1
|
Shanmugasundaram D, Awasthi S, Dwibedi B, Geetha S, Jain M, Malik S, Patel B, Singh H, Tripathi S, Viswanathan R, Agarwal A, Bonu R, Jain S, Jena SK, Priyasree J, Pushpalatha K, Ali S, Biswas D, Jain A, Narang R, Madhuri S, George S, Kaduskar O, Kiruthika G, Sabarinathan R, Sapakal G, Gupta N, Murhekar MV. Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019-20. PLoS Negl Trop Dis 2021; 15:e0009608. [PMID: 34297716 PMCID: PMC8376255 DOI: 10.1371/journal.pntd.0009608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 08/19/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting children aged between 9 months to <15 years and established a hospital-based sentinel surveillance for CRS. Reliable data about incidence of CRS is necessary to monitor progress towards the elimination goal. Methods We conducted serosurveys in 2019–20 among pregnant women attending antenatal clinics of 6 hospitals, which were also sentinel sites for CRS surveillance, to estimate the prevalence of IgG antibodies against rubella. We systematically sampled 1800 women attending antenatal clinics and tested their sera for IgG antibodies against rubella. We used rubella seroprevalence data from the current survey and the survey conducted in 2017 among antenatal women from another 6 CRS surveillance sites to construct a catalytic models to estimate the incidence and burden of CRS. Result The seroprevalence of rubella antibodies was 82.3% (95% CI: 80.4–84.0). Rubella seropositivity did not differ by age group and educational status. Based on the constant and age-dependent force of infection models, we estimated that the annual incidence of CRS in India was 225.58 per 100,000 live births (95% CI: 217.49–232.41) and 65.47 per 100,000 live births (95% CI: 41.60–104.16) respectively. This translated to an estimated 14,520 (95% CI: 9,225–23,100) and 50,028 (95% CI: 48,234–51,543) infants with CRS every year based on age-dependent and constant force of infection models respectively. Conclusions Our findings indicated that about one fifth of women in the reproductive age group in India were susceptible for rubella. The estimates of CRS incidence will serve as a baseline to monitor the impact of MRCV SIAs, as well progress towards the elimination goal of rubella/CRS. Rubella infection during the first trimester of pregnancy can affect fetus, resulting in spontaneous abortion, stillbirth or birth of a baby with a combination of birth defects known as congenital rubella syndrome (CRS). Vaccination with rubella containing vaccine (RCV) is recommended as one of the strategies for eliminating rubella/CRS. The Southeast Asia region has set a target to eliminate rubella/CRS by 2023. Towards this goal, India completed nationwide immunization campaigns using measles-rubella vaccine during 2017–19, targeting children aged 9 months to <15 years. A case-based surveillance for CRS was initiated in five sentinel hospitals (Phase-1) in 2016 and later expanded to additional 6 sites (Phase-2) in 2019, to estimate burden of CRS and monitor its trend. As an adjunct to CRS surveillance, periodic serologic surveys were also planned to monitor the rubella seroprevalence among the pregnant women. A serosurvey conducted in 2017 indicated that 83.4% pregnant women attending antenatal clinics of Phase-1 sentinel hospitals had IgG antibodies against rubella. The second serosurvey conducted during 2019–20 in 6 Phase-2 sites indicated a comparable seroprevalence of 82.3%. Using seroprevalence data from these two serosurveys, we estimated that the annual incidence of CRS in India was 225.58 per 100,000 live births with constant force of infection and 65.47 per 100,000 live births with age-dependent force of infection models. This incidence rates translated to an estimated 14,520 to 50,028 infants with CRS every year. The estimates of CRS incidence will serve as a baseline to monitor the progress towards the elimination goal of rubella/CRS in India.
Collapse
Affiliation(s)
| | - Shally Awasthi
- King George Medical University, Lucknow, Uttar Pradesh, India
| | | | - S Geetha
- Govt Medical College, Thiruvananthapuram, Kerala, India
| | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India
| | - Shikha Malik
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Bhupeshwari Patel
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | | | | | - Anjoo Agarwal
- King George Medical University, Lucknow, Uttar Pradesh, India
| | | | - Shuchi Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India
| | | | - J Priyasree
- Govt Medical College, Thiruvananthapuram, Kerala, India
| | - K Pushpalatha
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Syed Ali
- Govt Medical College, Thiruvananthapuram, Kerala, India
| | - Debasis Biswas
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Amita Jain
- King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rahul Narang
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India.,All India Institute of Medical Sciences, Bibinagar, Telangana
| | | | - Suji George
- ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Ojas Kaduskar
- ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - G Kiruthika
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - R Sabarinathan
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Gajanan Sapakal
- ICMR-National Institute of Virology, Pune, Maharashtra, India
| | | | - Manoj V Murhekar
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| |
Collapse
|
2
|
Dirsipam K, Ponnala D, Madduru D, Bonu R, Jahan P. Association of FOXP3 rs3761548 polymorphism and its reduced expression with unexplained recurrent spontaneous abortions: A South Indian study. Am J Reprod Immunol 2021; 86:e13431. [PMID: 33882185 DOI: 10.1111/aji.13431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/01/2021] [Accepted: 04/15/2021] [Indexed: 12/24/2022] Open
Abstract
PROBLEM Fork Head Box Protein 3 (FOXP3) is an X-linked gene, codes for a master transcription regulatory protein that controls the development and function of immunosuppressive T regulatory (Treg) cells. They are crucial mediators of maternal foetal tolerance and successful pregnancy outcome. The aim of the study is to evaluate the association of FOXP3 rs3761548 functional polymorphism and to assess the serum concentrations of full-length FOXP3 protein in Unexplained Recurrent Spontaneous Abortions (URSA) patients of Southern India. METHOD OF STUDY The study included blood samples from 150 URSA patients and 150 healthy, pregnant parous women. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism was done for rs3761548 FOXP3 genotyping. Serum concentrations of full-length FOXP3 protein were estimated by enzyme-linked immunosorbent assay. RESULTS The frequencies of mutant A allele, CA and AA genotypes of rs3761548 functional polymorphism were significantly elevated in patients compared to healthy, pregnant parous women and exhibited a two, three and twofold increased risk respectively towards URSA. Serum concentrations of full-length FOXP3 protein were high in controls compared to patients (10.14 ± .30 vs. 8.84 ± 1.73 ng/ml; p < .05). CONCLUSION Our results advocate an association of FOXP3 rs3761548 polymorphism and reduced expression of full-length FOXP3 protein with URSA.
Collapse
Affiliation(s)
- Kethora Dirsipam
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Hyderabad, India
| | - Deepika Ponnala
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Hyderabad, India
| | - Dhatri Madduru
- Department of Biochemistry, Osmania University, Hyderabad, India
| | - Rajeswari Bonu
- Department of Obstetrics & Gynaecology, Niloufer Hospital, Hyderabad, India
| | - Parveen Jahan
- School of Sciences, Maulana Azad National Urdu University, Hyderabad, India
| |
Collapse
|
3
|
Abstract
Dense deposit disease (DDD), earlier called Type II membranoproliferative glomerulonephritis is distinct disease having frequent relapses reaching end-stage kidney disease by 10-year in up to 50%-60% of cases and high recurrence rate in the allograft. The term DDD is derived from its distinctive ribbon-like osmiophilic deposits in the lamina densa of glomerular basement membrane by electron microscopy. Pathogenetically, alternate pathway dysfunction leads to this disease, which is diagnosed by ultrastructure. Herein, we describe our observation of C4d positivity in an adolescent boy with DDD.
Collapse
Affiliation(s)
- M Vankalakunti
- Department of Nephropathology, Manipal Hospital, Bengaluru, Karnataka, India
| | - R Augustine
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - R Jangamani
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - V Siddini
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - R Bonu
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - K Babu
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - S H Ballal
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
4
|
Vankalakunti M, Rohan A, Vishwanath S, Rampure S, Bonu R, Babu K, Ballal HS. Spectrum of renal involvement in hematolymphoid neoplasms: Renal biopsy findings of 12 cases. Indian J Nephrol 2015. [PMID: 26199470 PMCID: PMC4495473 DOI: 10.4103/0971-4065.139093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Spectrum of causes for renal dysfunction in patients with hematolymphoid malignancy (excluding plasma cell dyscrasia) is varied. A retrospective evaluation of “native” renal biopsies referred to our institute during the period from January 2010 to December 2013 revealed 12 cases. Age ranged between 7 and 69 (median 54.5) years. All patients were males. The neoplasms included non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, Burkitt's lymphoma, intravascular lymphoma, Hodgkin lymphoma and chronic myeloid leukemia. Proteinuria was noted in 66% of the patients (nephrotic range in 5, subnephrotic range in 3). Renal insufficiency was noted in 100% patients. Malignancy-related kidney injury was noted in 75% of the cases. Renal histology showed lymphomatous infiltration (8), membranoproliferative glomerulonephritis (MPGN) (3), intracapillary monoclonal deposit disease (1) and intravascular lymphoma (1). Distribution of lymphomatous infiltration was diffuse in 50% and focal in 50%. We observed that renal dysfunction was predominantly a direct effect, that is, lymphomatous invasion. Paraneoplastic glomerulopathic changes occur in the form of MPGN. Proteinuria of >2 g/day correlated with glomerular disease.
Collapse
Affiliation(s)
- M Vankalakunti
- Department of Pathology, Manipal Hospital, Bengaluru, Karnataka, India
| | - A Rohan
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - S Vishwanath
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - S Rampure
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - R Bonu
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| | - K Babu
- Department of Pathology, Manipal Hospital, Bengaluru, Karnataka, India
| | - H S Ballal
- Department of Nephrology, Manipal Hospital, Bengaluru, Karnataka, India
| |
Collapse
|