Episodes of the epidemiological factors correlated with prevailing viral infections with dengue virus and molecular characterization of serotype-specific dengue virus circulation in eastern India

A systematic review and meta-analysis of the effects of temperature on the development and survival of the Aedes mosquito

Introduction

The Aedes mosquito species, which are the vectors for the transmission of the dengue virus (DENV) to humans, are becoming increasingly susceptible to the formidable effects of influential factors, especially temperature. However, there are still very few studies that have systematically reviewed the existing literature. Hence, in the present study, a systematic literature review and meta-analysis was conducted into the effects of temperature on dengue vectors.

Method

Several research methodologies were incorporated into the current study, and a review was carried out using PRISMA as a guide. The publications for this study were chosen from two prominent databases, Scopus and Web of Science. All of the studies were assessed, reviewed, and evaluated independently by two reviewers. The meta-analysis tool, Review Manager (RevMan Copenhagen Version 5.4.1), was used to record the extracted data for the meta-analysis. Moran's I ² and a funnel plot were utilized to measure heterogeneity, and publication bias was investigated. A 95% confidence interval (CI) and overall risk difference (RD) were estimated using a random-effects model.

Result and discussion

As a consequence of the search efforts, a total of 46 articles were selected for inclusion in the systematic review and meta-analysis. This review was divided into five major themes, based on a thematic analysis: (i) hatching rate, (ii) development time, (iii) longevity, (iv) survival rate, and (v) wing morphology. In addition, the development time, survival rate, and wing morphology revealed significantly higher risk differences between the maximum and minimum temperatures (RD: 0.26, 95% CI: 0.16, 0.36; p = < 0.00001; RD: 0.10, 95% CI: 0.05, 0.14; p < 0.0001; and RD: 0.07, 95% CI: 0.02, 0.12; p = 0.006, respectively). This study makes several substantial contributions to the body of knowledge and to practical applications. Finally, a number of recommendations are made at the conclusion of this research for the future reference of researchers.

Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis

BACKGROUND

Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries.

METHODS

The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI).

RESULTS

Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277-0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases.

CONCLUSIONS

Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.

Assessment of Dengue and Chikungunya Infections among Febrile Patients Visiting Four Healthcare Centres in Yaoundé and Dizangué, Cameroon

Dengue and chikungunya are now widely distributed in Cameroon, but there is still not enough information on their prevalence in different epidemiological settings. This study was undertaken to assess the prevalence of dengue and chikungunya in both urban and rural settings in Cameroon using three diagnostic tools. From December 2019 to September 2021, willing febrile (temperature >38 °C) outpatients visiting four healthcare facilities in the cities of Yaoundé and Dizangué were screened for dengue, and chikungunya. Clinical features of patient were recorded in a form, and their blood samples were analysed using real-time reverse transcriptase-polymerase chain reaction (rtRT-PCR), rapid diagnostic tests (RDTs) and enzyme-linked immuno-sorbent assays (ELISA). Odds ratios were used to determine the level of association between socio-demographic factors, clinical features, and infection status. The Kappa coefficient permitted to assess the level of agreement between RDTs and ELISA. Overall, 301 febrile patients were recruited in the study: 198 in Yaoundé and 103 in Dizangué. The prevalence of infection varied with the diagnostic tool used. For dengue diagnostics, 110 patients were positive to rtRT-PCR: 90 (45.45%) in Yaoundé, and 20 (19.42%) in Dizangué. The prevalence of dengue IgM using ELISA varied from 22.3% in Dizangué to 30.8% in Yaoundé. Dengue IgM rate using RDTs was 7.6% in Yaoundé and 3.9% in Dizangué. For chikungunya, one (0.5%) patient (Yaoundé, suburb) was positive to rtRT-PCR. The prevalence of chikungunya IgM according to ELISA varied from 18.4% in Dizangué to 21.7% in Yaoundé, while it was 4.5% in Yaoundé and 12.6% in Dizangué with RDTs. Only abdominal and retro-orbital pains were significantly associated with acute dengue infection. All four dengue serotypes were recorded, with a predominance of DENV-3 (35.45%) and DENV-4 (25.45%). Rapid Diagnostic Tests for either chikungunya or dengue displayed very poor sensitivity. This study further confirms the high endemicity of both dengue and chikungunya in Yaoundé and Dizangué. These data stress the need for active surveillance and the implementation of vector control measures to prevent the occurrence of outbreaks across the country.

Molecular Characterization and Identification of Potential Inhibitors for 'E' Protein of Dengue Virus

Dengue is an arthropod-borne acute febrile illness caused by Dengue Virus (DENV), a member of Flaviviridae. Severity of the infection ranges from mild self-limiting illness to severe life-threatening hemorrhagic fever (DHF) and dengue shock syndrome (DSS). To date, there is no specific antiviral therapy established to treat the infection. The current study reports the epidemiology of DENV infections and potential inhibitors of DENV 'E' protein. Among the various serotypes, DENV-2 serotype was observed more frequently, followed by DENV-4, DENV-1, and DENV-3. New variants of existing genotypes were observed in DENV-1, 2, and 4 serotypes. Predominantly, the severe form of dengue was attributable to DENV-2 infections, and the incidence was more common in males and pediatric populations. Both the incidence and the disease severity were more common among the residents of non-urban environments. Due to the predominantly self-limiting nature of primary dengue infection and folk medicine practices of non-urban populations, we observed a greater number of secondary dengue cases than primary dengue cases. Hemorrhagic manifestations were more in secondary dengue in particularly in the pediatric group. Through different computational methods, ligands RGBLD1, RGBLD2, RGBLD3, and RGBLD4 are proposed as potential inhibitors in silico against DENV-1, -2, -3, and -4 serotypes.

Challenges of dengue and coronavirus disease 2019 coinfection: two case reports

BACKGROUND

Dengue fever and coronavirus disease 2019 have now begun to overlap within tropical and subtropical regions. This is due to the high prevalence of dengue fever in these regions and the current severe acute respiratory syndrome coronavirus 2 pandemic situation. The similarity of symptoms between the two diseases can confuse diagnoses, but coinfection can also occur.

CASE PRESENTATION

We present two cases of patients with dengue and severe acute respiratory syndrome coronavirus 2 coinfection. The first case is that of a 24-year-old Hispanic woman with acute fever, odynophagia, and diarrhea, without respiratory symptoms and with positive molecular tests for both dengue and severe acute respiratory syndrome coronavirus 2. The second case is that of a 59-year-old Hispanic male patient with fever and respiratory symptoms of 2 weeks duration, negative molecular tests, and positive serological tests for both viruses. The clinical and epidemiological characteristics of both viral infections can help elucidate diagnoses and prognoses.

CONCLUSIONS

Severe dengue infection is common in young adults, while coronavirus disease 2019 is generally asymptomatic. In older people, the severity of dengue fever will depend on their comorbidities or the infectious serotype, but coronavirus disease 2019 is consistently more severe in this group. The accurate diagnosis of both infections can better guide clinical management, as well as public health actions in transmission control, now especially important during the coronavirus disease 2019 pandemic.

Molecular investigation of the dengue outbreak in Karnataka, South India, reveals co-circulation of all four dengue virus serotypes

The growing incidence of dengue outbreaks in the state of Karnataka prompted us to study the circulating dengue virus (DENV) and their proportion among the suspected cases of dengue patients during the disease outbreak at Mysuru district of Southern India. The presence of the DENV in a patient's serum sample was identified by RT-PCR using previously published primer pairs targeting CprM gene. DENV serotyping was carried out by semi-nested multiplex PCR using serotype-specific primers and nucleotide sequencing. Three hundred fifty-five samples of serum from suspected dengue cases were collected, and 203 samples (57.18%) were found positives. In 2016, DENV-4 (97.87%) was found to be the most dominant DENV serotype either alone or as co-infection, followed by DENV-2 (8.51%) and DENV-3 (4.25%). In 47 positive cases, co-infection with more than one serotype was detected in 4 cases (8.51%). The analysis of the dengue cases in 2017, DENV-4 was dominating serotype (33.97%), followed by the emergence of DENV-2 (32.05%), DENV-3 (25.64%), and DENV-1 (25.00%). Our study also reports the circulation of all four DENV serotypes in the Mysuru district of Southern India, with concurrent infections rate of 16.66% in 2017. The present study provides information regarding the genetic variation among the circulating DENV serotype in an Indian state of Karnataka. The need for the studying genetic diversity of DENV will be useful during the continuous monitoring for disease burden as well as the development of appropriate prophylactic measures to control the spread of dengue infection.

Circulation of dengue virus serotypes in hyperendemic region of New Delhi, India during 2011-2017

BACKGROUND

Dengue fever has become a hampering menace in New Delhi India, since the disease has become hyperendemic, due to circulation of multiple serotypes of dengue virus (DENV). This hyperendemicity poses a greater risk of secondary infections in human health system. This is a major issue which leads to apprehension amongst the researchers and health organizations and thus requires regular epidemiological surveillance.

METHODS

We analyzed the prevalence and serotypic distribution of dengue fever cases reported from the Southern part of New Delhi during continued surveillance from 2011 to 2017. The blood samples for the investigation were obtained from the patients suspected with dengue fever attending the OPD at a local Health Centre. The data for 2011-2016 was already published from our laboratory. The samples collected during 2017 were serotyped and characterized in the present study.

RESULTS

A total of 565 samples (59%) were positive for DENV of 958 samples tested by RT-PCR during 7 years (2011-2017). Our study has shown that most infections were caused by DENV-2 during 2011-2015. The data has shown occurrence of all four serotypes of DENV during 2015 and predominance of DENV-3 in 2016 and 2017. Further, predominant combination of DENV-1 and DENV-2 was found in most of the co-infections. To the best of our knowledge this is the first study showing the epidemiological trend of dengue fever in reference to the circulating DENV serotypes and co-infections from a hyperendemic region of New Delhi during 2011-2017.

CONCLUSIONS

This hyperendemic pattern of DENV and instantaneous shift in circulation of its serotypes is likely pose a greater risk of secondary infections. Inclusion of comprehensive community and hospital surveillance of dengue fever will assist in formulation and implementation of effective control measures.

Risk factors for dengue outbreaks in Odisha, India: A case-control study

BACKGROUND

Environmental and climatic risk factors of dengue outbreak has been studied in detail. However, the socio-epidemiological association with the disease is least explored. The study aims to identify the social and ecological factors associated with emerging dengue in Odisha, India.

METHODS

A population-based case-control study (age and sex matched at the ratio of 1:1) was conducted in six districts of the state in 2017. A structured validated questionnaire was used to collect information for each consenting participant. An ecological household survey was done using a checklist during the month of July-September. Along with the descriptive statistics, conditional logistic regression model was used to calculate the adjusted odds ratio using STATA.

RESULTS

Of 380 cases, nearly 55% were male and the median age was 33years. The adjusted odds of having dengue was nearly three times higher among the people having occupation which demands long travel, presence of breeding sites (1.7; 95% CI 1.2-2.6), presence of swampy area near home (1.5; 95% CI 1.1-2.1) and having travel history close to the index date (1.6; 95% CI 1.1-2.4). People staying in thatched houses had three times higher risk of the disease, however, households keeping the swampy areas clean had 50% less risk for the disease (0.5; 95% CI 0.31-0.67). Nearly 22.2% of cases had a travel history during the index date. Of them, 36% had diagnosis before the travel, whereas, 64% developed the disease after the returning from the travel.

CONCLUSION

Household factors such as occupation and ecological condition of households play important roles in dengue outbreaks in Odisha. However, our study suggests travel/commuting are also essential factors to be considered during disease prevention planning.

Emergence of new genotypes and lineages of dengue viruses during the 2012-15 epidemics in southern India

OBJECTIVES

To genotypically characterize dengue virus (DENV) isolates among dengue-infected children from 2012-13/2014-15 outbreaks in southern India.

METHODS

Children hospitalized with suspected dengue were tested for dengue RT-PCR targeting Capsid-preMembrane (C-prM) and Envelope (Env) regions. Following virologic confirmation (n=612), a representative selection of DENV isolates (n=99) were sequenced for C-prM, aligned using ClustalW and subjected to phylogenetic analysis by maximum-likelihood method in MEGA6.

RESULTS

In 2012-13 (n=113), DENV-3 (44, 38.9%) and DENV-2 (43, 38.1%) predominated; DENV-1 (22, 19.5%) and DENV-4 (1, 0.9%) were less common. The pattern changed in 2014-15 (n=499), when DENV-1 (329, 65.7%) predominated, followed by DENV-2 (97, 21.2%), DENV-3 (36, 6.7%) and DENV-4 (10, 2.0%). Multiple-serotype co-infections occurred in 2.7% and 5.4% in 2012-13 and 2014-15, respectively. Genotype III (GIII) of DENV-1 predominated (85.7%) in 2012-13, ceding to GI predominance (80.8%) in 2014-15. Among DENV-2, 71.9% (23/32) showed distinct clustering suggesting a new lineage, 'GIVc'. All tested DENV-4 were GIC, whose clustering pattern showed the emergence of two distinct clades.

CONCLUSIONS

New genotypic/lineage variations in DENV-1 and DENV-2 may have influenced the magnitude and severity of dengue epidemics in southern India during this period. These findings emphasize the role of active surveillance of DENV serotypes/genotypes in aiding outbreak control and vaccine studies.

Co-circulation of four dengue serotypes at South Eastern Andhra Pradesh, India: A prospective study

Background

Dengue is one of the most important mosquito-borne viral diseases in the world. The emergence and spread of four dengue viruses (DENVs) (serotypes) represent a global pandemic. The four distinct serotypes are, namely, DENV-1, DENV-2, DENV-3 and DENV-4. Very few dengue serotyping studies have been reported from Andhra Pradesh. In this context, the present study focuses on the circulating serotypes of dengue in South-Eastern Andhra Pradesh.

Methodology

Study was done at Sri Venkateswara Institute of Medical Sciences, a teaching hospital in Tirupati, Andhra Pradesh. Acute phase dengue serum samples were collected and tested for NS1 antigen and anti-human IgM antibodies by enzyme-linked immunosorbent assay (ELISA). NS1-positive samples were further serotyped by reverse transcriptase real-time polymerase chain reaction (rRT-PCR).

Results

A total of 398 serum samples were received from clinically suspected dengue fever cases. Of these, 150 (37.7%) samples were positive for NS1 and/or IgM ELISA. The 96 NS1 antigen-positive samples were further processed for serotyping, of which 36 were negative by rRT-PCR. DENV-2 (41%) was the predominant serotype, followed by DENV-4 (37%), DENV-3 (12%) and DENV-1 (10%) in descending order.

Conclusion

This study reports the all four dengue serotypes' co-circulation. This is the first report from South Eastern Andhra Pradesh. Amongst four, DENV-2 was predominant followed by DENV-4. The information of predominant serotypes can guide in forecasting dengue outbreaks and improving control measures of vectors thus may be helpful in the prevention of outbreaks.

Dengue fever is an emerging public health concern in the city of Multan, Pakistan: its seroprevalence and associated risk factors

The prevalence of dengue IgG and IgM antibodies was investigated in 689 patients with suspected dengue. Of the 689 suspected cases, 373 (54.1%) were found to be positive for dengue antibodies, IgM being dominant. There was a significant relationship between incidence of dengue fever and season: all cases were reported during the rainy season, especially the post-monsoon season (89.5%), with none during the dry season. More male (79.3%) than female individuals were positive cases and the incidence was highest in the 21-49 year age group (63%). This is the first seroprevalence study reported from Multan, Pakistan.