Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Selection of Diagnostic Method for CKDu Patient Sera
2.1.1. Virus and Cells
2.1.2. Indirect Immunofluorescent Antibody Assay
2.1.3. Preparation of an rNP-Based IFA Antigen
2.1.4. Mouse Monoclonal Antibodies and Its IFA Profiles
2.1.5. ELISA by Using Recombinant NPs
2.2. Study Design, Study Population and Sample Size Calculation for the Cross-Sectional Study
2.2.1. Hospital-Based Study
2.2.2. Community-Based Study
2.3. Ethical Approval
2.4. Collection of Data and Blood Samples
2.5. Statistical Analysis
2.5.1. Univariate Descriptive Analysis
2.5.2. Comparison of Possible Risk Factors for Exposure to Hantavirus among Seropositive Individuals in the Two Areas
2.5.3. Binary Logistic Regression Model
3. Results
3.1. Characteristics of Anti-Hantavirus Antibodies in Sera Obtained in Sri Lanka
3.1.1. Reactivities in IFA
3.1.2. Reactivities in ELISA
3.2. Demographic Characteristics and Serological Results of the Study Subjects
3.3. Comparison of Possible Risk Factors for Exposure to Hantavirus
3.4. Binary Logistic Regression Models
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Area | Status | Gender | Number | Age Mean (SD) | Serum Antibody Positive to Hantavirus (%) | Occupation Paddy Farming |
---|---|---|---|---|---|---|
Girandurukotte | Renal patients | Male | 70 | 58 (12.3) | 42 (60.0%) | 65 |
Female | 34 | 60 (10.2) | 10 (29.4%) | 27 | ||
Total | 104 | 59 (11.7) | 52 (50.0%) | 92 | ||
Community | Male | 98 | 47 (14.8) | 25 (25.5%) | 68 | |
Female | 144 | 45 (14.0) | 17 (11.8%) | 44 | ||
Total | 242 | 46 (14.3) | 42 (17.4%) | 112 | ||
Kandy | Renal patients | Male | 28 | 54 (12.6) | 7 (25.0%) | 2 |
Female | 22 | 54 (11.1) | 2 (9.1%) | 1 | ||
Total | 50 | 54 (11.8) | 9 (18.0%) | 3 | ||
Community | Male | 126 | 48 (14.5) | 10 (7.9%) | 10 | |
Female | 144 | 46 (13.5) | 9 (6.3%) | 3 | ||
Total | 270 | 47 (14.0) | 19 (7.0%) | 13 |
Kandy | Girandurukotte | |||||||
---|---|---|---|---|---|---|---|---|
Category | Anti-Hantavirus Antibody | χ2 | p-Value | Anti-Hantavirus Antibody | χ2 | p-Value | ||
Positive | Negative | Positive | Negative | |||||
Age | ||||||||
Age category of ≥ 40 years | ||||||||
Renal patients | 8 | 38 | 3.85 | 0.050 | 48 | 47 | 21.89 | <0.001 |
Control | 14 | 166 | 32 | 116 | ||||
Age category of < 40 years | ||||||||
Renal patients | 1 | 3 | 2.42 | 0.235 | 4 | 5 | 7.99 | 0.005 |
Control | 5 | 85 | 10 | 84 | ||||
Gender | ||||||||
Female | ||||||||
Renal patients | 2 | 20 | 0.25 | 0.642 | 10 | 24 | 6.53 | 0.011 |
Community | 9 | 135 | 17 | 126 | ||||
Male | ||||||||
Renal patients | 7 | 21 | 6.79 | 0.010 | 42 | 28 | 20.3 | <0.001 |
Community | 10 | 116 | 25 | 73 | ||||
Occupation | ||||||||
Paddy farming | ||||||||
Renal patients | 3 | 0 | 11.08 | 0.007 | 47 | 45 | 18.3 | <0.001 |
Community | 1 | 12 | 25 | 87 | ||||
Other occupations | ||||||||
Renal patients | 6 | 41 | 1.81 | 0.178 | 5 | 7 | 18.3 | 0.009 |
Community | 18 | 239 | 17 | 113 | ||||
Storing crop at house | ||||||||
Yes | ||||||||
Renal patients | 2 | 4 | 1.44 | 0.260 | 48 | 49 | 29.32 | <0.001 |
Community | 4 | 26 | 28 | 131 | ||||
No | ||||||||
Renal patients | 7 | 37 | 4.85 | 0.028 | 4 | 3 | 6.55 | 0.027 |
Community | 15 | 225 | 14 | 69 | ||||
Rats seen at home or surroundings | ||||||||
Yes | ||||||||
Renal patients | 8 | 25 | 12.58 | <0.001 | 45 | 39 | 38.42 | <0.001 |
Community | 12 | 194 | 34 | 163 | ||||
No | ||||||||
Renal patients | 1 | 16 | 0.39 | 0.535 | 7 | 13 | 2.31 | 0.128 |
Community | 7 | 57 | 8 | 37 |
Predicted Risk Factors | Kandy | Girandurukotte | ||||
---|---|---|---|---|---|---|
χ2 | p-Value | OR (95% CI) | χ2 | p-Value | OR (95% CI) | |
Status | ||||||
Renal patient | 4.08 | 0.044 | 2.64 (1.07 to 6.54) | 18.83 | <0.001 | 3.66 (2.01 to 6.64) |
Age | ||||||
Age ≥ 40 years | 0.01 | 0.935 | 1.04 (0.38 to 2.86) | 3.62 | 0.057 | 1.92 (0.96 to 3.82) |
Gender | ||||||
Male | 0.70 | 0.402 | 1.43 (0.62 to 3.31) | 12.88 | <0.001 | 2.79 (1.58 to 4.95) |
Occupation | ||||||
Farmer | 1.02 | 0.313 | 2.18 (0.49 to 9.63) | 0 | 0.985 | 0.99 (0.45 to 2.18) |
Engaged in agriculture-related activities | ||||||
Yes | 2.76 | 0.097 | 2.53 (0.88 to 7.27) | 1.41 | 0.235 | 1.82 (0.67 to 4.91) |
Store crops at house | ||||||
Yes | 0.02 | 0.897 | 0.92 (0.24 to 3.47) | 1.30 | 0.255 | 0.65 (0.32 to 1.36) |
Sighting rodents at home or surrounding | ||||||
Yes | 0.06 | 0.446 | 0.67 (0.25 to 1.85) | 2.21 | 0.137 | 1.86 (0.81 to 4.24) |
Presence of rodent excreta at home or surrounding | ||||||
Yes | 0 | 0.982 | 1.01 (0.40 to 2.54) | 1.72 | 0.19 | 0.65 (0.34 to 1.24) |
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Sarathkumara, Y.D.; Gamage, C.D.; Lokupathirage, S.; Muthusinghe, D.S.; Nanayakkara, N.; Gunarathne, L.; Shimizu, K.; Tsuda, Y.; Arikawa, J.; Yoshimatsu, K. Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross Sectional Study. Viruses 2019, 11, 700. https://doi.org/10.3390/v11080700
Sarathkumara YD, Gamage CD, Lokupathirage S, Muthusinghe DS, Nanayakkara N, Gunarathne L, Shimizu K, Tsuda Y, Arikawa J, Yoshimatsu K. Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross Sectional Study. Viruses. 2019; 11(8):700. https://doi.org/10.3390/v11080700
Chicago/Turabian StyleSarathkumara, Yomani D., Chandika D. Gamage, Sithumini Lokupathirage, Devinda S. Muthusinghe, Nishantha Nanayakkara, Lishanthe Gunarathne, Kenta Shimizu, Yoshimi Tsuda, Jiro Arikawa, and Kumiko Yoshimatsu. 2019. "Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross Sectional Study" Viruses 11, no. 8: 700. https://doi.org/10.3390/v11080700