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Bos S, Zambrana JV, Duarte E, Graber AL, Huffaker J, Montenegro C, Premkumar L, Gordon A, Kuan G, Balmaseda A, Harris E. Serotype-specific epidemiological patterns of inapparent versus symptomatic primary dengue virus infections: a 17-year cohort study in Nicaragua. THE LANCET. INFECTIOUS DISEASES 2025; 25:346-356. [PMID: 39489898 PMCID: PMC11864988 DOI: 10.1016/s1473-3099(24)00566-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/09/2024] [Accepted: 08/19/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND Dengue is the most prevalent mosquito-borne viral disease and a major public health problem worldwide. Most primary infections with the four dengue virus serotypes (DENV1-4) are inapparent; nonetheless, whether the distribution of symptomatic versus inapparent infections by serotype varies remains unknown. Here, we present (1) the evaluation of a DENV1-4 envelope domain III multiplex microsphere-based assay (EDIII-MMBA) to serotype inapparent primary infections and (2) its application leveraging 17 years of prospective sample collection from the Nicaraguan Pediatric Dengue Cohort Study (PDCS). METHODS We analysed primary DENV infections in the PDCS from 2004 to 2022 detected by inhibition ELISA (iELISA) or RT-PCR. First, we evaluated the performance of the EDIII-MMBA for serotyping with samples characterised by RT-PCR or focus reduction neutralisation test. Next, we analysed a subset of inapparent primary DENV infections in the PDCS with the EDIII-MMBA to evaluate the epidemiology of inapparent infections. Remaining infections were inferred using stochastic imputation, taking year and neighbourhood into account. Infection incidence and percentage of inapparent, symptomatic, and severe infections were analysed by serotype. FINDINGS Between Aug 30, 2004, and March 10, 2022, a total of 5931 DENV-naive participants were followed in the PDCS. There were 1626 primary infections (382 symptomatic, 1244 inapparent) detected by iELISA or RT-PCR over the study period. The EDIII-MMBA demonstrated excellent overall accuracy (100%, 95% CI 95·8-100) for serotyping inapparent primary DENV infections when evaluated against gold-standard serotyping methods. Of the 1244 inapparent infections, we analysed 574 (46%) using the EDIII-MMBA. We found that the majority of primary infections were inapparent, with DENV3 exhibiting the highest likelihood of symptomatic (pooled odds ratio compared with DENV1: 2·13, 95% CI 1·28-3·56) and severe (6·75, 2·01-22·62) primary infections, whereas DENV2 was similar to DENV1 in both analyses. Considerable within-year and between-year variation in serotype distribution between symptomatic and inapparent infections and circulation of serotypes undetected in symptomatic cases were observed in multiple years. INTERPRETATION Our study indicates that case surveillance skews the perceived epidemiological footprint of DENV. We reveal a more complex and intricate pattern of serotype distribution in inapparent infections. The substantial differences in infection outcomes by serotype emphasises the need for vaccines with balanced immunogenicity and efficacy across serotypes. FUNDING National Institute of Allergy and Infectious Diseases (National Institutes of Health) and Bill & Melinda Gates Foundation. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sandra Bos
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - José Victor Zambrana
- Sustainable Sciences Institute, Managua, Nicaragua; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Elias Duarte
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Aaron L Graber
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Julia Huffaker
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Carlos Montenegro
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua; Centro de Salud Sócrates Flores Vivas, Ministerio de Salud, Managua, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua; Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
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Selvam K, Sudhakar C, Ragu Prasath A, Senbagam D, Almuhayawi MS, Alruhaili MH, Nagshabandi MK, Selim S. Anti-dengue Viral Protein NS5 and Antibacterial Efficacy of Andrographolide from Andrographis paniculata: An In Silico Approach. Appl Biochem Biotechnol 2025:10.1007/s12010-025-05191-7. [PMID: 39969740 DOI: 10.1007/s12010-025-05191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2025] [Indexed: 02/20/2025]
Abstract
The current study examines the anti-dengue and antibacterial potential and in silico drug development of the andrographolide against the pathogens Staphylococcus aureus (1JIJ) and Pseudomonas aeruginosa (6MVN) and the dengue viral protein NS5. The phytochemical analysis identified the presence of flavonoids, alkaloids, saponins, tannins, phenols, glycosides, and steroids in the Andrographis paniculata methanolic leaf extract. Based on the GC-MS analysis, andrographolide was identified as the primary chemical constituent of the medicinal plant A. paniculata and the compound with the largest peak area among other compounds. The agar well diffusion method was employed to observe the antibacterial potential of the methanolic leaf extract against S. aureus and P. aeruginosa. The maximal inhibition zones were 15.6 ± 0.34 mm and 11.7 ± 0.42 mm, respectively. Additionally, andrographolide was docked with the NS5 viral protein and bacterial proteins, including S. aureus TyrRS (PDB: 1JIJ) and P. aeruginosa LasR PDB (ID: 6MVN), resulting in a docking score of - 20.7384 kJ/mol, - 15.0969 kJ/mol, and - 11.1171 kJ/mol, respectively. In summary, our molecular docking experiments with the identified andrographolide compound demonstrated its potential as a drug with anti-dengue viral and antibacterial properties.
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Affiliation(s)
- Kandasamy Selvam
- Department of Biotechnology, Mahendra Arts and Science College (Autonomous), Tamil Nadu, Kalippatti, Namakkal, 637 501, India.
- Department of Biomaterials, Saveetha Dental College and Hospitals, SIMATS, Saveetha University, Tamil Nadu, Chennai, 600 077, India.
| | - Chinnappan Sudhakar
- Department of Biotechnology, Mahendra Arts and Science College (Autonomous), Tamil Nadu, Kalippatti, Namakkal, 637 501, India.
| | - Arunagiri Ragu Prasath
- Department of Biotechnology, Mahendra Arts and Science College (Autonomous), Tamil Nadu, Kalippatti, Namakkal, 637 501, India
| | - Duraisamy Senbagam
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology, Tamil Nadu, Kattankulathur, 603 203, India
| | - Mohammed S Almuhayawi
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
- Yousef Abdulatif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
| | - Mohammed H Alruhaili
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Mohammed K Nagshabandi
- Department of Basic Medical Sciences, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, 72388, Sakaka, Saudi Arabia.
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Bos S, Zambrana JV, Duarte EM, Graber AL, Huffaker J, Montenegro C, Premkumar L, Gordon A, Balmaseda A, Harris E. Serotype-Specific Epidemiological Patterns of Inapparent versus Symptomatic Primary Dengue Virus Infections: A 17-year cohort study in Nicaragua. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.05.24305281. [PMID: 38633800 PMCID: PMC11023678 DOI: 10.1101/2024.04.05.24305281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Dengue is the most prevalent mosquito-borne viral disease and a major public health problem worldwide. Most primary infections with the four dengue virus serotypes (DENV1-4) are inapparent; nonetheless, whether the distribution of symptomatic versus inapparent infections by serotype varies remains unknown. Here, we present (1) the evaluation of a multiplex DENV1-4 envelope domain III multiplex microsphere-based assay (EDIII-MMBA) to serotype inapparent primary infections and (2) its application leveraging 17 years of prospective sample collection from the Nicaraguan Pediatric Dengue Cohort Study (PDCS). First, we evaluated the performance of the EDIII-MMBA with samples characterized by RT-PCR or focus reduction neutralization test. Next, we analyzed 46% (N=574) of total inapparent primary DENV infections in the PDCS with the EDIII-MMBA to evaluate the epidemiology of inapparent infections. Remaining infections were inferred using stochastic imputation, taking year and neighborhood into account. Infection incidence and percentage of inapparent, symptomatic, and severe infections were analyzed by serotype. The EDIII-MMBA demonstrated excellent overall accuracy (100%, 95.8-100%) for serotyping symptomatic and inapparent primary DENV infections when evaluated against gold-standard serotyping methods. We found that a significant majority of primary infections were inapparent, with DENV3 exhibiting the highest likelihood of symptomatic and severe primary infections (Pooled OR compared to DENV1 = 2.13, 95% CI 1.28-3.56, and 6.75, 2.01-22.62, respectively), whereas DENV2 was similar to DENV1 in both analyses. Significant within- and between-year variation in serotype distribution between symptomatic and inapparent infections and circulation of serotypes undetected in symptomatic cases were observed in multiple years. Our study indicates that case surveillance skews the perceived epidemiological footprint of DENV. We reveal a more complex and intricate pattern of serotype distribution in inapparent infections. The significant differences in infection outcomes by serotype emphasizes the need for vaccines with balanced immunogenicity and efficacy across serotypes.
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Vicco A, McCormack C, Pedrique B, Ribeiro I, Malavige GN, Dorigatti I. A scoping literature review of global dengue age-stratified seroprevalence data: estimating dengue force of infection in endemic countries. EBioMedicine 2024; 104:105134. [PMID: 38718682 PMCID: PMC11096825 DOI: 10.1016/j.ebiom.2024.105134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dengue poses a significant burden worldwide, and a more comprehensive understanding of the heterogeneity in the intensity of dengue transmission within endemic countries is necessary to evaluate the potential impact of public health interventions. METHODS This scoping literature review aimed to update a previous study of dengue transmission intensity by collating global age-stratified dengue seroprevalence data published in the Medline, Embase and Web of Science databases from 2014 to 2023. These data were then utilised to calibrate catalytic models and estimate the force of infection (FOI), which is the yearly per-capita risk of infection for a typical susceptible individual. FINDINGS We found a total of 66 new publications containing 219 age-stratified seroprevalence datasets across 30 endemic countries. Together with the previously available average FOI estimates, there are now more than 250 dengue average FOI estimates obtained from seroprevalence studies from across the world. INTERPRETATION The results show large heterogeneities in average dengue FOI both across and within countries. These new estimates can be used to inform ongoing modelling efforts to improve our understanding of the drivers of the heterogeneity in dengue transmission globally, which in turn can help inform the optimal implementation of public health interventions. FUNDING UK Medical Research Council, Wellcome Trust, Community Jameel, Drugs for Neglected Disease initiative (DNDi) funded by the French Development Agency, Médecins Sans Frontières International; Swiss Agency for Development and Cooperation and UK aid.
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Affiliation(s)
- Anna Vicco
- Department of Molecular Medicine, University of Padua, Padua, Italy; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom.
| | - Clare McCormack
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom
| | - Belen Pedrique
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | - Isabela Ribeiro
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | | | - Ilaria Dorigatti
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom.
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Gupta S, Shakya A, Mishra N, Islahi S, Singh S, Nag S, Dwivedi A, Shukla M, Sen S, Dwivedi P, Agarwal M, Mukherjee A. Investigating the Clinico-Demographic Characteristics of Dengue Fever and Its Seroprevalence at a Tertiary Care Hospital in Northern India. Cureus 2024; 16:e57640. [PMID: 38707003 PMCID: PMC11070059 DOI: 10.7759/cureus.57640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Background and objective Dengue virus (DENV) is a major global health threat, causing over 50,000 deaths annually. The state of Uttar Pradesh (UP) in India faces significant challenges due to the increasing number of dengue cases detected. This study aimed to assess DENV seropositivity in the Raebareli district of UP, to offer crucial insights into the region's effective control and management strategies. Materials and methods This study, after obtaining approval from the ethics committee, analyzed blood samples of individuals suspected of having dengue at a teaching hospital in rural UP between January and December 2022. To determine the disease's seroprevalence, both dengue NS1 antigen ELISA and dengue IgM Microlisa were conducted. Furthermore, RT-PCR was performed on NS1-positive samples to confirm the serotypes. The collected data were analyzed using Epi Info 7.0. Results Of the 589 suspected dengue cases, 86 (14.60%) tested positive for dengue NS1 and/or IgM. Our findings showed that males (n=330, 56.03%) and adolescents and young adults (n=301, 51.1%) from rural areas (n=523, 88.4%) were predominantly affected. Cases peaked post-monsoon, and platelet levels were notably low in NS1-positive cases. Dengue serotype 2 (DEN-2) was found in all RT-PCR-positive samples. Our results revealed a dengue seroprevalence of 14.60% (n=86), which peaked in post-monsoon months. The higher incidence among males and young adults from rural areas attending the outpatient department highlights the importance of targeted interventions and community surveillance. RT-PCR confirmed the circulation of a single serotype in the region. Conclusions This study contributes crucial insights into dengue's epidemiology and clinical profile and its findings are all the more significant now as India prepares for phase 3 trials of a quadrivalent dengue-virus vaccine in 2024. Adolescent and young adult males have an increased likelihood of acquiring the virus, and this demographic can be prioritized for vaccine trials.
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Affiliation(s)
- Shefali Gupta
- Microbiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Akhalesh Shakya
- Microbiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Namita Mishra
- Paediatrics, All India Institute of Medical Sciences, Raebareli, IND
| | - Sana Islahi
- Microbiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Sweta Singh
- Microbiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Soumyabrata Nag
- Microbiology, All India Institute of Medical Sciences, Nagpur, IND
| | - Arti Dwivedi
- Virus Research and Diagnostic Laboratory, All India Institute of Medical Sciences, Raebareli, IND
| | - Mukesh Shukla
- Community and Family Medicine, All India Institute of Medical Sciences, Raebareli, IND
| | - Somdatt Sen
- Microbiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Priyanka Dwivedi
- Virus Research and Diagnostic Laboratory, All India Institute of Medical Sciences, Raebareli, IND
| | - Mayank Agarwal
- Physiology, All India Institute of Medical Sciences, Raebareli, IND
| | - Anirudh Mukherjee
- Internal Medicine, All India Institute of Medical Sciences, Raebareli, IND
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