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Trop. Med. Infect. Dis., Volume 5, Issue 2 (June 2020) – 58 articles

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16 pages, 2127 KiB  
Article
The Emergence of Chikungunya ECSA Lineage in a Mayaro Endemic Region on the Southern Border of the Amazon Forest
by Carla Julia da Silva Pessoa Vieira, David José Ferreira da Silva, Janaína Rigotti Kubiszeski, Laís Ceschini Machado, Lindomar José Pena, Roberta Vieira de Morais Bronzoni and Gabriel da Luz Wallau
Trop. Med. Infect. Dis. 2020, 5(2), 105; https://doi.org/10.3390/tropicalmed5020105 - 26 Jun 2020
Cited by 10 | Viewed by 3149
Abstract
Anthropic changes on the edges of the tropical forests may facilitate the emergence of new viruses from the sylvatic environment and the simultaneous circulation of sylvatic and urban viruses in the human population. In this study, we investigated the presence of arboviruses (arthropod-borne [...] Read more.
Anthropic changes on the edges of the tropical forests may facilitate the emergence of new viruses from the sylvatic environment and the simultaneous circulation of sylvatic and urban viruses in the human population. In this study, we investigated the presence of arboviruses (arthropod-borne viruses) in the sera of 354 patients, sampled from February 2014 to October 2018 in Sinop city. We sequenced the complete genomes of one chikungunya virus (CHIKV)-positive and one out of the 33 Mayaro virus (MAYV)-positive samples. The CHIKV genome obtained here belongs to the East/Central/South African (ECSA) genotype and the MAYV genome belongs to the L genotype. These genomes clustered with other viral strains from different Brazilian states, but the CHIKV strain circulating in Sinop did not cluster with other genomes from the Mato Grosso state, suggesting that at least two independent introductions of this virus occurred in Mato Grosso. Interestingly, the arrival of CHIKV in Sinop seems to not have caused a surge in human cases in the following years, as observed in the rest of the state, suggesting that cross immunity from MAYV infection might be protecting the population from CHIKV infection. These findings reinforce the need for continued genomic surveillance in order to evaluate how simultaneously circulating alphaviruses infecting the human population will unfold. Full article
(This article belongs to the Special Issue Arthropod-Borne Viruses: The Outbreak Edition)
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4 pages, 157 KiB  
Letter
Letter to the Editor: Venezuelan Equine Encephalitis virus 1B Invasion and Epidemic Control—South Texas, 1971
by Robert G. McLean
Trop. Med. Infect. Dis. 2020, 5(2), 104; https://doi.org/10.3390/tropicalmed5020104 - 22 Jun 2020
Cited by 1 | Viewed by 2129
Abstract
The epidemic strain of Venezuelan equine encephalitis virus (VEE) 1B invaded south Texas in 1971. The success of the eventual containment and control of the virus invasion was the early recognition and immediate detection, cooperation, coordination, and participation among multiple federal agencies. There [...] Read more.
The epidemic strain of Venezuelan equine encephalitis virus (VEE) 1B invaded south Texas in 1971. The success of the eventual containment and control of the virus invasion was the early recognition and immediate detection, cooperation, coordination, and participation among multiple federal agencies. There were 4739 wild vertebrate animals trapped on a ranch in the area with only 1 VEE virus isolation from a Virgina opossum (Didelphis virginiana). A large number of mosquitoes were also collected on the ranch and tested, resulting in 240 VEE virus isolations. Virus isolations were obtained from 58% of the 33 equines tested. Wild vertebrates did not play a significant role in the outbreak. Full article
(This article belongs to the Special Issue Arthropod-Borne Viruses: The Outbreak Edition)
3 pages, 152 KiB  
Editorial
Parasites, Zoonoses and War: A Themed Issue in Honor of Emeritus Professor John M. Goldsmid
by Richard S. Bradbury
Trop. Med. Infect. Dis. 2020, 5(2), 103; https://doi.org/10.3390/tropicalmed5020103 - 21 Jun 2020
Viewed by 2068
Abstract
This Special Issue of Tropical Medicine and Infectious Disease is dedicated to the life and work of Emeritus Professor John Marsden Goldsmid [...] Full article
15 pages, 2703 KiB  
Review
Evaluation of Malaria Diagnostic Methods as a Key for Successful Control and Elimination Programs
by Afoma Mbanefo and Nirbhay Kumar
Trop. Med. Infect. Dis. 2020, 5(2), 102; https://doi.org/10.3390/tropicalmed5020102 - 19 Jun 2020
Cited by 69 | Viewed by 14872
Abstract
Malaria is one of the leading causes of death worldwide. According to the World Health Organization’s (WHO’s) world malaria report for 2018, there were 228 million cases and 405,000 deaths worldwide. This paper reviews and highlights the importance of accurate, sensitive and affordable [...] Read more.
Malaria is one of the leading causes of death worldwide. According to the World Health Organization’s (WHO’s) world malaria report for 2018, there were 228 million cases and 405,000 deaths worldwide. This paper reviews and highlights the importance of accurate, sensitive and affordable diagnostic methods in the fight against malaria. The PubMed online database was used to search for publications that examined the different diagnostic tests for malaria. Currently used diagnostic methods include microscopy, rapid diagnostic tests (RDT), and polymerase chain reaction (PCR). Upcoming methods were identified as loop-mediated isothermal amplification (LAMP), nucleic acid sequence-based amplification (NASBA), isothermal thermophilic helicase-dependent amplification (tHDA), saliva-based test for nucleic-acid amplification, saliva-based test for Plasmodium protein detection, urine malaria test (UMT), and transdermal hemozoin detection. RDT, despite its increasing false negative, is still the most feasible diagnostic test because it is easy to use, fast, and does not need expensive equipment. Noninvasive tests that do not require a blood sample, but use saliva or urine, are some of the recent tests under development that have the potential to aid malaria control and elimination. Emerging resistance to anti-malaria drugs and to insecticides used against vectors continues to thwart progress in controlling malaria. Therefore, future innovation will be required to enable the application of more sensitive and affordable methods in resource-limited settings. Full article
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19 pages, 467 KiB  
Perspective
An Opportunity to END TB: Using the Sustainable Development Goals for Action on Socio-Economic Determinants of TB in High Burden Countries in WHO South-East Asia and the Western Pacific Regions
by Srinath Satyanarayana, Pruthu Thekkur, Ajay M. V. Kumar, Yan Lin, Riitta A. Dlodlo, Mohammed Khogali, Rony Zachariah and Anthony David Harries
Trop. Med. Infect. Dis. 2020, 5(2), 101; https://doi.org/10.3390/tropicalmed5020101 - 18 Jun 2020
Cited by 13 | Viewed by 5572
Abstract
The progress towards ending tuberculosis (TB) by 2035 is less than expected in 11 high TB burden countries in the World Health Organization South-East Asia and Western Pacific regions. Along with enhancing measures aimed at achieving universal access to quality-assured diagnosis, treatment and [...] Read more.
The progress towards ending tuberculosis (TB) by 2035 is less than expected in 11 high TB burden countries in the World Health Organization South-East Asia and Western Pacific regions. Along with enhancing measures aimed at achieving universal access to quality-assured diagnosis, treatment and prevention services, massive efforts are needed to mitigate the prevalence of health-related risk factors, preferably through broader actions on the determinants of the “exposure-infection-disease-adverse outcome” spectrum. The aim of this manuscript is to describe the major socio-economic determinants of TB and to discuss how there are opportunities to address these determinants in an englobing manner under the United Nations Sustainable Development Goals (SDGs) framework. The national TB programs must identify stakeholders working on the other SDGs, develop mechanisms to collaborate with them and facilitate action on social-economic determinants in high TB burden geographical areas. Research (to determine the optimal mechanisms and impact of such collaborations) must be an integral part of this effort. We call upon stakeholders involved in achieving the SDGs and End TB targets to recognize that all goals are highly interlinked, and they need to combine and complement each other’s efforts to end TB and the determinants behind this disease. Full article
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3 pages, 191 KiB  
Editorial
The 14th of April, Past and Present
by Simone Petraglia Kropf and Nísia Trindade Lima
Trop. Med. Infect. Dis. 2020, 5(2), 100; https://doi.org/10.3390/tropicalmed5020100 - 18 Jun 2020
Cited by 2 | Viewed by 1988
Abstract
In May 2019, the World Health Organization established the “World Chagas Disease Day”, to be celebrated on the 14th of April [...] Full article
(This article belongs to the Special Issue Chagas Disease)
9 pages, 229 KiB  
Article
Evidence of Q Fever and Rickettsial Disease in Chile
by Teresa Tapia, John Stenos, Roberto Flores, Oscar Duery, Rodrigo Iglesias, Maria Fernanda Olivares, Doris Gallegos, Cristian Rosas, Heidi Wood, Johanna Acevedo, Pamela Araya, Stephen R. Graves and Juan Carlos Hormazabal
Trop. Med. Infect. Dis. 2020, 5(2), 99; https://doi.org/10.3390/tropicalmed5020099 - 11 Jun 2020
Cited by 8 | Viewed by 3115
Abstract
Q fever and rickettsial diseases occur throughout the world and appear to be emergent zoonoses in Chile. The diagnosis of these diseases is currently uncommon in Chile, as their clinical presentations are non-specific and appropriate diagnostic laboratory assays are of limited availability. During [...] Read more.
Q fever and rickettsial diseases occur throughout the world and appear to be emergent zoonoses in Chile. The diagnosis of these diseases is currently uncommon in Chile, as their clinical presentations are non-specific and appropriate diagnostic laboratory assays are of limited availability. During a recent outbreak of undiagnosed human atypical pneumonia, we serologically investigated a series of 357 cases from three regions of southern Chile. The aim was to identify those caused by Coxiella burnetii and/or Rickettsia spp. Serological analysis was performed by ELISA and an immunofluorescence assay (IFA) for acute and convalescence sera of patients. Our results, including data from two international reference laboratories, demonstrate that 71 (20%) of the cases were Q fever, and 44 (15%) were a likely rickettsial infection, although the rickettsial species could not be confirmed by serology. This study is the first report of endemic Q fever and rickettsial disease affecting humans in Chile. Full article
(This article belongs to the Special Issue Selected Papers from The 2nd Asia Pacific Rickettsia Conference)
15 pages, 1673 KiB  
Meeting Report
Developing Feasible, Locally Appropriate Socioeconomic Support for TB-Affected Households in Nepal
by Bhola Rai, Kritika Dixit, Tara Prasad Aryal, Gokul Mishra, Noemia Teixeira de Siqueira-Filha, Puskar Raj Paudel, Jens W. Levy, Job van Rest, Suman Chandra Gurung, Raghu Dhital, Knut Lönnroth, S Bertel Squire, Maxine Caws and Tom Wingfield
Trop. Med. Infect. Dis. 2020, 5(2), 98; https://doi.org/10.3390/tropicalmed5020098 - 10 Jun 2020
Cited by 8 | Viewed by 4878
Abstract
Tuberculosis (TB), the leading single infectious diseases killer globally, is driven by poverty. Conversely, having TB worsens impoverishment. During TB illness, lost income and out-of-pocket costs can become “catastrophic”, leading patients to abandon treatment, develop drug-resistance, and die. WHO’s 2015 End TB Strategy [...] Read more.
Tuberculosis (TB), the leading single infectious diseases killer globally, is driven by poverty. Conversely, having TB worsens impoverishment. During TB illness, lost income and out-of-pocket costs can become “catastrophic”, leading patients to abandon treatment, develop drug-resistance, and die. WHO’s 2015 End TB Strategy recommends eliminating catastrophic costs and providing socioeconomic support for TB-affected people. However, there is negligible evidence to guide the design and implementation of such socioeconomic support, especially in low-income, TB-endemic countries. A national, multi-sectoral workshop was held in Kathmandu, Nepal, on the 11th and 12th September 2019, to develop a shortlist of feasible, locally appropriate socioeconomic support interventions for TB-affected households in Nepal, a low-income country with significant TB burden. The workshop brought together key stakeholders in Nepal including from the Ministry of Health and Population, Department of Health Services, Provincial Health Directorate, Health Offices, National TB Program (NTP); and TB/Leprosy Officers, healthcare workers, community health volunteers, TB-affected people, and external development partners (EDP). During the workshop, participants reviewed current Nepal NTP data and strategy, discussed the preliminary results of a mixed-methods study of the socioeconomic determinants and consequences of TB in Nepal, described existing and potential socioeconomic interventions for TB-affected households in Nepal, and selected the most promising interventions for future randomized controlled trial evaluations in Nepal. This report describes the activities, outcomes, and recommendations from the workshop. Full article
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7 pages, 679 KiB  
Article
Performance of an Automated Zika IgG Immunoassay in the Detection of Zika IgG Specific Antibodies—A Validation Approach in Samples from Prevalence Areas and Non-Endemic Countries
by Tina Laengin, Stephanie Augenstein, Elke Stadlbauer, Heike Girgnhuber, Mario Gloeck and Alexander Riedel
Trop. Med. Infect. Dis. 2020, 5(2), 97; https://doi.org/10.3390/tropicalmed5020097 - 08 Jun 2020
Cited by 2 | Viewed by 2629
Abstract
The diagnosis of Zika virus infection is complicated and includes testing for nucleic acids and IgM and IgG antibodies, depending on the stage of infection. Zika IgG is an important marker of infection after the acute stage; however, IgG assays can lack specificity [...] Read more.
The diagnosis of Zika virus infection is complicated and includes testing for nucleic acids and IgM and IgG antibodies, depending on the stage of infection. Zika IgG is an important marker of infection after the acute stage; however, IgG assays can lack specificity due to the similarities between Zika and other flaviviruses. In this study, the diagnostic sensitivity and specificity of the Elecsys® Zika IgG assay were assessed in 496 samples from Zika endemic regions, and specificity only was assessed in 1685 blood screening and diagnostic samples from Zika non-endemic regions. Cross-reactivity was also assessed against a panel of 202 potentially cross-reacting samples. The performance of the Elecsys® Zika IgG assay was compared with the anti-Zika virus ELISA IgG. In the samples from the Zika endemic regions, the Elecsys® Zika IgG assay had 92.88% (95% confidence interval 89.42–95.48) sensitivity and 100% specificity and in the samples from Europe the Elecsys® Zika IgG assay specificity was ≥99.62%. The Elecsys® Zika IgG assay was highly specific in samples from both prevalent and non-endemic regions. Full article
(This article belongs to the Special Issue Epidemiology of Dengue: Past, Present and Future (Volume II))
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10 pages, 712 KiB  
Perspective
Emergence of Arboviruses in the United States: The Boom and Bust of Funding, Innovation, and Capacity
by Rebekah C. Kading, Lee W. Cohnstaedt, Ken Fall and Gabriel L. Hamer
Trop. Med. Infect. Dis. 2020, 5(2), 96; https://doi.org/10.3390/tropicalmed5020096 - 06 Jun 2020
Cited by 9 | Viewed by 3235
Abstract
Mosquito-borne viruses will continue to emerge and generate a significant public health burden around the globe. Here, we provide a longitudinal perspective on how the emergence of mosquito-borne viruses in the Americas has triggered reactionary funding by sponsored agencies, stimulating a number of [...] Read more.
Mosquito-borne viruses will continue to emerge and generate a significant public health burden around the globe. Here, we provide a longitudinal perspective on how the emergence of mosquito-borne viruses in the Americas has triggered reactionary funding by sponsored agencies, stimulating a number of publications, innovative development of traps, and augmented capacity. We discuss the return on investment (ROI) from the oscillation in federal funding that influences demand for surveillance and control traps and leads to innovation and research productivity. Full article
(This article belongs to the Special Issue Arthropod-Borne Viruses: The Outbreak Edition)
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13 pages, 1371 KiB  
Article
Evaluation of Rapid Extraction Methods Coupled with a Recombinase Polymerase Amplification Assay for Point-of-Need Diagnosis of Post-Kala-Azar Dermal Leishmaniasis
by Rajashree Chowdhury, Prakash Ghosh, Md. Anik Ashfaq Khan, Faria Hossain, Khaledul Faisal, Rupen Nath, James Baker, Ahmed Abd El Wahed, Shomik Maruf, Proggananda Nath, Debashis Ghosh, Md. Masud-Ur-Rashid, Md. Utba Bin Rashid, Malcolm S. Duthie and Dinesh Mondal
Trop. Med. Infect. Dis. 2020, 5(2), 95; https://doi.org/10.3390/tropicalmed5020095 - 05 Jun 2020
Cited by 15 | Viewed by 3752
Abstract
To detect Post-kala-azar leishmaniasis (PKDL) cases, several molecular methods with promising diagnostic efficacy have been developed that involve complicated and expensive DNA extraction methods, thus limiting their application in resource-poor settings. As an alternative, we evaluated two rapid DNA extraction methods and determined [...] Read more.
To detect Post-kala-azar leishmaniasis (PKDL) cases, several molecular methods with promising diagnostic efficacy have been developed that involve complicated and expensive DNA extraction methods, thus limiting their application in resource-poor settings. As an alternative, we evaluated two rapid DNA extraction methods and determined their impact on the detection of the parasite DNA using our newly developed recombinase polymerase amplification (RPA) assay. Skin samples were collected from suspected PKDL cases following their diagnosis through national guidelines. The extracted DNA from three skin biopsy samples using three different extraction methods was subjected to RPA and qPCR. The qPCR and RPA assays exhibited highest sensitivities when reference DNA extraction method using Qiagen (Q) kit was followed. In contrast, the sensitivity of the RPA assay dropped to 76.7% and 63.3%, respectively, when the boil & spin (B&S) and SpeedXtract (SE) rapid extraction methods were performed. Despite this compromised sensitivity, the B&S-RPA technique yielded an excellent agreement with both Q-qPCR (k = 0.828) and Q-RPA (k = 0.831) techniques. As expected, the reference DNA extraction method was found to be superior in terms of diagnostic efficacy. Finally, to apply the rapid DNA extraction methods in resource-constrained settings, further methodological refinement is warranted to improve DNA yield and purity through rigorous experiments. Full article
(This article belongs to the Special Issue One Health and Neglected Tropical Diseases)
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13 pages, 919 KiB  
Article
Optimization of Culture Protocols to Isolate Leptospira spp. from Environmental Water, Field Investigation, and Identification of Factors Associated with the Presence of Leptospira spp. in the Environment
by Udomsak Narkkul, Janjira Thaipadungpanit, Prapaporn Srilohasin, Preeraya Singkhaimuk, Metawee Thongdee, Somjit Chaiwattanarungruengpaisan, Panadda Krairojananan and Wirichada Pan-ngum
Trop. Med. Infect. Dis. 2020, 5(2), 94; https://doi.org/10.3390/tropicalmed5020094 - 05 Jun 2020
Cited by 12 | Viewed by 3789
Abstract
The successful culture of Leptospira spp. from the environment is challenging. Here, we optimized the isolation of Leptospira spp. from water samples spiked with different species and initial concentrations of this organism. The time periods between water sampling and the isolation process were [...] Read more.
The successful culture of Leptospira spp. from the environment is challenging. Here, we optimized the isolation of Leptospira spp. from water samples spiked with different species and initial concentrations of this organism. The time periods between water sampling and the isolation process were varied (0, 2, and 4 weeks). Bacterial cultures were observed under a microscope, and cultures were graded for cell density, weekly, for 12 weeks. Most pathogenic Leptospira spp. were difficult to culture under all conditions. All conditions of water samples spiked with novel species of Leptospira subclade P1 were culture positive within 2 weeks. For Leptospira subclade P2, storing samples for 2 weeks prior to isolation resulted in more successful isolation compared with isolation after other storage conditions. For subclade S1, all samples with initial bacterial concentrations of more than 103 colonies/mL, under all storage conditions, were successfully cultured. These results suggest that storing contaminated water samples for 2 to 4 weeks in the dark at an ambient temperature prior to culturing can improve the isolation of Leptospira spp. from the samples. We implemented this protocol and collected water samples from natural sources accessed by both humans and animals. Leptospira spp. was identified in 32% (35/109) of water samples. The animal species using a water source influenced the likelihood of water samples being contaminated with Leptospira spp. Cultures of Leptospira spp. from environmental samples can provide useful information for understanding the complex interactions between humans, animals and the environment in the transmission of leptospirosis. Full article
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17 pages, 1661 KiB  
Review
Diagnostic Techniques of Soil-Transmitted Helminths: Impact on Control Measures
by Mirabeau Mbong Ngwese, Gédéon Prince Manouana, Paul Alvyn Nguema Moure, Michael Ramharter, Meral Esen and Ayola Akim Adégnika
Trop. Med. Infect. Dis. 2020, 5(2), 93; https://doi.org/10.3390/tropicalmed5020093 - 05 Jun 2020
Cited by 43 | Viewed by 27490
Abstract
Soil-transmitted helminth (STH) infections are common in the tropical and subtropical countries. The burden of disease is highest in endemic areas with limited access to good quality water supply and poor sanitary conditions. Major approaches to control and reduce morbidity caused by worm [...] Read more.
Soil-transmitted helminth (STH) infections are common in the tropical and subtropical countries. The burden of disease is highest in endemic areas with limited access to good quality water supply and poor sanitary conditions. Major approaches to control and reduce morbidity caused by worm infections include the periodic deworming of pre-school and school-aged children with anthelminthic drugs. Population-based studies and individual patient management including interventional studies can only be successful when accurate diagnostic techniques are used. The lack of appropriate diagnostic tools providing accurate results concerning both infectious status and intensity of infection—as these two factors vary in regions of low infection intensities—is a major challenge. Currently, available techniques show limited sensitivity and specificity and as such, a combination of several techniques is usually used to diagnose the large variety of parasite species. The objective of this review was to describe the advantages and disadvantages of the different available techniques for the diagnosis of STH infections and to highlight their use in control programs. Full article
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10 pages, 1364 KiB  
Article
Mandatory Notification of Chronic Chagas Disease: Confronting the Epidemiological Silence in the State of Goiás, Brazil
by Liliane da Rocha Siriano, Andrea Marchiol, Marina Pereira Certo, Juan-Carlos Cubides, Colin Forsyth and Fabrício Augusto de Sousa
Trop. Med. Infect. Dis. 2020, 5(2), 92; https://doi.org/10.3390/tropicalmed5020092 - 05 Jun 2020
Cited by 2 | Viewed by 3302
Abstract
Objectives: This paper presents the results of the design and implementation process for the policy of compulsory notification of chronic Chagas disease in the Brazilian state of Goiás (Resolution No. 004/2013-GAB/SES-GO). Methods: The narrative was based on information provided by key actors that [...] Read more.
Objectives: This paper presents the results of the design and implementation process for the policy of compulsory notification of chronic Chagas disease in the Brazilian state of Goiás (Resolution No. 004/2013-GAB/SES-GO). Methods: The narrative was based on information provided by key actors that were part of the different stages of the process, built on contextual axes based on participants’ reflections about the establishment of the most accurate and coherent notification mechanisms. Results: The notification policy addressed the absence of historical data from patients in the state Chagas program, an increase in cases identified through serology, and weaknesses in vector control. Two key challenges involved human resources capacity and dissemination to public agencies and health care workers. Effective training and communication processes were key ingredients for successful implementation. Conclusions: The lack of public health measures aimed at the epidemiological surveillance of chronic Chagas cases constitutes a significant barrier for patients to access appropriate diagnosis, management and follow-up, and hampers the planning of necessary activities within health systems. The implementation of the notification policy in Goiás allows authorities to determine the real magnitude of Chagas disease in the population, so that an appropriate public health response can be mounted to meet the needs of affected people, thereby ending the epidemiological silence of Chagas disease. Full article
(This article belongs to the Special Issue Chagas Disease)
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11 pages, 451 KiB  
Article
Trends and Factors Associated with Comprehensive Knowledge about HIV among Women in Vietnam
by Nguyen Van Son, Hoang Duc Luan, Ho Xuan Tuan, Le Manh Cuong, Nguyen Thi Thuy Duong and Vu Duy Kien
Trop. Med. Infect. Dis. 2020, 5(2), 91; https://doi.org/10.3390/tropicalmed5020091 - 03 Jun 2020
Cited by 12 | Viewed by 3759
Abstract
This study aimed to assess the trends and associated factors of comprehensive knowledge about HIV among women in Vietnam using the dataset of the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000, 2006, 2011, and 2014. The outcome variable was comprehensive knowledge about [...] Read more.
This study aimed to assess the trends and associated factors of comprehensive knowledge about HIV among women in Vietnam using the dataset of the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000, 2006, 2011, and 2014. The outcome variable was comprehensive knowledge about HIV, defined as the ability to correctly answer three knowledge questions and to reject the three most common misconceptions about HIV prevention. We found that comprehensive knowledge about HIV increased from 26.1% in 2000 to 44.1% in 2011, but it decreased slightly between 2011 and 2014, from 44.1% to 42.4%. Increased comprehensive knowledge about HIV was associated with women who had higher education and those in the fourth and fifth quintiles of household wealth in all four rounds of the MICS. Comprehensive knowledge about HIV among women was also associated with those who had ever been tested for HIV and those with knowledge of where to be tested for HIV. Women in the urban areas were more likely to have higher levels of comprehensive knowledge about HIV as compared to the women in the rural areas in 2000, 2006, and 2011 but not in 2014. Comprehensive knowledge about HIV among women in Vietnam increased from 2000 to 2014, but it was still relatively low. Full article
(This article belongs to the Special Issue HIV and Co-Infections: Old and New Challenges)
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11 pages, 706 KiB  
Opinion
Assessing Climate Change Impact on Ecosystems and Infectious Disease: Important Roles for Genomic Sequencing and a One Health Perspective
by Kenneth B. Yeh, Jeanne M. Fair, Woutrina Smith, Teresa Martinez Torres, Julie Lucas, Corina Monagin, Richard Winegar and Jacqueline Fletcher
Trop. Med. Infect. Dis. 2020, 5(2), 90; https://doi.org/10.3390/tropicalmed5020090 - 03 Jun 2020
Cited by 15 | Viewed by 5583
Abstract
Changes in the Earth’s climate and weather continue to impact the planet’s ecosystems, including the interface of infectious disease agents with their hosts and vectors. Environmental disasters, natural and human-made activities raise risk factors that indirectly facilitate infectious disease outbreaks. Subsequently, changes in [...] Read more.
Changes in the Earth’s climate and weather continue to impact the planet’s ecosystems, including the interface of infectious disease agents with their hosts and vectors. Environmental disasters, natural and human-made activities raise risk factors that indirectly facilitate infectious disease outbreaks. Subsequently, changes in habitat, displaced populations, and environmental stresses that affect the survival of species are amplified over time. The recurrence and spread of vector-borne (e.g., mosquito, tick, aphid) human, animal, and plant pathogens to new geographic locations are also influenced by climate change. The distribution and range of humans, agricultural animals and plants, wildlife and native plants, as well as vectors, parasites, and microbes that cause neglected diseases of the tropics as well as other global regions are also impacted. In addition, genomic sequencing can now be applied to detect signatures of infectious pathogens as they move into new regions. Molecular detection assays complement metagenomic sequencing to help us understand the microbial community found within the microbiomes of hosts and vectors, and help us uncover mechanistic relationships between climate variability and pathogen transmission. Our understanding of, and responses to, such complex dynamics and their impacts can be enhanced through effective, multi-sectoral One Health engagement coupled with applications of both traditional and novel technologies. Concerted efforts are needed to further harness and leverage technology that can identify and track these impacts of climate changes in order to mitigate and adapt to their effects. Full article
(This article belongs to the Special Issue One Health and Neglected Tropical Diseases)
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13 pages, 239 KiB  
Review
Rift Valley Fever: Important Considerations for Risk Mitigation and Future Outbreaks
by Elysse N. Grossi-Soyster and A. Desiree LaBeaud
Trop. Med. Infect. Dis. 2020, 5(2), 89; https://doi.org/10.3390/tropicalmed5020089 - 02 Jun 2020
Cited by 12 | Viewed by 4026
Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus of the Phenuiviridae family with great opportunity for emergence in previously unaffected regions, despite its current geographical limits. Outbreaks of RVFV often infect humans or domesticated animals, such as livestock, concurrently and occur sporadically, [...] Read more.
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus of the Phenuiviridae family with great opportunity for emergence in previously unaffected regions, despite its current geographical limits. Outbreaks of RVFV often infect humans or domesticated animals, such as livestock, concurrently and occur sporadically, ranging from localized outbreaks in villages to multi-country events that spread rapidly. The true burden of Rift Valley fever (RVF) is not well defined due to underreporting, misdiagnosis caused by the broad spectrum of disease presentation, and minimal access for rapid and accurate laboratory confirmation. Severe symptoms may include hemorrhagic fever, loss of vision, psychological impairment or disturbances, and organ failure. Those living in endemic areas and travelers should be aware of the potential for exposure to ongoing outbreaks or interepidemic transmission, and engage in behaviors to minimize exposure risks, as vaccinations in humans are currently unavailable and animal vaccinations are not used routinely or ubiquitously. The lack of vaccines approved for use in humans is concerning, as RVFV has proven to be highly pathogenic in naïve populations, causing severe disease in a large percent of confirmed cases, which could have considerable impact on human health. Full article
(This article belongs to the Special Issue Arthropod-Borne Viruses: The Outbreak Edition)
11 pages, 1055 KiB  
Article
Funding for Chagas Disease: A 10-Year (2009–2018) Survey
by Leandro S. Sangenito, Marta H. Branquinha and André L. S. Santos
Trop. Med. Infect. Dis. 2020, 5(2), 88; https://doi.org/10.3390/tropicalmed5020088 - 01 Jun 2020
Cited by 17 | Viewed by 3584
Abstract
Chagas disease was discovered in 1909 by the Brazilian scientist Carlos Chagas. After more than 110 years, many outcomes have been achieved in all research fields; however, Chagas disease remains a serious public health problem, mainly in Latin America, being one of the [...] Read more.
Chagas disease was discovered in 1909 by the Brazilian scientist Carlos Chagas. After more than 110 years, many outcomes have been achieved in all research fields; however, Chagas disease remains a serious public health problem, mainly in Latin America, being one of the most neglected tropical diseases in the world. As a neglected disease, it receives very little financial support. Nevertheless, how much is actually spent? With this question in mind, the goal of the present work was to summarize all funding employed by multiple institutions in the Chagas disease field in a 10-year survey. From 2009 to 2018, Chagas disease received only USD 236.31 million, representing 0.67% of the total applied for all neglected diseases in this period. Mostly, the investments are concentrated in basic research (47%) and drug development (42.5%), with the public sector responsible for 74% of all funding, followed by the industry (19%) and philanthropy (7%). Relevantly, NIH (USA) alone accounted for more than half of the total investment. Taking into account that Chagas disease has a great socio-economic impact, it is clear that more investments are needed, especially from endemic countries. Furthermore, coordinated strategies to make better use of resources and incentives for the pharmaceutical industry must be adopted. Full article
(This article belongs to the Special Issue Chagas Disease)
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10 pages, 1134 KiB  
Article
Elucidating the Mechanism of Trypanosoma cruzi Acquisition by Triatomine Insects: Evidence from a Large Field Survey of Triatoma infestans
by Aaron W. Tustin, Ricardo Castillo-Neyra, Laura D. Tamayo, Renzo Salazar, Katty Borini-Mayorí and Michael Z. Levy
Trop. Med. Infect. Dis. 2020, 5(2), 87; https://doi.org/10.3390/tropicalmed5020087 - 01 Jun 2020
Cited by 3 | Viewed by 2731
Abstract
Blood-sucking triatomine bugs transmit the protozoan parasite Trypanosoma cruzi, the etiologic agent of Chagas disease. We measured the prevalence of T. cruzi infection in 58,519 Triatoma infestans captured in residences in and near Arequipa, Peru. Among bugs from infected colonies, T. cruzi [...] Read more.
Blood-sucking triatomine bugs transmit the protozoan parasite Trypanosoma cruzi, the etiologic agent of Chagas disease. We measured the prevalence of T. cruzi infection in 58,519 Triatoma infestans captured in residences in and near Arequipa, Peru. Among bugs from infected colonies, T. cruzi prevalence increased with stage from 12% in second instars to 36% in adults. Regression models demonstrated that the probability of parasite acquisition was roughly the same for each developmental stage. Prevalence increased by 5.9% with each additional stage. We postulate that the probability of acquiring the parasite may be related to the number of feeding events. Transmission of the parasite does not appear to be correlated with the amount of blood ingested during feeding. Similarly, other hypothesized transmission routes such as coprophagy fail to explain the observed pattern of prevalence. Our results could have implications for the feasibility of late-acting control strategies that preferentially kill older insects. Full article
(This article belongs to the Special Issue Chagas Disease)
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5 pages, 172 KiB  
Commentary
Challenges in Tuberculosis Clinical Trials in the Face of the COVID-19 Pandemic: A Sponsor’s Perspective
by I.D. Rusen
Trop. Med. Infect. Dis. 2020, 5(2), 86; https://doi.org/10.3390/tropicalmed5020086 - 27 May 2020
Cited by 9 | Viewed by 4445
Abstract
The COVID-19 pandemic has caused unforeseen and extreme changes in societal and health system functioning not previously experienced in most countries in a lifetime. The impact of the pandemic on clinical trials can be especially profound given their complexities and operational requirements. The [...] Read more.
The COVID-19 pandemic has caused unforeseen and extreme changes in societal and health system functioning not previously experienced in most countries in a lifetime. The impact of the pandemic on clinical trials can be especially profound given their complexities and operational requirements. The STREAM Clinical Trial is the largest trial for MDR-TB ever conducted. Currently operating in seven countries, the trial had 126 participants on treatment and 312 additional participants in active follow up as of March 31, 2020. Areas of particular concern during this global emergency include treatment continuity, supply chain management and participant safety monitoring. This commentary highlights some of the challenges faced due to the pandemic and the steps taken to protect the safety of trial participants and the integrity of the trial. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
10 pages, 2273 KiB  
Article
Identification of Mutations in Antimalarial Resistance Gene Kelch13 from Plasmodium falciparum Isolates in Kano, Nigeria
by Umar F. Abubakar, Ruqayya Adam, Muhammad M. Mukhtar, Abdullahi Muhammad, Adamu A. Yahuza and Sulaiman S. Ibrahim
Trop. Med. Infect. Dis. 2020, 5(2), 85; https://doi.org/10.3390/tropicalmed5020085 - 27 May 2020
Cited by 10 | Viewed by 4624
Abstract
Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 [...] Read more.
Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 in P. falciparum isolates from Kano, Nigeria was investigated in this study. Microscopic examination of 154 blood samples obtained from patients revealed a high prevalence of P. falciparum infection (114 positive individuals, slide positivity rate = 74.03%). The 114 patients were administered Cartef® (ACT) and out of the 50 patients that returned for the 14-day follow up, 11 were positive for P. falciparum (slide positivity rate = 22%). On day 0, 80 samples out of 114 and 11 samples on day 14 (91 out of 125 microscopy-positive samples) were positive with Plasmodium according to the PCR of cytochrome oxidase I, which corresponds to 72.8%. A fragment of the kelch13 gene encompassing the propeller domains was sequenced in 49 samples, alongside samples of the susceptible strain pf_3D7. Low polymorphism was observed, suggesting a lack of selection on this gene, and only six mutations (Glu433Gly, Phe434Ile, Phe434Ser, Ile684Asn, Ile684Thr and Glu688Lys) were found. The epidemiologic impact of these mutations and their potential role in ACT resistance needs to be investigated further. Full article
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9 pages, 1254 KiB  
Article
Monitoring Insecticide Susceptibility in Aedes Aegypti Populations from the Two Biggest Cities, Ouagadougou and Bobo-Dioulasso, in Burkina Faso: Implication of Metabolic Resistance
by Moussa Namountougou, Dieudonné Diloma Soma, Mahamoudou Balboné, Didier Alexandre Kaboré, Mahamadi Kientega, Aristide Hien, Ahmed Coulibaly, Parfait Eric Ouattara, Benson Georges Meda, Samuel Drabo, Lassane Koala, Charles Nignan, Thérèse Kagoné, Abdoulaye Diabaté, Florence Fournet, Olivier Gnankiné and Roch Kounbobr Dabiré
Trop. Med. Infect. Dis. 2020, 5(2), 84; https://doi.org/10.3390/tropicalmed5020084 - 27 May 2020
Cited by 14 | Viewed by 3697
Abstract
In West Africa, Aedes aegypti remains the major vector of dengue virus. Since 2013, dengue fever has been reemerging in Burkina Faso with annual outbreaks, thus becoming a major public health problem. Its control relies on vector control, which is unfortunately facing the [...] Read more.
In West Africa, Aedes aegypti remains the major vector of dengue virus. Since 2013, dengue fever has been reemerging in Burkina Faso with annual outbreaks, thus becoming a major public health problem. Its control relies on vector control, which is unfortunately facing the problem of insecticide resistance. At the time of this study, although data on phenotypic resistance were available, information related to the metabolic resistance in Aedes populations from Burkina Faso remained very scarce. Here, we assessed the phenotypic and the metabolic resistance of Ae. aegypti populations sampled from the two main urban areas (Ouagadougou and Bobo-Dioulasso) of Burkina Faso. Insecticide susceptibility bioassays to chlorpyriphos-methyl 0.4%, bendiocarb 0.1% and deltamethrin 0.05% were performed on natural populations of Ae. aegypti using the WHO protocol. The activity of enzymes involved in the rapid detoxification of insecticides, especially non-specific esterases, oxidases (cytochrome P450) and glutathione-S-transferases, was measured on individual mosquitos. The mortality rates for deltamethrin 0.05% were low and ranged from 20.72% to 89.62% in the Bobo-Dioulasso and Ouagadougou sites, respectively. When bendiocarb 0.1% was tested, the mortality rates ranged from 7.73% to 71.23%. Interestingly, in the two urban areas, mosquitoes were found to be fully susceptible to chlorpyriphos-methyl 0.4%. Elevated activity of non-specific esterases and glutathione-S-transferases was reported, suggesting multiple resistance mechanisms involved in Ae. aegypti populations from Bobo-Dioulasso and Ouagadougou (including cytochrome P450). This update to the insecticide resistance status within Ae. aegypti populations in the two biggest cities is important to better plan dengue vectors control in the country and provides valuable information for improving vector control strategies in Burkina Faso, West Africa. Full article
(This article belongs to the Special Issue Epidemiology of Dengue: Past, Present and Future (Volume II))
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9 pages, 583 KiB  
Article
Yield of Systematic Longitudinal Screening of Household Contacts of Pre-Extensively Drug Resistant (PreXDR) and Extensively Drug Resistant (XDR) Tuberculosis Patients in Mumbai, India
by Roma Haresh Paryani, Vivek Gupta, Pramila Singh, Madhur Verma, Sabira Sheikh, Reeta Yadav, Homa Mansoor, Stobdan Kalon, Sriram Selvaraju, Mrinalini Das, Chinmay Laxmeshwar, Gabriella Ferlazzo and Petros Isaakidis
Trop. Med. Infect. Dis. 2020, 5(2), 83; https://doi.org/10.3390/tropicalmed5020083 - 26 May 2020
Cited by 2 | Viewed by 3951
Abstract
While risk of tuberculosis (TB) is high among household contacts (HHCs) of pre-extensively drug resistant (pre-XDR) TB and XDR-TB, data on yield of systematic longitudinal screening are lacking. We aim to describe the yield of systematic longitudinal TB contact tracing among HHCs of [...] Read more.
While risk of tuberculosis (TB) is high among household contacts (HHCs) of pre-extensively drug resistant (pre-XDR) TB and XDR-TB, data on yield of systematic longitudinal screening are lacking. We aim to describe the yield of systematic longitudinal TB contact tracing among HHCs of patients with pre-XDR-TB and XDR-TB. At the Médecins Sans Frontières (MSF) clinic, Mumbai, India a cohort comprising 518 HHCs of 109 pre-XDR and XDR index cases was enrolled between January 2016 and June 2018. Regular HHC follow-ups were done till one year post treatment of index cases. Of 518 HHCs, 23 had TB (21 on TB treatment and two newly diagnosed) at the time of first visit. Of the rest, 19% HHCs had no follow-ups. Fourteen (3.5%) TB cases were identified among 400 HHCs; incidence rate: 2072/100,000 person-years (95% CI: 1227–3499). The overall yield of household contact tracing was 3% (16/518). Of 14 who were diagnosed with TB during follow-up, six had drug susceptible TB (DSTB); six had pre-XDR-TB and one had XDR-TB. Five of fourteen cases had resistance patterns concordant with their index case. In view of the high incidence of TB among HHCs of pre-XDR and XDR-TB cases, follow-up of HHCs for at least the duration of index cases’ treatment should be considered. Full article
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5 pages, 223 KiB  
Opinion
Discussing the Score of Cardioembolic Ischemic Stroke in Chagas Disease
by Fernanda de Souza Nogueira Sardinha Mendes, Mauro Felippe Felix Mediano, Rudson Santos Silva, Sergio Salles Xavier, Pedro Emmanuel Alvarenga Americano do Brasil, Roberto Magalhães Saraiva, Alejandro Marcel Hasslocher-Moreno and Andrea Silvestre de Sousa
Trop. Med. Infect. Dis. 2020, 5(2), 82; https://doi.org/10.3390/tropicalmed5020082 - 26 May 2020
Cited by 7 | Viewed by 2153
Abstract
Chagas disease is an important infection in Latin America but it is also reported in non-endemic countries all over the world. Around 30% of infected patients develop chronic Chagas cardiopathy, which is responsible for most poor outcomes, mainly heart failure, arrhythmias and thromboembolic [...] Read more.
Chagas disease is an important infection in Latin America but it is also reported in non-endemic countries all over the world. Around 30% of infected patients develop chronic Chagas cardiopathy, which is responsible for most poor outcomes, mainly heart failure, arrhythmias and thromboembolic events. Of all thromboembolic events, stroke is the most feared, due to the high probability of evolution to death or disability. Despite its importance, the actual incidence of cardioembolic ischemic stroke in Chagas disease is not completely known. The Instituto de Pesquisa Evandro Chagas/Fundação Oswaldo Cruz (IPEC-FIOCRUZ) score aims to propose prophylaxis strategies against cardioembolic ischemic stroke in Chagas disease based on clinical risk–benefit. To date, the IPEC-FIOCRUZ score is considered the best tool to identify patients for stroke prophylaxis in Chagas disease according the Latin American guideline and Brazilian consensus. It can prevent many cardioembolic strokes that would not be predicted, by applying the current recommendations to other cardiopathies. However, the IPEC-FIOCRUZ score still requires external validation to be used in different Chagas disease populations with an appropriate study design. Full article
(This article belongs to the Special Issue Chagas Disease)
14 pages, 1791 KiB  
Article
Spatiotemporal and Socioeconomic Risk Factors for Dengue at the Province Level in Vietnam, 2013–2015: Clustering Analysis and Regression Model
by Polly Ashmore, Johanna F. Lindahl, Felipe J. Colón-González, Vu Sinh Nam, Dang Quang Tan and Graham F. Medley
Trop. Med. Infect. Dis. 2020, 5(2), 81; https://doi.org/10.3390/tropicalmed5020081 - 19 May 2020
Cited by 10 | Viewed by 3765
Abstract
Dengue is a serious infectious disease threat in Vietnam, but its spatiotemporal and socioeconomic risk factors are not currently well understood at the province level across the country and on a multiannual scale. We explore spatial trends, clusters and outliers in dengue case [...] Read more.
Dengue is a serious infectious disease threat in Vietnam, but its spatiotemporal and socioeconomic risk factors are not currently well understood at the province level across the country and on a multiannual scale. We explore spatial trends, clusters and outliers in dengue case counts at the province level from 2011–2015 and use this to extract spatiotemporal variables for regression analysis of the association between dengue case counts and selected spatiotemporal and socioeconomic variables from 2013–2015. Dengue in Vietnam follows anticipated spatial trends, with a potential two-year cycle of high-high clusters in some southern provinces. Small but significant associations are observed between dengue case counts and mobility, population density, a province’s dengue rates the previous year, and average dengue rates two years previous in first and second order contiguous neighbours. Significant associations were not found between dengue case counts and housing pressure, access to electricity, clinician density, province-adjusted poverty rate, percentage of children below one vaccinated, or percentage of population in urban settings. These findings challenge assumptions about socioeconomic and spatiotemporal risk factors for dengue, and support national prevention targeting in Vietnam at the province level. They may also be of wider relevance for the study of other arboviruses, including Japanese encephalitis, Zika, and Chikungunya. Full article
(This article belongs to the Special Issue Epidemiology of Dengue: Past, Present and Future (Volume II))
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14 pages, 1534 KiB  
Review
Prognosis of COVID-19 in Patients with Liver and Kidney Diseases: An Early Systematic Review and Meta-Analysis
by Tope Oyelade, Jaber Alqahtani and Gabriele Canciani
Trop. Med. Infect. Dis. 2020, 5(2), 80; https://doi.org/10.3390/tropicalmed5020080 - 15 May 2020
Cited by 113 | Viewed by 10606
Abstract
The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite [...] Read more.
The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite end point of COVID-19 patients from Medline and Embase which had been released from inception by the April 16, 2020. The data on two comorbidities, liver diseases and chronic kidney disease, were pooled and statistically analysed to explain the associated severity and mortality rate. One hundred and forty-two abstracts were screened, and 41 full articles were then read. In total, 22 studies including 5595 COVID-19 patients were included in this study with case fatality rate of 16%. The prevalence of liver diseases and chronic kidney disease (CKD) were 3% (95% CI; 2–3%) and 1% (95% CI; 1–2%), respectively. In patients with COVID-19 and underlying liver diseases, 57.33% (43/75) of cases were severe, with 17.65% mortality, while in CKD patients, 83.93% (47/56) of cases were severe and 53.33% (8/15) mortality was reported. This study found an increased risk of severity and mortality in COVID-19 patients with liver diseases or CKD. This will lead to better clinical management and inform the process of implementing more stringent preventative measures for this group of patients. Full article
(This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives)
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8 pages, 227 KiB  
Article
The Predictive Factors for Severe Leptospirosis Cases in Kedah
by Rakesh Singh Sandhu, Halim Bin Ismail, Mohd Hasni Bin Ja’afar and Sanjay Rampal
Trop. Med. Infect. Dis. 2020, 5(2), 79; https://doi.org/10.3390/tropicalmed5020079 - 14 May 2020
Cited by 12 | Viewed by 2946
Abstract
Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to [...] Read more.
Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients’ medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58–6.00]), hepatomegaly (OR: 7.14 [1.10–45.98]), hypotension (OR: 2.16 [1.08–4.34]), leukocytosis (OR: 2.12 [1.37–3.29]), low hematocrit (OR: 2.33 [1.43–3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36–3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis. Full article
11 pages, 1135 KiB  
Article
Modelling the Use of Vaccine and Wolbachia on Dengue Transmission Dynamics
by Meksianis Z. Ndii
Trop. Med. Infect. Dis. 2020, 5(2), 78; https://doi.org/10.3390/tropicalmed5020078 - 13 May 2020
Cited by 17 | Viewed by 3762
Abstract
The use of vaccine and Wolbachia has been proposed as strategies against dengue. Research showed that the Wolbachia intervention is highly effective in areas with low to moderate transmission levels. On the other hand, the use of vaccine is strongly effective when it [...] Read more.
The use of vaccine and Wolbachia has been proposed as strategies against dengue. Research showed that the Wolbachia intervention is highly effective in areas with low to moderate transmission levels. On the other hand, the use of vaccine is strongly effective when it is implemented on seropositive individuals and areas with high transmission levels. The question that arises is could the combination of both strategies result in higher reduction in the number of dengue cases? This paper seeks to answer the aforementioned question by the use of a mathematical model. A deterministic model in the presence of vaccine and Wolbachia has been developed and analysed. Numerical simulations were presented and public health implications were discussed. The results showed that the performance of Wolbachia in reducing the number of dengue cases is better than that of vaccination if the vaccine efficacy is low, otherwise, the use of vaccine is sufficient to reduce dengue incidence and hence the combination of Wolbachia and vaccine is not necessary. Full article
(This article belongs to the Special Issue Epidemiology of Dengue: Past, Present and Future (Volume II))
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11 pages, 554 KiB  
Article
Gaps in Hepatitis B Vaccination Completion and Sero-Protection for People Who Inject Drugs in Hpakant, Myanmar, 2015–2018
by Nilar Shwe Yee, Aung Yu Naing, Julita Gil Cuesta, Mrinalini Das and Kapilkumar Dave
Trop. Med. Infect. Dis. 2020, 5(2), 77; https://doi.org/10.3390/tropicalmed5020077 - 12 May 2020
Cited by 2 | Viewed by 2884
Abstract
Hepatitis B vaccination (HBV) is recommended for high-risk groups, such as people who inject drugs (PWIDs). As part of a harm reduction program by a non-governmental organization, hepatitis B screening, vaccination and antibody (HBAb) testing after completion of the vaccination schedule were offered [...] Read more.
Hepatitis B vaccination (HBV) is recommended for high-risk groups, such as people who inject drugs (PWIDs). As part of a harm reduction program by a non-governmental organization, hepatitis B screening, vaccination and antibody (HBAb) testing after completion of the vaccination schedule were offered to PWIDS in Myanmar. We determined the proportions of HBV non-completion and sero-unprotection among PWIDs enrolled in the program and their association with socio-demographic and clinical characteristics. We conducted a descriptive study based on routine program data in five selected clinics in Hpakant Township, Myanmar. PWIDs who were Hepatitis B antigen negative at screening during January 2015–December 2018 were included. Among 5386 participants eligible for HBV, 9% refused vaccination. Among those who accepted vaccination (n = 3177 individuals), 65% completed vaccination. Of those tested for HBsAb (n = 2202), 30% were sero-unprotected. Young-adults (aged 18–44 years) and migrant workers had a higher risk of incomplete vaccination. However, participants who used methadone had a lower risk of incomplete vaccination. Migrant workers had higher risk of not returning for HBsAb testing and HIV-positive participants had a higher risk of being HBV sero-unprotected. Efforts to increase HBV vaccination in PWIDs for young adults and clients during methadone and anti-retroviral services should be prioritized. Full article
(This article belongs to the Special Issue HIV and Co-Infections: Old and New Challenges)
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11 pages, 436 KiB  
Article
Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort
by Alejandro Marcel Hasslocher-Moreno, Sergio Salles Xavier, Roberto Magalhães Saraiva, Luiz Henrique Conde Sangenis, Marcelo Teixeira de Holanda, Henrique Horta Veloso, Andrea Rodrigues da Costa, Fernanda de Souza Nogueira Sardinha Mendes, Pedro Emmanuel Alvarenga Americano do Brasil, Gilberto Marcelo Sperandio da Silva, Mauro Felippe Felix Mediano and Andrea Silvestre de Sousa
Trop. Med. Infect. Dis. 2020, 5(2), 76; https://doi.org/10.3390/tropicalmed5020076 - 12 May 2020
Cited by 16 | Viewed by 2789
Abstract
Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form [...] Read more.
Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form were followed by means of annual electrocardiogram at our outpatient clinic. The studied endpoint was progression to cardiac form defined by the appearance of electrocardiographic changes typical of CD. The progression rate was calculated as the cumulative progression rate and the incidence progression rate per 100 patient years. Results: Thirty-seven patients progressed to the CD cardiac form within a mean of 73 ± 48 months of follow-up, which resulted in a 6.9% cumulative progression rate and incidence rate of 1.48 cases/100 patient years. Patients who progressed were older (mean age 47.8 ± 12.2 years), had a higher prevalence of associated heart diseases (p < 0.0001), positive xenodiagnosis (p = 0.007), and were born in the most endemic Brazilian states (p = 0.018). Previous co-morbidities remained the only variable associated with CD progression after multivariate Cox proportional hazards regression analysis (p = 0.002). Conclusion: The progression rate to chronic CD cardiac form is low and inferior to rates previously reported in other studies. Full article
(This article belongs to the Special Issue Chagas Disease)
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