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Basharat N, Sadiq A, Dawood M, Ali S, Khan A, Ullah R, Khan H, Aziz A, Ali H, Shah AA, Ali I, Khan J. Rotavirus gastroenteritis in Pakistan, 2018: updated disease burden. BMC Infect Dis 2021; 21:426. [PMID: 33957883 PMCID: PMC8103586 DOI: 10.1186/s12879-021-06123-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Rotavirus A (RVA) is a significant cause of severe diarrheal illness and one of the common causes of death in children under the age of five. This study was aimed at detecting the prevalence of RVA in Pakistan after rotavirus vaccines were introduced. Fecal samples were obtained from 813 children from different hospitals in Rawalpindi and Islamabad, Pakistan, from January 2018 to December 2018. To obtain additional information from the parents / guardians of the children, a standard questionnaire was used. Results Using an enzyme-linked immunosorbent assay kit (ELISA), rotavirus antigen was detected and ELISA positive samples were subjected to reverse transcription PCR (RT-PCR). The findings showed 22% prevalence of RVA in children with acute gastroenteritis (AGE) via ELISA and 21% prevalence via RT-PCR in children with AGE. There was no statistically significant difference between gender, age and RVA infections. The winter, spring and fall/autumn seasons were statistically significant for RVA prevalence. Conclusion The present study will provide post vaccine prevalence data for the health policy makers. The implementation of rotavirus vaccines, along with adequate nutrition for babies, clean water supply and maternal hygienic activities during infant feeding, is recommended. Furthermore, continuous surveillance is mandatory in the whole country to calculate the disease burden caused by RVA.
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Affiliation(s)
- Nosheen Basharat
- Molecular Virology Laboratory, Department of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Asma Sadiq
- Molecular Virology Laboratory, Department of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Muhammad Dawood
- Department of Microbiology and Medical Laboratory Technology, COMWAVE Institute, Islamabad, Pakistan
| | - Shahid Ali
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Alam Khan
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rooh Ullah
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Hayat Khan
- Department of Microbiology, University of Swabi, Khyber Pakhtoonkhwa, Pakistan
| | - Aamir Aziz
- Institute of Biological Sciences, Sarhad University, Peshawar, Pakistan
| | - Hamid Ali
- Molecular Virology Laboratory, Department of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Aamer Ali Shah
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Ijaz Ali
- Molecular Virology Laboratory, Department of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Jadoon Khan
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan.
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Du H, Xiong P, Ji F, Lin X, Wang S, Zhang L, Liu Y, Song Y, Tao Z, Xu A. Genetic diversity and molecular epidemiological characterization of group A rotaviruses in raw sewage in Jinan by next generation sequencing. INFECTION GENETICS AND EVOLUTION 2021; 91:104814. [PMID: 33753310 DOI: 10.1016/j.meegid.2021.104814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/24/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To understand the genetic diversity and molecular epidemiology characteristics of group A Rotavirus (RVA) in domestic sewage through next generation sequencing (NGS), and to explore the feasibility and necessity of NGS method for RVA environmental surveillance. METHODS In this study, two sewage samples from Jinan each quarter in 2019 were selected for concentration, RNA extraction, and then RT-PCR reaction. The amplified positive products were subjected to NGS. Finally, the results were analyzed for diversity and phylogeny. RESULTS A total of 9 G-genotypes and 13 P-genotypes were detected. The Simpson diversity indices in autumn and winter were relatively high. Phylogenetic analysis showed that the dominant types G9 and P[8] were closely related to human-derived sequences. CONCLUSIONS This study proves that environmental surveillance as a means to understand the prevalence of RVA in the population is not only feasible but necessary. NGS based environmental surveillance greatly improves our understanding on RVA genetic diversity, and should be encouraged as a sensitive surveillance tool.
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Affiliation(s)
- Haibo Du
- Department of Microbiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan 250012, PR China
| | - Ping Xiong
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Feng Ji
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Xiaojuan Lin
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Suting Wang
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Li Zhang
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Yao Liu
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
| | - Yanyan Song
- Department of Microbiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan 250012, PR China.
| | - Zexin Tao
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China.
| | - Aiqiang Xu
- Department of Microbiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan 250012, PR China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, PR China
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Brindisino F, Passudetti V, Pennella D, Giovannico G, Heick JD. Recognition of pulmonary pathology in a patient presenting with shoulder pain. Physiother Theory Pract 2020; 38:597-607. [PMID: 32459135 DOI: 10.1080/09593985.2020.1768611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND . Shoulder pain is a common symptom of musculoskeletal disorder about the shoulder. However, shoulder pain can also be symptomatic of other non- musculoskeletal disease. Careful assessment of the clinical presentation is essential in differential diagnosis and decisions to treat or refer. CASE DESCRIPTION . A 56-year-old male preseted with shoulder pain and a previous diagnosis of subacromial impingement of the left shoulder. The shoulder pain increased with effort, was present at night making it difficult to sleep and became disabling for the patient in work and activities of daily living. In addition, the patient reported left thoracic pain and increasing episodes of dry coughing, shortness of breath, fever and unusual generalized fatigue. Physical examination did not reveal a musculoskeletal concern about the patient's shoulder. An increased body temperature was detected and when combined with auscultation and thorax percussion led the physiotherapist to hypothesize pulmonary involvement, later reinforced by the evocation of the patient's symptoms while measuring his peak expiratory flow. DISCUSSION . An underlyng serious pathology can be easily masked by shoulder pain. Physiotherapists need to consider that when a patient presents with a cluster of history and physical examination findings that are negative for mechanical shoulder pain, other systems must be considered as the source of presenting symptoms. Through the identification of risk factors and red flag findings, the physiotherapist can identify the need for referral.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,FTM, Physiotherapy and Manual Therapy, Physiotherapy Department, Lecce, Italy
| | - Valerio Passudetti
- "Pain Free" Manual Therapy Office, Physiotherapy Department, Treviso, Italy
| | - Denis Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Manual Therapy Lab Clinic, Physiotherapy Department, Bari, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,FTM, Physiotherapy and Manual Therapy, Physiotherapy Department, Lecce, Italy
| | - John D Heick
- Department of Physical Therapy and Athletic Training, Northern Arizona University Flagstaff, Flagstaff, AZ, USA
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Sadiq A, Bostan N, Bokhari H, Matthijnssens J, Yinda KC, Raza S, Nawaz T. Molecular characterization of human group A rotavirus genotypes circulating in Rawalpindi, Islamabad, Pakistan during 2015-2016. PLoS One 2019; 14:e0220387. [PMID: 31361761 PMCID: PMC6667158 DOI: 10.1371/journal.pone.0220387] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 07/15/2019] [Indexed: 01/17/2023] Open
Abstract
Group A rotaviruses (RVA) are one of the major causes of acute gastroenteritis (AGE) in young children worldwide. Owing to lack of proper surveillance programs and health facilities, developing countries of Asia and Africa carry a disproportionately heavy share of the RVA disease burden. The aim of this hospital-based study was to investigate the circulation of RVA genotypes in Rawalpindi and Islamabad, Pakistan in 2015 and 2016, prior to the implementation of RVA vaccine. 639 faecal samples collected from children under 10 years of age hospitalized with AGE were tested for RVA antigen by ELISA. Among 171 ELISA positive samples, 143 were successfully screened for RT-PCR and sequencing. The prevalence of RVA was found to be 26.8% with the highest frequency (34.9%) found among children of age group 6-11 months. The most predominant circulating genotypes were G3P[8] (22.4%) followed by G12P[6] (20.3%), G2P[4] (12.6%), G1P[8] (11.9%), G9P[6] (11.9%), G3P[4] (9.1%), G1P[6] (4.2%), G9P[8] (4.2%), and G3P[6] (0.7%). A single mixed genotype G1G3P[8] was also detected. The findings of this study provide baseline data, that will help to assess if future vaccination campaigns using currently available RVA vaccine will reduce RVA disease burden and instigate evolutionary changes in the overall RVA biology. The high prevalence of RVA infections in Pakistan require to improve and strengthen the surveillance and monitoring system for RVA. This will provide useful information for health authorities in planning public health care strategies to mitigate the disease burden caused by RVA.
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Affiliation(s)
- Asma Sadiq
- Department of Biosciences, COMSATS University (CUI), Tarlai Kalan, Chak Shahzad, Islamabad, Pakistan
| | - Nazish Bostan
- Department of Biosciences, COMSATS University (CUI), Tarlai Kalan, Chak Shahzad, Islamabad, Pakistan
| | - Habib Bokhari
- Department of Biosciences, COMSATS University (CUI), Tarlai Kalan, Chak Shahzad, Islamabad, Pakistan
| | - Jelle Matthijnssens
- KU Leuven-University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Viral Metagenomics, Leuven, Belgium
| | - Kwe Claude Yinda
- KU Leuven-University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Viral Metagenomics, Leuven, Belgium
| | - Saqlain Raza
- Department of Biosciences, COMSATS University (CUI), Tarlai Kalan, Chak Shahzad, Islamabad, Pakistan
| | - Tayyab Nawaz
- Department of Biosciences, COMSATS University (CUI), Tarlai Kalan, Chak Shahzad, Islamabad, Pakistan
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