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Burnett E, Riaz A, Anwari P, Myat TW, Chavers TP, Talat N, Safi N, Aung NNT, Cortese MM, Sultana S, Samsor A, Thu HM, Saddal NS, Safi S, Lin H, Qazi SH, Safi H, Ali A, Parashar UD, Tate JE. Intussusception risk following oral monovalent rotavirus vaccination in 3 Asian countries: A self-control case series evaluation. Vaccine 2023; 41:7220-7225. [PMID: 37884416 PMCID: PMC10929074 DOI: 10.1016/j.vaccine.2023.10.042] [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: 07/24/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023]
Abstract
Rotavirus vaccines have substantially decreased rotavirus hospitalizations in countries where they have been implemented. In some high- and middle-income countries, a low-level of increased risk of intussusception, a type of acute bowel obstruction, has been detected following rotavirus vaccination. However, no increased risk of intussusception was found in India, South Africa, or a network of 7 other African countries. We assessed the association between a 2-dose monovalent rotavirus vaccine (Rotarix) and intussusception in 3 early-adopter low-income Asian countries -- Afghanistan, Myanmar, and Pakistan. Children <12 months of age admitted to a sentinel surveillance hospital with Brighton level 1 intussusception were eligible for enrollment. We collected information about each child's vaccination status and used the self-controlled case series method to calculate the relative incidence of intussusception 1-7 days, 8-21 days, and 1-21 days following each dose of vaccine and derived confidence intervals with bootstrapping. Of the 585 children meeting the analytic criteria, the median age at intussusception symptom onset was 24 weeks (IQR: 19-29). Overall, 494 (84 %) children received the first Rotarix dose and 398 (68 %) received the second dose. There was no increased intussusception risk during any of the risk periods following the first (1-7 days: 1.01 (95 %CI: 0.39, 2.60); 8-21 days: 1.37 (95 %CI: 0.81, 2.32); 1-21 days: 1.28 (95 %CI: 0.78, 2.11)) or second (1-7 days: 0.81 (95 %CI: 0.42, 1.54); 8-21 days: 0.77 (95 %CI: 0.53, 1.16); 1-21 days: 0.78 (95 %CI: 0.53, 1.16)) rotavirus vaccine dose. Our findings are consistent with other data showing no increased intussusception risk with rotavirus vaccination in low-income countries and add to the growing body of evidence demonstrating safety of rotavirus vaccines.
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Affiliation(s)
| | - Atif Riaz
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | | | - Nabila Talat
- Pediatric Surgery Unit, University of Child Health Sciences and Children Hospital, Lahore, Pakistan
| | | | | | | | - Shazia Sultana
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | | | | | - Htin Lin
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Saqib Hamid Qazi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Yadana S, Valitutto MT, Aung O, Hayek LAC, Yu JH, Myat TW, Lin H, Htun MM, Thu HM, Hagan E, Francisco L, Murray S. Assessing Behavioral Risk Factors Driving Zoonotic Spillover Among High-risk Populations in Myanmar. Ecohealth 2023:10.1007/s10393-023-01636-9. [PMID: 37256491 DOI: 10.1007/s10393-023-01636-9] [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] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/22/2023] [Indexed: 06/01/2023]
Abstract
The increasing global emergence of zoonoses warrants improved awareness of activities that predispose vulnerable communities to greater risk of disease. Zoonotic disease outbreaks regularly occur within Myanmar and at its borders partly due to insufficient knowledge of behavioral risks, hindering participatory surveillance and reporting. This study employed a behavioral surveillance strategy among high-risk populations to understand the behavioral risks for zoonotic disease transmission in an effort to identify risk factors for pathogen spillover. To explore behavioral mechanisms of spillover in Myanmar, we aimed to: (1) evaluate the details around animal contact and types of interaction, (2) assess the association between self-reported unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) and animal contact activities and (3) identify the potential risk factors including behavioral practices of self-reported illness. Participants were enrolled at two community sites: Hpa-An and Hmawbi in Southern Myanmar. A behavioral questionnaire was administered to understand participants' animal exposures, behaviors and self-reported illnesses. From these responses, associations between (1) animal contact activities and self-reported unusual illnesses, and (2) potential risk factors and self-reported unusual illness were tested. Contact with poultry seemed to be very frequent (91.1%) and many participants reported raising, handling and having poultry in their houses as well as slaughtering or being scratched/bitten by them, followed by contact with rodents (57.8%) and swine (17.9%). Compared to participants who did not have any unusual symptoms, participants who had unusual symptoms in the past year were more likely to have sold dead animals (OR = 13.6, 95% CI 6.8-27.2), slaughtered (OR = 2.4, 95% CI 1.7-3.3), raised (OR = 3.4, 95% CI 2.3-5.0) or handled animals (OR = 2.1, 95% CI 1.2-3.6), and had eaten sick (OR = 4.4, 95% CI 3.0-6.4) and/or dead animals (OR = 6.0, 95% CI 4.1-8.8) in the same year. Odds of having reported unusual symptoms was higher among those involved in animal production business (OR = 3.4, 95% CI 1.9-6.2) and animal-involved livelihoods (OR = 3.3, 95% CI 1.5-7.2) compared to other livelihoods. The results suggest that there is a high level of interaction between humans, livestock and wild animals in communities we investigated in Myanmar. The study highlights the specific high-risk behaviors as they relate to animal contact and demographic risk factors for zoonotic spillover. Our findings contribute to human behavioral data needed to develop targeted interventions to prevent zoonotic disease transmission at human-animal interfaces.
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Affiliation(s)
- Su Yadana
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Marc T Valitutto
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA.
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA.
| | - Ohnmar Aung
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Lee-Ann C Hayek
- National Museum of Natural History, Smithsonian Institution. 10th St. & Constitution Ave NW, Washington DC, 20560, USA
| | - Jennifer H Yu
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Theingi Win Myat
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Htin Lin
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Moh Moh Htun
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Hlaing Myat Thu
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Emily Hagan
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Leilani Francisco
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Suzan Murray
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
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Myat TW, Thu HM, Tate JE, Burnett E, Cates JE, Parashar UD, Kyaw YM, Khaing TEE, Moh KM, Win NN, Khine WK, Kham MMZ, Kyaw T, Khine YY, Oo KK, Aung KM. Rotavirus infection among children under five years of age hospitalized with acute gastroenteritis in Myanmar during 2018-2020 - Multicentre surveillance before rotavirus vaccine introduction. Vaccine 2021; 39:6907-6912. [PMID: 34702620 PMCID: PMC10862084 DOI: 10.1016/j.vaccine.2021.10.014] [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: 05/21/2021] [Revised: 09/24/2021] [Accepted: 10/09/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Rotavirus gastroenteritis (RVGE) is a leading cause of severe diarrhea in children under-five worldwide, with the majority of mortality in lower -income countries. This study aimed to provide baseline information on epidemiology of rotavirus and circulating strains before rotavirus vaccine introduction in Myanmar. METHODS Hospital-based, prospective surveillance was conducted from May 2018 to January 2020 at four sentinel sites; two hospitals in Lower Myanmar, one hospital each in Middle Myanmar and East Myanmar. Children under five years of age hospitalized for acute gastroenteritis were enrolled; demographic and clinical data were collected. Stool samples were screened by ELISA (ProSpecT™ Rotavirus, OXOID-UK) for rotavirus antigen and a subset of ELISA positive samples were genotyped by reverse transcription polymerase chain reaction. RESULTS Rotavirus was detected in 45.7% (799/1750) of cases enrolled at three sites in May 2018-April 2019 and 42.5% (521/1227) at four sites in May 2019-January 2020. RVGE cases were predominantly male (58.7%; 775/1320) and 92.6% (1223/1320) of RVGE cases occurred in <2 years old. Rotavirus detection was higher in the cold and dry season (November-April). RVGE compared to non-RVGE cases had more frequent vomiting (78.3% Vs 68.1%, p < 0.01), fever (65.8% Vs 61.3%, p = 0.01), severe dehydration (3.6% Vs 2.1%, p < 0.01) and requirement of treatment by IV fluid (58.3% Vs 53.1%, p < 0.01). The most prevalent genotypes identified were G1P[6] (113/359, 31.5%), G1P[8] (94/359, 26.2%) and G2P[4] (33/359, 9.2%). CONCLUSIONS This study confirms the persistent high prevalence of RVGE among children under-five admitted to hospitals in different parts of Myanmar and the diversity of rotavirus strains over time prior to vaccine introduction. The rotavirus vaccine was introduced nationwide in February 2020 in Myanmar and these data will be important baseline data for post-vaccination monitoring of vaccine impact and circulating strains.
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Affiliation(s)
- Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, Myanmar.
| | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | | | | | | | | | - Ye Myint Kyaw
- Yangon Children's Hospital, Ministry of Health and Sports, Myanmar
| | - Tin Ei Ei Khaing
- 550 Bedded Children's Hospital, Mandalay, Ministry of Health and Sports, Myanmar
| | - Khin Moh Moh
- Women and Children Hospital (Shan State, Taunggyi), Ministry of Health and Sports, Myanmar
| | - Nwet Nwet Win
- North Okkalapa General and Teaching Hospital, Ministry of Health and Sports, Myanmar
| | - Win Kay Khine
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Myat Mo Zar Kham
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Thida Kyaw
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Yin Yin Khine
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Khin Khin Oo
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Khaing Moe Aung
- Department of Medical Research, Ministry of Health and Sports, Myanmar
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Evans TS, Myat TW, Hom NS, Ricks KM, Maw MT, Oo ZM, Toe AT, Aung NT, Aung P, Aung TH, Kuehnert P, Thant KZ, Win YT, Thein WZ, Gardner NR, Schoepp RJ, Johnson CK, Thu HM. Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Logging Communities, Myanmar. Emerg Infect Dis 2021; 27:1709-1713. [PMID: 34013868 PMCID: PMC8153884 DOI: 10.3201/eid2706.203223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Asia, infecting many animal hosts, but CCHFV has not been reported in Myanmar. We conducted a seroepidemiologic survey of logging communities in Myanmar and found CCHFV exposure was common (9.8%) and exposure to wild animal blood and body fluids was associated with seropositivity.
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Nyunt MH, Soe HO, Aye KT, Aung WW, Kyaw YY, Kyaw AK, Myat TW, Latt AZ, Win MM, Win AA, Htun YM, Zaw KM, Ei PW, Hein KT, San LL, Oo NAT, Lin H, Mon NCN, Yee KT, Htun KL, Aye LPP, Ko YK, Htoo THH, Aung KM, Azili H, Han SS, Zaw NN, Win SM, Thwe WM, Aye TT, Hlaing MS, Minn WY, Thu PP, Thu HM, Htun ZT. Surge of severe acute respiratory syndrome coronavirus 2 infections linked to single introduction of a virus strain in Myanmar, 2020. Sci Rep 2021; 11:10203. [PMID: 33986354 PMCID: PMC8119731 DOI: 10.1038/s41598-021-89361-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/23/2021] [Indexed: 01/19/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a major health concern globally. Genomic epidemiology is an important tool to assess the pandemic of coronavirus disease 2019 (COVID-19). Several mutations have been reported by genome analysis of the SARS-CoV-2. In the present study, we investigated the mutational and phylogenetic analysis of 30 whole-genome sequences for the virus's genomic characteristics in the specimens collected in the early phase of the pandemic (March-June, 2020) and the sudden surge of local transmission (August-September, 2020). The four samples in the early phase of infection were B.6 lineage and located within a clade of the samples collected at the same time in Singapore and Malaysia, while five returnees by rescue flights showed the lineage B. 1.36.1 (three from India), B.1.1 (one from India) and B.1.80 (one from China). However, there was no evidence of local spread from these returnees. Further, all 19 whole-genome sequences collected in the sudden surge of local transmission showed lineage B.1.36. The surge of the second wave on SARS-CoV-2 infection was linked to the single-introduction of a variant (B.1.36) that may result from the strict restriction of international travel and containment efforts. These genomic data provides the useful information to disease control and prevention strategy.
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Affiliation(s)
- Myat Htut Nyunt
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar.
| | - Hnin Ohnmar Soe
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Kay Thi Aye
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Wah Wah Aung
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Yi Yi Kyaw
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Aung Kyaw Kyaw
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Aung Zaw Latt
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Min Min Win
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Aye Aye Win
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Yin Min Htun
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Khaing Mar Zaw
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Phyu Win Ei
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Kyaw Thu Hein
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Lai Lai San
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Nan Aye Thida Oo
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Htin Lin
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Nan Cho Nwe Mon
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Khin Than Yee
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Khin Lapyae Htun
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Lynn Pa Pa Aye
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Yamin Ko Ko
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Thitsar Htet Htet Htoo
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Kham Mo Aung
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Hnin Azili
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Soe Soe Han
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Ni Ni Zaw
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Su Mon Win
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Wai Myat Thwe
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Thin Thin Aye
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Myat Su Hlaing
- Department of Microbiology, University of Medicine-2, Yangon, Republic of the Union of Myanmar
| | - Wai Yan Minn
- Department of Microbiology, University of Medicine-2, Yangon, Republic of the Union of Myanmar
| | - Pyae Phyo Thu
- Department of Microbiology, University of Medicine-2, Yangon, Republic of the Union of Myanmar
| | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
| | - Zaw Than Htun
- Department of Medical Research, Ministry of Health and Sports, 5, Ziwaka Road, Dagon, Yangon, 11191, Republic of the Union of Myanmar
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Myat TW, Thin Aung NN, Thu HM, Aye A, Win NN, Lwin MM, Lin H, Hom NS, Lin KS, Htun MM. Epidemiology of intussusception among children less than 2 years of age; findings from baseline surveillance before rotavirus vaccine introduction in Myanmar. Heliyon 2021; 7:e06601. [PMID: 33855244 PMCID: PMC8026906 DOI: 10.1016/j.heliyon.2021.e06601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/18/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background Rotavirus vaccine was planned to be introduced in the National Immunization Program of Myanmar in 2020. Reported potential association of a small increased risk of intussusception after rotavirus vaccination in some countries is a major safety concern and it is mandatory to collect baseline information before vaccine introduction. Methods Retrospective study reviewed medical records of intussusception cases for past 3 years (2015-2018) and prospective, active study was conducted from August 2018 to January 2020 at three tertiary children hospitals where pediatric surgical facility is present. Brighton Level 1 Criteria was used for confirmation of intussusception among children <2 years of age admitted to surgical wards. Demographic, clinical, diagnostic and treatment practices data were collected and descriptive data analysis was performed. Results A total of 697 (421 in retrospective and 276 in prospective) confirmed intussusception cases were identified. Majority of intussusception cases (550/697, 78.9%) were observed in the first year of life and most frequent between 5-7 months of age (292/697, 41.9%) with a peak at 6 months (114/697, 16.4%). The most common clinical presentations were vomiting and bloody diarrhea accounting 82.1% and 77.5% respectively. Regarding diagnosis and treatment, 458/697 (65.7%) required surgical intervention either manual reduction or intestinal resection and 34.4% by either air or barium enema. Overall mortality was 0.7% (5/697) and four out of five children died needed intestinal resection. Late arrival to hospital (>3days after onset) is significantly associated with requirement of surgery (61/85, 71.8%), which in turn is significantly associated with longer hospital stay (296/452, 65.5%) (p < 0.05). Conclusions Intussusception occurrence is most frequent between 5-7 months age group which is old enough to be vaccinated under the schedule that has now been introduced in Myanmar. More than half of the cases were treated by surgery and late arrival to hospital enhances requirement of surgery and poor outcome. Findings of this baseline surveillance provide important facts for public health officials in balancing risks and benefits of rotavirus vaccine introduction, defining targeted age and dosage scheduling and facilitate monitoring system in post-vaccination.
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Affiliation(s)
- Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | | | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Aye Aye
- Yangon Children's Hospital, Ministry of Health and Sports, Myanmar
| | - Nyo Nyo Win
- Yankin Children Hospital, Ministry of Health and Sports, Myanmar
| | - Maung Maung Lwin
- 550 Bedded Children's Hospital, Mandalay, Ministry of Health and Sports, Myanmar
| | - Htin Lin
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Nang Sarm Hom
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Kyaw Swar Lin
- 550 Bedded Children's Hospital, Mandalay, Ministry of Health and Sports, Myanmar
| | - Moh Moh Htun
- Department of Medical Research, Ministry of Health and Sports, Myanmar
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Evans TS, Myat TW, Aung P, Oo ZM, Maw MT, Toe AT, Aung TH, Hom NS, Shein KT, Thant KZ, Win YT, Thein WZ, Gilardi K, Thu HM, Johnson CK. Bushmeat hunting and trade in Myanmar's central teak forests: Threats to biodiversity and human livelihoods. Glob Ecol Conserv 2020; 22. [PMID: 35574577 PMCID: PMC9098047 DOI: 10.1016/j.gecco.2019.e00889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Tierra Smiley Evans
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, USA
| | - Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Pyaephyo Aung
- Biodiversity and Nature Conservation Association, Myanmar
| | - Zaw Min Oo
- Myanmar Timber Enterprise, Ministry of Natural Resources and Environmental Conservation, Myanmar
| | - Min Thein Maw
- Livestock Breeding and Veterinary Department, Ministry of Agriculture, Livestock and Irrigation, Myanmar
| | - Aung Than Toe
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, USA
| | - Tin Htun Aung
- Biodiversity and Nature Conservation Association, Myanmar
| | - Nang Sarm Hom
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | | | | | - Ye Tun Win
- Livestock Breeding and Veterinary Department, Ministry of Agriculture, Livestock and Irrigation, Myanmar
| | - Wai Zin Thein
- Livestock Breeding and Veterinary Department, Ministry of Agriculture, Livestock and Irrigation, Myanmar
| | - Kirsten Gilardi
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, USA
| | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, Myanmar
| | - Christine Kreuder Johnson
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, USA
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8
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Thu HM, Myat TW, Win MM, Thant KZ, Rahman S, Umeda K, Nguyen SV, Icatlo FC, Higo-Moriguchi K, Taniguchi K, Tsuji T, Oguma K, Kim SJ, Bae HS, Choi HJ. Chicken Egg Yolk Antibodies (IgY) for Prophylaxis and Treatment of Rotavirus Diarrhea in Human and Animal Neonates: A Concise Review. Korean J Food Sci Anim Resour 2017; 37:1-9. [PMID: 28316465 PMCID: PMC5355572 DOI: 10.5851/kosfa.2017.37.1.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 01/25/2017] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 01/22/2023] Open
Abstract
The rotavirus-induced diarrhea of human and animal neonates is a major public health concern worldwide. Until recently, no effective therapy is available to specifically inactivate the rotavirion particles within the gut. Passive immunotherapy by oral administration of chicken egg yolk antibody (IgY) has emerged of late as a fresh alternative strategy to control infectious diseases of the alimentary tract and has been applied in the treatment of diarrhea due to rotavirus infection. The purpose of this concise review is to evaluate evidence on the properties and performance of anti-rotavirus immunoglobulin Y (IgY) for prevention and treatment of rotavirus diarrhea in human and animal neonates. A survey of relevant anti-rotavirus IgY basic studies and clinical trials among neonatal animals (since 1994-2015) and humans (since 1982-2015) have been reviewed and briefly summarized. Our analysis of a number of rotavirus investigations involving animal and human clinical trials revealed that anti-rotavirus IgY significantly reduced the severity of clinical manifestation of diarrhea among IgY-treated subjects relative to a corresponding control or placebo group. The accumulated information as a whole depicts oral IgY to be a safe and efficacious option for treatment of rotavirus diarrhea in neonates. There is however a clear need for more randomized, placebo controlled and double-blind trials with bigger sample size to further solidify and confirm claims of efficacy and safety in controlling diarrhea caused by rotavirus infection especially among human infants with health issues such as low birth weights or compromised immunity in whom it is most needed.
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Affiliation(s)
- Hlaing Myat Thu
- Department of Medical Research, No. 5, Ziwaka road, Dagon township, P.O. 11191, Yangon, Myanmar
| | - Theingi Win Myat
- Department of Medical Research, No. 5, Ziwaka road, Dagon township, P.O. 11191, Yangon, Myanmar
| | - Mo Mo Win
- Department of Medical Research, No. 5, Ziwaka road, Dagon township, P.O. 11191, Yangon, Myanmar
| | - Kyaw Zin Thant
- Department of Medical Research, No. 5, Ziwaka road, Dagon township, P.O. 11191, Yangon, Myanmar
| | - Shofiqur Rahman
- Immunology Research Institute in Gifu, EW Nutrition Japan, 839-7 Sano, Gifu 501-1101, Japan
| | - Kouji Umeda
- Immunology Research Institute in Gifu, EW Nutrition Japan, 839-7 Sano, Gifu 501-1101, Japan
| | - Sa Van Nguyen
- Immunology Research Institute in Gifu, EW Nutrition Japan, 839-7 Sano, Gifu 501-1101, Japan
| | - Faustino C Icatlo
- Immunology Research Institute in Gifu, EW Nutrition Japan, 839-7 Sano, Gifu 501-1101, Japan
| | - Kyoko Higo-Moriguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Takao Tsuji
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Keiji Oguma
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Sang Jong Kim
- Dairy Team, Lotte R&D Center, 30 Seonyu-ro 9-gil, Yeongdeungpo-gu, Seoul, Korea
| | - Hyun Suk Bae
- Dairy Team, Lotte R&D Center, 30 Seonyu-ro 9-gil, Yeongdeungpo-gu, Seoul, Korea
| | - Hyuk Joon Choi
- BK bio, #2706-38, Iljudong-ro, Gujwa-eup, Jeju-si, Jeju-do, 63359, Korea
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Ide T, Higo-Moriguchi K, Komoto S, Htun KW, Myint YY, Myat TW, Thant KZ, Thu HM, Win MM, Oo HN, Htut T, Rahman S, Nguyen SV, Umeda K, Oguma K, Tsuji T, Taniguchi K. High Prevalence of G12 Human Rotaviruses in Children with Gastroenteritis in Myanmar. Jpn J Infect Dis 2015; 69:326-7. [PMID: 26370431 DOI: 10.7883/yoken.jjid.2015.267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Human rotavirus samples from 54 children with acute gastroenteritis in Myanmar in 2011 were subjected to reverse transcription-PCR to determine their G and P types. On G typing, G2 (24/54; 44.4%) was found to be the most prevalent, followed by G12 (17/54; 31.5%) and G1 (1/54; 1.9%). Mixed cases with G2 and G12 were found in 12 of the 54 (22.2%) samples. On P typing, P[4] was found to be the most predominant (29/54; 53.7%), followed by P[8] (17/54; 31.5%) and P[6] (4/54; 7.4%). Mixed cases with P[4] and P[8] were detected in 4 of 54 (7.4%) samples. Thus, occurrence of G2 and unusual G12 in high proportions was characteristic of human rotaviruses in Myanmar in this study setting.
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Affiliation(s)
- Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine
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10
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Ide T, Komoto S, Higo-Moriguchi K, Htun KW, Myint YY, Myat TW, Thant KZ, Thu HM, Win MM, Oo HN, Htut T, Wakuda M, Dennis FE, Haga K, Fujii Y, Katayama K, Rahman S, Nguyen SV, Umeda K, Oguma K, Tsuji T, Taniguchi K. Whole Genomic Analysis of Human G12P[6] and G12P[8] Rotavirus Strains that Have Emerged in Myanmar. PLoS One 2015; 10:e0124965. [PMID: 25938434 PMCID: PMC4418666 DOI: 10.1371/journal.pone.0124965] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/20/2015] [Indexed: 11/18/2022] Open
Abstract
G12 rotaviruses are emerging rotavirus strains causing severe diarrhea in infants and young children worldwide. However, the whole genomes of only a few G12 strains have been fully sequenced and analyzed. In this study, we sequenced and characterized the complete genomes of six G12 strains (RVA/Human-tc/MMR/A14/2011/G12P[8], RVA/Human-tc/MMR/A23/2011/G12P[6], RVA/Human-tc/MMR/A25/2011/G12P[8], RVA/Human-tc/MMR/P02/2011/G12P[8], RVA/Human-tc/MMR/P39/2011/G12P[8], and RVA/Human-tc/MMR/P43/2011/G12P[8]) detected in six stool samples from children with acute gastroenteritis in Myanmar. On whole genomic analysis, all six Myanmarese G12 strains were found to have a Wa-like genetic backbone: G12-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strains A14, A25, P02, P39, and P43, and G12-P[6]-I1-R1-C1-M1-A1-N1-T1-E1-H1 for strain A23. Phylogenetic analysis showed that most genes of the six strains examined in this study were genetically related to globally circulating human G1, G3, G9, and G12 strains. Of note is that the NSP4 gene of strain A23 exhibited the closest relationship with the cognate genes of human-like bovine strains as well as human strains, suggesting the occurrence of reassortment between human and bovine strains. Furthermore, strains A14, A25, P02, P39, and P43 were very closely related to one another in all the 11 gene segments, indicating derivation of the five strains from a common origin. On the other hand, strain A23 consistently formed distinct clusters as to all the 11 gene segments, indicating a distinct origin of strain A23 from that of strains A14, A25, P02, P39, and P43. To our knowledge, this is the first report on whole genome-based characterization of G12 strains that have emerged in Myanmar. Our observations will provide important insights into the evolutionary dynamics of spreading G12 rotaviruses in Asia.
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Affiliation(s)
- Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- * E-mail:
| | - Kyoko Higo-Moriguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Khaing Win Htun
- Nay Pyi Taw General Hospital (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Yi Yi Myint
- Department of Medical Research (Upper Myanmar), Pyin Oo Lwin, Myanmar
| | | | - Kyaw Zin Thant
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Hlaing Myat Thu
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Mo Mo Win
- Department of Medical Research (Lower Myanmar), Yangon, Myanmar
| | - Htun Naing Oo
- Department of Traditional Medicine (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Than Htut
- Ministry of Health (Central Myanmar), Nay Pyi Taw, Myanmar
| | - Mitsutaka Wakuda
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Francis Ekow Dennis
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kei Haga
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Yoshiki Fujii
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Kazuhiko Katayama
- Department of Virology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, Japan
| | - Shofiqur Rahman
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Sa Van Nguyen
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Kouji Umeda
- Immunology Research Institute in Gifu, EW Nutrition Japan, Gifu, Japan
| | - Keiji Oguma
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takao Tsuji
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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