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Sarton R, Carbonnier M, Robin S, Ramful D, Sampériz S, Gauthier P, Bintner M, Boumahni B, Gérardin P. Perinatal Mother-to-Child Chikungunya Virus Infection: Screening of Cognitive and Learning Difficulties in a Follow-Up Study of the Chimere Cohort on Reunion Island. Viruses 2025; 17:704. [PMID: 40431715 PMCID: PMC12116154 DOI: 10.3390/v17050704] [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: 11/15/2024] [Revised: 04/17/2025] [Accepted: 04/30/2025] [Indexed: 05/29/2025] Open
Abstract
In this cohort study, we evaluated the cognitive and learning difficulties of school-age children perinatally infected with Chikungunya virus (CHIKV) on Reunion Island using the Evaluation of Cognitive Functions and Learning in Children (EDA) battery screening test compared to the healthy children cohort used for EDA development. Of the 19 infected children, 11 (57.9%) exhibited subnormal or abnormal scores, of whom 3 were classified as high risk, and 8 were classified as at risk for cognitive and learning difficulties. Children who had encephalopathy were at higher risk for displaying at least one difficulty than non-encephalopathic children (relative risk 2.13; 95% CI 1.05-4.33). The difficulties observed affected verbal functions, non-verbal functions, and learning abilities, such as phonology, lexical evocation and comprehension, graphism, selective visual attention, planning, visual-spatial reasoning, dictation and mathematics, as well as core executive functions, such as inhibitory control, shifting, and working memory. Neurocognitive dysfunctions could be linked to severe brain damage, as evidenced by severe white matter reduction mainly in the frontal lobes and corpus callosum and potentially in all functional networks involved in difficulties. These results should motivate further investigation of intellectual and adaptive functioning to diagnose intellectual deficiency and severe maladaptive behaviour in children perinatally infected with Chikungunya virus.
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Affiliation(s)
- Raphaëlle Sarton
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) de La Réunion, 97410 Saint Pierre, Reunion, France
| | - Magali Carbonnier
- Centre d’Action Médico-Sociale Précoce Isautier, Fondation Père Favron, 97450 Saint Louis, Reunion, France;
| | - Stéphanie Robin
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) de La Réunion, 97400 Saint Denis, Reunion, France;
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Centre Hospitalier Universitaire (CHU) de La Réunion, 97400 Saint Denis, Reunion, France
| | - Duksha Ramful
- Neonatal Intensive Care Unit, Centre Hospitalier Universitaire (CHU) de La Réunion, 97400 Saint Denis, Reunion, France; (D.R.); (S.S.)
| | - Sylvain Sampériz
- Neonatal Intensive Care Unit, Centre Hospitalier Universitaire (CHU) de La Réunion, 97400 Saint Denis, Reunion, France; (D.R.); (S.S.)
| | - Pascale Gauthier
- Neuroradiology Department, Centre Hospitalier Universitaire (CHU) de La Réunion, 97410 Saint Pierre, Reunion, France; (P.G.); (M.B.)
| | - Marc Bintner
- Neuroradiology Department, Centre Hospitalier Universitaire (CHU) de La Réunion, 97410 Saint Pierre, Reunion, France; (P.G.); (M.B.)
| | - Brahim Boumahni
- Neonatalogy Unit, Centre Hospitalier Universitaire (CHU) de La Réunion, 97410 Saint Pierre, Reunion, France;
| | - Patrick Gérardin
- Centre for Clinical Investigation Clinical Epidemiology (INSERM CIC 1410), Centre Hospitalier Universitaire (CHU) de La Réunion, 97410 Saint Pierre, Reunion, France
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Nielsen-Saines K, Kalbasi-Romero T, Duarte ACM, Almeida da Silva S, Adachi K, Damasceno L, Kerin T, Fuller T, Deville JG, Moreira ME, Vasconcelos Z, Zin A, Shin-Sim M, Barbosa de Lima SM, Brasil P. Development of Maternal Antibodies Post ZIKV in Pregnancy is Associated with Lower Risk of Microcephaly and Structural Brain Abnormalities in Exposed Infants. J Infect Dis 2025:jiaf146. [PMID: 40257773 DOI: 10.1093/infdis/jiaf146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Indexed: 04/22/2025] Open
Abstract
BACKGROUND We investigated the association between maternal neutralizing antibodies (nAb) to Zika virus (ZIKV) in pregnancy and neonatal outcomes. METHODS In pregnant participants with confirmed ZIKV infection, we determined trimester of infection, collected sera longitudinally, and measured nAbs via plaque reduction. In neonates, adverse outcomes included microcephaly (MC), structural brain abnormalities (SBA), hearing, and eye abnormalities. Associations between trimester of infection, nAbs, and neonatal outcomes were analyzed with Cox regression. RESULTS In total, 137 ZIKV-positive pregnant participants had neutralization assays performed during pregnancy and postdelivery. Infection rates were 29% in the first, 50% in the second, and 21% in the third trimester. Mean ZIKV nAb titer >2 weeks postinfection was 64 258 (SD 213 288). Ten percent of 90% plaque reduction neutralization assays (PRNT90) titers were <500, 10% 500-1000, 73% > 1000, and 7% did not have serologic follow-up; 15%. of infants had adverse findings. Protective factors against MC in 88 mothers with nAb titers available during pregnancy included infection later in gestation (adjusted hazard ratio [aHR], 0.06; P = .036) and adequate nAb titers (aHR, 0.17; P = .014). No SBA was associated with later infection in pregnancy (aHR, 0.16; P = .017) and adequate nAb titers (aHR, 0.34; P = .012). Adjusting for trimester, higher maternal nAb titers were associated with lower risk of MC and SBA. Seven of 137 participants (5.1%) had positive serum ZIKV polymerase chain reaction (PCR) results beyond 14 days (range, 35-269 days). Participants with ZIKV PCR positivity >60 days (n = 2) had infants with MC/SBA. CONCLUSIONS MC and SBA were less frequent in infants of mothers with higher ZIKV nAb titers during pregnancy.
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Affiliation(s)
- Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Tahmineh Kalbasi-Romero
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, California, USA
| | | | | | - Kristina Adachi
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Luana Damasceno
- Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Tara Kerin
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Trevon Fuller
- Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, California, USA
| | - Jaime G Deville
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Maria Elisabeth Moreira
- Fernandes Figueira National Institute of Women's, Children's, and Adolescents' Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Zilton Vasconcelos
- Fernandes Figueira National Institute of Women's, Children's, and Adolescents' Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Andrea Zin
- Fernandes Figueira National Institute of Women's, Children's, and Adolescents' Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Myung Shin-Sim
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, California, USA
| | | | - Patricia Brasil
- Acute Febrile Illness Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Pinho de Almeida Di Maio Ferreira FC, Nielsen-Saines K, Lopes Moreira ME, Dessimoni Salgado A, Pereira Costa R, de Campos SB, Zhang D, Hüning B, Einspieler C, Marschik PB, Fuller T, Brasil P. Neurodevelopmental Follow-Up in Children with Intrauterine and Perinatal Exposure to Chikungunya Virus. J Pediatr 2025; 279:114477. [PMID: 39864503 PMCID: PMC12071021 DOI: 10.1016/j.jpeds.2025.114477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 01/10/2025] [Accepted: 01/17/2025] [Indexed: 01/28/2025]
Abstract
OBJECTIVE To investigate the effects of intrauterine and perinatal exposure to chikungunya virus (CHIKV) on neurodevelopment in infants and toddlers. STUDY DESIGN We conducted a cohort study comparing children with intrauterine or perinatal exposure to maternal CHIKV infection with unexposed controls in Rio de Janeiro, Brazil. Neurodevelopment was assessed with General Movement Assessments in the first 6 months of life, and the Bayley-III Scales of Infant and Toddler Development and Modified Checklist for Autism in Toddlers for older children. Developmental delay (DD) was defined as a Bayley score less than 70 and risk of DD as a score less than 85. RESULTS Among 60 children exposed to intrauterine or perinatal CHIKV, 20 (33%) had laboratory confirmation of CHIKV infection by reverse transcription polymerase chain reaction or immunoglobulin M serology and 40 did not; 44 exposed children (15 infected and 29 uninfected) had General Movement Assessment performed, with 19% having suboptimal or abnormal results. At 11-42 months of age, 35 exposed children and 78 unexposed controls had Bayley-III assessments. Compared with controls, exposed children had higher rates of DD (7 [20%] vs 2 [3%], P = .004) driven by the language domain, and greater risk of DD driven by motor and cognitive domains scores (10 [29%] vs 10 [13%], P = .03 and 8 [23%] vs 5 [6%], P = .02, respectively). Eight of 35 (23%), CHIKV exposed children screened positive for autism spectrum disorder. CHIKV-exposed uninfected children had 2 (9.5%) cases of DD and 5 (23.8%) cases of autism spectrum disorder. CONCLUSIONS Abnormal neurodevelopmental results were seen in both infected and uninfected children with intrauterine or perinatal CHIKV exposure. Infant neurodevelopment monitoring should be considered following exposure to maternal CHIKV infection in pregnancy to facilitate early interventions and to mitigate neurodevelopmental sequelae.
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Affiliation(s)
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Maria Elisabeth Lopes Moreira
- Department of Clinical Research, Fernandes Figueira National Institute of Children's, Adolescents', and Women's Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Aline Dessimoni Salgado
- Department of Neonatal Intensive Care, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roozemeria Pereira Costa
- Department of Acute Febrile Illnesses, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Simone B de Campos
- Department of Physiotherapy and Occupational Therapy, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dajie Zhang
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany; Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, German Center for Child and Adolescent Health (DZKJ) and Leibniz Science Campus Primate Cognition, Göttingen, Germany; interdisciplinary Developmental Neuroscience (iDN), Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Britta Hüning
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, German Center for Child and Adolescent Health (DZKJ) and Leibniz Science Campus Primate Cognition, Göttingen, Germany
| | - Christa Einspieler
- interdisciplinary Developmental Neuroscience (iDN), Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany; Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, German Center for Child and Adolescent Health (DZKJ) and Leibniz Science Campus Primate Cognition, Göttingen, Germany; interdisciplinary Developmental Neuroscience (iDN), Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Trevon Fuller
- Institute of the Environment and Sustainability, University of California, Los Angeles, Los Angeles, CA
| | - Patricia Brasil
- Department of Acute Febrile Illnesses, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Ferreira FCPADM, de Filippis AMB, Moreira MEL, de Campos SB, Fuller T, Lopes FCR, Brasil P. Perinatal and Neonatal Chikungunya Virus Transmission: A Case Series. J Pediatric Infect Dis Soc 2024; 13:576-584. [PMID: 39360854 PMCID: PMC11599154 DOI: 10.1093/jpids/piae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 10/02/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND Large-scale epidemics in countries with high birth rates can create a concerning scenario where pregnant people are more likely to transmit the virus. In addition, increased international mobility has made arboviruses a growing problem for travelers. The increased risk of vertical transmission has been related to maternal viremia near delivery. Such transmission leads to severe infection of newborns and may be associated with subsequent neurological impairment including cerebral palsy. This case series provides an overview of clinical and laboratory findings in pregnant individuals with confirmed chikungunya virus (CHIKV) infection as well as the clinical effects on their newborn emphasizing the severity of neonatal chikungunya. METHODS An ambispective case series enrolled newborns with confirmed exposure to CHIKV in utero or in the neonatal period. RESULTS During the delivery period, the transmission rate among viremic individuals was approximately 62% (18/29). Fever, irritability, rash, and poor feeding in the first week of life were critical signs of neonatal chikungunya, highlighting its severity. CONCLUSION Close monitoring of healthy newborns during the first week of life is essential in areas affected by CHIKV epidemics, and in offspring of pregnant travelers who visited the outbreaks zones. This case series is intended to increase neonatologists' awareness of the possibility of mother-to-child transmission of CHIKV among newborns with a sepsis-like presentation. Prioritizing CHIKV vaccination for women of childbearing age should also be considered.
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Affiliation(s)
- Fátima C P A Di Maio Ferreira
- Follow-up Clinic, Neonatal Intensive Care Unit, Hospital Universtário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Department of Pediatrics and Neonatology (UNIRIO), Rio de Janeiro, Brazil
| | - Ana M Bispo de Filippis
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Maria Elisabeth L Moreira
- Pesquisa Clínica Aplicada, Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Simone B de Campos
- Follow-up Clinic, Physiotherapy and Occupational Therapy Clinic, Hospital Universtário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO, Physiotherapy Departament), Rio de Janeiro, Brazil
| | - Trevon Fuller
- UCLA Institute for the Enviroment and Sustainability, Los Angeles, CA, USA
| | - Fernanda C R Lopes
- Departament of Radiology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
| | - Patrícia Brasil
- Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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Flandes X, Hansen CA, Palani S, Abbas K, Bennett C, Caro WP, Hutubessy R, Khazhidinov K, Lambach P, Maure C, Marshall C, Rojas DP, Rosewell A, Sahastrabuddhe S, Tufet M, Wilder-Smith A, Beasley DWC, Bourne N, Barrett ADT. Vaccine value profile for Chikungunya. Vaccine 2024; 42:S9-S24. [PMID: 38407992 PMCID: PMC11554007 DOI: 10.1016/j.vaccine.2023.07.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 02/28/2024]
Abstract
Chikungunya virus (CHIKV) a mosquito-borne alphavirus is the causative agent of Chikungunya (CHIK), a disease with low mortality but high acute and chronic morbidity resulting in a high overall burden of disease. After the acute disease phase, chronic disease including persistent arthralgia is very common, and can cause fatigue and pain that is severe enough to limit normal activities. On average, around 40% of people infected with CHIKV will develop chronic arthritis, which may last for months or years. Recommendations for protection from CHIKV focus on infection control through preventing mosquito proliferation. There is currently no licensed antiviral drug or vaccine against CHIKV. Therefore, one of the most important public health impacts of vaccination would be to decrease burden of disease and economic losses in areas impacted by the virus, and prevent or reduce chronic morbidity associated with CHIK. This benefit would particularly be seen in Low and Middle Income Countries (LMIC) and socio-economically deprived areas, as they are more likely to have more infections and more severe outcomes. This 'Vaccine Value Profile' (VVP) for CHIK is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of vaccines in the development pipeline and vaccine-like products.This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships, and multi-lateral organizations. All contributors have extensive expertise on various elements of the CHIK VVP and collectively aimed to identify current research and knowledge gaps.The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Ximena Flandes
- Department of Preventative Medicine and Population Health and University of Texas Medical Branch, Galveston, TX, United States
| | - Clairissa A Hansen
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
| | - Sunil Palani
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
| | - Kaja Abbas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | | | | | | | | | - Clara Maure
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | - Marta Tufet
- Gavi the Vaccine Alliance, Geneva, Switzerland
| | | | - David W C Beasley
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States; Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, United States.
| | - Nigel Bourne
- Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, United States; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, United States.
| | - Alan D T Barrett
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, United States.
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Ramphal Y, Tegally H, San JE, Reichmuth ML, Hofstra M, Wilkinson E, Baxter C, CLIMADE Consortium, de Oliveira T, Moir M. Understanding the Transmission Dynamics of the Chikungunya Virus in Africa. Pathogens 2024; 13:605. [PMID: 39057831 PMCID: PMC11279734 DOI: 10.3390/pathogens13070605] [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: 06/15/2024] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
The Chikungunya virus (CHIKV) poses a significant global public health concern, especially in Africa. Since its first isolation in Tanzania in 1953, CHIKV has caused recurrent outbreaks, challenging healthcare systems in low-resource settings. Recent outbreaks in Africa highlight the dynamic nature of CHIKV transmission and the challenges of underreporting and underdiagnosis. Here, we review the literature and analyse publicly available cases, outbreaks, and genomic data, providing insights into the epidemiology, genetic diversity, and transmission dynamics of CHIKV in Africa. Our analyses reveal the circulation of geographically distinct CHIKV genotypes, with certain regions experiencing a disproportionate burden of disease. Phylogenetic analysis of sporadic outbreaks in West Africa suggests repeated emergence of the virus through enzootic spillover, which is markedly different from inferred transmission dynamics in East Africa, where the virus is often introduced from Asian outbreaks, including the recent reintroduction of the Indian Ocean lineage from the Indian subcontinent to East Africa. Furthermore, there is limited evidence of viral movement between these two regions. Understanding the history and transmission dynamics of outbreaks is crucial for effective public health planning. Despite advances in surveillance and research, diagnostic and surveillance challenges persist. This review and secondary analysis highlight the importance of ongoing surveillance, research, and collaboration to mitigate the burden of CHIKV in Africa and improve public health outcomes.
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Affiliation(s)
- Yajna Ramphal
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Houriiyah Tegally
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | | | | | - Marije Hofstra
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Eduan Wilkinson
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | - Cheryl Baxter
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
| | | | - Tulio de Oliveira
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, Durban 4001, South Africa
| | - Monika Moir
- Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa; (Y.R.); (H.T.); (M.H.); (E.W.); (C.B.)
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Ngwe Tun MM, Luvai EAC, Toizumi M, Moriuchi M, Takamatsu Y, Inoue S, Urano T, Bui MX, Thai Hung D, Thi Nguyen HA, Anh DD, Yoshida LM, Moriuchi H, Morita K. Possible vertical transmission of Chikungunya virus infection detected in the cord blood samples from a birth cohort in Vietnam. J Infect Public Health 2024; 17:1050-1056. [PMID: 38688178 DOI: 10.1016/j.jiph.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) is an alphavirus (genus Alphavirus, family Togaviridae) that is primarily transmitted to humans by Aedes mosquitoes, and can be transmitted from mother to child. Little is known about CHIKV transmission in Vietnam, where dengue is endemic and Aedes mosquitoes are abundant. This study aimed to determine the prevalence and characteristics of vertical CHIKV infection in a birth cohort, and seroprevalence of anti-CHIKV antibodies with or without confirmation by neutralization tests among women bearing children in Vietnam. METHODS We collected umbilical cord blood plasma samples from each newly delivered baby in Nha Trang, Central Vietnam, between July 2017 and September 2018. Samples were subjected to molecular assay (quantitative real-time RT-PCR) and serological tests (anti-CHIKV IgM capture and IgG indirect enzyme-linked immunosorbent assay, and neutralization tests). RESULTS Of the 2012 tested cord blood samples from newly delivered babies, the CHIKV viral genome was detected in 6 (0.3%) samples by RT-PCR, whereas, 15 samples (0.7%) were anti-CHIKV-IgM positive. Overall, 18 (0.9%, 95% CI: 0.6-1.5) samples, including three positives for both CHIKV IgM and viral genome on RT-PCR, were regarded as vertical transmission of CHIKV infection. Of the 2012 cord blood samples, 10 (0.5%, 95% CI: 0.2-0.9) were positive for both anti-CHIKV IgM and IgG. Twenty-nine (1.4%, 95% CI: 1.0-2.1) were seropositive for anti-CHIKV IgG while 26 (1.3%, 95% CI: 0.8-1.9) of them were also positive for neutralizing antibodies, and regarded as seropositive with neutralization against CHIKV infection. CONCLUSION This is the first report of a possible CHIKV maternal-neonatal infection in a birth cohort in Vietnam. The findings indicate that follow-up and a differential diagnosis of CHIKV infection in pregnant women are needed to clarify the potential for CHIKV vertical transmission and its impact in the newborn.
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Affiliation(s)
- Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan.
| | - Elizabeth Ajema Chebichi Luvai
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Biomedical Sciences and Technology, Technical University of Kenya, Nairobi, Kenya
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Masako Moriuchi
- Department of Pediatrics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuki Takamatsu
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shingo Inoue
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Takeshi Urano
- Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan
| | - Minh Xuan Bui
- Khanh Hoa Provincial Public Health Service, Nha Trang, Viet Nam
| | - Do Thai Hung
- Pasteur Institute in Nha Trang, Nha Trang, Viet Nam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan
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8
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Gonzales Y Tucker RD, Addepalli A. Fever and Rash. Emerg Med Clin North Am 2024; 42:303-334. [PMID: 38641393 DOI: 10.1016/j.emc.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses. A provisional diagnosis and immediate treatment with antimicrobials and supportive care are usually required prior to the return of confirmatory laboratory testing.
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Affiliation(s)
- Richard Diego Gonzales Y Tucker
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Emergency Medicine, Alameda Health System - Wilma Chan Highland Hospital, 1411 E 31st Street, Oakland, CA 94602, USA.
| | - Aravind Addepalli
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA
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9
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Faria BS, da Silva LB, Avelar CFR, de Morais PAS, Bentes AA. Vertical transmission of chikungunya virus: a worldwide concern. Braz J Infect Dis 2024; 28:103747. [PMID: 38723664 PMCID: PMC11169065 DOI: 10.1016/j.bjid.2024.103747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 06/03/2024] Open
Abstract
The Chikungunya Virus (CHIKV) already has endemic circulation in about 100 countries and the number of infected patients increases every year, due to the effectiveness of the vector and human universal susceptibility to infection. The virus can also be transmitted from mother to child, more frequently intrapartum. About 50 % of neonates with CHIKV symptoms will have neurodevelopmental delay. It is therefore an infection of worldwide concern with a great impact on people's quality of life. The objective of this work is to describe two cases of confirmed vertical transmission by chikungunya virus, one of them with intrauterine infection and death of the neonate. Neonates with vertical chikungunya infection may present with clinical sepsis in the first few days of life, which is why this is a very important diagnosis, especially during outbreaks of the infection.
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Affiliation(s)
| | - Lívia Barbosa da Silva
- Hospital Maternidade Sofia Feldman, Minas Gerais, MG, Brazil; Hospital Infantil João Paulo II, FHEMIG, Minas Gerais, MG, Brazil.
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10
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Cruz-Holguín VJ, González-García LD, Velázquez-Cervantes MA, Arévalo-Romero H, De Jesús-González LA, Helguera-Repetto AC, León-Reyes G, Salazar MI, Cedillo-Barrón L, León-Juárez M. Collateral Damage in the Placenta during Viral Infection in Pregnancy: A Possible Mechanism for Vertical Transmission and an Adverse Pregnancy Outcome. Diseases 2024; 12:59. [PMID: 38534983 PMCID: PMC10969698 DOI: 10.3390/diseases12030059] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 11/11/2024] Open
Abstract
In mammals, the placenta is a connection between a mother and a new developing organism. This tissue has a protective function against some microorganisms, transports nutrients, and exchanges gases and excretory substances between the mother and the fetus. Placental tissue is mainly composed of chorionic villi functional units called trophoblasts (cytotrophoblasts, the syncytiotrophoblast, and extravillous trophoblasts). However, some viruses have developed mechanisms that help them invade the placenta, causing various conditions such as necrosis, poor perfusion, and membrane rupture which, in turn, can impact the development of the fetus and put the mother's health at risk. In this study, we collected the most relevant information about viral infection during pregnancy which can affect both the mother and the fetus, leading to an increase in the probability of vertical transmission. Knowing these mechanisms could be relevant for new research in the maternal-fetal context and may provide options for new therapeutic targets and biomarkers in fetal prognosis.
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Affiliation(s)
- Victor Javier Cruz-Holguín
- Laboratorio de Virologia Perinatal y Diseño Molecular de Antigenos y Biomarcadores, Departamento de Inmunobioquimica, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (V.J.C.-H.); (L.D.G.-G.); (M.A.V.-C.)
- Departamento de Biomedicina Molecular, Centro de Investigación y Estudios Avanzados del IPN (CINVESTAV), Mexico City 07360, Mexico;
| | - Luis Didier González-García
- Laboratorio de Virologia Perinatal y Diseño Molecular de Antigenos y Biomarcadores, Departamento de Inmunobioquimica, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (V.J.C.-H.); (L.D.G.-G.); (M.A.V.-C.)
- Departamento de Biomedicina Molecular, Centro de Investigación y Estudios Avanzados del IPN (CINVESTAV), Mexico City 07360, Mexico;
- Posgrado de Inmunología, Escuela Nacional de Ciencias Biologócas (ENCB), Instituto Politecnico Naciona, Mexico City 11350, Mexico;
| | - Manuel Adrián Velázquez-Cervantes
- Laboratorio de Virologia Perinatal y Diseño Molecular de Antigenos y Biomarcadores, Departamento de Inmunobioquimica, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (V.J.C.-H.); (L.D.G.-G.); (M.A.V.-C.)
| | - Haruki Arévalo-Romero
- Laboratorio de Inmunologia y Microbiologia Molecular, Division Academica Multidisciplinaria de Jalpa de Méndez, Jalpa de Mendez 86205, Mexico;
| | | | | | - Guadalupe León-Reyes
- Laboratorio de Nutrigenética y Nutrigenómica, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City 14610, Mexico;
| | - Ma. Isabel Salazar
- Posgrado de Inmunología, Escuela Nacional de Ciencias Biologócas (ENCB), Instituto Politecnico Naciona, Mexico City 11350, Mexico;
- Laboratorio Nacional de Vacunología y Virus Tropicales (LNVyVT), Escuela Nacional de Ciencias Biologócas (ENCB), Instituto Politecnico Naciona, Mexico City 11350, Mexico
| | - Leticia Cedillo-Barrón
- Departamento de Biomedicina Molecular, Centro de Investigación y Estudios Avanzados del IPN (CINVESTAV), Mexico City 07360, Mexico;
| | - Moisés León-Juárez
- Laboratorio de Virologia Perinatal y Diseño Molecular de Antigenos y Biomarcadores, Departamento de Inmunobioquimica, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (V.J.C.-H.); (L.D.G.-G.); (M.A.V.-C.)
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11
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Hcini N, Lambert V, Picone O, Carod JF, Carles G, Pomar L, Epelboin L, Nacher M. Arboviruses and pregnancy: are the threats visible or hidden? Trop Dis Travel Med Vaccines 2024; 10:4. [PMID: 38355934 PMCID: PMC10868105 DOI: 10.1186/s40794-023-00213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
Mosquito-borne arboviral diseases are a global concern and can have severe consequences on maternal, neonatal, and child health. Their impact on pregnancy tends to be neglected in developing countries. Despite hundreds of millions of infections, 90% pregnancies being exposed, scientific data on pregnant women is poor and sometimes non-existent. Recently and since the 2016 Zika virus outbreak, there has been a newfound interest in these diseases. Through various neuropathogenic, visceral, placental, and teratogenic mechanisms, these arbovirus infections can lead to fetal losses, obstetrical complications, and a wide range of congenital abnormalities, resulting in long-term neurological and sensory impairments. Climate change, growing urbanization, worldwide interconnectivity, and ease of mobility allow arboviruses to spread to other territories and impact populations that had never been in contact with these emerging agents before. Pregnant travelers are also at risk of infection with potential subsequent complications. Beyond that, these pathologies show the inequalities of access to care on a global scale in a context of demographic growth and increasing urbanization. It is essential to promote research, diagnostic tools, treatments, and vaccine development to address this emerging threat.Background The vulnerability of pregnant women and fetuses to emergent and re-emergent pathogens has been notably illustrated by the outbreaks of Zika virus. Our comprehension of the complete scope and consequences of these infections during pregnancy remains limited, particularly among those involved in perinatal healthcare, such as obstetricians and midwives. This review aims to provide the latest information and recommendations regarding the various risks, management, and prevention for pregnant women exposed to arboviral infections.
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Affiliation(s)
- Najeh Hcini
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.
- CIC Inserm 1424 and DFR Santé Université Guyane, Cayenne, French Guiana, France.
| | - Véronique Lambert
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Olivier Picone
- Department of Obstetrics and Gynecology, Hôpital Louis Mourier, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique : Hôpitaux de Paris, Université Paris Diderot, CEDEX, Colombes, France
| | - Jean-Francois Carod
- Department of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Gabriel Carles
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Department "Woman-Mother-Child", Lausanne University Hospital, Lausanne, Switzerland
| | - Loïc Epelboin
- Department of Infectious and Tropical Diseases, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
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12
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Mohapatra RK, Bhattacharjee P, Desai DN, Kandi V, Sarangi AK, Mishra S, Sah R, Ibrahim AAAL, Rabaan AA, Zahan KE. Global health concern on the rising dengue and chikungunya cases in the American regions: Countermeasures and preparedness. Health Sci Rep 2024; 7:e1831. [PMID: 38274135 PMCID: PMC10808844 DOI: 10.1002/hsr2.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND AND AIM Severe morbidity and mortality due to seasonal infectious diseases are common global public health issues. Vector-borne viral illnesses like dengue and chikungunya overload the healthcare systems leading to critical financial burden to manage them. There is no effective drug or vaccine currently available to control these two diseases. METHODS The review was formulated by incorporating relevant reports on chikungunya and dengue in the Americas regions through a comprehensive search of literature that were available on dedicated scientific publication portals such as PubMed, ScienceDirect, and Web of Science. RESULTS The strategies of public health administrations to control largely the mosquito vectors during tropical monsoon seem to be effective. Yet, it seems practically impossible to completely eliminate them. The mosquito vector disseminates the virus via transovarian route thereby internalising the virus through generations, a reason behind reappearing and recurring outbreaks. The numerous factors associated with industrialisation, urbanisation, population density, and easy transboundary movements appear to have contributed to the spread of vectors from an endemic region to elsewhere. CONCLUSION The article made a state-of-affair comprehensive analysis of the rising dengue and chikungunya cases in the tropics, particularly the tropical Americas, as a human health concern, the countermeasures undertaken and the overall preparedness. The viral transmission is a hard situation to tackle as the vector survives in diverse temperature and ecology, is resistant to insecticides, and the unavailability of drugs. Better vector-control measures and improved understanding of the reemerging arboviral infections could offer an extended reaction time to counter outbreaks, and minimise associated morbidity/mortality.
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Affiliation(s)
| | | | - Dhruv N. Desai
- Department of PathobiologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Venkataramana Kandi
- Department of MicrobiologyPrathima Institute of Medical SciencesKarimnagarTelanganaIndia
| | - Ashish K. Sarangi
- Department of ChemistryCenturion University of Technology and ManagementBalangirOdishaIndia
| | - Snehasish Mishra
- School of BiotechnologyKIIT Deemed UniversityBhubaneswarOdishaIndia
| | - Ranjit Sah
- Department of MicrobiologyTribhuvan University Teaching Hospital, Institute of MedicineKathmanduNepal
- Department of Clinical MicrobiologyDr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil VidyapeethPuneMaharashtraIndia
| | | | - Ali A. Rabaan
- Molecular Diagnostic LaboratoryJohns Hopkins Aramco HealthcareDhahranSaudi Arabia
- Department of Medicine, College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
- Department of Public Health and NutritionThe University of HaripurHaripurPakistan
| | - Kudrat E. Zahan
- Department of ChemistryRajshahi UniversityRajshahiBangladesh
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13
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Vinay K, Thind A, Mehta H, Bishnoi A. Mucocutaneous manifestations of chikungunya fever: an update. Int J Dermatol 2023; 62:1475-1484. [PMID: 37781980 DOI: 10.1111/ijd.16853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/16/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023]
Abstract
Chikungunya is a viral disease transmitted by female Aedes mosquitoes that has been increasingly reported in many parts of the world across the geographical borders. In addition to fever and joint pain, mucocutaneous manifestations of chikungunya have been reported in 40-75% of infected patients. Dermatological manifestations of chikungunya are often under-recognized and misdiagnosed as clinicians are not sensitized or educated regarding these. The early-onset cutaneous manifestations of chikungunya fever, occurring within 1 month of the fever, include maculopapular rashes, vesiculobullous eruptions, Steven-Johnson syndrome/toxic epidermal necrolysis-like eruptions, flagellate lesions, scrotal dermatitis, oro-genital ulcers, and exacerbation of preexisting dermatoses like psoriasis. Hyperpigmentation, lichenoid eruptions, diffuse hair fall, and exacerbation of acne usually occur as a late manifestation. Diagnosis of these mucocutaneous manifestations can be challenging as they often resemble other common dermatoses. This review article elaborates on various mucocutaneous manifestations of chikungunya fever, based on literature review and authors' clinical experience.
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Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anish Thind
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Hitaishi Mehta
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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14
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Recaioglu H, Kolk SM. Developing brain under renewed attack: viral infection during pregnancy. Front Neurosci 2023; 17:1119943. [PMID: 37700750 PMCID: PMC10493316 DOI: 10.3389/fnins.2023.1119943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/26/2023] [Indexed: 09/14/2023] Open
Abstract
Living in a globalized world, viral infections such as CHIKV, SARS-COV-2, and ZIKV have become inevitable to also infect the most vulnerable groups in our society. That poses a danger to these populations including pregnant women since the developing brain is sensitive to maternal stressors including viral infections. Upon maternal infection, the viruses can gain access to the fetus via the maternofetal barrier and even to the fetal brain during which factors such as viral receptor expression, time of infection, and the balance between antiviral immune responses and pro-viral mechanisms contribute to mother-to-fetus transmission and fetal infection. Both the direct pro-viral mechanisms and the resulting dysregulated immune response can cause multi-level impairment in the maternofetal and brain barriers and the developing brain itself leading to dysfunction or even loss of several cell populations. Thus, maternal viral infections can disturb brain development and even predispose to neurodevelopmental disorders. In this review, we discuss the potential contribution of maternal viral infections of three relevant relative recent players in the field: Zika, Chikungunya, and Severe Acute Respiratory Syndrome Coronavirus-2, to the impairment of brain development throughout the entire route.
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Affiliation(s)
| | - Sharon M. Kolk
- Faculty of Science, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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15
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Muhsen IN, Galeano S, Niederwieser D, Koh MBC, Ljungman P, Machado CM, Kharfan-Dabaja MA, de la Camara R, Kodera Y, Szer J, Rasheed W, Cesaro S, Hashmi SK, Seber A, Atsuta Y, Saleh MFM, Srivastava A, Styczynski J, Alrajhi A, Almaghrabi R, Abid MB, Chemaly RF, Gergis U, Brissot E, El Fakih R, Riches M, Mikulska M, Worel N, Weisdorf D, Greinix H, Cordonnier C, Aljurf M. Endemic or regionally limited bacterial and viral infections in haematopoietic stem-cell transplantation recipients: a Worldwide Network for Blood and Marrow Transplantation (WBMT) Review. THE LANCET HAEMATOLOGY 2023; 10:e284-e294. [PMID: 36990623 DOI: 10.1016/s2352-3026(23)00032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/04/2022] [Accepted: 01/18/2023] [Indexed: 03/29/2023]
Abstract
Literature discussing endemic and regionally limited infections in recipients of haematopoietic stem-cell transplantation (HSCT) outside western Europe and North America is scarce. This Worldwide Network for Blood and Marrow Transplantation (WBMT) article is part one of two papers aiming to provide guidance to transplantation centres around the globe regarding infection prevention and treatment, and considerations for transplantation based on current evidence and expert opinion. These recommendations were initially formulated by a core writing team from the WBMT and subsequently underwent multiple revisions by infectious disease experts and HSCT experts. In this paper, we summarise the data and provide recommendations on several endemic and regionally limited viral and bacterial infections, many of which are listed by WHO as neglected tropical diseases, including Dengue, Zika, yellow fever, chikungunya, rabies, brucellosis, melioidosis, and leptospirosis.
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16
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Ortu G, Grard G, Parenton F, Ruello M, Paty MC, Durand GA, Hassani Y, De Valk H, Noël H. Long lasting anti-IgG chikungunya seropositivity in the Mayotte population will not be enough to prevent future outbreaks: A seroprevalence study, 2019. PLoS One 2023; 18:e0285879. [PMID: 37200250 DOI: 10.1371/journal.pone.0285879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/04/2023] [Indexed: 05/20/2023] Open
Abstract
Chikungunya is an arboviral disease causing arthralgia which may develop into a debilitating chronic arthritis. In Mayotte, a French overseas department in the Indian Ocean, a chikungunya outbreak was reported in 2006, affecting a third of the population. We aimed at assessing the chikungunya seroprevalence in this population, after over a decade from that epidemic. A multi-stage cross sectional household-based study exploring socio-demographic factors, and knowledge and attitude towards mosquito-borne disease prevention was carried out in 2019. Blood samples from participants aged 15-69 years were taken for chikungunya IgG serological testing. We analyzed associations between chikungunya serological status and selected factors using Poisson regression models, and estimated weighted and adjusted prevalence ratios (w/a PR). The weighted seroprevalence of chikungunya was 34.75% (n = 2853). Seropositivity for IgG anti-chikungunya virus was found associated with living in Mamoudzou (w/a PR = 1.49, 95%CI: 1.21-1.83) and North (w/a PR = 1.41, 95%CI: 1.08-1.84) sectors, being born in the Comoros islands (w/a PR = 1.30, 95%CI: 1.03-1.61), being a student or unpaid trainee (w/a PR = 1.35, 95%CI: 1.01-1.81), living in precarious housing (w/a PR = 1.30, 95%CI: 1.02-1.67), accessing water streams for bathing (w/a PR = 1.72, 95%CI: 1.1-2.7) and knowing that malaria is a mosquito-borne disease (w/a PR = 1.42, 95%CI: 1.21-1.83). Seropositivity was found inversely associated with high education level (w/a PR = 0.50, 95%CI: 0.29-0.86) and living in households with access to running water and toilets (w/a PR = 0.64, 95%CI: 0.51-0.80) (n = 1438). Our results indicate a long-lasting immunity from chikungunya exposure. However, the current population seroprevalence is not enough to protect from future outbreaks. Individuals naïve to chikungunya and living in precarious socio-economic conditions are likely to be at high risk of infection in future outbreaks. To prevent and prepare for future chikungunya epidemics, it is essential to address socio-economic inequalities as a priority, and to strengthen chikungunya surveillance in Mayotte.
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Affiliation(s)
- Giuseppina Ortu
- Santé Publique France, Saint-Maurice, France
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Santé Publique France, Saint-Maurice, France
| | - Gilda Grard
- National Reference Center for Arboviruses, French Armed Forces Biomedical Research Institute (IRBA), Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Fanny Parenton
- Agence Régionale Santé Mayotte Centre Kinga- 90, Mamoudzou, Mayotte
| | - Marc Ruello
- Santé Publique France, Saint-Maurice, France
| | | | - Guillaume André Durand
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille, France
| | - Youssouf Hassani
- Agence Régionale Santé Mayotte Centre Kinga- 90, Mamoudzou, Mayotte
| | | | - Harold Noël
- Santé Publique France, Saint-Maurice, France
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17
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Bin S, Phou K, Im S. Congenital chikungunya in a neonate with early-onset sepsis and petechiae: An unusual case report. Clin Case Rep 2023; 11:e6896. [PMID: 36703765 PMCID: PMC9871401 DOI: 10.1002/ccr3.6896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/25/2023] Open
Abstract
Chikungunya, a mosquito-borne disease, is posing threat to neonatal population in Cambodia because of its challenging diagnosis and insufficient attention compared with Dengue. In what follows, we present a case of serologically-confirmed congenital chikungunya in a newborn presenting early-onset sepsis, and the mother was underdiagnosed with intrapartum flu-like infection.
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Affiliation(s)
- Sakviseth Bin
- Neonatal Intensive Care UnitCalmette HospitalPhnom PenhCambodia
| | - Kimyi Phou
- Neonatal Intensive Care UnitCalmette HospitalPhnom PenhCambodia
| | - Sethikar Im
- Neonatal Intensive Care UnitCalmette HospitalPhnom PenhCambodia
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18
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Zabel RR, Favaro RR, Groten T, Brownbill P, Jones S. Ex vivo perfusion of the human placenta to investigate pregnancy pathologies. Placenta 2022; 130:1-8. [DOI: 10.1016/j.placenta.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/26/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
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Mourad O, Makhani L, Chen LH. Chikungunya: An Emerging Public Health Concern. Curr Infect Dis Rep 2022; 24:217-228. [DOI: 10.1007/s11908-022-00789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Abstract
Abstract
Purpose of Review
The worldwide spread of chikungunya over the past two decades calls for greater knowledge and awareness of the virus, its route of transmission, methods of diagnosis, and the use of available treatment and prevention measures.
Recent Findings
Chikungunya virus infection, an Aedes mosquito-borne febrile disease, has spread from Africa and Asia to Europe and the Americas and from the tropics and subtropics to temperate regions. International travel is a pivotal influence in the emergence of chikungunya as a global public health threat, as evidenced by a growing number of published reports on travel-related chikungunya infections. The striking features of chikungunya are arthralgia and arthritis, and the disease is often mistaken for dengue. Although mortality is low, morbidity can be profound and persistent. Current treatment for chikungunya is supportive; chikungunya vaccines and therapeutics are in development. Travelers planning to visit areas where the mosquito vectors are present should be advised on preventive measures.
Summary
Chikungunya is an emerging disease in the Americas. Frequent travel, the presence of at least two competent mosquito species, and a largely naïve human population in the Western Hemisphere create a setting conducive to future outbreaks. Awareness of the disease and its manifestations is critical to effectively and safely manage and limit its impact. Vaccines in late-stage clinical trials offer a new pathway to prevention.
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20
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Ferreira FCPDADM, da Silva ASV, Recht J, Guaraldo L, Moreira MEL, de Siqueira AM, Gerardin P, Brasil P. Correction: Vertical transmission of chikungunya virus: A systematic review. PLoS One 2022; 17:e0272761. [PMID: 35921358 PMCID: PMC9348725 DOI: 10.1371/journal.pone.0272761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Susceptibility to endemic Aedes-borne viruses among pregnant women in Risaralda, Colombia. Int J Infect Dis 2022; 122:832-840. [PMID: 35817285 DOI: 10.1016/j.ijid.2022.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Aedes-borne viruses (ABV) affect humans on every inhabited continent and frequently cause epidemics. Recent epidemics of chikungunya and Zika viruses highlight that preparedness for future epidemics requires assessment of susceptibility, particularly among high-risk groups. We sought to determine immunity against the three major circulating ABV among pregnant women in an ABV-endemic area of Colombia. METHODS A cross-sectional seroprevalence study was performed, enrolling women presenting to Labor and Delivery. Cord blood and maternal peripheral blood was obtained. IgG seroprevalence to flaviviruses and chikungunya was determined by ELISA. An abbreviated neutralization test was used to estimate the frequency and magnitude of immunity to Zika and four dengue serotypes. Cluster analyses explored epidemiologic factors associated with seroprevalence. RESULTS Most women exhibited high levels of neutralizing antibodies to one or more ABV; however, nearly 20% were seronegative for flaviviruses. Our research took place after the epidemic peak of the ZIKV outbreak in Colombia in 2016, but only 20% of pregnant women had high levels of Zika-neutralizing antibodies consistent with likely protective immunity to ZIKV. CONCLUSIONS Hence, a high proportion pregnant women in Risaralda remain susceptible to one or more ABV including the teratogenic ZIKV, indicating risk for future epidemics in this region.
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22
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A Review on Chikungunya Virus Epidemiology, Pathogenesis and Current Vaccine Development. Viruses 2022; 14:v14050969. [PMID: 35632709 PMCID: PMC9147731 DOI: 10.3390/v14050969] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 12/20/2022] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that recently re-emerged in many parts of the world causing large-scale outbreaks. CHIKV infection presents as a febrile illness known as chikungunya fever (CHIKF). Infection is self-limited and characterized mainly by severe joint pain and myalgia that can last for weeks or months; however, severe disease presentation can also occur in a minor proportion of infections. Among the atypical CHIKV manifestations that have been described, severe arthralgia and neurological complications, such as encephalitis, meningitis, and Guillain–Barré Syndrome, are now reported in many outbreaks. Moreover, death cases were also reported, placing CHIKV as a relevant public health disease. Virus evolution, globalization, and climate change may have contributed to CHIKV spread. In addition to this, the lack of preventive vaccines and approved antiviral treatments is turning CHIKV into a major global health threat. In this review, we discuss the current knowledge about CHIKV pathogenesis, with a focus on atypical disease manifestations, such as persistent arthralgia and neurologic disease presentation. We also bring an up-to-date review of the current CHIKV vaccine development. Altogether, these topics highlight some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development and clinical trials of CHIKV potential vaccine candidates.
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Hakami AR, Alshamrani AA, Alqahtani M, Alraey Y, Alhefzi RA, Alasmari S, Makkawi M, Dobie G, Mir M, Alshahrani M, Dera A, Alfaifi M, Al Shahrani M, Matari A, Asiry AE. Detection of chikungunya virus in the Southern region, Saudi Arabia. Virol J 2021; 18:190. [PMID: 34544442 PMCID: PMC8454052 DOI: 10.1186/s12985-021-01660-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background and aim Despite the fact that the chikungunya viral infection is a neglected disease, complications such as hemorrhagic fever, arthritis, and lymphopenia remain a health concern. The aim of this study was to determine the prevalence of the chikungunya virus in the Southern Region, Saudi Arabia. Enzyme immunoassay and polymerase chain reaction have been compared between samples. Materials and methods Forty samples from two southern hospitals in Saudi Arabia were collected between December 2019 and February 2020 and screened for chikungunya virus IgG antibodies and for viral RNA. Selection criteria were based on hematological parameters and rheumatological profiles such as rheumatoid factor, c-reactive protein, anti-nuclear antibody, and anti-cyclic citrullinated peptide (anti-CCP) of out-patients. Results One confirmed case of chikungunya virus was detected using the ELISA test. However, no viral RNA was detected in any of the samples. This suggests that the virus is cleared rapidly in patients. Conclusion Chikungunya is a neglected viral disease in Saudi Arabia. Future work should focus on detailed investigation of this viral infection and its vectors.
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Affiliation(s)
- Abdulrahim R Hakami
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia.
| | - Abdullah A Alshamrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Mohamad Alqahtani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Yasser Alraey
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Razan A Alhefzi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Sultan Alasmari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Mohamed Makkawi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Gasim Dobie
- Department of Medical Laboratory Technology, Jazan University, Jazan, Saudi Arabia
| | - Mushtaq Mir
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Mohamed Alshahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Ayed Dera
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Mohammed Alfaifi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Mesfer Al Shahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61481, Saudi Arabia
| | - Ahmad Matari
- Department of Hematology and Blood Bank, Baish General Hospital, Jazan, Saudi Arabia
| | - Ali Essa Asiry
- Department of Serology, Asir Central Hospital, Abha, Saudi Arabia
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24
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Chan SM, Khoo KS, Sekaran SD, Sit NW. Mode-Dependent Antiviral Activity of Medicinal Plant Extracts against the Mosquito-Borne Chikungunya Virus. PLANTS 2021; 10:plants10081658. [PMID: 34451702 PMCID: PMC8400731 DOI: 10.3390/plants10081658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022]
Abstract
The lack of specific treatment for chikungunya fever makes the need for anti-chikungunya virus agents more crucial. This study was conducted to evaluate 132 extracts obtained by sequential solvent extraction from 21 medicinal plants for cytopathic effect inhibitory activity using virus-infected Vero cells in two different sample introduction modes. Among the extracts, 42 extracts (31.8%) from 12 plants in the concurrent mode and three extracts (2.3%) from a plant in the non-concurrent mode displayed strong cytopathic effect inhibitory activity (cell viability ≥70%). Viral load quantification analysis unveiled that the extracts of Clinacanthus nutans (chloroform, ethyl acetate, and ethanol), Hydrocotyle sibthorpioides (ethanol), and Ocimum americanum (ethanol and methanol) hindered the release of viral progeny from the infected cells while the extracts of Ficus deltoidea (ethanol), Gynura bicolor (water), H. sibthorpioides (water), and O. americanum (chloroform and ethyl acetate) blocked the entry of virus into the cells. The extracts of Diodella sarmentosa (ethyl acetate), Diplazium esculentum (chloroform, ethyl acetate, and ethanol), and G. bicolor (ethanol) possessed virucidal effect and caused 5.41-log to 6.63-log reductions of viral load compared to the virus control. The results indicate that these medicinal plants are potential sources of anti-chikungunya virus agents that have varied modes of action.
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Affiliation(s)
- Sze Mun Chan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia;
| | - Kong Soo Khoo
- Department of Chemical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia;
| | - Shamala Devi Sekaran
- Faculty of Medicine & Health Sciences, UCSI University, Bandar Springhill, Port Dickson 71010, Malaysia;
| | - Nam Weng Sit
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia;
- Correspondence: or
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