised: 02/09/2024] [Accepted: 05/17/2024] [Indexed: 07/24/2024] Open
Abstract
Infectious disease (ID) cohorts are key to advancing public health surveillance, public policies, and pandemic responses. Unfortunately, ID cohorts often lack funding to store and share clinical-epidemiological (CE) data and high-dimensional laboratory (HDL) data long term, which is evident when the link between these data elements is not kept up to date. This becomes particularly apparent when smaller cohorts fail to successfully address the initial scientific objectives due to limited case numbers, which also limits the potential to pool these studies to monitor long-term cross-disease interactions within and across populations. CE data from 9 arbovirus (arthropod-borne viruses) cohorts in Latin America were retrospectively harmonized using the Maelstrom Research methodology and standardized to Clinical Data Interchange Standards Consortium (CDISC). We created a harmonized and standardized meta-cohort that contains CE and HDL data from 9 arbovirus studies from Latin America. To facilitate advancements in cross-population inference and reuse of cohort data, the Reconciliation of Cohort Data for Infectious Diseases (ReCoDID) Consortium harmonized and standardized CE and HDL from 9 arbovirus cohorts into 1 meta-cohort. Interested parties will be able to access data dictionaries that include information on variables across the data sets via Bio Studies. After consultation with each cohort, linked harmonized and curated human cohort data (CE and HDL) will be made accessible through the European Genome-phenome Archive platform to data users after their requests are evaluated by the ReCoDID Data Access Committee. This meta-cohort can facilitate various joint research projects (eg, on immunological interactions between sequential flavivirus infections and for the evaluation of potential biomarkers for severe arboviral disease).
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Affiliation(s)
- Gustavo Gómez
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Heather Hufstedler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Yannik Roell
- Center for Global Health, Colorado School of Public Health, Aurora, CO, United States
| | - Anyela Lozano-Parra
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Departamento de Estudios Clínicos, Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Venezuela
| | - Tereza Magalhaes
- Department of Entomology, Texas A&M University, College Station, TX, United States
- Department of Preventive and Social Medicine, School of Medicine, Universidade Federal da Bahia, Salvador, Brazil
| | - Ernesto T A Marques
- Department of Virology and Experimental Therapeutics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Guilherme Calvet
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Eva Harris
- Division of Infectious Diseases, School of Public Health, University of California Berkeley, Berkeley, CA, United States
| | - Patricia Brasil
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Victor Herrera
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Luis Villar
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Colombia
- Centro de Atención y Diagnóstico de Enfermedades Infecciosas, Bucaramanga, Colombia
| | - Lauren Maxwell
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Jaenisch
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Center for Global Health, Colorado School of Public Health, Aurora, CO, United States
- Section Clinical Tropical Medicine, Department for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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Luque N, Cilloniz C, Pons MJ, Donaires F, Albornoz R, Mendocilla-Risco M, Espinoza M. Clinical-epidemiological characteristics of deaths due to dengue during an outbreak in northern Peru. Rev Peru Med Exp Salud Publica 2023; 40:67-72. [PMID: 37377238 PMCID: PMC10953633 DOI: 10.17843/rpmesp.2023.401.12148] [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: 09/24/2022] [Accepted: 03/22/2023] [Indexed: 06/29/2023] Open
Abstract
Motivation for the study. To describe the characteristics of patients who died from severe dengue fever during the 2017 El Niño in Piura. Main findings. Mortality from severe dengue was higher in adult women. First contact with healthcare took place mostly in higher level hospitals. Admission to a specialized unit was late for severe dengue cases. Implications. Control of dengue fever involves several aspects, such as, access to health, prevention, water availability, vector control and education; therefore, it is important to strengthen public health policies in this regard. In order to achieve this goal, local and central government sectors must be involved.
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Affiliation(s)
- Néstor Luque
- School of Human Medicine, Faculty of Health Sciences, Universidad Peruana Unión (UPeU), Lima, Peru.Universidad Peruana UniónSchool of Human MedicineFaculty of Health SciencesUniversidad Peruana Unión (UPeU)LimaPeru
| | - Catia Cilloniz
- Universidad Continental, Lima, Peru.Universidad ContinentalLimaPeru
| | - María J. Pons
- Re-emerging infectious diseases group, Universidad Científica del Sur, Lima, Peru.Universidad Científica del SurRe-emerging infectious diseases groupUniversidad Científica del SurLimaPeru
| | - Fernando Donaires
- Instituto Nacional de Salud, Lima, Peru.Instituto Nacional de SaludLimaPeru
| | - Roger Albornoz
- School of Human Medicine, Faculty of Health Sciences, Universidad Peruana Unión (UPeU), Lima, Peru.Universidad Peruana UniónSchool of Human MedicineFaculty of Health SciencesUniversidad Peruana Unión (UPeU)LimaPeru
| | - Moisés Mendocilla-Risco
- Universidad Nacional Mayor San Marcos, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor San MarcosLimaPeru
| | - Manuel Espinoza
- Instituto Nacional de Salud, Lima, Peru.Instituto Nacional de SaludLimaPeru
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A systematic review and meta-analysis on the accuracy of rapid immunochromatographic tests for dengue diagnosis. Eur J Clin Microbiol Infect Dis 2022; 41:1191-1201. [PMID: 35988010 DOI: 10.1007/s10096-022-04485-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
Rapid immunochromatographic tests are frequently used to diagnose dengue due to their easy use, low cost, and fast response. A high level of accuracy is essential for rapid diagnostic tests to support their large-scale use. Thus, this systematic review aims to evaluate the accuracy of rapid dengue diagnostic tests. The investigation was run through the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database, and Google Scholar. To solve difficulties, two independent reviewers performed document screening and selection. ELISA assay was adopted as a reference test because of several methodologic advantages. Seventeen articles were included accordingly, reckoning 6837 participating individuals. The receiver operating characteristic (ROC) and Forest Plot were conducted to evaluate the sensitivity and specificity for each analyzed parameter (anti-dengue IgM, IgG, and NS1 antigen). The risk of bias and quality of evidence were assessed as moderate using QUADAS-2 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The sensitivity of IgM concerning the studied tests ranged from 13.8 to 90%, while that of NS1 ranged from 14.7 to 100% (95% CI). The antibodies with NS1 presented increased sensitivity; pooled data show that the association of the three analytes bestows the best result, with a combined sensitivity of 90% (CI 95%: 87-92%) and a pooled specificity of 89% (CI 95%: 87-92%). Thus, the present review provides relevant knowledge for decision-making between available rapid diagnostic tests.
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Outcomes among children and adults at risk of severe dengue in Sri Lanka: Opportunity for outpatient case management in countries with high disease burden. PLoS Negl Trop Dis 2021; 15:e0010091. [PMID: 34962920 PMCID: PMC8746768 DOI: 10.1371/journal.pntd.0010091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/10/2022] [Accepted: 12/14/2021] [Indexed: 12/02/2022] Open
Abstract
Background Healthcare systems in dengue-endemic countries are often overburdened due to the high number of patients hospitalized according to dengue management guidelines. We systematically evaluated clinical outcomes in a large cohort of patients hospitalized with acute dengue to support triaging of patients to ambulatory versus inpatient management in the future. Methods/Principal findings From June 2017- December 2018, we conducted surveillance among children and adults with fever within the prior 7 days who were hospitalized at the largest tertiary-care (1,800 bed) hospital in the Southern Province, Sri Lanka. Patients who developed platelet count ≤100,000/μL (threshold for hospital admission in Sri Lanka) and who met at least two clinical criteria consistent with dengue were eligible for enrollment. We confirmed acute dengue by testing sera collected at enrollment for dengue NS1 antigen or IgM antibodies. We defined primary outcomes as per the 1997 and 2009 World Health Organization (WHO) classification criteria: dengue hemorrhagic fever (DHF; WHO 1997), dengue shock syndrome (DSS; WHO 1997), and severe dengue (WHO 2009). Overall, 1064 patients were confirmed as having acute dengue: 318 (17.4%) by NS1 rapid antigen testing and 746 (40.7%) by IgM antibody testing. Of these 1064 patients, 994 (93.4%) were adults ≥18 years and 704 (66.2%) were male. The majority (56, 80%) of children and more than half of adults (544, 54.7%) developed DHF during hospitalization, while 6 (8.6%) children and 22 (2.2%) adults developed DSS. Overall, 10 (14.3%) children and 113 (11.4%) adults developed severe dengue. A total of 2 (0.2%) patients died during hospitalization. Conclusions One-half of patients hospitalized with acute dengue progressed to develop DHF and a very small number developed DSS or severe dengue. Developing an algorithm for triaging patients to ambulatory versus inpatient management should be the future goal to optimize utilization of healthcare resources in dengue-endemic countries. In countries where dengue is prevalent, hospitals are often overwhelmed due to the high numbers of patient admissions during dengue epidemics. We studied 1064 children and adults hospitalized with acute dengue in Sri Lanka to determine the prevalence of severe disease outcomes to support the development of a system which can limit hospitalizations in the future. We found that only half of patients developed severe disease outcomes during hospitalization and only a small minority of patients developed life-threatening disease. For dengue-prevalent countries, developing systems to identify patients with acute dengue who can be managed without hospital admission should be a priority.
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Brazilian Dengue Virus Type 2-Associated Renal Involvement in a Murine Model: Outcomes after Infection by Two Lineages of the Asian/American Genotype. Pathogens 2021; 10:pathogens10091084. [PMID: 34578117 PMCID: PMC8467194 DOI: 10.3390/pathogens10091084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/25/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
Dengue virus type 2 (DENV-2) is, traditionally, the most studied serotype due to its association with explosive outbreaks and severe cases. In Brazil, almost 20 years after the first introduction in the 1990s, a new lineage (Lineage II) of the DENV-2 Asian/American genotype emerged and caused an epidemic with severe cases and hospitalizations. Severe dengue includes multiple organ failure, and renal involvement can be potentially related to increased mortality. In order to better understand the role of DENV infection in renal injury, here we aimed to investigate the outcomes of infection with two distinct lineages of DENV-2 Asian/American genotype in the kidney of a murine model. BALB/c mice were infected with Lineages I and II and tissues were submitted to histopathology, immunohistochemistry, histomorphometry and ultrastructural analysis. Blood urea nitrogen (BUN) was detected in blood sample accessed by cardiac puncture. A tendency in kidney weight increase was observed in mice infected with both lineages, but urea levels, on average, were increased only in mice infected with Lineage II. The DENV antigen was detected in the tissue of mice infected with Lineage II and morphological changes were similar to those observed in human dengue cases. Furthermore, the parameters such as organ weight, urea levels and morphometric analysis, showed significant differences between the two lineages in the infected BALB/c, which was demonstrated to be a suitable experimental model for dengue pathophysiology studies in kidneys.
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Sarathy VV, Walker DH. Ideal Criteria for Accurate Mouse Models of Vector-Borne Diseases with Emphasis on Scrub Typhus and Dengue. Am J Trop Med Hyg 2020; 103:970-975. [PMID: 32602433 DOI: 10.4269/ajtmh.19-0955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Nine criteria regarding the infectious agent, mode of transmission, portal of entry, route of spread, target organs, target cells, pathologic lesions, incubation period, and modifiable spectrum of disease and outcomes appropriate to the intended experimental purpose are described. To provide context for each criterion, mouse models of two vector-borne zoonotic infectious diseases, scrub typhus and dengue, are summarized. Application of the criteria indicates that intravenous inoculation of Orientia tsutsugamushi into inbred mice is the best current model for life-threatening scrub typhus, and intradermal inoculation accurately models sublethal human scrub typhus, whereas the immunocompromised mouse models of dengue provide disease outcomes most closely associated with human dengue. In addition to addressing basic questions of immune and pathogenic mechanisms, mouse models are useful for preclinical testing of experimental vaccines and therapeutics. The nine criteria serve as guidelines to evaluate and compare models of vector-borne infectious diseases.
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Affiliation(s)
- Vanessa V Sarathy
- Department of Pathology, Sealy Institute for Vaccine Sciences, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas
| | - David H Walker
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, Texas.,Department of Pathology, Sealy Institute for Vaccine Sciences, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas
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Illustrated histopathological features of fatal dengue cases in Colombia. ACTA ACUST UNITED AC 2020; 40:438-447. [PMID: 33030821 PMCID: PMC7666849 DOI: 10.7705/biomedica.5016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Indexed: 11/21/2022]
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Hegazi MA, Bakarman MA, Alahmadi TS, Butt NS, Alqahtani AM, Aljedaani BS, Almajnuni AH. Risk Factors and Predictors of Severe Dengue in Saudi Population in Jeddah, Western Saudi Arabia: A Retrospective Study. Am J Trop Med Hyg 2020; 102:613-621. [PMID: 31933467 DOI: 10.4269/ajtmh.19-0650] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This study was performed to determine the risk factors and predictors of severe dengue fever (SDF) in Saudi population in Jeddah, Western Saudi Arabia. This 7-year retrospective study included children and adults with confirmed dengue from 2010 to 2016. Demographic, clinical, laboratory, serological, and virologic data were collected. Comparative analyses were performed between pediatric and adult SDF cases defined according to the WHO 2009 dengue classification. During the study period, dengue was confirmed in 17,646 cases with predominant infection of adults (6.5 times that of children) and males (3.8 times that of females). May and June were associated with 43.9% of total dengue cases. All 56 pediatric and 187 adult SDF cases were hospitalized. At least one warning sign of severe illness was present in 92.2% of total SDF cases. Mortality rates were 8.9% and 10.7% of pediatric and adult SDF cases, respectively. Multiple logistic regression detected that the most significant risk factors and predictors of SDF in adults versus children were significantly more secondary dengue infection (adjusted odds ratio [AOR]: 2.20, 95% CI: 1.09-4.44, P = 0.02), significantly less clinical fluid accumulation (AOR: 0.17, 95% CI: 0.07-0.44, P < 0.001) and significantly less neutropenia (AOR: 0.41, 95% CI: 0.17-0.97, P = 0.04). This was the first large multicenter study evaluating SDF in Saudi population and considering the WHO 2009 dengue classification, which showed predominant infection of adults and males with dengue, few SDF cases with low mortality and highlighted predictors of SDF in adults versus children. Consideration of warning signs for severe dengue may result in hospital admission, prompting closer monitoring, timely and proper interventions and reduced mortality in SDF cases.
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Affiliation(s)
- Moustafa A Hegazi
- Department of Pediatrics, Mansoura University Children's Hospital, Mansoura, Egypt.,Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marwan A Bakarman
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turki S Alahmadi
- Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.,Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nadeem S Butt
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M Alqahtani
- Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badr S Aljedaani
- Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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