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Brooks WA, Zaman K, Goswami D, Prosperi C, Endtz HP, Hossain L, Rahman M, Ahmed D, Rahman MZ, Banu S, Shikder AU, Jahan Y, Nahar K, Chisti MJ, Yunus M, Khan MA, Matin FB, Mazumder R, Shahriar Bin Elahi M, Saifullah M, Alam M, Bin Shahid ASMS, Haque F, Sultana S, Higdon MM, Haddix M, Feikin DR, Murdoch DR, Hammitt LL, O’Brien KL, Deloria Knoll M. The Etiology of Childhood Pneumonia in Bangladesh: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study. Pediatr Infect Dis J 2021; 40:S79-S90. [PMID: 34448747 PMCID: PMC8448409 DOI: 10.1097/inf.0000000000002648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pneumonia remains the leading infectious cause of death among children <5 years, but its cause in most children is unknown. We estimated etiology for each child in 2 Bangladesh sites that represent rural and urban South Asian settings with moderate child mortality. METHODS As part of the Pneumonia Etiology Research for Child Health study, we enrolled children 1-59 months of age with World Health Organization-defined severe and very severe pneumonia, plus age-frequency-matched controls, in Matlab and Dhaka, Bangladesh. We applied microbiologic methods to nasopharyngeal/oropharyngeal swabs, blood, induced sputum, gastric and lung aspirates. Etiology was estimated using Bayesian methods that integrated case and control data and accounted for imperfect sensitivity and specificity of the measurements. RESULTS We enrolled 525 cases and 772 controls over 24 months. Of the cases, 9.1% had very severe pneumonia and 42.0% (N = 219) had infiltrates on chest radiograph. Three cases (1.5%) had positive blood cultures (2 Salmonella typhi, 1 Escherichia coli and Klebsiella pneumoniae). All 4 lung aspirates were negative. The etiology among chest radiograph-positive cases was predominantly viral [77.7%, 95% credible interval (CrI): 65.3-88.6], primarily respiratory syncytial virus (31.2%, 95% CrI: 24.7-39.3). Influenza virus had very low estimated etiology (0.6%, 95% CrI: 0.0-2.3). Mycobacterium tuberculosis (3.6%, 95% CrI: 0.5-11.0), Enterobacteriaceae (3.0%, 95% CrI: 0.5-10.0) and Streptococcus pneumoniae (1.8%, 95% CrI: 0.0-5.9) were the only nonviral pathogens in the top 10 etiologies. CONCLUSIONS Childhood severe and very severe pneumonia in young children in Bangladesh is predominantly viral, notably respiratory syncytial virus.
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Affiliation(s)
- W. Abdullah Brooks
- From the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Doli Goswami
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Hubert P. Endtz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Department of Clinical Microbiology & Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Fondation Mérieux, Lyon, France
| | - Lokman Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Dilruba Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Arif Uddin Shikder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Yasmin Jahan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kamrun Nahar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Mohammed Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | | | - Razib Mazumder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Muhammad Saifullah
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Muntasir Alam
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Fahim Haque
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabiha Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Melissa M. Higdon
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Meredith Haddix
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel R. Feikin
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David R. Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
- Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Laura L. Hammitt
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Hassan MZ, Monjur MR, Biswas MAAJ, Chowdhury F, Kafi MAH, Braithwaite J, Jaffe A, Homaira N. Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey. BMJ Glob Health 2021; 6:bmjgh-2020-004010. [PMID: 33903174 PMCID: PMC8076944 DOI: 10.1136/bmjgh-2020-004010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/02/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown. Methods We analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI. Results We analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics. Conclusion In this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
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Affiliation(s)
- Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh .,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mohammad Riashad Monjur
- Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.,St George Hospital, Sydney, New South Wales, Australia
| | - Md Abdullah Al Jubayer Biswas
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | - Fahmida Chowdhury
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | | | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.,NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Respiratory Department, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Nusrat Homaira
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Respiratory Department, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
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Das P, Satter SM, Ross AG, Abdullah Z, Nazneen A, Sultana R, Rimi NA, Chowdhury K, Alam R, Parveen S, Rahman MM, Hossain ME, Rahman MZ, Mazumder R, Abdullah A, Rahman M, Banu S, Ahmed T, Clemens JD, Rahman M. A Case Series Describing the Recurrence of COVID-19 in Patients Who Recovered from Initial Illness in Bangladesh. Trop Med Infect Dis 2021; 6:41. [PMID: 33807247 PMCID: PMC8103235 DOI: 10.3390/tropicalmed6020041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023] Open
Abstract
To date, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected over 80 million people globally. We report a case series of five clinically and laboratory confirmed COVID-19 patients from Bangladesh who suffered a second episode of COVID-19 illness after 70 symptom-free days. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), is a leading public health research institution in South Asia. icddr, b staff were actively tested, treated and followed-up for COVID-19 by an experienced team of clinicians, epidemiologists, and virologists. From 21 March to 30 September 2020, 1370 icddr,b employees working at either the Dhaka (urban) or Matlab (rural) clinical sites were tested for COVID-19. In total, 522 (38%) were positive; 38% from urban Dhaka (483/1261) and 36% from the rural clinical site Matlab (39/109). Five patients (60% male with a mean age of 41 years) had real-time reverse transcription-polymerase chain reaction (rRT-PCR) diagnosed recurrence (reinfection) of SARS-CoV-2. All had mild symptoms except for one who was hospitalized. Though all cases reported fair risk perceptions towards COVID-19, all had potential exposure sources for reinfection. After a second course of treatment and home isolation, all patients fully recovered. Our findings suggest the need for COVID-19 vaccination and continuing other preventive measures to further mitigate the pandemic. An optimal post-recovery follow-up strategy to allow the safe return of COVID-19 patients to the workforce may be considered.
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Affiliation(s)
- Pritimoy Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (S.M.S.); (A.G.R.); (Z.A.); (A.N.); (R.S.); (N.A.R.); (K.C.); (R.A.); (S.P.); (M.M.R.); (M.E.H.); (M.Z.R.); (R.M.); (A.A.); (M.R.); (S.B.); (T.A.); (J.D.C.); (M.R.)
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Chowdhury F, Shahid ASMSB, Ghosh PK, Rahman M, Hassan MZ, Akhtar Z, Muneer SME, Shahrin L, Ahmed T, Chisti MJ. Viral etiology of pneumonia among severely malnourished under-five children in an urban hospital, Bangladesh. PLoS One 2020; 15:e0228329. [PMID: 32017782 PMCID: PMC6999894 DOI: 10.1371/journal.pone.0228329] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 01/13/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In Bangladesh, pneumonia has a higher mortality among malnourished children aged <5 years. Evaluating pneumonia etiology among malnourished children may help improve empiric treatment guidelines. METHODS During April 2015-December 2017, we conducted a case-control study among severe acute malnourished (SAM) children aged <5 years admitted to the Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). We enrolled hospital admitted SAM children with clinical or radiological pneumonia as cases (during April 2015 to March 2017) and hospital admitted SAM children without any respiratory symptom in the past 10 days before admission as controls (during February 2016 to December 2017). We tested nasopharyngeal wash from both case and control for respiratory syncytial virus (RSV), human metapneumovirus (HMPV), influenza viruses, human parainfluenza viruses (HPIV), rhinovirus and adenovirus by singleplex real-time reverse transcriptase polymerase chain reaction. To identify the independent association of pneumonia with viral pathogens during February 2016 to March 2017, we used multivariable logistic regression for calculating adjusted odds ratios. RESULTS We enrolled 360 cases and 334 controls. For case and control the median age was 8 months (IQR: 5-13) and 11 months (IQR: 6-18) (p = 0.001) respectively. Weight/age Z-score was -4.3 (SD ±0.7) for cases and -4.1 (SD ±1.1) for controls (p = 0.01). Among cases 68% had both clinical and radiological pneumonia, 1% had clinical pneumonia and 31% had only radiological pneumonia. Respiratory virus detection was high in cases compared to controls [69.9% (251) vs. 44.8% (148), p = 0.0001]. The most frequently detected viruses among cases were rhinoviruses (79, 22.0%) followed by RSV (32, 8.9%), adenovirus (23, 6.4%), HPIV (22, 6.1%), influenza virus (16, 4.5%), and HMPV (16, 4.5%). Among the controls, rhinoviruses (82, 24.8%) were most commonly detected one followed by adenovirus (26,7.9%), HMPV (5, 1.5%), HPIV (4, 1.2%), RSV (3, 0.9%), and influenza virus (2, 0.6%). RSV (OR 13.1; 95% CI: 1.6, 106.1), influenza virus (OR 8.7; 95% CI: 1.0, 78.9), HPIV (3.8; 95% CI: 1.0, 14.8), and HMPV (2.7; 95% CI: 1.3, 5.5) were independently associated with pneumonia while compared between 178 cases and 174 controls. CONCLUSION Viral etiology of pneumonia in SAM children were mainly attributable to RSV, influenza, HPIV and HMPV. Our study findings may help in planning further studies targeting vaccines or drugs against common respiratory viruses responsible for pneumonia among SAM children.
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Affiliation(s)
- Fahmida Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Probir Kumar Ghosh
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafizur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Zakiul Hassan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Zubair Akhtar
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - S. Mah-E- Muneer
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Lubaba Shahrin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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5
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Paul RC, Gidding HF, Nazneen A, Banik KC, Sumon SA, Paul KK, Luby SP, Gurley ES, Hayen A. A Low-Cost, Community Knowledge Approach to Estimate Maternal and Jaundice-Associated Mortality in Rural Bangladesh. Am J Trop Med Hyg 2019; 99:1633-1638. [PMID: 30298803 DOI: 10.4269/ajtmh.17-0974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In the absence of a civil registration system, a house-to-house survey is often used to estimate cause-specific mortality in low- and middle-income countries. However, house-to-house surveys are resource and time intensive. We applied a low-cost community knowledge approach to identify maternal deaths from any cause and jaundice-associated deaths among persons aged ≥ 14 years, and stillbirths and neonatal deaths in mothers with jaundice during pregnancy in five rural communities in Bangladesh. We estimated the method's sensitivity and cost savings compared with a house-to-house survey. In the five communities with a total of 125,570 population, we identified 13 maternal deaths, 60 deaths among persons aged ≥ 14 years associated with jaundice, five neonatal deaths, and four stillbirths born to a mother with jaundice during pregnancy over the 3-year period before the survey using the community knowledge approach. The sensitivity of community knowledge method in identifying target deaths ranged from 80% for neonatal deaths to 100% for stillbirths and maternal deaths. The community knowledge approach required 36% of the staff time to undertake compared with the house-to-house survey. The community knowledge approach was less expensive but highly sensitive in identifying maternal and jaundice-associated mortality, as well as all-cause adult mortality in rural settings in Bangladesh. This method can be applied in rural settings of other low- and middle-income countries and, in conjunction with hospital-based hepatitis diagnoses, used to monitor the impact of programs to reduce the burden of cause-specific hepatitis mortality, a current World Health Organization priority.
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Affiliation(s)
- Repon C Paul
- School of Public Health and Community Medicine, UNSW Medicine, Sydney, Australia.,International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Heather F Gidding
- School of Public Health and Community Medicine, UNSW Medicine, Sydney, Australia
| | - Arifa Nazneen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kajal C Banik
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shariful A Sumon
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kishor K Paul
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Stephen P Luby
- Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California
| | - Emily S Gurley
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Andrew Hayen
- Australian Centre for Public and Population Health, Research, University of Technology Sydney, Sydney, Australia
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Das P, Sazzad HMS, Aleem MA, Rahman MZ, Rahman M, Anthony SJ, Lipkin WI, Gurley ES, Luby SP, Openshaw JJ. Hospital-based zoonotic disease surveillance in Bangladesh: design, field data and difficulties. Philos Trans R Soc Lond B Biol Sci 2019; 374:20190019. [PMID: 31401956 DOI: 10.1098/rstb.2019.0019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Early detection of zoonotic diseases allows for the implementation of early response measures, reducing loss of human life and economic disruption. We implemented a surveillance system in hospitals in Bangladesh to screen acutely ill hospitalized patients with severe respiratory infection and meningoencephalitis for zoonotic exposures. Patients were screened for the risk of zoonotic exposures with five questions covering vocational exposures, sick domestic animal and wild animal contact, and date palm sap consumption in the three weeks preceding illness onset. Patients giving at least one positive response were considered a potential zoonotic exposure. From September 2013 to March 2017, a total of 11 429 hospitalized patients across 14 participating hospitals were screened for exposures. Overall, 2% of patients reported a potential zoonotic exposure in the three-week period prior to becoming ill. Sixteen per cent of hospitalized patients with reported exposures died. After routine surveillance diagnostic testing, 88% of patients admitted to the hospital after a potential zoonotic exposure did not have a laboratory diagnosed aetiology for their illness. Hospital-based surveillance systems such as the Bangladeshi example presented here could play an important future role in the early detection of zoonotic spillover diseases. This article is part of the theme issue 'Dynamic and integrative approaches to understanding pathogen spillover'.
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Affiliation(s)
- Pritimoy Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh
| | - Hossain M S Sazzad
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh
| | - Mohammad Abdul Aleem
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh
| | - M Ziaur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology Disease Control and Research, Mohakhali, Dhaka 1212, Bangladesh
| | - Simon J Anthony
- Center for Infection and Immunity, Columbia University, New York, NY 10032, USA
| | - W Ian Lipkin
- Center for Infection and Immunity, Columbia University, New York, NY 10032, USA
| | - Emily S Gurley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Stephen P Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 94305, USA
| | - John J Openshaw
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 94305, USA
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Rahman MZ, Sumiya M, Sahabuddin M, Pell LG, Gubbay JB, Rahman R, Momtaz F, Azmuda N, Shanta SS, Jahan I, Rahman M, Mahmud AA, Roth DE, Morris SK. Genetic characterization of human metapneumovirus identified through community and facility-based surveillance of infants in Dhaka, Bangladesh. J Med Virol 2018; 91:549-554. [PMID: 30372530 DOI: 10.1002/jmv.25351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/16/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Acute respiratory infection (ARI) is a leading cause of morbidity and mortality in children in low and middle-income countries. Human metapneumovirus (hMPV) is one of the most common viral etiological agents for ARIs in children. OBJECTIVES In this study, we explored the genotypic diversity and the epidemiology of hMPV among infants in Dhaka, Bangladesh. STUDY DESIGN Between December 2014 and August 2016, a total of 3810 mid-turbinate nasal swab samples were collected from infants (0 to 6 months of age) who met clinical ARI criteria, as a part of a prospective ARI cohort study. hMPV was detected using polymerase chain reaction, and genotyped by sequencing and phylogenetic analysis. RESULTS hMPV was identified in 206 (5.4%) nasal swab specimens. One-tenth of the hMPV-positive swabs (n = 19) were also positive for other respiratory viruses. hMPV activity peaked in January and September in 2015; however, no seasonal pattern of hMPV infection was detected. Phylogenetic analyses of the N and F gene-fragments revealed that the hMPV strains circulating in Dhaka, Bangladesh, belonged to three genotypes: A2b, A2c, and B1. Genotype A (57%) was the predominant hMPV genotype circulating in Bangladesh during the study period. CONCLUSION This study describes both the epidemiology of hMPV infection and its genotypic strain diversity in Dhaka, Bangladesh.
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Affiliation(s)
| | - Mariya Sumiya
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | | | - Lisa G Pell
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jonathan B Gubbay
- Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Rajibur Rahman
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Farhana Momtaz
- Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Nafisa Azmuda
- Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh
| | - Shaila S Shanta
- Nutrition and Clinical Services Division (NCSD), icddr,b, Dhaka, Bangladesh
| | - Ishrat Jahan
- Maternal and Child Health Training Institute (MCHTI), Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | | | - Abdullah A Mahmud
- Nutrition and Clinical Services Division (NCSD), icddr,b, Dhaka, Bangladesh
| | - Daniel E Roth
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Shaun K Morris
- Centre for Global Child Health and Child Health Evaluative Sciences, Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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8
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Kurskaya O, Ryabichenko T, Leonova N, Shi W, Bi H, Sharshov K, Kazachkova E, Sobolev I, Prokopyeva E, Kartseva T, Alekseev A, Shestopalov A. Viral etiology of acute respiratory infections in hospitalized children in Novosibirsk City, Russia (2013 - 2017). PLoS One 2018; 13:e0200117. [PMID: 30226876 PMCID: PMC6143185 DOI: 10.1371/journal.pone.0200117] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022] Open
Abstract
Background Acute respiratory infections (ARIs) cause a considerable morbidity and mortality worldwide especially in children. However, there are few studies of the etiological structure of ARIs in Russia. In this work, we analyzed the etiology of ARIs in children (0–15 years old) admitted to Novosibirsk Children’s Municipal Clinical Hospital in 2013–2017. Methods We tested nasal and throat swabs of 1560 children with upper or lower respiratory infection for main respiratory viruses (influenza viruses A and B, parainfluenza virus types 1–4, respiratory syncytial virus, metapneumovirus, four human coronaviruses, rhinovirus, adenovirus and bocavirus) using a RT-PCR Kit. Results We detected 1128 (72.3%) samples were positive for at least one virus. The most frequently detected pathogens were respiratory syncytial virus (358/1560, 23.0%), influenza virus (344/1560, 22.1%), and rhinovirus (235/1560, 15.1%). Viral co-infections were found in 163 out of the 1128 (14.5%) positive samples. We detected significant decrease of the respiratory syncytial virus-infection incidence in children with increasing age, while the reverse relationship was observed for influenza viruses. Conclusions We evaluated the distribution of respiratory viruses in children with ARIs and showed the prevalence of respiratory syncytial virus and influenza virus in the etiological structure of infections. This study is important for the improvement and optimization of diagnostic tactics, control and prevention of the respiratory viral infections.
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Affiliation(s)
- Olga Kurskaya
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
- * E-mail:
| | - Tatyana Ryabichenko
- Department of Propaedeutic of Childhood Diseases, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Natalya Leonova
- Department of Children’s Diseases, Novosibirsk Children’s Municipal Clinical Hospital №6, Novosibirsk, Russia
| | - Weifeng Shi
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Taishan Medical College, Taian, Shandong, China
| | - Hongtao Bi
- Qinghai Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation, Northwest Institute of Plateau Biology, CAS, Xining, China
| | - Kirill Sharshov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Eugenia Kazachkova
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Ivan Sobolev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Elena Prokopyeva
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Tatiana Kartseva
- Department of Propaedeutic of Childhood Diseases, Novosibirsk State Medical University, Novosibirsk, Russia
| | - Alexander Alekseev
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
| | - Alexander Shestopalov
- Department of Experimental Modeling and Pathogenesis of Infectious Diseases, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russia
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9
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Ahmed M, Roguski K, Tempia S, Iuliano AD. Reply to Alonso et al. "Bangladesh and Rwanda: Cases of high burden of influenza in tropical countries?". Influenza Other Respir Viruses 2018; 12:669-671. [PMID: 29858873 PMCID: PMC6086846 DOI: 10.1111/irv.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Makhdum Ahmed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Katherine Roguski
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angela D Iuliano
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Chittaganpitch M, Waicharoen S, Yingyong T, Praphasiri P, Sangkitporn S, Olsen SJ, Lindblade KA. Viral etiologies of influenza-like illness and severe acute respiratory infections in Thailand. Influenza Other Respir Viruses 2018. [PMID: 29518269 PMCID: PMC6005612 DOI: 10.1111/irv.12554] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Information on the burden, characteristics and seasonality of non‐influenza respiratory viruses is limited in tropical countries. Objectives Describe the epidemiology of selected non‐influenza respiratory viruses in Thailand between June 2010 and May 2014 using a sentinel surveillance platform established for influenza. Methods Patients with influenza‐like illness (ILI; history of fever or documented temperature ≥38°C, cough, not requiring hospitalization) or severe acute respiratory infection (SARI; history of fever or documented temperature ≥38°C, cough, onset <10 days, requiring hospitalization) were enrolled from 10 sites. Throat swabs were tested for influenza viruses, respiratory syncytial virus (RSV), metapneumovirus (MPV), parainfluenza viruses (PIV) 1‐3, and adenoviruses by polymerase chain reaction (PCR) or real‐time reverse transcriptase‐PCR. Results We screened 15 369 persons with acute respiratory infections and enrolled 8106 cases of ILI (5069 cases <15 years old) and 1754 cases of SARI (1404 cases <15 years old). Among ILI cases <15 years old, influenza viruses (1173, 23%), RSV (447, 9%), and adenoviruses (430, 8%) were the most frequently identified respiratory viruses tested, while for SARI cases <15 years old, RSV (196, 14%) influenza (157, 11%) and adenoviruses (90, 6%) were the most common. The RSV season significantly overlapped the larger influenza season from July to November in Thailand. Conclusions The global expansion of influenza sentinel surveillance provides an opportunity to gather information on the characteristics of cases positive for non‐influenza respiratory viruses, particularly seasonality, although adjustments to case definitions may be required.
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Affiliation(s)
| | | | | | - Prabda Praphasiri
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Somchai Sangkitporn
- National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Sonja J Olsen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim A Lindblade
- Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Bhuiyan MU, Luby SP, Alamgir NI, Homaira N, Sturm-Ramirez K, Gurley ES, Abedin J, Zaman RU, Alamgir A, Rahman M, Ortega-Sanchez IR, Azziz-Baumgartner E. Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010. J Glob Health 2018; 7:010412. [PMID: 28702175 PMCID: PMC5502704 DOI: 10.7189/jogh.07.010412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged <5 years with laboratory–confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case–patients’ homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non–medical costs (costs for food, lodging and transportation); indirect costs (caregivers’ productivity loss), and coping strategies used by families to pay for treatment. We used WHO–Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost–per–episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43–101), indirect cost was US$ 19 (IQR = 11–29) and total cost was US$ 94 (IQR = 67–127). The median out–of–pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV–associated hospitalization in children aged <5 years in Bangladesh was US$ 10 million (IQR: US$ 7–16 million), the median indirect cost was US$ 3.0 million (IQR: 2–5 million) in 2010. Conclusion RSV–associated hospitalization among children aged <5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.
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Affiliation(s)
- Mejbah Uddin Bhuiyan
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Stephen P Luby
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nadia Ishrat Alamgir
- James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, Dhaka, Bangladesh
| | - Nusrat Homaira
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Randwick, Australia
| | - Katharine Sturm-Ramirez
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily S Gurley
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Jaynal Abedin
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Rashid Uz Zaman
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Oxford Policy Management, Oxford, UK
| | - Asm Alamgir
- Institute of Epidemiology, Disease Control and Research, Dhanka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Dhanka, Bangladesh
| | | | - Eduardo Azziz-Baumgartner
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.,Centres for Disease Control and Prevention, Atlanta, Georgia, USA
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12
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Ahmed M, Aleem MA, Roguski K, Abedin J, Islam A, Alam KF, Gurley ES, Rahman M, Azziz‐Baumgartner E, Homaira N, Sturm‐Ramirez K, Danielle Iuliano A. Estimates of seasonal influenza-associated mortality in Bangladesh, 2010-2012. Influenza Other Respir Viruses 2018; 12:65-71. [PMID: 29197174 PMCID: PMC5818342 DOI: 10.1111/irv.12490] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Seasonal influenza-associated mortality estimates help identify the burden of disease and assess the value of public health interventions such as annual influenza immunization. Vital registration is limited in Bangladesh making it difficult to estimate seasonal influenza mortality. OBJECTIVES Our study aimed to estimate seasonal influenza-associated mortality rates for 2010-2012 in Bangladesh. METHODS We conducted surveillance among hospitalized patients with severe acute respiratory illness (SARI) for persons aged ≥5 years and severe pneumonia for children <5 years in 11 sites across Bangladesh. We defined the catchment areas of these sites and conducted a community survey in 22 randomly selected unions (administrative units) within the catchment areas to identify respiratory deaths. We multiplied the proportion of influenza-positive patients at our surveillance sites by the age-specific number of respiratory deaths identified to estimate seasonal influenza-associated mortality. RESULTS Among 4221 surveillance case-patients, 553 (13%) were positive for influenza viruses. Concurrently, we identified 1191 persons who died within 2 weeks of developing an acute respiratory illness within the catchment areas of the surveillance hospitals. In 2010-2011, the estimated influenza-associated mortality rate was 6 (95% CI 4-9) per 100 000 for children <5 years and 41 (95% CI 35-47) per 100 000 for persons >60 years. During 2011-2012, the estimated influenza-associated mortality rate was 13 (95% CI 10-16) per 100 000 among children <5 years and 88 (95% CI 79-98) per 100 000 among persons aged >60 years. CONCLUSIONS We identified a substantial burden of influenza-associated deaths in Bangladesh suggesting that the introduction of prevention and control measures including seasonal vaccination should be considered by local public health decision-makers.
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Affiliation(s)
- Makhdum Ahmed
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
- The University of Texas Health Science Center at HoustonHoustonTXUSA
- The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Mohammad Abdul Aleem
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
| | | | - Jaynal Abedin
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
| | - Ariful Islam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
| | - Kazi Faisal Alam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
| | - Emily S. Gurley
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR)DhakaBangladesh
| | | | - Nusrat Homaira
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladeshUSA
- School of Women's and Children's HealthThe University of New South Wales (UNSW)SydneyNSWAustralia
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13
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Tahamtan A, Samieipoor Y, Nayeri FS, Rahbarimanesh AA, Izadi A, Rashidi-Nezhad A, Tavakoli-Yaraki M, Farahmand M, Bont L, Shokri F, Mokhatri-Azad T, Salimi V. Effects of cannabinoid receptor type 2 in respiratory syncytial virus infection in human subjects and mice. Virulence 2017; 9:217-230. [PMID: 28992427 PMCID: PMC5955186 DOI: 10.1080/21505594.2017.1389369] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An accumulating body of evidence suggests that the endocannabinoid system plays a significant role in pathophysiological processes and impacts disease severity. Here we investigate the possible role of a cannabinoid receptor type 2 (CB2) functional variant in determining disease severity and the potential pharmacological therapeutic effects of CB2 activation in viral respiratory infection. The common missense variant (CAA/CGG; Q63R) of the gene-encoding CB2 receptor (CNR2) was evaluated in 90 inpatient and 90 outpatient children with acute respiratory tract infection (ARTI). The frequency distribution of respiratory syncytial virus (RSV)-the main cause of severe cases of bronchiolitis and pneumonia in children-was studied in all collected samples. The mechanism through which CB2 affects clinical outcomes in case of RSV infection was studied in Balb/c mice model using AM630 as a CB2 antagonist. The potential therapeutic effect of CB2 activation during RSV infection was studied using a selective agonist, JWH133. The CB2 Q63R variation was associated with increased risk of hospitalization in children with ARTI. Children carrying the QQ genotype were more prone to developing severe ARTI (OR = 3.275, 95% CI: 1.221–8.705; p = 0.019). Of all the children enrolled in the study, 83 patients (46.1%) were found positive for RSV infection. The associated risk of developing severe ARTI following RSV infection increased more than two-fold in children carrying the Q allele (OR = 2.148, 95% CI: 1.092–4.224; p = 0.026). In mice, the blockade of CB2 by AM630 during RSV infection enhanced the influx of BAL cells and production of cytokines/chemokines while exaggerating lung pathology. CB2 activation by JWH133 reduces the influx of BAL cells and production of cytokines/chemokines while alleviating lung pathology. Collectively, CB2 is associated with RSV severity during infancy and may serve as a therapeutic target in RSV infection through the alleviation of virus-associated immunopathology.
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Affiliation(s)
- Alireza Tahamtan
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Yazdan Samieipoor
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Fatemeh Sadat Nayeri
- b Fetal and Neonatal Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Anahita Izadi
- c Bahrami Children Hospital , Tehran University of Medical Sciences , Tehran , Iran
| | - Ali Rashidi-Nezhad
- d Maternal, Fetal and Neonatal Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Mohammad Farahmand
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Louis Bont
- f University Medical Center Utrecht (UMCU), Wilhelmina Children's Hospital (WKZ) , Department of Pediatrics , Utrecht , The Netherlands
| | - Fazel Shokri
- g Department of Immunology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Talat Mokhatri-Azad
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
| | - Vahid Salimi
- a Department of Virology , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran
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14
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Huang Y, Hua J, Wang D, Chen L, Zhang J, Zhu H, Tian J, Zhang T, Zhao G. Risk factors of respiratory syncytial virus infection among pediatric influenza-like illness and severe acute respiratory infections in Suzhou, China. J Med Virol 2017; 90:397-404. [PMID: 28975651 DOI: 10.1002/jmv.24961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/12/2017] [Indexed: 01/06/2023]
Abstract
The characteristics and risk factors of respiratory syncytial virus (RSV) infection among children has not yet been fully understood. To address the characteristics of RSV-associated illness and risk factors of RSV infection among children under 5 years of age in Suzhou, China. From April 2011 to March 2014, we conducted a prospective surveillance among children in Suzhou, China. Nasal or throat swabs were collected from outpatients with influenza-like illness (ILI) and inpatients with severe acute respiratory infections (SARI). RSV was detected by reverse-transcriptase polymerase chain reaction and direct fluorescent antibody assay for children with ILI and SARI, respectively. Multivariable logistic-regression models were constructed to explore risk factors and symptoms of RSV infection. Of 3267 ILI and 1838 SARI children enrolled in the study, 192 (5.9%) and 287 (15.6%) tested positive for RSV, respectively. Among ILI patients, children with RSV infections visited clinics more often (P = 0.005) and had longer duration of fever (P = 0.032) than those without RSV infection. All RSV-positive children had an increased risk of having cough (OR = 2.9), rhinorrhea (OR = 1.6), breathing difficulty (OR = 3.4), wheezing (OR = 3.3), and irritability (OR = 2.7). Children aged <2 years, had history of prematurity (OR = 2.0) and recent respiratory infections (OR = 1.3) were more likely to get infected by RSV. Children with SARI had higher positive rate of RSV than those with ILI. Cough, rhinorrhea, and wheezing were the most common symptoms in RSV infection. Children aged <2 years, had history of prematurity and recent respiratory infections were the potential risk factors for RSV infection.
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Affiliation(s)
- Yukai Huang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jun Hua
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Dan Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Liling Chen
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Hong Zhu
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Jianmei Tian
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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15
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Adhikary AK. Genomic diversity of human adenovirus type 3 isolated in Fukui, Japan over a 24-year period. J Med Microbiol 2017; 66:1616-1622. [PMID: 29068283 DOI: 10.1099/jmm.0.000625] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Recently, human adenovirus type 3 (HAdV-3) has become the most isolated HAdV worldwide. Restriction endonuclease analysis of globally isolated strains of HAdV-3 has uncovered 51 genome types to date. Information on the genome type is important to the epidemiological study of HAdV-3. In this study, analysis of 75 isolates of HAdV- 3 collected over a 24-year period in Fukui revealed: (1) the emergence of three novel genome types (HAdV-3a52, HAdV-3a53 and HAdV-3a54) and two known genome types (HAdV-3a and HAdV-3a54); (2) the spectrum of diseases caused by individual genome types and their major involvement in the paediatric age population; and (3) the co-circulation and replacement of genome types as a usual phenomenon. The rising number of HAdV-3 genome types indicates that the genetic variation of HAdV-3 is more than other HAdVs. Considering the clinical importance of HAdV-3 infection, its genetic diversity underscores the need for its continuous surveillance and genetic characterization.
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Affiliation(s)
- Arun K Adhikary
- Infectious Disease Surveillance Centre, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.,Unit of Microbiology, Faculty of Medicine, AIMST University, Semeling, 08100 Bedong, Kedah Darul Aman, Malaysia
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16
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Nguyen VH, Dubot-Pérès A, Russell FM, Dance DAB, Vilivong K, Phommachan S, Syladeth C, Lai J, Lim R, Morpeth M, Mayxay M, Newton PN, Richet H, De Lamballerie X. Acute respiratory infections in hospitalized children in Vientiane, Lao PDR - the importance of Respiratory Syncytial Virus. Sci Rep 2017; 7:9318. [PMID: 28839157 PMCID: PMC5571090 DOI: 10.1038/s41598-017-09006-6] [Citation(s) in RCA: 14] [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: 03/22/2017] [Accepted: 07/14/2017] [Indexed: 01/12/2023] Open
Abstract
The Human respiratory syncytial virus (RSV) is one of the most important viral pathogens, causing epidemics of acute respiratory infection (ARI), especially bronchiolitis and pneumonia, in children worldwide. To investigate the RSV burden in Laos, we conducted a one-year study in children <5 years old admitted to Mahosot Hospital, Vientiane Capital, to describe clinical and epidemiological characteristics and predictive factors for severity of RSV-associated ARI. Pooled nasal and throat swabs were tested using multiplex real-time PCR for 33 respiratory pathogens (FTD® kit). A total of 383 patients were included, 277 (72.3%) of whom presented with pneumonia. 377 (98.4%) patients were positive for at least one microorganism, of which RSV was the most common virus (41.0%), with a peak observed between June and September, corresponding to the rainy season. Most RSV inpatients had pneumonia (84.1%), of whom 35% had severe pneumonia. Children <3-months old were a high-risk group for severe pneumonia, independently of RSV infection. Our study suggests that RSV infection is frequent in Laos and commonly associated with pneumonia in hospitalized young children. Further investigations are required to provide a better overall view of the Lao nationwide epidemiology and public health burden of RSV infection over time.
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Affiliation(s)
- Van Hoan Nguyen
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
- Department of Infectious Diseases, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Audrey Dubot-Pérès
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France.
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France.
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom.
| | - Fiona M Russell
- Dept. of Paediatrics, The University of Melbourne, Melbourne, Australia
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - David A B Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Keoudomphone Vilivong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Souphatsone Phommachan
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Chanthaphone Syladeth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
| | - Jana Lai
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Ruth Lim
- Pneumococcal Research Group, Murdoch Childrens Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Melinda Morpeth
- Dept. of Paediatrics, The University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR, Vientiane, Laos
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom
| | - Hervé Richet
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
| | - Xavier De Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD190 - Inserm 1207 - EHESP), Marseille, France
- Institut hospitalo-universitaire Méditerranée infection, APHM Public Hospitals of Marseille, Marseille, France
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17
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Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city. PLoS One 2017; 12:e0174488. [PMID: 28346512 PMCID: PMC5367831 DOI: 10.1371/journal.pone.0174488] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 03/09/2017] [Indexed: 02/01/2023] Open
Abstract
The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had significant involvement in coinfections with P values of 0.0001, 0.009 and 0.0001, 0.0001 and 0.001 respectively. Further investigations are required to better understand the clinical roles of the isolated pathogens and their seasonality.
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18
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Abstract
Pneumonia is of great global public health importance. Viral infections play both direct and indirect parts in its cause across the globe. Influenza is a leading cause of viral pneumonia in both children and adults, and respiratory syncytial virus is increasingly recognized as causing disease at both extremes of age. Vaccination offers the best prospect for prevention but current influenza vaccines do not provide universal and durable protection, and require yearly reformulation. In the future, it is hoped that influenza vaccines will give better and universal protection, and that new vaccines can be found for other causes of viral pneumonia.
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Affiliation(s)
- Clementine S Fraser
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Akhilesh Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Peter J M Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK.
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19
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Fall A, Dia N, Cisse EHAK, Kiori DE, Sarr FD, Sy S, Goudiaby D, Richard V, Niang MN. Epidemiology and Molecular Characterization of Human Respiratory Syncytial Virus in Senegal after Four Consecutive Years of Surveillance, 2012-2015. PLoS One 2016; 11:e0157163. [PMID: 27315120 PMCID: PMC4912143 DOI: 10.1371/journal.pone.0157163] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/25/2016] [Indexed: 12/11/2022] Open
Abstract
Background The burden of respiratory syncytial virus (RSV) infection remains poorly defined in Africa. To address this, we carried out a descriptive and retrospective pilot study, with a focus on the epidemiology of RSV in Senegal after 4 years of surveillance. Methodology and Results From January 2012 to October 2015 swabs were collected from consenting ILI outpatients. Viral detection was performed using RV16 kit enabling direct subtyping of RSV-A and B. For the molecular characterization of HRSV, the second hypervariable region of the Glycoprotein (G) gene was targeted for sequencing. We enrolled 5338 patients with 2803 children younger than five years of age (52.5%). 610 (11.4%) were positive for RSV infection: 276 (45.2%) were group A infections, 334 (54.8%) were group B infections and 21 (3.4%) were A/B co-infections. RSV detection rate is significantly higher (P < 0.0001) in children below 5 years. We noted that the annual distribution of RSV varied substantially by season and for the predominant subtype. Globally, results show a clear circulation pattern in the second half of each year; between June and September and possibly extended into November. The majority of RSV-A strains from Senegal clustered with strains that were previously assigned NA1 and novel ON1 genotype sequences. RSV-B sequences from Senegal clustered with the BA9 genotype. At the amino acid level, RSV-A strains from Senegal show proximity with the genotype ON1 characterized by a 72 nt insertion in G, resulting in 24 extra amino acids of which 23 are duplications of aa 261–283. Conclusion Globally our results show a clear circulation pattern of RSV in the second half of each year, between June and September and possibly extending into November, with children under 5 being more susceptible. Molecular studies identified the novel strains ON1 and BA9 as the major genotypes circulating in Senegal between 2012 and 2015.
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Affiliation(s)
- Amary Fall
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Ndongo Dia
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
- * E-mail: (MNN); (ND)
| | | | - Davy E. Kiori
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Fatoumata Diene Sarr
- Institut Pasteur de Dakar, Unité d’Epidémiologie des maladies infectieuses, Dakar, Sénégal
| | - Sara Sy
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Debora Goudiaby
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
| | - Vincent Richard
- Institut Pasteur de Dakar, Unité d’Epidémiologie des maladies infectieuses, Dakar, Sénégal
| | - Mbayame Ndiaye Niang
- Institut Pasteur de Dakar, Unité de Virologie Médicale, Dakar, Sénégal
- * E-mail: (MNN); (ND)
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