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1.
J Assoc Physicians India ; 70(9): 11-12, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36082881

ABSTRACT

BACKGROUND: Dengue infection is a disease that progresses rapidly to life-threatening conditions. Our goal was to develop a practical scoring system based on clinical profiles and routine tests to predict the severity of infection. METHODS: This cross-sectional observational study included 500 patients with dengue infection. Patient demographics, clinical symptoms, regular laboratory tests, and results were collected. Dengue infections are divided into three classes, depending on their severity: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Based on the total score, patients were divided into three severities. RESULTS: Patients with DSS and DHF scored higher with worsening clinical features and routine laboratory tests compared to DF. Clinical predictors of severity include older age, increased white blood cell (WBC) count, increased hematocrit, increased prothrombin time, decreased platelet count, decreased blood pressure, presence of peri-gallbladder (GB) edema, third space loss, hepatomegaly, and other organ involvement. The severity range is 0-12, and the score is 0-3 for DF, 4-8 for DHF, and 9-12 for DSS. Based on the derived scores, patients were classified according to their original severity in 63% of cases. CONCLUSION: This dengue infection severity scores correctly classified patients according to their original severity grade of DF, DHF, or DSS. This scoring system helps to quickly assess dengue infections and start treatment according to the correct severity category.


Subject(s)
Dengue , Severe Dengue , Cross-Sectional Studies , Dengue/diagnosis , Humans , Severe Dengue/diagnosis , Severity of Illness Index
2.
Front Immunol ; 13: 892469, 2022.
Article in English | MEDLINE | ID: mdl-36091000

ABSTRACT

Background: Dengue virus (DENV) infection induces various clinical manifestations and even causes organ injuries, leading to severe dengue haemorrhagic fever and dengue shock syndrome. Hepatic dysfunction was identified as a risk predictor of progression to severe disease during the febrile phase of dengue. However, the underlying mechanisms of hepatic injury remain unclear. Methods: A model of dengue disease was established in IFNAR -/- C57BL/6 mice by challenge with DENV-2. Body weight, symptoms, haematological parameters and liver pathological observations in mice were used to determine the effects of DENV infection. Liver transcriptome sequencing was performed to evaluate the features of the host response in IFNAR -/- mice challenged with DENV. Functional enrichment analysis and analysis of significantly differentially expressed genes (DEGs) were used to determine the critical molecular mechanism of hepatic injury. Results: We observed haemoconcentration, leukopenia and liver pathologies in mice, consistent with findings in clinical dengue patients. Some differences in gene expression and biological processes were identified in this study. Transcriptional patterns in the liver indicated that antiviral responses to DENV and tissue damage via abnormal expression of proinflammatory cytokines were induced. Further analysis showed that the upregulated DEGs were significantly enriched in the leukocyte transendothelial migration, complement and coagulation cascades, and cytokine-cytokine receptor interactions signalling pathways, which are considered to be closely associated with the pathogenic mechanism of dengue. IL6, IL 10, ICAM-1, VCAM-1, MMP9 and NLRP3 were identified as biomarkers of progression to severe disease. Conclusions: The interactions of these cytokines, which activate inflammatory signalling, may lead to organ injury and haemoconcentration and even to vascular leakage in tissues, including the mouse liver. Our study identifies candidate host targets that could be used for further functional verification.


Subject(s)
Dengue Virus , Dengue , Animals , Cytokines/genetics , Dengue Virus/physiology , Disease Models, Animal , Liver/pathology , Mice , Mice, Inbred C57BL , Transcriptome
3.
Pak J Biol Sci ; 25(9): 816-821, 2022 Jan.
Article in English | MEDLINE | ID: mdl-36098083

ABSTRACT

<b>Background and Objective:</b> Dengue cases have increased while the spread is getting broader worldwide. Temephos has been frequently used to control the larvae of the <i>Aedes aegypti</i> L., the primary vector of dengue. The intensive use of this larvicide has given rise to resistance. This study aims to determine the susceptibility status of <i>Ae. aegypti</i> to temephos and examine the two mutations (F290V and F455W) that possibly occur in the <i>Ace-1</i> gene of <i>Ae. aegypti</i> from Salido Sub-District, IV Jurai District, Pesisir Selatan Regency. <b>Materials and Methods:</b> The susceptibility test was performed referring to a standard method of the World Health Organization, followed by a molecular test (polymerase chain reaction) and sequencing. <b>Results:</b> The results showed that the larvae of <i>Ae. aegypti</i> have been tolerant to temephos (0.012 mg L<sup></sup><sup>1</sup>) with a percentage of larval mortality of 91.67%. The sequencing analysis in the <i>Ace-1</i> gene revealed the absence of F290V and F455W mutation in temephos-resistant <i>Ae. aegypti</i>, but a point mutation was detected at codon 506. This mutation shifts the ACA codon to ACT, but still codes for the same amino acid, threonine. <b>Conclusion:</b> Our study indicates the presence of other resistance mechanisms in the major dengue vector of the Salido District. Implementation of the alternative population control strategy is required to prevent the temephos resistance further.


Subject(s)
Aedes , Dengue , Insecticides , Aedes/genetics , Animals , Indonesia , Insecticide Resistance/genetics , Insecticides/pharmacology , Larva/genetics , Mosquito Vectors/genetics , Mutation , Temefos
4.
Trans R Soc Trop Med Hyg ; 116(9): 853-867, 2022 Sep 10.
Article in English | MEDLINE | ID: mdl-36088278

ABSTRACT

BACKGROUND: Dengue is an acute viral disease of major relevance and impact on public health, causing major epidemics around the world, especially in tropical regions. Here we aimed to analyse the temporal trend and spatial risk, as well as social vulnerability factors, associated with the occurrence of dengue in the state of Bahia, Brazil between 2009 and 2018. METHODS: This is an ecological study carried out with all suspected cases of dengue in Bahia between 2009 and 2018. The data were obtained from the National Notifiable Diseases Information System, available on the website of the Health Department of the State of Bahia, and from the Brazilian Institute of Geography and Statistics. We used the Joinpoint regression model, local empirical Bayesian model for smoothing, global and local Moran statistics and spatial scanning statistics. The relationship between the dengue incidence rate and social determinants was tested using Moran's bivariate correlation. RESULTS: During the study period, 451 847 probable dengue cases were registered in Bahia. A declining trend was observed in 39.28% (n=11) of the state's health regions and 60.71% (n=17) showed a stationary tendency. The spatiotemporal scanning statistic showed nine clusters of dengue occurrence. The largest cluster had a radius of 342.14 km, consisting of 160 municipalities, 120 094 cases (710.20 cases/100 000 inhabitants) and a relative risk of 2.80. In the multivariate regression model, 11 variables showed a significant association: Social Vulnerability Index (SVI), Municipal Human Development Index (MHDI), SVI urban infrastructure, SVI human capital, MHDI longevity, MHDI education, proportion of people living in households with per capita income less than half the minimum wage (in 2010) and who spend more than 1 h commuting, proportion of mothers who are heads of household who did not complete elementary school and with children <15 y of age, activity rate of persons ages 10-14 y and per capita income. CONCLUSIONS: In the analysis of the spatial distribution, areas of risk of disease transmission throughout the state were identified. These results can provide subsidies for the strategic planning of actions, as well as for the implementation of programs and/or public policies in order to control the incidence of dengue in the population.


Subject(s)
Dengue , Adolescent , Bayes Theorem , Brazil/epidemiology , Child , Dengue/epidemiology , Humans , Incidence , Risk Factors
5.
J Assoc Physicians India ; 70(9): 11-12, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36082886

ABSTRACT

BACKGROUND: There were widespread unconfirmed reports about the increased severity of dengue post-second wave of the COVID-19 pandemic in India. It is known that a second dengue infection with a different strain in an individual can trigger antibody-dependent enhancement (ADE). A similar phenomenon is hypothesized for severe COVID-19 infection since both dengue and COVID-19 are viral diseases with different and varying strains. However, much research is needed to confirm this hypothesis. In this context, we intended to assess the severity of dengue illness in relation to previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, possibly the role of COVID-19 antibodies as an early predictor of severe dengue illness. OBJECTIVE: To assess the utility of COVID-19 antibodies for early identification of severe dengue illness among children in the post-third-wave period of COVID-19 infection in India. MATERIALS AND METHODS: All hospitalized children with dengue illness were categorized as severe (shock and/or hemorrhage and/or multi-organ dysfunction) and non-severe dengue illness (dengue with or without warning signs) as per WHO definition. COVID-19 antibody titers were estimated in both groups. Clinical features and seroprevalence of COVID-19 antibodies were compared in both groups. RESULT: A total of 31 children were studied (13 severe and 18 non-severe dengue illnesses). The most common symptoms prior to presenting to the hospital included fever (100% in both groups), vomiting (85% in severe and 63% in non-severe), abdominal pain (85% in severe and 50% in non-severe), poor feeding (54% in severe and 28% in non-severe), and skin rashes (15% in severe and none in non-severe). The mean duration from the onset of fever to the first hospital visit was 4.6 days in severe illness and 5.3 days in non-severe dengue illness. The mean duration of hospitalization was 9.7 days in severe dengue illness and 4.1 days in non-severe dengue illness. While 92.3% of all severe dengue had significantly higher COVID-19 antibody titers, it was found elevated only in 44.4% of the children with non-severe dengue illness (p-value 0.0059; Yates' corrected p-value 0.0179). CONCLUSION: Clinical symptoms prior to presenting to the hospital were fever, vomiting, abdominal pain, poor oral feeding, and skin rashes. While fever, vomiting, and abdominal pain were seen commonly in both severe and non-severe dengue illnesses, the presence of skin rash during febrile phase is associated with severe dengue illness only. Hospitalized children having severe dengue had increased seroprevalence of COVID-19 antibodies (92.3%) compared to children with non-severe dengue (44.4%). However, there is no corelation of the severity of dengue illness with absolute values of COVID-19 antibody levels. Therefore, the presence of COVID-19 antibodies (previous COVID-19 infection) can be a predictor of severe illness in children with dengue especially if associated with poor oral feeding and skin rashes. The limitation of the study is its lesser sample size to conclude any definitive statement; nevertheless, the study paves way for a similar cohort of a larger sample size to draw conclusions.


Subject(s)
COVID-19 , Dengue , Severe Dengue , Abdominal Pain , Antibodies, Viral , COVID-19/diagnosis , COVID-19/epidemiology , Child , Child, Hospitalized , Dengue/complications , Dengue/diagnosis , Dengue/epidemiology , Fever/diagnosis , Humans , Pandemics , SARS-CoV-2 , Seroepidemiologic Studies , Severe Dengue/diagnosis , Severe Dengue/epidemiology , Vomiting
6.
Sci Data ; 9(1): 547, 2022 09 07.
Article in English | MEDLINE | ID: mdl-36071062

ABSTRACT

Dengue, a mosquito-transmitted viral disease, has posed a public health challenge to Singaporean residents over the years. In 2020, Singapore experienced an unprecedented dengue outbreak. We collected a dataset of geographical dengue clusters reported by the National Environment Agency (NEA) from 15 February to 9 July in 2020, covering the nationwide lockdown associated with Covid-19 during the period from 7 April to 1 June. NEA regularly updates the dengue clusters during which an infected person may be tagged to one cluster based on the most probable infection location (residential apartment or workplace address), which is further matched to fine-grained spatial units with an average coverage of about 1.35 km2. Such dengue cluster dataset helps not only reveal the dengue transmission patterns, but also reflect the effects of lockdown on dengue spreading dynamics. The resulting data records are released in simple formats for easy access to facilitate studies on dengue epidemics.


Subject(s)
COVID-19 , Dengue , Animals , COVID-19/epidemiology , Communicable Disease Control , Dengue/epidemiology , Disease Outbreaks , Humans , Singapore/epidemiology
7.
Front Public Health ; 10: 942381, 2022.
Article in English | MEDLINE | ID: mdl-36051997

ABSTRACT

Introduction: Co-infection of coronavirus disease 2019 (COVID-19) and dengue may coexist, as both viruses share similar laboratory and clinical features, making diagnosis and treatment challenging for health care professionals to prescribe, negatively impacting patient prognosis, and outcomes. Results and discussions: Both cases were positive for PCR and X-ray laboratory investigation at clinical examination, confirming COVID-19 and dengue co-infection, admission, and better management in referral hospitals are presented and discussed. The timeline provides detailed cases of situational analysis and the medical actions taken, as well as the outcomes. Conclusion: Both co-infection cases' (patients) health conditions had a poor prognosis and diagnosis and ended with undesired outcomes. Scaling up dual mosquito-vector linked viral diseases surveillance in understanding the transmission dynamics, early diagnosis, and the timely and safe monitoring of case management in clinical and hospital settings nationwide is paramount in curbing preventable co-infections and mortality.


Subject(s)
COVID-19 , Coinfection , Dengue , Animals , Coinfection/epidemiology , Dengue/diagnosis , Dengue/epidemiology , Humans , Saudi Arabia/epidemiology
8.
PLoS One ; 17(9): e0273902, 2022.
Article in English | MEDLINE | ID: mdl-36048788

ABSTRACT

Understanding the distribution of pathogens causing acute febrile illness (AFI) is important for clinical management of patients in resource-poor settings. We evaluated the proportion of AFI caused by specific pathogens among outpatients in Bangladesh. During May 2019-March 2020, physicians screened patients aged ≥2 years in outpatient departments of four tertiary level public hospitals. We randomly enrolled patients having measured fever (≥100.4°F) during assessment with onset within the past 14 days. Blood and urine samples were tested at icddr,b through rapid diagnostic tests, bacterial culture, and polymerase chain reaction (PCR). Acute and convalescent samples were sent to the Centers for Disease Control and Prevention (USA) for Rickettsia and Orientia (R/O) and Leptospira tests. Among 690 patients, 69 (10%) had enteric fever (Salmonella enterica serotype Typhi orSalmonella enterica serotype Paratyphi), 51 (7.4%) Escherichia coli, and 28 (4.1%) dengue detected. Of the 441 patients tested for R/O, 39 (8.8%) had rickettsioses. We found 7 (2%) Leptospira cases among the 403 AFI patients tested. Nine patients (1%) were hospitalized, and none died. The highest proportion of enteric fever (15%, 36/231) and rickettsioses (14%, 25/182) was in Rajshahi. Dhaka had the most dengue cases (68%, 19/28). R/O affected older children and young adults (IQR 8-23 years) and was detected more frequently in the 21-25 years age-group (17%, 12/70). R/O was more likely to be found in patients in Rajshahi region than in Sylhet (aOR 2.49, 95% CI 0.85-7.32) between July and December (aOR 2.01, 1.01-5.23), and who had a history of recent animal entry inside their house than not (aOR 2.0, 0.93-4.3). Gram-negative Enterobacteriaceae were the most common bacterial infections, and dengue was the most common viral infection among AFI patients in Bangladeshi hospitals, though there was geographic variability. These results can help guide empiric outpatient AFI management.


Subject(s)
COVID-19 , Dengue , Leptospira , Rickettsia Infections , Rickettsia , Typhoid Fever , Bangladesh/epidemiology , Delivery of Health Care , Dengue/epidemiology , Fever/diagnosis , Hospitals , Humans , Outpatients , Pandemics , Rickettsia Infections/microbiology , Salmonella paratyphi A , Typhoid Fever/diagnosis
9.
Vopr Virusol ; 67(4): 322-330, 2022 09 12.
Article in Russian | MEDLINE | ID: mdl-36097713

ABSTRACT

INTRODUCTION: In Russia, the approved morbidity statistics system is represented by the International Classification of Diseases of the 10th revision (ICD-10). This classification provides two forms of dengue fever (DF): dengue fever (A90) and hemorrhagic dengue (A91). Official statistics on the ratio of forms of DF is not published in open sources and this lack of information about the real ratio of the forms of DF makes it difficult to objectively assess the factors that determine the severity of this disease. THE AIM: compare the clinical and epidemiological features of dengue fever and hemorrhagic dengue fever in patients hospitalized in 2009-2019 to the City Infectious Clinical Hospital No. 1, Moscow. MATERIALS AND METHODS: A retrospective cohort study. We analyzed the patient database and reviewed 391 medical records of patients with diagnosed dengue fever. We compared gender, age characteristics, travel geography including information about previous visits of patients to endemic regions and dengue virus serotype. To determine the primary and re-infection rate, an analysis of IgG for the dengue virus was carried out on days 1-5 of the disease. To compare indicators, 95% confidence intervals for proportions, medians, and interquartile ranges were calculated. The significance of differences between independent samples for assessing qualitative characteristics was carried out using the criteria χ2, the odds ratio. To assess the quantitative characteristics, the Mann-Whitney test was used. Differences were considered statistically significant at p ≤ 0.05. RESULTS: The proportion of patients with dengue fever was 14.9% of all hospitalized with febrile illnesses that developed after international travel. Hemorrhagic dengue fever (DHF) was diagnosed in 15.7% of patients with dengue fever. DHF developed significantly more often in women, as well as in those who had history of repeated visits to endemic regions. However, DHF was also diagnosed in 10.9% of first-time travelers to tropical countries. We did not find significant differences in the rates of DHF development depending on age and dengue virus serotype. In a number of patients who had not previously traveled to endemic regions, IgG to the dengue virus were detected, which may indicate a previous infection with related flaviviruses. CONCLUSION: It has been established that in the regions most visited by Russians, there is a circulation of all serotypes of the dengue virus with an annual change in the predominant serotype.


Subject(s)
Dengue , Severe Dengue , Dengue/diagnosis , Dengue/epidemiology , Female , Humans , Immunoglobulin G , Odds Ratio , Retrospective Studies , Severe Dengue/diagnosis , Severe Dengue/epidemiology
10.
Front Cell Infect Microbiol ; 12: 979996, 2022.
Article in English | MEDLINE | ID: mdl-36171757

ABSTRACT

The mechanistic target of rapamycin (mTOR) functions in two distinct complexes: mTORC1, and mTORC2. mTORC1 has been implicated in the pathogenesis of flaviviruses including dengue, where it contributes to the establishment of a pro-viral autophagic state. Activation of mTORC2 occurs upon infection with some viruses, but its functional role in viral pathogenesis remains poorly understood. In this study, we explore the consequences of a physical protein-protein interaction between dengue non-structural protein 5 (NS5) and host cell mTOR proteins during infection. Using shRNA to differentially target mTORC1 and mTORC2 complexes, we show that mTORC2 is required for optimal dengue replication. Furthermore, we show that mTORC2 is activated during viral replication, and that mTORC2 counteracts virus-induced apoptosis, promoting the survival of infected cells. This work reveals a novel mechanism by which the dengue flavivirus can promote cell survival to maximize viral replication.


Subject(s)
Dengue , Multiprotein Complexes , Apoptosis , Humans , Mechanistic Target of Rapamycin Complex 1/genetics , Mechanistic Target of Rapamycin Complex 1/metabolism , Mechanistic Target of Rapamycin Complex 2/genetics , Mechanistic Target of Rapamycin Complex 2/metabolism , Multiprotein Complexes/genetics , Multiprotein Complexes/metabolism , RNA, Small Interfering , Sirolimus/pharmacology , TOR Serine-Threonine Kinases/metabolism , Virus Replication
11.
Parasit Vectors ; 15(1): 346, 2022 Sep 29.
Article in English | MEDLINE | ID: mdl-36175962

ABSTRACT

BACKGROUND: Mosquito-borne diseases (e.g., transmitted by Aedes aegypti) affect almost 700 million people each year and result in the deaths of more than 1 million people annually. METHODS: We examined research undertaken during the period 1951-2020 on the effects of temperature and climate change on Ae. aegypti, and also considered research location and between-country collaborations. RESULTS: The frequency of publications on the effects of climate change on Ae. aegypti increased over the period examined, and this topic received more attention than the effects of temperature alone on this species. The USA, UK, Australia, Brazil, and Argentina were the dominant research hubs, while other countries fell behind with respect to number of scientific publications and/or collaborations. The occurrence of Ae. aegypti and number of related dengue cases in the latter are very high, and climate change scenarios predict changes in the range expansion and/or occurrence of this species in these countries. CONCLUSIONS: We conclude that some of the countries at risk of expanding Ae. aegypti populations have poor research networks that need to be strengthened. A number of mechanisms can be considered for the improvement of international collaboration, representativity and diversity, such as research networks, internationalization programs, and programs that enhance representativity. These types of collaboration are considered important to expand the relevant knowledge of these countries and for the development of management strategies in response to climate change scenarios.


Subject(s)
Aedes , Dengue , Aedes/physiology , Animals , Australia/epidemiology , Brazil/epidemiology , Climate Change , Dengue/epidemiology , Dengue/prevention & control , Humans , Mosquito Vectors/physiology , Temperature
12.
Bull Math Biol ; 84(11): 124, 2022 09 19.
Article in English | MEDLINE | ID: mdl-36121515

ABSTRACT

Vector-borne diseases are progressively spreading in a growing number of countries, and it has the potential to invade new areas and habitats. From the dynamical perspective, the spatial-temporal interaction of models that try to adjust to such events is rich and challenging. The first challenge is to address the dynamics of vectors (very fast and local) and the dynamics of humans (very heterogeneous and non-local). The objective of this work is to use the well-known Ross-Macdonald models, identifying different time scales, incorporating human spatial movements and estimate in a suitable way the parameters. We will concentrate on a practical example, a simplified space model, and apply it to dengue spread in the state of Rio de Janeiro, Brazil.


Subject(s)
Dengue , Vector Borne Diseases , Brazil/epidemiology , Dengue/epidemiology , Humans , Mathematical Concepts , Models, Biological , Vector Borne Diseases/epidemiology , Vector Borne Diseases/prevention & control
13.
Viruses ; 14(9)2022 09 18.
Article in English | MEDLINE | ID: mdl-36146879

ABSTRACT

Dengue virus (DENV) is primarily transmitted by the bite of an infected mosquito of Aedes aegypti and Aedes albopictus, and symptoms caused may range from mild dengue fever to severe dengue hemorrhagic fever and dengue shock syndrome. Reverse genetic system represents a valuable tool for the study of DENV virology, infection, pathogenesis, etc. Here, we generated and characterized an eukaryotic-activated full-length infectious cDNA clone for a DENV serotype 1 (DENV-1) isolate, D19044, collected in 2019. Initially, nearly the full genome was determined by sequencing overlapping RT-PCR products, and was classified to be genotype I DENV-1. D19044 wild-type cDNA clone (D19044_WT) was assembled by four subgenomic fragments, in a specific order, into a low-copy vector downstream the CMV promoter. D19044_WT released the infectious virus at a low level (1.26 × 103 focus forming units per milliliter [FFU/mL]) following plasmid transfection of BHK-21 cells. Further adaptation by consecutive virus passages up to passage 37, and seven amino acid substitutions (7M) were identified from passage-recovered viruses. The addition of 7M (D19044_7M) greatly improved viral titer (7.5 × 104 FFU/mL) in transfected BHK-21 culture, and virus infections in 293T, Huh7.5.1, and C6/36 cells were also efficient. D19044_7M plasmid was genetically stable in transformant bacteria after five transformation-purification cycles, which did not change the capacity of producing infectious virus. Moreover, the D19044_7M virus was inhibited by mycophenolic acid in a dose-dependent manner. In conclusion, we have developed a DNA-launched full-length infectious clone for a genotype I isolate of DENV-1, with genetic stability in transformant bacteria, thus providing a useful tool for the study of DENV-1.


Subject(s)
Aedes , Dengue Virus , Dengue , Animals , Clone Cells , DNA, Complementary , Dengue Virus/genetics , Genotype , Mosquito Vectors , Mycophenolic Acid , Serogroup
14.
PLoS One ; 17(9): e0273414, 2022.
Article in English | MEDLINE | ID: mdl-36074783

ABSTRACT

Blood culturing remains the "gold standard" for bloodstream infection (BSI) diagnosis, but the method is inaccessible to many developing countries due to high costs and insufficient resources. To better understand the utility of blood cultures among patients in Indonesia, a country where blood cultures are not routinely performed, we evaluated data from a previous cohort study that included blood cultures for all participants. An acute febrile illness study was conducted from July 2013 to June 2016 at eight major hospitals in seven provincial capitals in Indonesia. All participants presented with a fever, and two-sided aerobic blood cultures were performed within 48 hours of hospital admission. Positive cultures were further assessed for antimicrobial resistance (AMR) patterns. Specimens from participants with negative culture results were screened by advanced molecular and serological methods for evidence of causal pathogens. Blood cultures were performed for 1,459 of 1,464 participants, and the 70.6% (1,030) participants that were negative by dengue NS1 antigen test were included in further analysis. Bacteremia was observed in 8.9% (92) participants, with the most frequent pathogens being Salmonella enterica serovar Typhi (41) and Paratyphi A (10), Escherichia coli (14), and Staphylococcus aureus (10). Two S. Paratyphi A cases had evidence of AMR, and several E. coli cases were multidrug resistant (42.9%, 6/14) or monoresistant (14.3%, 2/14). Culture contamination was observed in 3.6% (37) cases. Molecular and serological assays identified etiological agents in participants having negative cultures, with 23.1% to 90% of cases being missed by blood cultures. Blood cultures are a valuable diagnostic tool for hospitalized patients presenting with fever. In Indonesia, pre-screening patients for the most common viral infections, such as dengue, influenza, and chikungunya viruses, would maximize the benefit to the patient while also conserving resources. Blood cultures should also be supplemented with advanced laboratory tests when available.


Subject(s)
Bacteremia , Dengue , Typhoid Fever , Anti-Bacterial Agents , Bacteremia/complications , Bacteremia/diagnosis , Bacteremia/epidemiology , Dengue/complications , Escherichia coli , Fever/diagnosis , Hospitalization , Humans , Indonesia/epidemiology , Typhoid Fever/complications , Typhoid Fever/diagnosis , Typhoid Fever/epidemiology
15.
Vaccine ; 40(41): 5912-5923, 2022 Sep 29.
Article in English | MEDLINE | ID: mdl-36068106

ABSTRACT

In the CYD14 trial of the CYD-TDV dengue vaccine in 2-14 year-olds, neutralizing antibody (nAb) titers to the vaccine-insert dengue strains correlated inversely with symptomatic, virologically-confirmed dengue (VCD). Also, vaccine efficacy against VCD was higher against dengue prM/E amino acid sequences closer to the vaccine inserts. We integrated the nAb and sequence data types by assessing nAb titers as a correlate of sequence-specific VCD separately in the vaccine arm and in the placebo arm. In both vaccine and placebo recipients the correlation of nAb titer with sequence-specific VCD was stronger for dengue nAb contact site sequences closer to the vaccine (p = 0.005 and p = 0.012, respectively). The risk of VCD in vaccine (placebo) recipients was 6.7- (1.80)-fold lower at the 90th vs 10th percentile of nAb for viruses perfectly matched to CYD-TDV, compared to 2.1- (0.78)-fold lower at the 90th vs 10th percentile for viruses with five amino acid mismatches. The evidence for a stronger sequence-distance dependent correlate of risk for the vaccine arm indicates departure from the Prentice criteria for a valid sequence-distance specific surrogate endpoint and suggests that the nAb marker may affect dengue risk differently depending on whether nAbs arise from infection or also by vaccination. However, when restricting to baseline-seropositive 9-14 year-olds, the correlation pattern became more similar between the vaccine and placebo arms, supporting nAb titers as an approximate surrogate endpoint in this population. No sequence-specific nAb titer correlates of VCD were seen in baseline-seronegative participants. Integrated immune response/pathogen sequence data correlates analyses could help increase knowledge of correlates of risk and surrogate endpoints for other vaccines against genetically diverse pathogens. Trial registration: EU Clinical Trials Register 2014-001708-24; registration date 2014-05-26.


Subject(s)
Dengue Vaccines , Dengue Virus , Dengue , Amino Acids , Antibodies, Neutralizing , Antibodies, Viral , Asia/epidemiology , Dengue/prevention & control , Dengue Virus/genetics , Humans , Vaccine Efficacy , Vaccines, Combined
16.
J Vector Borne Dis ; 59(2): 109-114, 2022.
Article in English | MEDLINE | ID: mdl-36124476

ABSTRACT

BACKGROUND & OBJECTIVES: Dengue virus (DENV) is an RNA virus that infects approximately 2.5 billion people around the world. The incidence of dengue fever has rapidly increased at an alarming rate in the last few years and has affected thousands of people in Pakistan. This review explores the prevalence, serotypes and pathogenesis of dengue virus circulating in Pakistan. METHODS: A systematic review of observational studies published between 1994 and December 2019 was performed. All records of the confirmed outbreak of dengue fever in Pakistan were reviewed and articles containing no primary data were excluded. RESULTS: Four identified serotypes of dengue virus (DENV 1-4) circulate in different regions of the world causing epidemics. The most prevalent serotype, which is still epidemic and dominant in Pakistan, is DENV-2. Many factors like over-population, rapid urbanization, travelling, lack of vector control in dengue endemic areas and inadequate health-care are responsible of dynamic and huge raise of dengue in Pakistan. INTERPRETATION & CONCLUSION: Currently there is no specific treatment for prevention of dengue virus. Recently some antiviral compounds were being tested to eradicate this disease. There is a need to develop an efficient and safe vaccine for all four serotypes to combat dengue viral infection globally and particularly in Pakistan.


Subject(s)
Dengue Virus , Dengue , Antiviral Agents , Dengue/epidemiology , Dengue/prevention & control , Dengue Virus/genetics , Humans , Pakistan/epidemiology , Serogroup
17.
J Vector Borne Dis ; 59(2): 139-144, 2022.
Article in English | MEDLINE | ID: mdl-36124479

ABSTRACT

Malaysia Mosquito Autocidal Trap (MyMAT) is a green technology Aedes mosquito trap that does not use harmful chemical substances. This study aimed to evaluate the efficiency of MyMAT in reducing dengue cases and relating the cases to rainfall. An experimental field study was conducted for 42 weeks at Pangsapuri Nilam Sari, Shah Alam, Selangor. A total of 624 MyMAT was allocated at four blocks: inside each apartment and outside at the corridors in each level. Mosquito and rainfall data were collected weekly using MyMAT and a mobile rain gauge, respectively. The dengue cases data was retrieved from the e-dengue system obtained from the Malaysia Ministry of Health. The findings showed that MyMAT could catch 97% of Aedes mosquitoes and reduced dengue cases on average of 78%, indicating MyMAT is a reliable Aedes mosquito trap. Interestingly the findings also revealed a significant relationship between dengue cases, the number of Aedes mosquitoes, and rainfall. This week notified dengue cases increased when last two weeks mosquitoes increased due to previous two weeks rainfall increment. Thus indicating an indirect but significant relationship between this week notified dengue cases with the last four weeks rainfall. These relationships can be used in establishing a dengue outbreak forecasting model, which can act as an early warning system.


Subject(s)
Aedes , Dengue , Animals , Dengue/epidemiology , Dengue/prevention & control , Disease Outbreaks , Malaysia/epidemiology , Rain
18.
J Vector Borne Dis ; 59(2): 145-153, 2022.
Article in English | MEDLINE | ID: mdl-36124480

ABSTRACT

We aimed to assess the effect of gamma radiation on the expression of heat shock proteins Hsc70 and Hsp83 in Aedes aegypti. Adult males were irradiated with 50Gy of gamma radiation, and changes in the expression of proteins in SDS-PAGE gel bands corresponding to molecular weights ~60-75kDa and ~80-95kDa were analyzed at two different time points 6 and 12-hour post-irradiation, using a temporal mass spectrometry based semi-quantitative analysis. A 2-3-fold increase was observed in both proteins Hsc70 and Hsp83, at both time points. In addition, the experiment also revealed the overexpression of several other molecules such as Arginine Kinase - known to be upregulated in certain insects during stress, Esterase B1- implicated in insecticide resistance, and also down-regulation of the 26S proteasome non-ATPase regulatory subunit 1 and ubiquitin-activating enzyme E1 - both known to be involved in ubiquitin-mediated protein degradation. The results taken together with existing data on Hsp83 and Hsc70, indicate that these proteins may enhance the survival of Ae. aegypti following gamma radiation and could serve as molecular markers for the detection of radiation-induced stress.


Subject(s)
Aedes , Arginine Kinase , Dengue , Aedes/genetics , Animals , Arginine Kinase/metabolism , Esterases/metabolism , Esterases/pharmacology , Gamma Rays , Heat-Shock Proteins/genetics , Heat-Shock Proteins/metabolism , Heat-Shock Proteins/pharmacology , Male , Ubiquitin-Activating Enzymes/metabolism , Ubiquitin-Activating Enzymes/pharmacology , Ubiquitins/metabolism , Ubiquitins/pharmacology
19.
Salud Publica Mex ; 64(5, sept-oct): 478-487, 2022 Aug 19.
Article in English | MEDLINE | ID: mdl-36130361

ABSTRACT

OBJECTIVE: Evaluate spatially and temporally simultaneous presence of clusters of dengue and Zika clinical cases and their relationship with expected dengue transmission risk. MATERIALS AND METHODS: A classification of dengue risk transmission was carried out for whole country, and spatial autocorrelation analyses to identify clusters of confirmed clinical cases of dengue and Zika from 2015 to 2018 was conducted using Moran's Index statistics. RESULTS: Clusters of both diseases were identified in dengue-high risk munici-palities at the beginning of the outbreak, but, at the end of the outbreak, Zika clusters occurred in dengue low-risk mu-nicipalities. CONCLUSION: This study identified Zika clusters in low-risk dengue areas suggesting participation of several factors that favor virus introduction and dissemination, such as differences in entomological and control interventions, and the possibility of cross-immunity in the population.


Subject(s)
Dengue , Zika Virus Infection , Zika Virus , Dengue/epidemiology , Dengue/prevention & control , Disease Outbreaks , Humans , Incidence , Mexico/epidemiology , Zika Virus Infection/epidemiology
20.
Front Cell Infect Microbiol ; 12: 975222, 2022.
Article in English | MEDLINE | ID: mdl-36159640

ABSTRACT

Dengue is a major public health concern, affecting almost 400 million people worldwide, with about 70% of the global burden of disease in Asia. Despite revised clinical classifications of dengue infections by the World Health Organization, the wide spectrum of the manifestations of dengue illness continues to pose challenges in diagnosis and patient management for clinicians. When the Zika epidemic spread through the American continent and then later to Africa and Asia in 2015, researchers compared the characteristics of the Zika infection to Dengue, considering both these viruses were transmitted primarily through the same vector, the Aedes aegypti female mosquitoes. An important difference to note, however, was that the Zika epidemic diffused in a shorter time span compared to the persisting feature of Dengue infections, which is endemic in many Asian countries. As the pathogenesis of viral illnesses is affected by host immune responses, various immune modulators have been proposed as biomarkers to predict the risk of the disease progression to a severe form, at a much earlier stage of the illness. However, the findings for most biomarkers are highly discrepant between studies. Meanwhile, the cross-reactivity of CD8+ and CD4+ T cells response to Dengue and Zika viruses provide important clues for further development of potential treatments. This review discusses similarities between Dengue and Zika infections, comparing their disease transmissions and vectors involved, and both the innate and adaptive immune responses in these infections. Consideration of the genetic identity of both the Dengue and Zika flaviviruses as well as the cross-reactivity of relevant T cells along with the actions of CD4+ cytotoxic cells in these infections are also presented. Finally, a summary of the immune biomarkers that have been reported for dengue and Zika viral infections are discussed which may be useful indicators for future anti-viral targets or predictors for disease severity. Together, this information appraises the current understanding of both Zika and Dengue infections, providing insights for future vaccine design approaches against both viruses.


Subject(s)
Aedes , Dengue Virus , Dengue , Vaccines , Zika Virus Infection , Zika Virus , Animals , Cross Reactions , Female , Humans , Immunity, Humoral , Mosquito Vectors
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