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Laban N, Bosomprah S, Chilengi R, Simuyandi M, Chisenga C, Ng'ombe H, Musukuma-Chifulo K, Goodier M. Human cytomegalovirus seropositivity and its influence on oral rotavirus vaccine immunogenicity: a specific concern for HIV-exposed-uninfected infants. Clin Exp Immunol 2024; 217:99-108. [PMID: 38546123 DOI: 10.1093/cei/uxae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/28/2024] [Accepted: 03/25/2024] [Indexed: 06/21/2024] Open
Abstract
Oral rotavirus vaccines demonstrate diminished immunogenicity in low-income settings where human cytomegalovirus infection is acquired early in childhood and modulates immunity. We hypothesized that human cytomegalovirus infection around the time of vaccination may influence immunogenicity. We measured plasma human cytomegalovirus-specific immunoglobulin M antibodies in rotavirus vaccinated infants from 6 weeks to 12 months old and compared rotavirus immunoglobulin A antibody titers between human cytomegalovirus seropositive and seronegative infants. There was no evidence of an association between human cytomegalovirus serostatus at 9 months and rotavirus-specific antibody titers at 12 months (geometric mean ratio 1.01, 95% CI: 0.70, 1.45; P = 0.976) or fold-increase in RV-IgA titer between 9 and 12 months (risk ratio 0.999, 95%CI: 0.66, 1.52; P = 0.995) overall. However, HIV-exposed-uninfected infants who were seropositive for human cytomegalovirus at 9 months old had a 63% reduction in rotavirus antibody geometric mean titers at 12 months compared to HIV-exposed-uninfected infants who were seronegative for human cytomegalovirus (geometric mean ratio 0.37, 95% CI: 0.17, 0.77; P = 0.008). While the broader implications of human cytomegalovirus infections on oral rotavirus vaccine response might be limited in the general infant population, the potential impact in the HIV-exposed-uninfected infants cannot be overlooked. This study highlights the complexity of immunological responses and the need for targeted interventions to ensure oral rotavirus vaccine efficacy, especially in vulnerable subpopulations.
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Affiliation(s)
- Natasha Laban
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Samuel Bosomprah
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Roma Chilengi
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Michelo Simuyandi
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Caroline Chisenga
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Harriet Ng'ombe
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Kalo Musukuma-Chifulo
- Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Martin Goodier
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Flow Cytometry and Immunology Facility, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
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Ndebe J, Harima H, Chambaro HM, Sasaki M, Yamagishi J, Kalonda A, Shawa M, Qiu Y, Kajihara M, Takada A, Sawa H, Saasa N, Simulundu E. Prevalence and Genomic Characterization of Rotavirus A from Domestic Pigs in Zambia: Evidence for Possible Porcine-Human Interspecies Transmission. Pathogens 2023; 12:1199. [PMID: 37887715 PMCID: PMC10609906 DOI: 10.3390/pathogens12101199] [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] [Received: 08/15/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Rotavirus is a major cause of diarrhea globally in animals and young children under 5 years old. Here, molecular detection and genetic characterization of porcine rotavirus in smallholder and commercial pig farms in the Lusaka Province of Zambia were conducted. Screening of 148 stool samples by RT-PCR targeting the VP6 gene revealed a prevalence of 22.9% (34/148). Further testing of VP6-positive samples with VP7-specific primers produced 12 positives, which were then Sanger-sequenced. BLASTn of the VP7 positives showed sequence similarity to porcine and human rotavirus strains with identities ranging from 87.5% to 97.1%. By next-generation sequencing, the full-length genetic constellation of the representative strains RVA/pig-wt/ZMB/LSK0137 and RVA/pig-wt/ZMB/LSK0147 were determined. Genotyping of these strains revealed a known Wa-like genetic backbone, and their genetic constellations were G4-P[6]-I5-R1-C1-M1-A8-N1-T1-E1-H1 and G9-P[13]-I5-R1-C1-M1-A8-N1-T1-E1-H1, respectively. Phylogenetic analysis revealed that these two viruses might have their ancestral origin from pigs, though some of their gene segments were related to human strains. The study shows evidence of reassortment and possible interspecies transmission between pigs and humans in Zambia. Therefore, the "One Health" surveillance approach for rotavirus A in animals and humans is recommended to inform the design of effective control measures.
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Affiliation(s)
- Joseph Ndebe
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (A.T.); (H.S.); (N.S.)
| | - Hayato Harima
- Laboratory of Veterinary Public Health, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Saiwai-cho 3-5-8, Fuchu, Tokyo 183-8509, Japan;
| | - Herman Moses Chambaro
- Central Veterinary Research Institute (CVRI), Ministry of Fisheries and Livestock, Lusaka 10101, Zambia;
| | - Michihito Sasaki
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Sapporo 001-0020, Japan;
| | - Junya Yamagishi
- Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Sapporo 001-0020, Japan;
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia;
| | - Misheck Shawa
- Hokudai Center for Zoonosis Control in Zambia, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (M.S.); (M.K.)
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Sapporo 001-0020, Japan
| | - Yongjin Qiu
- National Institute of Infectious Diseases, Management Department of Biosafety, Laboratory Animal, and Pathogen Bank, Toyama 1-23-1, Tokyo 162-8640, Japan
- Department of Virology-I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Masahiro Kajihara
- Hokudai Center for Zoonosis Control in Zambia, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (M.S.); (M.K.)
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Sapporo 001-0020, Japan
| | - Ayato Takada
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (A.T.); (H.S.); (N.S.)
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, N20 W10, Sapporo 001-0020, Japan
- One Health Research Center, Hokkaido University, N18 W9, Sapporo 001-0020, Japan
| | - Hirofumi Sawa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (A.T.); (H.S.); (N.S.)
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
- One Health Research Center, Hokkaido University, N18 W9, Sapporo 001-0020, Japan
- Hokkaido University, Institute for Vaccine Research and Development (HU-IVReD), N21 W11, Sapporo 001-0020, Japan
- Global Virus Network, 725 W Lombard Street, Baltimore, MD 21201, USA
| | - Ngonda Saasa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (A.T.); (H.S.); (N.S.)
| | - Edgar Simulundu
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia; (A.T.); (H.S.); (N.S.)
- Macha Research Trust, Choma 20100, Zambia
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Meki CD, Ncube EJ, Voyi K. Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review. Syst Rev 2022; 11:73. [PMID: 35436979 PMCID: PMC9016942 DOI: 10.1186/s13643-022-01947-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterborne diarrhea diseases are among the leading causes of morbidity and mortality globally. These diseases can be mitigated by implementing various interventions. We reviewed the literature to identify available interventions to mitigate the risk of waterborne diarrheal diseases. METHODS We conducted a systematic database review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Web of Science Core Collection, Cochrane library, Scopus, African Index Medicus (AIM), and LILACS (Latin American and Caribbean Health Sciences Literature). Our search was limited to articles published between 2009 and 2020. We conducted the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist. The identified studies were qualitatively synthesized. RESULTS Our initial search returned 28 773 articles of which 56 studies met the inclusion criteria. The included studies reported interventions, including vaccines for rotavirus disease (monovalent, pentavalent, and Lanzhou lamb vaccine); enhanced water filtration for preventing cryptosporidiosis, Vi polysaccharide for typhoid; cholera 2-dose vaccines, water supply, water treatment and safe storage, household disinfection, and hygiene promotion for controlling cholera outbreaks. CONCLUSION We retrieved few studies on interventions against waterborne diarrheal diseases in low-income countries. Interventions must be specific to each type of waterborne diarrheal disease to be effective. Stakeholders must ensure collaboration in providing and implementing multiple interventions for the best outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190411 .
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Affiliation(s)
- Chisala D Meki
- University of Zambia, School of Public Health, University of Zambia, P O. BOX 50110, Lusaka, Zambia. .,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | - Esper J Ncube
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.,Rand Water, Johannesburg, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Schwartz LM, Zaman K, Yunus M, Basunia AUH, Faruque ASG, Ahmed T, Rahman M, Sugimoto JD, Halloran ME, Rowhani-Rahbar A, Neuzil KM, Victor JC. Impact of Rotavirus Vaccine Introduction in Children Less Than 2 Years of Age Presenting for Medical Care With Diarrhea in Rural Matlab, Bangladesh. Clin Infect Dis 2020; 69:2059-2070. [PMID: 30753368 PMCID: PMC6880338 DOI: 10.1093/cid/ciz133] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 02/07/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Following the conclusion of a human rotavirus vaccine (HRV) cluster-randomized, controlled trial (CRT) in Matlab, Bangladesh, HRV was included in Matlab's routine immunization program. We describe the population-level impact of programmatic rotavirus vaccination in Bangladesh in children <2 years of age. METHODS Interrupted time series were used to estimate the impact of HRV introduction. We used diarrheal surveillance collected between 2000 and 2014 within the 2 service delivery areas (International Centre for Diarrhoeal Disease Research, Bangladesh [icddr,b] service area [ISA] and government service area [GSA]) of the Matlab Health and Demographic Surveillance System, administered by icddr,b. Age group-specific incidence rates were calculated for both rotavirus-positive (RV+) and rotavirus-negative (RV-) diarrhea diagnoses of any severity presenting to the hospital. We used 2 models to assess the impact within each service area: Model 1 used the pre-vaccine time period in all villages (HRV- and control-only) and Model 2 combined the pre-vaccine time period and the CRT time period, using outcomes from control-only villages. RESULTS Both models demonstrated a downward trend in RV+ diarrheal incidences in the ISA villages during 3.5 years of routine HRV use, though only Model 2 was statistically significant. Significant impacts of HRV on RV+ diarrhea incidences in GSA villages were not observed in either model. Differences in population-level impacts between the 2 delivery areas may be due to the varied rotavirus vaccine coverage and presentation rates to the hospital. CONCLUSIONS This study provides initial evidence of the population-level impact of rotavirus vaccines in children <2 years of age in Matlab, Bangladesh. Further studies are needed of the rotavirus vaccine impact after the nationwide introduction in Bangladesh.
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Affiliation(s)
- Lauren M Schwartz
- Department of Epidemiology, School of Public Health, University of Washington, Seattle.,Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle
| | - K Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Md Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Jonathan D Sugimoto
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle
| | - M Elizabeth Halloran
- Department of Epidemiology, School of Public Health, University of Washington, Seattle.,Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle.,Department of Biostatistics, School of Public Health, University of Washington, Seattle.,Center for Inference and Dynamics of Infectious Diseases, Seattle
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle
| | - Kathleen M Neuzil
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - John C Victor
- Center for Vaccine Innovation and Access, PATH, Seattle, Washington
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Molecular Characterisation of a Rare Reassortant Porcine-Like G5P[6] Rotavirus Strain Detected in an Unvaccinated Child in Kasama, Zambia. Pathogens 2020; 9:pathogens9080663. [PMID: 32824526 PMCID: PMC7460411 DOI: 10.3390/pathogens9080663] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 11/25/2022] Open
Abstract
A human-porcine reassortant strain, RVA/Human-wt/ZMB/UFS-NGS-MRC-DPRU4723/2014/G5P[6], was identified in a sample collected in 2014 from an unvaccinated 12 month old male hospitalised for gastroenteritis in Zambia. We sequenced and characterised the complete genome of this strain which presented the constellation: G5-P[6]-I1-R1-C1-M1-A8-N1-T1-E1-H1. The genotype A8 is often observed in porcine strains. Phylogenetic analyses showed that VP6, VP7, NSP2, NSP4, and NSP5 genes were closely related to cognate gene sequences of porcine strains (e.g., RVA/Pig-wt/CHN/DZ-2/2013/G5P[X] for VP7) from the NCBI database, while VP1, VP3, VP4, and NSP3 were closely related to porcine-like human strains (e.g., RVA/Human-wt/CHN/E931/2008/G4P[6] for VP1, and VP3). On the other hand, the origin of the VP2 was not clear from our analyses, as it was not only close to both porcine (e.g., RVA/Pig-tc/CHN/SWU-1C/2018/G9P[13]) and porcine-like human strains (e.g., RVA/Human-wt/LKA/R1207/2009/G4P[6]) but also to three human strains (e.g., RVA/Human-wt/USA/1476/1974/G1P[8]). The VP7 gene was located in lineage II that comprised only porcine strains, which suggests the occurrence of independent porcine-to-human reassortment events. The study strain may have collectively been derived through interspecies transmission, or through reassortment event(s) involving strains of porcine and porcine-like human origin. The results of this study underline the importance of whole-genome characterisation of rotavirus strains and provide insights into interspecies transmissions from porcine to humans.
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Mwenda JM, Parashar UD, Cohen AL, Tate JE. Impact of rotavirus vaccines in Sub-Saharan African countries. Vaccine 2018; 36:7119-7123. [PMID: 29914848 DOI: 10.1016/j.vaccine.2018.06.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/25/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
By the end of 2017, 32 (68%) of 47 countries in the World Health Organization's African Region had introduced rotavirus vaccine into their national immunization programs, including 27 countries that received financial support from the Gavi, the Vaccine Alliance. Several early introducing African countries previously evaluated the impact, vaccine effectiveness, and/or cost effectiveness of their routine rotavirus vaccination programs and found that rotavirus vaccine was effective and resulted in substantial declines in hospitalizations due to rotavirus. This Special Issue of Vaccine provides additional rotavirus vaccine effectiveness and impact data from a broader range of African countries, describes the longer term impact and potential indirect benefits of rotavirus vaccination programs, describes trends in circulating genotypes in the pre- and post-vaccine introduction eras, and evaluates the cost-effectiveness of a rotavirus vaccination program in a post-introduction setting. As countries begin transitioning from Gavi support, the findings of these studies provide evidence of the impact and effectiveness of rotavirus vaccination programs under conditions of routine use.
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Affiliation(s)
- Jason M Mwenda
- World Health Organization Regional Office for Africa, (WHO/AFRO), Brazzaville, Congo
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