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1.
Rev Soc Bras Med Trop ; 52: e20190167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596350

RESUMO

INTRODUCTION: The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017). METHODS: Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed. RESULTS: Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99). CONCLUSIONS: The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.


Assuntos
Febre de Chikungunya/epidemiologia , Epidemias , Adolescente , Adulto , Brasil/epidemiologia , Febre de Chikungunya/complicações , Comorbidade , Estudos Transversais , Escolaridade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-31618377

RESUMO

Chikungunya virus (CHIKV) is an arbovirus that emerged in the Americas in 2013. Infection with CHIKV is symptomatic in most of the cases and patients can develop chronic arthralgia that lasts from months to years in over 40% of the cases. The East-Central-South Africa (ECSA) genotype was introduced in Brazil in 2014, in Bahia State. Here we report the circulation of the CHIKV ECSA genotype in Piaui State, Northeast Brazil, during the years 2016-2017. The phylogenetic analysis revealed a single introduction of this lineage probably in 2015 and its maintenance at least until 2017. This analysis has also demonstrated the proximity of this genotype with isolates from neighboring States, and its partial nucleotide sequence of the viral E1 gene revealed a synapomorphy synonyms. This finding highlights the spread of the ECSA genotype in Brazil and supports its circulation in the Brazilian Northeast.


Assuntos
Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Genoma Viral/genética , Sequência de Bases , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Surtos de Doenças , Genótipo , Humanos , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , África do Sul
3.
Emerg Microbes Infect ; 8(1): 1490-1500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631794

RESUMO

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.


Assuntos
Febre de Chikungunya/virologia , Vírus Chikungunya/isolamento & purificação , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Febre de Chikungunya/sangue , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Vírus Chikungunya/genética , Vírus Chikungunya/imunologia , Cidades/estatística & dados numéricos , Estudos de Coortes , Colômbia/epidemiologia , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
J Ayub Med Coll Abbottabad ; 31(3): 474-475, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535534

RESUMO

First Chikungunya outbreak occurred in Karachi, Pakistan in 2016. Chikungunya is transmitted by the Aedes mosquito which is also transmits Dengue fever. The first Dengue fever outbreak of Pakistan also occurred in Karachi in 1994. In the past 23 years the disease has spread to all parts of the country. This is comprehensible as there is a lot of travelling between Karachi and other parts of the country which increases the chances of spread of the virus. Based on the precedent of Dengue fever in Pakistan, if appropriate preventive measures are not taken to control Chikungunya, it will only be a matter of time before it hits other parts of the country. At the same time International Health Regulations has to be practiced with all its zest to avoid introduction of diseases like Zika virus and yellow fever, which are also transmitted by Aedes.


Assuntos
Febre de Chikungunya/epidemiologia , Febre de Chikungunya/transmissão , Dengue/epidemiologia , Epidemias , Aedes , Animais , Febre de Chikungunya/prevenção & controle , Vetores de Doenças , Humanos , Paquistão/epidemiologia
6.
PLoS Negl Trop Dis ; 13(9): e0007047, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31487279

RESUMO

BACKGROUND: Pathogens causing acute fever, with the exception of malaria, remain largely unidentified in sub-Saharan Africa, given the local unavailability of diagnostic tests and the broad differential diagnosis. METHODOLOGY: We conducted a cross-sectional study including outpatient acute undifferentiated fever in both children and adults, between November 2015 and June 2016 in Kinshasa, Democratic Republic of Congo. Serological and molecular diagnostic tests for selected arboviral infections were performed on blood, including PCR, NS1-RDT, ELISA and IFA for acute, and ELISA and IFA for past infections. RESULTS: Investigation among 342 patients, aged 2 to 68 years (mean age of 21 years), with acute undifferentiated fever (having no clear focus of infection) revealed 19 (8.1%) acute dengue-caused by DENV-1 and/or DENV-2 -and 2 (0.9%) acute chikungunya infections. Furthermore, 30.2% and 26.4% of participants had been infected in the past with dengue and chikungunya, respectively. We found no evidence of acute Zika nor yellow fever virus infections. 45.3% of patients tested positive on malaria Rapid Diagnostic Test, 87.7% received antimalarial treatment and 64.3% received antibacterial treatment. DISCUSSION: Chikungunya outbreaks have been reported in the study area in the past, so the high seroprevalence is not surprising. However, scarce evidence exists on dengue transmission in Kinshasa and based on our data, circulation is more important than previously reported. Furthermore, our study shows that the prescription of antibiotics, both antibacterial and antimalarial drugs, is rampant. Studies like this one, elucidating the causes of acute fever, may lead to a more considerate and rigorous use of antibiotics. This will not only stem the ever-increasing problem of antimicrobial resistance, but will-ultimately and hopefully-improve the clinical care of outpatients in low-resource settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT02656862.


Assuntos
Febre de Chikungunya/diagnóstico , Dengue/diagnóstico , Febre/diagnóstico , Adolescente , Adulto , Idoso , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Vírus Chikungunya/isolamento & purificação , Vírus Chikungunya/fisiologia , Criança , Pré-Escolar , Estudos Transversais , República Democrática do Congo/epidemiologia , Dengue/epidemiologia , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Vírus da Dengue/fisiologia , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Malária/diagnóstico , Malária/epidemiologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Adulto Jovem
7.
Acta Trop ; 199: 105131, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31401192

RESUMO

Chikungunya is a viral disease caused by chikungunya virus (CHIKV) belonging to the Alphavirus genus and transmitted to humans by mosquitoes of Aedes spp. Nearly 40 countries in Asia, Africa, Europe, and the Americas have documented chikungunya cases. Most recent severe outbreaks have occurred in Indian Ocean islands of Réunion and Mauritius and India. There is no specific drug treatment for the disease, neither is there a standardized vaccine available for prevention of the disease. The present review gives a global perspective on patents filed pertaining to chikungunya. The United States has been the top patent filing jurisdiction followed by China, Europe, and India. The patents have been classified into categories of therapeutics, diagnostics, and vaccines. Maximum patent documents fall under the therapeutics category, in which patent applications are predominantly related to chemically derived drugs. They include nucleic acid analogues, various other host and virus enzyme/protein inhibitors. Patents on biological or plant derived drugs are being filed relatively recently. In the category of diagnostics, immunoassay based tests seemed to be of choice until the year 2005, whereas, patent filings for molecular diagnostics have now surpassed those with immunoassay techniques. In the vaccines category, vaccines based on viral vectors appear to be emerging as the preferred vaccine platform with the majority of patents filed in the years 2014-2017. Corporate sector has the most patent filings to its credit, followed closely by academic institutions. Pasteur Institut along with Chinese Agency for Science, Technology and Research is the top patent filing entity in chikungunya related technology space. Presently, nine vaccine products, three antiviral drugs and one mRNA based gene therapy are under development. Three vaccine products have been given fast track designation by US Food and Drug Administration (FDA) to expedite review and facilitate the development of a vaccine to prevent a serious or life-threatening condition and fill an unmet medical need. Similarly, one vaccine has been given PRIME (Priority Medicines) status by the European Medicines Agency (EMA).


Assuntos
Febre de Chikungunya/diagnóstico , Vírus Chikungunya/imunologia , Surtos de Doenças , Patentes como Assunto/estatística & dados numéricos , Vacinas Virais , Aedes/virologia , África/epidemiologia , Américas/epidemiologia , Animais , Ásia/epidemiologia , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/prevenção & controle , Vírus Chikungunya/genética , China , Surtos de Doenças/prevenção & controle , Europa (Continente)/epidemiologia , Humanos , Índia , Mosquitos Vetores/virologia , Ilhas do Pacífico/epidemiologia , Estados Unidos
8.
PLoS Negl Trop Dis ; 13(8): e0007622, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31449532

RESUMO

BACKGROUND: A severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. Enhanced surveillance of GBS in Latin America and the Caribbean (LAC) following the 2015-2016 Zika virus (ZIKV) epidemic presents an opportunity to estimate, for the first time, the regional incidence of GBS. METHODS AND FINDINGS: For this systematic review and meta-analysis, we searched nine scientific databases and grey literature from January 1, 1980 to October 1, 2018. Sources with primary data on incident GBS cases in LAC within a well-defined population and timeframe, published in English, Spanish, Portuguese, or French, were included. We calculated the annual GBS incidence rates (IRs) and 95% confidence intervals (CIs) for each source based on published data. Following an assessment of heterogeneity, we used random-effects meta-analysis to calculate the pooled annual IR of GBS. The study is registered with PROSPERO, number CRD42018086659. Of the 6568 initial citation hits, 31 were eligible for inclusion. Background annual GBS IRs in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29-2.12, I2<0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 (95% CI 2.3-2.9) times during ZIKV and 1.9 (95% CI 1.1-3.4) times during chikungunya outbreaks over background rates. A limitation of this review is that the studies included employed different methodologies to find and ascertain cases of GBS, which could contribute to IR heterogeneity. In addition, it is important to consider that data on GBS are lacking for many countries in the region. CONCLUSIONS: Background IRs of GBS appear to peak during arboviral disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness, particularly during arboviral epidemics. TRIAL REGISTRATION: Registered with PROSPERO: CRD42018086659.


Assuntos
Síndrome de Guillain-Barré/epidemiologia , Infecção por Zika virus/epidemiologia , Região do Caribe/epidemiologia , Febre de Chikungunya/epidemiologia , Bases de Dados Factuais , Epidemias , Feminino , Humanos , Incidência , América Latina/epidemiologia , Masculino , Martinica/epidemiologia , Zika virus
9.
Rev Inst Med Trop Sao Paulo ; 61: e40, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31432989

RESUMO

Several arboviruses have emerged and/or re-emerged in North, Central and South-American countries. Viruses from some regions of Africa and Asia, such as the Zika and Chikungunya virus have been introduced in new continents causing major public health problems. The aim of this study was to investigate the presence of RNA from Zika, Dengue and Chikungunya viruses in symptomatic patients from Rondonia, where the epidemiological profile is still little known, by one-step real-time RT-PCR. The main clinical signs and symtoms were fever (51.2%), headache (78%), chills (6.1%), pruritus (12.2%), exanthema (20.1%), arthralgia (35.3%), myalgia (26.8%) and retro-orbital pain (19.5%). Serum from 164 symptomatic patients were collected and tested for RNA of Zika, Dengue types 1 to 4 and Chikungunya viruses, in addition to antibodies against Dengue NS1 antigen. Direct microscopy for Malaria was also performed. Only ZIKV RNA was detected in 4.3% of the patients, and in the remaining 95.7% of the patients RNA for Zika, Dengue and Chikungunya viruses were not detected. This finding is intriguing as the region has been endemic for Dengue for a long time and more recently for Chikungunya virus as well. The results indicated that medical and molecular parameters obtained were suitable to describe the first report of symptomatic Zika infections in this region. Furthermore, the low rate of detection, compared to clinical signs and symptoms as the solely diagnosis criteria, suggests that molecular assays for detection of viruses or other pathogens that cause similar symptoms should be used and the corresponding diseases could be included in the compulsory notification list.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/genética , Vírus da Dengue/genética , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Zika virus/genética , Brasil/epidemiologia , Febre de Chikungunya/diagnóstico , Dengue/diagnóstico , Humanos , Vírus de RNA/genética , Reação em Cadeia da Polimerase em Tempo Real , Infecção por Zika virus/diagnóstico
10.
BMC Public Health ; 19(1): 1014, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366341

RESUMO

BACKGROUND: Many tropical countries are currently experiencing dengue (DEN), chikungunya (CHIK) and also more recently Zika (ZIKA) epidemics (particularly in Latin America). Although the risk of transmission and spread of these infections in temperate regions remains a controversial issue, vector-borne diseases have been widely reported in the media and have been the focus of preventive strategies by national and international policy-makers and public health authorities. In this context, we wanted to determine the extent of risk perception in infectious diseases (ID) physicians of the current and future risk of arboviral disease introduction, autochthonous case development and epidemic scenarios in France, Western Europe. METHODS: To this aim, we developed an original standardized questionnaire survey which was disseminated by the French Infectious Diseases Society to ID physician members. RESULTS: We found that ID physicians perceived the risk of introduction and outbreak development of DEN, CHIK and ZIKA in France to be low to medium-low. Generalized Linear Model(s) identified medical school training, the extent of professional experience, and awareness of the French national plan regarding arboviral infections as significant predictors for lower risk perception among respondents. CONCLUSION: Despite the fact that arboviral diseases are increasingly being imported into France, sometimes resulting in sporadic autochtonous transmission, French ID physicians do not perceive the risk as high. Better communication and education targeting health professionals and citizens will be needed to enhance the effectiveness of the French national plan to prepare against arboviral diseases.


Assuntos
Atitude do Pessoal de Saúde , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Surtos de Doenças , Infectologia , Médicos/psicologia , Infecção por Zika virus/epidemiologia , Adulto , Europa (Continente)/epidemiologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Médicos/estatística & dados numéricos , Medição de Risco , Inquéritos e Questionários
11.
PLoS Negl Trop Dis ; 13(7): e0007563, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31323020

RESUMO

Chikungunya virus (CHIKV), an alphavirus that causes fever and severe polyarthralgia, swept through the Americas in 2014 with almost 2 million suspected or confirmed cases reported by April 2016. In this study, we estimate the direct medical costs, cost of lost wages due to absenteeism, and years lived with disability (YLD) associated with the 2014-2015 CHIKV outbreak in the U.S. Virgin Islands (USVI). For this analysis, we used surveillance data from the USVI Department of Health, medical cost data from three public hospitals in USVI, and data from two studies of laboratory-positive cases up to 12 months post illness. On average, employed case-patients missed 9 days of work in the 12 months following their disease onset, which resulted in an estimated cost of $15.5 million. Estimated direct healthcare costs were $2.9 million for the first 2 months and $0.6 million for 3-12 months following the outbreak. The total estimated cost associated with the outbreak ranged from $14.8 to $33.4 million (approximately 1% of gross domestic product), depending on the proportion of the population infected with symptomatic disease, degree of underreporting, and proportion of cases who were employed. The estimated YLDs associated with long-term sequelae from the CHIKV outbreak in the USVI ranged from 599-1,322. These findings highlight the significant economic burden of the recent CHIKV outbreak in the USVI and will aid policy-makers in making informed decisions about prevention and control measures for inevitable, future CHIKV outbreaks.


Assuntos
Febre de Chikungunya/economia , Surtos de Doenças/economia , Adulto , Febre de Chikungunya/epidemiologia , Criança , Efeitos Psicossociais da Doença , Monitoramento Epidemiológico , Humanos , Ilhas Virgens Americanas
12.
Emerg Infect Dis ; 25(8): 1589-1591, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310205

RESUMO

We report a disease outbreak caused by chikungunya virus in Zhejiang Province, China, in August 2017. Phylogenic analysis indicated that this virus belonged to the Indian Ocean clade of the East/Central/South African genotype and was imported by a traveler returning from Bangladesh.


Assuntos
Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya , Surtos de Doenças , Bangladesh , Febre de Chikungunya/história , Vírus Chikungunya/classificação , Vírus Chikungunya/genética , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/virologia , Genoma Viral , História do Século XXI , Humanos , Filogenia , Doença Relacionada a Viagens
13.
14.
BMC Infect Dis ; 19(1): 572, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269906

RESUMO

BACKGROUND: We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India. METHODS: Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA. RESULTS: Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001). CONCLUSIONS: Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.


Assuntos
Febre de Chikungunya/etiologia , Dengue/etiologia , Febre/etiologia , Tifo por Ácaros/etiologia , Adolescente , Adulto , Idoso , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Criança , Pré-Escolar , Dengue/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/epidemiologia , Humanos , Índia/epidemiologia , Lactente , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologia , Malária Falciparum/etiologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Reação em Cadeia da Polimerase , Prevalência , Kit de Reagentes para Diagnóstico , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/epidemiologia
15.
Arch Pediatr ; 26(5): 259-262, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31281036

RESUMO

BACKGROUND: We aimed to describe the clinical and laboratory features of Chikungunya disease in infants aged from 1 month to 2years. METHODS: This epidemiologic study was carried out at the Pointe-à-Pitre University Hospital from May to September 2014. We collected data prospectively from infants hospitalized for Chikungunya disease. RESULTS: A total of 154 infants were included. Hyperthermia was greater than 38.5°C the first 48h and during on average 2.7 days. Pain (on mobilization and/or cutaneous hyperesthesia and/or arthralgia) was present in 82% of the cases. Loss of appetite was reported for 62% of the infants. Initial maculopapular erythematous eruption occurred in 69% of the cases. A vesiculobullous eruption was secondarily observed in 7% of the cases. Edema on the feet and/or hands was present in 48% of the cases. Febrile seizure was observed in 12% of the cases. Lymphopenia was the most frequent laboratory finding, present in 94% of the infants. No cases of thrombocytopenia were observed. The reported complications were: bullous epidermolysis, state of epilepticus, and severe acute hepatitis. CONCLUSION: This study highlights a suggestive clinical presentation of Chikungunya diseases combining pain, fever, tachycardia, foot and/or hand edema. Lymphopenia, monocytosis, and the absence of thrombocytopenia were relevant biological signs.


Assuntos
Febre de Chikungunya/diagnóstico , Surtos de Doenças , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/terapia , Pré-Escolar , Estudos Transversais , Feminino , Guadalupe/epidemiologia , Hospitalização , Humanos , Lactente , Masculino , Estudos Prospectivos
16.
PLoS Negl Trop Dis ; 13(7): e0007538, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31344040

RESUMO

BACKGROUND: Public health responses to outbreaks of dengue, chikungunya, and Zika virus have been stymied by the inability to control the primary vector, Aedes aegypti mosquitos. Consequently, the need for novel approaches to Aedes vector control is urgent. Placement of three autocidal gravid ovitraps (AGO traps) in ~85% of homes in a community was previously shown to sustainably reduce the density of female Ae. aegypti by >80%. Following the introduction of chikungunya virus (CHIKV) to Puerto Rico, we conducted a seroprevalence survey to estimate the prevalence of CHIKV infection in communities with and without AGO traps and evaluate their effect on reducing CHIKV transmission. METHODS AND FINDINGS: Multivariate models that calculated adjusted prevalence ratios (aPR) showed that among 175 and 152 residents of communities with and without AGO traps, respectively, an estimated 26.1% and 43.8% had been infected with CHIKV (aPR = 0.50, 95% CI: 0.37-0.91). After stratification by time spent in their community, protection from CHIKV infection was strongest among residents who reported spending many or all weekly daytime hours in their community:10.3% seropositive in communities with AGO traps vs. 48.7% in communities without (PR = 0.21, 95% CI: 0.11-0.41). The age-adjusted rate of fever with arthralgia attributable to CHIKV infection was 58% (95% CI: 46-66%). The monthly number of CHIKV-infected mosquitos and symptomatic residents were diminished in communities with AGO traps compared to those without. CONCLUSIONS: These findings indicate that AGO traps are an effective tool that protects humans from infection with a virus transmitted by Ae. aegypti mosquitos. Future studies should evaluate their protective effectiveness in large, urban communities.


Assuntos
Aedes/virologia , Febre de Chikungunya/prevenção & controle , Controle de Mosquitos/instrumentação , Controle de Mosquitos/métodos , Mosquitos Vetores/virologia , Adolescente , Animais , Febre de Chikungunya/epidemiologia , Vírus Chikungunya , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Prevalência , Porto Rico/epidemiologia , Adulto Jovem
17.
BMC Res Notes ; 12(1): 332, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186058

RESUMO

OBJECTIVE: Arboviruses, Dengue and Chikungunya have become major international public health concerns due to their epidemics and introduction in new areas. In Ghana, little is known is about Dengue and Chikungunya viruses though the country has been listed as part of the 34 countries in which the viruses are endemic. This has been attributed partly to the lack of diagnostic tools for these viruses in several health facilities and institutions across the country. The purpose of this study was to detect and characterize these viral pathogens among febrile patients in Accra Ghana. RESULTS: This hospital-based cross-sectional study enrolled 260 suspected Dengue and/or Chikungunya febrile patients who submitted their clinical specimens of serum. Out of the total number tested with both molecular and serological tools, Chikungunya and Dengue specific total antibodies were detected from 72 (27.69%) and 180 (69.23%) respectively. None of the participants tested positive for Dengue and Chikungunya by reverse transcription-polymerase chain reaction (RT-PCR) and with the Dengue-specific NS1 antigen strip kits. Our findings suggested that Dengue and Chikungunya viruses may be circulating but are being missed among febrile patients. Differential diagnosis work-up in febrile patients should be made to include Dengue and Chikungunya infections.


Assuntos
Febre de Chikungunya/epidemiologia , Coinfecção/epidemiologia , Infecção Hospitalar/epidemiologia , Dengue/epidemiologia , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Arbovirus/classificação , Arbovirus/imunologia , Arbovirus/fisiologia , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/virologia , Vírus Chikungunya/imunologia , Vírus Chikungunya/fisiologia , Criança , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/virologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/virologia , Estudos Transversais , Dengue/diagnóstico , Dengue/virologia , Vírus da Dengue/imunologia , Vírus da Dengue/fisiologia , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Am J Trop Med Hyg ; 100(6): 1545-1548, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31038100

RESUMO

Chikungunya (CHIK) has emerged as a major public health concern worldwide. Recently, atypical manifestations are drawing special attention because these might be associated with various complications. Information on atypical manifestations of CHIK is still limited. Here, we analyzed a dataset of 1,326 cases from our recent Dhaka outbreak study to explore the demographics and distributions of atypical manifestations. About 80% of cases reported at least one atypical symptom. Among all atypical symptoms, the most common and unique atypical symptom was joint pain before fever (90.2%), occurred predominantly in female respondents. Other common symptoms included red eye (68.2%), oral ulcer (37.7%), and dermatological manifestations (27.1%). More than two-thirds of patients reported multiple atypical symptoms. Atypical manifestations were not significantly different across age groups, except ocular complications. This study would be an important resource for clinicians and epidemiologists to understand the diversity of Chikungunya infection and, thus, help in better patient management.


Assuntos
Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Surtos de Doenças , Adolescente , Adulto , Bangladesh/epidemiologia , Febre de Chikungunya/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Drug Discov Ther ; 13(2): 101-107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080200

RESUMO

Acute febrile illness (AFI) is one of the commonest indications for hospitalization and can present with varying severity including single or multiple organ dysfunction syndrome (MODS). During monsoon season, there is a spurt of AFI often caused by vector borne diseases leading to substantial morbidity and mortality. Our aim was to determine distribution of etiological causes, differential organ involvement and predictors of mortality in critically ill patients with AFI. It was a hospital based observational study which included patients with AFI with dysfunction of at least one organ system. The study was conducted over 4 months during monsoon season. Admitted patients were included who had been subjected to a standard battery of tests and managed with standard hospital based management protocol. 145 patients were included and etiology of fever was ascertained in 81.4% of patients with the most common single infection being chikungunya (20.7%) followed by dengue (20%) fever. Thrombocytopenia and deranged liver biochemistry each were seen in nearly 75% of the patients. Renal (50.3%) and nervous system (46.2%) dysfunction were the predominant organ failures. 49 patients died (33.8%) which correlated with predicted mortality by APACHE (acute physiological assessment and chronic health evaluation) II score. Independent predictors for mortality were older age (> 55 years) (p = 0.01), acidemia (p = 0.01), altered sensorium (p = 0.02) and coagulopathy (p = 0.048). Sub-group analysis revealed that amongst patients with MODS, hypotension could help differentiate between bacterial and non-bacterial causes (p = 0.01). Critically ill patients with AFI suffer from significant morbidity and mortality. Features like the presence of hypotension in MODS may differentiate between a bacterial cause vis-à-vis viral or protozoal etiology.


Assuntos
Febre de Chikungunya/epidemiologia , Estado Terminal/mortalidade , Dengue/epidemiologia , Hipotensão/epidemiologia , Insuficiência de Múltiplos Órgãos/etiologia , APACHE , Adolescente , Adulto , Febre de Chikungunya/complicações , Febre de Chikungunya/transmissão , Criança , Dengue/complicações , Dengue/transmissão , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/classificação , Insuficiência de Múltiplos Órgãos/mortalidade , Estudos Prospectivos , Fatores de Risco , Estações do Ano , Centros de Atenção Terciária , Adulto Jovem
20.
Emerg Infect Dis ; 25(6): 1041-1049, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31107221

RESUMO

With regard to fully harvesting the potential of big data, public health lags behind other fields. To determine this potential, we applied big data (air passenger volume from international areas with active chikungunya transmission, Twitter data, and vectorial capacity estimates of Aedes albopictus mosquitoes) to the 2017 chikungunya outbreaks in Europe to assess the risks for virus transmission, virus importation, and short-range dispersion from the outbreak foci. We found that indicators based on voluminous and velocious data can help identify virus dispersion from outbreak foci and that vector abundance and vectorial capacity estimates can provide information on local climate suitability for mosquitoborne outbreaks. In contrast, more established indicators based on Wikipedia and Google Trends search strings were less timely. We found that a combination of novel and disparate datasets can be used in real time to prevent and control emerging and reemerging infectious diseases.


Assuntos
Big Data , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/transmissão , Vírus Chikungunya , Aedes/virologia , Animais , Febre de Chikungunya/história , Febre de Chikungunya/virologia , Clima , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/história , Doenças Transmissíveis Emergentes/transmissão , Doenças Transmissíveis Emergentes/virologia , Mineração de Dados , Surtos de Doenças , Europa (Continente)/epidemiologia , Geografia Médica , História do Século XXI , Humanos , Mosquitos Vetores/virologia , Dinâmica Populacional , Vigilância em Saúde Pública , Estações do Ano
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