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de Souza WM, Weaver SC. Effects of climate change and human activities on vector-borne diseases. Nat Rev Microbiol 2024:10.1038/s41579-024-01026-0. [PMID: 38486116 DOI: 10.1038/s41579-024-01026-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/18/2024]
Abstract
Vector-borne diseases are transmitted by haematophagous arthropods (for example, mosquitoes, ticks and sandflies) to humans and wild and domestic animals, with the largest burden on global public health disproportionately affecting people in tropical and subtropical areas. Because vectors are ectothermic, climate and weather alterations (for example, temperature, rainfall and humidity) can affect their reproduction, survival, geographic distribution and, consequently, ability to transmit pathogens. However, the effects of climate change on vector-borne diseases can be multifaceted and complex, sometimes with ambiguous consequences. In this Review, we discuss the potential effects of climate change, weather and other anthropogenic factors, including land use, human mobility and behaviour, as possible contributors to the redistribution of vectors and spread of vector-borne diseases worldwide.
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Affiliation(s)
- William M de Souza
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, College of Medicine, Lexington, KY, USA
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
- Global Virus Network, Baltimore, MD, USA
| | - Scott C Weaver
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA.
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA.
- Global Virus Network, Baltimore, MD, USA.
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Renard A, Pérez Lombardini F, Pacheco Zapata M, Porphyre T, Bento A, Suzán G, Roiz D, Roche B, Arnal A. Interaction of Human Behavioral Factors Shapes the Transmission of Arboviruses by Aedes and Culex Mosquitoes. Pathogens 2023; 12:1421. [PMID: 38133304 PMCID: PMC10746986 DOI: 10.3390/pathogens12121421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Arboviruses, i.e., viruses transmitted by blood-sucking arthropods, trigger significant global epidemics. Over the past 20 years, the frequency of the (re-)emergence of these pathogens, particularly those transmitted by Aedes and Culex mosquitoes, has dramatically increased. Therefore, understanding how human behavior is modulating population exposure to these viruses is of particular importance. This synthesis explores human behavioral factors driving human exposure to arboviruses, focusing on household surroundings, socio-economic status, human activities, and demographic factors. Household surroundings, such as the lack of water access, greatly influence the risk of arbovirus exposure by promoting mosquito breeding in stagnant water bodies. Socio-economic status, such as low income or low education, is correlated to an increased incidence of arboviral infections and exposure. Human activities, particularly those practiced outdoors, as well as geographical proximity to livestock rearing or crop cultivation, inadvertently provide favorable breeding environments for mosquito species, escalating the risk of virus exposure. However, the effects of demographic factors like age and gender can vary widely through space and time. While climate and environmental factors crucially impact vector development and viral replication, household surroundings, socio-economic status, human activities, and demographic factors are key drivers of arbovirus exposure. This article highlights that human behavior creates a complex interplay of factors influencing the risk of mosquito-borne virus exposure, operating at different temporal and spatial scales. To increase awareness among human populations, we must improve our understanding of these complex factors.
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Affiliation(s)
- Aubane Renard
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
| | - Fernanda Pérez Lombardini
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Mitsuri Pacheco Zapata
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Thibaud Porphyre
- Laboratoire de Biométrie et Biologie Évolutive, VetAgro Sup, Campus Vétérinaire de Lyon, 69280 Marcy-l’Etoile, France;
| | - Ana Bento
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA;
| | - Gerardo Suzán
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - David Roiz
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Benjamin Roche
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Audrey Arnal
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
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3
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Su H, Liu J, Yu J, Qiu Z, Liang W, Wu W, Mo H, Li H, Zhao W, Gu W. EDIII-Fc induces protective immune responses against the Zika virus in mice and rhesus macaque. PLoS Negl Trop Dis 2023; 17:e0011770. [PMID: 37983259 PMCID: PMC10695381 DOI: 10.1371/journal.pntd.0011770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/04/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Zika virus can infect the fetus through the placental barrier, causing ZIKV congenital syndrome and even miscarriage, which can cause great harm to pregnant women and infants. Currently, there is no vaccine and drug available to combat the Zika virus. In this study, we designed a fusion protein named EDIII-Fc, including the EDIII region of Zika E protein and human IgG Fc fragment, and obtained 293T cells that stably secreted EDIII-Fc protein using the lentiviral expression system. Mice were immunized with the EDIII-Fc protein, and it was observed that viral replication was significantly inhibited in the immunized mice compared to non-immunized mice. In rhesus macaques, we found that EDIII-Fc effectively induce the secretion of neutralizing antibodies and T cell immunity. These experimental data provide valid data for further use of Zika virus E protein to prepare an effective, safe, affordable Zika vaccine.
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Affiliation(s)
- Hailong Su
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Jun Liu
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Jianhai Yu
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhenzhen Qiu
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wenhan Liang
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Wangsheng Wu
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Haifeng Mo
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Hongwei Li
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Wei Zhao
- BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Weiwang Gu
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, South China Institute of Large Animal Models for Biomedicine, Wuyi University, Jiangmen, China
- Institute of Comparative Medicine & Laboratory Animal Center, Southern Medical University, Guangzhou, China
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Kayange N, Hau DK, Pain K, Mshana SE, Peck R, Gehring S, Groendahl B, Koliopoulos P, Revocatus B, Msaki EB, Malande O. Seroprevalence of Dengue and Chikungunya Virus Infections in Children Living in Sub-Saharan Africa: Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1662. [PMID: 37892325 PMCID: PMC10605353 DOI: 10.3390/children10101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Dengue and chikungunya viruses are frequent causes of malarial-like febrile illness in children. The rapid increase in virus transmission by mosquitoes is a global health concern. This is the first systematic review and meta-analysis of the childhood prevalence of dengue and chikungunya in Sub-Saharan Africa (SSA). A comprehensive search of the MEDLINE (Ovid), Embase (Ovid), and Cochrane Library (Wiley) databases was conducted on 28 June 2019, and updated on 12 February 2022. The search strategy was designed to retrieve all articles pertaining to arboviruses in SSA children using both controlled vocabulary and keywords. The pooled (weighted) proportion of dengue and chikungunya was estimated using a random effect model. The overall pooled prevalence of dengue and chikungunya in SSA children was estimated to be 16% and 7%, respectively. Prevalence was slightly lower during the period 2010-2020 compared to 2000-2009. The study design varied depending on the healthcare facility reporting the disease outbreak. Importantly, laboratory methods used to detect arbovirus infections differed. The present review documents the prevalence of dengue and chikungunya in pediatric patients throughout SSA. The results provide unprecedented insight into the transmission of dengue and chikungunya viruses among these children and highlight the need for enhanced surveillance and controlled methodology.
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Affiliation(s)
- Neema Kayange
- Department of Pediatrics, Bugando Medical Centre, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Duncan K Hau
- Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA;
| | - Kevin Pain
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA;
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Robert Peck
- Department of Pediatrics, Bugando Medical Centre, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
- Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA;
- Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Stephan Gehring
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Britta Groendahl
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Philip Koliopoulos
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (S.G.); (B.G.); (P.K.)
| | - Baraka Revocatus
- Department of Data and Statistics, Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania;
| | - Evarist B Msaki
- Department of Epidemiology and Biostatistics, Bugando Medical Centre, Mwanza P.O. Box 1370, Tanzania;
| | - Ombeva Malande
- East Africa Centre for Vaccines and Immunization (ECAVI), Kampala P.O. Box 3040, Uganda;
- Department of Public Health Phamarmacy, Sefako Makgatho Health Sciences University, Pretoria P.O. Box 60, South Africa
- Department of Paediatrics & Child Health, Makerere University, Kampala P.O. Box 7072, Uganda
- Department of Public Health, UNICAF University, Lusaka P.O. Box 20842, Zambia
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5
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Vu DM, Krystosik AR, Ndenga BA, Mutuku FM, Ripp K, Liu E, Bosire CM, Heath C, Chebii P, Maina PW, Jembe Z, Malumbo SL, Amugongo JS, Ronga C, Okuta V, Mutai N, Makenzi NG, Litunda KA, Mukoko D, King CH, LaBeaud AD. Detection of acute dengue virus infection, with and without concurrent malaria infection, in a cohort of febrile children in Kenya, 2014-2019, by clinicians or machine learning algorithms. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001950. [PMID: 37494331 PMCID: PMC10370704 DOI: 10.1371/journal.pgph.0001950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Abstract
Poor access to diagnostic testing in resource limited settings restricts surveillance for emerging infections, such as dengue virus (DENV), to clinician suspicion, based on history and exam observations alone. We investigated the ability of machine learning to detect DENV based solely on data available at the clinic visit. We extracted symptom and physical exam data from 6,208 pediatric febrile illness visits to Kenyan public health clinics from 2014-2019 and created a dataset with 113 clinical features. Malaria testing was available at the clinic site. DENV testing was performed afterwards. We randomly sampled 70% of the dataset to develop DENV and malaria prediction models using boosted logistic regression, decision trees and random forests, support vector machines, naïve Bayes, and neural networks with 10-fold cross validation, tuned to maximize accuracy. 30% of the dataset was reserved to validate the models. 485 subjects (7.8%) had DENV, and 3,145 subjects (50.7%) had malaria. 220 (3.5%) subjects had co-infection with both DENV and malaria. In the validation dataset, clinician accuracy for diagnosis of malaria was high (82% accuracy, 85% sensitivity, 80% specificity). Accuracy of the models for predicting malaria diagnosis ranged from 53-69% (35-94% sensitivity, 11-80% specificity). In contrast, clinicians detected only 21 of 145 cases of DENV (80% accuracy, 14% sensitivity, 85% specificity). Of the six models, only logistic regression identified any DENV case (8 cases, 91% accuracy, 5.5% sensitivity, 98% specificity). Without diagnostic testing, interpretation of clinical findings by humans or machines cannot detect DENV at 8% prevalence. Access to point-of-care diagnostic tests must be prioritized to address global inequities in emerging infections surveillance.
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Affiliation(s)
- David M Vu
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Amy R Krystosik
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Bryson A Ndenga
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Francis M Mutuku
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Kelsey Ripp
- University of Global Health Equity, Butaro, Rwanda
| | - Elizabeth Liu
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Carren M Bosire
- Department of Pure and Applied Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Claire Heath
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Philip Chebii
- Vector-Borne Diseases Unit, Msambweni County Referral Hospital, Msambweni, Kwale, Kenya
| | | | - Zainab Jembe
- Vector-Borne Diseases Unit, Diani Health Center, Ukunda, Kwale, Kenya
| | - Said Lipi Malumbo
- Vector-Borne Diseases Unit, Msambweni County Referral Hospital, Msambweni, Kwale, Kenya
| | - Jael Sagina Amugongo
- Vector-Borne Diseases Unit, Msambweni County Referral Hospital, Msambweni, Kwale, Kenya
| | - Charles Ronga
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Victoria Okuta
- Paediatric Department, Obama Children's Hospital, Jaramogi Oginga Odinga Referral Hospital, Kisumu, Kenya
| | - Noah Mutai
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Nzaro G Makenzi
- Department of Pure and Applied Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Kennedy A Litunda
- Department of Pure and Applied Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Dunstan Mukoko
- Vector-Borne Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Charles H King
- Department of Pathology, Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - A Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
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Peña-García VH, Mutuku FM, Ndenga BA, Mbakaya JO, Ndire SO, Agola GA, Mutuku PS, Malumbo SL, Ng'ang'a CM, Andrews JR, Mordecai EA, LaBeaud AD. The Importance of Including Non-Household Environments in Dengue Vector Control Activities. Viruses 2023; 15:1550. [PMID: 37515236 PMCID: PMC10384488 DOI: 10.3390/v15071550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Most vector control activities in urban areas are focused on household environments; however, information relating to infection risks in spaces other than households is poor, and the relative risk that these spaces represent has not yet been fully understood. We used data-driven simulations to investigate the importance of household and non-household environments for dengue entomological risk in two Kenyan cities where dengue circulation has been reported. Fieldwork was performed using four strategies that targeted different stages of mosquitoes: ovitraps, larval collections, Prokopack aspiration, and BG-sentinel traps. Data were analyzed separately between household and non-household environments to assess mosquito presence, the number of vectors collected, and the risk factors for vector presence. With these data, we simulated vector and human populations to estimate the parameter m and mosquito-to-human density in both household and non-household environments. Among the analyzed variables, the main difference was found in mosquito abundance, which was consistently higher in non-household environments in Kisumu but was similar in Ukunda. Risk factor analysis suggests that small, clean water-related containers serve as mosquito breeding places in households as opposed to the trash- and rainfall-related containers found in non-household structures. We found that the density of vectors (m) was higher in non-household than household environments in Kisumu and was also similar or slightly lower between both environments in Ukunda. These results suggest that because vectors are abundant, there is a potential risk of transmission in non-household environments; hence, vector control activities should take these spaces into account.
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Affiliation(s)
- Víctor Hugo Peña-García
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Francis M Mutuku
- Department of Environmental and Health Sciences, Technical University of Mombasa, Mombasa 80110, Kenya
| | | | | | | | | | - Paul S Mutuku
- Vector Borne Disease Control Unit, Msambweni County Referral Hospital, Msambweni, Kwale County 80404, Kenya
| | - Said L Malumbo
- Vector Borne Disease Control Unit, Msambweni County Referral Hospital, Msambweni, Kwale County 80404, Kenya
| | - Charles M Ng'ang'a
- Vector Borne Disease Control Unit, Msambweni County Referral Hospital, Msambweni, Kwale County 80404, Kenya
| | - Jason R Andrews
- School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Erin A Mordecai
- Department of Biology, Stanford University, Stanford, CA 94305, USA
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Man O, Kraay A, Thomas R, Trostle J, Lee GO, Robbins C, Morrison AC, Coloma J, Eisenberg JNS. Characterizing dengue transmission in rural areas: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011333. [PMID: 37289678 PMCID: PMC10249895 DOI: 10.1371/journal.pntd.0011333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Dengue has historically been considered an urban disease associated with dense human populations and the built environment. Recently, studies suggest increasing dengue virus (DENV) transmission in rural populations. It is unclear whether these reports reflect recent spread into rural areas or ongoing transmission that was previously unnoticed, and what mechanisms are driving this rural transmission. We conducted a systematic review to synthesize research on dengue in rural areas and apply this knowledge to summarize aspects of rurality used in current epidemiological studies of DENV transmission given changing and mixed environments. We described how authors defined rurality and how they defined mechanisms for rural dengue transmission. We systematically searched PubMed, Web of Science, and Embase for articles evaluating dengue prevalence or cumulative incidence in rural areas. A total of 106 articles published between 1958 and 2021 met our inclusion criteria. Overall, 56% (n = 22) of the 48 estimates that compared urban and rural settings reported rural dengue incidence as being as high or higher than in urban locations. In some rural areas, the force of infection appears to be increasing over time, as measured by increasing seroprevalence in children and thus likely decreasing age of first infection, suggesting that rural dengue transmission may be a relatively recent phenomenon. Authors characterized rural locations by many different factors, including population density and size, environmental and land use characteristics, and by comparing their context to urban areas. Hypothesized mechanisms for rural dengue transmission included travel, population size, urban infrastructure, vector and environmental factors, among other mechanisms. Strengthening our understanding of the relationship between rurality and dengue will require a more nuanced definition of rurality from the perspective of DENV transmission. Future studies should focus on characterizing details of study locations based on their environmental features, exposure histories, and movement dynamics to identify characteristics that may influence dengue transmission.
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Affiliation(s)
- Olivia Man
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Alicia Kraay
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, United States of America
- Institution for Genomic Biology, University of Illinois, Urbana, Illinois, United States of America
| | - Ruth Thomas
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut, United States of America
| | - Gwenyth O. Lee
- Rutgers Global Health Institute, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
- Rutgers Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
| | - Charlotte Robbins
- Department of Anthropology, Trinity College, Hartford, Connecticut, United States of America
| | - Amy C. Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, United States of America
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
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8
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Fernandes M, Evans R, Cheng M, Landon B, Noël T, Macpherson C, Cudjoe N, Burgen KS, Waechter R, LaBeaud AD, Blackmon K. Does Intra-Uterine Exposure to the Zika Virus Increase Risks of Cognitive Delay at Preschool Ages? Findings from a Zika-Exposed Cohort from Grenada, West Indies. Viruses 2023; 15:1290. [PMID: 37376590 PMCID: PMC10304152 DOI: 10.3390/v15061290] [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: 02/14/2023] [Revised: 05/10/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
Maternal infection with Zika virus (ZIKV) is associated with a distinct pattern of birth defects, known as congenital Zika syndrome (CZS). In ZIKV-exposed children without CZS, it is often unclear whether they were protected from in utero infection and neurotropism. Early neurodevelopmental assessment is essential for detecting neurodevelopmental delays (NDDs) and prioritizing at-risk children for early intervention. We compared neurodevelopmental outcomes between ZIKV-exposed and unexposed children at 1, 3 and 4 years to assess exposure-associated NDD risk. A total of 384 mother-child dyads were enrolled during a period of active ZIKV transmission (2016-2017) in Grenada, West Indies. Exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. Neurodevelopment was assessed using the Oxford Neurodevelopment Assessment, the NEPSY® Second Edition and Cardiff Vision Tests, at 12 (n = 66), 36 (n = 58) and 48 (n = 59) months, respectively. There were no differences in NDD rates or vision scores between ZIKV-exposed and unexposed children. Rates of microcephaly at birth (0.88% vs. 0.83%, p = 0.81), and childhood stunting and wasting did not differ between groups. Our results show that Grenadian ZIKV-exposed children, the majority of whom were without microcephaly, had similar neurodevelopmental outcomes to unexposed controls up to at least an age of 4 years.
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Affiliation(s)
- Michelle Fernandes
- MRC Lifecourse Epidemiology Centre, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Nuffield Department of Women’s Productive Health, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Roberta Evans
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Mira Cheng
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Barbara Landon
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Trevor Noël
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Calum Macpherson
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Nikita Cudjoe
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Kemi S. Burgen
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
| | - Randall Waechter
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
- Department of Physiology, Neuroscience, and Behavioral Science, School of Medicine, St. George’s University, St. George P.O. Box 7, Grenada
| | - A. Desiree LaBeaud
- Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, St. George P.O. Box 7, Grenada
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Karen Blackmon
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL 32224, USA
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9
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Khan A, Bisanzio D, Mutuku F, Ndenga B, Grossi-Soyster EN, Jembe Z, Maina PW, Chebii PK, Ronga CO, Okuta V, LaBeaud AD. Spatiotemporal overlapping of dengue, chikungunya, and malaria infections in children in Kenya. BMC Infect Dis 2023; 23:183. [PMID: 36991340 PMCID: PMC10053720 DOI: 10.1186/s12879-023-08157-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.
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Affiliation(s)
- Aslam Khan
- Stanford University School of Medicine, Stanford, CA, USA.
- Center for Academic Medicine, 453 Quarry Road, Palo Alto, CA, 94304, USA.
| | | | | | | | | | - Zainab Jembe
- Msambweni County Referral hospital, Msambweni, Kenya
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10
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Chiuya T, Villinger J, Falzon LC, Alumasa L, Amanya F, Bastos ADS, Fèvre EM, Masiga DK. Molecular screening reveals non-uniform malaria transmission in western Kenya and absence of Rickettsia africae and selected arboviruses in hospital patients. Malar J 2022; 21:268. [PMID: 36115978 PMCID: PMC9482282 DOI: 10.1186/s12936-022-04287-3] [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: 09/22/2021] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In sub-Saharan Africa, malaria is the common diagnosis for febrile illness and related clinical features, resulting in the under-diagnosis of other aetiologies, such as arboviruses and Rickettsia. While these may not be significant causes of mortality in malaria-endemic areas, they affect the daily life and performance of affected individuals. It is, therefore, important to have a clear picture of these other aetiologies to institute correct diagnoses at hospitals and improve patient outcomes.
Methods
Blood samples were collected from patients with fever and other clinical features associated with febrile illness at selected hospitals in the malaria-endemic counties of Busia, Bungoma, and Kakamega, and screened for Crimean-Congo haemorrhagic fever, Sindbis, dengue and chikungunya viruses, Rickettsia africae, and Plasmodium spp. using high-throughput real-time PCR techniques. A logistic regression was performed on the results to explore the effect of demographic and socio-economic independent variables on malaria infection.
Results
A total of 336 blood samples collected from hospital patients between January 2018 and February 2019 were screened, of which 17.6% (59/336) were positive for Plasmodium falciparum and 1.5% (5/336) for Plasmodium malariae. Two patients had dual P. falciparum/P. malariae infections. The most common clinical features reported by the patients who tested positive for malaria were fever and headache. None of the patients were positive for the arboviruses of interest or R. africae. Patients living in Busia (OR 5.2; 95% CI 2.46–11.79; p < 0.001) and Bungoma counties (OR 2.7; 95% CI 1.27–6.16; p = 0.013) had higher odds of being infected with malaria, compared to those living in Kakamega County.
Conclusions
The reported malaria prevalence is in line with previous studies. The absence of arboviral and R. africae cases in this study may have been due to the limited number of samples screened, low-level circulation of arboviruses during inter-epidemic periods, and/or the use of PCR alone as a detection method. Other sero-surveys confirming their circulation in the area indicate that further investigations are warranted.
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11
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A Retrospective Study of the Seroprevalence of Dengue Virus and Chikungunya Virus Exposures in Nigeria, 2010–2018. Pathogens 2022; 11:pathogens11070762. [PMID: 35890007 PMCID: PMC9318586 DOI: 10.3390/pathogens11070762] [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: 05/10/2022] [Revised: 06/25/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
Arboviruses are important public health threats in many regions of the world. Nigeria has experienced outbreaks of arboviruses over the past decades, leading to concerns of widespread endemicity, which are frequently misdiagnosed. This study aimed to determine the seroprevalence of dengue virus (DENV) (a flavivirus) and chikungunya virus (CHIKV) (an alphavirus) infections in three major population centers of Nigeria. A convenience sample of 701 sera was collected from both healthy and febrile participants between August 2010 and March 2018. Sera were tested for prior exposure to CHIKV virus and DENV using indirect IgG ELISA. Results showed that 54.1% (379/701) of participants were seropositive for anti-DENV antibodies, 41.3% (290/701) were seropositive for anti-CHIKV antibodies, and 20.1% (141/701) had previous exposure to both. The seropositivity for prior CHIKV exposure and prior exposure to DENV and CHIKV was significantly associated with age (CHIKV: OR = 2.7 (95% CI: 1.7–4.3); DENV and CHIKV: OR = 2.2 (95% CI: 1.2–4.0) for adults compared to participants under 18 years old). Overall, the high seropositivity across all age groups suggests that arboviral infections are prevalent in Nigeria and indicates that surveillance and further epidemiological studies are required to determine the true burden of these infections and the spectrum of diseases associated with these exposures.
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Masika MM, Korhonen EM, Smura T, Uusitalo R, Ogola J, Mwaengo D, Jääskeläinen AJ, Alburkat H, Gwon YD, Evander M, Anzala O, Vapalahti O, Huhtamo E. Serological Evidence of Exposure to Onyong-Nyong and Chikungunya Viruses in Febrile Patients of Rural Taita-Taveta County and Urban Kibera Informal Settlement in Nairobi, Kenya. Viruses 2022; 14:v14061286. [PMID: 35746757 PMCID: PMC9230508 DOI: 10.3390/v14061286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/28/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Several alphaviruses, such as chikungunya (CHIKV) and Onyong-nyong (ONNV), are endemic in Kenya and often cause outbreaks in different parts of the country. We assessed the seroprevalence of alphaviruses in patients with acute febrile illness in two geographically distant areas in Kenya with no previous record of alphavirus outbreaks. Blood samples were collected from febrile patients in health facilities located in the rural Taita-Taveta County in 2016 and urban Kibera informal settlement in Nairobi in 2017 and tested for CHIKV IgG and IgM antibodies using an in-house immunofluorescence assay (IFA) and a commercial ELISA test, respectively. A subset of CHIKV IgG or IgM antibody-positive samples were further analyzed using plaque reduction neutralization tests (PRNT) for CHIKV, ONNV, and Sindbis virus. Out of 537 patients, 4 (0.7%) and 28 (5.2%) had alphavirus IgM and IgG antibodies, respectively, confirmed on PRNT. We show evidence of previous and current exposure to alphaviruses based on serological testing in areas with no recorded history of outbreaks.
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Affiliation(s)
- Moses Muia Masika
- KAVI Institute of Clinical Research, University of Nairobi, POB 19676, Nairobi 00202, Kenya; (J.O.); (O.A.)
- Department of Medical Microbiology, University of Nairobi, POB 19676, Nairobi 00202, Kenya;
- Correspondence: ; Tel.: +254-721770306
| | - Essi M. Korhonen
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
| | - Teemu Smura
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- HUS Diagnostic Center, HUSLAB, Virology and Immunology, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Ruut Uusitalo
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Department of Geosciences and Geography, University of Helsinki, 00014 Helsinki, Finland
| | - Joseph Ogola
- KAVI Institute of Clinical Research, University of Nairobi, POB 19676, Nairobi 00202, Kenya; (J.O.); (O.A.)
- Department of Medical Microbiology, University of Nairobi, POB 19676, Nairobi 00202, Kenya;
| | - Dufton Mwaengo
- Department of Medical Microbiology, University of Nairobi, POB 19676, Nairobi 00202, Kenya;
| | - Anne J. Jääskeläinen
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- HUS Diagnostic Center, HUSLAB, Virology and Immunology, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Hussein Alburkat
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
| | - Yong-Dae Gwon
- Department of Clinical Microbiology, Umeå University, 90185 SE Umeå, Sweden; (Y.-D.G.); (M.E.)
| | - Magnus Evander
- Department of Clinical Microbiology, Umeå University, 90185 SE Umeå, Sweden; (Y.-D.G.); (M.E.)
| | - Omu Anzala
- KAVI Institute of Clinical Research, University of Nairobi, POB 19676, Nairobi 00202, Kenya; (J.O.); (O.A.)
- Department of Medical Microbiology, University of Nairobi, POB 19676, Nairobi 00202, Kenya;
| | - Olli Vapalahti
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- HUS Diagnostic Center, HUSLAB, Virology and Immunology, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Eili Huhtamo
- Department of Virology, University of Helsinki, 00014 Helsinki, Finland; (E.M.K.); (T.S.); (R.U.); (A.J.J.); (H.A.); (O.V.); (E.H.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
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13
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Blackmon K, Evans R, Fernandes M, Landon B, Noel T, Macpherson C, Cudjoe N, Burgen KS, Punch B, Krystosik A, Grossi-Soyster EN, LaBeaud AD, Waechter R. Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure. Arch Dis Child 2022; 107:244-250. [PMID: 34479857 PMCID: PMC8857021 DOI: 10.1136/archdischild-2020-321031] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Zika virus (ZIKV) targets neural stem cells in the developing brain. However, the majority of ZIKV-exposed children are born without apparent neurological manifestations. It remains unclear if these children were protected from ZIKV neurotropism or if they harbour subtle pathology that is disruptive to brain development. We assess this by comparing neurodevelopmental outcomes in normocephalic ZIKV-exposed children relative to a parallel control group of unexposed controls. DESIGN Cohort study. SETTING Public health centres in Grenada, West Indies. PATIENTS 384 mother-child pairs were enrolled during a period of active ZIKV transmission (April 2016-March 2017) and prospectively followed up to 30 months. Child exposure status was based on laboratory assessment of prenatal and postnatal maternal serum. MAIN OUTCOME MEASURES The INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) package and Cardiff Vision Tests, administered and scored by research staff masked to child's exposure status. RESULTS A total of 131 normocephalic ZIKV exposed (n=68) and unexposed (n=63) children were assessed between 22 and 30 months of age. Approximately half of these children completed vision testing. There were no group differences in sociodemographics. Deficits in visual acuity (31%) and contrast sensitivity (23%) were apparent in the ZIKV-exposed infants in the absence of cognitive, motor, language or behavioural delays. CONCLUSIONS Overall neurodevelopment is likely to be unaffected in ZIKV-exposed children with normal head circumference at birth and normal head growth in the first 2 years of life. However, the visual system may be selectively vulnerable, which indicates the need for vision testing by 3 years of age.
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Affiliation(s)
- Karen Blackmon
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA .,Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Michelle Fernandes
- Department of Paediatrics, University of Southampton, Southampton Children’s Hospital, Southhampton, UK,Nuffield Department of Women's Productive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Trevor Noel
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Kemi S Burgen
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Bianca Punch
- Windward Islands Research and Education Foundation, St. Georges, Grenada
| | - Amy Krystosik
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Elysse N Grossi-Soyster
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Angelle Desiree LaBeaud
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, California, USA
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St. Georges, Grenada,Department of Physiology, Neuroscience, and Behavioral Sciences, St George's University School of Medicine, St. George's, Grenada
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14
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Suhr F, Steinert JI. Epidemiology of floods in sub-Saharan Africa: a systematic review of health outcomes. BMC Public Health 2022; 22:268. [PMID: 35144560 PMCID: PMC8830087 DOI: 10.1186/s12889-022-12584-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/17/2022] [Indexed: 11/28/2022] Open
Abstract
Background Floods have affected 2.3 billion people worldwide in the last 20 years, and are associated with a wide range of negative health outcomes. Climate change is projected to increase the number of people exposed to floods due to more variable precipitation and rising sea levels. Vulnerability to floods is highly dependent on economic wellbeing and other societal factors. Therefore, this systematic review synthesizes the evidence on health effects of flood exposure among the population of sub-Saharan Africa. Methods We systematically searched two databases, Web of Science and PubMed, to find published articles. We included studies that (1) were published in English from 2010 onwards, (2) presented associations between flood exposure and health indicators, (3) focused on sub-Saharan Africa, and (4) relied on a controlled study design, such as cohort studies, case-control studies, cross-sectional studies, or quasi-experimental approaches with a suitable comparator, for instance individuals who were not exposed to or affected by floods or individuals prior to experiencing a flood. Results Out of 2306 screened records, ten studies met our eligibility criteria. We included studies that reported the impact of floods on water-borne diseases (n = 1), vector-borne diseases (n = 8) and zoonotic diseases (n = 1). Five of the ten studies assessed the connection between flood exposure and malaria. One of these five evaluated the impact of flood exposure on malaria co-infections. The five non-malaria studies focused on cholera, scabies, taeniasis, Rhodesian sleeping sickness, alphaviruses and flaviviruses. Nine of the ten studies reported significant increases in disease susceptibility after flood exposure. Conclusion The majority of included studies of the aftermath of floods pointed to an increased risk of infection with cholera, scabies, taeniasis, Rhodesian sleeping sickness, malaria, alphaviruses and flaviviruses. However, long-term health effects, specifically on mental health, non-communicable diseases and pregnancy, remain understudied. Further research is urgently needed to improve our understanding of the health risks associated with floods, which will inform public policies to prevent and reduce flood-related health risks. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12584-4.
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Affiliation(s)
- Friederike Suhr
- School of Social Sciences and Technology, Technical University of Munich, Richard-Wagner Str. 1, 80333, Munich, Germany.
| | - Janina Isabel Steinert
- School of Social Sciences and Technology, Technical University of Munich, Richard-Wagner Str. 1, 80333, Munich, Germany.,Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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15
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Uncovering the Burden of Dengue in Africa: Considerations on Magnitude, Misdiagnosis, and Ancestry. Viruses 2022; 14:v14020233. [PMID: 35215827 PMCID: PMC8877195 DOI: 10.3390/v14020233] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 01/27/2023] Open
Abstract
Dengue is a re-emerging neglected disease of major public health importance. This review highlights important considerations for dengue disease in Africa, including epidemiology and underestimation of disease burden in African countries, issues with malaria misdiagnosis and co-infections, and potential evidence of genetic protection from severe dengue disease in populations of African descent. The findings indicate that dengue virus prevalence in African countries and populations may be more widespread than reported data suggests, and that the Aedes mosquito vectors appear to be increasing in dissemination and number. Changes in climate, population, and plastic pollution are expected to worsen the dengue situation in Africa. Dengue misdiagnosis is also a problem in Africa, especially due to the typical non-specific clinical presentation of dengue leading to misdiagnosis as malaria. Finally, research suggests that a protective genetic component against severe dengue exists in African descent populations, but further studies should be conducted to strengthen this association in various populations, taking into consideration socioeconomic factors that may contribute to these findings. The main takeaway is that Africa should not be overlooked when it comes to dengue, and more attention and resources should be devoted to this disease in Africa.
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16
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Braga DADO, Barreto FKDA, Paiva CN, Ramalho ILC, Cavalcanti LPDG, Alencar CH. Seroepidemiological survey on chikungunya in endemic zones for arboviruses in Brazil, 2019. Zoonoses Public Health 2021; 68:955-964. [PMID: 34472209 DOI: 10.1111/zph.12888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to identify the seroprevalence of chikungunya and its associated factors in the city of Quixadá, Ceará, Brazil. We also aimed to identify the spatial distribution patterns of positive cases. A cross-sectional survey was conducted with a questionnaire about clinical symptoms, socioeconomic and demographic factors, and a 10 ml blood sample was collected and analysed by ELISA. For the bivariate analysis, we use the chi-square test, a prevalence ratio and its 95% confidence interval. A robust Poisson hierarchical regression was used to adjust for confounders. The Kernel density was performed for the spatial analysis. A total of 409 samples were analysed; of them, 70.7% were seropositive for previous exposure to chikungunya virus (CHIKV). High seropositivity for CHIKV was higher in female participants (75.5%; PR = 1.23; 95% CI: 1.06-1.43), those aged 31 years or more (74.3%; PR = 1.62; 95% CI: 1.04-2.52), and those with elementary education level (75.0%; PR = 1.30; 95% CI: 1.06-1.60). There were also high seroprevalence in those with less than a minimum wage per month (89.5%; PR = 1.59; 95% CI: 1.11-2.30), housewives (87.5%; PR = 1.64; 95% CI: 1.24-2.18) and unemployed (80.0%; PR = 1.50; 95% CI: 1.10-2.06). After adjusting for age, morning stiffness was the only chikungunya symptom that remained associated (PR = 1.20; 95% CI: 1.06-1.37; p < .001). There was an area of high density of cases in the downtown and two areas of medium density in nearby regions. Otherwise, the higher seroprevalence rates were in the peripherical neighbourhoods. There is a hyperendemicity of CHIKV in Quixadá, and most cases are spatially contiguous. The main associated clinical sign is morning stiffness, but other factors such as low income and spending a longer time at home were significantly associated with higher seroprevalence.
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Affiliation(s)
| | | | | | | | - Luciano Pamplona de Góes Cavalcanti
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, Brazil.,Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Carlos Henrique Alencar
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, Brazil.,Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brazil
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17
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Coalson JE, Anderson EJ, Santos EM, Madera Garcia V, Romine JK, Luzingu JK, Dominguez B, Richard DM, Little AC, Hayden MH, Ernst KC. The Complex Epidemiological Relationship between Flooding Events and Human Outbreaks of Mosquito-Borne Diseases: A Scoping Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:96002. [PMID: 34582261 PMCID: PMC8478154 DOI: 10.1289/ehp8887] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change-driven disease forecasting. OBJECTIVES We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps. METHODS PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail. RESULTS From 3,008 initial results, we included 131 relevant studies (dengue n = 45 , malaria n = 61 , other MBD n = 49 ). Dengue studies indicated short-term (< 1 month ) decreases and subsequent (1-4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding. DISCUSSION Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887.
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Affiliation(s)
- Jenna E. Coalson
- Center for Insect Science, University of Arizona, Tucson, Arizona, USA
| | | | - Ellen M. Santos
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Valerie Madera Garcia
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - James K. Romine
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Joy K. Luzingu
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Brian Dominguez
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Danielle M. Richard
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Ashley C. Little
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Mary H. Hayden
- National Institute for Human Resilience, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Kacey C. Ernst
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
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Anjos RO, Mugabe VA, Moreira PSS, Carvalho CX, Portilho MM, Khouri R, Sacramento GA, Nery NRR, Reis MG, Kitron UD, Ko AI, Costa F, Ribeiro GS. Transmission of Chikungunya Virus in an Urban Slum, Brazil. Emerg Infect Dis 2021; 26:1364-1373. [PMID: 32568045 PMCID: PMC7323528 DOI: 10.3201/eid2607.190846] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
After a chikungunya outbreak in Salvador, Brazil, we performed a cross-sectional, community-based study of 1,776 inhabitants to determine chikungunya virus (CHIKV) seroprevalence, identify factors associated with exposure, and estimate the symptomatic infection rate. From November 2016 through February 2017, we collected sociodemographic and clinical data by interview and tested serum samples for CHIKV IgG. CHIKV seroprevalence was 11.8% (95% CI 9.8%–13.7%), and 15.3% of seropositive persons reported an episode of fever and arthralgia. Infections were independently and positively associated with residences served by unpaved streets, a presumptive clinical diagnosis of chikungunya, and recall of an episode of fever with arthralgia in 2015–2016. Our findings indicate that the chikungunya outbreak in Salvador may not have conferred sufficient herd immunity to preclude epidemics in the near future. The unusually low frequency of symptomatic disease points to a need for further longitudinal studies to better investigate these findings.
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Climate predicts geographic and temporal variation in mosquito-borne disease dynamics on two continents. Nat Commun 2021; 12:1233. [PMID: 33623008 PMCID: PMC7902664 DOI: 10.1038/s41467-021-21496-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/26/2021] [Indexed: 11/08/2022] Open
Abstract
Climate drives population dynamics through multiple mechanisms, which can lead to seemingly context-dependent effects of climate on natural populations. For climate-sensitive diseases, such as dengue, chikungunya, and Zika, climate appears to have opposing effects in different contexts. Here we show that a model, parameterized with laboratory measured climate-driven mosquito physiology, captures three key epidemic characteristics across ecologically and culturally distinct settings in Ecuador and Kenya: the number, timing, and duration of outbreaks. The model generates a range of disease dynamics consistent with observed Aedes aegypti abundances and laboratory-confirmed arboviral incidence with variable accuracy (28–85% for vectors, 44–88% for incidence). The model predicted vector dynamics better in sites with a smaller proportion of young children in the population, lower mean temperature, and homes with piped water and made of cement. Models with limited calibration that robustly capture climate-virus relationships can help guide intervention efforts and climate change disease projections. The effects of climate on vector-borne disease systems are highly context-dependent. Here, the authors incorporate laboratory-measured physiological traits of the mosquito Aedes aegypti into climate-driven mechanistic models to predict number, timing, and duration of outbreaks in Ecuador and Kenya.
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20
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Wat'senga Tezzo F, Fasine S, Manzambi Zola E, Marquetti MDC, Binene Mbuka G, Ilombe G, Mundeke Takasongo R, Smitz N, Bisset JA, Van Bortel W, Vanlerberghe V. High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo. Parasit Vectors 2021; 14:92. [PMID: 33522947 PMCID: PMC7852359 DOI: 10.1186/s13071-021-04588-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts. METHODS In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N'Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats, which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA barcoding of the specimens to validate identifications. RESULTS The most rural commune (Mont Ngafula) had the highest pupal index (number of Aedes spp. pupae per 100 inspected houses) at 246 (20) pupae/100 houses, and Breteau index (BI; number of containers positive for immature stages of Aedes spp. per 100 households) at 82.2 (19.5) positive containers/100 houses for the rainy (and dry) season, respectively. The BI was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N'Djili in the rainy (and dry) season, respectively. The house index (number of houses positive for at least one container with immature stages of Aedes spp. per 100 inspected houses) was, on average, across all communes, 27.5% (7.6%); and the container index (number of containers positive for immature stages of Aedes spp. per 100 inspected containers) was 15.0% (10.0%) for the rainy (and dry) season, respectively. The vast majority of Aedes-positive containers were found outside the houses [adjusted odds ratio 27.4 (95% confidence interval 14.9-50.1)]. During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. CONCLUSIONS In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key types of containers for Aedes larvae, which are mainly located in outdoor spaces, for larval habitat destruction or reduction.
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Affiliation(s)
- Francis Wat'senga Tezzo
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Sylvie Fasine
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Emile Manzambi Zola
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Maria Del Carmen Marquetti
- Department of Vector Control, Instituto Medicina Tropical Pedro Kourí (IPK), Avenida Novia del Mediodía, KM 6 1/2, La Lisa, Havana, Cuba
| | - Guillaume Binene Mbuka
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Gillon Ilombe
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Richard Mundeke Takasongo
- Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, 5345 Avenue De la Démocratie, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Smitz
- Department of Biology, Royal Museum for Central Africa (BopCo), Leuvensesteenweg 13-17, Tervuren, Belgium
| | - Juan Andre Bisset
- Department of Vector Control, Instituto Medicina Tropical Pedro Kourí (IPK), Avenida Novia del Mediodía, KM 6 1/2, La Lisa, Havana, Cuba
| | - Wim Van Bortel
- Outbreak Research Team, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium
- Unit of Entomology, Biomedical Science Department, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium
| | - Veerle Vanlerberghe
- Tropical Infectious Disease Group, Public Health Department, Institute of Tropical Medicine (ITM), Nationalestraat 155, Antwerp, Belgium.
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Blackmon K, Waechter R, Landon B, Noël T, Macpherson C, Donald T, Cudjoe N, Evans R, Burgen KS, Jayatilake P, Oyegunle V, Pedraza O, Abdel Baki S, Thesen T, Dlugos D, Chari G, Patel AA, Grossi-Soyster EN, Krystosik AR, LaBeaud AD. Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure. PLoS Negl Trop Dis 2020; 14:e0008874. [PMID: 33253174 PMCID: PMC7728266 DOI: 10.1371/journal.pntd.0008874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 12/10/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003-0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.
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Affiliation(s)
- Karen Blackmon
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- * E-mail:
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | | | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Kemi S. Burgen
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Piumi Jayatilake
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Vivian Oyegunle
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Otto Pedraza
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
| | - Samah Abdel Baki
- Biosignal Group Inc., Boston, Massachusetts, United States of America
| | - Thomas Thesen
- New York University School of Medicine, Department of Neurology, New York, New York, United States of America
- Department of Biomedical Sciences, University of Houston College of Medicine, USA
| | - Dennis Dlugos
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Geetha Chari
- SUNY Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - Archana A. Patel
- Boston Children’s Hospital, Department of Neurology, Boston, Massachusetts, United States of America
| | - Elysse N. Grossi-Soyster
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - Amy R. Krystosik
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - A. Desiree LaBeaud
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
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22
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Jayatilake P, Oyegunle V, Waechter R, Landon B, Fernandes M, Cudjoe N, Evans R, Noël T, Macpherson C, Donald T, Abdelbaki SG, Mandalaneni K, Dlugos D, Chari G, Patel AA, Grossi-Soyster EN, Desiree LaBeaud A, Blackmon K. Focal epilepsy features in a child with Congenital Zika Syndrome. Epilepsy Behav Rep 2020; 14:100411. [PMID: 33313503 PMCID: PMC7720018 DOI: 10.1016/j.ebr.2020.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 11/30/2022] Open
Abstract
Congenital Zika Syndrome with microcephaly can present with focal seizures. TeleEEG can augment epilepsy care in Zika-endemic resource limited settings. A seizure questionnaire can prompt caregiver report of relevant seizure features.
Zika virus (ZIKV) is a mosquito-borne, single-stranded DNA flavivirus that is teratogenic and neurotropic. Similar to the teratogenic effects of other TORCH infections, ZIKV infection during pregnancy can have an adverse impact on fetal and neonatal development. Epilepsy is detected in 48–96% of children with Congenital Zika Syndrome (CZS) and microcephaly. Early epilepsy surveillance is needed in children with prenatal ZIKV exposure; yet, most ZIKV-endemic regions do not have specialist epilepsy care. Here, we describe the demographic, clinical, imaging, and EEG characteristics of a 2-year-old child with CZS and microcephaly who presented with focal epileptiform activity, suboptimal growth, and severe neurodevelopmental delays. Administration of a brief seizure questionnaire by allied health professionals to the patient’s caregiver helped to characterize the child’s seizure semiology and differentiate focal from generalized seizure features. A telemedicine EEG interpretation platform provided valuable diagnostic information for the patient’s local pediatrician to integrate into her treatment plan. This case illustrates that CZS can present with focal epilepsy features and that a telemedicine approach can be used to bridge the gap between epilepsy specialists and local care providers in resource limited ZIKV-endemic regions to achieve better seizure control in children with CZS.
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Affiliation(s)
| | | | - Randall Waechter
- St. George's University, St. George's, West Indies, Grenada.,Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University of Southampton, Southampton, UK
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada
| | - Tyhiesia Donald
- Ministry of Health, Government of Grenada, West Indies, Grenada
| | | | | | - Dennis Dlugos
- Children's Hospital of Pennsylvania, Philadelphia, PA, USA
| | - Geetha Chari
- SUNY Downstate Health Sciences University, New York, NY, USA
| | - Archana A Patel
- Boston Children's Hospital, Division of Epilepsy and Clinical Neurophysiology, Boston, MA, USA
| | | | - A Desiree LaBeaud
- Stanford University School of Medicine, Department of Pediatrics, CA, USA
| | - Karen Blackmon
- Windward Islands Research and Education Foundation, St George's University, West Indies, Grenada.,Mayo Clinic, Jacksonville, FL, USA
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23
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Pollett S, Gathii K, Figueroa K, Rutvisuttinunt W, Srikanth A, Nyataya J, Mutai BK, Awinda G, Jarman RG, Berry IM, Waitumbi JN. The evolution of dengue-2 viruses in Malindi, Kenya and greater East Africa: Epidemiological and immunological implications. INFECTION GENETICS AND EVOLUTION 2020; 90:104617. [PMID: 33161179 DOI: 10.1016/j.meegid.2020.104617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 10/15/2020] [Accepted: 11/01/2020] [Indexed: 01/17/2023]
Abstract
Kenya experiences a substantial burden of dengue, yet there are very few DENV-2 sequence data available from this country and indeed the entire continent of Africa. We therefore undertook whole genome sequencing and evolutionary analysis of fourteen dengue virus (DENV)-2 strains sampled from Malindi sub-County Hospital during the 2017 DENV-2 outbreak in the Kenyan coast. We further performed an extended East African phylogenetic analysis, which leveraged 26 complete African env genes. Maximum likelihood analysis showed that the 2017 outbreak was due to the Cosmopolitan genotype, indicating that this has been the only confirmed human DENV-2 genotype circulating in Africa to date. Phylogeographic analyses indicated transmission of DENV-2 viruses between East Africa and South/South-West Asia. Time-scaled genealogies show that DENV-2 viruses shows spatial structure at the country level in Kenya, with a time-to-most-common-recent ancestor analysis indicating that these DENV-2 strains were circulating for up to 5.38 years in Kenya before detection in the 2017 Malindi outbreak. Selection pressure analyses indicated sampled Kenyan DENV strains uniquely being under positive selection at 6 sites, predominantly across the non-structural genes, and epitope prediction analyses showed that one of these sites corresponds to a putative predicted MHC-I CD8+ DENV-2 Cosmopolitan virus epitope only evident in a sampled Kenyan virus. Taken together, our findings indicate that the 2017 Malindi DENV-2 outbreak arose from a strain which had circulated for several years in Kenya before recent detection, has experienced diversifying selection pressure, and may contain new putative immunogens relevant to vaccine design. These findings prompt further genomic epidemiology studies in this and other Kenyan locations to further elucidate the transmission dynamics of DENV in this region.
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Affiliation(s)
- Simon Pollett
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Kimita Gathii
- Basic Science Laboratory, US Army Medical Research Directorate - Africa (USAMRD-A), Kisumu, Kenya
| | - Katherine Figueroa
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Wiriya Rutvisuttinunt
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Abhi Srikanth
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Josphat Nyataya
- Basic Science Laboratory, US Army Medical Research Directorate - Africa (USAMRD-A), Kisumu, Kenya
| | - Beth K Mutai
- Basic Science Laboratory, US Army Medical Research Directorate - Africa (USAMRD-A), Kisumu, Kenya
| | - George Awinda
- Basic Science Laboratory, US Army Medical Research Directorate - Africa (USAMRD-A), Kisumu, Kenya
| | - Richard G Jarman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America
| | - Irina Maljkovic Berry
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America.
| | - J N Waitumbi
- Basic Science Laboratory, US Army Medical Research Directorate - Africa (USAMRD-A), Kisumu, Kenya
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Kimata Y, Borus P, Nzunza R, Ofula V, Chepkorir E, Waihenya R, Sang R. Serological Evidence of Chikungunya Virus Infection Among Suspected Measles Cases in Selected Regions of Kenya: 2008-2014. Vector Borne Zoonotic Dis 2020; 20:903-909. [PMID: 32845826 DOI: 10.1089/vbz.2019.2593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Chikungunya virus (family Togavirdae and genus Alphavirus) is an emerging and reemerging virus of public health importance both regionally and globally. In Kenya, about 50-60% of the suspected measles cases remain undiagnosed once measles and rubella is ruled out by immunoglobulin M (IgM) ELISA thus prompted the need to do differential diagnosis on the measles/rubella negative samples. Nothing is known about the role played by chikungunya infection among these suspected measles cases. Febrile rash illness is a common clinical presentation of arboviruses, including chikungunya. In this study, we conducted a serosurvey to explore the possible role of chikungunya infections among suspected measles cases in Kenya that had tested negative for measles and rubella. Sera were tested by commercially available ELISA for the presence of IgG and IgM antibodies against the chikungunya virus. All positive samples for chikungunya by ELISA were confirmed by plaque reduction neutralization test (PRNT), and to rule out cross-reactivity with other alphaviruses a panel of viruses was used, namely o' nyong' nyong, Semliki Forest, and Sindbis viruses. Of the 392 serum samples screened, 0.3% (n = 1) tested positive for IgM antibodies, while 4.6% (n = 18) tested positive for IgG antibodies against the chikungunya virus. PRNT results indicated 2 (11%) chikungunya positives and 7 (38.9%) o' nyong' nyong positives. We recommend awareness among health care providers and improved surveillance for these arboviruses by both serology and molecular testing. Testing for other pathogens should also be done to improve disease detection and diagnosis.
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Affiliation(s)
- Yvonne Kimata
- School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Peter Borus
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rosemary Nzunza
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Victor Ofula
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edith Chepkorir
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Rebecca Waihenya
- School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Rosemary Sang
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
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Evidence of transovarial transmission of Chikungunya and Dengue viruses in field-caught mosquitoes in Kenya. PLoS Negl Trop Dis 2020; 14:e0008362. [PMID: 32559197 PMCID: PMC7329127 DOI: 10.1371/journal.pntd.0008362] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 07/01/2020] [Accepted: 05/04/2020] [Indexed: 01/14/2023] Open
Abstract
Arboviruses are among the most important emerging pathogens due to their increasing public health impact. In Kenya, continued population growth and associated urbanization are conducive to vector spread in both urban and rural environments, yet mechanisms of viral amplification in vector populations is often overlooked when assessing risks for outbreaks. Thus, the characterization of local arbovirus circulation in mosquito populations is imperative to better inform risk assessments and vector control practices. Aedes species mosquitoes were captured at varying stages of their life cycle during different seasons between January 2014 and May 2016 at four distinct sites in Kenya, and tested for chikungunya (CHIKV), dengue (DENV) and Zika (ZIKV) viruses by RT-PCR. CHIKV was detected in 45 (5.9%) and DENV in 3 (0.4%) mosquito pools. No ZIKV was detected. Significant regional variation in prevalence was observed, with greater frequency of CHIKV on the coast. DENV was detected exclusively on the coast. Both viruses were detected in immature mosquitoes of both sexes, providing evidence of transovarial transmission of these arboviruses in local mosquitoes. This phenomenon may be driving underlying viral maintenance that may largely contribute to periodic re-emergence among humans in Kenya. Transovarial transmission, or vertical transmission, is the spread of a pathogen from parent to offspring. It has been observed that some mosquito-borne viruses can be transmitted from female mosquitoes to their offspring during follicle development or during oviposition. The occurrence of transovarial transmission is evident in the presence of virally infected male mosquitoes, which typically do not take bloodmeals, and the presence of virus in immature mosquitoes of any sex. Transovarial transmission aids in the amplification of mosquito-borne viruses in the environment by increasing the number of infected mosquitoes in a given region, thus expanding the possibility of viral transmission to humans. The combination of transovarial transmission and the preservation of viable eggs during dry seasons may trigger sudden amplification of the virus after rainy periods, resulting in an outbreak. This study provides some of the first evidence of transovarial transmission of chikungunya and dengue viruses in Aedes aegypti mosquitoes in Africa during interepidemic periods, which has important implications for local virus persistence and epidemic patterns.
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Abstract
Since the identification of chikungunya virus (CHIKV), sporadic cases and outbreaks were reported in several African countries, on the Indian subcontinent, and in south-east Asia. In the last 20 years, there is a growing number of reports of CHIKV infections from African countries, but the overall picture of its circulation at the continent level remains ill-characterized because of under-diagnosis and under-reporting. Moreover, the public health impact of the infection in Africa is generally poorly understood, especially during outbreak situations. Our work has the aim to review available data on CHIKV circulation in Africa to facilitate the understanding of underlying reasons of its increased detection in the African continent.
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Affiliation(s)
- Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Subissi
- Directorate Infectious Diseases in Humans Sciensano, Brussels, Belgium
| | - Giovanni Rezza
- Department of Infectious Diseases, Istituto Superiore Di Sanita (ISS), Rome, Italy
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Uelmen JA, Brokopp C, Patz J. A 15 Year Evaluation of West Nile Virus in Wisconsin: Effects on Wildlife and Human Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1767. [PMID: 32182764 PMCID: PMC7084944 DOI: 10.3390/ijerph17051767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/01/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
West Nile virus (WNV) is the most important and widespread mosquito-borne virus in the United States (U.S.). WNV has the ability to spread rapidly and effectively, infecting more than 320 bird and mammalian species. An examination of environmental conditions and the health of keystone species may help predict the susceptibility of various habitats to WNV and reveal key risk factors, annual trends, and vulnerable regions. Since 2002, WNV outbreaks in Wisconsin varied by species, place, and time, significantly affected by unique climatic, environmental, and geographical factors. During a 15 year period, WNV was detected in 71 of 72 counties, resulting in 239 human and 1397 wildlife cases. Controlling for population and sampling efforts in Wisconsin, rates of WNV are highest in the western and northwestern rural regions of the state. WNV incidence rates were highest in counties with low human population densities, predominantly wetland, and at elevations greater than 1000 feet. Resources for surveillance, prevention, and detection of WNV were lowest in rural counties, likely resulting in underestimation of cases. Overall, increasing mean temperature and decreasing precipitation showed positive influence on WNV transmission in Wisconsin. This study incorporates the first statewide assessment of WNV in Wisconsin.
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Affiliation(s)
- Johnny A. Uelmen
- Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, USA; (C.B.); (J.P.)
- Department of Pathobiology, University of Illinois, 2001 South Lincoln Avenue, Urbana, IL 61802, USA
| | - Charles Brokopp
- Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, USA; (C.B.); (J.P.)
- Wisconsin State Laboratory of Hygiene, 2601 Agriculture Drive, P.O. Box 7904, Madison, WI 53718, USA
| | - Jonathan Patz
- Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, USA; (C.B.); (J.P.)
- Nelson Institute for Environmental Sciences, University of Wisconsin, 258 Enzyme Institute, 1710 University Avenue, Madison, WI 53726, USA
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Masika MM, Korhonen EM, Smura T, Uusitalo R, Vapalahti K, Mwaengo D, Jääskeläinen AJ, Anzala O, Vapalahti O, Huhtamo E. Detection of dengue virus type 2 of Indian origin in acute febrile patients in rural Kenya. PLoS Negl Trop Dis 2020; 14:e0008099. [PMID: 32126086 PMCID: PMC7069648 DOI: 10.1371/journal.pntd.0008099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 03/13/2020] [Accepted: 01/29/2020] [Indexed: 01/25/2023] Open
Abstract
Dengue virus (DENV) has caused recent outbreaks in coastal cities of Kenya, but the epidemiological situation in other areas of Kenya is largely unknown. We investigated the role of DENV infection as a cause of acute febrile disease in non-epidemic settings in rural and urban study areas in Kenya. Altogether, 560 patients were sampled in 2016–2017 in rural Taita–Taveta County (n = 327) and urban slums of Kibera, Nairobi (n = 233). The samples were studied for DENV IgM, IgG, NS1 antigen and flaviviral RNA. IgG seroprevalence was found to be higher in Taita–Taveta (14%) than in Nairobi (3%). Five Taita–Taveta patients were positive for flaviviral RNA, all identified as DENV-2, cosmopolitan genotype. Local transmission in Taita–Taveta was suspected in a patient without travel history. The sequence analysis suggested that DENV-2 strains circulating in coastal and southern Kenya likely arose from a single introduction from India. The molecular clock analyses dated the most recent ancestor to the Kenyan strains a year before the large 2013 outbreak in Mombasa. After this, the virus has been detected in Kilifi in 2014, from our patients in Taita–Taveta in 2016, and in an outbreak in Malindi in 2017. The results highlight that silent transmission occurs between epidemics and also affects rural areas. More information is needed to understand the local epidemiological characteristics and future risks of dengue in Kenya. Dengue virus (DENV) is an emerging mosquito-borne global health threat in the tropics and subtropics. The majority of the world’s population live in areas at risk of dengue that can cause a wide variety of symptoms from febrile illness to haemorrhagic fever. Information of DENV in Africa is limited and fragmented. In Kenya, dengue is a recognized disease in coastal cities that have experienced recent outbreaks. We investigated the role of DENV infection as a cause of acute febrile disease in non-epidemic settings in rural and urban study areas in Kenya. We found DENV-2 in five febrile patients from rural Taita–Taveta, where no dengue has been reported before. Genetic analysis of the virus suggests it to be most likely of Indian origin. This Indian origin DENV-2 was detected in the Mombasa outbreak in 2013, in Kilifi in 2014, in Taita–Taveta in 2016 (our study samples) and again in the Malindi outbreak in 2017. The results suggest that dengue is unrecognized in rural Kenya and more studies are needed for local risk assessment. Our findings of virus transmission between epidemics contribute to better understanding of the epidemiological situation and origins of DENV in Kenya.
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Affiliation(s)
- Moses Muia Masika
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
| | - Essi M. Korhonen
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Teemu Smura
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
| | - Ruut Uusitalo
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Geosciences and Geography, University of Helsinki, Helsinki, Finland
| | - Katariina Vapalahti
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | - Dufton Mwaengo
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Anne J. Jääskeläinen
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
- Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Omu Anzala
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
| | - Olli Vapalahti
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eili Huhtamo
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
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29
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Inziani M, Adungo F, Awando J, Kihoro R, Inoue S, Morita K, Obimbo E, Onyango F, Mwau M. Seroprevalence of yellow fever, dengue, West Nile and chikungunya viruses in children in Teso South Sub-County, Western Kenya. Int J Infect Dis 2019; 91:104-110. [PMID: 31712089 DOI: 10.1016/j.ijid.2019.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Arboviruses often cause widespread morbidity in children in endemic regions. Data on the burden of arboviruses in Kenyan children are limited. OBJECTIVES This study was performed to determine the seroprevalence of yellow fever (YFV), dengue (DENV), West Nile (WNV), and chikungunya (CHIKV) viruses among children 1-12 years of age at two health facilities in Teso South Sub-County in Western Kenya. METHODS In a hospital-based cross-sectional survey, a questionnaire was used to collect socio-demographic information. Serum drawn from the children was tested for IgA/IgM/IgG serocomplex antibodies to selected arboviruses using indirect ELISA and plaque reduction neutralization tests. RESULTS A total of 182 (27.7%) of the 656 participants tested were positive for any arbovirus antibody. Of these, 4.4% (29/656) tested positive for YFV, 9.6% (62/649) for WNV, 5.6% (36/649) for CHIKV, 1.4% (5/368) for DENV1, 9% (59/656) for DENV2, and 19.7% (40/203) for DENV3. Neutralizing antibodies to CHIKV were found in 77.8% (42/54) of participants, to YFV in 15.8% (3/19), to DENV2 in 58% (29/50), and to WNV in 8% (1/55). Sex, age, urban residence, schooling, and lack of vaccination were associated with arbovirus exposure. CONCLUSIONS This study confirmed that children under 12 years of age in Teso South Sub-County are exposed to ongoing arbovirus infections early in life.
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Affiliation(s)
- Mary Inziani
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
| | - Ferdinard Adungo
- Centre for Infectious and Parasitic Diseases Control Research (CIPDCR), Kenya Medical Research Institute, Busia, Kenya
| | - Janet Awando
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Richelle Kihoro
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Shingo Inoue
- Nagasaki University Africa Research Station, Nairobi, Kenya
| | - Kouichi Morita
- Nagasaki University Institute of Tropical Medicine, Nagasaki, Japan
| | - Elizabeth Obimbo
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Francis Onyango
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Matilu Mwau
- Centre for Infectious and Parasitic Diseases Control Research (CIPDCR), Kenya Medical Research Institute, Busia, Kenya
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Proesmans S, Katshongo F, Milambu J, Fungula B, Muhindo Mavoko H, Ahuka-Mundeke S, Inocêncio da Luz R, Van Esbroeck M, Ariën KK, Cnops L, De Smet B, Lutumba P, Van Geertruyden JP, Vanlerberghe V. Dengue and chikungunya among outpatients with acute undifferentiated fever in Kinshasa, Democratic Republic of Congo: A cross-sectional study. PLoS Negl Trop Dis 2019; 13:e0007047. [PMID: 31487279 PMCID: PMC6748445 DOI: 10.1371/journal.pntd.0007047] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/17/2019] [Accepted: 08/06/2019] [Indexed: 12/25/2022] Open
Abstract
Background Pathogens causing acute fever, with the exception of malaria, remain largely unidentified in sub-Saharan Africa, given the local unavailability of diagnostic tests and the broad differential diagnosis. Methodology We conducted a cross-sectional study including outpatient acute undifferentiated fever in both children and adults, between November 2015 and June 2016 in Kinshasa, Democratic Republic of Congo. Serological and molecular diagnostic tests for selected arboviral infections were performed on blood, including PCR, NS1-RDT, ELISA and IFA for acute, and ELISA and IFA for past infections. Results Investigation among 342 patients, aged 2 to 68 years (mean age of 21 years), with acute undifferentiated fever (having no clear focus of infection) revealed 19 (8.1%) acute dengue–caused by DENV-1 and/or DENV-2 –and 2 (0.9%) acute chikungunya infections. Furthermore, 30.2% and 26.4% of participants had been infected in the past with dengue and chikungunya, respectively. We found no evidence of acute Zika nor yellow fever virus infections. 45.3% of patients tested positive on malaria Rapid Diagnostic Test, 87.7% received antimalarial treatment and 64.3% received antibacterial treatment. Discussion Chikungunya outbreaks have been reported in the study area in the past, so the high seroprevalence is not surprising. However, scarce evidence exists on dengue transmission in Kinshasa and based on our data, circulation is more important than previously reported. Furthermore, our study shows that the prescription of antibiotics, both antibacterial and antimalarial drugs, is rampant. Studies like this one, elucidating the causes of acute fever, may lead to a more considerate and rigorous use of antibiotics. This will not only stem the ever-increasing problem of antimicrobial resistance, but will–ultimately and hopefully–improve the clinical care of outpatients in low-resource settings. Trial registration ClinicalTrials.gov NCT02656862. Malaria remains one of the most important causes of fever in sub-Saharan Africa. However, its share is declining, since the diagnosis and treatment of malaria have improved significantly over the years. Hence leading to an increase in the number of patients presenting with non-malarial fever. Often, obvious clinical signs and symptoms like cough or diarrhea are absent, probing the question: “What causes the fever?” Previous studies have shown that the burden of arboviral infections–like dengue and chikungunya–in sub-Saharan Africa is underestimated, which is why we screened for four common arboviral infections in patients presenting with ‘undifferentiated fever’ at an outpatient clinic in suburban Kinshasa, Democratic Republic of Congo. Among the patients tested, we found that one in ten presented with an acute arboviral infection and that almost one in three patients had been infected in the past. These findings suggest that clinicians should think about arboviral infections more often, thereby refraining from the prescription of antibiotics, a practice increasingly problematic given the global rise of antimicrobial resistance.
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Affiliation(s)
| | - Freddy Katshongo
- Institut Supérieur des Techniques Médicales, Kinshasa, Democratic Republic of Congo
| | - John Milambu
- Centre Hospitalier Lisungi, Kinshasa, Democratic Republic of Congo
| | - Blaise Fungula
- Centre Hospitalier Lisungi, Kinshasa, Democratic Republic of Congo
| | - Hypolite Muhindo Mavoko
- University of Antwerp, Antwerp, Belgium.,Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- Université de Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Reserche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | - Kevin K Ariën
- University of Antwerp, Antwerp, Belgium.,Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Pascal Lutumba
- Université de Kinshasa, Kinshasa, Democratic Republic of Congo.,Institut National de Reserche Biomédicale, Kinshasa, Democratic Republic of Congo
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31
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Seruyange E, Ljungberg K, Muvunyi CM, Gahutu JB, Katare S, Nyamusore J, Gwon YD, Evander M, Norder H, Liljeström P, Bergström T. Seroreactivity to Chikungunya and West Nile Viruses in Rwandan Blood Donors. Vector Borne Zoonotic Dis 2019; 19:731-740. [PMID: 31246538 DOI: 10.1089/vbz.2018.2393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Introduction: Chikungunya virus (CHIKV) and West Nile virus (WNV) have previously been reported from several African countries, including those bordering Rwanda where they may have originated. However, there have been no serosurveillance reports from Rwanda regarding these two viral pathogens. In this article, we present the first study of immunoglobulin G (IgG) seroreactivity of CHIKV and WNV in Rwandan blood donor samples. Methods: Blood donors from Rwanda (n = 874) and Sweden (n = 199) were tested for IgG reactivity against CHIKV, using an in-house enzyme-linked immunosorbent assay with the E1 envelope protein fused with p62 as antigen, and against WNV using a commercial kit. Data on mosquito distribution were obtained from the 2012 assessment of yellow fever virus circulation in Rwanda. Results: Seroreactivity to CHIKV was high in Rwanda (63.0%), when compared with Swedish donors, where only 8.5% were IgG positive. However, a cross-reactivity to O'nyong'nyong virus in neutralization test was noted in Rwandan donors. No significant difference in WNV seroreactivity was found (10.4% for Rwandan and 14.1% for Swedish donors). The relatively high seroreactivity to WNV among Swedish donors could partly be explained by cross-reactivity with tick-borne encephalitis virus prevalent in Sweden. Donors from the Eastern Province of Rwanda had the highest IgG reactivity to the two investigated viruses (86.7% for CHIKV and 33.3% for WNV). Five genera of mosquitoes were found in Rwanda where Culex was the most common (82.5%). The vector of CHIKV, Aedes, accounted for 9.6% of mosquitoes and this species was most commonly found in the Eastern Province. Conclusions: Our results showed high seroreactivity to CHIKV in Rwandan donors. The highest IgG reactivity to CHIKV, and to WNV, was found in the Eastern Province, the area reporting the highest number of mosquito vectors for these two viruses. Infection control by eliminating mosquito-breeding sites in population-dense areas is recommended, especially in eastern Rwanda.
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Affiliation(s)
- Eric Seruyange
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,Rwanda Military Hospital, Kigali, Rwanda.,Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Karl Ljungberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Claude Mambo Muvunyi
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Bosco Gahutu
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Swaibu Katare
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, Kigali, Rwanda
| | - José Nyamusore
- Division of Epidemic Surveillance and Response, Rwanda Biomedical Center, Kigali, Rwanda
| | - Yong-Dae Gwon
- Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden
| | - Magnus Evander
- Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden
| | - Heléne Norder
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Liljeström
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
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Chepkorir E, Tchouassi DP, Konongoi SL, Lutomiah J, Tigoi C, Irura Z, Eyase F, Venter M, Sang R. Serological evidence of Flavivirus circulation in human populations in Northern Kenya: an assessment of disease risk 2016-2017. Virol J 2019; 16:65. [PMID: 31101058 PMCID: PMC6525424 DOI: 10.1186/s12985-019-1176-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/06/2019] [Indexed: 01/05/2023] Open
Abstract
Background Yellow fever, Dengue, West Nile and Zika viruses are re-emerging mosquito-borne Flaviviruses of public health concern. However, the extent of human exposure to these viruses and associated disease burden in Kenya and Africa at large remains unknown. We assessed the seroprevalence of Yellow fever and other Flaviviruses in human populations in West Pokot and Turkana Counties of Kenya. These areas border Uganda, South Sudan and Ethiopia where recent outbreaks of Yellow fever and Dengue have been reported, with possibility of spillover to Kenya. Methodology Human serum samples collected through a cross-sectional survey in West Pokot and Turkana Counties were screened for neutralizing antibodies to Yellow fever, Dengue-2, West Nile and Zika virus using the Plaque Reduction Neutralization Test (PRNT). Seroprevalence was compared by county, site and important human demographic characteristics. Adjusted odds ratios (aOR) were estimated using Firth logistic regression model. Results Of 877 samples tested, 127 neutralized with at least one of the four flaviviruses (14.5, 95% CI 12.3–17.0%), with a higher proportion in Turkana (21.1%, n = 87/413) than in West Pokot (8.6%, n = 40/464). Zika virus seroprevalence was significantly higher in West Pokot (7.11%) than in Turkana County (0.24%; χ2P < 0.0001). A significantly higher Yellow fever virus seroprevalence was also observed in Turkana (10.7%) compared to West Pokot (1.29%; χ2 P < 0.0001). A high prevalence of West Nile virus was detected in Turkana County only (10.2%) while Dengue was only detected in one sample, from West Pokot. The odds of infection with West Nile virus was significantly higher in males than in females (aOR = 2.55, 95% CI 1.22–5.34). Similarly, the risk of Zika virus infection in West Pokot was twice higher in males than females (aOR = 2.01, 95% CI 0.91–4.41). Conclusion Evidence of neutralizing antibodies to West Nile and Zika viruses indicates that they have been circulating undetected in human populations in these areas. While the observed Yellow Fever prevalence in Turkana and West Pokot Counties may imply virus activity, we speculate that this could also be as a result of vaccination following the Yellow Fever outbreak in the Omo river valley, South Sudan and Uganda across the border. Electronic supplementary material The online version of this article (10.1186/s12985-019-1176-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Chepkorir
- International Centre of Insect Physiology and Ecology, P. O. Box 30772-00100, Nairobi, Kenya. .,Center for Viral Zoonoses, Department of Medical Virology, University of Pretoria, P. O. Box 323, Arcadia, 0007, South Africa.
| | - D P Tchouassi
- International Centre of Insect Physiology and Ecology, P. O. Box 30772-00100, Nairobi, Kenya
| | - S L Konongoi
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54628-00200, Nairobi, Kenya
| | - J Lutomiah
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54628-00200, Nairobi, Kenya
| | - C Tigoi
- International Centre of Insect Physiology and Ecology, P. O. Box 30772-00100, Nairobi, Kenya
| | - Z Irura
- Division of Disease Surveillance and Response, Ministry of Health, P. O. Box 20781-00202, Nairobi, Kenya
| | - F Eyase
- Jomo Kenyatta University of Agriculture and Technology, P.O. Box 606, Village Market, Nairobi, Kenya
| | - M Venter
- Center for Viral Zoonoses, Department of Medical Virology, University of Pretoria, P. O. Box 323, Arcadia, 0007, South Africa
| | - R Sang
- International Centre of Insect Physiology and Ecology, P. O. Box 30772-00100, Nairobi, Kenya
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Grossi-Soyster EN, Lee J, King CH, LaBeaud AD. The influence of raw milk exposures on Rift Valley fever virus transmission. PLoS Negl Trop Dis 2019; 13:e0007258. [PMID: 30893298 PMCID: PMC6443189 DOI: 10.1371/journal.pntd.0007258] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/01/2019] [Accepted: 02/23/2019] [Indexed: 02/07/2023] Open
Abstract
Rift Valley fever virus (RVFV) is a zoonotic phlebovirus that can be transmitted to humans or livestock by mosquitoes or through direct contact with contaminated bodily fluids and tissues. Exposure to bodily fluids and tissues varies by types of behaviors engaged for occupational tasks, homestead responsibilities, or use in dietary or therapeutic capacities. While previous studies have included milk exposures in their analyses, their primary focus on livestock exposures has been on animal handling, breeding, and slaughter. We analyzed data from multiple field surveys in Kenya with the aim of associating RVFV infection to raw milk exposures from common animal species. Of those with evidence of prior RVFV infection by serology (n = 267), 77.2% engaged in milking livestock compared to 32.0% for 3,956 co-local seronegative individuals (p < 0.001), and 86.5% of seropositive individuals consumed raw milk compared to 33.4% seronegative individuals (p < 0.001). Individuals who milked and also consumed raw milk had greater odds of RVFV exposure than individuals whose only contact to raw milk was through milking. Increased risks were associated with exposure to milk sourced from cows (p < 0.001), sheep (p < 0.001), and goats (p < 0.001), but not camels (p = 0.98 for consuming, p = 0.21 for milking). Our data suggest that exposure to raw milk may contribute to a significant number of cases of RVFV, especially during outbreaks and in endemic areas, and that some animal species may be associated with a higher risk for RVFV exposure. Livestock trade is regulated to limit RVFV spread from endemic areas, yet further interventions designed to fully understand the risk of RVFV exposure from raw milk are imperative.
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Affiliation(s)
- Elysse N. Grossi-Soyster
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
- * E-mail:
| | - Justin Lee
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States of America
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
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Neighborhood Violence Impacts Disease Control and Surveillance: Case Study of Cali, Colombia from 2014 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102144. [PMID: 30274270 PMCID: PMC6211120 DOI: 10.3390/ijerph15102144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 01/02/2023]
Abstract
Arboviruses are responsible for a large burden of disease globally and are thus subject to intense epidemiological scrutiny. However, a variable notably absent from most epidemiological analyses has been the impact of violence on arboviral transmission and surveillance. Violence impedes surveillance and delivery of health and preventative services and affects an individual’s health-related behaviors when survival takes priority. Moreover, low and middle-income countries bear a disproportionately high burden of violence and related health outcomes, including vector borne diseases. To better understand the epidemiology of arboviral outbreaks in Cali, Colombia, we georeferenced chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viral cases from The National System of Surveillance in Public Health between October 2014 and April 2016. We extracted homicide data from the municipal monthly reports and kernel density of homicide distribution from IdeasPaz. Crucially, an overall higher risk of homicide is associated with increased risk of reported DENV, lower rates of acute testing, and higher rates of lab versus clinical discordance. In the context of high violence as a potential barrier to access to preventive health services, a community approach to improve health and peace should be considered.
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