Clinical and epidemiologic characteristics associated with dengue fever in 2011-2016 in Bang Phae district, Ratchaburi province, Thailand

Evaluating a rapid molecular assay in a mobile laboratory for improved diagnosis of dengue in Bangladesh

OBJECTIVES

Dengue emerged as a significant health threat in endemic regions in recent years. However, inconsistent diagnostic accuracy in sequential dengue infections necessitate improved testing methods to ensure effective management of dengue cases. Here, we evaluated a portable, rapid, and sensitive molecular assay-reverse transcriptase recombinase polymerase amplification assay (RT-RAA)-utilizing a mobile suitcase laboratory to detect infections in suspected dengue cases in Bangladesh.

METHODS

A total of 364 suspected patients with dengue were enrolled in the study. Dengue cases were confirmed by a positive result from any of the four tests: non-structural protein 1 (NS1) rapid diagnostic test (RDT), immunoglobulin (Ig) M RDT, quantitative reverse transcriptive-polymerase chain reaction (RT-PCR), and RT-RAA assay. IgG RDT was performed to differentiate between primary and secondary dengue infections.

RESULTS

Of 364 suspected cases, 320 were confirmed dengue cases, with 55.94% classified as primary and 44.06% as secondary infections. Laboratory results showed comparable positivity rates between RT-RAA (78.8%) and NS1 RDT (77.1%) in primary dengue, followed by quantitative RT-PCR (57.5%) and IgM RDT (12.8%). RT-RAA demonstrated superior positivity rates in secondary dengue (76.6%), surpassing RT-PCR (60.3%), NS1 RDT (27%), and IgM RDT (24.8%). Combining RT-RAA with NS1 RDT detected infections in 89.95% primary and 81.56% secondary dengue.

CONCLUSIONS

The findings suggest that complementing RT-RAA with NS1 RDT could significantly improve dengue detection rate, particularly, for secondary infections.

Investigating the impact of climate and seasonality on mosquito (Diptera: Culicidae) vector populations in the connecting areas of the Tenasserim range forests in Thailand

Mosquito-borne diseases pose a significant public health challenge globally. Our study focused on the seasonal diversity of mosquito species in the connecting areas of the Tenasserim (also known as Tanaosri) range forests in Thailand. Additionally, we employed the geometric morphometric technique to assess variations in wing size and shape among five predominant mosquito species. Throughout the study period, we collected a total of 9,522 mosquitoes, encompassing 42 species across eight genera. In these connecting areas of forests, the Simpson index and Shannon species diversity index were recorded at 0.86 and 2.36, respectively, indicating a high level of mosquito diversity. Our analysis using the Analysis of Similarities (ANOSIM) test showed significant seasonal differences in mosquito communities, with an R-value of 0.30 (p < 0.05) in the lower connecting areas and 0.37 (p < 0.05) in the upper connecting areas. Additionally, canonical correspondence analyses showed that the abundance of each mosquito species is influenced by various climate factors. Phenotypic analyses of wing size and shape have deepened our understanding of local adaptation and the seasonal pressures impacting these vectors. Notably, most species exhibited larger wing sizes in the dry season compared to other seasons. Additionally, seasonal assessments of wing shape in five predominant mosquito species revealed significant differences across seasonal populations (p < 0.05). Ongoing monitoring of these populations is crucial to enhancing our understanding of the seasonal effects on mosquito abundance and physiological adaptations. These insights are essential for developing more effective strategies to manage mosquito-borne diseases.

Temperature-Driven Dengue Transmission in a Changing Climate: Patterns, Trends, and Future Projections

Dengue is a rapidly spreading mosquito-borne infectious disease that is sensitive to climate factors and poses a major public health concern worldwide. We analyzed dengue incidence trends and the relationship between annual mean minimum temperatures (AMMTs) and dengue incidence rates from 1990 to 2019 in 122 countries using the Global Burden of Disease and TerraClimate data sets. We also projected global dengue incidence rates under different carbon emission scenarios using temperature data from the Coupled Model Intercomparison Project Phase 6 (CMIP6) data set. Our results reveal a significant increase in global dengue cases from 1990 to 2019 and a positive correlation between temperature and dengue incidence. The association between AMMT and dengue incidence strengthened at temperatures exceeding 21°C. Central and eastern sub-Saharan Africa, as well as Oceania, were identified as the regions most sensitive to dengue; males and individuals aged 15-19 or 70-84 years were the most susceptible to dengue under rising temperatures. Our projections suggest that global dengue incidence will substantially increase by 2050 and 2100. By 2100, regions including Africa, the Arabian Peninsula, the southern United States, southern China, and island countries in the Pacific and Indian Oceans are projected to become year-round dengue-endemic under a high-emission climate scenario. Our findings underscore the importance of implementing effective measures to mitigate the impact of climate change on dengue transmission. Identifying high-risk areas and susceptible populations, along with understanding the projected expansion of dengue-endemic regions, will provide valuable guidance for targeted interventions to address this growing global health challenge in the face of changing climatic conditions.

Dengue in Pune city, India (2017-2019): a comprehensive analysis

Objectives

To understand the dynamics of dengue disease with special reference to (1) age (2) primary/secondary infections (3) serostatus and (4) serotypes examined during three consecutive years.

Methods

During 3 dengue seasons (2017-19), NS1/IgM ELISAs were used for dengue diagnosis in one of the 15 administrative wards of Pune City, India. Predefined symptoms were recorded at the time of diagnosis/hospitalization. IgG-capture ELISA (Panbio) was used to differentiate primary/secondary infections. DENV serotypes were determined for 260 viral RNA-positive patients.

Results

During the 3 years, 3,014/6,786 (44.4%, 41.4-49.9%) suspected cases were diagnosed as dengue. Use of either NS1 or IgM would have missed 25.5% or 43% of the confirmed dengue cases, respectively. Notably, a higher proportion of secondary dengue cases remained mild while a substantial proportion of primary infections developed warning signs. The symptoms among Dengue/non-dengue patients and primary/secondary infections varied and influenced by age and serostatus. The number and proportion of dengue serotypes varied yearly. A remarkable decline in dengue cases was observed during the COVID-19 pandemic years.

Conclusion

A substantial proportion of primary and secondary dengue patients progress to warning signs/severity or mild infection respectively, underscoring the possible role of non-ADE mechanisms in causing severe dengue that requires hospitalization. Both NS1 and IgM should be used for efficient diagnosis.

High-throughput peptide array analysis and computational techniques for serological profiling of flavivirus infections: Implications for diagnostics and vaccine development

Arthropod-borne viruses, such as dengue virus (DENV), pose significant global health threats, with DENV alone infecting around 400 million people annually and causing outbreaks beyond endemic regions. This study aimed to enhance serological diagnosis and discover new drugs by identifying immunogenic protein regions of DENV. Utilizing a comprehensive approach, the study focused on peptides capable of distinguishing DENV from other flavivirus infections through serological analyses. Over 200 patients with confirmed arbovirus infection were profiled using high-density pan flavivirus peptide arrays comprising 6253 peptides and the computational method matrix of local coupling energy (MLCE). Twenty-four peptides from nonstructural and structural viral proteins were identified as specifically recognized by individuals with DENV infection. Six peptides were confirmed to distinguish DENV from Zika virus (ZIKV), West Nile virus (WNV), Yellow Fever virus (YFV), Usutu virus (USUV), and Chikungunya virus (CHIKV) infections, as well as healthy controls. Moreover, the combination of two immunogenic peptides emerged as a potential serum biomarker for DENV infection. These peptides, mapping to highly accessible regions on protein structures, show promise for diagnostic and prophylactic strategies against flavivirus infections. The described methodology holds broader applicability in the serodiagnosis of infectious diseases.

Performance of the onstructural 1 Antigen Rapid Test for detecting all four DENV serotypes in clinical specimens from Bangkok, Thailand

BACKGROUND

Dengue is an arboviral disease that has a large effect on public health in subtropical and tropical countries. Rapid and accurate detection of dengue infection is necessary for diagnosis and disease management. We previously developed highly sensitive immunochromatographic devices, the TKK 1st and TKK 2nd kits, based on dengue virus (DENV) nonstructural protein 1 detection. However, these TKK kits were evaluated mainly using DENV type 2 clinical specimens collected in Bangladesh, and further validation using clinical specimens of other serotypes was needed.

METHODS

In the present study, one of the TKK kits, TKK 2nd, was evaluated using 10 DENV-1, 10 DENV-2, 4 DENV-3, 16 DENV-4, and 10 zika virus-infected clinical specimens collected in Bangkok, Thailand.

RESULTS

The TKK 2nd kit successfully detected all four DENV serotypes in patient serum specimens and did not show any cross-reactivities against zika virus serum specimens. The IgM and/or IgG anti-DENV antibodies were detected in seven serum specimens, but did not seem to affect the results of antigen detection in the TKK 2nd kit.

CONCLUSION

The results showed that the TKK 2nd kit successfully detected all four DENV serotypes in clinical specimens and confirmed the potential of the kit for dengue diagnosis in endemic countries.

Anti-Dengue Screening on Several Vietnamese Medicinal Plants: Experimental Evidences and Computational Analyses

Worldwide, medicinal plants have been known for economic and geographical advantages, thus possibly holding potentiality against dengue hemorrhagic fever. The methanol/water extracts from different parts of fourteen Vietnam-based plant species were subjected for experimental screening on anti-dengue activity using baby hamster kidney cells (BHK21) and plaque reduction neutralisation test (PRNT). Firstly, the methanol/water extracts were tested against serotype dengue virus DENV-1. Seven out from nineteen extracts show the PRNT₅₀ values less than 31.25 μg/mL. Four of the above extracts namely from Euphorbia hirta, Cordyline terminalis, Carica papaya, and Elaeagnus latifolia were chosen for testing against the serotype DENV-2. All of them exhibit good activity with the PRNT₅₀ values less than 31.25 μg/ml, which were further fractionated to obtain hexane, ethyl acetate and butanol fractions. Anti-dengue virus activity of the fractions against four serotypes DENV-1, -2, -3 and -4 was evaluated. As results, the ethyl acetate fraction of Elaeagnus latifolia is highly active against all four serotype viruses. The structural formulae of its nine constituents were input for molecular docking simulation. The docking-based order for static inhibitability is 6-3L6P>7-3L6P>9-3L6P>2-3L6P>3-3L6P≈5-3L6P>9-3L6P>1-3L6P>8-3L6P; QSARIS-based analysis reveals the biocompatibility of the most promising ligands (4-7); ADMET-based analysis expects their pharmacological suitability. Exceptional finding on 2-3LKW hydrophilic interaction at Lys43 (with the associated Gibbs free energy of -10.3 kcal mol^-1 ) raises an open explanation for inhibitory effects. The results encourage further investigations for more in-depth mechanisms and drug development, such as in vitro enzyme assays or in vitro clinical trials with natural substances from E. latifolia.

Dynamic Changes of Platelet and Factors Related Dengue Haemorrhagic Fever: A Retrospective Study in Indonesian

Dengue is a viral infection caused by the dengue virus (DENV). Dengue infection is a self-limited acute febrile illness caused by four serotypes of DENV (DENV-1~4). Early recognition of high-risk patients would be helpful to reduce mortality rates and prevent severe dengue. Our study aimed to identify factors related to dengue hemorrhagic fever (DHF) based on admission-day data, and further to understand the distribution of biochemical laboratory data in dengue patients. This retrospective study was conducted in hospitals in Yogyakarta city, Indonesia, and involved febrile patients who were admitted to the hospital with a diagnosis of dengue during 2018 and 2020. Logistic regression models were used to identify variables related to DHF. In this study, 1087 patients were included as suspected dengue patients, among them 468 had dengue fever (DF) and 619 had DHF. Over half of the DHF patients were males (55.9%) with an average age of 17.9 years, and with a secondary infection (71.3%). By a multivariate analysis, on-admission laboratory data of thrombocytopenia and hemoglobin showed significant association with DHF. Furthermore, DHF patients had significantly prolonged hospitalizations compared to DF patients. In conclusion, on-admission platelet counts and hemoglobin laboratory data are useful as predictors of DHF especially for suspected dengue patients with the limitations of diagnostic tests.

Lab-scale characterization and semi-field trials of Wolbachia Strain wAlbB in a Taiwan Wolbachia introgressed Ae. aegypti strain

Dengue fever is one of the most severe viral diseases transmitted by Aedes mosquitoes, with traditional approaches of disease control proving insufficient to prevent significant disease burden. Release of Wolbachia-transinfected mosquitoes offers a promising alternative control methodologies; Wolbachia-transinfected female Aedes aegypti demonstrate reduced dengue virus transmission, whilst Wolbachia-transinfected males cause zygotic lethality when crossed with uninfected females, providing a method for suppressing mosquito populations. Although highly promising, the delicate nature of population control strategies and differences between local species populations means that controlled releases of Wolbachia-transinfected mosquitoes cannot be performed without extensive testing on specific local Ae. aegypti populations. In order to investigate the potential for using Wolbachia to suppress local Ae. aegypti populations in Taiwan, we performed lab-based and semi-field fitness trials. We first transinfected the Wolbachia strain wAlbB into a local Ae. aegypti population (wAlbB-Tw) and found no significant changes in lifespan, fecundity and fertility when compared to controls. In the laboratory, we found that as the proportion of released male mosquitoes carrying Wolbachia was increased, population suppression could reach up to 100%. Equivalent experiments in semi-field experiments found suppression rates of up to 70%. The release of different ratios of wAlbB-Tw males in the semi-field system provided an estimate of the optimal size of male releases. Our results indicate that wAlbB-Tw has significant potential for use in vector control strategies aimed at Ae. aegypti population suppression in Taiwan. Open field release trials are now necessary to confirm that wAlbB-Tw mediated suppression is feasible in natural environments.