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Sinha R, Datta MR. Dengue in Early Pregnancy: A Neglected Problem? Cureus 2023; 15:e38740. [PMID: 37303396 PMCID: PMC10247336 DOI: 10.7759/cureus.38740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Dengue is caused by a virus from the Flaviviridae family. Although the literature on this disease is sparse, some studies have shown the effects of dengue in the first trimester of pregnancy. However, the sample size in these studies is limited. Aims and objective The current study aimed to compare foetomaternal outcomes in pregnant patients with dengue in early (< 24 weeks) and late (> 24 weeks) pregnancy and find the prevalence and predictive factors for abortion in pregnant patients with dengue. Material and methods This retrospective study included all pregnant patients (n = 62) admitted to the labour room over a period of six years from April 2016 to February 2022 and who were diagnosed with dengue anytime during pregnancy. Data were collected from their medical records and analysed. Differences between the two groups were assessed by the Chi-square test, Fisher's exact test, and Mann-Whitney U test. A p value of less than 0.05 was considered significant. Results Out of a total of 62 patients, those with dengue at a gestational age of less than 24 weeks (n = 15) had more incidence of intrauterine growth restriction (55.6 vs 12.9%) (p value = 0.012) and oligohydramnios (66.7 vs 17.9%) (p value = 0.007). The incidence of abortion was 33.3%; among the patients at a gestational age of less than 12 weeks, 71.4% had an abortion. When the patients who had abortions were compared with those who did not, the factors predicting abortion were found to be a history of previous abortion (p value = 0.004), gestational age of less than 12 weeks (p value = 0.003), and decreased platelet count (p value = 0.03). Conclusion The effect of dengue infection in early pregnancy includes abortion, intrauterine growth restriction, and oligohydramnios, and these patients should be managed in a tertiary care hospital.
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Affiliation(s)
- Ruchita Sinha
- Obstetrics and Gynaecology, Tata Manipal Medical College, Jamshedpur, IND
| | - Mamta R Datta
- Obstetrics and Gynaecology, Tata Main Hospital, Jamshedpur, IND
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2
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Watanabe S, Vasudevan SG. Clinical and experimental evidence for transplacental vertical transmission of flaviviruses. Antiviral Res 2023; 210:105512. [PMID: 36572192 DOI: 10.1016/j.antiviral.2022.105512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
The Zika virus (ZIKV) epidemic outbreak in Americas in 2016 attracted global attention because of the association of the virus infection with severe birth defects such as microcephaly, mediated through transplacental virus transmission during pregnancy. Less well-known, but also reported is the increasing evidence that prenatal vertical transmission can be caused by other flaviviruses such as dengue virus (DENV). Currently, the mechanism(s) that cause the vertical transmission of flaviviruses is understudied. Here we review the published reports of clinical evidence of intrauterine transmission of ZIKV and other flaviviruses. We also discuss the animal models for flavivirus infection during pregnancy that have been developed to study the mechanisms underlying the transplacental transmission of flaviviruses in order to develop potential countermeasures for its prevention.
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Affiliation(s)
- Satoru Watanabe
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road, 169857, Singapore.
| | - Subhash G Vasudevan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road, 169857, Singapore
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3
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Dengue in Pregnancy: A Southeast Asian Perspective. Trop Med Infect Dis 2023; 8:tropicalmed8020086. [PMID: 36828502 PMCID: PMC9964792 DOI: 10.3390/tropicalmed8020086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Dengue cases have been rising in recent years. In 2019 alone, over 658,301 of the 5.6 million reported cases originated from Southeast Asia (SEA). Research has also shown detrimental outcomes for pregnant infected women. Despite this, existing literature describing dengue's effects on pregnancy in SEA is insufficient. Through this narrative review, we sought to describe dengue's effects on pregnancy systemically and emphasize the existing gaps in the literature. We extensively searched various journals cited in PubMed and Ovid Medline, national clinical practice guidelines, and governmental reports. Dengue in pregnancy increases the risk of pre-eclampsia, Dengue Hemorrhagic Fever (DHF), fetal distress, preterm delivery, Caesarean delivery, and maternal mortality. Vertical transmission, intrauterine growth restriction, and stillbirth are possible sequelae of dengue in fetuses. We found that trimester-specific physiological impacts of dengue in pregnancy (to both mother and child) and investigations and management methods demanded further research, especially in the SEA region.
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Ateutchia Ngouanet S, Wanji S, Yadouleton A, Demanou M, Djouaka R, Nanfack-Minkeu F. Factors enhancing the transmission of mosquito-borne arboviruses in Africa. Virusdisease 2022; 33:477-488. [PMID: 36278029 PMCID: PMC9579656 DOI: 10.1007/s13337-022-00795-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sandra Ateutchia Ngouanet
- International Institute of Tropical Agriculture (IITA), 08 Tri-Postal, P.O. Box 0932, Cotonou, Benin
- Department Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. BOX 63, Buea, Cameroon
| | - Samuel Wanji
- Department Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. BOX 63, Buea, Cameroon
| | - Anges Yadouleton
- Centre de Recherche Entomologique de Cotonou (CREC), Cotonou, Benin
| | - Maurice Demanou
- Regional Yellow Fever Laboratory Coordinator World Health Organization, Inter-Country Support Team West Africa, 03 P.O. Box 7019, Ouagadougou 03, Burkina Faso
| | - Rousseau Djouaka
- International Institute of Tropical Agriculture (IITA), 08 Tri-Postal, P.O. Box 0932, Cotonou, Benin
| | - Ferdinand Nanfack-Minkeu
- International Institute of Tropical Agriculture (IITA), 08 Tri-Postal, P.O. Box 0932, Cotonou, Benin
- Department of Biology, The College of Wooster, Wooster, OH USA
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Sang R, Lutomiah J, Chepkorir E, Tchouassi DP. Evolving dynamics of Aedes-borne diseases in Africa: a cause for concern. CURRENT OPINION IN INSECT SCIENCE 2022; 53:100958. [PMID: 35878761 DOI: 10.1016/j.cois.2022.100958] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
Aedes-borne viruses, yellow fever (YF), dengue, Chikungunya and Zika are taking a huge toll on global health as Africa faces re-emergence with potential for massive human catastrophe. Transmission driven by diverse vectors in ecological settings that range from urban to rural and sylvatic habitats with human and nonhuman primate/reservoir activities across such habitats has facilitated virus movement and spillover to susceptible human populations. Approved vaccine exists for YF, although availability for routine and mass vaccination is often constrained. Integrating vector surveillance, understanding disease ecology with rationalised vaccination in high-risk areas (YF) remains important in disease prevention and control. We review trends in disease occurrence in Africa, hinting on gaps in disease detection and management and the prospects for prevention and/or control.
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Affiliation(s)
- Rosemary Sang
- International Centre of Insect Physiology and Ecology, P.O. Box 30772-00100, Nairobi, Kenya.
| | - Joel Lutomiah
- Center for Virus Research, Kenya Medical Research Institute, Kenya
| | - Edith Chepkorir
- Center for Virus Research, Kenya Medical Research Institute, Kenya
| | - David P Tchouassi
- International Centre of Insect Physiology and Ecology, P.O. Box 30772-00100, Nairobi, Kenya
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Sebastião CS, Neto Z, Jandondo D, Mirandela M, Morais J, Brito M. Dengue virus among HIV-infected pregnant women attending antenatal care in Luanda, Angola: An emerging public health concern. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rathore SS, Oberoi S, Hilliard J, Raja R, Ahmed NK, Vishwakarma Y, Iqbal K, Kumari C, Velasquez-Botero F, Nieto-Salazar MA, Cortes GAM, Akomaning E, Musa IEM. Maternal and foetal-neonatal outcomes of dengue virus infection during pregnancy. Trop Med Int Health 2022; 27:619-629. [PMID: 35689528 DOI: 10.1111/tmi.13783] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Given that women of reproductive age in dengue-endemic areas are at risk of infection, it is necessary to determine whether dengue virus (DENV) infection during pregnancy is associated with adverse outcomes. The aim of this systematic review and meta-analysis is to investigate the consequences of DENV infection in pregnancy on various maternal and foetal-neonatal outcomes. METHODS A systematic literature search was undertaken using PubMed, Google Scholar, and Embase till December 2021. Mantel-Haenszel risk ratios were calculated to report overall effect size using random effect models. The pooled prevalence was computed using the random effect model. All statistical analyses were performed on MedCalc Software. RESULT We obtained data from 36 studies involving 39,632 DENV-infected pregnant women. DENV infection in pregnancy was associated with an increased risk of maternal mortality (OR = 4.14 [95% CI, 1.17-14.73]), stillbirth (OR = 2.71 [95% CI, 1.44-5.10]), and neonatal deaths (OR = 3.03 [95% CI, 1.17-7.83]) compared with pregnant women without DENV infection. There was no significant statistical association established between maternal DENV infection and the outcomes of preterm birth, maternal bleeding, low birth weight in neonates, and risk of miscarriage. Pooled prevalences were 14.9% for dengue shock syndrome, 14% for preterm birth, 13.8% for maternal bleeding, 10.1% for low birth weight, 6% for miscarriages, and 5.6% for stillbirth. CONCLUSION DENV infection in pregnant women may be associated with adverse outcomes such as maternal mortality, stillbirth, and neonatal mortality. Hence, pregnant women should be considered an at-risk population for dengue management programmes.
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Affiliation(s)
- Sawai Singh Rathore
- Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India
| | - Sharvi Oberoi
- Internal Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Jonathan Hilliard
- College of Medicine, All Saints University College of Medicine, Amos Vale, Saint Vincent and the Grenadines
| | - Ritesh Raja
- Internal Medicine, China Three Georges University, Yichang, Hubei Province, China
| | | | - Yogesh Vishwakarma
- Internal Medicine, American University of Barbados, Wildey, St. Michael, Barbados
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Chandani Kumari
- Internal Medicine, American University of Barbados, Wildey, St. Michael, Barbados
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Watanabe S, Chan KWK, Tan NWW, Mahid MBA, Chowdhury A, Chang KTE, Vasudevan SG. Experimental evidence for a high rate of maternal-fetal transmission of dengue virus in the presence of antibodies in immunocompromised mice. EBioMedicine 2022; 77:103930. [PMID: 35290828 PMCID: PMC8921544 DOI: 10.1016/j.ebiom.2022.103930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Congenital disorders associated with prenatal vertical transmission of Zika virus (ZIKV) is well established since the 2016 outbreak in the Americas. However, despite clinical reports of similar mode of transmission for other flaviviruses such as dengue virus (DENV), the phenomenon has not been experimentally explored. Methods Pregnant AG129 mice were infected with DENV1 in the presence or absence of enhancing antibodies at different gestational time points. ZIKV was used for comparison. We quantified viral load in fetus and placentas and performed comprehensive gene expression profiling in the maternal (decidua) and fetal portion of placenta separately. Findings We demonstrate in a laboratory experimental setting that DENV can be transmitted vertically in a gestation stage-dependent manner similar to ZIKV, and this incidence drastically increases in the presence of enhancing antibodies. Interestingly, a high rate of DENV fetal infection occurs even though the placental viral load is significantly lower than that found in ZIKV-infected dams. Comprehensive gene expression profiling revealed DENV infection modulates a variety of inflammation-associated genes comparable to ZIKV in decidua and fetal placenta in early pregnancy. Interpretation Our findings suggest that the virus-induced modulation of host gene expression may facilitate DENV to cross the placental barrier in spite of lower viral burden compared to ZIKV. This mouse model may serve to identify the host determinants required for the vertical transmission of flaviviruses and develop appropriate countermeasures. Funding National Medical Research Council/Open Fund Individual Research Grant MOH-000524 (SW), MOH-000086 and OFIRG20nov-0017 (SGV).
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Affiliation(s)
- Satoru Watanabe
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore.
| | - Kitti Wing Ki Chan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | - Nicole Wei Wen Tan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | | | - Avisha Chowdhury
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | - Kenneth Tou En Chang
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road 229899, Singapore
| | - Subhash G Vasudevan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore; Institute for Glycomics, Griffith University, Gold Coast Campus, Queensland 4222, Australia.
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Sinha R, Datta M, Singh V. A study on maternal and foetal prognosis and predictive factors for adverse outcome in pregnant patients with dengue in an endemic state of India. J Family Med Prim Care 2022; 11:912-917. [PMID: 35495816 PMCID: PMC9051706 DOI: 10.4103/jfmpc.jfmpc_633_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/21/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022] Open
Abstract
Aims: Dengue fever is a major health problem with high morbidity and mortality especially during epidemic season; pregnant females being no exception. But, there is paucity of published data on dengue fever during pregnancy. Hence, this study was planned to study the clinical profile, maternal outcome and predictors of poor outcome in pregnant dengue patients. Materials and Methods: All pregnant females attending labour room of Tata Main Hospital, Jamshedpur from April 2016 to October2020 with acute febrile illness caused by dengue virus at any gestational age were included in the study. Diagnosis of dengue was made by detection of NS1 antigen or dengue serology. A predesigned proforma was used to record materno-foetal outcomes and were analysed. Results: Dengue was the cause of fever in 7.1% febrile patients. Maternal complications included abortions (26%), abruptio (1.9%), postpartum haemorrhage (11.9%) . Of all the pregnant dengue patients, five had severe dengue(SD) with high mortality (3/5; 60%). Fetal complications were intrauterine death(7.7%),preterm(42.3%). Thrombocytopenia and elevated transaminases were associated with adverse outcome. Conclusions: Dengue fever in pregnancy is associated with poor outcomes more in cases of SD rather than dengue fever . Pregnant females with high risk predictors should be identified and managed aggressively in intensive care units to improve outcomes.
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Mate A, Reyes-Goya C, Santana-Garrido Á, Sobrevia L, Vázquez CM. Impact of maternal nutrition in viral infections during pregnancy. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166231. [PMID: 34343638 PMCID: PMC8325560 DOI: 10.1016/j.bbadis.2021.166231] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/05/2021] [Accepted: 07/23/2021] [Indexed: 12/11/2022]
Abstract
Other than being a physiological process, pregnancy is a condition characterized by major adaptations of maternal endocrine and metabolic homeostasis that are necessary to accommodate the fetoplacental unit. Unfortunately, all these systemic, cellular, and molecular changes in maternal physiology also make the mother and the fetus more prone to adverse outcomes, including numerous alterations arising from viral infections. Common infections during pregnancy that have long been recognized as congenitally and perinatally transmissible to newborns include toxoplasmosis, rubella, cytomegalovirus, and herpes simplex viruses (originally coined as ToRCH infections). In addition, enterovirus, parvovirus B19, hepatitis virus, varicella-zoster virus, human immunodeficiency virus, Zika and Dengue virus, and, more recently, coronavirus infections including Middle Eastern respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) infections (especially the novel SARS-CoV-2 responsible for the ongoing COVID-19 pandemic), constitute relevant targets for current research on maternal-fetal interactions in viral infections during pregnancy. Appropriate maternal education from preconception to the early postnatal period is crucial to promote healthy pregnancies in general and to prevent and/or reduce the impact of viral infections in particular. Specifically, an adequate lifestyle based on proper nutrition plans and feeding interventions, whenever possible, might be crucial to reduce the risk of virus-related gestational diseases and accompanying complications in later life. Here we aim to provide an overview of the emerging literature addressing the impact of nutrition in the context of potentially harmful viral infections during pregnancy.
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Affiliation(s)
- Alfonso Mate
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Sevilla, Spain.
| | - Claudia Reyes-Goya
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain
| | - Álvaro Santana-Garrido
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Luis Sobrevia
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Medical School (Faculty of Medicine), São Paulo State University (UNESP), Brazil; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Australia; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen (UMCG), 9713GZ Groningen, the Netherlands
| | - Carmen M Vázquez
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Sevilla, Spain
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Agboli E, Zahouli JBZ, Badolo A, Jöst H. Mosquito-Associated Viruses and Their Related Mosquitoes in West Africa. Viruses 2021; 13:v13050891. [PMID: 34065928 PMCID: PMC8151702 DOI: 10.3390/v13050891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022] Open
Abstract
Mosquito-associated viruses (MAVs), including mosquito-specific viruses (MSVs) and mosquito-borne (arbo)viruses (MBVs), are an increasing public, veterinary, and global health concern, and West Africa is projected to be the next front for arboviral diseases. As in-depth knowledge of the ecologies of both western African MAVs and related mosquitoes is still limited, we review available and comprehensive data on their diversity, abundance, and distribution. Data on MAVs’ occurrence and related mosquitoes were extracted from peer-reviewed publications. Data on MSVs, and mosquito and vertebrate host ranges are sparse. However, more data are available on MBVs (i.e., dengue, yellow fever, chikungunya, Zika, and Rift Valley fever viruses), detected in wild and domestic animals, and humans, with infections more concentrated in urban areas and areas affected by strong anthropogenic changes. Aedes aegypti, Culex quinquefasciatus, and Aedes albopictus are incriminated as key arbovirus vectors. These findings outline MAV, related mosquitoes, key knowledge gaps, and future research areas. Additionally, these data highlight the need to increase our understanding of MAVs and their impact on host mosquito ecology, to improve our knowledge of arbovirus transmission, and to develop specific strategies and capacities for arboviral disease surveillance, diagnostic, prevention, control, and outbreak responses in West Africa.
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Affiliation(s)
- Eric Agboli
- Molecular Biology and Immunology Department, Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany;
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana
| | - Julien B. Z. Zahouli
- Centre d’Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, Bouake, 27 BP 529 Abidjan 27, Cote D’Ivoire;
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Département de Recherche et Développement, 01 BP 1303 Abidjan 01, Cote D’Ivoire
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
| | - Athanase Badolo
- Laboratory of Fundamental and Applied Entomology, Universitée Joseph Ki-Zerbo, Ouagadougou 03 BP 7021, Burkina Faso;
| | - Hanna Jöst
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Hemorrhagic Fever Reference and Research, 20359 Hamburg, Germany
- Correspondence:
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Mwanyika GO, Mboera LEG, Rugarabamu S, Ngingo B, Sindato C, Lutwama JJ, Paweska JT, Misinzo G. Dengue Virus Infection and Associated Risk Factors in Africa: A Systematic Review and Meta-Analysis. Viruses 2021; 13:v13040536. [PMID: 33804839 PMCID: PMC8063827 DOI: 10.3390/v13040536] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/09/2023] Open
Abstract
Dengue contributes a significant burden on global public health and economies. In Africa, the burden of dengue virus (DENV) infection is not well described. This review was undertaken to determine the prevalence of dengue and associated risk factors. A literature search was done on PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify articles published between 1960 and 2020. Meta-analysis was performed using a random-effect model at a 95% confidence interval, followed by subgroup meta-analysis to determine the overall prevalence. Between 1960 and 2020, 45 outbreaks were identified, of which 17 and 16 occurred in East and West Africa, respectively. Dengue virus serotype 1 (DENV-1) and DENV-2 were the dominant serotypes contributing to 60% of the epidemics. Of 2211 cases reported between 2009 and 2020; 1954 (88.4%) were reported during outbreaks. Overall, the prevalence of dengue was 29% (95% CI: 20–39%) and 3% (95% CI: 1–5%) during the outbreak and non-outbreak periods, respectively. Old age (6/21 studies), lack of mosquito control (6/21), urban residence (4/21), climate change (3/21), and recent history of travel (3/21) were the leading risk factors. This review reports a high burden of dengue and increased risk of severe disease in Africa. Our findings provide useful information for clinical practice and health policy decisions to implement effective interventions.
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Affiliation(s)
- Gaspary O. Mwanyika
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
- Department of Health Science and Technology, Mbeya University of Science and Technology, P.O. Box 131 Mbeya, Tanzania
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
| | - Sima Rugarabamu
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65595 Dar es Salaam, Tanzania
| | - Baraka Ngingo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Biology Department, St. John’s University of Tanzania, P.O. Box 47 Dodoma, Tanzania
| | - Calvin Sindato
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Tabora Research Centre, National Institute for Medical Research, P.O. Box 482 Tabora, Tanzania
| | - Julius J. Lutwama
- Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, P.O. Box 49 Entebbe, Uganda;
| | - Janusz T. Paweska
- National Health Laboratory Service, National Institute for Communicable Diseases, Sandringham, 2192 Johannesburg, South Africa;
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
- Correspondence:
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Brar R, Sikka P, Suri V, Singh MP, Suri V, Mohindra R, Biswal M. Maternal and fetal outcomes of dengue fever in pregnancy: a large prospective and descriptive observational study. Arch Gynecol Obstet 2021; 304:91-100. [PMID: 33389093 PMCID: PMC7778400 DOI: 10.1007/s00404-020-05930-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
Abstract
Purpose The primary objective of the study was to assess maternal and fetal outcomes of pregnancies affected with dengue fever. Methods This was a prospective, observational and descriptive study carried out over a period of 1 year. 216 pregnant women with fever were screened. Of these, 44 women tested positive for dengue (non-structural protein antigen 1 or dengue IgM antibodies in the sera). The clinical and laboratory characteristics of women with dengue were recorded. Maternal outcomes, pregnancy outcomes and fetal outcomes were studied. Results Mean period of gestation was 31.89 ± 7.31 weeks. Thrombocytopenia was seen in 23 (52.3%) women. Of 40 women, 10 (25%) developed post-partum haemorrhage. The incidence of maternal systemic complications was high: eight (18.2%) women developed acute kidney injury and two (4.5%) required haemodialysis support; eight (18.2%) women developed ARDS and seven (15.9%) women required ventilatory support; four (9.1%) women developed acute liver failure. 18 (40.9%) women had evidence of shock. Seven (15.9%) women died and another seven (15.9%) were classified as WHO maternal near-miss cases. Two (4.5%) pregnancies suffered from miscarriages, four (9%) from still births and two (4.5%) from neonatal deaths. Preterm babies were delivered in 15 (34.1%) and low birth weight babies in 13 (29.5%). Conclusions Dengue in pregnancy adversely affects maternal and fetal outcomes with high maternal mortality of 15.9%. Prematurity and postpartum haemorrhage are significant risks to mother and baby. Vector control strategies should be implemented with vigour in affected areas.
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Affiliation(s)
- Rinnie Brar
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Pooja Sikka
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| | - Vikas Suri
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Mini P Singh
- Department of Virology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Vanita Suri
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Ritin Mohindra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
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