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Horwood PF, Karlsson EA, Horm SV, Ly S, Heng S, Chin S, Darapheak C, Saunders D, Chanthap L, Rith S, Y P, Chea KL, Sar B, Parry A, Ieng V, Tsuyouka R, Deng YM, Hurt AC, Barr IG, Komadina N, Buchy P, Dussart P. Circulation and characterization of seasonal influenza viruses in Cambodia, 2012-2015. Influenza Other Respir Viruses 2019; 13:465-476. [PMID: 31251478 PMCID: PMC6692578 DOI: 10.1111/irv.12647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 12/13/2018] [Accepted: 04/26/2019] [Indexed: 12/04/2022] Open
Abstract
Background Influenza virus circulation is monitored through the Cambodian influenza‐like illness (ILI) sentinel surveillance system and isolates are characterized by the National Influenza Centre (NIC). Seasonal influenza circulation has previously been characterized by year‐round activity and a peak during the rainy season (June‐November). Objectives We documented the circulation of seasonal influenza in Cambodia for 2012‐2015 and investigated genetic, antigenic, and antiviral resistance characteristics of influenza isolates. Patients/Methods Respiratory samples were collected from patients presenting with influenza‐like illness (ILI) at 11 hospitals throughout Cambodia. First‐line screening was conducted by the National Institute of Public Health and the Armed Forces Research Institute of Medical Sciences. Confirmation of testing and genetic, antigenic and antiviral resistance characterization was conducted by Institute Pasteur in Cambodia, the NIC. Additional virus characterization was conducted by the WHO Collaborating Centre for Reference and Research on Influenza (Melbourne, Australia). Results Between 2012 and 2015, 1,238 influenza‐positive samples were submitted to the NIC. Influenza A(H3N2) (55.3%) was the dominant subtype, followed by influenza B (30.9%; predominantly B/Yamagata‐lineage) and A(H1N1)pdm09 (13.9%). Circulation of influenza viruses began earlier in 2014 and 2015 than previously described, coincident with the emergence of A(H3N2) clades 3C.2a and 3C.3a, respectively. There was high diversity in the antigenicity of A(H3N2) viruses, and to a smaller extent influenza B viruses, during this period, with some mismatches with the northern and southern hemisphere vaccine formulations. All isolates tested were susceptible to the influenza antiviral drugs oseltamivir and zanamivir. Conclusions Seasonal and year‐round co‐circulation of multiple influenza types/subtypes were detected in Cambodia during 2012‐2015.
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Affiliation(s)
- Paul F Horwood
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia.,Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Erik A Karlsson
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
| | - Srey Viseth Horm
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
| | - Sovann Ly
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Seng Heng
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Savuth Chin
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Chau Darapheak
- National Institute of Public Health, Phnom Penh, Cambodia
| | - David Saunders
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Lon Chanthap
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Sareth Rith
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
| | - Phalla Y
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
| | - Kim Lay Chea
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
| | - Borann Sar
- Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | - Amy Parry
- World Health Organization, Phnom Penh, Cambodia
| | - Vanra Ieng
- World Health Organization, Phnom Penh, Cambodia
| | | | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Aeron C Hurt
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Naomi Komadina
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Philippe Buchy
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia.,GlaxoSmithKline Vaccines R&D Intercontinental, Singapore, Singapore
| | - Philippe Dussart
- Virology Unit, Institute Pasteur in Cambodia, Institute Pasteur International Network, Phnom Penh, Cambodia
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Ruksasiri S, Lurchachaiwong W, Wassanarungroj P, Serichantalergs O, Sivhour C, Samon N, Ly S, Chanthap L, Bodhidatta L, Crawford J. Antimicrobial resistant Helicobacter fennelliae isolated from non-diarrheal child stool sample in Battambang, Cambodia. Gut Pathog 2018; 10:18. [PMID: 29854008 PMCID: PMC5975586 DOI: 10.1186/s13099-018-0246-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/19/2018] [Indexed: 01/19/2023] Open
Abstract
Helicobacter fennelliae (H. fennelliae) is associated with human gastroenteritis; however, H. fennelliae was isolated and confirmed by phenotypic and genotypic identification from a non-diarrheal child stool sample in Cambodia. Antimicrobial susceptibility testing demonstrated that this isolate had a high minimal inhibitory concentration against macrolides and quinolones, which are first-line antibiotic treatment choices for Campylobacter infections. Consequently, macrolides and quinolones were likewise expected to be ineffective against Campylobacter-like organisms such as H. fennelliae. This isolate warranted further genetic characterization to better understand associated antibiotic resistance mechanisms. Resistant pathogens from asymptomatic diarrheal cases are likely underestimated, and as such colonized individuals may spread resistant organisms to local community members and the environment.
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Affiliation(s)
- Supaporn Ruksasiri
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
| | - Woradee Lurchachaiwong
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
| | - Patcharawalai Wassanarungroj
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
| | - Oralak Serichantalergs
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
| | - Chiek Sivhour
- Battambang Referral Hospital, PrekMohatep Village, SvayPor Commune, Battambang, Cambodia
| | - Nou Samon
- Armed Forces Research Institute of Medical Sciences, 18.118 Street Sangkat Mettapheap Khan 7 Makara, Phnom Penh, Cambodia
| | - Sovann Ly
- 4Communicable Disease Control Department, Ministry of Health, 151-153, Kampuchea KromBlvd, Phnom Penh, Cambodia
| | - Lon Chanthap
- Armed Forces Research Institute of Medical Sciences, 18.118 Street Sangkat Mettapheap Khan 7 Makara, Phnom Penh, Cambodia
| | - Ladaporn Bodhidatta
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
| | - John Crawford
- 1Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand
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Timmermans A, Melendrez MC, Se Y, Chuang I, Samon N, Uthaimongkol N, Klungthong C, Manasatienkij W, Thaisomboonsuk B, Tyner SD, Rith S, Horm VS, Jarman RG, Bethell D, Chanarat N, Pavlin J, Wongstitwilairoong T, Saingam P, El BS, Fukuda MM, Touch S, Sovann L, Fernandez S, Buchy P, Chanthap L, Saunders D. Human Sentinel Surveillance of Influenza and Other Respiratory Viral Pathogens in Border Areas of Western Cambodia. PLoS One 2016; 11:e0152529. [PMID: 27028323 PMCID: PMC4814059 DOI: 10.1371/journal.pone.0152529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/15/2016] [Indexed: 01/16/2023] Open
Abstract
Little is known about circulation of influenza and other respiratory viruses in remote populations along the Thai-Cambodia border in western Cambodia. We screened 586 outpatients (median age 5, range 1–77) presenting with influenza-like-illness (ILI) at 4 sentinel sites in western Cambodia between May 2010 and December 2012. Real-time reverse transcriptase (rRT) PCR for influenza was performed on combined nasal and throat specimens followed by viral culture, antigenic analysis, antiviral susceptibility testing and full genome sequencing for phylogenetic analysis. ILI-specimens negative for influenza were cultured, followed by rRT-PCR for enterovirus and rhinovirus (EV/RV) and EV71. Influenza was found in 168 cases (29%) and occurred almost exclusively in the rainy season from June to November. Isolated influenza strains had close antigenic and phylogenetic relationships, matching vaccine and circulating strains found elsewhere in Cambodia. Influenza vaccination coverage was low (<20%). Western Cambodian H1N1(2009) isolate genomes were more closely related to 10 earlier Cambodia isolates (94.4% genome conservation) than to 13 Thai isolates (75.9% genome conservation), despite sharing the majority of the amino acid changes with the Thai references. Most genes showed signatures of purifying selection. Viral culture detected only adenovirus (5.7%) and parainfluenza virus (3.8%), while non-polio enteroviruses (10.3%) were detected among 164 culture-negative samples including coxsackievirus A4, A6, A8, A9, A12, B3, B4 and echovirus E6 and E9 using nested RT-PCR methods. A single specimen of EV71 was found. Despite proximity to Thailand, influenza epidemiology of these western Cambodian isolates followed patterns observed elsewhere in Cambodia, continuing to support current vaccine and treatment recommendations from the Cambodian National Influenza Center. Amino acid mutations at non-epitope sites, particularly hemagglutinin genes, require further investigation in light of an increasingly important role of permissive mutations in influenza virus evolution. Further research about the burden of adenovirus and non-polio enteroviruses as etiologic agents in acute respiratory infections in Cambodia is also needed.
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Affiliation(s)
- Ans Timmermans
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Melanie C. Melendrez
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- * E-mail:
| | - Youry Se
- Department of Immunology, Armed Forces Research Institute of Medical Sciences, Battambang, Cambodia
| | - Ilin Chuang
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Nou Samon
- Department of Immunology, Armed Forces Research Institute of Medical Sciences, Battambang, Cambodia
| | - Nichapat Uthaimongkol
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Chonticha Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Wudtichai Manasatienkij
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Butsaya Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Stuart D. Tyner
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Sareth Rith
- Virology Department, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Viseth Srey Horm
- Virology Department, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Richard G. Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Delia Bethell
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Nitima Chanarat
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Julie Pavlin
- Deputy Director, Armed Forces Health Surveillance Center, Silver Spring, Maryland, United States of America
| | | | - Piyaporn Saingam
- Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - But Sam El
- Department of Immunology, Armed Forces Research Institute of Medical Sciences, Battambang, Cambodia
| | - Mark M. Fukuda
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Sok Touch
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Ly Sovann
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | - Stefan Fernandez
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Philippe Buchy
- Virology Department, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Lon Chanthap
- Department of Immunology, Armed Forces Research Institute of Medical Sciences, Phnom Penh, Cambodia
| | - David Saunders
- Department of Immunology, US Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
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Chanthap L, Ariey F, Socheat D, Tsuyuoka R, Bell D. Low-technology cooling box for storage of malaria RDTs and other medical supplies in remote areas. Malar J 2010; 9:31. [PMID: 20096130 PMCID: PMC2834699 DOI: 10.1186/1475-2875-9-31] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2009] [Accepted: 01/23/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With the increase in use of point-of-care diagnostic tests for malaria and other diseases comes the necessity of storing the diagnostic kits and the drugs required for subsequent management, in remote areas, where temperatures are high and electricity supply is unreliable or unavailable. METHODS To address the lack of temperature-controlled storage during the introduction of community-based malaria management in Cambodia, the Cambodian National Centre for Parasitology, Entomology and Malaria Control (CNM) developed prototype evaporative cooling boxes (Cambodian Cooler Boxes - CCBs) for storage of perishable medical commodities in remote clinics. The performance of these CCBs for maintaining suitable storage temperatures was evaluated over two phases in 2005 and 2006-7, comparing conditions in CCBs using water as designed, CCBs with no water for evaporation, and ambient storage room temperatures. Temperature and humidity was monitored, together with the capacity of the RDTs recommended for storage between 2 to 30 degree Celsius to detect low-density malaria parasite samples after storage under these conditions. RESULTS Significant differences were recorded between the proportion of temperatures within the recommended RDT storage conditions in the CCBs with water and the temperatures in the storage room (p < 0.001) and maximum temperatures were lower. RDTs stored at ambient temperatures were negative when tested with parasitized blood (2,000 parasites per micro litre) at 210 days, while the field RDTs kept in CCBs with water gave positive results until 360 days. DISCUSSION AND CONCLUSIONS The CCB was an effective tool for storage of RDTs at optimal conditions, and extended the effective life-span of the tests. The concept of evaporative cooling has potential to greatly enhance access to perishable diagnostics and medicines in remote communities, as it allows prolonged storage at low cost using locally-available materials, in the absence of electricity.
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Affiliation(s)
- Lon Chanthap
- National Center for Parasitology, Entomology and Malaria Control, #372 Blv Monivong, Phnom Penh, Cambodia
| | - Frédéric Ariey
- Laboratory of Molecular Epidemiology Pasteur Institute of Cambodia, #5, Monivong Blvd, PO Box 983, Phnom Penh, Cambodia
| | - Duong Socheat
- National Center for Parasitology, Entomology and Malaria Control, #372 Blv Monivong, Phnom Penh, Cambodia
| | - Reiko Tsuyuoka
- Communicable Diseases Surveillance and Response, World Health Organization, Ban Phonexay, That Luang Road, PO Box 343, Vientiane, Lao PDR
| | - David Bell
- Foundation for Innovative New Diagnostics (FIND), 16 Avenue de Budé, 1202 Geneva, Switzerland (Formerly World Health Organization - Regional Office for the Western Pacific)
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Jorgensen P, Chanthap L, Rebueno A, Tsuyuoka R, Bell D. Malaria rapid diagnostic tests in tropical climates: the need for a cool chain. Am J Trop Med Hyg 2006; 74:750-4. [PMID: 16687674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Malaria control programs in endemic countries increasingly rely on early case detection and treatment at village level. The rapid diagnostic tests (RDTs) and accompanying drugs on which the success of these programs depends deteriorate to varying degrees at high temperatures. To assess the ability of health systems to maintain RDTs within manufacturers' specifications, we monitored temperatures in the delivery chain from manufacturer through to the village health worker in Cambodia and the Philippines. In both countries, storage temperatures regularly exceeded those recommended for most RDTs intended for field use, whereas temperatures during transport greatly exceeded the lower and upper limits. These results emphasize the need for good logistical planning during the introduction of point-of-care tests in tropical countries and the importance of considering the stability of diagnostic tests during procurement.
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Affiliation(s)
- Pernille Jorgensen
- World Health Organization-Regional Office for the Western Pacific, Manila, The Philippines
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Chanthap L, Tsuyuoka R, Na-Bangchang K, Nivanna N, Suksom D, Sovannarith T, Socheat D. Investigation of bioavailability, pharmacokinetics and safety of new pediatric formulations of artesunate and mefloquine. Southeast Asian J Trop Med Public Health 2005; 36:34-43. [PMID: 15906639] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The bioavailability/pharmacokinetics of dihydroartemisinin and mefloquine following the oral doses of 4 mg/kg body weight artesunate (Cambodian Pharmaceutical Enterprise) given concurrently with 10 mg/kg body weight oral mefloquine artesunate (Cambodian Pharmaceutical Enterprise) were investigated in 15 healthy Cambodian male volunteers. Both formulations were generally well tolerated. Both produced satisfactory plasma/blood concentration-time profiles. Oral artesunate and mefloquine were rapidly absorbed from gastrointestinal tract with marked inter-individual variation. For the dihydroartemisinin, the median (95% Cl) Cmax of 748 (304-1,470) ng/ml was observed at 1.5 (0.3-3.0) hours (tmax) after drug administration. The median (95% CI) values for AUC0-infinity, lambda(z) and tl/2z were 1.673 (1.08-2.88) microg.h/ml, 0.54(0.24-1.1)/hour and 1.3 (0.6-2.9) hours, respectively. For mefloquine, a median (95% Cl) Cmax of 1,000 (591-1,500) ng/ml was observed at 4 (2-6) hours (tmax) after drug administration. The median (95% CI) value for AUC0-168h was 3.92 (2.88-7.02) microg.h/ml.
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Affiliation(s)
- L Chanthap
- National Center for Parasitological Entomology and Malaria Control Program, Ministry of Health, Cambodia
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