1
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Kitro A, Imad HA, Pisutsan P, Matsee W, Sirikul W, Sapbamrer R, Rapheal E, Fernandez S, Cotrone TS, Farmer AR, Hunsawong T, Silachamroon U, Chatapat L, Olanwijitwong J, Salee P, Anderson KB, Piyaphanee W. Seroprevalence of dengue, Japanese encephalitis and Zika among long-term expatriates in Thailand. J Travel Med 2024; 31:taae022. [PMID: 38335250 DOI: 10.1093/jtm/taae022] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Travel to Southeast Asia increases the likelihood of acquiring mosquito-borne Flavivirus infections such as dengue (DENV), Japanese encephalitis (JEV) and Zika viruses (ZIKV). Expatriates are long-term travellers who have a higher risk of mosquito-borne illness at their destination country. The purpose of this study was to evaluate the seroprevalence of DENV, JEV and ZIKV infections and the determinants contributing to seropositivity among expatriates living in Thailand. METHODS A cross-sectional study was performed from December 2017 to February 2020. Expatriates from non-Flavivirus endemic countries were recruited. 5 mL of blood was collected for DENV 1-4, JEV and ZIKV antibody testing by plaque reduction neutralization test (PRNT50). Individuals with vaccination histories or diagnoses for dengue, Japanese encephalitis, yellow fever and tick-borne encephalitis were excluded. RESULTS Among 254 participants, most participants (83.1%) were male, the mean age was 65 years and the median duration of stay in Thailand was 6 years. Seroprevalence rate of any Flavivirus, non-specific DENV, DENV1-4, JEV and ZIKV were 34.3, 30.7, 20.5, 18.1, 18.9, 10.6, 4.7 and 2.8%, respectively. The presence of neutralizing antibodies against DENV1-4 positively correlates with the duration of stay in Thailand. DENV seropositivity was associated with living in urban areas (aOR 2.75, 95% CI 1.36-5.57). Expatriates were unlikely to have detectable anti-JEV antibodies regardless of time spent in a JEV-endemic area. No risk factors were identified that were significantly associated with JEV or ZIKV seropositivity. Only 48.4% received pre-travel counselling services, while only 18.9% visited a travel medicine specialist. CONCLUSIONS A high proportion (34.3%) of long-term expatriates living in Thailand were seropositive for flavivirus, mainly from dengue (30.7%). To minimize risk, travel medicine practitioners should provide adequate pre-travel health risk information on mosquito-borne flavivirus infection and offer advice on mosquito bite prevention strategies. Dengue vaccine might be considered in high-risk travellers such as long-term expatriate.
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Affiliation(s)
- Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Hisham Ahmed Imad
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Suita 565-0871, Japan
| | - Phimphan Pisutsan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wasin Matsee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Erica Rapheal
- School of Public Health, University of Minnesota, Minnesota, MN 55414, USA
| | - Stefan Fernandez
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Thomas S Cotrone
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Aaron R Farmer
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Taweewun Hunsawong
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Lapakorn Chatapat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Jutarmas Olanwijitwong
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Parichat Salee
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kathryn B Anderson
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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2
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Paz-Bailey G, Adams LE, Deen J, Anderson KB, Katzelnick LC. Dengue. Lancet 2024; 403:667-682. [PMID: 38280388 DOI: 10.1016/s0140-6736(23)02576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 01/29/2024]
Abstract
Dengue, caused by four closely related viruses, is a growing global public health concern, with outbreaks capable of overwhelming health-care systems and disrupting economies. Dengue is endemic in more than 100 countries across tropical and subtropical regions worldwide, and the expanding range of the mosquito vector, affected in part by climate change, increases risk in new areas such as Spain, Portugal, and the southern USA, while emerging evidence points to silent epidemics in Africa. Substantial advances in our understanding of the virus, immune responses, and disease progression have been made within the past decade. Novel interventions have emerged, including partially effective vaccines and innovative mosquito control strategies, although a reliable immune correlate of protection remains a challenge for the assessment of vaccines. These developments mark the beginning of a new era in dengue prevention and control, offering promise in addressing this pressing global health issue.
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Affiliation(s)
| | - Laura E Adams
- Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jacqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Kathryn B Anderson
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Leah C Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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3
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Williams RJ, Brintz BJ, Ribeiro Dos Santos G, Huang AT, Buddhari D, Kaewhiran S, Iamsirithaworn S, Rothman AL, Thomas S, Farmer A, Fernandez S, Cummings DAT, Anderson KB, Salje H, Leung DT. Integration of population-level data sources into an individual-level clinical prediction model for dengue virus test positivity. Sci Adv 2024; 10:eadj9786. [PMID: 38363842 PMCID: PMC10871531 DOI: 10.1126/sciadv.adj9786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/17/2024] [Indexed: 02/18/2024]
Abstract
The differentiation of dengue virus (DENV) infection, a major cause of acute febrile illness in tropical regions, from other etiologies, may help prioritize laboratory testing and limit the inappropriate use of antibiotics. While traditional clinical prediction models focus on individual patient-level parameters, we hypothesize that for infectious diseases, population-level data sources may improve predictive ability. To create a clinical prediction model that integrates patient-extrinsic data for identifying DENV among febrile patients presenting to a hospital in Thailand, we fit random forest classifiers combining clinical data with climate and population-level epidemiologic data. In cross-validation, compared to a parsimonious model with the top clinical predictors, a model with the addition of climate data, reconstructed susceptibility estimates, force of infection estimates, and a recent case clustering metric significantly improved model performance.
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Affiliation(s)
- Robert J. Williams
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ben J. Brintz
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Angkana T. Huang
- Department of Genetics, University of Cambridge, Cambridge, UK
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Alan L. Rothman
- Institute for Immunology and Informatics and Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
| | - Stephen Thomas
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Aaron Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Derek A. T. Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Kathryn B. Anderson
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Daniel T. Leung
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, UT, USA
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4
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Hamins-Puértolas M, Buddhari D, Salje H, Cummings DAT, Fernandez S, Farmer A, Kaewhiran S, Khampaen D, Iamsirithaworn S, Srikiatkhachorn A, Waickman A, Thomas SJ, Rothman AL, Endy T, Rodriguez-Barraquer I, Anderson KB. Household immunity and individual risk of infection with dengue virus in a prospective, longitudinal cohort study. Nat Microbiol 2024; 9:274-283. [PMID: 38110699 PMCID: PMC10895643 DOI: 10.1038/s41564-023-01543-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/02/2023] [Indexed: 12/20/2023]
Abstract
Although it is known that household infections drive the transmission of dengue virus (DENV), it is unclear how household composition and the immune status of inhabitants affect the individual risk of infection. Most population-based studies to date have focused on paediatric cohorts because more severe forms of dengue mainly occur in children, and the role of adults in dengue transmission is understudied. Here we analysed data from a multigenerational cohort study of 470 households, comprising 2,860 individuals, in Kamphaeng Phet, Thailand, to evaluate risk factors for DENV infection. Using a gradient-boosted regression model trained on annual haemagglutination inhibition antibody titre inputs, we identified 1,049 infections, 90% of which were subclinical. By analysing imputed infections, we found that individual antibody titres, household composition and antibody titres of other members in the same household affect an individual's risk of DENV infection. Those individuals living in households with high average antibody titres, or households with more adults, had a reduced risk of infection. We propose that herd immunity to dengue acts at the household level and may provide insight into the drivers of the recent change in the shifting age distribution of dengue cases in Thailand.
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Affiliation(s)
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK
- Department of Biology, University of Florida, Gainesville, FL, USA
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Aaron Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | | | - Anon Srikiatkhachorn
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
- Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Adam Waickman
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen J Thomas
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alan L Rothman
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
| | - Timothy Endy
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
- Coalition for Epidemic Preparedness Innovations (CEPI), Washington DC, USA
| | | | - Kathryn B Anderson
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA.
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, USA.
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Meyer AD, Guerrero SM, Dean NE, Anderson KB, Stoddard ST, Perkins TA. Model-based estimates of chikungunya epidemiological parameters and outbreak risk from varied data types. Epidemics 2023; 45:100721. [PMID: 37890441 DOI: 10.1016/j.epidem.2023.100721] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Assessing the factors responsible for differences in outbreak severity for the same pathogen is a challenging task, since outbreak data are often incomplete and may vary in type across outbreaks (e.g., daily case counts, serology, cases per household). We propose that outbreaks described with varied data types can be directly compared by using those data to estimate a common set of epidemiological parameters. To demonstrate this for chikungunya virus (CHIKV), we developed a realistic model of CHIKV transmission, along with a Bayesian inference method that accommodates any type of outbreak data that can be simulated. The inference method makes use of the fact that all data types arise from the same transmission process, which is simulated by the model. We applied these tools to data from three real-world outbreaks of CHIKV in Italy, Cambodia, and Bangladesh to estimate nine model parameters. We found that these populations differed in several parameters, including pre-existing immunity and house-to-house differences in mosquito activity. These differences resulted in posterior predictions of local CHIKV transmission risk that varied nearly fourfold: 16% in Italy, 28% in Cambodia, and 62% in Bangladesh. Our inference method and model can be applied to improve understanding of the epidemiology of CHIKV and other pathogens for which outbreaks are described with varied data types.
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Affiliation(s)
- Alexander D Meyer
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
| | | | - Natalie E Dean
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Kathryn B Anderson
- Department of Microbiology and Immunology, The State University of New York (SUNY) Upstate Medical University, Syracuse, NY 13210, USA
| | - Steven T Stoddard
- Bavarian Nordic Inc., 6275 Nancy Ridge Drive Suite 110/120, San Diego, CA 92121, USA; Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - T Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
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6
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Jones AM, Saretsky TL, Panter C, Wells JR, White F, Smith V, Kendal H, Russell K, Ruggieri M, Calhoun SR, Gater A, O'Hagan J, Anderson KB, Paz-Soldan VA, Morrison AC, Ware L, Klick M, Thomas S, Marks MA. Measuring dengue illness intensity: Development and content validity of the dengue virus daily diary (DENV-DD). J Patient Rep Outcomes 2023; 7:84. [PMID: 37610665 PMCID: PMC10447358 DOI: 10.1186/s41687-023-00624-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Dengue is the most prevalent arboviral infection causing an estimated 50-60 million cases of febrile illness globally per year, exacting considerable disease burden. Few instruments exist to assess the patient illness experience, with most based on healthcare provider assessment, lacking standardization in timepoints and symptom assessment. This study aimed to evaluate the content validity of the novel 'Dengue Virus Daily Diary (DENV-DD)', designed to measure symptom intensity and disease burden within outpatient infant to adult populations. METHODS The Dengue Illness Index Report Card was used as a foundation to create the DENV-DD, consisting of patient- and observer-reported outcome (PRO/ObsRO) instruments. In two South American dengue-endemic communities, qualitative combined concept elicitation and cognitive debriefing interviews were conducted among individuals and caregivers of children with symptomatic laboratory-confirmed dengue. Interviews were conducted across two rounds allowing DENV-DD modifications. A small-scale quantitative assessment of the DENV-DD was also conducted with data from an independent Dengue Human Infection Model (DHIM) to generate early evidence of feasibility of DENV-DD completion, instrument performance and insight into the sign/symptom trajectory over the course of illness. RESULTS Forty-eight participants were interviewed (20 adults, 20 older children/adolescents with their caregivers, 8 caregivers of younger children). A wide spectrum of signs/symptoms lasting 3-15 days were reported with fever, headache, body ache/pain, loss of appetite, and body weakness each reported by > 70% participants. DENV-DD instructions, items and response scales were understood, and items were considered relevant across ages. DHIM data supported feasibility of DENV-DD completion. CONCLUSIONS Findings demonstrate content validity of the DENV-DD (PRO/ObsRO instruments) in dengue-endemic populations. Psychometric and cultural validity studies are ongoing to support use of the DENV-DD in clinical studies.
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Affiliation(s)
- Amy M Jones
- Adelphi Values Ltd., Patient Centered Outcomes, Cheshire, UK.
| | | | | | | | - Frances White
- Adelphi Values Ltd., Patient Centered Outcomes, Cheshire, UK
| | - Verity Smith
- Adelphi Values Ltd., Patient Centered Outcomes, Cheshire, UK
| | - Helen Kendal
- Adelphi Values Ltd., Patient Centered Outcomes, Cheshire, UK
| | | | | | | | - Adam Gater
- Adelphi Values Ltd., Patient Centered Outcomes, Cheshire, UK
| | | | - Kathryn B Anderson
- Institute for Global Health and Translational Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Valerie A Paz-Soldan
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Amy C Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Lisa Ware
- Institute for Global Health and Translational Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Michelle Klick
- Institute for Global Health and Translational Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Stephen Thomas
- Institute for Global Health and Translational Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
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7
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Williams RJ, Brintz BJ, Santos GRD, Huang A, Buddhari D, Kaewhiran S, Iamsirithaworn S, Rothman AL, Thomas S, Farmer A, Fernandez S, Cummings DAT, Anderson KB, Salje H, Leung DT. Integration of population-level data sources into an individual-level clinical prediction model for dengue virus test positivity. medRxiv 2023:2023.08.08.23293840. [PMID: 37609267 PMCID: PMC10441499 DOI: 10.1101/2023.08.08.23293840] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The differentiation of dengue virus (DENV) infection, a major cause of acute febrile illness in tropical regions, from other etiologies, may help prioritize laboratory testing and limit the inappropriate use of antibiotics. While traditional clinical prediction models focus on individual patient-level parameters, we hypothesize that for infectious diseases, population-level data sources may improve predictive ability. To create a clinical prediction model that integrates patient-extrinsic data for identifying DENV among febrile patients presenting to a hospital in Thailand, we fit random forest classifiers combining clinical data with climate and population-level epidemiologic data. In cross validation, compared to a parsimonious model with the top clinical predictors, a model with the addition of climate data, reconstructed susceptibility estimates, force of infection estimates, and a recent case clustering metric, significantly improved model performance.
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Affiliation(s)
- RJ Williams
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | - Ben J. Brintz
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | | | - Angkana Huang
- Department of Genetics, University of Cambridge, United Kingdom
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Alan L. Rothman
- Institute for Immunology and Informatics and Department of Cell and Molecular Biology, University of Rhode Island, Providence, USA
| | - Stephen Thomas
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, USA
| | - Aaron Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, USA
| | - Kathryn B Anderson
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, USA
| | - Henrik Salje
- Department of Genetics, University of Cambridge, United Kingdom
| | - Daniel T. Leung
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, USA
- Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, USA
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8
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Heslin KP, Haruna A, George RA, Chen S, Nobel I, Anderson KB, Faraone SV, Zhang-James Y. Association Between ADHD and COVID-19 Infection and Clinical Outcomes: A Retrospective Cohort Study From Electronic Medical Records. J Atten Disord 2023; 27:169-181. [PMID: 36264064 PMCID: PMC9596686 DOI: 10.1177/10870547221129305] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Though psychiatric illnesses have been associated with increased COVID-19 infection risk, limited information exists about the relationship between ADHD and COVID-19. METHODS Using the TriNetX COVID-19 Research Network, we examined the impact of ADHD diagnosis and treatment on COVID-19 infection rates and outcomes. RESULTS ADHD patients had greater risk of COVID-19 (risk ratio (RR) 1.11, 95% CI [1.09, 1.12]). Increased risk was higher in females than males, and highest among Asian and Black patients. Within 60 days after COVID-19 diagnosis, ADHD patients had lower rates of hospitalization (RR 0.91, 95% CI [0.86, 0.96]) and mechanical ventilation (RR 0.69, 95% CI [0.58, 0.83]), and a nonsignificant reduced death rate (RR 0.65, 95% CI [0.42, 1.02]). Patients who recently received ADHD medication had higher rates of COVID-19 (RR 1.13; 95% CI [1.10, 1.15]). CONCLUSION ADHD poses increased risk for COVID-19, but may reduce risk of severe outcomes. ADHD medications modestly impacted COVID-19 risk.
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Affiliation(s)
- Kathleen P. Heslin
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Aminat Haruna
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Regina A. George
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Shiyu Chen
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ishak Nobel
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kathryn B. Anderson
- Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, New York
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Yanli Zhang-James
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York
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9
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Fansiri T, Buddhari D, Pathawong N, Pongsiri A, Klungthong C, Iamsirithaworn S, Jones AR, Fernandez S, Srikiatkhachorn A, Rothman AL, Anderson KB, Thomas SJ, Endy TP, Ponlawat A. Entomological Risk Assessment for Dengue Virus Transmission during 2016-2020 in Kamphaeng Phet, Thailand. Pathogens 2021; 10:pathogens10101234. [PMID: 34684183 PMCID: PMC8538081 DOI: 10.3390/pathogens10101234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Individual houses with high risks of dengue virus (DENV) transmission might be a source of virus transmission within the neighborhood. We conducted an entomological risk assessment for DENV transmission at the household level, comprising family cohort members residing in the same location, to assess the risk for dengue virus transmitted by mosquito vectors. The studies were conducted in Kamphaeng Phet Province, Thailand, during 2016-2020. Entomological investigations were performed in 35 cohort families on day 1 and day 14 after receiving dengue case reports. DENV was found in 22 Aedes samples (4.9%) out of 451 tested samples. A significantly higher DENV infection rate was detected in vectors collected on day 1 (6.64%) compared to those collected on day 14 (1.82%). Annual vector surveillance was carried out in 732 houses, with 1002 traps catching 3653 Aedes females. The majority of the 13,228 water containers examined were made from plastic and clay, with used tires serving as a primary container, with 59.55% larval abundance. Larval indices, as indicators of dengue epidemics and to evaluate disease and vector control approaches, were calculated. As a result, high values of larval indices indicated the considerably high risk of dengue transmission in these communities.
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Affiliation(s)
- Thanyalak Fansiri
- Department of Entomology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (T.F.); (N.P.); (A.P.)
| | - Darunee Buddhari
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (D.B.); (C.K.); (A.R.J.); (S.F.)
| | - Nattaphol Pathawong
- Department of Entomology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (T.F.); (N.P.); (A.P.)
| | - Arissara Pongsiri
- Department of Entomology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (T.F.); (N.P.); (A.P.)
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (D.B.); (C.K.); (A.R.J.); (S.F.)
| | - Sopon Iamsirithaworn
- Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand;
| | - Anthony R. Jones
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (D.B.); (C.K.); (A.R.J.); (S.F.)
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (D.B.); (C.K.); (A.R.J.); (S.F.)
| | - Anon Srikiatkhachorn
- Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI 02903, USA;
| | - Alan L. Rothman
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI 02903, USA;
| | - Kathryn B. Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA; (K.B.A.); (S.J.T.); (T.P.E.)
| | - Stephen J. Thomas
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA; (K.B.A.); (S.J.T.); (T.P.E.)
| | - Timothy P. Endy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA; (K.B.A.); (S.J.T.); (T.P.E.)
| | - Alongkot Ponlawat
- Department of Entomology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok 10400, Thailand; (T.F.); (N.P.); (A.P.)
- Correspondence:
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10
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Shaw J, Hanley S, Stewart T, Salmon DA, Ortiz C, Trief PM, Asiago Reddy E, Morley CP, Thomas SJ, Anderson KB. Healthcare Personnel (HCP) Attitudes About Coronavirus Disease 2019 (COVID-19) Vaccination After Emergency Use Authorization. Clin Infect Dis 2021; 75:e814-e821. [PMID: 34467370 PMCID: PMC8513411 DOI: 10.1093/cid/ciab731] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 07/23/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We previously reported on coronavirus disease 2019 (COVID-19) vaccination intent among healthcare personnel (HCP) before emergency use authorization. We found widespread hesitancy and a substantial proportion of HCP did not intend to vaccinate. METHODS We conducted a cross-sectional survey of HCP, including clinical and nonclinical staff, researchers, and trainees between 21 February and 19 March 2021. The survey evaluated vaccine attitudes, beliefs, intent, and acceptance. RESULTS Overall, 3981 (87.7%) of respondents had already received a COVID-19 vaccine or planned to get vaccinated. There were significant differences in vaccine acceptance by gender, age, race, and hospital role. Males (93.7%) were more likely than females (89.8%) to report vaccine acceptance (P < .001). Mean age was higher among those reporting vaccine acceptance (P < .001). Physicians and scientists showed the highest acceptance rate (97.3%), whereas staff in ancillary services showed the lowest acceptance rate (79.9%). Unvaccinated respondents were more likely to be females, to have refused vaccines in the past due to reasons other than illness or allergy, to care for COVID-19 patients, or to rely on themselves when making vaccination decision. Vaccine acceptance was more than twice previous intent among Black respondents, an increase from 30.8% to 73.8%, and across all hospital roles with all > 80% vaccine acceptance. CONCLUSIONS The majority of HCP were vaccinated, much higher than reporting intent before vaccine was available. However, many HCP-particularly ancillary services-are still hesitant. Feasible and effective interventions to address the hesitant, including individually-tailored education strategies are needed, or vaccine can be mandated.
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Affiliation(s)
- Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA,Corresponding Author: Dr. Jana Shaw, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University, Golisano Children's Hospital, 750 East Adams Street, Syracuse, NY 13210, USA. . Phone: 315-464-6331
| | - Samantha Hanley
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Telisa Stewart
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Ortiz
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Paula M Trief
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Christopher P Morley
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Stephen J Thomas
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kathryn B Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA
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11
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Sanchez-Vargas LA, Anderson KB, Srikiatkhachorn A, Currier JR, Friberg H, Endy TP, Fernandez S, Mathew A, Rothman AL. Longitudinal Analysis of Dengue Virus-Specific Memory T Cell Responses and Their Association With Clinical Outcome in Subsequent DENV Infection. Front Immunol 2021; 12:710300. [PMID: 34394112 PMCID: PMC8355709 DOI: 10.3389/fimmu.2021.710300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/15/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Memory T cells resulting from primary dengue virus (DENV) infection are hypothesized to influence the clinical outcome of subsequent DENV infection. However, the few studies involving prospectively collected blood samples have found weak and inconsistent associations with outcome and variable temporal trends in DENV-specific memory T cell responses between subjects. This study used both ex-vivo and cultured ELISPOT assays to further evaluate the associations between DENV serotype-cross-reactive memory T cells and severity of secondary infection. Using ex-vivo ELISPOT assays, frequencies of memory T cells secreting IFN-γ in response to DENV structural and non-structural peptide pools were low in PBMC from multiple time points prior to symptomatic secondary DENV infection and showed a variable response to infection. There were no differences in responses between subjects who were not hospitalized (NH, n=6) and those who were hospitalized with dengue hemorrhagic fever (hDHF, n=4). In contrast, responses in cultured ELISPOT assays were more reliably detectable prior to secondary infection and showed more consistent increases after infection. Responses in cultured ELISPOT assays were higher in individuals with hDHF (n=8) compared to NH (n=9) individuals before the secondary infection, with no difference between these groups after infection. These data demonstrate an association of pre-existing DENV-specific memory responses with the severity of illness in subsequent DENV infection, and suggest that frequencies of DENV-reactive T cells measured after short-term culture may be of particular importance for assessing the risk for more severe dengue disease.
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Affiliation(s)
- Luis Alberto Sanchez-Vargas
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Kathryn B Anderson
- Department of Medicine, Department of Microbiology and Immunology, Institute for Global Health and Translational Sciences, State University of New York-Upstate Medical University, Syracuse, NY, United States
| | - Anon Srikiatkhachorn
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States.,Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Jeffrey R Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Heather Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Timothy P Endy
- Department of Medicine, Department of Microbiology and Immunology, Institute for Global Health and Translational Sciences, State University of New York-Upstate Medical University, Syracuse, NY, United States
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Anuja Mathew
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Alan L Rothman
- Department of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
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12
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Sharp TM, Anderson KB, Katzelnick LC, Clapham H, Johansson MA, Morrison AC, Harris E, Paz-Bailey G, Waterman SH. Knowledge gaps in the epidemiology of severe dengue impede vaccine evaluation. Lancet Infect Dis 2021; 22:e42-e51. [PMID: 34265259 DOI: 10.1016/s1473-3099(20)30871-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/21/2020] [Accepted: 11/03/2020] [Indexed: 10/20/2022]
Abstract
The most severe consequences of dengue virus infection include shock, haemorrhage, and major organ failure; however, the frequency of these manifestations varies, and the relative contribution of pre-existing anti-dengue virus antibodies, virus characteristics, and host factors (including age and comorbidities) are not well understood. Reliable characterisation of the epidemiology of severe dengue first depends on the use of consistent definitions of disease severity. As vaccine trials have shown, severe dengue is a crucial interventional endpoint, yet the infrequency of its occurrence necessitates the inclusion of thousands of study participants to appropriately compare its frequency among participants who have and have not been vaccinated. Hospital admission is frequently used as a proxy for severe dengue; however, lack of specificity and variability in clinical practices limit the reliability of this approach. Although previous infection with a dengue virus is the best characterised risk factor for developing severe dengue, the influence of the timing between dengue virus infections and the sequence of dengue virus infections on disease severity is only beginning to be elucidated. To improve our understanding of the diverse factors that shape the clinical spectrum of disease resulting from dengue virus infection, prospective, community-based and clinic-based immunological, virological, genetic, and clinical studies across a range of ages and geographical regions are needed.
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Affiliation(s)
- Tyler M Sharp
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, PR, USA; United States Public Health Service, Silver Springs, MD, USA.
| | - Kathryn B Anderson
- Institute for Global Health and Translational Sciences and Department of Medicine, and Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Virology, Armed Forces Research Institute for Medical Sciences, Bangkok, Thailand
| | - Leah C Katzelnick
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Biology, University of Florida, Gainesville, FL, USA
| | - Hannah Clapham
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Michael A Johansson
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Amy C Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Gabriela Paz-Bailey
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - Stephen H Waterman
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, PR, USA; United States Public Health Service, Silver Springs, MD, USA
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13
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Buddhari D, Anderson KB, Gromowski GD, Jarman RG, Iamsirithaworn S, Thaisomboonsuk B, Hunsawong T, Srikiatkhachorn A, Rothman AL, Jones AR, Fernandez S, Thomas SJ, Endy TP. Correlation between reported dengue illness history and seropositivity in rural Thailand. PLoS Negl Trop Dis 2021; 15:e0009459. [PMID: 34129599 PMCID: PMC8232416 DOI: 10.1371/journal.pntd.0009459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/18/2020] [Revised: 06/25/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022] Open
Abstract
In the latest World Health Organization (WHO) recommendation for Dengvaxia implementation, either serological testing or a person's history of prior dengue illness may be used as supporting evidence to identify dengue virus (DENV)-immune individuals eligible for vaccination, in areas with limited capacity for laboratory confirmation. This analysis aimed to estimate the concordance between self-reported dengue illness histories and seropositivity in a prospective cohort study for dengue virus infection in Kamphaeng Phet province, a dengue-endemic area in northern Thailand. The study enrolled 2,076 subjects from 516 multigenerational families, with a median age of 30.6 years (range 0-90 years). Individual and family member dengue illness histories were obtained by questionnaire. Seropositivity was defined based on hemagglutination inhibition (HAI) assays. Overall seropositivity for DENV was 86.5% among those aged 9-45 years, which increased with age. 18.5% of participants reported a history of dengue illness prior to enrollment; 30.1% reported a previous DENV infection in the family, and 40.1% reported DENV infection in either themselves or a family member. Relative to seropositivity by HAI in the vaccine candidate group, the sensitivity and specificity of individual prior dengue illness history were 18.5% and 81.6%, respectively; sensitivity and specificity of reported dengue illness in a family member were 29.8% and 68.0%, and of either the individual or a family member were 40.1% and 60.5%. Notably, 13.4% of individuals reporting prior dengue illness were seronegative. Given the high occurrence of asymptomatic and mild DENV infection, self-reported dengue illness history is poorly sensitive for prior exposure and may misclassify individuals as 'exposed' when they were not. This analysis highlights that a simple, highly sensitive, and highly specific test for determining serostatus prior to Dengvaxia vaccination is urgently needed.
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Affiliation(s)
- Darunee Buddhari
- Department of Virology, USAMD-AFRIMS, Bangkok, Thailand
- * E-mail:
| | - Kathryn B. Anderson
- Department of Virology, USAMD-AFRIMS, Bangkok, Thailand
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
| | | | - Richard G. Jarman
- Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
| | | | | | | | - Anon Srikiatkhachorn
- University of Rhode Island, Providence, Rhode Island, United States of America
- Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Alan L. Rothman
- University of Rhode Island, Providence, Rhode Island, United States of America
| | | | | | - Stephen J. Thomas
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
| | - Timothy P. Endy
- State University of New York Upstate Medical University, Syracuse, New York, United States of America
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14
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Shaw J, Stewart T, Anderson KB, Hanley S, Thomas SJ, Salmon DA, Morley C. Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system. Clin Infect Dis 2021; 73:1776-1783. [PMID: 33491049 PMCID: PMC7929026 DOI: 10.1093/cid/ciab054] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [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: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background As a priority group, healthcare personnel (HCP) will be key to success of COVID-19 vaccination programs. The purpose of this study was to assess HCP willingness to get vaccinated and identify specific concerns that would undermine vaccination efforts. Methods We conducted a cross-sectional survey of HCP, including clinical and non-clinical staff, researchers, and trainees between November 23 rd ,2020 and December 5 th ,2020. The survey evaluated attitudes, beliefs and willingness to get vaccinated. Results A total of 5287 respondents had a mean age of 42.5 years (SD=13.56), and were 72.8% female (n=3842). Overall 57.5 % of individuals expressed intent to receive COVID-19 vaccine. 80.4% were physicians and scientists representing the largest group. 33.6% of registered nurses, 31.6% of allied health professionals, and 32% of master’s level clinicians were unsure they would take the vaccine (p<.001). Respondents who were older, males, White, or Asian were more likely to get vaccinated compared to other groups. Vaccine safety, potential adverse events, efficacy and speed of vaccine development dominated concerns listed by participants. Fewer (54.0%) providers of direct care vs. non-care providers (62.4%), and 52.0% of those who had provided care for COVID-19 patients (vs. 60.6% of those who had not) indicated they would take the vaccine if offered (p<.001). Conclusions We observed that self-reported willingness to receive vaccination against COVID-19 differs by hospital roles, with physicians and research scientists showing the highest acceptance. These findings highlight important heterogeneity in personal attitudes among HCPs around COVID-19 vaccines and highlight a need for tailored communication strategies.
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Affiliation(s)
- Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, SUNY Upstate Medical University, Syracuse, NY
| | - Telisa Stewart
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Kathryn B Anderson
- Department of Medicine, SUNY Upstate Institute for Global Health and Translational Science, Syracuse, NY
| | - Samantha Hanley
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Stephen J Thomas
- Department of Medicine, SUNY Upstate Institute for Global Health and Translational Science, Syracuse, NY
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher Morley
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
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15
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Kerdpanich P, Kongkiatngam S, Buddhari D, Simasathien S, Klungthong C, Rodpradit P, Thaisomboonsuk B, Wongstitwilairoong T, Hunsawong T, Anderson KB, Fernandez S, Jones AR. Comparative Analyses of Historical Trends in Confirmed Dengue Illnesses Detected at Public Hospitals in Bangkok and Northern Thailand, 2002-2018. Am J Trop Med Hyg 2020; 104:1058-1066. [PMID: 33319725 PMCID: PMC7941814 DOI: 10.4269/ajtmh.20-0396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/03/2020] [Indexed: 01/27/2023] Open
Abstract
Dengue is a re-emerging global public health problem, the most common arbovirus causing human disease in the world, and a major cause of hospitalization in endemic countries causing significant economic burden. Data were analyzed from passive surveillance of hospital-attended dengue cases from 2002 to 2018 at Phramongkutklao Hospital (PMKH) located in Bangkok, Thailand, and Kamphaeng Phet Provincial Hospital (KPPH) located in the lower northern region of Thailand. At PMKH, serotype 1 proved to be the most common strain of the virus, whereas at KPPH, serotypes 1, 2, and 3 were the most common strains from 2006 to 2008, 2009 to 2012, and 2013 to 2015, respectively. The 11–17 years age-group made up the largest proportion of patients impacted by dengue illnesses during the study period at both sites. At KPPH, dengue virus (DENV)-3 was responsible for most cases of dengue fever (DF), whereas it was DENV-1 at PMKH. In cases where dengue hemorrhagic fever was the clinical diagnosis, DENV-2 was the predominant serotype at KPPH, whereas at PMKH, it was DENV-1. The overall disease prevalence remained consistent across the two study sites with DF being the predominant clinical diagnosis as the result of an acute secondary dengue infection, representing 40.7% of overall cases at KPPH and 56.8% at PMKH. The differences seen between these sites could be a result of climate change increasing the length of dengue season and shifts in migration patterns of these populations from rural to urban areas and vice versa.
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Affiliation(s)
| | - Suthinee Kongkiatngam
- Department of Pediatrics, Kamphaeng Phet Provincial Hospital (KPPH), Kamphaeng Phet, Thailand
| | - Darunee Buddhari
- Kamphaeng Phet-AFRIMS Virology Research Unit, AFRIMS, Kamphaeng Phet, Thailand
| | | | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Prinyada Rodpradit
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Tippa Wongstitwilairoong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Taweewun Hunsawong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Kathryn B Anderson
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.,Department of Medicine, SUNY Upstate Medical University, Syracuse, New York.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York.,Institute for Global Health and Translational Sciences, SUNY Upstate Medical University, Syracuse, New York
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Anthony R Jones
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
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16
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Rapheal E, Stoddard ST, Anderson KB. Surveying Health-Related Knowledge, Attitudes, and Behaviors of U.S.-Based Residents Traveling Internationally to Visit Friends and Relatives. Am J Trop Med Hyg 2020; 103:2591-2599. [PMID: 32959762 PMCID: PMC7695092 DOI: 10.4269/ajtmh.20-0508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
U.S. residents traveling internationally to regions with increased risk of infectious diseases infrequently seek pretravel health care. First- and second-generation immigrants traveling to their countries of origin and visiting friends and relatives (VFRs) have increased risk of certain infectious diseases and are more likely to participate in high-risk activities. In an online survey of 994 U.S. residents with two foreign-born parents who went on at least one international trip to an at-risk country (defined as having a typhoid vaccine recommendation) in the prior 3 years, respondents were questioned about their international travel over the previous 3 years and their knowledge and individual risk of disease. Participants reported infrequently seeking pretravel health information (32% of trips) or consulting a healthcare provider before their trips (15% of trips). Participants reported seeking pretravel health information less often for VFR trips home (22%) than to other regions (30%). Perceived risk of disease was directly associated with seeking pretravel health information (82% for the highest and 13% for the lowest perceived risk), consulting a healthcare provider (55% for the highest and 5% for the lowest perceived risk), and reporting travel-associated illness (54% for the highest and 10% for the lowest perceived risk). Respondents were generally knowledgeable about cholera, hepatitis B, malaria, and rabies but had low knowledge of hepatitis A and typhoid. Understanding where VFR travelers lack understanding of disease transmission and which travelers are ideal targets for interventions has the potential to shape physician recommendations and public health strategy in this vulnerable population.
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Affiliation(s)
| | | | - Kathryn B Anderson
- Institute for Global Health and Translational Sciences, State University of New York-Upstate Medical University, Syracuse, New York.,Department of Medicine, State University of New York-Upstate Medical University, Syracuse, New York.,University of Minnesota, Minneapolis, Minnesota.,Department of Microbiology and Immunology, State University of New York-Upstate Medical University, Syracuse, New York
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17
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Anderson KB, Buddhari D, Srikiatkhachorn A, Gromowski GD, Iamsirithaworn S, Weg AL, Ellison DW, Macareo L, Cummings DAT, Yoon IK, Nisalak A, Ponlawat A, Thomas SJ, Fernandez S, Jarman RG, Rothman AL, Endy TP. An Innovative, Prospective, Hybrid Cohort-Cluster Study Design to Characterize Dengue Virus Transmission in Multigenerational Households in Kamphaeng Phet, Thailand. Am J Epidemiol 2020; 189:648-659. [PMID: 31971570 PMCID: PMC7393304 DOI: 10.1093/aje/kwaa008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 01/30/2023] Open
Abstract
Difficulties inherent in the identification of immune correlates of protection or severe disease have challenged the development and evaluation of dengue vaccines. There persist substantial gaps in knowledge about the complex effects of age and sequential dengue virus (DENV) exposures on these correlations. To address these gaps, we were conducting a novel family-based cohort-cluster study for DENV transmission in Kamphaeng Phet, Thailand. The study began in 2015 and is funded until at least 2023. As of May 2019, 2,870 individuals in 485 families were actively enrolled. The families comprise at least 1 child born into the study as a newborn, 1 other child, a parent, and a grandparent. The median age of enrolled participants is 21 years (range 0–93 years). Active surveillance is performed to detect acute dengue illnesses, and annual blood testing identifies subclinical seroconversions. Extended follow-up of this cohort will detect sequential infections and correlate antibody kinetics and sequence of infections with disease outcomes. The central goal of this prospective study is to characterize how different DENV exposure histories within multigenerational family units, from DENV-naive infants to grandparents with multiple prior DENV exposures, affect transmission, disease, and protection at the level of the individual, household, and community.
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Affiliation(s)
- Kathryn B Anderson
- Correspondence to Dr. Kathryn B. Anderson, Department of Medicine, Upstate Medical University, 750 E. Adams Street, Syracuse, NY 13210 (e-mail: )
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18
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Anderson KB, Stewart-Ibarra AM, Buddhari D, Beltran Ayala EF, Sippy RJ, Iamsirithaworn S, Ryan SJ, Fernandez S, Jarman RG, Thomas SJ, Endy TP. Key Findings and Comparisons From Analogous Case-Cluster Studies for Dengue Virus Infection Conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand. Front Public Health 2020; 8:2. [PMID: 32117847 PMCID: PMC7028768 DOI: 10.3389/fpubh.2020.00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/27/2019] [Accepted: 01/03/2020] [Indexed: 11/21/2022] Open
Abstract
Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.
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Affiliation(s)
- Kathryn B Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Armed Forces Research Institute of Medical Science, Bangkok, Thailand.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Anna M Stewart-Ibarra
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Montevideo, Inter-American Institute for Global Change Research (IAI), Montevideo, Uruguay
| | - Darunee Buddhari
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | | | - Rachel J Sippy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Geography, University of Florida, Gainesville, FL, United States
| | | | - Sadie J Ryan
- Department of Geography, University of Florida, Gainesville, FL, United States.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | - Richard G Jarman
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Stephen J Thomas
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Timothy P Endy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
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Holloway-Kew KL, Zhang Y, Betson AG, Anderson KB, Hans D, Hyde NK, Nicholson GC, Pocock NA, Kotowicz MA, Pasco JA. How well do the FRAX (Australia) and Garvan calculators predict incident fractures? Data from the Geelong Osteoporosis Study. Osteoporos Int 2019; 30:2129-2139. [PMID: 31317250 DOI: 10.1007/s00198-019-05088-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 07/09/2019] [Indexed: 11/26/2022]
Abstract
UNLABELLED This study reports that both FRAX and Garvan calculators underestimated fractures in Australian men and women, particularly in those with osteopenia or osteoporosis. Major osteoporotic fractures were poorly predicted, while both calculators performed acceptably well for hip fractures. INTRODUCTION This study assessed the ability of the FRAX (Australia) and Garvan calculators to predict fractures in Australian women and men. METHODS Women (n = 809) and men (n = 821) aged 50-90 years, enrolled in the Geelong Osteoporosis Study, were included. Fracture risk was estimated using FRAX and Garvan calculators with and without femoral neck bone mineral density (BMD) (FRAXBMD, FRAXnoBMD, GarvanBMD, GarvannoBMD). Incident major osteoporotic (MOF), fragility, and hip fractures over the following 10 years were verified radiologically. Differences between observed and predicted numbers of fractures were assessed using a chi-squared test. Diagnostics indexes were calculated. RESULTS In women, 115 MOF, 184 fragility, and 42 hip fractures occurred. For men, there were 73, 109, and 17 fractures, respectively. FRAX underestimated MOFs, regardless of sex or inclusion of BMD. FRAX accurately predicted hip fractures, except in women with BMD (20 predicted, p = 0.004). Garvan underestimated fragility fractures except in men using BMD (88 predicted, p = 0.109). Garvan accurately predicted hip fractures except for women without BMD (12 predicted, p < 0.001). Fractures were underestimated primarily in the osteopenia and osteoporosis groups; MOFs in the normal BMD group were only underestimated by FRAXBMD and fragility fractures by GarvannoBMD, both in men. AUROCs were not different between scores with and without BMD, except for fragility fractures predicted by Garvan in women (0.696, 95% CI 0.652-0.739 and 0.668, 0.623-0.712, respectively, p = 0.008) and men, which almost reached significance (0.683, 0.631-0.734, and 0.667, 0.615-0.719, respectively, p = 0.051). Analyses of sensitivity and specificity showed overall that MOFs and fragility fractures were poorly predicted by both FRAX and Garvan, while hip fractures were acceptably predicted. CONCLUSIONS Overall, the FRAX and Garvan calculators underestimated MOF and fragility fractures, particularly in individuals with osteopenia or osteoporosis. Hip fractures were predicted better by both calculators. AUROC analyses suggest that GarvanBMD performed better than GarvannoBMD for prediction of fragility fractures.
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Affiliation(s)
| | - Y Zhang
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Australia
| | - A G Betson
- School of Medicine, Deakin University, Geelong, Australia
| | - K B Anderson
- School of Medicine, Deakin University, Geelong, Australia
| | - D Hans
- Center of Bone Diseases, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - N K Hyde
- School of Medicine, Deakin University, Geelong, Australia
| | - G C Nicholson
- Rural Clinical School, The University of Queensland, Toowoomba, QLD, Australia
| | - N A Pocock
- University of New South Wales, Sydney, NSW, Australia
| | - M A Kotowicz
- School of Medicine, Deakin University, Geelong, Australia
- Center of Bone Diseases, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland
- Barwon Health, Geelong, Australia
| | - J A Pasco
- School of Medicine, Deakin University, Geelong, Australia
- Center of Bone Diseases, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland
- Barwon Health, Geelong, Australia
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Anderson KB, Endy TP, Thomas SJ. Finding the Signal in the Noise in the Serologic Diagnosis of Flavivirus Infections. J Infect Dis 2019; 218:516-518. [PMID: 29618090 DOI: 10.1093/infdis/jiy166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/01/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kathryn B Anderson
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis
| | - Timothy P Endy
- State University of New York Upstate Medical University, Syracuse
| | - Stephen J Thomas
- State University of New York Upstate Medical University, Syracuse
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Tam CC, Anderson KB, Offeddu V, Weg A, Macareo LR, Ellison DW, Rangsin R, Fernandez S, Gibbons RV, Yoon IK, Simasathien S. Epidemiology and Transmission of Respiratory Infections in Thai Army Recruits: A Prospective Cohort Study. Am J Trop Med Hyg 2019; 99:1089-1095. [PMID: 30182916 PMCID: PMC6159564 DOI: 10.4269/ajtmh.18-0219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Military recruits are at high risk of respiratory infections. However, limited data exist on military populations in tropical settings, where the epidemiology of respiratory infections differs substantially from temperate settings. We enrolled recruits undertaking a 10-week military training at two Royal Thai Army barracks between May 2014 and July 2015. We used a multiplex respiratory panel to analyze nose and throat swabs collected at the start and end of the training period, and from participants experiencing respiratory symptoms during follow-up. Paired sera were tested for influenza seroconversion using a hemagglutinin inhibition assay. Overall rates of upper respiratory illness and influenza-like illness were 3.1 and 2.0 episodes per 100 person-weeks, respectively. A pathogen was detected in 96% of samples. The most commonly detected microbes were Haemophilus influenzae type B (62.7%) or non–type B (58.2%) and rhinovirus (22.4%). At baseline, bacterial colonization was high and included H. influenzae type B (82.3%), H. influenzae non–type B (31.5%), Klebsiella pneumoniae (14.6%), Staphylococcus aureus (8.5%), and Streptococcus pneumoniae (8.5%). At the end of follow-up, colonization with H. influenzae non–type B had increased to 74.1%, and S. pneumoniae to 33.6%. In the serology subset, the rate of influenza infection was 3.4 per 100 person-months; 58% of influenza infections resulted in clinical disease. Our study provides key data on the epidemiology and transmission of respiratory pathogens in tropical settings. Our results emphasize the need for improved infection prevention and control in military environments, given the high burden of illness and potential for intense transmission of respiratory pathogens.
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Affiliation(s)
- Clarence C Tam
- London School of Hygiene & Tropical Medicine, London, United Kingdom.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health Systems, Singapore, Singapore
| | | | - Vittoria Offeddu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health Systems, Singapore, Singapore
| | - Alden Weg
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Louis R Macareo
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Damon W Ellison
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Ram Rangsin
- Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - In-Kyu Yoon
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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España G, Yao Y, Anderson KB, Fitzpatrick MC, Smith DL, Morrison AC, Wilder-Smith A, Scott TW, Perkins TA. Model-based assessment of public health impact and cost-effectiveness of dengue vaccination following screening for prior exposure. PLoS Negl Trop Dis 2019; 13:e0007482. [PMID: 31260441 PMCID: PMC6625736 DOI: 10.1371/journal.pntd.0007482] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 09/03/2018] [Revised: 07/12/2019] [Accepted: 05/21/2019] [Indexed: 11/18/2022] Open
Abstract
The tetravalent dengue vaccine CYD-TDV (Dengvaxia) is the first licensed vaccine against dengue, but recent findings indicate an elevated risk of severe disease among vaccinees without prior dengue virus (DENV) exposure. The World Health Organization currently recommends CYD-TDV only for individuals with serological confirmation of past DENV exposure. Our objective was to evaluate the potential health impact and cost-effectiveness of vaccination following serological screening. To do so, we used an agent-based model to simulate DENV transmission with and without vaccination over a 10-year timeframe. Across a range of values for the proportion of vaccinees with prior DENV exposure, we projected the proportion of symptomatic and hospitalized cases averted as a function of the sensitivity and specificity of serological screening. Scenarios about the cost-effectiveness of screening and vaccination were chosen to be representative of Brazil and the Philippines. We found that public health impact depended primarily on sensitivity in high-transmission settings and on specificity in low-transmission settings. Cost-effectiveness could be achievable from the perspective of a public payer provided that sensitivity and the value of a disability-adjusted life-year were both high, but only in high-transmission settings. Requirements for reducing relative risk and achieving cost-effectiveness from an individual perspective were more restricted, due to the fact that those who test negative pay for screening but receive no benefit. Our results predict that cost-effectiveness could be achieved only in high-transmission areas of dengue-endemic countries with a relatively high per capita GDP, such as Panamá (13,680 USD), Brazil (8,649 USD), México (8,201 USD), or Thailand (5,807 USD). In conclusion, vaccination with CYD-TDV following serological screening could have a positive impact in some high-transmission settings, provided that screening is highly specific (to minimize individual harm), at least moderately sensitive (to maximize population benefit), and sufficiently inexpensive (depending on the setting).
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Affiliation(s)
- Guido España
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Yutong Yao
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
| | - Kathryn B. Anderson
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - David L. Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
| | - Amy C. Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA
| | - Annelies Wilder-Smith
- Global Health and Vaccinology Programme, Lee Kong Chian School of Medicine, Singapore
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute of Public Health, University of Heidelberg, Germany
| | - Thomas W. Scott
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - T. Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States of America
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Sánchez-Vargas LA, Kounlavouth S, Smith ML, Anderson KB, Srikiatkhachorn A, Ellison DW, Currier JR, Endy TP, Mathew A, Rothman AL. Longitudinal Analysis of Memory B and T Cell Responses to Dengue Virus in a 5-Year Prospective Cohort Study in Thailand. Front Immunol 2019; 10:1359. [PMID: 31263466 PMCID: PMC6585174 DOI: 10.3389/fimmu.2019.01359] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 02/02/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022] Open
Abstract
Prior exposure to dengue virus (DENV) has a profound impact on the outcome of infection, which varies according to the interval between infections. Antibodies secreted by B cells and cytokines secreted by T cells are thought to contribute both to protective immunity against DENV and the pathogenesis of dengue disease. We analyzed peripheral blood mononuclear cells (PBMC) collected from Thai children over a 5-year prospective cohort study to define the dynamics of DENV-specific memory B and T cell responses and the impact of symptomatic or subclinical DENV infections. To measure B cell responses, PBMC were stimulated with IL-2 plus R848 and culture supernatants were tested for DENV-binding antibodies by ELISA. To measure T cell responses, PBMC were stimulated in dual-color ELISPOT assays with overlapping peptide pools of structural and non-structural proteins from the four DENV types. B cell responses were low to one or more DENV types prior to symptomatic infection and increased with reactivity to all four types after infection. Subjects who had a subclinical infection or who did not experience a DENV infection during the study period showed strong memory B cell responses to all four DENV types. T cell responses to DENV peptides demonstrated a cytokine hierarchy of IFN-γ > IL-2 > IFN-γ/IL-2. T cell responses were low or absent prior to secondary infections. The trends in T cell responses to DENV peptides over 3 year post-infection were highly variable, but subjects who had experienced a secondary DENV1 infection showed higher cytokine responses compared to subjects who had experienced a secondary DENV2 or subclinical infection. The longitudinal nature of our study demonstrates persistent memory B cell responses over years and a lasting but variable impact of secondary DENV infection on DENV-specific T cell responses.
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Affiliation(s)
- Luis A Sánchez-Vargas
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Sonia Kounlavouth
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Madison L Smith
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Kathryn B Anderson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Anon Srikiatkhachorn
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Damon W Ellison
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Jeffrey R Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Timothy P Endy
- Department of Microbiology and Immunology, State University of New York-Upstate Medical University, Syracuse, NY, United States
| | - Anuja Mathew
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
| | - Alan L Rothman
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, United States
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Friberg H, Beaumier CM, Park S, Pazoles P, Endy TP, Mathew A, Currier JR, Jarman RG, Anderson KB, Hatch S, Thomas SJ, Rothman AL. Protective versus pathologic pre-exposure cytokine profiles in dengue virus infection. PLoS Negl Trop Dis 2018; 12:e0006975. [PMID: 30557313 PMCID: PMC6312351 DOI: 10.1371/journal.pntd.0006975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/19/2018] [Revised: 12/31/2018] [Accepted: 11/05/2018] [Indexed: 12/21/2022] Open
Abstract
Background Hyperendemic circulation of all four types of dengue virus (DENV-1-4) has expanded globally, fueling concern for increased incidence of severe dengue. While the majority of DENV infections are subclinical, epidemiologic studies suggest that type-cross-reactive immunity can influence disease outcome in subsequent infections. The mechanisms controlling these differential clinical outcomes remain poorly defined. Methodology/Principal findings Blood samples were collected from a cohort of school-aged Thai children who subsequently experienced a subclinical DENV infection or developed dengue illness. PBMC collected prior to infection were stimulated in vitro with DENV and the secretion of 30 cytokines was measured using a multiplexed, bead-based array. Significant differences were found in cytokine production based on both the type of DENV used for stimulation and the occurrence of clinical illness. Secretion of IL-15 and MCP-1 was significantly higher by PBMC of subjects who later developed symptomatic DENV infection. In addition, IL-6 was produced by PBMC from all subjects who subsequently developed symptomatic infection, versus 59% of subjects who had subclinical infection. Secretion of IL-12, IL-2R, MIP-1α, RANTES, GM-CSF, and TNFα was significantly lower by PBMC from subjects with symptomatic infection. Conclusions/Significance These data demonstrate significant differences in pre-existing immune responses to DENV associated with the clinical outcome of subsequent infection. The finding of higher levels of some cytokines in subjects with symptomatic infection and higher levels of other cytokines in subjects with subclinical infection supports the existence of both protective and pathologic immune profiles. Clinical-immunological correlations identified in the context of natural DENV infection may be useful for evaluating immune responses to dengue vaccines. Dengue is one of the most prevalent mosquito-borne infectious diseases worldwide. It is caused by one of four viruses, types 1–4, and ranges in severity from subclinical (mild or no symptoms) to dengue fever (febrile illness with headache and bone pain), or less frequently, dengue hemorrhagic fever, where patients experience leaky blood vessels, sometimes significant bleeding, and may be severe enough to cause death. While many risk factors have been associated with development of severe dengue, sequential infection with different virus types is a major factor, implying that the immune response generated after an initial infection is partly responsible for making subsequent exposure clinically worse. This study sought to identify profiles of immune markers that correlate with increased or decreased risk of dengue. Using samples from individuals ~5 months prior to dengue virus infection, who later experienced either subclinical infection or overt disease, we modeled virus exposure in vitro and compared the production of various immune proteins between the two outcome groups. Three of the proteins studied were produced at higher levels by subjects who subsequently had dengue, and six of the proteins were produced at higher levels by subjects who subsequently had subclinical infection. These results help define what constitutes beneficial versus potentially harmful immune responses, aiding in the design of effective dengue vaccines.
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Affiliation(s)
- Heather Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- * E-mail:
| | - Coreen M. Beaumier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Sangshin Park
- Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Pamela Pazoles
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Timothy P. Endy
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Anuja Mathew
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, Rhode Island, United States of America
| | - Jeffrey R. Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Richard G. Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Kathryn B. Anderson
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Steven Hatch
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Stephen J. Thomas
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Alan L. Rothman
- Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, Rhode Island, United States of America
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Anderson KB, Endy TP, Thomas SJ. The dynamic role of dengue cross-reactive immunity: changing the approach to defining vaccine safety and efficacy. The Lancet Infectious Diseases 2018; 18:e333-e338. [DOI: 10.1016/s1473-3099(18)30126-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 12/12/2017] [Accepted: 01/25/2018] [Indexed: 12/11/2022]
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Tam CC, Offeddu V, Anderson KB, Weg AL, Macareo LR, Ellison DW, Rangsin R, Fernandez S, Gibbons RV, Yoon IK, Simasathien S. Association between semi-quantitative microbial load and respiratory symptoms among Thai military recruits: a prospective cohort study. BMC Infect Dis 2018; 18:462. [PMID: 30217168 PMCID: PMC6137728 DOI: 10.1186/s12879-018-3358-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/23/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Multiplex real-time polymerase chain reaction assays have improved diagnostic sensitivity for a wide range of pathogens. However, co-detection of multiple agents and bacterial colonization make it difficult to distinguish between asymptomatic infection or illness aetiology. We assessed whether semi-quantitative microbial load data can differentiate between symptomatic and asymptomatic states for common respiratory pathogens. METHODS We obtained throat and nasal swab samples from military trainees at two Thai Army barracks. Specimens were collected at the start and end of 10-week training periods (non-acute samples), and from individuals who developed upper respiratory tract infection during training (acute samples). We analysed the samples using a commercial multiplex respiratory panel comprising 33 bacterial, viral and fungal targets. We used random effects tobit models to compare cycle threshold (Ct) value distributions from non-acute and acute samples. RESULTS We analysed 341 non-acute and 145 acute swab samples from 274 participants. Haemophilus influenzae type B was the most commonly detected microbe (77.4% of non-acute and 64.8% of acute samples). In acute samples, nine specific microbe pairs were detected more frequently than expected by chance. Regression models indicated significantly lower microbial load in non-acute relative to acute samples for H. influenzae non-type B, Streptococcus pneumoniae and rhinovirus, although it was not possible to identify a Ct-value threshold indicating causal etiology for any of these organisms. CONCLUSIONS Semi-quantitative measures of microbial concentration did not reliably differentiate between illness and asymptomatic colonization, suggesting that clinical symptoms may not always be directly related to microbial load for common respiratory infections.
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Affiliation(s)
- Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore. .,London School of Hygiene & Tropical Medicine, WC1E7HT, London, UK.
| | - Vittoria Offeddu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Kathryn B Anderson
- University of Minnesota, Minneapolis, 55455, USA.,Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Alden L Weg
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Louis R Macareo
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Damon W Ellison
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | | | - In-Kyu Yoon
- International Vaccine Institute, Seoul, 08826, South Korea
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Anderson KB, Bohanon L. Book Review: Toxic relationships: Knowing the rules and dealing with the friends who break them. Psychology of Women Quarterly 2016. [DOI: 10.1177/0361684316638497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Zika virus (ZIKV) is yet another arbovirus that is rapidly emerging on a global scale, on the heels of a chikungunya epidemic in the Americas that began in 2013. A ZIKV epidemic that began in Brazil in 2015 has now spread rapidly to more than 30 countries in the Americas and the Caribbean, infecting more than 2 million inhabitants. This epidemic currently continues unabated. The explosive nature of recent outbreaks and concerning links to Guillain-Barré syndrome and microcephaly are incompletely understood. Also unknown is the relative importance of sexual transmission of ZIKV and asymptomatic ZIKV infections to the overall burden of transmission. The limited understanding of ZIKV presents an enormous challenge for responses to this rapidly emerging threat to human health. This article reviews the existing literature on ZIKV and proposes critical questions for vaccine development and other areas of needed research.
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Abstract
An overview discusses (a) the importance of rape attitudes, (b) the major rape attitude measures, and (c) the applicability of four theoretical frameworks of hostility toward women to rape attitude maintenance. Findings from 72 studies of rape attitudes and individual differences were quantitatively synthesized. The meta-analysis revealed more rape acceptance for men, older people, and people from lower socioeconomic status backgrounds. For men, cognitive predispositions toward perpetrating rape were strong predictors of rape acceptance. For women, experience as and exposure to rape victims were associated with slightly less rape acceptance. Consistent with some theoretical predictions, traditional gender role beliefs, adversarial sexual beliefs, needs for power and dominance, aggressiveness and anger, and conservative political beliefs predicted rape acceptance. Implications for rape education programs and research are discussed.
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Peeraphatdit T, Gulleen EA, Anderson KB, Chaiteerakij R, Skarda PK. Letter: underutilisation of albumin infusion in high-risk spontaneous bacterial peritonitis. Aliment Pharmacol Ther 2015; 42:241-2. [PMID: 26081688 DOI: 10.1111/apt.13252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- T Peeraphatdit
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - E A Gulleen
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - K B Anderson
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - R Chaiteerakij
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - P K Skarda
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA.,Department of Internal Medicine, Regions Hospital, Saint Paul, MN, USA
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Anderson KB, Pureza V, Walker PF. Chikungunya: acute fever, rash and debilitating arthralgias in a returning traveler from Haiti. J Travel Med 2014; 21:418-20. [PMID: 25345984 DOI: 10.1111/jtm.12159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/21/2014] [Accepted: 07/21/2014] [Indexed: 11/29/2022]
Abstract
The following case report details a case of chikungunya fever in a returning traveler from Haiti. The report highlights the clinical presentation and natural history of the disease, and emphasizes that chikungunya has become established in the western hemisphere, with a resultant need for heightened provider awareness.
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Arnold KB, Hermos JA, Anderson KB, Minasian LM, Cook ED. Retention of Black and White Populations in the Selenium and Vitamin E Cancer Prevention Trial. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1055-9965.epi-14-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Adequate retention of Black (African-American) participants in long-term, randomized trials is important for achieving broadly applicable results. Purpose: To determine the incidence of retention failures and the individual and study site factors associated with retention failure among White and Black participants from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), a phase III study of selenium and vitamin E for prevention of prostate cancer. Methods: SELECT randomized 35,533 participants from 427 study sites. Age eligibility was >55 years for Whites, >50 years for Blacks; race was determined by self-report. The primary analysis included 28,118 (87%) White and 4,322 (13%) Black men. Time to retention failure was defined as days to the earliest of either (1) the second consecutive missed in-person or phone visit or (2) refusal of future contact with study staff. Covariates included participant demographic and clinical characteristics, reasons for participating in SELECT and study site characteristics. Results: In SELECT, Blacks had a higher age-adjusted risk of disengagement than Whites [HR = 1.9; 95% CI 1.7–2.0; p-value < .0001]. Younger Black participants, age 50–54, representing 32% of Black participants, were at three times the risk of disengagement than those age 65+ [HR = 3.34, 95%CI 2.24,4.94, p < .0001]. Blacks age 65+ had 1.6 times the risk of disengagement than Whites age 65+ [HR = 1.58, 95%CI 1.37, 1.83, p < .0001]. By six years post-randomization, 83% of Whites were still retained on the study compared to 68% of Blacks. Among Whites, participant risk factors for disengagement were Hispanic ethnicity, graduate degree, living alone or current smoking; among Blacks, younger age and current smoking were risk factors. The site characteristic associated with disengagement among both racial groups was staff missing SELECT training sessions. Sites with a low staff attendance at training sessions had a high percentage of disengaged participants of either race. Both Whites and Blacks at sites receiving SELECT retention and adherence grants had lower risks for retention failure. Conclusion: These results may be useful in identifying personal and study site characteristics to guide recruitment and enhance retention of both Black and White men in long-term prevention trials.
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Anderson KB, Gibbons RV, Cummings DAT, Nisalak A, Green S, Libraty DH, Jarman RG, Srikiatkhachorn A, Mammen MP, Darunee B, Yoon IK, Endy TP. A shorter time interval between first and second dengue infections is associated with protection from clinical illness in a school-based cohort in Thailand. J Infect Dis 2013; 209:360-8. [PMID: 23964110 DOI: 10.1093/infdis/jit436] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite the strong association between secondary dengue virus (DENV) infections and dengue hemorrhagic fever (DHF), the majority of secondary infections are subclinical or mild. The determinants of clinical severity remain unclear, though studies indicate a titer-dependent and time-dependent role of cross-protective anti-DENV antibodies. METHODS Data from 2 sequential prospective cohort studies were analyzed for subclinical and symptomatic DENV infections in schoolchildren in Kamphaeng Phet, Thailand (1998-2002 and 2004-2007). Children experiencing ≥ 1 DENV infection were selected as the population for analysis (contributing 2169 person-years of follow-up). RESULTS In total, 1696 children had ≥ 1 DENV infection detected during their enrollment; 268 experienced 2 or more infections. A shorter time interval between infections was associated with subclinical infection in children seronegative for DENV at enrollment, for whom a second-detected DENV infection is more likely to reflect a true second infection (average of 2.6 years between infections for DHF, 1.9 for DF, and 1.6 for subclinical infections). CONCLUSIONS These findings support a pathogenesis model where cross-reactive antibodies wane from higher-titer, protective levels to lower-titer, detrimental levels. This is one of the first studies of human subjects to suggest a window of cross-protection following DENV infection since Sabin's challenge studies in the 1940s.
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Affiliation(s)
- Kathryn B Anderson
- Department of Medicine, University of Minnesota Medical School, Minneapolis
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Anderson KB. Book Review: Domestic Violence and Psychology: A Critical Perspective. Psychology of Women Quarterly 2011. [DOI: 10.1177/0361684311417404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Anderson KB, Gibbons RV, Thomas SJ, Rothman AL, Nisalak A, Berkelman RL, Libraty DH, Endy TP. Preexisting Japanese encephalitis virus neutralizing antibodies and increased symptomatic dengue illness in a school-based cohort in Thailand. PLoS Negl Trop Dis 2011; 5:e1311. [PMID: 21991398 PMCID: PMC3186763 DOI: 10.1371/journal.pntd.0001311] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [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: 01/30/2011] [Accepted: 07/28/2011] [Indexed: 11/18/2022] Open
Abstract
Background Dengue viruses (DENVs) and Japanese encephalitis virus (JEV) have significant cross-reactivity in serological assays; the clinical implications of this remain undefined. An improved understanding of whether and how JEV immunity modulates the clinical outcome of DENV infection is important as large-scale DENV vaccine trials will commence in areas where JEV is co-endemic and/or JEV immunization is routine. Methods and Findings The association between preexisting JEV neutralizing antibodies (NAbs) and the clinical severity of DENV infection was evaluated in a prospective school-based cohort in Thailand that captured asymptomatic, non-hospitalized, and hospitalized DENV infections. Covariates considered included age, baseline DENV antibody status, school of attendance, epidemic year, and infecting DENV serotype. 942 children experienced at least one DENV infection between 1998 and 2002, out of 3,687 children who were enrolled for at least one full year. In crude analysis, the presence of JEV NAbs was associated with an increased occurrence of symptomatic versus asymptomatic infection (odds ratio [OR] = 1.55, 95% CI: 1.08–2.23) but not hospitalized illness or dengue hemorrhagic fever (DHF). The association was strongest in children with negative DENV serology (DENV-naive) (OR = 2.75, 95% CI: 1.12–6.72), for whom the presence of JEV NAbs was also associated with a symptomatic illness of longer duration (5.4 days for JEV NAb+ versus 2.6 days for JEV NAb-, p = 0.048). JEV NAbs were associated with increased DHF in younger children with multitypic DENV NAb profiles (OR = 4.05, 95% CI: 1.18 to 13.87). Among those with JEV NAbs, the association with symptomatic illness did not vary by antibody titer. Interpretation The prior existence of JEV NAbs was associated with an increased probability of symptomatic as compared to asymptomatic DENV illness. These findings are in contrast to previous studies suggesting an attenuating effect of heterologous flavivirus immunity on DENV disease severity. Dengue viruses (DENVs) and Japanese encephalitis virus (JEV) have significant cross-reactivity in serological assays, but the possible clinical implications of this remain poorly understood. Interactions between these flaviviruses are potentially important for public health because wild-type JEV continues to co-circulate with DENV in Southeast Asia, the area with the highest burden of DENV illness, and JEV vaccination coverage in this region is high. In this study, we examined how preexisting JEV neutralizing antibodies (NAbs) influenced the clinical severity of subsequent DENV infection using data from a prospective school-based cohort study in Thailand that captured a wide range of clinical severities, including asymptomatic, non-hospitalized, and hospitalized DENV infections. We found that the prior existence of JEV NAbs was associated with an increased occurrence of symptomatic versus asymptomatic DENV infection. This association was most notable in DENV-naives, in whom the presence of JEV NAbs was also associated with an illness of longer duration. These findings suggest that the issue of heterologous flavivirus immunity and DENV infection merits renewed attention and interest and that DENV vaccine developers might incorporate detailed assessments of preexisting immunity to non-DENV flaviviruses and histories of vaccination against non-DENV flaviviruses in evaluating DENV vaccine safety and efficacy.
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Affiliation(s)
- Kathryn B. Anderson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Robert V. Gibbons
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Stephen J. Thomas
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Alan L. Rothman
- University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Ananda Nisalak
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Ruth L. Berkelman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Daniel H. Libraty
- University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Timothy P. Endy
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Jarman RG, Nisalak A, Anderson KB, Klungthong C, Thaisomboonsuk B, Kaneechit W, Kalayanarooj S, Gibbons RV. Factors influencing dengue virus isolation by C6/36 cell culture and mosquito inoculation of nested PCR-positive clinical samples. Am J Trop Med Hyg 2011; 84:218-23. [PMID: 21292887 DOI: 10.4269/ajtmh.2011.09-0798] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [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
Dengue viral isolation is necessary for definitive diagnosis, pathogenesis and evolutionary research, vaccine candidates, and diagnostic materials. Using standardized techniques, we analyzed isolation rates of 1,544 randomly selected polymerase chain reaction (PCR)-positive samples, representing all four dengue serotypes, from patients with serologically confirmed dengue infections and evaluated whether clinical and laboratory results could be predictive of isolation using standard and mosquito isolation techniques. Viruses were isolated from 62.5% of the samples by direct application to C6/36 cells and increased to 79.4% when amplifying C6/36 negative samples by intrathorasic inoculation in Toxyrhynchites splendens mosquitoes. High viremia, measured by reverse transcriptase (RT)-PCR, was a strong predictor for viral isolation by either method. Isolation was most successful in samples collected early in the disease, had low antibody levels, temperatures greater than 38°C, and had a final clinical diagnosis of dengue fever. Dengue serotypes also played a role in the success of viral isolation.
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Affiliation(s)
- Richard G Jarman
- Department of Virology, United States Army Medical Component, Armed Forces Research, Institute of Medical Sciences, Bangkok, Thailand.
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Thomas SJ, Nisalak A, Anderson KB, Libraty DH, Kalayanarooj S, Vaughn DW, Putnak R, Gibbons RV, Jarman R, Endy TP. Dengue plaque reduction neutralization test (PRNT) in primary and secondary dengue virus infections: How alterations in assay conditions impact performance. Am J Trop Med Hyg 2009; 81:825-33. [PMID: 19861618 DOI: 10.4269/ajtmh.2009.08-0625] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [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
Dengue virus (DENV) infection is a worsening global health problem. The plaque reduction neutralization test (PRNT) is currently considered to be the "gold standard" to characterize and quantify circulating levels of anti-DENV neutralizing antibody (NAb). Many variations of the PRNT are currently in use and neither the assay nor its performance conditions have been standardized or harmonized between laboratories. We used a well-characterized panel of acute and late convalescent follow-up sera samples from children experiencing primary and secondary DENV infections to evaluate the performance of the dengue PRNT under a variety of testing conditions. Investigators varied cell type, control virus passage, and the use of complement across multiple assay runs of the same sample panel. Our findings indicate wide variation in PRNT titer results in response to varied testing conditions.
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Affiliation(s)
- Stephen J Thomas
- Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
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Abstract
Two studies examined the effects of individual differences identified by the Confluence Model of aggression against women [Malamuth Linz, Hevey et al., 1995] and the General Aggression Model [GAM: Anderson and Carnagey, 2004] as predictors of male-on-female aggression. Study 1, a correlational study, found that hostile masculinity predicts self-reported sexual aggression independently of nonsexual aggression against women, and is itself predicted by proneness to general hostility, masculine gender role stress, and violent attitudes toward women. Furthermore, hostility toward women independently predicted sexual and nonsexual aggression against women, above the effects of general attitudes toward violence and general levels of hostility and aggression. Study 2, an experimental study, found that under high provocation, high hostility toward women predicted increases in male nonsexual aggression against women and slight decreases in male aggression against men. This effect remained significant even after controlling for general attitudes toward violence and for general levels of hostility and aggression, indicating that males who are highly hostile toward women specifically target women and that their aggression toward women generalizes beyond sexual aggression. The findings are discussed in terms of a model that integrates the Confluence Model with GAM.
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Affiliation(s)
- Craig A Anderson
- Department of Psychology and the Center for the Study of Violence, Iowa State University, Ames, Iowa 50011-3180, USA.
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Castaño MT, Biever JL, González CG, Anderson KB. Challenges of providing mental health services in Spanish. Professional Psychology: Research and Practice 2007. [DOI: 10.1037/0735-7028.38.6.667] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Anderson CA, Anderson KB, Dorr N, DeNeve KM, Flanagan M. Temperature and aggression. Advances in Experimental Social Psychology Volume 32 2000. [DOI: 10.1016/s0065-2601(00)80004-0] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Wong KK, Anderson KB, Kibblewhite R. Effects of the laccase-mediator system on the handsheet properties of two high kappa kraft pulps. Enzyme Microb Technol 1999. [DOI: 10.1016/s0141-0229(99)00022-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nedelcheva Kristensen V, Haraldsen EK, Anderson KB, Lønning PE, Erikstein B, Kåresen R, Gabrielsen OS, Børresen-Dale AL. CYP17 and breast cancer risk: the polymorphism in the 5' flanking area of the gene does not influence binding to Sp-1. Cancer Res 1999; 59:2825-8. [PMID: 10383140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The ability of a motif of the CYP17 5' untranslated region, created by a polymorphic T to C substitution, to bind to the human transcription factor Sp-1 was investigated. No binding of any of the polymorphic alleles was observed in electromobility shift assay. No other sequence within +1 to +100 of each of the CYP17 alleles formed complex with the Sp-1 or enhanced binding to the polymorphic CACC box. Genotyping of 510 breast cancer patients and 201 controls revealed no difference in genotype frequencies. Age at onset, tumor grade, lymph node status and distant metastases, stage, and estrogen and progesterone receptor status were not associated with the CYP17 genotype.
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Affiliation(s)
- V Nedelcheva Kristensen
- Department of Genetics, Institute of Cancer Research, the Norwegian Radium Hospital, University Clinic, Oslo.
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Anderson KB, Ede RM, Franich RA, Kroese HW, Lloyd JA, Meder R. Preparation of Dehydroabietic Acid and “Dihydroabietic Lactone” by Disproportionation of Tall Oil Rosin with Trifluoroacetic Acid. SYNTHETIC COMMUN 1998. [DOI: 10.1080/00397919808006835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Anderson CA, Anderson KB. Violent crime rate studies in philosophical context: A destructive testing approach to heat and southern culture of violence effects. J Pers Soc Psychol 1996. [DOI: 10.1037/0022-3514.70.4.740] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Olsson PJ, Fierer JA, Kelly CE, Wright RW, Blaise D, Anderson KB, Peterson JC, Alexander RW. Renal carcinoma and dialysis in end-stage renal disease. South Med J 1985; 78:507-12. [PMID: 3992297 DOI: 10.1097/00007611-198505000-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We describe five patients receiving long-term hemodialysis (mean duration of 6.4 years) in whom eight renal carcinomas were found. In four patients, the carcinoma was confirmed by tissue pathology, while the fifth patient had multiple (four) areas of neovascularity on selective renal arteriography. Two patients died of metastases. In four patients the diagnosis was initially made with selective renal arteriography and in the remaining one, with sonography and computerized tomography. In three of the four arteriography showed diffuse cystic degeneration; pathologic findings revealed renal carcinoma and the changes of "end-stage" disease. Two patients had brief pharmacologic immunosuppression during unsuccessful renal transplantation six years earlier. These cases demonstrate an apparently increased risk of renal carcinomas in end-stage renal disease, a risk that appears to be independent of pharmacologic immunosuppression.
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