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Khaleque MA, Hossain SI, Ali MR, Aly Saad Aly M, Abuelmakarem HS, Al Mamun MS, Hossain Khan MZ. Bioreceptor modified electrochemical biosensors for the detection of life threating pathogenic bacteria: a review. RSC Adv 2024; 14:28487-28515. [PMID: 39247512 PMCID: PMC11378029 DOI: 10.1039/d4ra04038d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 08/23/2024] [Indexed: 09/10/2024] Open
Abstract
The lack of reliable and efficient techniques for early monitoring to stop long-term effects on human health is an increasing problem as the pathogenesis effect of infectious bacteria is growing continuously. Therefore, developing an effective early detection technique coupled with efficient and continuous monitoring of pathogenic bacteria is increasingly becoming a global public health prime target. Electrochemical biosensors are among the strategies that can be utilized for accomplishing that goal with promising potential. In recent years, identifying target biological analytes by interacting with bioreceptors modified electrodes is among the most commonly used detection techniques in electrochemical biosensing strategies. The commonly employed bioreceptors are nucleic acid molecules (DNA or RNA), proteins, antibodies, enzymes, organisms, tissues, and biomimetic components such as molecularly imprinted polymers. Despite the advancement in electrochemical biosensing, developing a reliable and effective biosensor for detecting pathogenic bacteria is still in the infancy stage with so much room for growth. A major milestone in addressing some of the issues and improving the detection pathway is the investigation of specific bacterial detection techniques. The present study covers the fundamental concepts of electrochemical biosensors, human PB illnesses, and the latest electrochemical biosensors based on bioreceptor elements that are designed to detect specific pathogenic bacteria. This study aims to assist researchers with the most up-to-date research work in the field of bio-electrochemical pathogenic bacteria detection and monitoring.
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Affiliation(s)
- Md Abdul Khaleque
- Dept. of Chemical Engineering, Jashore University of Science and Technology Jashore 7408 Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and Technology Jashore 7408 Bangladesh
| | - Syed Imdadul Hossain
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and Technology Jashore 7408 Bangladesh
- Centre for Sophisticated Instrumentation and Research Laboratory (CSIRL), Jashore University of Science and Technology Jashore 7408 Bangladesh
| | - Md Romzan Ali
- Dept. of Chemical Engineering, Jashore University of Science and Technology Jashore 7408 Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and Technology Jashore 7408 Bangladesh
| | - Mohamed Aly Saad Aly
- Department of Electrical and Computer Engineering at Georgia Tech Shenzhen Institute (GTSI) Shenzhen Guangdong 518055 China
| | - Hala S Abuelmakarem
- Systems and Biomedical Engineering Department, The Higher Institute of Engineering El Shorouk Egypt
| | - Muhammad Shamim Al Mamun
- Chemistry Discipline, School of Science, Engineering and Technology, Khulna University Khulna 9208 Bangladesh
| | - Md Zaved Hossain Khan
- Dept. of Chemical Engineering, Jashore University of Science and Technology Jashore 7408 Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and Technology Jashore 7408 Bangladesh
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Lane S, Hilliam Y, Bomberger JM. Microbial and Immune Regulation of the Gut-Lung Axis during Viral-Bacterial Coinfection. J Bacteriol 2023; 205:e0029522. [PMID: 36409130 PMCID: PMC9879096 DOI: 10.1128/jb.00295-22] [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] [Indexed: 11/23/2022] Open
Abstract
Viral-bacterial coinfections of the respiratory tract have long been associated with worsened disease outcomes. Clinical and basic research studies demonstrate that these infections are driven via complex interactions between the infecting pathogens, microbiome, and host immune response, although how these interactions contribute to disease progression is still not fully understood. Research over the last decade shows that the gut has a significant role in mediating respiratory outcomes, in a phenomenon known as the "gut-lung axis." Emerging literature demonstrates that acute respiratory viruses can modulate the gut-lung axis, suggesting that dysregulation of gut-lung cross talk may be a contributing factor during respiratory coinfection. This review will summarize the current literature regarding modulation of the gut-lung axis during acute respiratory infection, with a focus on the role of the microbiome, secondary infections, and the host immune response.
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Affiliation(s)
- Sidney Lane
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yasmin Hilliam
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jennifer M. Bomberger
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Bokoro TA, Gebresilassie HK, Zeru MA. Joint binary response modelling for childhood comorbidity in Ethiopia. PLoS One 2022; 17:e0268040. [PMID: 35584190 PMCID: PMC9116622 DOI: 10.1371/journal.pone.0268040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
Childhood diarrhea and Acute Respiratory Infection (ARI) are two diseases with similar risk factors in tropical developing regions. The objective of this study was to employ a joint binary response model and identify risk factors for childhood diarrhea and ARI in children under the age of five. A joint binary response model that takes into account the interdependence of the two diseases was used. Explanatory variables such as residence, vaccination, mother’s education, and antenatal care visits during pregnancy were found to be statistically significant risk factors for diarrhea in the joint model, whereas residence, the number of children ever born, vaccination, mother’s education, and wealth index were found to be statistically significant risk factors for childhood Acute Respiratory Infection. We discovered a common odds ratio value (4.30) greater than one, indicating a positive relationship between the two childhood diseases. As a result, using a joint model to assess the risk factors for diarrhea and acute respiratory infection (ARI) was reasonable. Furthermore, the standard errors of the parameter estimates in the joint response model were found to be smaller than the corresponding standard errors in the separate models. The risk factors such as residence, vaccination, and mother’s education all had a significant effect on the two correlated dichotomous response variables, diarrhea and ARI.
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Affiliation(s)
| | | | - Melkamu A. Zeru
- Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia
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Ghimire P, Gachhadar R, Piya N, Shrestha K, Shrestha K. Prevalence and factors associated with acute respiratory infection among under-five children in selected tertiary hospitals of Kathmandu Valley. PLoS One 2022; 17:e0265933. [PMID: 35390028 PMCID: PMC8989212 DOI: 10.1371/journal.pone.0265933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is responsible for about 30-50 percent of visits to health facilities and for about 20-30 percent of admissions to hospitals in Nepal for children under 5 years old. Incidence of ARI in children among under-five years of age is 344 per 1000 in Nepal. Hence, the study aims to find out the prevalence and factors associated with acute respiratory infection among under-five children. METHODS A cross-sectional study was conducted at Nepal Medical College and Teaching Hospital and International Friendship Children's Hospital (IFCH) in Kathmandu among children of age 2-59 months attending Pediatric OPD. A total of 286 children were selected using the non-probability (convenient) sampling technique. Data were collected using pre-tested semi-structured tool through interview schedule, and descriptive and inferential statistical analyses were used. RESULTS Out of 286 children, more than half of children (60.8%) had Acute Respiratory Infection (ARI). Nearly one-fifth of the children had severe or very severe pneumonia. Acute respiratory infection was significantly associated with religion followed by the family (p = 0.009, OR = 4.59 CI = 1.47-14.36), presence of the child in the kitchen while cooking (p = 0.001, OR = 2.03 CI = 1.17-3.51), and presence of respiratory tract infection in family (p = <0.001 OR = 2.83 CI = 1.59-5.05). CONCLUSION The study concluded that male children are more susceptible to acute respiratory infection than female children. Parents and family members should be aware of the prevention of acute respiratory infection by addressing and minimizing the factors contributing to ARI.
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Affiliation(s)
- Pratima Ghimire
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Rashmi Gachhadar
- Maharajgunj Nursing Campus, Institute of Medicine/Tribhuvan University, Kathmandu, Bagmati Province, Nepal
| | - Nebina Piya
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Kunja Shrestha
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Kalpana Shrestha
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
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Trivedi S, Grossmann AH, Jensen O, Cody MJ, Wahlig TA, Hayakawa Serpa P, Langelier C, Warren KJ, Yost CC, Leung DT. Intestinal Infection Is Associated With Impaired Lung Innate Immunity to Secondary Respiratory Infection. Open Forum Infect Dis 2021; 8:ofab237. [PMID: 34189172 PMCID: PMC8231398 DOI: 10.1093/ofid/ofab237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pneumonia and diarrhea are among the leading causes of death worldwide, and epidemiological studies have demonstrated that diarrhea is associated with an increased risk of subsequent pneumonia. Our aim was to determine the impact of intestinal infection on innate immune responses in the lung. Methods Using a mouse model of intestinal infection by Salmonella enterica serovar Typhimurium (S. Typhimurium [ST]), we investigated associations between gastrointestinal infections and lung innate immune responses to bacterial (Klebsiella pneumoniae) challenge. Results We found alterations in frequencies of innate immune cells in the lungs of intestinally infected mice compared with uninfected mice. On subsequent challenge with K. pneumoniae, we found that mice with prior intestinal infection have higher lung bacterial burden and inflammation, increased neutrophil margination, and neutrophil extracellular traps, but lower overall numbers of neutrophils, compared with mice without prior intestinal infection. Total numbers of dendritic cells, innate-like T cells, and natural killer cells were not different between mice with and without prior intestinal infection. Conclusions Together, these results suggest that intestinal infection impacts lung innate immune responses, most notably neutrophil characteristics, potentially resulting in increased susceptibility to secondary pneumonia.
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Affiliation(s)
- Shubhanshi Trivedi
- Division of Infectious Disease, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Allie H Grossmann
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.,Division of Anatomic Pathology, Department of Pathology, University of Utah, Salt Lake City, Utah, USA.,Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Owen Jensen
- Division of Infectious Disease, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Mark J Cody
- Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Taylor A Wahlig
- Division of Infectious Disease, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Paula Hayakawa Serpa
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Division of Infectious Diseases, Department of Medicine, University of California-San Francisco, San Francisco, California, USA
| | - Charles Langelier
- Chan Zuckerberg Biohub, San Francisco, California, USA.,Division of Infectious Diseases, Department of Medicine, University of California-San Francisco, San Francisco, California, USA
| | - Kristi J Warren
- Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Christian C Yost
- Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.,Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Daniel T Leung
- Division of Infectious Disease, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.,Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, Utah, USA
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Bham SQ, Saeed F, Khan MA, Khan RN. Assessment of episodes of pneumonia and diarrhea in vaccinated and unvaccinated children under 60 months of age. Pak J Med Sci 2020; 36:1596-1600. [PMID: 33235581 PMCID: PMC7674870 DOI: 10.12669/pjms.36.7.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To assess the episodes of pneumonia and diarrhea in vaccinated and unvaccinated children under 60 months of age. Methods: This descriptive cross-sectional study was carried out at Darul Sehat Hospital and SESSI, Karachi in the Department of Pediatrics from 1st November 2018 to 3rd February 2019. An interview based questionnaire was administered and selection of participants was done by convenience sampling. Total of 196 participants were selected for interview. Results: Total 196 participants were interviewed which included mothers of children between the age group of 1- 60 months. The questions were entered on the questionnaire after taking consent from the mothers. Among them, males were 98 (52.7%) and females were 88(47.3%). One hundred seventy two (88.7%) children were vaccinated for pneumococcal and rotavirus whereas unvaccinated children were 22(11.3%). There was an incidence of 66(63.5%) for loose watery diarrhea. In vaccinated children, grading of diarrhea was found to be severe cases as 30 (34.9%), moderate cases as 27 (31.4%) and mild cases as 29(33.7%). For unvaccinated children, severe cases were 12 (66.7%) and for mild and moderate cases were (11.1%) and 04(22.2%) respectively with p value of 0.035. As compared to their unvaccinated counterparts, the frequency of severe pneumonia was far less than cough and cold in vaccinated children (p<0.001). Conclusion: There is significant reduction in cases of severe pneumonia in children receiving pneumococcal vaccine as compared to children receiving Rota vaccine there is moderate reduction in cases of severe diarrhea. The overall coverage of Pneumococcal and Rota vaccines was higher in our sample population. Efforts should be made to increase the awareness of Rotavirus vaccination in order to have better coverage in future.
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Affiliation(s)
- Shireen Qassim Bham
- Dr. Shireen Qassim Bham, FCPS. Department of Pediatrics, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
| | - Farhan Saeed
- Dr. Farhan Saeed, FCPS. Department of Pediatrics, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
| | - Muhammad Athar Khan
- Dr. Muhammad Athar Khan, MCPS, DPH, MBA, PGD Statistics, DCPS-HCSM, DCPS-HPE, CCRP Department of Community Medicine, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
| | - Rashid Naseem Khan
- Dr. Rashid Naseem Khan, MCPS, MD. Department of Medicine, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
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Mulatya DM, Mutuku FW. Assessing Comorbidity of Diarrhea and Acute Respiratory Infections in Children Under 5 Years: Evidence From Kenya's Demographic Health Survey 2014. J Prim Care Community Health 2020; 11:2150132720925190. [PMID: 32450734 PMCID: PMC7252376 DOI: 10.1177/2150132720925190] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Kenya is one among the 15 countries that account for three-quarters of the global mortality burden due to diarrhea and respiratory tract infections (RTIs). Comorbidity of diarrhea and acute respiratory infection (ARI) can either be simultaneous (both occurring at the same time) or sequential (where the occurrence of one leads to the occurrence of the other. This study aimed to determine the shared risks that influence comorbidity of diarrhea and RTIs among Kenya's children younger than 5 years. Methods: The study entailed an analysis of secondary data from the Kenya Demographic Health Survey (DHS) 2014 using STATA Corp 2010. Descriptive analysis of independent variables and logistic regression model was used to analyze risk factors associated with comorbidity from diarrhea and ARI in children <5 years. Results: A total of 18 702 children <5 years were in the study out of whom 411 had comorbidity from diarrhea and ARI in the 2 weeks prior to the survey. Comorbidity peaked at 6 to 11 months (4.6%). Child's age between 6 and 11 months (adjusted odds ratio [aOR] = 3.48, 95% CI = 2.02-5.99) and caregivers with incomplete primary education (aOR = 1.66, 95% CI = 1.11-2.50) were associated with higher odds of comorbidity from diarrhea and ARI. The main determinants associated with lower odds of combined morbidity from diarrhea and ARI were high wealth quintile (aOR = 0.58, 95% CI = 0.39-0.85) and older aged caregivers (aOR = 0.47, 95% CI = 0.23-0.95). However, we found no association between nutritional status of a child, sex, residence, exclusive breastfeeding between 0 and 6 months, and combined morbidity from diarrhea and ARI. Conclusion: Programs aimed at reducing comorbidity should target children between 6 and 11 months and deliberate emphasis should be placed on addressing barriers to wealth and caregivers' education.
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Avanceña ALV, Tejano KPS, Hutton DW. Cost-effectiveness analysis of a physician deployment program to improve access to healthcare in rural and underserved areas in the Philippines. BMJ Open 2019; 9:e033455. [PMID: 31888937 PMCID: PMC6937106 DOI: 10.1136/bmjopen-2019-033455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/01/2019] [Accepted: 12/05/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES The objective of this study is to explore the cost-effectiveness of Doctor to the Barrios (DTTB), a physician deployment program in the Philippines. DESIGN Cost-effectiveness analysis using decision tree models with a lifetime time horizon and probabilistic sensitivity analysis. SETTING Societal and healthcare perspectives. POPULATION Hypothetical cohort of children under 5 years in two provinces (Aklan and Nueva Ecija) and in a representative rural municipality. PARTICIPANTS None. INTERVENTIONS DTTB's impact on paediatric pneumonia and diarrhoea outcomes compared with a scenario without DTTB. MAIN OUTCOME MEASURES Costs, effectiveness (in terms of lives saved and quality-adjusted life years (QALYs) gained) and incremental cost-effectiveness ratio (ICER). RESULTS DTTB is cost-effective in the two provinces that were included in the study from societal and healthcare perspectives. Looking at a representative rural municipality, base case analysis and probabilistic sensitivity analyses suggest that DTTB has an ICER of 27 192 per QALY gained from a societal perspective. From a healthcare perspective, the base case ICER of DTTB is Philippine pesos (PHP) 71 839 per QALY gained and PHP 2 064 167 per life saved, and 10 000 Monte Carlo simulations produced similar average estimates. The cost per QALY of DTTB from a healthcare perspective is lower than the WHO recommended willingness-to-pay threshold of 100% of the country's per-capita gross domestic product. CONCLUSIONS DTTB can be a cost-effective intervention, but its value varies by setting and the conditions of the municipality where it is implemented. By focusing on a narrow set of paediatric outcomes, this study has likely underestimated the health benefits of DTTB. Additional research is needed to understand the full extent of DTTB's impact on the health of communities in rural and remote areas. Future cost-effectiveness analysis should empirically estimate various parameters and include other health conditions in addition to pneumonia and diarrhoea in children.
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Affiliation(s)
- Anton L V Avanceña
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, United States
| | - Kim Patrick S Tejano
- Health Policy Development and Planning Bureau, Philippines Department of Health, Manila, Philippines
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, United States
- Department of Industrial and Operations Engineering, University of Michigan College of Engineering, Ann Arbor, MI, United States
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Newman KL, Gustafson K, Englund JA, Khatry SK, LeClerq SC, Tielsch JM, Katz J, Chu HY. Risk of Respiratory Infection following Diarrhea among Adult Women and Infants in Nepal. Am J Trop Med Hyg 2019; 102:28-30. [PMID: 31769386 PMCID: PMC6947774 DOI: 10.4269/ajtmh.19-0405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Globally, diarrheal and respiratory infections are responsible for more than 24% of deaths in children aged less than 5 years. Historically, these disease entities have been studied separately; recent evidence suggests that preceding diarrheal disease may be a risk factor for subsequent respiratory illness. We used data from a community-based, prospective randomized trial of maternal influenza immunization of 3,693 pregnant women and their 3,646 infants conducted in rural Nepal from 2011 to 2014. A case-crossover design was used to determine whether the risk of respiratory infection in the 30 days following a diarrheal episode was increased compared with that 30 days prior. Diarrheal illness was a significant risk factor for subsequent respiratory illness in infants but not in women during pregnancy or in women up to six months postpartum. Diarrheal illness and respiratory infections remain important global sources of morbidity and mortality, and our study supports a causal relationship between them in infants.
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Affiliation(s)
| | | | - Janet A Englund
- Seattle Children's Hospital, Seattle, Washington.,University of Washington, Seattle, Washington
| | - Subarna K Khatry
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Nepal Nutrition Intervention Project-Sarlahi (NNIPS), Sarlahi, Nepal
| | - Stephen C LeClerq
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Nepal Nutrition Intervention Project-Sarlahi (NNIPS), Sarlahi, Nepal
| | - James M Tielsch
- George Washington University Milken Institute School of Public Health, Washington, District of Columbia
| | - Joanne Katz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Helen Y Chu
- University of Washington, Seattle, Washington
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Muendo C, Laving A, Kumar R, Osano B, Egondi T, Njuguna P. Prevalence of rotavirus infection among children with acute diarrhoea after rotavirus vaccine introduction in Kenya, a hospital cross-sectional study. BMC Pediatr 2018; 18:323. [PMID: 30309343 PMCID: PMC6180366 DOI: 10.1186/s12887-018-1291-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rotavirus infection is the most common cause of acute gastroenteritis globally in children under 5 years of age and is responsible for approximately 5% of all child deaths yearly. Rotavirus vaccination is considered an effective public health strategy to prevent infection and reduce the severity of disease. Multi-centre country trials on rotavirus vaccines demonstrated efficacy rates of more than 85% in developed countries but only about 65% in developing nations. Rotavirus vaccination was introduced into the Kenya Expanded Programme on Immunization (KEPI) in 2014. The objective of our study was to determine the prevalence of rotavirus infection, severity of acute diarrhoea and to determine the rotavirus vaccination status among children aged 3-24 months presenting with acute diarrhoea at Kenyatta National Hospital after introduction of rotavirus vaccine in Kenya. METHODS A total of 365 children aged 3-24 months presenting with acute diarrhoea at KNH were recruited from August 2016 to April 2017. Data on rotavirus vaccination status, nutritional status, feeding practices and sociodemographic characteristics were obtained and a full clinical evaluation of the patients was done. Severity of the gastroenteritis was assessed using the 20 point Vesikari Clinical Severity Scoring System. The children who were admitted were followed up for 7 days using hospital ward registers. Comorbid conditions were established from patient's clinical records and physical examination. Stool specimens from study participants were tested for rotavirus using a commercially available enzyme linked immunosorbent immunoassay kit- ProSpecT Rotavirus Microplate Assay. RESULTS Majority of the children (96.7%) had received rotavirus vaccinations. The overall rotavirus prevalence was 14.5% and was higher among 17-24 months at 19.5%. The prevalence somewhat differed by gender, nutritional status, exclusive breastfeeding status, age and education level of mother/caregiver. Overall, a half of the children had severe acute diarrhoea and there were some differences in severity by child/mother characteristics. CONCLUSION There is still burden of rotavirus diarrhoea after introduction of rotavirus vaccine and the prevalence varies by child characteristics.
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Affiliation(s)
| | - Ahmed Laving
- Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 19676–00202, Nairobi, Kenya
| | - Rashmi Kumar
- Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 19676–00202, Nairobi, Kenya
| | - Boniface Osano
- Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 19676–00202, Nairobi, Kenya
| | - Thaddaeus Egondi
- Drugs for Neglected Diseases initiative, P.O. Box 21936–00505, Nairobi, Kenya
| | - Pamela Njuguna
- Public Health Specialist, Afya Resource Associates, P. O. Box 238–00202, Nairobi, Kenya
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Richard SA, McCormick BJJ, Seidman JC, Rasmussen Z, Kosek MN, Rogawski ET, Petri W, Bose A, Mduma E, Maciel BLL, Chandyo RK, Bhutta Z, Turab A, Bessong P, Mahfuz M, Caulfield LE, On Behalf Of The Mal-Ed Network Investigators. Relationships among Common Illness Symptoms and the Protective Effect of Breastfeeding in Early Childhood in MAL-ED: An Eight-Country Cohort Study. Am J Trop Med Hyg 2018; 98:904-912. [PMID: 29380724 PMCID: PMC5930868 DOI: 10.4269/ajtmh.17-0457] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident diarrhea after the first 6 months of life (relative risk [RR] 1.10, 95% confidence interval [CI] 1.04, 1.16) and with higher risk of incident ALRI in the 3- to 5-month period (RR 1.23, 95% CI 1.03, 1.47). Fever was a consistent risk factor for both diarrhea and ALRI. Exclusive breastfeeding 0-6 months was protective against diarrhea (0-2 months: RR 0.39, 95% CI 0.32, 0.49; 3-5 months: RR 0.83, 95% CI 0.75, 0.93) and ALRI (3-5 months: RR 0.81, 95% CI 0.68, 0.98). Children with recent illness who were exclusively breastfed were half as likely as those not exclusively breastfed to experience diarrhea in the first 3 months of life. Recent illness was associated with greater risk of new illness, causing illnesses to cluster within children, indicating that specific illness-prevention programs may have benefits for preventing other childhood illnesses. The results also underscore the importance of exclusive breastfeeding in the first 6 months of life for disease prevention.
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Affiliation(s)
- Stephanie A Richard
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | - Jessica C Seidman
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | - Zeba Rasmussen
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | | | | | | | - Ali Turab
- Aga Khan University, Karachi, Pakistan
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Abstract
Purpose of review This review focuses on recent data highlighting the interactions between intestinal pathogens, enteropathy and malnutrition in developing countries, which drive morbidity and mortality and hinder the long-term developmental potential of children. Recent findings Diarrhoea remains the second commonest cause of death in children below 5 years, and malnutrition underlies 45% of all child deaths. Even in the absence of diarrhoea, subclinical pathogen carriage and enteropathy are almost universal in developing countries. Here, we review recent studies addressing the causes and consequences of diarrhoea; emerging data on environmental influences that govern postnatal development of the gut and microbiota; current concepts of environmental enteric dysfunction; and recent intervention trials in the field. We highlight the interactions between these processes, whereby intestinal pathogens drive a cycle of gut damage, malabsorption, chronic inflammation and failed mucosal regeneration, leading to malnutrition and susceptibility to further enteric infections. Summary Efforts to improve child survival and long-term developmental potential need to address the overlapping and interacting effects of diarrhoea, enteropathy and malnutrition. Recent insights from human and animal studies suggest potential targets for intervention.
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Abstract
Pneumonia and diarrhea are the 2 leading infectious causes of death in children younger than 5 years worldwide, most of which occur in low- and middle-income countries (LMICs) in sub-Saharan Africa and Southern Asia. The past decade has seen large reductions in global childhood mortality, partly due to expansion of nonspecific public health interventions and vaccines against Streptococcus pneumoniae, Haemophilus influenzae, and rotavirus in LMICs. Further progress in this field depends on the international community's commitment to fund and implement programs using currently available vaccines and development of new vaccines against pathogens common to children in LMICs.
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Affiliation(s)
- Daniel T. Leung
- Division of Infectious Diseases, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT
,Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - Mohammod J. Chisti
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh
,ICU and Respiratory Wards, Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh
| | - Andrew T. Pavia
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
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