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Golden MR, Soge OO, Mills M, Berzkalns A, Cannon C, Ramchandani M, Dombrowski JC, Karmarkar EN, Chow EJ, Gov JP, Swenson P, Greninger AL. Asymptomatic and Subclinical Mpox: An Association With Modified Vaccinia Ankara Vaccine. Sex Transm Dis 2024; 51:342-347. [PMID: 38301634 DOI: 10.1097/olq.0000000000001939] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND How often mpox causes asymptomatic infections, particularly among persons who have received the Modified Vaccinia Ankara (MVA) vaccine, is unknown. METHODS We performed mpox polymerase chain reaction testing on rectal and pharyngeal specimens collected from symptomatic and asymptomatic patients at a sexual health clinic in Seattle, WA, between May 2022 and May 2023. Analyses evaluated the prevalence of asymptomatic or subclinical infection and, among persons with polymerase chain reaction-positive tests, the association of MVA vaccination status with the symptomatic infection. RESULTS The study population included 1663 persons tested for mpox during 2353 clinic visits. Ninety-three percent of study participants were cisgender men and 96% were men who have sex with men. A total of 198 symptomatic patients (30%) had a first mpox-positive test during 664 visits. Eighteen patients (1.1%) tested during 1689 visits had asymptomatic or subclinical mpox based on a positive rectal or pharyngeal test done in the absence of testing done because of clinical suspicion for mpox. Fourteen (78%) of 18 persons with asymptomatic/subclinical mpox and 53 (26%) of 198 persons with symptomatic mpox had received at least 1 dose of the MVA vaccine ( P < 0.0001). Controlling for calendar month, study subjects who received 1 and 2 doses of MVA vaccine were 4.4 (95% confidence interval, 1.3-15) and 11.9 (3.6-40) times more likely to have asymptomatic versus symptomatic mpox, respectively, than persons who were unvaccinated. CONCLUSIONS Asymptomatic mpox is uncommon. Modified Vaccinia Ankara vaccination is associated with an asymptomatic/subclinical infection among persons with mpox.
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Affiliation(s)
| | | | - Margaret Mills
- Laboratory Medicine and Pathology, Washington, Seattle, WA
| | | | | | | | | | - Ellora N Karmarkar
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington
| | | | - Jolene P Gov
- Laboratory Medicine and Pathology, Washington, Seattle, WA
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Sekiya S, Masuoka H, Mizuno Y, Kibe M, Kosaka S, Natsuhara K, Hirayama K, Inthavong N, Kounnavong S, Tomita S, Takayasu L, Suda W, Yagyu F, Umezaki M. Asymptomatic Enteric Virus Infections and Association with the Gut Microbiome in Rural Residents of Northern Laos. Am J Trop Med Hyg 2024; 110:759-767. [PMID: 38471149 PMCID: PMC10993851 DOI: 10.4269/ajtmh.23-0209] [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] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/03/2023] [Indexed: 03/14/2024] Open
Abstract
Viral gastrointestinal infections are an important public health concern, and the occurrence of asymptomatic enteric virus infections makes it difficult to prevent and control their spread. This study aimed to determine the prevalence of and factors associated with asymptomatic enteric virus infection in adults in northern Laos. Fecal samples were collected from apparently healthy participants who did not report diarrhea or high fever at the time of the survey in northern Laos, and enteric viruses were detected using polymerase chain reaction (PCR) and reverse transcription (RT)-PCR. Individual characteristics, including the gut microbiome, were compared between asymptomatic carriers and noncarriers of each enteric virus. Of the participants (N = 255), 12 (4.7%) were positive for norovirus genogroup I (GI), 8 (3.1%) for human adenovirus, and 1 (0.4%) for norovirus GII; prevalence tended to be higher in less-modernized villages. Gut microbial diversity (evaluated by the number of operational taxonomic units) was higher in asymptomatic carriers of norovirus GI or human adenovirus than in their noncarriers. Gut microbiome compositions differed significantly between asymptomatic carriers and noncarriers of norovirus GI or human adenovirus (permutational analysis of variance, P <0.05). These findings imply an association between asymptomatic enteric virus infection and modernization and/or the gut microbiome in northern Laos.
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Affiliation(s)
- Sae Sekiya
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Masuoka
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yuki Mizuno
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Kibe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoko Kosaka
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Kazuhiro Hirayama
- Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Nouhak Inthavong
- Ministry of Health, Lao Tropical and Public Health Institute, Vientiane, Laos
| | | | - Shinsuke Tomita
- Graduate School of Environmental Studies, Nagoya University, Nagoya, Japan
| | - Lena Takayasu
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Wataru Suda
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Fumihiro Yagyu
- Graduate School of International Development and Cooperation, Kibi International University, Hyogo, Japan
| | - Masahiro Umezaki
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kiener M, Shayegh N, Nyathi SV, Ndenga BA, Mutuku FM, LaBeaud AD. Low Rate of Asymptomatic Dengue Infection Detected in Coastal Kenya Using Pooled Polymerase Chain Reaction Testing. Am J Trop Med Hyg 2024; 110:738-740. [PMID: 38471167 PMCID: PMC10993852 DOI: 10.4269/ajtmh.23-0650] [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] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/24/2023] [Indexed: 03/14/2024] Open
Abstract
Asymptomatic dengue virus (DENV) infections have important public health implications but are challenging to identify. We performed a cross-sectional study of reverse transcription quantitative polymerase chain reaction on pooled sera of asymptomatic individuals from the south coast of Kenya at two time periods to identify cases of asymptomatic viremia. Among 2,460 samples tested in pools of 9 or 10, we found only one positive case (0.04% incidence). Although pooling of samples has the potential to be a cost-effective and time-efficient method for asymptomatic DENV detection, mass cross-sectional pooled testing may not provide accurate data on rates of asymptomatic infection, likely owing to a decrease in the sensitivity with pooling of samples, a short period of viremia, or testing in the absence of an outbreak.
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Affiliation(s)
- Melanie Kiener
- Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California
| | - Nader Shayegh
- Howard University College of Medicine, Washington, District of Columbia
| | - Sindiso Victor Nyathi
- Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California
| | | | | | - Angelle Desiree LaBeaud
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, California
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Hide M, Michel G, Legueult K, Pin R, Leonard S, Simon L, Bañuls AL, Delaunay P, Marty P, Pomares C. Asymptomatic Leishmania infantum infection in dogs and dog owners in an endemic area in southeast France. Parasite 2024; 31:16. [PMID: 38530209 DOI: 10.1051/parasite/2024019] [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: 10/25/2023] [Accepted: 03/04/2024] [Indexed: 03/27/2024] Open
Abstract
The prevalence of asymptomatic leishmaniasis in dogs and their owners in the main endemic areas of France has not been studied to date. The objective of this study was to quantify asymptomatic Leishmania infantum infection in southeast France in healthy people and their dogs using molecular and serological screening techniques. We examined the presence of parasitic DNA using specific PCR targeting kinetoplast DNA (kDNA) and specific antibodies by serology (ELISA for dogs and Western blot for humans) among immunocompetent residents and their dogs in the Alpes-Maritimes. Results from 343 humans and 607 dogs were included. 46.9% (n = 161/343) of humans and 18.3% (n = 111/607) of dogs were PCR positive; 40.2% of humans (n = 138/343) and 9.9% of dogs (n = 60/607) were serology positive. Altogether, 66.2% of humans (n = 227) and 25.7% of dogs (n = 156) had positive serologies and/or positive PCR test results. Short-haired dogs were more frequently infected (71.8%, n = 112) than long-haired dogs (12.2%, n = 19) (p = 0.043). Dogs seemed to be more susceptible to asymptomatic infection according to their breed types (higher infection rates in scenthounds, gun dogs and herding dogs) (p = 0.04). The highest proportion of dogs and human asymptomatic infections was found in the Vence Region, corresponding to 28.2% (n = 20/71) of dogs and 70.5% (n = 31/44) of humans (4.5/100,000 people). In conclusion, the percentage of infections in asymptomatic humans is higher than in asymptomatic dogs in the studied endemic area. It is questionable whether asymptomatic infection in humans constitutes a risk factor for dogs.
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Affiliation(s)
- Mallorie Hide
- MIVEGEC, Université de Montpellier, IRD, CNRS, 911 av Agropolis, 34090, Montpellier, France
| | - Gregory Michel
- Centre Méditerranéen de Médecine Moléculaire (C3M), U1065, Université Côte d'Azur, Inserm, 151 route Saint Antoine de Ginestière, BP 2 3194 06204, Nice, France
| | - Kevin Legueult
- Département de Santé Publique, UR2CA, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, 151, route de Saint Antoine de Ginestière, CS 23079 06202, Nice, France
| | - Raphaelle Pin
- Laboratoire Vétérinaire Départemental, 105 route des Chappes, BP 107 06902, Sophia-Antipolis, France
| | - Susana Leonard
- MIVEGEC, Université de Montpellier, IRD, CNRS, 911 av Agropolis, 34090, Montpellier, France
| | - Loïc Simon
- Centre Méditerranéen de Médecine Moléculaire (C3M), U1065, Université Côte d'Azur, Inserm, 151 route Saint Antoine de Ginestière, BP 2 3194 06204, Nice, France - Service de Parasitologie Mycologie, CHU Nice, 151, route de Saint Antoine de Ginestière, CS 23079 06202, Nice, France
| | - Anne-Laure Bañuls
- MIVEGEC, Université de Montpellier, IRD, CNRS, 911 av Agropolis, 34090, Montpellier, France
| | - Pascal Delaunay
- Service de Parasitologie Mycologie, CHU Nice, 151, route de Saint Antoine de Ginestière, CS 23079 06202, Nice, France
| | - Pierre Marty
- Centre Méditerranéen de Médecine Moléculaire (C3M), U1065, Université Côte d'Azur, Inserm, 151 route Saint Antoine de Ginestière, BP 2 3194 06204, Nice, France - Service de Parasitologie Mycologie, CHU Nice, 151, route de Saint Antoine de Ginestière, CS 23079 06202, Nice, France
| | - Christelle Pomares
- Centre Méditerranéen de Médecine Moléculaire (C3M), U1065, Université Côte d'Azur, Inserm, 151 route Saint Antoine de Ginestière, BP 2 3194 06204, Nice, France - Service de Parasitologie Mycologie, CHU Nice, 151, route de Saint Antoine de Ginestière, CS 23079 06202, Nice, France
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Popkin-Hall ZR, Seth MD, Madebe RA, Budodo R, Bakari C, Francis F, Pereus D, Giesbrecht DJ, Mandara CI, Mbwambo D, Aaron S, Lusasi A, Lazaro S, Bailey JA, Juliano JJ, Gutman JR, Ishengoma DS. Prevalence of non-falciparum malaria infections among asymptomatic individuals in four regions of Mainland Tanzania. Parasit Vectors 2024; 17:153. [PMID: 38519992 PMCID: PMC10960463 DOI: 10.1186/s13071-024-06242-4] [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: 12/29/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Recent studies point to the need to incorporate the detection of non-falciparum species into malaria surveillance activities in sub-Saharan Africa, where 95% of the world's malaria cases occur. Although malaria caused by infection with Plasmodium falciparum is typically more severe than malaria caused by the non-falciparum Plasmodium species P. malariae, P. ovale spp. and P. vivax, the latter may be more challenging to diagnose, treat, control and ultimately eliminate. The prevalence of non-falciparum species throughout sub-Saharan Africa is poorly defined. Tanzania has geographical heterogeneity in transmission levels but an overall high malaria burden. METHODS To estimate the prevalence of malaria species in Mainland Tanzania, we randomly selected 1428 samples from 6005 asymptomatic isolates collected in previous cross-sectional community surveys across four regions and analyzed these by quantitative PCR to detect and identify the Plasmodium species. RESULTS Plasmodium falciparum was the most prevalent species in all samples, with P. malariae and P. ovale spp. detected at a lower prevalence (< 5%) in all four regions; P. vivax was not detected in any sample. CONCLUSIONS The results of this study indicate that malaria elimination efforts in Tanzania will need to account for and enhance surveillance of these non-falciparum species.
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Affiliation(s)
- Zachary R Popkin-Hall
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
| | - Misago D Seth
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Rashid A Madebe
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Rule Budodo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Catherine Bakari
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Tanga Center, Tanga, Tanzania
| | - Dativa Pereus
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Celine I Mandara
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | | | | | - Samwel Lazaro
- National Malaria Control Programme, Dodoma, Tanzania
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA
| | - Jonathan J Juliano
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Julie R Gutman
- Malaria Branch, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Deus S Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Faculty of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
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Guha SK, Sardar AA, Saha P, Chatterjee M, Jana K, Samanta A, Maji D, Biswas P, Bhattacharya R, Maji AK. Challenges for maintaining post elimination phase of visceral leishmaniasis control programme in India: A field-based study. PLoS Negl Trop Dis 2024; 18:e0012028. [PMID: 38452055 PMCID: PMC10950250 DOI: 10.1371/journal.pntd.0012028] [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: 09/02/2023] [Revised: 03/19/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND India is going through the maintenance phase of VL elimination programme which may be threatened by the persistence of hidden parasite pools among asymptomatic leishmanial infection (ALI) and PKDL. The present work was designed to determine the burden of VL, PKDL, and ALI and to assess the role of treatment of ALI in maintaining post-elimination phase. METHODS AND FINDING The study was undertaken in Malda district, West Bengal, India during October 2016 to September 2021. Study areas were divided into 'Study' and 'Control' arms. VL and PKDL cases of both the arms were diagnosed by three active mass surveys with an interval of one year and treated as per National guideline. ALI of 'Study' arm was treated like VL. ALI of 'Control' arm was followed up to determine their fate. Fed sand-fly pools were analysed for parasitic DNA. No significant difference was noted between the incidence of VL and PKDL in both the arms. Incidence of ALI declined sharply in 'Study' arm but an increasing trend was observed in 'Control' arm. Significantly higher rate of sero-conversion was noted in 'Control' arm and was found to be associated with untreated ALI burden. Parasitic DNA was detected in 22.8% ALI cases and 2.2% sand-fly pools. CONCLUSION Persistence of a significant number of PKDL and ALI and ongoing transmission, as evidenced by new infection and detection of leishmanial DNA in vector sand-flies, may threaten the maintenance of post-elimination phase. Emphasis should be given for elimination of pathogen to prevent resurgence of VL epidemics.
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Affiliation(s)
| | - Ashif Ali Sardar
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Pabitra Saha
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
- Department of Zoology, P. R. Thakur Govt. College, Thakurnagar, West Bengal, India
| | - Moytrey Chatterjee
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Kingsuk Jana
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Anwesha Samanta
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Dipankar Maji
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Kolkata, West Bengal, India
| | - Prasanta Biswas
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Kolkata, West Bengal, India
| | - Rahul Bhattacharya
- Department of Statistics, University of Calcutta, Kolkata, West Bengal, India
| | - Ardhendu Kumar Maji
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
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Figueiredo G, Chiaravalloti F, Campos S, Pellini ACG, Felix AC, Luna E. A spatial case-control study on symptomatic and inapparent primary dengue infections in an endemic city in Brazil. Rev Inst Med Trop Sao Paulo 2024; 66:e12. [PMID: 38381897 PMCID: PMC10881063 DOI: 10.1590/s1678-9946202466012] [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: 09/04/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024] Open
Abstract
We conducted a spatial case-control study nested in a dengue incidence cohort to explore the role of the spatial and socioeconomic factors in the proportion of symptomatic (cases) and inapparent primary dengue virus infections (controls). Cohort participants were children and adolescents (2 to 16 years of age) at the beginning of the follow-up. Case definitions were, for symptomatic cases, fever plus a positive lab result for acute dengue (NS1, RT-PCR, ELISA IgM/IgG), and for inapparent infection a positive result for dengue IgG (ELISA) in subjects without symptoms and with a previously negative result at baseline. The covariates included sociodemographic factors, residential location, and socioeconomic context variables of the census tracts of residence of cases and controls. We used principal component analysis to reduce the contextual covariates, with the component values assigned to each one based on their residences. The data were modeled in a Bayesian context, considering the spatial dependence. The final sample consisted of 692 children, 274 cases and 418 controls, from the first year of follow-up (2014-2015). Being male, older age, higher educational level of the head of the family and having a larger number of rooms in the household were associated with a greater chance of presenting dengue symptomatic infection at the individual level. The contextual covariates were not associated with the outcome. Inapparent dengue infection has extensive epidemiological consequences. Relying solely on notifications of symptomatic dengue infections underestimates the number of cases, preserves a silent source of the disease, potentially spreading the virus to unaffected areas.
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Affiliation(s)
- Gerusa Figueiredo
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Francisco Chiaravalloti
- Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Epidemiologia, São Paulo, São Paulo, Brazil
| | - Sérgio Campos
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Alvina Clara Felix
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia, São Paulo, São Paulo, Brazil
| | - Expedito Luna
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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Sun J, Zhang H, Yang Z. A retrospective analysis of children with mild and asymptomatic Omicron infections under 14: A single-center study. Medicine (Baltimore) 2024; 103:e37149. [PMID: 38363889 PMCID: PMC10869072 DOI: 10.1097/md.0000000000037149] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Abstract
Omicron BA.5 subvariant has been proven to be more transmissible than other Omicron subvariants. But the studies on the spread of the Omicron BA.5 subvariant in children are still limited. This study aimed to analyze the clinical features of children infected with Omicron BA.5.2 variant in the mobile cabin hospital and the influence factors of the infections. Children with mild and asymptomatic Omicron infections under 14 years old who were admitted to the mobile cabin hospital from October 30 to December 7, 2022 were retrospectively collected. A total of 741 children, 424 boys (57.2%) and 317 girls (42.8%) were enrolled, including 145 asymptomatic cases (22.7%) and 493 (77.3%) mild cases. Upper respiratory tract infection was the dominant manifestation. Fever was the most common presenting symptom (80.7%), followed by cough (52.5%). The average time to symptom disappearance was 3.76 days, and the average negative conversion time of nucleic acid was 12.3 days. Univariate analysis showed that the negative conversion time of nucleic acid differed significantly across the age groups. The multivariate analysis showed that the older the age, the longer the negative conversion time of nucleic acid. Among those with the negative conversion time of nucleic acid longer than 12 days, age was positively correlated to the negative conversion time of nucleic acid, while the number of vaccine doses received was negatively correlated to the negative conversion time of nucleic acid. Omicron infection occurred in children of any age group, with good prospect for recovery. Age and number of vaccine doses received were risk factors influencing the negative conversion time of nucleic acid.
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Affiliation(s)
- Jing Sun
- Department of Pediatrics, Lanzhou Chengguan District People’s Hospital, Lanzhou City, China
| | - Haiyan Zhang
- Department of Pediatrics, Lanzhou Chengguan District People’s Hospital, Lanzhou City, China
| | - Zhen Yang
- Department of Pediatrics, Lanzhou Maternal and Child Health Care Hospital, Lanzhou City, China
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9
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Cai T, Li Y, Li XM, Chen B, Liang LX, Yuan LZ, Hu H, Zhang ML, Deng AJ, Liu XM, Wang F. A population-based study of Helicobacter pylori: Does asymptomatic infection mean no gastroscopic lesions? Postgrad Med J 2024; 100:179-186. [PMID: 38079630 DOI: 10.1093/postmj/qgad119] [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: 05/06/2023] [Revised: 10/19/2023] [Accepted: 11/10/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVES We determined the common clinical characteristics of patients infected with Helicobacter pylori (H. pylori) and investigated the relationship between H. pylori infection, and clinical symptoms, and gastroscopic manifestations. Our focus was specifically on the clinical manifestations in asymptomatic patients. METHODS We obtained the physical examination data of patients who underwent the 14C urea breath test between January 2018 and December 2020 at our Hospital. Basic demographic data, questionnaire data on clinical symptoms, and clinical examination data of the patients were also collected, and the correlation analysis was performed. RESULTS A total of 2863 participants were included in the study. The overall H. pylori infection rate was 26.30%. The clinical symptoms between H. pylori-positive patients and H. pylori-negative patients did not differ significantly (P > .05). However, H. pylori-positive patients exhibited more severe gastroscopic manifestations (P < .001). The 14C urea breath test disintegrations per minute (DPM) values in H. pylori-positive patients correlated with their serum pepsinogen and gastrin-17 levels. With an increase in the DPM value, more combinations of clinical symptoms appeared in the patients. Among H. pylori-positive patients, DPM levels in asymptomatic patients were lower than those in symptomatic patients (P < .001). However, gastroscopic manifestations did not vary significantly between asymptomatic and symptomatic patients (P > .05). CONCLUSION Patients infected with H. pylori showed no specific gastrointestinal symptoms. Patients with asymptomatic infection showed lower DPM levels, but their gastroscopic manifestations were similar to those of patients with symptomatic infection, and their lesions were more severe than H. pylori-negative people.
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Affiliation(s)
- Ting Cai
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Xin-Meng Li
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Bing Chen
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Lun-Xi Liang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Ling-Zhi Yuan
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Hai Hu
- Department of Orthopedics, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Ming-Lin Zhang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Ao-Jian Deng
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Xiao-Ming Liu
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Fen Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
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10
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Diouf MP, Kande S, Oboh MA, Manga IA, Tairou F, Seck A, Diallo A, Lo AC, Sow D, Sylla K, Ndiaye M, Tine RC, Faye B, Merle C, Amambua-Ngwa A, Miligan P, Ndiaye JLA. Prevalence of Malaria Infection in Pregnant Women Attending Antenatal Clinics in Southern Senegal. Am J Trop Med Hyg 2024; 110:214-219. [PMID: 38167431 PMCID: PMC10859798 DOI: 10.4269/ajtmh.23-0164] [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: 03/13/2023] [Accepted: 09/13/2023] [Indexed: 01/05/2024] Open
Abstract
Despite marked progress in Senegal, three regions in the southeast part continue to have a high burden of malaria, but there have been no recent studies assessing the prevalence of malaria associated with pregnancy. This study aimed to determine the prevalence of malaria infection in pregnant women attending antenatal clinics in Senegal. During the malaria transmission season of 2019, pregnant women attending 11 health care facilities for a scheduled visit and those presenting unwell with signs of malaria were invited to participate in a malaria screening study. A finger prick blood sample was taken for malaria diagnosis by rapid diagnosis test (RDT) and polymerase chain reaction (PCR). A total of 877 pregnant women were enrolled, 787 for a scheduled antenatal consultation and 90 for an unscheduled consultation with signs of malaria. The prevalence of Plasmodium falciparum among the first group was 48% by PCR and 20% by RDT, and that among the second group was 86% by PCR and 83% by RDT. RDT sensitivity in capturing asymptomatic, PCR-positive infections was 9.2% but ranged from 83% to 94% among febrile women. The prevalence of infection by PCR in women who reported having received at least three doses of sulfadoxine pyrimethamine (SP) was 41.9% compared with 58.9% in women who reported they had not received any SP doses (prevalence ratio adjusted for gravidity and gestational age, 0.54; 95% CI, 0.41-0.73). The burden of P. falciparum infections remains high among pregnant women, the majority of which are not captured by RDT. More effective measures to prevent malaria infection in pregnancy are needed.
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Affiliation(s)
- Marie Pierre Diouf
- Service Parasitologie Mycologie, UFR Santé Thiès, Senegal
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Safietou Kande
- Service Parasitologie Mycologie, UFR Santé Thiès, Senegal
| | | | | | - Fassiatou Tairou
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Amadou Seck
- Service Parasitologie Mycologie, UFR Santé Thiès, Senegal
| | | | - Aminata Colle Lo
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Doudou Sow
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
- Gaston Berger University, Saint Louis, Senegal
| | - Khadime Sylla
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Magatte Ndiaye
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Roger Clément Tine
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Babacar Faye
- Service Parasitologie Mycologie, Cheikh Anta Diop University, Dakar, Senegal
| | - Corinne Merle
- World Health Organization Tropical Disease Research, Geneva, Switzerland
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit, London School of Hygiene & Tropical Medicine, Serekunda, The Gambia
| | - Paul Miligan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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11
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Kimenyi KM, Akinyi MY, Mwikali K, Gilmore T, Mwangi S, Omer E, Gichuki B, Wambua J, Njunge J, Obiero G, Bejon P, Langhorne J, Abdi A, Ochola-Oyier LI. Distinct transcriptomic signatures define febrile malaria depending on initial infective states, asymptomatic or uninfected. BMC Infect Dis 2024; 24:140. [PMID: 38287287 PMCID: PMC10823747 DOI: 10.1186/s12879-024-08973-2] [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: 09/21/2023] [Accepted: 01/01/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Cumulative malaria parasite exposure in endemic regions often results in the acquisition of partial immunity and asymptomatic infections. There is limited information on how host-parasite interactions mediate the maintenance of chronic symptomless infections that sustain malaria transmission. METHODS Here, we determined the gene expression profiles of the parasite population and the corresponding host peripheral blood mononuclear cells (PBMCs) from 21 children (< 15 years). We compared children who were defined as uninfected, asymptomatic and those with febrile malaria. RESULTS Children with asymptomatic infections had a parasite transcriptional profile characterized by a bias toward trophozoite stage (~ 12 h-post invasion) parasites and low parasite levels, while early ring stage parasites were characteristic of febrile malaria. The host response of asymptomatic children was characterized by downregulated transcription of genes associated with inflammatory responses, compared with children with febrile malaria,. Interestingly, the host responses during febrile infections that followed an asymptomatic infection featured stronger inflammatory responses, whereas the febrile host responses from previously uninfected children featured increased humoral immune responses. CONCLUSIONS The priming effect of prior asymptomatic infection may explain the blunted acquisition of antibody responses seen to malaria antigens following natural exposure or vaccination in malaria endemic areas.
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Affiliation(s)
- Kelvin M Kimenyi
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | | | - Kioko Mwikali
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Shaban Mwangi
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | - Elisha Omer
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - James Njunge
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | - George Obiero
- Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | - Philip Bejon
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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12
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von Bartheld CS, Wang L. An Explanation for Reports of Increased Prevalence of Olfactory Dysfunction With Omicron: Asymptomatic Infections. J Infect Dis 2024; 229:155-160. [PMID: 37697932 PMCID: PMC11032248 DOI: 10.1093/infdis/jiad394] [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: 07/02/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023] Open
Abstract
The prevalence of olfactory dysfunction (OD) in people infected with the Omicron variant is substantially reduced compared with previous variants. However, 4 recent studies reported a greatly increased prevalence of OD with Omicron. We provide a likely explanation for these outlier studies and reveal a major methodological flaw. When the proportion of asymptomatic infections is large, studies on the prevalence of OD will examine and report predominantly on nonrepresentative cohorts, those with symptomatic subjects, thereby artificially inflating the prevalence of OD by up to 10-fold. Estimation of the true OD prevalence requires representative cohorts that include relevant fractions of asymptomatic cases.
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Affiliation(s)
- Christopher S von Bartheld
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Lingchen Wang
- School of Public Health, University of Nevada, Reno, Nevada, USA
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13
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Aidoo EK, Aboagye FT, Agginie GE, Botchway FA, Osei-Adjei G, Appiah M, Takyi RD, Sakyi SA, Amoah L, Arthur G, Lawson BW, Asmah RH, Boateng P, Ansah O, Krogfelt KA. Malaria elimination in Ghana: recommendations for reactive case detection strategy implementation in a low endemic area of Asutsuare, Ghana. Malar J 2024; 23:5. [PMID: 38167067 PMCID: PMC10759473 DOI: 10.1186/s12936-023-04792-z] [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: 10/01/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Progress toward malaria elimination is increasing as many countries near zero indigenous malaria cases. In settings nearing elimination, interventions will be most effective at interrupting transmission when targeted at the residual foci of transmission. These foci may be missed due to asymptomatic infections. To solve this problem, the World Health Organization recommends reactive case detection (RACD). This case study was conducted to identify individuals with asymptomatic malaria, their predisposing risk factors and recommend RACD in Asutsuare, Ghana based on literature review and a cross sectional study. METHODS The study involved a search on PubMed and Google Scholar of literature published between 1st January, 2009-14th August, 2023 using the search terms "malaria" in "Asutsuare". Furthermore, structured questionnaires were administered to one hundred individuals without symptoms of malaria and screened using rapid diagnostic test (RDT) kits, microscopy and real-time polymerase chain reaction (rt-PCR). Malaria prevalence based on the three diagnostic techniques as well as potential malaria risk factors were assessed through questionnaires in a cross-sectional study. RESULTS Cumulatively, sixty-four (64) studies (Google Scholar, 57 and PubMed, 7) were reviewed and 22 studies included in the literature on malaria in Asutsuare, Ghana. Significant risk factors were occupation, distance from a house to a waterbody, age group and educational level. Out of the 100 samples, 3 (3%) were positive by RDT, 6 (6%) by microscopy and 9 (9%) by rt-PCR. Ages 5-14.9 years had the highest mean malaria parasite densities of 560 parasites/µl with Plasmodium falciparum as the dominant species in 4 participants. Moreover, in the age group ≥ 15, 2 participants (1 each) harboured P. falciparum and Plasmodium malariae parasites. RDT had a higher sensitivity (76.54%; CI95 66.82-85.54) than rt-PCR (33.33%; CI95 4.33-77.72), while both rt-PCR and RDT were observed to have a higher specificity (92.55; CI95 85.26-96.95) and (97.30; CI95 93.87-99.13), respectively in the diagnosis of malaria. CONCLUSION In Asutsuare, Ghana, a low endemic area, the elimination of malaria may require finding individuals with asymptomatic infections. Given the low prevalence of asymptomatic individuals identified in this study and as repleted in the literature review, which favours RACD, Asutsuare is a possible setting receptive for RACD implementation.
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Affiliation(s)
| | - Frank Twum Aboagye
- Bio-Medical and Public Health Research Unit, Council for Scientific and Industrial Research - Water Research Institute, Accra, Ghana
| | - George Edem Agginie
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Felix Abekah Botchway
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - George Osei-Adjei
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Michael Appiah
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Ruth Duku Takyi
- Department of Medical Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, Kwame Nkrumah University of Science & Technology, University Post Office, Kumasi, Ghana
| | - Linda Amoah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - George Arthur
- Department of Medical Laboratory, Accra Psychiatric Hospital, Accra, Ghana
| | - Bernard Walter Lawson
- Department of Theoretical & Applied Biology, Kwame Nkrumah University of Science & Technology, University Post Office, Kumasi, Ghana
| | - Richard Harry Asmah
- Department of Biomedical Sciences, School of Basic and Biomedical Science, University of Health & Allied Sciences, Ho, Ghana
| | - Paul Boateng
- National Malaria Elimination Programme, Accra, Ghana
| | - Otubea Ansah
- National Malaria Elimination Programme, Accra, Ghana
| | - Karen Angeliki Krogfelt
- Department of Science and Environment, Unit of Molecular and Medical Biology, The PandemiX Center, Roskilde University, 4000, Roskilde, Denmark
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, 2300, Copenhagen, Denmark
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14
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Jafari M, Jabrodini A, Pirouzi A, Meshkin A, Mohsenzadeh M. Comparative analysis of asymptomatic infection prevalence in Beta, Delta, and Omicron surges of COVID-19. Braz J Infect Dis 2024; 28:103724. [PMID: 38365183 PMCID: PMC10897804 DOI: 10.1016/j.bjid.2024.103724] [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: 09/30/2023] [Revised: 12/23/2023] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a devastating impact on the global population, with an estimated 650 million people infected and more than 6.6 million lives lost. Asymptomatic individuals have been shown to play a significant role in the transmission of the virus. Therefore, this study aims to investigate and compare the prevalence of asymptomatic individuals across three waves associated with the Beta, Delta, and Omicron variants of the virus. METHODS This retrospective study was conducted between December 2020 and March 2022. The study population consisted of passengers on international flights who were referred to the Gerash Clinical and Molecular Diagnosis Laboratory. Real-time PCR was employed for the diagnosis of SARS-CoV-2. RESULTS Out of a total of 8592 foreign travelers referred to our laboratory, 139 (1.16 %) tested positive for SARS-CoV-2 infection and were asymptomatic. During the Beta surge, 35 (1.49 %) out of 2335 passengers tested positive for SARS-CoV-2. In the Delta surge, 31 (0.6 %) out of 5127 passengers tested positive. However, during the Omicron surge, a significantly higher number of passengers, specifically 73 (6.46 %) out of 1130, had a positive result for the SARS-CoV-2 test. CONCLUSION Considering the significant role of asymptomatic transmission in the spread of COVID-19, it is imperative to reconsider health policies when dealing with future surges of the Omicron subvariants. Additionally, we strongly recommend that the World Health Organization prioritize the development and distribution of second-generation vaccines that target not only disease but also infection prevention.
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Affiliation(s)
- Mohammad Jafari
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Ahmad Jabrodini
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Aliyar Pirouzi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Ahmad Meshkin
- Education Development Center, Committee of Medical Education Development, Gerash University of Medical Sciences, Gerash, Iran
| | - Mehdi Mohsenzadeh
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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15
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Hergott DEB, Owalla TJ, Staubus WJ, Seilie AM, Chavtur C, Balkus JE, Apio B, Lema J, Cemeri B, Akileng A, Chang M, Egwang TG, Murphy SC. Assessing the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda: a longitudinal cohort study. Lancet Microbe 2024; 5:e72-e80. [PMID: 38185134 PMCID: PMC10790327 DOI: 10.1016/s2666-5247(23)00262-8] [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: 01/25/2023] [Revised: 08/13/2023] [Accepted: 08/16/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Low-density asymptomatic Plasmodium infections are prevalent in endemic areas, but little is known about their natural history. The trajectories of these infections and their propensity to fluctuate to undetectable densities can affect detection in clinical trials and field studies. We aimed to classify the natural history of these infections in a high transmission area over 29 days. METHODS In this longitudinal cohort study, we enrolled healthy, malaria-asymptomatic, afebrile, adults (age 18-59 years) and older children (age 8-17 years) in Katakwi District, Uganda, who were negative for Plasmodium infection on rapid diagnostic tests. Participants were instructed to self-collect one dried blood spot (DBS) per day for a maximum of 29 days. We excluded people if they were pregnant or taking antimalarials. During weekly clinic visits, staff collected a DBS and a 4 mL sample of venous blood. We analysed DBSs by Plasmodium 18S rRNA quantitative RT-PCR (qRT-PCR). We classified DBS by infection type as negative, P falciparum, non-P falciparum, or mixed. We plotted infection type over time for each participant and categorised trajectories as negative, new, cleared, chronic, or indeterminate infections. To estimate the effect of single timepoint sampling, we calculated the daily prevalence for each study day and estimated the number of infections that would have been detected in our population if sampling frequency was reduced. FINDINGS Between April 9 and May 20, 2021, 3577 DBSs were collected by 128 (40 male adults, 60 female adults, 12 male children, and 16 female children) study participants. 2287 (64%) DBSs were categorised as negative, 751 (21%) as positive for P falciparum, 507 (14%) as positive for non-P falciparum, and 32 (1%) as mixed infections. Daily Plasmodium prevalence in the population ranged from 45·3% (95% CI 36·6-54·1) at baseline to 30·3% (21·9-38·6) on day 24. 37 (95%) of 39 P falciparum and 35 (85%) of 41 non-P falciparum infections would have been detected with every other day sampling, whereas, with weekly sampling, 35 (90%) P falciparum infections and 31 (76%) non-P falciparum infections would have been detected. INTERPRETATION Parasite dynamics and species are highly variable among low-density asymptomatic Plasmodium infections. Sampling every other day or every 3 days detected a similar proportion of infections as daily sampling, whereas testing once per week or even less frequently could misclassify up to a third of the infections. Even using highly sensitive diagnostics, single timepoint testing might misclassify the true infection status of an individual. FUNDING US National Institutes of Health and Bill and Melinda Gates Foundation.
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Affiliation(s)
- Dianna E B Hergott
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Tonny J Owalla
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Weston J Staubus
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Annette M Seilie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Chris Chavtur
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Jennifer E Balkus
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Bernadette Apio
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Jimmy Lema
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Barbara Cemeri
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Andrew Akileng
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Ming Chang
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Thomas G Egwang
- Department of Parasitology and Immunology, Med Biotech Laboratories, Kampala, Uganda
| | - Sean C Murphy
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle, WA, USA; Department of Microbiology, University of Washington, Seattle, WA, USA.
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16
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Wang J, Ji ZH, Zhang SB, Yang ZR, Sun XQ, Zhang H. Asymptomatic norovirus infection during outbreaks in China: A systematic review and meta-analysis. J Med Virol 2024; 96:e29393. [PMID: 38235934 DOI: 10.1002/jmv.29393] [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: 08/04/2023] [Revised: 11/05/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
Acute gastroenteritis outbreaks may be caused by the excretion of norovirus (NoV) from asymptomatic individuals. Despite numerous studies involving asymptomatic NoV infection during outbreaks in China, a comprehensive assessment of its role has not been conducted, which is critical for emergency management. Our objective was to assess the prevalence of asymptomatic NoV infection during outbreaks in China. We conducted a comprehensive search of multiple databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Wanfang, and China Weipu, between January 1, 1997 and June 19, 2023. The retrieved articles and their references underwent screening, which utilized polymerase chain reaction-based assays for the detection of NoV in asymptomatic individuals during outbreaks that occurred in China. The primary summary data were the prevalence of asymptomatic NoV infection in outbreaks. We generated pooled estimates of asymptomatic prevalence in the population as a whole and in subgroups by using random-effect models. Of the 97 articles included, the pooled asymptomatic prevalence of NoV among 5117 individuals in outbreaks was 17.6% (95% confidence interval [CI]: 14.1-21.3). The asymptomatic prevalence of NoV GII (17.1%, 95% CI: 12.9-21.5) was similar to that of NoV GI (22.0%, 95% CI: 12.8-32.4). However, the proportion of asymptomatic individuals involved in NoV GII (57.44%) was significantly higher than that of NoV GI (5.12%), and NoV GII (75.26%) was reported much more frequently than NoV GI (14.43%) in the included articles. Meta-regression analysis of 11 possible influencing factors (geographic region, setting, season, sample type, genotype, transmission route, occupation, age, per capita income, study quality, and cases definition) showed that the source of heterogeneity might be related to the outbreak settings, per capita income, and study quality (p = 0.037, 0.058, and 0.026, respectively). Of particular note was the asymptomatic prevalence peaked in preschoolers (27.8%), afterward, it fell into trough in elementary and junior school children (10.5%), before the second peak located in adults (17.8%), and the elderly (25.2%). Prevalent genotypes reported include GII.4, followed by GII.17, GII.2, GII.3, GII.6, and so forth. The estimated asymptomatic prevalence of NoV during outbreaks in China was as high as 17.6%, with NoV GII dominating. In addition, genetic subtypes of NoV in outbreaks should be detected whenever possible. The role of asymptomatic individuals in NoV outbreaks cannot be ignored. This knowledge will help governments develop public health policies and emergency response strategies for outbreaks, assess the burden, and develop vaccines.
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Affiliation(s)
- Jun Wang
- Department of Clinical Laboratory, Jiaozhou Central Hospital, Qingdao, Shandong, China
| | - Zhen-Hao Ji
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Shao-Bai Zhang
- Institute for Prevention and Control of Viral Diseases, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Zu-Rong Yang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xue-Qiang Sun
- Department of Surgery Emergency, Jiaozhou Hospital, East Hospital Affiliated to Tongji University, Qingdao, Shandong, China
| | - Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China
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17
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Deni A, De Pascali AM, Ortalli M, Balducelli E, Provenzano M, Ferrara F, Busutti M, La Manna G, Zammarchi L, Bartoloni A, Caroti L, Ibarra-Meneses AV, Carrillo E, Comai G, Varani S. Identification of asymptomatic Leishmania infection in patients undergoing kidney transplant using multiple tests. Int J Infect Dis 2024; 138:81-83. [PMID: 37995832 DOI: 10.1016/j.ijid.2023.11.012] [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: 09/11/2023] [Revised: 10/25/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES In immunocompromised patients, asymptomatic Leishmania infection can reactivate, and evolve to severe disease. To date, no test is considered the gold standard for the identification of asymptomatic Leishmania infection. A combination of methods was employed to screen for Leishmania infection in patients undergoing kidney transplant (KT). METHODS We employed polymerase chain reaction for the detection of parasitic DNA in peripheral blood, Western blot to identify serum immunoglobulin G and whole blood assay to detect cytokines/chemokines after stimulation of whole blood with parasitic antigen. RESULTS One-hundred twenty patients residing in Italy were included in the study at the time of KT. Each patient that tested positive to at least one test was considered as Leishmania positive. Fifty out of 120 patients (42%) tested positive for one or more tests. The detection of specific cell-mediated response (32/111, 29%) was the most common marker of Leishmania infection, followed by a positive serology (24/120, 20%). Four patients (3%) harbored parasitic DNA in the blood. CONCLUSION Our findings underline the high prevalence of asymptomatic Leishmania infection in patients undergoing KT in Italy, who are potentially at-risk for parasite reactivation and can benefit from an increased vigilance. Understanding the clinical relevance of these findings deserves further studies.
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Affiliation(s)
- Alessandro Deni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Margherita Ortalli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Unit of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emma Balducelli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Michele Provenzano
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienza Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Ferrara
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marco Busutti
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienza Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gaetano La Manna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienza Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Leonardo Caroti
- Nephrology, Dialysis, Transplantation Unit, Careggi University Hospital, Florence, Italy
| | - Ana Victoria Ibarra-Meneses
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, J2S 2M2 Saint-Hyacinthe, Canada; The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, J2S 2M2 Montreal, Canada
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Giorgia Comai
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienza Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefania Varani
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Unit of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
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Zhang L, Zhang Z, Pei S, Gao Q, Chen W. Quantifying the presymptomatic transmission of COVID-19 in the USA. Math Biosci Eng 2024; 21:861-883. [PMID: 38303446 DOI: 10.3934/mbe.2024036] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The emergence of many presymptomatic hidden transmission events significantly complicated the intervention and control of the spread of COVID-19 in the USA during the year 2020. To analyze the role that presymptomatic infections play in the spread of this disease, we developed a state-level metapopulation model to simulate COVID-19 transmission in the USA in 2020 during which period the number of confirmed cases was more than in any other country. We estimated that the transmission rate (i.e., the number of new infections per unit time generated by an infected individual) of presymptomatic infections was approximately 59.9% the transmission rate of reported infections. We further estimated that {at any point in time the} average proportion of infected individuals in the presymptomatic stage was consistently over 50% of all infected individuals. Presymptomatic transmission was consistently contributing over 52% to daily new infections, as well as consistently contributing over 50% to the effective reproduction number from February to December. Finally, non-pharmaceutical intervention targeting presymptomatic infections was very effective in reducing the number of reported cases. These results reveal the significant contribution that presymptomatic transmission made to COVID-19 transmission in the USA during 2020, as well as pave the way for the design of effective disease control and mitigation strategies.
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Affiliation(s)
- Luyu Zhang
- LMIB and School of Mathematical Sciences, Beihang University, Beijing 100191, China
| | - Zhaohua Zhang
- LMIB and School of Mathematical Sciences, Beihang University, Beijing 100191, China
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Qing Gao
- School of Automation Science and Electrical Engineering, Beihang University, Beijing 100191, China
- Zhongguancun Laboratory, Beijing 100194, China
| | - Wei Chen
- Zhongguancun Laboratory, Beijing 100194, China
- Institute of Artificial Intelligence, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Big Data and Brain Computing, Beihang University, Beijing 100191, China
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19
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de Oliveira LA, dos Santos Barbosa M, Leite Torres AJ, Croda MG, Oliveira da Silva B, dos Santos PCP, Rossoni R, Machado LOCL, Croda J, Maymone Gonçalves CC, Marques MF, da Silva Ferreira T, Sardi SI, Campos GS, de Almeida GB, Alves Gomes MM, Marchioro SB, Simionatto S. Seroprevalence Of SARS-COV-2 infection in asymptomatic indigenous from the largest Brazilian periurban area. PLoS One 2023; 18:e0295211. [PMID: 38134187 PMCID: PMC10745159 DOI: 10.1371/journal.pone.0295211] [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: 08/24/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
This study assessed the seroprevalence of SARS-CoV-2 in 496 asymptomatic individuals from Mato Grosso do Sul, located in Dourados, the largest periurban indigenous area in Brazil, from January 25 to February 4, 2021. The volunteers participated before receiving their first dose of the CoronaVac inactivated vaccine. For screening, blood samples were collected and analyzed using SARS-CoV-2 rapid tests and the enzyme-linked immunosorbent assay (ELISA). We observed varying trends in total anti-SARS-CoV-2 antibodies across different variables. Seropositivity among the participants tested was 63.70% (316/496) using the rapid test and 52.82% (262/496) were positive using the ELISA method. The majority of participants identified with the Guarani-Kaiowá ethnic group, with 66.15% (217/328), and other ethnic groups with 58.84% (193/328). The median age of the subjects was 30.5 years, with 79.57% (261/328) being femaleThis research showed the elevated seroprevalence of SARS-CoV-2 antibodies in asymptomatic Brazilians. The findings indicate a high seropositivity rate among the asymptomatic indigenous population of Midwest Brazil. This underscores the overlooked status of these communities and underscores the need for targeted national initiatives that emphasize the protection of vulnerable ethnic groups in the fight against COVID-19.
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Affiliation(s)
| | - Marcelo dos Santos Barbosa
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Alex José Leite Torres
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Garcia Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Bruna Oliveira da Silva
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Regina Rossoni
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
| | - Crhistinne Cavalheiro Maymone Gonçalves
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- State Secretariat of Health of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Michele Ferreira Marques
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Tiago da Silva Ferreira
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Silvia Inês Sardi
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gubio Soares Campos
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gabriel Barroso de Almeida
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Marilia Maria Alves Gomes
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Silvana Beutinger Marchioro
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Simone Simionatto
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
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20
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Hammer CC, Diallo MD, Kann B, Sanoh F, Leno TN, Mansare O, Diakité I, Sow AD, Konate Y, Ryan-Castillo E, Barry AM, Standley CJ. High prevalence of asymptomatic malaria in Forest Guinea: Results from a rapid community survey. Epidemiol Infect 2023; 152:e1. [PMID: 38050416 PMCID: PMC10789974 DOI: 10.1017/s0950268823001929] [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: 07/21/2023] [Revised: 10/07/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023] Open
Abstract
Malaria is endemic in Guinea; however, the extent and role in transmission of asymptomatic malaria are not well understood. In May 2023, we conducted a rapid community survey to determine Plasmodium falciparum (P. falciparum) prevalence among asymptomatic individuals in Middle Guinea (Prefecture Dalaba) and Forest Guinea (Prefecture Guéckédou). In Dalaba, 6 of 239 (2.1%, confidence interval (CI) 0.9-4.8%) individuals tested positive for P. falciparum by a rapid diagnostic test (RDT), while in Guéckédou, 147 of 235 (60.9%, CI 54.5-66.9%) participants tested positive. Asymptomatic malaria needs to be considered more strongly as a driver of transmission when designing control strategies, especially in Forest Guinea and potentially other hyper-endemic settings.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yacouba Konate
- Santé Plus, Conakry, Guinea
- ISSMV, Laboratoire, Dalaba, Guinea
| | - Emilie Ryan-Castillo
- Georgetown University, Center for Global Health Science and Security, Washington, DC, USA
| | | | - Claire J. Standley
- Georgetown University, Center for Global Health Science and Security, Washington, DC, USA
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21
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Kamau E, Maisiba R, Dear N, Esber A, Parikh AP, Iroezindu M, Bahemana E, Kibuuka H, Owuoth J, Maswai J, Opot B, Okoth RO, Abdi F, Mwalo M, Juma D, Andagalu B, Akala HM, Shah N, Crowell TA, Cowden J, Polyak CS, Ake JA. Implications of asymptomatic malaria infections on hematologic parameters in adults living with HIV in malaria-endemic regions with varying transmission intensities. Int J Infect Dis 2023; 137:82-89. [PMID: 37788741 DOI: 10.1016/j.ijid.2023.09.018] [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: 04/25/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES HIV and malaria coinfection impacts disease management and clinical outcomes. This study investigated hematologic abnormalities in malaria-asymptomatic people living with HIV (PLHIV) in regions with differing malaria transmission. METHODS Study participants were enrolled in the African Cohort Study: two sites in Kenya, one in Uganda, and one in Nigeria. Data was collected at enrollment and every 6 months. Logistic regression estimated odds ratios for associations between HIV/malaria status and anemia, thrombocytopenia, and leucopenia. RESULTS Samples from 1587 participants with one or more visits comprising 1471 (92.7%) from PLHIV and 116 (7.3%) without HIV were analyzed. Parasite point prevalence significantly differed across the study sites (P <0.001). PLHIV had higher odds of anemia, with males at lower odds compared to females; the odds of anemia decreased with age, reaching significance in those ≥50 years old. Participants in Kisumu, Kenya had higher odds of anemia compared to other sites. PLHIV had higher odds of leucopenia, but malaria co-infection was not associated with worsened leucopenia. The odds of thrombocytopenia were decreased in HIV/malaria co-infection compared to the uninfected group. CONCLUSION Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria co-infection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region-specific.
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Affiliation(s)
- Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Department of Pathology and Area Laboratory Service, Tripler Army Medical Center, Honolulu, USA.
| | - Risper Maisiba
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Ajay P Parikh
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; HJF Medical Research International, Mbeya, Tanzania
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - John Owuoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya; HJF Medical Research International, Kisumu, Kenya
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; U.S. Army Medical Research Directorate - Africa, Kericho, Kenya
| | - Benjamin Opot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Raphael O Okoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Farid Abdi
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Maureen Mwalo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Dennis Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya; Kenya Medical Research Institute, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Neha Shah
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Jessica Cowden
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
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22
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Xu C, Zhang Z, Huang X, Cheng K, Guo S, Wang X, Liu M, Liu X. A study on the transmission dynamics of COVID-19 considering the impact of asymptomatic infection. J Biol Dyn 2023; 17:2244980. [PMID: 37656780 DOI: 10.1080/17513758.2023.2244980] [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] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/01/2023] [Indexed: 09/03/2023]
Abstract
The COVID-19 epidemic has been spreading around the world for nearly three years, and asymptomatic infections have exacerbated the spread of the epidemic. To analyse and evaluate the role of asymptomatic infections in the spread of the epidemic, we establish an improved COVID-19 infectious disease dynamics model. We fit the epidemic data in the four time periods corresponding to the selected 614G, Alpha, Delta and Omicron variants and obtain the proportion of asymptomatic persons among the infected persons gradually increased and with the increase of the detection ratio, the cumulative number of cases has dropped significantly, but the decline in the proportion of asymptomatic infections is not obvious. Therefore, in view of the hidden transmission of asymptomatic infections, the cooperation between various epidemic prevention and control policies is required to effectively curb the spread of the epidemic.
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Affiliation(s)
- Chuanqing Xu
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Zonghao Zhang
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Xiaotong Huang
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Kedeng Cheng
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Songbai Guo
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Xiaojing Wang
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Maoxing Liu
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing, People's Republic of China
| | - Xiaoling Liu
- Mathematics department, Hanshan Normal University, Chaozhou, People's Republic of China
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23
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Chen N, Chen S, Li X, Li Z. Modelling and analysis of the HIV/AIDS epidemic with fast and slow asymptomatic infections in China from 2008 to 2021. Math Biosci Eng 2023; 20:20770-20794. [PMID: 38124575 DOI: 10.3934/mbe.2023919] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The aim of this paper is to investigate the spread of the HIV/AIDS epidemic in China during 2008-2021. A new mathematical model is proposed to study the dynamics of HIV transmission with acute infection, fast asymptomatic infections, and slow asymptomatic infections. The basic reproduction number is obtained by the next-generation matrix method. A quantitative analysis of the model, including the local behavior, global behavior, and permanence, is performed. Numerical simulations are presented to enhance the results of these analyses. The behavior or the model's parameters are estimated from real data. A sensitivity analysis shows that the proportion of asymptomatic infections co-infected with other diseases significantly affects the basic reproduction number. We further analyze the impact of implementing single and multiple measure(s) in parallel with the epidemic. The study results conclude that multiple measures are more effective in controlling the spread of AIDS compared to just one. The HIV epidemic can be effectively curbed by reducing the contact rate between fast asymptomatic infected individuals and susceptible populations, increasing the early diagnosis and screening of HIV-infected individuals co-infected with other diseases, and treating co-infected patients promptly.
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Affiliation(s)
- Nawei Chen
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Shenglong Chen
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Xiaoyu Li
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
| | - Zhiming Li
- College of Mathematics and System Science, Xinjiang University, Urumqi 830017, China
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24
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Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, W Kazura J, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. Malar J 2023; 22:341. [PMID: 37940948 PMCID: PMC10634149 DOI: 10.1186/s12936-023-04762-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Water resource development projects, such as dams and irrigation schemes, have a positive impact on food security and poverty reduction. However, such projects could increase prevalence of vector borne disease, such as malaria. This study investigate the impact of different agroecosystems and prevalence of malaria infection in Southwest Ethiopia. METHODS Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 study participants from 1449 households in Arjo and 546 households in Gambella enrolled in the study and blood samples were collected, respectively. All blood samples were microscopically examined and a subset of microscopy negative blood samples (n = 2244) were analysed by qPCR. Mixed effect logistic regression and generalized estimating equation were used to determine microscopic and submicroscopic malaria infection and the associated risk factors, respectively. RESULTS Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). On the other hand, of the 1713 and 531 samples analysed by qPCR from Arjo and Gambella the presence of submicroscopic infection was 1.2% and 12.8%, respectively. Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale were identified by qPCR in both sites. Irrigation was a risk factor for submicroscopic infection in both Arjo and Gambella. Irrigation, being a migrant worker, outdoor job, < 6 months length of stay in the area were risk factors for microscopic infection in Gambella. Moreover, school-age children and length of stay in the area for 1-3 years were significant predictors for submicroscopic malaria in Gambella. However, no ITN utilization was a predictor for both submicroscopic and microscopic infection in Arjo. Season was also a risk factor for microscopic infection in Arjo. CONCLUSION The study highlighted the potential importance of different irrigation practices impacting on submicroscopic malaria transmission. Moreover, microscopic and submicroscopic infections coupled with population movement may contribute to residual malaria transmission and could hinder malaria control and elimination programmes in the country. Therefore, strengthening malaria surveillance and control by using highly sensitive diagnostic tools to detect low-density parasites, screening migrant workers upon arrival and departure, ensuring adequate coverage and proper utilization of vector control tools, and health education for at-risk groups residing or working in such development corridors is needed.
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Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch, Ethiopia.
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia.
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch, Ethiopia
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Kassahun Habtamu
- Menelik II Medical & Health Science College, Addis Ababa, Ethiopia
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University, Fort Collins, USA
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dawit Hawaria
- School of Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Arega Tsegaye
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Biology, College of Natural Science, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, OH, USA
- Center for Global Health & Disease School of Medicine Case, Western Reserve University, Cleveland, OH, USA
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
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25
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Slavov SN, Lima ARJ, Ribeiro G, de Lima LPO, Barros CRDS, Marqueze EC, Martins AJ, Martininghi M, Palmieri M, Caldeira LAV, da Silva FEV, Cacherik G, Nicolodelli AL, Kashima S, Giovanetti M, Alcantara LCJ, Sampaio SC, Elias MC. Epidemiological and Genomic Analysis of Asymptomatic SARS-CoV-2 Infections during the Delta and Omicron Epidemic Waves in São Paulo City, Brazil. Viruses 2023; 15:2210. [PMID: 38005887 PMCID: PMC10675288 DOI: 10.3390/v15112210] [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: 09/21/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
We examined the asymptomatic rates of SARS-CoV-2 infection during the Delta and Omicron waves in the city of São Paulo. Nasopharyngeal swabs were collected at strategic points of the city (open-air markets, bus terminals, airports) for SARS-CoV-2 RNA testing. Applying the questionnaire, the symptomatic individuals were excluded, and only asymptomatic cases were analyzed. During the Delta wave, a total of 4315 samples were collected, whereas 2372 samples were collected during the first Omicron wave. The incidence of the asymptomatic SARS-CoV-2 infection was 0.6% during the Delta wave and 0.8% during the Omicron wave. No statistical differences were found in the threshold amplification cycle. However, there was a statistical difference observed in the sublineage distribution between asymptomatic and symptomatic individuals. Our study determined the incidence of asymptomatic infection by monitoring individuals who remained symptom-free, thereby providing a reliable evaluation of asymptomatic SARS-CoV-2 carriage. Our findings reveal a relatively low proportion of asymptomatic cases, which could be attributed to our rigorous monitoring protocol for the presence of clinical symptoms. Investigating asymptomatic infection rates is crucial to develop and implement effective disease control strategies.
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Affiliation(s)
- Svetoslav N. Slavov
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
- Ribeirão Preto Medical School, Ribeirão Preto 14051-140, SP, Brazil;
- Blood Center of Ribeirão Preto, Ribeirão Preto 14051-140, SP, Brazil
| | - Alex R. J. Lima
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Gabriela Ribeiro
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Loyze P. O. de Lima
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Claudia R. dos S. Barros
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Elaine C. Marqueze
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Antonio J. Martins
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Maiara Martininghi
- Health Surveillance Coordination, Municipal Health Department of São Paulo, Coordenadoria de Vigilância em Saúde (COVISA), Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (M.M.); (M.P.); (L.A.V.C.)
| | - Melissa Palmieri
- Health Surveillance Coordination, Municipal Health Department of São Paulo, Coordenadoria de Vigilância em Saúde (COVISA), Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (M.M.); (M.P.); (L.A.V.C.)
| | - Luiz A. V. Caldeira
- Health Surveillance Coordination, Municipal Health Department of São Paulo, Coordenadoria de Vigilância em Saúde (COVISA), Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (M.M.); (M.P.); (L.A.V.C.)
| | - Fabiana E. V. da Silva
- Primary Care Coordination Municipal Health Department of São Paulo, Coordenadoria de Atenção Básica, Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (F.E.V.d.S.); (G.C.); (A.L.N.)
| | - Giselle Cacherik
- Primary Care Coordination Municipal Health Department of São Paulo, Coordenadoria de Atenção Básica, Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (F.E.V.d.S.); (G.C.); (A.L.N.)
| | - Aline L. Nicolodelli
- Primary Care Coordination Municipal Health Department of São Paulo, Coordenadoria de Atenção Básica, Secretaria Municipal de São Paulo (SMS SP), São Paulo 01223-010, SP, Brazil; (F.E.V.d.S.); (G.C.); (A.L.N.)
| | - Simone Kashima
- Ribeirão Preto Medical School, Ribeirão Preto 14051-140, SP, Brazil;
- Blood Center of Ribeirão Preto, Ribeirão Preto 14051-140, SP, Brazil
- University of São Paulo, Ribeirão Preto 14051-140, SP, Brazil
| | - Marta Giovanetti
- Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (M.G.); (L.C.J.A.)
- Institute Rene Rachou Foundation Oswaldo Cruz, Belo Horizonte 30190-002, MG, Brazil
- Sciences and Technologies for Sustainable Development and One Health, University Campus Bio-Medico Rome, 00128 Roma, Italy
| | - Luiz Carlos Junior Alcantara
- Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (M.G.); (L.C.J.A.)
- Institute Rene Rachou Foundation Oswaldo Cruz, Belo Horizonte 30190-002, MG, Brazil
| | - Sandra C. Sampaio
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
| | - Maria C. Elias
- Center for Viral Surveillance and Serological Assessment (CeVIVAS), Butantan Institute, São Paulo 05507-000, SP, Brazil; (S.N.S.); (A.R.J.L.); (G.R.); (L.P.O.d.L.); (C.R.d.S.B.); (E.C.M.); (A.J.M.)
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Affiliation(s)
- Laura A Graham
- Stanford University, School of Medicine, Stanford, California
- VA Palo Alto Healthcare System, Palo Alto, California
| | - Yvonne A Maldonado
- Stanford University, School of Medicine, Stanford, California
- Stanford Health Care and Lucile Packard Children's Hospital, Stanford, California
| | - Lucy S Tompkins
- Stanford University, School of Medicine, Stanford, California
| | - Samuel H Wald
- Stanford University, School of Medicine, Stanford, California
| | - Amanda Chawla
- Stanford Health Care and Lucile Packard Children's Hospital, Stanford, California
| | - Mary T Hawn
- Stanford University, School of Medicine, Stanford, California
- VA Palo Alto Healthcare System, Palo Alto, California
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Biruksew A, Demeke A, Birhanu Z, Golassa L, Getnet M, Yewhalaw D. Schoolchildren with asymptomatic malaria are potential hotspot for malaria reservoir in Ethiopia: implications for malaria control and elimination efforts. Malar J 2023; 22:311. [PMID: 37845680 PMCID: PMC10580533 DOI: 10.1186/s12936-023-04736-7] [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: 07/14/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Schoolchildren with asymptomatic malaria infections often go undiagnosed and untreated, serving as reservoirs for infection that hamper malaria control and elimination efforts. In this context, little is known about the magnitude of asymptomatic malaria infections in apparently healthy schoolchildren in Ethiopia. This study was aimed at determining the prevalence of asymptomatic malaria infection and its associated factors in apparently healthy schoolchildren in Ethiopia. METHODS From September 2021 to January 2022, a school-based cross-sectional study was conducted on 994 apparently healthy schoolchildren (aged 6-15 years) selected from 21 primary schools in the Gomma district, of Jimma zone, southwestern Oromia, Ethiopia. A multi-stage sampling technique was used to select schools and participants. After allocating the total sample proportionally to each school and then to each grade, participants were selected using the lottery method from a list of student records (rosters). Finger-pricked blood samples were collected for microscopy blood film preparation and malaria rapid diagnostic test (RDT) (SD Bioline Malaria Ag Pf/Pv). Moreover, dry blood spots (DBSs) were prepared onto filter papers for quantitative real time polymerase chain reaction (qPCR) analysis. RESULTS As determined by RDT and microscopy, the prevalence of asymptomatic malaria was 2.20% and 1.51%, respectively. Using qPCR, the overall prevalence was 5.03% (50/994). Of this, Plasmodium falciparum, Plasmodium vivax and mixed infections accounted for 90%, 6% and 4%, respectively. Submicroscopic asymptomatic malaria infection was also accounted for 70% (35/50) of the overall prevalence. Household head age, nighttime outdoor activities of household heads, family history of malaria, absence of insecticide-treated nets (ITN), and presence of stagnant water around the houses are all significantly associated with asymptomatic malaria infections among schoolchildren. CONCLUSIONS This study found that both RDT and microscopy underestimated the prevalence of asymptomatic malaria in schoolchildren. However, qPCR was able to detect even low levels of parasitaemia and revealed a higher prevalence of asymptomatic submicroscopic malaria infections. The findings imply that schoolchildren with asymptomatic malaria infection are potential hotspot for malaria reservoir that fuels ongoing transmission. Therefore, it is imperative to include schoolchildren and schools in malaria intervention package and equally important is the adoption of more advanced and sensitive diagnostic tools, which would be crucial for successful malaria control and elimination efforts. Targeted interventions for asymptomatic malaria-infected schoolchildren can provide invaluable support to the National Malaria Control Programme in controlling and eventually eliminating the disease.
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Affiliation(s)
- Abdissa Biruksew
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIRC), Jimma University, Jimma, Ethiopia
| | | | - Zewdie Birhanu
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health Jimma University, Jimma, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Masrie Getnet
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIRC), Jimma University, Jimma, Ethiopia
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Rocha R, Gonçalves L, Conceição C, Andrade P, Cristóvão JM, Condeço J, Delgado B, Caeiro C, Kuzmenko T, Vasconcelos E, Escoval MA, Rey C, Guz M, Norte C, Aldeia C, Cruz D, Maia C. Prevalence of asymptomatic Leishmania infection and knowledge, perceptions, and practices in blood donors in mainland Portugal. Parasit Vectors 2023; 16:357. [PMID: 37817278 PMCID: PMC10563231 DOI: 10.1186/s13071-023-05980-1] [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: 07/21/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Asymptomatic infection is the most common outcome of exposure to Leishmania parasites. In the Mediterranean region, where Leishmania infantum is endemic, studies on the prevalence of asymptomatic infection have often relied on serological testing in blood donors. In Spain, regional studies have shown seroprevalence in blood donors between 1 and 8%; in Portugal, values of 0 and 2% were suggested by two localized studies, in different populations. The purpose of this study was (i) to estimate the prevalence of asymptomatic Leishmania infection in blood donors in mainland Portugal, and (ii) to study the association between the detection of antibodies to Leishmania and sociodemographic factors, and also the knowledge, perceptions and practices (KPP) of the blood donors regarding leishmaniasis. METHODS A cross-sectional study targeted the population of people who donated blood in mainland Portugal. Participants, distributed proportionally by municipality and aged between 18 and 65 years, were selected randomly in 347 blood collection points between February and June 2022, and completed a sociodemographic and a KPP questionnaire. Detection of anti-Leishmania antibodies in serum was performed using an ELISA commercial kit. Individual KPP scores were calculated by adding grades defined for each question. RESULTS Globally, 201/3763 samples were positive. The estimated national true seroprevalence was 4.8% (95% CI 4.1-5.5%). The proportion of positive results was significantly different between NUTS (Nomenclature of Territorial Units for Statistics) regions. Models suggested that seropositivity was significantly higher in male sex, people older than 25 years, or residing in the Centro NUTS2 region, but not in dog owners nor people with lower KPP scores. Overall, 72.3% of participants had previously heard of leishmaniasis and, in multivariate analysis, a higher Knowledge score was associated with age 25-40 years, female sex, ownership of dogs, and higher education. CONCLUSIONS Global estimated true seroprevalence (4.8%) was similar to previous regional studies in blood donors in neighboring Spain. Higher seroprevalence values in the NUTS2 Centro region were consistent with incidence data from humans and seroprevalence studies in dogs. On the other hand, the low values in the Alentejo and the high values in the northern subregions may be the result of geographical shifts in parasite circulation due to climate change and should prompt localized and integrated, vector, canine, and human research, following a One Health approach.
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Affiliation(s)
- Rafael Rocha
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Lisbon, Portugal
| | - Luzia Gonçalves
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Lisbon, Portugal
- Centro de Estatística E Aplicações da Universidade de Lisboa (UL), Lisbon, Portugal
- , Z-Stat4life, Lisbon, Portugal
| | - Cláudia Conceição
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Lisbon, Portugal
| | - Patrícia Andrade
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - José Manuel Cristóvão
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Lisbon, Portugal
| | - Jorge Condeço
- Instituto Português Do Sangue E da Transplantação, Lisbon, Portugal
| | - Beatriz Delgado
- Instituto Português Do Sangue E da Transplantação, Lisbon, Portugal
| | - Cristina Caeiro
- Instituto Português Do Sangue E da Transplantação, Lisbon, Portugal
| | - Tetyana Kuzmenko
- Instituto Português Do Sangue E da Transplantação, Lisbon, Portugal
| | | | | | - Carmen Rey
- Centro Hospitalar Universitário Do Algarve, Portimão, Portugal
| | - Madalina Guz
- Hospital do Espírito Santo de Évora, Évora, Portugal
| | - Cláudia Norte
- Unidade Local de Saúde Do Baixo Alentejo, Beja, Portugal
| | - Carlos Aldeia
- Unidade Local de Saúde Do Litoral Alentejano, Santiago Do Cacém, Portugal
| | - Diego Cruz
- Unidade Local de Saúde Do Norte Alentejano, Elvas, Portugal
| | - Carla Maia
- Instituto de Higiene E Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal.
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, UNL, Lisbon, Portugal.
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Dabaro D, Birhanu Z, Adissu W, Yilma D, Yewhalaw D. Prevalence and predictors of asymptomatic malaria infection in Boricha District, Sidama Region, Ethiopia: implications for elimination strategies. Malar J 2023; 22:284. [PMID: 37752572 PMCID: PMC10521520 DOI: 10.1186/s12936-023-04722-z] [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: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Malaria remains a major public health threat in Ethiopia despite the tremendous progress made towards the 2030 elimination targets. The silent transmission of asymptomatic infection is one of the factors that enhance the persistence of the disease as a public health issue and impedes efforts to eliminate malaria. Thus, this study aimed at investigating the prevalence and risk factors of asymptomatic malaria infection in Boricha district, Sidama region of Ethiopia. METHODS A community-based cross-sectional study was conducted in eight selected kebeles (smallest administrative unit) in Boricha district. Representative households were chosen using a multi-stage sampling technique. A total of 573 participants were included in the study. Malaria diagnosis was performed using rapid diagnostic test (RDT) and microscopy. A structured questionnaire was administered to collect socio-demographic information. Epi data 3.1 was employed for data entry, and SPSS version 25 was used for analysis. RESULTS Of the 573 asymptomatic participants tested, 6.1% were found to be positive by RDT and 4.0% by microscopy. Participants aged under 5 years (AOR = 1.57, 95% CI 0.46-5.39) and 5-14 years old (AOR = 2.42, 95% CI 1.08-5.40), Insecticide-treated net utilization (AOR = 8.41; 95% CI 1.09-65.08), travel history (AOR = 6.85, 95% CI 2.32-20.26) and living in a house with windows (AOR = 2.11, 95% CI 1.02-4.36) were significantly associated with the asymptomatic malaria infection. CONCLUSION The findings of this study revealed that prevalence of asymptomatic malaria infection was higher in the study area. As a result, rigorous implementation of existing interventions, such as vector control and anti-malaria drugs, is strongly recommended. In addition, devising new ones that are suited to the contextual situations is highly suggested.
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Affiliation(s)
- Desalegn Dabaro
- Yirgalem Hospital Medical College, Yirgalem, Ethiopia.
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia.
| | - Zewdie Birhanu
- Department of Health Education and Behavioral Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Clinical Trial Unit, Jimma University, Jimma, Ethiopia
| | - Daniel Yilma
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
- Clinical Trial Unit, Jimma University, Jimma, Ethiopia
| | - Delenasaw Yewhalaw
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Wang J, Gao Z, Yang ZR, Liu K, Zhang H. Global prevalence of asymptomatic norovirus infection in outbreaks: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:595. [PMID: 37700223 PMCID: PMC10496210 DOI: 10.1186/s12879-023-08519-y] [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: 04/11/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Although many studies on asymptomatic norovirus infection in outbreaks have been conducted globally, structured data (important for emergency management of outbreaks) on the prevalence of this epidemic are still not available. This study assessed the global prevalence of asymptomatic norovirus infection in outbreaks. METHODS We identified publications on asymptomatic infections from norovirus outbreaks by searching the PubMed, Embase, Cochrane Library, Medline, and Web of Science databases and screening references from the articles reviewed. Prevalence of asymptomatic norovirus infection in outbreaks was employed as the primary summary data. The random-effects model of the meta-analysis was fitted to generate estimates of the prevalence in the overall and subgroup populations. RESULTS In total, 44 articles with a sample size of 8,115 asymptomatic individuals were included. The estimated pooled prevalence of asymptomatic norovirus infection in outbreaks was 21.8% (95%CI, 17.4-27.3). The asymptomatic prevalence of norovirus GII (20.1%) was similar to that of GI (19.8%); however, the proportion prevalence of asymptomatic individuals involved in the former (33.36%) was significantly higher than that of in the latter (0.92%) and the former (93.18%) was reported much more frequently than the latter (15.91%) in the included articles. These studies had significant heterogeneity (I2 = 92%, τ2 = 0.4021, P < 0.01). However, the source of heterogeneity could not be identified even after subgroup analysis of 10 possible influencing factors (geographical area, outbreak settings, outbreak seasons, sample types, norovirus genotypes, transmission routes, subjects' occupations, subjects' age, per capita national income, and clear case definition). Meta-regression analysis of these 10 factors demonstrated that the geographical area could be partly responsible for this heterogeneity (P = 0.012). CONCLUSIONS The overall pooled asymptomatic prevalence of norovirus in outbreaks was high, with genome II dominating. Asymptomatic individuals may play an important role in norovirus outbreaks. This knowledge could help in developing control strategies and public health policies for norovirus outbreaks.
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Affiliation(s)
- Jun Wang
- Department of Clinical Laboratory, Jiaozhou Central Hospital, 29 Xuzhou Road, Qingdao, Shandong, 266300, P.R. China
| | - Zhao Gao
- Department of Clinical Laboratory, Jinan Second Peoples' Hospital, 148 Jingyi Road, Jinan, Shandong, 250000, P.R. China
| | - Zu-Rong Yang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, 169 Changle west Road, Xi'an, Shaanxi, 710032, P.R. China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, 169 Changle west Road, Xi'an, Shaanxi, 710032, P.R. China.
| | - Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, 599 Xiying Road, Xi'an, Shaanxi, 710054, P.R. China.
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Neyer PJ, Kaboré B, Nakas CT, Hartmann B, Post A, Diallo S, Tinto H, Hammerer-Lercher A, Largiadèr CR, van der Ven AJ, Huber AR. Exploring the host factors affecting asymptomatic Plasmodium falciparum infection: insights from a rural Burkina Faso study. Malar J 2023; 22:252. [PMID: 37658365 PMCID: PMC10474782 DOI: 10.1186/s12936-023-04686-0] [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: 06/27/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Asymptomatic Plasmodium falciparum parasitaemia forms a reservoir for the transmission of malaria disease in West Africa. Certain haemoglobin variants are known to protect against severe malaria infection. However, data on the potential roles of haemoglobin variants and nongenetic factors in asymptomatic malaria infection is scarce and controversial. Therefore, this study investigated the associations of iron homeostasis, inflammation, nutrition, and haemoglobin mutations with parasitaemia in an asymptomatic cohort from a P. falciparum-endemic region during the high transmission season. METHODS A sub-study population of 688 asymptomatic individuals (predominantly children and adolescents under 15 years, n = 516) from rural Burkina Faso previously recruited by the NOVAC trial (NCT03176719) between June and October 2017 was analysed. Parasitaemia was quantified with conventional haemocytometry. The haemoglobin genotype was determined by reverse hybridization assays targeting a selection of 21 HBA and 22 HBB mutations. Demographics, inflammatory markers (interleukins 6 and 10, hepcidin), nutritional status (mid upper-arm circumference and body mass index), and anaemia (total haemoglobin, ferritin, soluble transferrin receptor) were assessed as potential predictors through logistic regression. RESULTS Malaria parasites were detected in 56% of subjects. Parasitaemia was associated most strongly with malnutrition. The effect size increased with malnutrition severity (OR = 6.26, CI95: 2.45-19.4, p < 0.001). Furthermore, statistically significant associations (p < 0.05) with age, cytokines, hepcidin and heterozygous haemoglobin S were observed. CONCLUSIONS According to these findings, asymptomatic parasitaemia is attenuated by haemoglobin S, but not by any of the other detected genotypes. Aside from evidence for slight iron imbalance, overall undernutrition was found to predict parasitaemia; thus, further investigations are required to elucidate causality and inform strategies for interventions.
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Affiliation(s)
- Peter J Neyer
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland.
- Graduate School for Cellular & Biomedical Sciences, University of Bern, Bern, Switzerland.
- Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Bérenger Kaboré
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- IRSS/Clinical Research Unit of Nanoro (CRUN), Nanoro, Burkina Faso
| | - Christos T Nakas
- Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Laboratory of Biometry, Department of Agriculture Crop, Production and Rural Environment, University of Thessaly, Volos, Greece
| | - Britta Hartmann
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Annelies Post
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Salou Diallo
- IRSS/Clinical Research Unit of Nanoro (CRUN), Nanoro, Burkina Faso
| | - Halidou Tinto
- IRSS/Clinical Research Unit of Nanoro (CRUN), Nanoro, Burkina Faso
| | | | - Carlo R Largiadèr
- Graduate School for Cellular & Biomedical Sciences, University of Bern, Bern, Switzerland
- Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andre J van der Ven
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andreas R Huber
- Private University in the Principality of Liechtenstein, Triesen, Principality of Liechtenstein
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Shaikh N, Swali P, Houben RMGJ. Asymptomatic but infectious - The silent driver of pathogen transmission. A pragmatic review. Epidemics 2023; 44:100704. [PMID: 37413887 PMCID: PMC10260263 DOI: 10.1016/j.epidem.2023.100704] [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: 05/22/2022] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
Throughout 2020, COVID-19 interventions prioritised symptomatic individuals despite growing evidence of pre-symptomatic and asymptomatic transmission. From the pandemic we have learned that global health is slow to quantify asymptomatic disease transmission and slow to implement relevant interventions. While asymptomatic infectious periods exist for nearly all pathogens, it is frequently ignored during case finding, and there are limited research efforts to understand its potential to drive small scale outbreaks, epidemics and pandemics. We conducted a pragmatic review on 15 key pathogens including SARS-CoV-2 and Ebola to demonstrate substantial variation in terminology around asymptomatic infectious individuals, and varying proportions of asymptomatic amongst prevalent infectious cases (0-99 %) and their contribution to transmission (0-96 %). While no pattern was discernible by pathogen type (virus, bacteria, parasite) or mode of transmission (direct, indirect or mixed), there are multiple lessons to learn from previous and current control programmes. As found during the COVID-19 pandemic, overlooking asymptomatic infectious individuals can impede disease control. Improving our understanding of how asymptomatic individuals can drive epidemics can strengthen our efforts to control current pathogens, and improve our preparedness for when the next new pathogen emerges..
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Affiliation(s)
- Nabila Shaikh
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Sanofi Pasteur, 410 Thames Valley Park Drive, Reading RG6 1PT, United Kingdom.
| | - Pooja Swali
- Ancient Genomics Laboratory, The Francis Crick Institute, 1 Midland Road, London NW11AT, United Kingdom
| | - Rein M G J Houben
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
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Asish PR, Dasgupta S, Rachel G, Bagepally BS, Girish Kumar CP. Global prevalence of asymptomatic dengue infections - a systematic review and meta-analysis. Int J Infect Dis 2023; 134:292-298. [PMID: 37463631 DOI: 10.1016/j.ijid.2023.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/22/2023] [Revised: 06/20/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES The burden of asymptomatic dengue infections is understudied. Therefore, we systematically reviewed the literature to estimate the global prevalence of asymptomatic dengue infections. METHODS We searched cross-sectional studies reporting the prevalence of asymptomatic dengue infections from PubMed, Scopus, and Embase. Prevalence of asymptomatic dengue infections was pooled and reported as proportions with a 95% confidence interval (CI). This systematic review protocol was a priori registered in The International Prospective Register of Systematic Reviews (Reg: No. CRD42020218446). RESULTS We included 41 studies with 131,953 cases in our analysis. The overall pooled prevalence of asymptomatic dengue infections was 59.26% (95% CI: 43.76-74.75, I2 = 99.93%), with 65.52% (95% CI: 38.73-92.32, I2 = 99.95%) during outbreaks and 30.78% (95% CI: 21.39-40.16, I2 = 98.78%) during non-outbreak periods. The pooled prevalence among the acutely infected individuals was 54.52% (95% CI: 17.73-46.76, I2 = 99.91%), whereas, among primary and secondary asymptomatic dengue infections, it was 65.36% (95% CI: 45.76-84.96, I2 = 98.82) and 48.99% (95% CI: 27.85-70.13, I2 = 99.08%) respectively. CONCLUSION The majority of dengue cases are asymptomatic and may play a significant role in disease transmission. Public health strategies aimed at dengue outbreak response and mitigation of disease burden should include early detection of asymptomatic cases.
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Affiliation(s)
| | | | - Gladys Rachel
- ICMR-National Institute of Epidemiology, Chennai, India
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Tan J, Shen Y, Ge Y, Martinez L, Huang H. Age-related model for estimating the symptomatic and asymptomatic transmissibility of COVID-19 patients. Biometrics 2023; 79:2525-2536. [PMID: 36517992 PMCID: PMC9877699 DOI: 10.1111/biom.13814] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/16/2022]
Abstract
Estimation of age-dependent transmissibility of COVID-19 patients is critical for effective policymaking. Although the transmissibility of symptomatic cases has been extensively studied, asymptomatic infection is understudied due to limited data. Using a dataset with reliably distinguished symptomatic and asymptomatic statuses of COVID-19 cases, we propose an ordinary differential equation model that considers age-dependent transmissibility in transmission dynamics. Under a Bayesian framework, multi-source information is synthesized in our model for identifying transmissibility. A shrinkage prior among age groups is also adopted to improve the estimation behavior of transmissibility from age-structured data. The added values of accounting for age-dependent transmissibility are further evaluated through simulation studies. In real-data analysis, we compare our approach with two basic models using the deviance information criterion (DIC) and its extension. We find that the proposed model is more flexible for our epidemic data. Our results also suggest that the transmissibility of asymptomatic infections is significantly lower (on average, 76.45% with a credible interval (27.38%, 88.65%)) than that of symptomatic cases. In both symptomatic and asymptomatic patients, the transmissibility mainly increases with age. Patients older than 30 years are more likely to develop symptoms with higher transmissibility. We also find that the transmission burden of asymptomatic cases is lower than that of symptomatic patients.
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Affiliation(s)
- Jianbin Tan
- School of MathematicsSun Yat‐sen UniversityGuangzhouChina
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public HealthUniversity of GeorgiaAthensGeorgiaUSA
| | - Yang Ge
- School of Health ProfessionsUniversity of Southern MississippiHattiesburgMississippiUSA
| | | | - Hui Huang
- School of MathematicsSun Yat‐sen UniversityGuangzhouChina
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Reasoner SA, Fazili IF, Bernard R, Parnell JM, Sokolow AG, Thomsen KF, Edwards KM, Brown RF, Nicholson MR. Prevalence, Risk Factors, and Sequelae of Asymptomatic Clostridioides difficile Colonization in Children with Cystic Fibrosis. J Cyst Fibros 2023; 22:884-887. [PMID: 36585317 PMCID: PMC10300225 DOI: 10.1016/j.jcf.2022.12.014] [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: 10/20/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
Patients with CF (pwCF) have high antibiotic use and an altered intestinal microbiome, known risk factors for infection with Clostridioides difficile. However, in adults with CF, C. difficile infection (CDI) is uncommon and asymptomatic colonization with C. difficile occurs frequently, for reasons that remain unclear. We investigated the rate, risk factors, and sequelae of asymptomatic C. difficile colonization in children with CF (cwCF). We identified that 32% of cwCF were colonized with C. difficile without acute gastrointestinal symptoms. Higher BMI and exposure to specific antibiotic classes (cephalosporins, fluoroquinolones, and vancomycin) were significantly associated with C. difficile colonization. No children developed symptomatic CDI in 90-days following enrollment.
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Affiliation(s)
- Seth A Reasoner
- Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Irtiqa F Fazili
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Rachel Bernard
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, United States of America
| | - Jacob M Parnell
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Andrew G Sokolow
- Division of Pediatric Pulmonary, Allergy, and Immunology, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, United States of America
| | - Kelly F Thomsen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, United States of America
| | - Kathryn M Edwards
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, Tennessee, United States of America
| | - Rebekah F Brown
- Division of Pediatric Pulmonary, Allergy, and Immunology, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, United States of America
| | - Maribeth R Nicholson
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, United States of America; Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
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de-la-Rosa-Martinez D, Bobadilla Del Valle M, Esteban-Kenel V, Zinser Peniche P, Ponce De León Garduño A, Cornejo Juárez P, Sánchez Cruz MN, Camacho-Ortiz A, Vilar-Compte D. Molecular characterization and genotyping of isolates from cancer patients with Clostridioides difficile infection or asymptomatic colonization. J Med Microbiol 2023; 72. [PMID: 37624363 DOI: 10.1099/jmm.0.001748] [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] [Indexed: 08/26/2023] Open
Abstract
Introduction. Cancer patients with Clostridioides difficile infection (CDI) are at a higher risk for adverse outcomes. In addition, a high prevalence of Clostridioides difficile asymptomatic colonization (CDAC) has been reported in this vulnerable population.Gap Statement. The molecular characteristics and potential role of CDAC in healthcare-related transmission in the cancer population have been poorly explored.Aim. We aimed to compare the molecular and genotypic characteristics of C. difficile isolates from cancer patients with CDAC and CDI.Method. We conducted a prospective cohort study of cancer patients with CDAC or CDI from a referral centre. Molecular characterization, typification and tcdC gene expression of isolates were performed.Results. The hospital-onset and community-onset healthcare facility-associated CDI rates were 4.5 cases/10 000 patient-days and 1.4 cases/1 000 admissions during the study period. Fifty-one C. difficile strains were isolated: 37 (72 %) and 14 (28 %) from patients with CDI or CDAC, respectively. All isolates from symptomatic patients were tcdA+/tcdB+, and four (10 %) were ctdA+/ctdB+. In the CDAC group, 10 (71 %) isolates were toxigenic, and none were ctdA+/ctdB+. The Δ18 in-frame tcdC deletion and two transition mutations were found in five isolates. After bacterial typing, 60 % of toxigenic isolates from asymptomatic carriers were clonal to those from patients with C. difficile-associated diarrhoea. No NAP1/027/BI strains were detected.Conclusions. We found a clonal association between C. difficile isolates from patients with CDAC and CDI. Studies are needed to evaluate the potential role of asymptomatic carriers in the dynamics of nosocomial transmission to support infection control measures and reduce the burden of CDI in high-risk groups.
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Affiliation(s)
- Daniel de-la-Rosa-Martinez
- Plan de Estudios Combinados en Medicina (PECEM), Faculty of Medicine, Universidad Nacional Autonoma de Mexico, México City, Mexico
- Departament of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Miriam Bobadilla Del Valle
- Laboratory of Clinical Microbiology, Departament of Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico
| | - Veronica Esteban-Kenel
- Laboratory of Clinical Microbiology, Departament of Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico
| | - Paola Zinser Peniche
- Departament of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Alfredo Ponce De León Garduño
- Laboratory of Clinical Microbiology, Departament of Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico
| | | | - María Nancy Sánchez Cruz
- Laboratory of Clinical Microbiology, Departament of Infectious Diseases, Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico
| | - Adrian Camacho-Ortiz
- Department of Infectious Diseases, Department of Internal Medicine, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Diana Vilar-Compte
- Departament of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
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Shenzhen Neonatal Data Network. [Clinical characteristics of neonates infected with the Omicron variant of SARS-CoV-2: a multicenter cross-sectional survey]. Zhongguo Dang Dai Er Ke Za Zhi 2023; 25:678-84. [PMID: 37529948 DOI: 10.7499/j.issn.1008-8830.2302049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/09/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To investigate the clinical characteristics of neonates infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS A cross-sectional survey was conducted on 542 hospitalized neonates with confirmed coronavirus disease 2019 (COVID-19) in 27 hospitals in Shenzhen from December 7, 2022, to January 12, 2023 (during the Omicron variant epidemic period). The neonates were divided into two groups: asymptomatic infection and symptomatic infection. The clinical characteristics, results of laboratory examination, chest X-ray findings, and outcome were compared between the two groups. RESULTS Among the 542 neonates, there were 285 males and 257 females. Among them, 515 (95.0%) were full-term infants, and 27 (5.0%) were preterm infants. The asymptomatic infection group had 60 cases, and the symptomatic infection group had 482 cases. Among them, 336 cases (69.7%) were mild, 125 cases (25.9%) were moderate, 15 cases (3.1%) were severe, and 6 cases (1.2%) were critical. Fever was the most common symptom (434 cases, 90.0%), followed by cough and/or spitting (183 cases, 38.0%), nasal congestion and/or runny nose (131 cases, 27.2%), shortness of breath (36 cases, 7.5%), and feeding intolerance (30 cases, 6.2%). Among the 325 cases who underwent chest X-ray examination, 136 cases (41.8%) had patchy or consolidative shadows in the lungs, 2 cases (0.6%) had pneumothorax, 2 cases (0.6%) had decreased lung transparency, and 185 cases (57.0%) showed no abnormality. Among the 396 cases (73.1%) who received treatment, 341 cases (86.1%) received symptomatic treatment, 137 cases (34.6%) received antibiotic treatment, 4 cases (1.0%) received immunoglobulin treatment, and 23 cases (5.8%) received respiratory support treatment. All 542 neonates were discharged from the hospital after their clinical symptoms were relieved, and the median hospital stay was 5 days. The white blood cell count, neutrophil count, hemoglobin, and procalcitonin were lower in the symptomatic infection group than those in the asymptomatic infection group (P<0.05), while the platelet count and blood glucose levels were higher in the symptomatic infection group than those in the asymptomatic infection group (P<0.05). The proportions of neonates with decreased neutrophil count, increased platelet count, and decreased hemoglobin concentration were higher in the symptomatic infection group than those in the asymptomatic group (P<0.05). CONCLUSIONS Most neonates with COVID-19 caused by the Omicron variant of SARS-CoV-2 are mild, with fever as the predominant symptom. Symptomatic neonates with COVID-19 are often accompanied by decreased neutrophil count, increased platelet count, and decreased hemoglobin level. Symptomatic treatment is the main treatment, and the prognosis is good.
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Liu Y, Ge X, Zhang J, Xu L, Hu F, Wang S, Liu J, Yang X, Shi D, Cai Y. Sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China: the mediating role of entrapment and defeat. BMC Public Health 2023; 23:993. [PMID: 37248465 PMCID: PMC10225749 DOI: 10.1186/s12889-023-15803-8] [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: 08/23/2022] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic increases the risk of psychological problems, especially for the infected population. Sleep disturbance and feelings of defeat and entrapment are well-documented risk factors of anxiety symptoms. Exploring the psychological mechanism of the development of anxiety symptoms is essential for effective prevention. This study aimed to examine the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China. METHODS A cross-sectional study was conducted from March to April, 2022. Participants were 1,283 asymptomatic COVID-19 carriers enrolled from the Ruijin Jiahe Fangcang Shelter Hospital, Shanghai (59.6% male; mean age = 39.6 years). Questionnaire measures of sleep disturbance, entrapment, defeat, anxiety symptoms, and background characteristics were obtained. A mediation model was constructed to test the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms. RESULTS The prevalence rates of sleep disturbance and anxiety symptoms were 34.3% and 18.8%. Sleep disturbance was positively associated with anxiety symptoms (OR [95%CI] = 5.013 [3.721-6.753]). The relationship between sleep disturbance and anxiety symptoms (total effect: Std. Estimate = 0.509) was partially mediated by entrapment (indirect effect: Std. Estimate = 0.129) and defeat (indirect effect: Std. Estimate = 0.126). The mediating effect of entrapment and defeat accounted for 50.3% of the association between sleep disturbance and anxiety symptoms. CONCLUSION Sleep disturbance and anxiety symptoms were prevalent among asymptomatic COVID-19 carriers. Entrapment and defeat mediate the association between sleep disturbance and anxiety symptoms. More attention is needed to monitoring sleep conditions and feelings of defeat and entrapment to reduce the risk of anxiety.
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Affiliation(s)
- Yujie Liu
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200335, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xin Ge
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200335, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jinxin Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lulu Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Fan Hu
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200335, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Suping Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jialin Liu
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaodong Yang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Dake Shi
- Department of Infection Control, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200335, China.
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Gayedyu-Dennis D, Fallah MP, Drew C, Badio M, Moses JS, Fayiah T, Johnson K, Richardson ET, Weiser SD, Porco TC, Martin JN, Sneller MC, Rutherford GW, Reilly C, Lindan CP, Kelly JD. Identifying Paucisymptomatic or Asymptomatic and Unrecognized Ebola Virus Disease Among Close Contacts Based on Exposure Risk Assessments and Screening Algorithms. J Infect Dis 2023; 227:878-887. [PMID: 36047331 PMCID: PMC10319948 DOI: 10.1093/infdis/jiac359] [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: 04/18/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There is limited evidence to evaluate screening algorithms with rapid antigen testing and exposure assessments as identification strategies for paucisymptomatic or asymptomatic Ebola virus (EBOV) infection and unrecognized EBOV disease (EVD). METHODS We used serostatus and self-reported postexposure symptoms from a cohort study to classify contact-participants as having no infection, paucisymptomatic or asymptomatic infection, or unrecognized EVD. Exposure risk was categorized as low, intermediate, or high. We created hypothetical scenarios to evaluate the World Health Organization (WHO) case definition with or without rapid diagnostic testing (RDT) or exposure assessments. RESULTS This analysis included 990 EVD survivors and 1909 contacts, of whom 115 (6%) had paucisymptomatic or asymptomatic EBOV infection, 107 (6%) had unrecognized EVD, and 1687 (88%) were uninfected. High-risk exposures were drivers of unrecognized EVD (adjusted odds ratio, 3.5 [95% confidence interval, 2.4-4.9]). To identify contacts with unrecognized EVD who test negative by the WHO case definition, the sensitivity was 96% with RDT (95% confidence interval, 91%-99%), 87% with high-risk exposure (82%-92%), and 97% with intermediate- to high-risk exposures (93%-99%). The proportion of false-positives was 2% with RDT and 53%-93% with intermediate- and/or high-risk exposures. CONCLUSION We demonstrated the utility and trade-offs of sequential screening algorithms with RDT or exposure risk assessments as identification strategies for contacts with unrecognized EVD.
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Affiliation(s)
- Dehkontee Gayedyu-Dennis
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
| | - Mosoka P Fallah
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Clara Drew
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Moses Badio
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - J S Moses
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Tamba Fayiah
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
| | - Kumblytee Johnson
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
| | - Eugene T Richardson
- Department of Medicine, Brigham and Women’s Hospital, Boston, Minnesota, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Minnesota, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Travis C Porco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Michael C Sneller
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - George W Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Cavan Reilly
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christina P Lindan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - J D Kelly
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
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González F, Diez-Valcarce M, Reyes Y, Vielot NA, Toval-Ruíz C, Gutiérrez L, Zepeda O, Cuadra EC, Blandón P, Browne H, Bowman NM, Vílchez S, Vinjé J, Becker-Dreps S, Bucardo F. Timing and genotype distribution of symptomatic and asymptomatic sapovirus infections and re-infections in a Nicaraguan birth cohort. Clin Microbiol Infect 2023; 29:540.e9-540.e15. [PMID: 36423864 PMCID: PMC10077563 DOI: 10.1016/j.cmi.2022.11.013] [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: 08/16/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To characterize the timing and genotype distribution of symptomatic and asymptomatic sapovirus infections and re-infections in a Nicaraguan birth cohort. METHODS Infants (N = 444) were enrolled at 10-14 days of life and observed weekly until 2 years of age. Stool samples were collected for each acute gastroenteritis (AGE) episode, and routine stool samples were collected monthly. Stool samples were tested for sapovirus using RT-qPCR, and positive samples were genotyped. RESULTS A total of 348 children completed 2 years of AGE weekly surveillance; 93 (26.7%) of them experienced sapovirus AGE. Most infections occurred after 5 months of age and mainly during the second year of life (62.4%, 58/93) and early in the rainy season. Sapovirus screening in all stools from a subset of 67 children who consistently provided samples showed sapovirus infections in 91 of 330 (27.6%) AGE episodes and in 39 of 1350 (2.9%) routine stools. In this subset, the median age at the first sapovirus AGE was 11.2 months (95% CI, 9.3-15.9 months); 38 of 67 (57%) children experienced re-infections, 19 symptomatic and 19 asymptomatic. On average, sapovirus re-infections were reported 7.2 months after symptomatic and 5.3 months after asymptomatic infections. Genogroup GI (64%, 69/108) was the most common detected. Sapovirus GI.1 was more frequently detected in AGE stool samples than in routine stool samples (47.2%, 43/91 vs. 25.6%, 10/39; p 0.005), and re-infection with the same genotype was uncommon. DISCUSSION The first sapovirus infections occurred at approximately 11 months of age, whereas the median time to symptomatic re-infection was 7.2 months. Re-infections with the same sapovirus genotype were rare during 2 years of life suggesting genotype-specific protection after natural infection.
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Affiliation(s)
- Fredman González
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Marta Diez-Valcarce
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yaoska Reyes
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Nadja A Vielot
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christian Toval-Ruíz
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Lester Gutiérrez
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Omar Zepeda
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Edwing Centeno Cuadra
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Patricia Blandón
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Hannah Browne
- National Foundation for the Centers for Disease Control and Prevention Inc., Atlanta, GA, USA
| | - Natalie M Bowman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samuel Vílchez
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua
| | - Jan Vinjé
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sylvia Becker-Dreps
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Filemón Bucardo
- Department of Microbiology, National Autonomous University of Nicaragua - León, León, Nicaragua.
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Wang B, Andraweera P, Elliott S, Mohammed H, Lassi Z, Twigger A, Borgas C, Gunasekera S, Ladhani S, Marshall HS. Asymptomatic SARS-CoV-2 Infection by Age: A Global Systematic Review and Meta-analysis. Pediatr Infect Dis J 2023; 42:232-239. [PMID: 36730054 PMCID: PMC9935239 DOI: 10.1097/inf.0000000000003791] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Asymptomatic SARS-CoV-2 infections have raised concerns for public health policies to manage epidemics. This systematic review and meta-analysis aimed to estimate the age-specific proportion of asymptomatic SARS-CoV-2 infected persons globally by year of age. METHODS We searched PubMed, Embase, medRxiv and Google Scholar on September 10, 2020, and March 1, 2021. We included studies conducted during January to December 2020, before routine vaccination against COVID-19. Because we expected the relationship between the asymptomatic proportion and age to be nonlinear, multilevel mixed-effects logistic regression (QR decomposition) with a restricted cubic spline was used to model asymptomatic proportions as a function of age. RESULTS A total of 38 studies were included in the meta-analysis. In total, 6556 of 14,850 cases were reported as asymptomatic. The overall estimate of the proportion of people who became infected with SARS-CoV-2 and remained asymptomatic throughout infection was 44.1% (6556/14,850, 95% CI: 43.3%-45.0%). The predicted asymptomatic proportion peaked in children (36.2%, 95% CI: 26.0%-46.5%) at 13.5 years, gradually decreased by age and was lowest at 90.5 years of age (8.1%, 95% CI: 3.4%-12.7%). CONCLUSIONS Given the high rates of asymptomatic carriage in adolescents and young adults and their active role in virus transmission in the community, heightened vigilance and public health strategies are needed among these individuals to prevent disease transmission.
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Affiliation(s)
- Bing Wang
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Prabha Andraweera
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Salenna Elliott
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hassen Mohammed
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zohra Lassi
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Shamez Ladhani
- Immunisation Division, UK Health Security Agency, London, UK; Paediatric Infectious Diseases Research Group, St George’s University of London, London, United Kingdom
| | - Helen Siobhan Marshall
- From the Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Ibrahim AO, Bello IS, Ajetunmobi AO, Ayodapo A, Afolabi BA, Adeniyi MA. Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria. PLoS One 2023; 18:e0280981. [PMID: 36787321 PMCID: PMC9928065 DOI: 10.1371/journal.pone.0280981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/11/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. METHODS A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. RESULTS Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. CONCLUSION The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections.
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Affiliation(s)
- Azeez Oyemomi Ibrahim
- Department of Family Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
- Department of Family Medicine, College of Medicine and Health Sciences, Afe Babalola University, Ad Ekiti, Ekiti State, Nigeria
| | - Ibrahim Sebutu Bello
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- * E-mail:
| | | | - Abayomi Ayodapo
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - Babatunde Adeola Afolabi
- Department of Family Medicine, Ladoke Akintola University Teaching Hospital, Oshogbo, Osun State, Nigeria
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Riswari SF, Velies DS, Lukman N, Jaya UA, Djauhari H, Ma’roef CN, Myint KSA, Widjaja S, van der Ven A, Alisjahbana B, de Mast Q, Kosasih H. Dengue incidence and length of viremia by RT-PCR in a prospective observational community contact cluster study from 2005-2009 in Indonesia. PLoS Negl Trop Dis 2023; 17:e0011104. [PMID: 36745606 PMCID: PMC9901748 DOI: 10.1371/journal.pntd.0011104] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/16/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dengue has become a major global health threat since being recognized three centuries ago. Important gaps remain in understanding the transmission dynamics of dengue virus (DENV) infection. This study reports the results of a prospective observational cluster study that investigated the incidence of symptomatic and asymptomatic infections and length of viremia among close community contacts of hospitalized DENV-infected patients. METHODOLOGY/PRINCIPAL FINDINGS Between 2005 and 2009, dengue-confirmed cases (n = 97) admitted to Hasan Sadikin Hospital in Bandung, Indonesia, were enrolled as index cases. Subsequently, twenty close community contacts (n = 1928) living with and around the index cases were included and followed up for up to 14 days. Body temperature was measured daily; blood samples were collected every 3-4 days and when reported fever. DENV infection was confirmed using Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR), IgM rapid test, and Enzyme-linked Immunosorbent Assay (ELISA). Among the 1928 community contacts, a total of 72 (3.7%) acute DENV infections were diagnosed, which equates to an incidence of 636 cases per 1,000 person-years (95% Confidence interval (CI) 588 to 687 cases per 1,000 person-years). Twenty-nine cases (40%) were symptomatic (22 dengue fever (DF) & 7 dengue hemorrhagic fever (DHF)), and 43 (60%) were asymptomatic. Primary and secondary DENV infections were detected in 18 (25%) and 54 (75%) subjects. Among the RT-PCR positives, viremia was observed as early as seven days before fever onset and converted to negative as late as seven days after the onset of fever. CONCLUSIONS DENV infections are common among close community contacts of hospitalized dengue patients. The high number of asymptomatic infections and the observation that viremia precedes the onset of fever for up to seven days highlight the importance of unrecognized dengue transmission and the need for improved transmission control.
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Affiliation(s)
- Silvita Fitri Riswari
- Health Research Unit, Faculty of Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
| | - Dyana Safitri Velies
- Health Research Unit, Faculty of Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Nurhayati Lukman
- Viral Diseases Program, U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia
| | - Ungke Anton Jaya
- Viral Diseases Program, U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia
| | - Hofiya Djauhari
- Health Research Unit, Faculty of Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Chairin Nisa Ma’roef
- Viral Diseases Program, U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia
| | | | - Susana Widjaja
- Viral Diseases Program, U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia
| | - Andre van der Ven
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bachti Alisjahbana
- Health Research Unit, Faculty of Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Quirijn de Mast
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Herman Kosasih
- Viral Diseases Program, U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia
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Ma Y, Deng J, Liu Q, Du M, Liu M, Liu J. Long-Term Consequences of Asymptomatic SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2023; 20:ijerph20021613. [PMID: 36674367 PMCID: PMC9863678 DOI: 10.3390/ijerph20021613] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/06/2023] [Accepted: 01/14/2023] [Indexed: 05/12/2023]
Abstract
Little is known about the long-term consequences of asymptomatic infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to review the data available to explore the long-term consequences of asymptomatic SARS-CoV-2 infection in the real world. We searched observational cohort studies that described the long-term health effects of asymptomatic SARS-CoV-2 infections. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of long-term symptoms. Random effects were used to estimate the pooled odds ratios (OR) and its 95%CI of different long-term symptoms between symptomatic and asymptomatic infections. Five studies involving a total of 1643 cases, including 597 cases of asymptomatic and 1043 cases of symptomatic SARS-CoV-2 infection were included in this meta-analysis. The PPs of long-term consequences after asymptomatic SARS-CoV-2 infections were 17.13% (95%CI, 7.55−26.71%) for at least one symptom, 15.09% (95%CI, 5.46−24.73%) for loss of taste, 14.14% (95%CI, −1.32−29.61%) for loss of smell, and 9.33% (95%CI, 3.07−15.60) for fatigue. Compared with symptomatic SARS-CoV-2 infection, asymptomatic infection was associated with a significantly lower risk of developing COVID-19-related sequelae (p < 0.05), with 80% lower risk of developing at least one symptom (OR = 0.20, 95%CI, 0.09−0.45), 81% lower risk of fatigue (OR = 0.19, 95%CI, 0.08−0.49), 90% lower risk of loss of taste/smell (OR = 0.10, 95%CI, 0.02−0.58). Our results suggested that there were long-term effects of asymptomatic SARS-CoV-2 infection, such as loss of taste or smell, fatigue, cough and so on. However, the risk of developing long-term symptoms in asymptomatic SARS-CoV-2 infected persons was significantly lower than those in symptomatic SARS-CoV-2 infection cases.
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Affiliation(s)
- Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (M.L.); (J.L.); Tel.: +86-10-8-2805146 (M.L.); +86-10-8-2801528-316 (J.L.); Fax: +86-10-8-2805146 (M.L. & J.L.)
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Institute for Global Health and Development, Peking University, Beijing 100871, China
- Correspondence: (M.L.); (J.L.); Tel.: +86-10-8-2805146 (M.L.); +86-10-8-2801528-316 (J.L.); Fax: +86-10-8-2805146 (M.L. & J.L.)
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Alharbi MH. Global investigation for an "SIS" model for COVID-19 epidemic with asymptomatic infection. Math Biosci Eng 2023; 20:5298-5315. [PMID: 36896546 DOI: 10.3934/mbe.2023245] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this paper, we analyse a dynamical system taking into account the asymptomatic infection and we consider optimal control strategies based on a regular network. We obtain basic mathematical results for the model without control. We compute the basic reproduction number (R) by using the method of the next generation matrix then we analyse the local stability and global stability of the equilibria (disease-free equilibrium (DFE) and endemic equilibrium (EE)). We prove that DFE is LAS (locally asymptotically stable) when R<1 and it is unstable when R>1. Further, the existence, the uniqueness and the stability of EE is carried out. We deduce that when R>1, EE exists and is unique and it is LAS. By using generalized Bendixson-Dulac theorem, we prove that DFE is GAS (globally asymptotically stable) if R<1 and that the unique endemic equilibrium is globally asymptotically stable when R>1. Later, by using Pontryagin's maximum principle, we propose several reasonable optimal control strategies to the control and the prevention of the disease. We mathematically formulate these strategies. The unique optimal solution was expressed using adjoint variables. A particular numerical scheme was applied to solve the control problem. Finally, several numerical simulations that validate the obtained results were presented.
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Affiliation(s)
- Mohammed H Alharbi
- Department of Mathematics, Faculty of Science, University of Jeddah, P.O. Box 80327, Jeddah 21589, Saudi Arabia
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Kumar G, Shankar H, Pasi S, Kaur J. Asymptomatic and low-density Plasmodium infections in India: an unexplored link. Pathog Glob Health 2022; 116:465-466. [PMID: 35979713 PMCID: PMC9639558 DOI: 10.1080/20477724.2022.2113304] [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] [Indexed: 10/15/2022] Open
Abstract
Presently in India, high endemic zones of malaria are shifting towards low endemic zones and in this changing scenario, tackling the asymptomatic and low-density infections (LDI) would be an important factor. Role of the asymptomatic and LDI in transmitting parasites successfully to mosquito vectors needs to be systematically investigated. We here highlight the limited work done on the burden of asymptomatic Plasmodium infections in India with an emphasis on its infectiousness, and infrastructure available for the detection of LDI. Studies reporting the threshold of gametocytes required for transmission of parasites are lacking for Indian malaria vectors. In the wake of malaria elimination target by 2030, specific point of care test is required to be developed for the detection of low density infections and/or asymptomatic patients. Also, mapping of asymptomatic malaria burden pan India and the role of LDI in vector infectivity would guide the way forward in achieving malaria elimination goal in India.
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Affiliation(s)
- Gaurav Kumar
- Epidemiology and Environmental Biology Group, ICMR-National Institute of Malaria Research, Delhi, India
| | - Hari Shankar
- Indian Council of Medical Research, Delhi, India
| | - Shweta Pasi
- Epidemiology and Environmental Biology Group, ICMR-National Institute of Malaria Research, Delhi, India
| | - Jaspreet Kaur
- Epidemiology and Environmental Biology Group, ICMR-National Institute of Malaria Research, Delhi, India
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Suzuki T, Aizawa K, Shibuya K, Yamanaka S, Anzai Y, Kurokawa K, Nagai R. Prevalence of Asymptomatic SARS-CoV-2 Infection in Japan. JAMA Netw Open 2022; 5:e2247704. [PMID: 36574249 PMCID: PMC9856923 DOI: 10.1001/jamanetworkopen.2022.47704] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IMPORTANCE Real-world evidence of SARS-CoV-2 transmission is needed to understand the prevalence of infection in the Japanese population. OBJECTIVE To conduct sentinel screening of the Japanese population to determine the prevalence of SARS-CoV-2 infection in asymptomatic individuals, with complementary analysis for symptomatic patients as reported by active epidemiologic surveillance used by the government. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of a sentinel screening program investigated approximately 1 million asymptomatic individuals with polymerase chain reaction (PCR) testing for SARS-CoV-2 infection between February 22 and December 8, 2021. Participants included children, students, employed adults, and older individuals, as well as volunteers to broadly reflect the general Japanese population in the 14 prefectures of Japan that declared a state of emergency. Saliva samples and a cycle threshold (Ct) value of approximately 40 as standard in Japan were used. Polymerase chain reaction testing for symptomatic patients was separately done by public health authorities, and the results were obtained from the Ministry of Health, Labour, and Welfare of Japan to complement data on asymptomatic infections from the present study. MAIN OUTCOMES AND MEASURES Temporal trends in positivity and prevalence (including surges of different variants) and demographic associations (eg, age, geographic location, and vaccination status) were assessed. RESULTS The positive rate of SARS-CoV-2 infection in 1 082 976 asymptomatic individuals (52.08% males; mean [SD] age 39.4 [15.7] years) was 0.03% (95% CI, 0.02%-0.05%) during periods without surges and a maximum of 0.33% (95% CI, 0.25%-0.43%) during peak surges at the Japanese standard Ct value of approximately 40; however, the positive rate would have been 10-fold less at a Ct value of 25 as used elsewhere in the world (eg, UK). There was an increase in patients with a positive PCR test result with a Ct value of 25 or 30 preceding surges in infection and hotspots of asymptomatic infections. CONCLUSIONS AND RELEVANCE In this cross-sectional study of asymptomatic SARS-CoV-2 infection in the general population of Japan in 2021, as investigated by sentinel surveillance, a low rate of infection was seen in the Japanese population compared with reported levels elsewhere in the world. This finding provides real-world data on the state of infection in Japan.
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Affiliation(s)
- Toru Suzuki
- Jichi Medical University, Tochigi, Japan
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- University of Leicester, NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Kenichi Aizawa
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, Japan
| | | | - Shinya Yamanaka
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
- The Advisory Board of the COVID-19 Artificial Intelligence Simulation Project promoted by the Office for COVID-19 and Other Emerging Infectious Disease Control, Cabinet Secretariat, Government of Japan
| | - Yuichiro Anzai
- Tokyo Foundation for Policy Research, Tokyo, Japan
- The Advisory Board of the COVID-19 Artificial Intelligence Simulation Project promoted by the Office for COVID-19 and Other Emerging Infectious Disease Control, Cabinet Secretariat, Government of Japan
| | - Kiyoshi Kurokawa
- The Advisory Board of the COVID-19 Artificial Intelligence Simulation Project promoted by the Office for COVID-19 and Other Emerging Infectious Disease Control, Cabinet Secretariat, Government of Japan
- Health and Global Policy Institute, Tokyo, Japan
| | - Ryozo Nagai
- Jichi Medical University, Tochigi, Japan
- The Advisory Board of the COVID-19 Artificial Intelligence Simulation Project promoted by the Office for COVID-19 and Other Emerging Infectious Disease Control, Cabinet Secretariat, Government of Japan
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Thompson MG, Yoon SK, Naleway AL, Meece J, Fabrizio TP, Caban-Martinez AJ, Burgess JL, Gaglani M, Olsho LEW, Bateman A, Lundgren J, Grant L, Phillips AL, Groom HC, Stefanski E, Solle NS, Ellingson K, Lutrick K, Dunnigan K, Wesley MG, Guenther K, Hunt A, Mak J, Hegmann KT, Kuntz JL, Bissonnette A, Hollister J, Rose S, Morrill TC, Respet K, Fowlkes AL, Thiese MS, Rivers P, Herring MK, Odean MJ, Yoo YM, Brunner M, Bedrick EJ, Fleary DE, Jones JT, Praggastis J, Romine J, Dickerson M, Khan SM, Lamberte JM, Beitel S, Webby RJ, Tyner HL. Association of mRNA Vaccination With Clinical and Virologic Features of COVID-19 Among US Essential and Frontline Workers. JAMA 2022; 328:1523-1533. [PMID: 36255426 PMCID: PMC9579910 DOI: 10.1001/jama.2022.18550] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/20/2022] [Indexed: 11/14/2022]
Abstract
Importance Data on the epidemiology of mild to moderately severe COVID-19 are needed to inform public health guidance. Objective To evaluate associations between 2 or 3 doses of mRNA COVID-19 vaccine and attenuation of symptoms and viral RNA load across SARS-CoV-2 viral lineages. Design, Setting, and Participants A prospective cohort study of essential and frontline workers in Arizona, Florida, Minnesota, Oregon, Texas, and Utah with COVID-19 infection confirmed by reverse transcriptase-polymerase chain reaction testing and lineage classified by whole genome sequencing of specimens self-collected weekly and at COVID-19 illness symptom onset. This analysis was conducted among 1199 participants with SARS-CoV-2 from December 14, 2020, to April 19, 2022, with follow-up until May 9, 2022, reported. Exposures SARS-CoV-2 lineage (origin strain, Delta variant, Omicron variant) and COVID-19 vaccination status. Main Outcomes and Measures Clinical outcomes included presence of symptoms, specific symptoms (including fever or chills), illness duration, and medical care seeking. Virologic outcomes included viral load by quantitative reverse transcriptase-polymerase chain reaction testing along with viral viability. Results Among 1199 participants with COVID-19 infection (714 [59.5%] women; median age, 41 years), 14.0% were infected with the origin strain, 24.0% with the Delta variant, and 62.0% with the Omicron variant. Participants vaccinated with the second vaccine dose 14 to 149 days before Delta infection were significantly less likely to be symptomatic compared with unvaccinated participants (21/27 [77.8%] vs 74/77 [96.1%]; OR, 0.13 [95% CI, 0-0.6]) and, when symptomatic, those vaccinated with the third dose 7 to 149 days before infection were significantly less likely to report fever or chills (5/13 [38.5%] vs 62/73 [84.9%]; OR, 0.07 [95% CI, 0.0-0.3]) and reported significantly fewer days of symptoms (10.2 vs 16.4; difference, -6.1 [95% CI, -11.8 to -0.4] days). Among those with Omicron infection, the risk of symptomatic infection did not differ significantly for the 2-dose vaccination status vs unvaccinated status and was significantly higher for the 3-dose recipients vs those who were unvaccinated (327/370 [88.4%] vs 85/107 [79.4%]; OR, 2.0 [95% CI, 1.1-3.5]). Among symptomatic Omicron infections, those vaccinated with the third dose 7 to 149 days before infection compared with those who were unvaccinated were significantly less likely to report fever or chills (160/311 [51.5%] vs 64/81 [79.0%]; OR, 0.25 [95% CI, 0.1-0.5]) or seek medical care (45/308 [14.6%] vs 20/81 [24.7%]; OR, 0.45 [95% CI, 0.2-0.9]). Participants with Delta and Omicron infections who received the second dose 14 to 149 days before infection had a significantly lower mean viral load compared with unvaccinated participants (3 vs 4.1 log10 copies/μL; difference, -1.0 [95% CI, -1.7 to -0.2] for Delta and 2.8 vs 3.5 log10 copies/μL, difference, -1.0 [95% CI, -1.7 to -0.3] for Omicron). Conclusions and Relevance In a cohort of US essential and frontline workers with SARS-CoV-2 infections, recent vaccination with 2 or 3 mRNA vaccine doses less than 150 days before infection with Delta or Omicron variants, compared with being unvaccinated, was associated with attenuated symptoms, duration of illness, medical care seeking, or viral load for some comparisons, although the precision and statistical significance of specific estimates varied.
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Affiliation(s)
- Mark G Thompson
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Sarang K Yoon
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - Allison L Naleway
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Jennifer Meece
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | | | | | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Manjusha Gaglani
- Baylor Scott and White Health, Temple, Texas
- Texas A&M University College of Medicine, Temple
| | | | | | | | - Lauren Grant
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Andrew L Phillips
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - Holly C Groom
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | | | | | - Katherine Ellingson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Karen Lutrick
- College of Medicine - Tucson, University of Arizona, Tucson
| | | | | | | | - Angela Hunt
- St Luke's Regional Health Care System, Duluth, Minnesota
| | - Josephine Mak
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Kurt T Hegmann
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - Jennifer L Kuntz
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | | | - James Hollister
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | | | | | - Karley Respet
- St Luke's Regional Health Care System, Duluth, Minnesota
| | - Ashley L Fowlkes
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Matthew S Thiese
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - Patrick Rivers
- College of Medicine - Tucson, University of Arizona, Tucson
| | | | - Marilyn J Odean
- Whiteside Institute for Clinical Research, St Luke's, Duluth, Minnesota
| | - Young M Yoo
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Matthew Brunner
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - Edward J Bedrick
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | | | - John T Jones
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Jenna Praggastis
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City, Utah
| | - James Romine
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Monica Dickerson
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Sana M Khan
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Julie Mayo Lamberte
- Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta, Georgia
| | - Shawn Beitel
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
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Matsuba I, Takuma T, Hatori N, Takai M, Watanabe Y, Takada N, Kishi S, Matsuzawa Y, Nishikawa T, Kunishima T, Degawa H, Nishikawa M, Ono Y, Miyakawa M, Hatori Y, Kanamori A. The Proportion of Long-term Response to Anti-N IgG Antibody after 12 Months for COVID-19 Subclinical Infections and a Longitudinal Survey for COVID-19 Subclinical Infections in 2021. Intern Med 2022; 61:3053-3062. [PMID: 35945024 PMCID: PMC9646357 DOI: 10.2169/internalmedicine.9628-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 12/12/2022] Open
Abstract
Objective To examine the continuation of antibody prevalence status after 12 months and background factors in antibody-positive subjects following asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We initially determined the SARS-CoV-2 anti-nucleocapsid protein immunoglobulin G (anti-N IgG) antibody prevalence in 1,603 patients, doctors, and nurses at 65 medical institutions in Kanagawa Prefecture, Japan. We then obtained consent from 33 of the 39 subjects who tested positive and performed follow-up for 12 months. Results Follow-up for up to 12 months showed that a long-term response of the anti-N IgG antibody could be detected in 6 of the 33 participants (18.2%). The proportions with hypertension, using an angiotensin-receptor blocker, and without a drinking habit were higher among the participants with a long-term anti-N IgG antibody response for up to 12 months than among those without a long-term antibody response. Conclusions The proportion of individuals with subclinical COVID-19 who continuously had a positive result for the anti-N IgG antibody at 12 months was low.
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Abstract
This Medical News article discusses recent European reports of asymptomatic monkeypox virus infections.
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