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Khan A, Bisanzio D, Mutuku F, Ndenga B, Grossi-Soyster EN, Jembe Z, Maina PW, Chebii PK, Ronga CO, Okuta V, LaBeaud AD. Spatiotemporal overlapping of dengue, chikungunya, and malaria infections in children in Kenya. BMC Infect Dis 2023; 23:183. [PMID: 36991340 PMCID: PMC10053720 DOI: 10.1186/s12879-023-08157-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.
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Affiliation(s)
- Aslam Khan
- Stanford University School of Medicine, Stanford, CA, USA.
- Center for Academic Medicine, 453 Quarry Road, Palo Alto, CA, 94304, USA.
| | | | | | | | | | - Zainab Jembe
- Msambweni County Referral hospital, Msambweni, Kenya
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2
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Blackmon K, Evans R, Fernandes M, Landon B, Noel T, Macpherson C, Cudjoe N, Burgen KS, Punch B, Krystosik A, Grossi-Soyster EN, LaBeaud AD, Waechter R. Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure. Arch Dis Child 2022; 107:244-250. [PMID: 34479857 PMCID: PMC8857021 DOI: 10.1136/archdischild-2020-321031] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Zika virus (ZIKV) targets neural stem cells in the developing brain. However, the majority of ZIKV-exposed children are born without apparent neurological manifestations. It remains unclear if these children were protected from ZIKV neurotropism or if they harbour subtle pathology that is disruptive to brain development. We assess this by comparing neurodevelopmental outcomes in normocephalic ZIKV-exposed children relative to a parallel control group of unexposed controls. DESIGN Cohort study. SETTING Public health centres in Grenada, West Indies. PATIENTS 384 mother-child pairs were enrolled during a period of active ZIKV transmission (April 2016-March 2017) and prospectively followed up to 30 months. Child exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. MAIN OUTCOME MEASURES The INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) package and Cardiff Vision Tests, administered and scored by research staff masked to child's exposure status. RESULTS A total of 131 normocephalic ZIKV exposed (n=68) and unexposed (n=63) children were assessed between 22 and 30 months of age. Approximately half of these children completed vision testing. There were no group differences in sociodemographics. Deficits in visual acuity (31%) and contrast sensitivity (23%) were apparent in the ZIKV-exposed infants in the absence of cognitive, motor, language or behavioural delays. CONCLUSIONS Overall neurodevelopment is likely to be unaffected in ZIKV-exposed children with normal head circumference at birth and normal head growth in the first 2 years of life. However, the visual system may be selectively vulnerable, which indicates the need for vision testing by 3 years of age.
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Affiliation(s)
- Karen Blackmon
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA .,Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Michelle Fernandes
- Department of Paediatrics, University of Southampton, Southampton Children’s Hospital, Southhampton, UK,Nuffield Department of Women's Productive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Trevor Noel
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Kemi S Burgen
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Bianca Punch
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Amy Krystosik
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Elysse N Grossi-Soyster
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Angelle Desiree LaBeaud
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St. Georges, Grenada,Department of Physiology, Neuroscience, and Behavioral Sciences, St George's University School of Medicine, St. George's, Grenada
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Shah MM, Ndenga BA, Mutuku FM, Vu DM, Grossi-Soyster EN, Okuta V, Ronga CO, Chebii PK, Maina P, Jembe Z, Bosire CM, Amugongo JS, Sahoo MK, Huang C, Weber J, Edgerton SV, Hortion J, Bennett SN, Pinsky BA, LaBeaud AD. High Dengue Burden and Circulation of 4 Virus Serotypes among Children with Undifferentiated Fever, Kenya, 2014-2017. Emerg Infect Dis 2021; 26:2638-2650. [PMID: 33079035 PMCID: PMC7588514 DOI: 10.3201/eid2611.200960] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Little is known about the extent and serotypes of dengue viruses circulating in Africa. We evaluated the presence of dengue viremia during 4 years of surveillance (2014–2017) among children with febrile illness in Kenya. Acutely ill febrile children were recruited from 4 clinical sites in western and coastal Kenya, and 1,022 participant samples were tested by using a highly sensitive real-time reverse transcription PCR. A complete case analysis with genomic sequencing and phylogenetic analyses was conducted to characterize the presence of dengue viremia among participants during 2014–2017. Dengue viremia was detected in 41.9% (361/862) of outpatient children who had undifferentiated febrile illness in Kenya. Of children with confirmed dengue viremia, 51.5% (150/291) had malaria parasitemia. All 4 dengue virus serotypes were detected, and phylogenetic analyses showed several viruses from novel lineages. Our results suggests high levels of dengue virus infection among children with undifferentiated febrile illness in Kenya.
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Blackmon K, Waechter R, Landon B, Noël T, Macpherson C, Donald T, Cudjoe N, Evans R, Burgen KS, Jayatilake P, Oyegunle V, Pedraza O, Abdel Baki S, Thesen T, Dlugos D, Chari G, Patel AA, Grossi-Soyster EN, Krystosik AR, LaBeaud AD. Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure. PLoS Negl Trop Dis 2020; 14:e0008874. [PMID: 33253174 PMCID: PMC7728266 DOI: 10.1371/journal.pntd.0008874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 12/10/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003-0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.
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Affiliation(s)
- Karen Blackmon
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- * E-mail:
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | | | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Kemi S. Burgen
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Piumi Jayatilake
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Vivian Oyegunle
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Otto Pedraza
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
| | - Samah Abdel Baki
- Biosignal Group Inc., Boston, Massachusetts, United States of America
| | - Thomas Thesen
- New York University School of Medicine, Department of Neurology, New York, New York, United States of America
- Department of Biomedical Sciences, University of Houston College of Medicine, USA
| | - Dennis Dlugos
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Geetha Chari
- SUNY Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - Archana A. Patel
- Boston Children’s Hospital, Department of Neurology, Boston, Massachusetts, United States of America
| | - Elysse N. Grossi-Soyster
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - Amy R. Krystosik
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - A. Desiree LaBeaud
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
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5
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Jayatilake P, Oyegunle V, Waechter R, Landon B, Fernandes M, Cudjoe N, Evans R, Noël T, Macpherson C, Donald T, Abdelbaki SG, Mandalaneni K, Dlugos D, Chari G, Patel AA, Grossi-Soyster EN, Desiree LaBeaud A, Blackmon K. Focal epilepsy features in a child with Congenital Zika Syndrome. Epilepsy Behav Rep 2020; 14:100411. [PMID: 33313503 PMCID: PMC7720018 DOI: 10.1016/j.ebr.2020.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 11/30/2022] Open
Abstract
Congenital Zika Syndrome with microcephaly can present with focal seizures. TeleEEG can augment epilepsy care in Zika-endemic resource limited settings. A seizure questionnaire can prompt caregiver report of relevant seizure features.
Zika virus (ZIKV) is a mosquito-borne, single-stranded DNA flavivirus that is teratogenic and neurotropic. Similar to the teratogenic effects of other TORCH infections, ZIKV infection during pregnancy can have an adverse impact on fetal and neonatal development. Epilepsy is detected in 48–96% of children with Congenital Zika Syndrome (CZS) and microcephaly. Early epilepsy surveillance is needed in children with prenatal ZIKV exposure; yet, most ZIKV-endemic regions do not have specialist epilepsy care. Here, we describe the demographic, clinical, imaging, and EEG characteristics of a 2-year-old child with CZS and microcephaly who presented with focal epileptiform activity, suboptimal growth, and severe neurodevelopmental delays. Administration of a brief seizure questionnaire by allied health professionals to the patient’s caregiver helped to characterize the child’s seizure semiology and differentiate focal from generalized seizure features. A telemedicine EEG interpretation platform provided valuable diagnostic information for the patient’s local pediatrician to integrate into her treatment plan. This case illustrates that CZS can present with focal epilepsy features and that a telemedicine approach can be used to bridge the gap between epilepsy specialists and local care providers in resource limited ZIKV-endemic regions to achieve better seizure control in children with CZS.
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Affiliation(s)
| | | | - Randall Waechter
- St. George's University, St. George's, West Indies, Grenada.,Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University of Southampton, Southampton, UK
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Tyhiesia Donald
- Ministry of Health, Government of Grenada, West Indies, Grenada
| | | | | | - Dennis Dlugos
- Children's Hospital of Pennsylvania, Philadelphia, PA, USA
| | - Geetha Chari
- SUNY Downstate Health Sciences University, New York, NY, USA
| | - Archana A Patel
- Boston Children's Hospital, Division of Epilepsy and Clinical Neurophysiology, Boston, MA, USA
| | | | - A Desiree LaBeaud
- Stanford University School of Medicine, Department of Pediatrics, CA, USA
| | - Karen Blackmon
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada.,Mayo Clinic, Jacksonville, FL, USA
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6
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Grossi-Soyster EN, LaBeaud AD. Rift Valley Fever: Important Considerations for Risk Mitigation and Future Outbreaks. Trop Med Infect Dis 2020; 5:tropicalmed5020089. [PMID: 32498264 PMCID: PMC7345646 DOI: 10.3390/tropicalmed5020089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 12/02/2022] Open
Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus of the Phenuiviridae family with great opportunity for emergence in previously unaffected regions, despite its current geographical limits. Outbreaks of RVFV often infect humans or domesticated animals, such as livestock, concurrently and occur sporadically, ranging from localized outbreaks in villages to multi-country events that spread rapidly. The true burden of Rift Valley fever (RVF) is not well defined due to underreporting, misdiagnosis caused by the broad spectrum of disease presentation, and minimal access for rapid and accurate laboratory confirmation. Severe symptoms may include hemorrhagic fever, loss of vision, psychological impairment or disturbances, and organ failure. Those living in endemic areas and travelers should be aware of the potential for exposure to ongoing outbreaks or interepidemic transmission, and engage in behaviors to minimize exposure risks, as vaccinations in humans are currently unavailable and animal vaccinations are not used routinely or ubiquitously. The lack of vaccines approved for use in humans is concerning, as RVFV has proven to be highly pathogenic in naïve populations, causing severe disease in a large percent of confirmed cases, which could have considerable impact on human health.
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7
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Hortion J, Mutuku FM, Eyherabide AL, Vu DM, Boothroyd DB, Grossi-Soyster EN, King CH, Ndenga BA, LaBeaud AD. Acute Flavivirus and Alphavirus Infections among Children in Two Different Areas of Kenya, 2015. Am J Trop Med Hyg 2019; 100:170-173. [PMID: 30457092 DOI: 10.4269/ajtmh.18-0297] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Alphaviruses and flaviviruses are known to be endemic in Eastern Africa, but few data are available to evaluate the prevalence of these infections. This leads to missed opportunities for prevention against future outbreaks. This cohort study investigated the frequency of alphavirus and flavivirus incident infections in two regions of Kenya and identified potential risk factors. Seroconversions for alphavirus and flavivirus infections were identified by immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA) in a cohort of 1,604 acutely ill children over the year 2015. The annual incidence was 0.5% (0.2-1.2%) for alphaviruses and 1.2% (0.7-2.2%) for flaviviruses. Overall, seroprevalence was significantly higher for alphaviruses in western Kenya than on the coast (P = 0.014), whereas flavivirus seroprevalence was higher on the coast (P = 0.044). Poverty indicators did not emerge as risk factors, but reliance on household water storage was associated with increased exposure to both alphaviruses and flaviviruses (odds ratio = 2.3).
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Affiliation(s)
- Jimmy Hortion
- Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.,Département de Biologie, Ecole Normale Supérieure de Lyon, Lyon, France
| | - Francis M Mutuku
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Ana L Eyherabide
- Departamento de Pediatría, Sanatorio de Niños, Rosario, Argentina
| | - David M Vu
- Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Derek B Boothroyd
- Quantitative Science Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
| | - Bryson A Ndenga
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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8
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Grossi-Soyster EN, Lee J, King CH, LaBeaud AD. The influence of raw milk exposures on Rift Valley fever virus transmission. PLoS Negl Trop Dis 2019; 13:e0007258. [PMID: 30893298 PMCID: PMC6443189 DOI: 10.1371/journal.pntd.0007258] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/01/2019] [Accepted: 02/23/2019] [Indexed: 02/07/2023] Open
Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus that can be transmitted to humans or livestock by mosquitoes or through direct contact with contaminated bodily fluids and tissues. Exposure to bodily fluids and tissues varies by types of behaviors engaged for occupational tasks, homestead responsibilities, or use in dietary or therapeutic capacities. While previous studies have included milk exposures in their analyses, their primary focus on livestock exposures has been on animal handling, breeding, and slaughter. We analyzed data from multiple field surveys in Kenya with the aim of associating RVFV infection to raw milk exposures from common animal species. Of those with evidence of prior RVFV infection by serology (n = 267), 77.2% engaged in milking livestock compared to 32.0% for 3,956 co-local seronegative individuals (p < 0.001), and 86.5% of seropositive individuals consumed raw milk compared to 33.4% seronegative individuals (p < 0.001). Individuals who milked and also consumed raw milk had greater odds of RVFV exposure than individuals whose only contact to raw milk was through milking. Increased risks were associated with exposure to milk sourced from cows (p < 0.001), sheep (p < 0.001), and goats (p < 0.001), but not camels (p = 0.98 for consuming, p = 0.21 for milking). Our data suggest that exposure to raw milk may contribute to a significant number of cases of RVFV, especially during outbreaks and in endemic areas, and that some animal species may be associated with a higher risk for RVFV exposure. Livestock trade is regulated to limit RVFV spread from endemic areas, yet further interventions designed to fully understand the risk of RVFV exposure from raw milk are imperative.
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Affiliation(s)
- Elysse N. Grossi-Soyster
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
- * E-mail:
| | - Justin Lee
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States of America
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
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9
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Grossi-Soyster EN, Cook EAJ, de Glanville WA, Thomas LF, Krystosik AR, Lee J, Wamae CN, Kariuki S, Fèvre EM, LaBeaud AD. Serological and spatial analysis of alphavirus and flavivirus prevalence and risk factors in a rural community in western Kenya. PLoS Negl Trop Dis 2017; 11:e0005998. [PMID: 29040262 PMCID: PMC5659799 DOI: 10.1371/journal.pntd.0005998] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/27/2017] [Accepted: 09/27/2017] [Indexed: 01/29/2023] Open
Abstract
Alphaviruses, such as chikungunya virus, and flaviviruses, such as dengue virus, are (re)-emerging arboviruses that are endemic in tropical environments. In Africa, arbovirus infections are often undiagnosed and unreported, with febrile illnesses often assumed to be malaria. This cross-sectional study aimed to characterize the seroprevalence of alphaviruses and flaviviruses among children (ages 5-14, n = 250) and adults (ages 15 ≥ 75, n = 250) in western Kenya. Risk factors for seropositivity were explored using Lasso regression. Overall, 67% of participants showed alphavirus seropositivity (CI95 63%-70%), and 1.6% of participants showed flavivirus seropositivity (CI95 0.7%-3%). Children aged 10-14 were more likely to be seropositive to an alphavirus than adults (p < 0.001), suggesting a recent transmission period. Alphavirus and flavivirus seropositivity was detected in the youngest participants (age 5-9), providing evidence of inter-epidemic transmission. Demographic variables that were significantly different amongst those with previous infection versus those without infection included age, education level, and occupation. Behavioral and environmental variables significantly different amongst those in with previous infection to those without infection included taking animals for grazing, fishing, and recent village flooding. Experience of recent fever was also found to be a significant indicator of infection (p = 0.027). These results confirm alphavirus and flavivirus exposure in western Kenya, while illustrating significantly higher alphavirus transmission compared to previous studies.
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Affiliation(s)
- Elysse N. Grossi-Soyster
- Departments of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, United States of America
| | - Elizabeth A. J. Cook
- Zoonotic and Emerging Diseases Group, International Livestock Research Institute, Nairobi, Kenya
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - William A. de Glanville
- Zoonotic and Emerging Diseases Group, International Livestock Research Institute, Nairobi, Kenya
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Lian F. Thomas
- Zoonotic and Emerging Diseases Group, International Livestock Research Institute, Nairobi, Kenya
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Amy R. Krystosik
- Departments of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, United States of America
| | - Justin Lee
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California, United States of America
| | - C. Njeri Wamae
- Department of Microbiology, School of Medicine, Mount Kenya University, Thika, Kenya
| | - Samuel Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Eric M. Fèvre
- Zoonotic and Emerging Diseases Group, International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Neston, United Kingdom
| | - A. Desiree LaBeaud
- Departments of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, United States of America
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10
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Grossi-Soyster EN, Banda T, Teng CY, Muchiri EM, Mungai PL, Mutuku FM, Gildengorin G, Kitron U, King CH, Desiree Labeaud A. Rift Valley Fever Seroprevalence in Coastal Kenya. Am J Trop Med Hyg 2017; 97:115-120. [PMID: 28719329 DOI: 10.4269/ajtmh.17-0104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rift Valley fever virus (RVFV) causes severe disease in both animals and humans, resulting in significant economic and public health damages. The objective of this study was to measure RVFV seroprevalence in six coastal Kenyan villages between 2009 and 2011, and characterize individual-, household-, and community-level risk factors for prior RVFV exposure. Sera were tested for anti-RVFV IgG via enzyme-linked immunosorbent assay. Overall, 51 (1.8%; confidence interval [CI95] 1.3-2.3) of 2,871 samples were seropositive for RVFV. Seroprevalence differed significantly among villages, and was highest in Jego Village (18/300; 6.0%; CI95 3.6-9.3) and lowest in Magodzoni (0/248). Adults were more likely to be seropositive than children (P < 0.001). Seropositive subjects were less likely to own land or a motor vehicle (P < 0.01), suggesting exposure is associated with lower socioeconomic standing (P = 0.03). RVFV exposure appears to be low in coastal Kenya, although with some variability among villages.
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Affiliation(s)
| | - Tamara Banda
- Children's Hospital Oakland Research Institute, Oakland, California
| | - Crystal Y Teng
- Children's Hospital Oakland Research Institute, Oakland, California
| | - Eric M Muchiri
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Msambweni, Kenya
| | - Peter L Mungai
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Msambweni, Kenya
| | - Francis M Mutuku
- Department of Environmental studies, Emory University, Atlanta, Georgia.,Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Msambweni, Kenya
| | | | - Uriel Kitron
- Department of Environmental studies, Emory University, Atlanta, Georgia
| | | | - A Desiree Labeaud
- Children's Hospital Oakland Research Institute, Oakland, California.,Stanford University School of Medicine, Stanford, California
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