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Prasert K, Praphasiri P, Lerdsamran H, Nakphook S, Ditsungnoen D, Chawalchitiporn S, Sornwong K, Poopipatpol K, Wirachwong P, Narakorn P, Surichan S, Suthepakul N, Thangsupanimitchai N, Pittayawonganon C, Puthavathana P, Davis WW, Mott JA, Olsen SJ, Patumanond J. Safety and immunogenicity of locally produced trivalent inactivated influenza vaccine (Tri Fluvac) in healthy Thai adults aged 18-64 years in Nakhon Phanom: A Phase III double blinded, three-arm, randomized, controlled trial. Vaccine 2024; 42:24-32. [PMID: 38042698 PMCID: PMC10733862 DOI: 10.1016/j.vaccine.2023.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Domestic influenza vaccine production facilitates a sustainable supply for mitigating seasonal influenza and improves national health security by providing infrastructure and experience for pandemic vaccine production, if needed. METHODS A Phase III, double blind, randomized controlled trial was conducted from Sep 2019-Oct 2020 in healthy adults 18-64 years in Nakhon Phanom, Thailand. Randomization (3:3:1) compared study vaccine (Tri Fluvac), saline placebo, and an active comparator (licensed vaccine). Primary outcomes were superior efficacy compared to placebo based on RT-PCR-confirmed influenza virus infection within 12 months and non-inferiority compared to active comparator based on immunogenicity (HAI assay) at 28 days. Safety was also assessed. RESULTS The trial enrolled 4,284 participants (Tri Fluvac = 1,836; placebo = 1,836; active comparator = 612). There were 29 RT-PCR positive influenza infections (10 Tri Fluvac, 5.5/1,000 PY; 19 placebo, 10.4/1,000PY; 0 comparator) for an absolute protective efficacy of 46.4 (95 % CI = -22.0-76.5) compared with placebo, but the power was 43.7 %. Seroconversion difference rates between Tri Fluvac and comparator at Day 28 were 1.74 (95 % CI: -2.77, 6.25), 2.22 (-2.40, 6.84), and -0.57 (-5.41, 4.27) for A(H1N1), A(H3N2), and B strains, respectively. Adverse and severe adverse events occurred in 175 (9.5 %) Tri Fluvac, 177 (10.8 %) placebo, and 66 (10.8 %) comparator arms (p-value = 0.437, Tri Fluvac vs. comparator) CONCLUSIONS: Tri Fluvac was well tolerated, and immunogenicity was non-inferior to the active comparator, meeting U.S. Food and Drug Administration (FDA) criteria for adult vaccine licensure. Few acute respiratory infections were reported during intense COVID-19 pandemic restrictions, resulting in insufficient power to evaluate clinical efficacy.
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Affiliation(s)
- Kriengkrai Prasert
- Nakhon Phanom Provincial Hospital, Nakhon Phanom, Thailand; Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand
| | - Prabda Praphasiri
- Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand; Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
| | - Hatairat Lerdsamran
- Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Sutthichai Nakphook
- Faculty of Public Health, Kasetsart University, Chalermprakiat Sakon Nakhon Province Campus, Thailand; Institute of Preventive Medicine, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Darunee Ditsungnoen
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | | | | | | | | | | | - Nava Suthepakul
- Government Pharmaceutical Organization (GPO), Bangkok, Thailand
| | | | - Chakrarat Pittayawonganon
- Institute of Preventive Medicine, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Pilaipan Puthavathana
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - William W Davis
- Influenza Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua A Mott
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sonja J Olsen
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jayanton Patumanond
- Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Thailand
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Masyeni S, Fatawy RM, Paramasatiari AAAL, Maheraditya A, Dewi RK, Winianti NW, Santosa A, Setiabudy M, Sumadewi NT, Herawati S. Dengue seroprevalence study in Bali. PLoS One 2023; 18:e0271939. [PMID: 37450543 PMCID: PMC10348525 DOI: 10.1371/journal.pone.0271939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Dengue infection poses significant public health problems in tropical and subtropical regions worldwide. The clinical manifestations of dengue vary from asymptomatic to severe dengue manifestations. This serological survey highlighted the high incidence of asymptomatic cases. This study aimed to determine the prevalence of dengue in healthy and ill adults in Bali. METHODS Cross-sectional seroprevalence surveys were performed between July 2020 and June 2021 among healthy and ill adults in Denpasar Bali. Blood samples were collected from 539 randomly selected urban sites in Denpasar. Immunoglobulin G antibodies against the dengue virus were detected in serum using a commercial enzyme-linked immunosorbent assay kit. RESULTS Overall, the dengue seroprevalence rate among the 539 clinically healthy and ill adults was high (85.5%). The median age was 34.1 (18-86.1). Most of the participants in the study were younger than 40 years (61.2%). Men were the dominant sex (54.5%). The study found a significant association between dengue seropositivity among people aged > 40 years and healthy status (p = 0.005; odds ratio [OR] = 0.459 and p < 0.001; OR = 0.336, respectively). The study reported that as many as 60% of the subjects had a history of previously suspected dengue infection. This study reflected the proportion of asymptomatic dengue patients requiring better assessment with a serological test. CONCLUSION The current study highlighted that real cases of dengue infection may be higher than reported, with a high prevalence of dengue seropositivity and a relatively dominant proportion of asymptomatic cases. The study guides physicians to be aware of every dengue infection in tropical countries and prevent the spread of the disease.
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Affiliation(s)
- Sri Masyeni
- Faculty of Medicine and Health Science, Department of Internal Medicine, University of Warmadewa, Bali, Indonesia
| | - Rois Muqsith Fatawy
- Faculty of Medicine, Infectious Disease and Immunology Research Center, Indonesia Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia
| | | | - Ananda Maheraditya
- Faculty of Medicine and Health Science, University of Warmadewa, Bali, Indonesia
| | - Ratna Kartika Dewi
- Faculty of Medicine and Health Science, University of Warmadewa, Bali, Indonesia
| | - N. W. Winianti
- Faculty of Medicine and Health Science, University of Warmadewa, Bali, Indonesia
| | - Agus Santosa
- Faculty of Medicine and Health Science, University of Warmadewa, Bali, Indonesia
| | - Marta Setiabudy
- Faculty of Medicine and Health Science, University of Warmadewa, Bali, Indonesia
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Ferreira DA, Vida C, Mendonça É, Vieira P, Freitas S, Silva G. Effect of Protective Measures Adopted in the COVID-19 Pandemic on Hemodialysis Patients. Cureus 2023; 15:e35552. [PMID: 37007313 PMCID: PMC10060006 DOI: 10.7759/cureus.35552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
Introduction The use of masks and other preventive measures is nowadays an essential measure to prevent COVID-19 infections, particularly in hemodialysis patients. The aim of this study was to understand whether these protective measures adopted during the COVID-19 pandemic reduced or somehow contained the number of respiratory infections in a population of hemodialysis patients. Methods This was a longitudinal retrospective single-center study of hemodialysis patients with at least six months of follow-up in a central hospital. A total of 103 patients were evaluated for the study. Two groups were defined: a control group that was followed in the year before the beginning of the pandemic and a group that followed in the year after its beginning. Results Patients in the pandemic group had a higher prevalence of previous major cardiovascular events (48.9% vs 8.6%) and heart failure (31.3% vs 12.1%) than those in the control group. Vaccination rates for influenza and pneumococcus as well as the monthly analytical results were similar in both groups. There were no significant differences in lower respiratory infections, hospitalizations caused by lower respiratory infections, and mortality between both groups. However, not accounting for aspiration pneumonias, the pandemic group had half the mortality due to respiratory infections (2.2% vs 5.2%). Conclusion Despite patients in the pandemic group having a similar prevalence of respiratory infections and hospitalizations motivated by lower respiratory infections, they presented about half the mortality of the control group. This suggests that although there was no decrease in the number of infections, protective measures may have contributed to a decreased mortality.
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Khan S, Akbar SMF, Yahiro T, Mahtab MA, Kimitsuki K, Hashimoto T, Nishizono A. Dengue Infections during COVID-19 Period: Reflection of Reality or Elusive Data Due to Effect of Pandemic. Int J Environ Res Public Health 2022; 19:ijerph191710768. [PMID: 36078486 PMCID: PMC9518125 DOI: 10.3390/ijerph191710768] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 05/07/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) devastated the overall health management strategy of most countries. In this scenario, the present study provided insights into the possible impact of the COVID-19 pandemic on dengue infection. This ecological study retrieved data from WHO/Government reporting system from 22 major dengue epidemic countries. Incidence of dengue infections during the pre-COVID-19 time (2015~2019) and COVID-19 period (2020~2021) was compared. A correlation between the dengue and COVID-19 cases and predicted dengue incidence in 2022 was calculated using the linear regression equation. Data indicated that dengue incidences across the studied area decreased by 16% during the pandemic period (2.73 million vs. 2.29 million; p < 0.05) than the same reported in pre-COVID-19 time. Although countries in Latin America reported more cases than Asia, a positive correlation (r = 0.83) between dengue and COVID-19 cases was observed in Asia. Prediction analysis warned that specific preparation for dengue management is needed in some countries of both regions in 2022 to contain the upsurge in incidences. Due to the similar nature of symptoms of dengue and COVID-19, a state of confusion will be prevailing during the ongoing pandemic. Therefore, comprehensive and evidence-based scientific approaches were warranted at all levels.
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Affiliation(s)
- Sakirul Khan
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
- Correspondence: (S.K.); (A.N.); Tel.: +81-97-586-5712 (S.K. & A.N.); Fax: +81-97-586-5719 (S.K. & A.N.)
| | - Sheikh Mohammad Fazle Akbar
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Ehime, Japan
- Miyakawa Memorial Research Foundation, Tokyo 107-0062, Japan
| | - Takaaki Yahiro
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
- Research Center for Global and Local Infectious Diseases, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
| | - Mamun Al Mahtab
- Division of Interventional Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
| | - Kazunori Kimitsuki
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
| | - Takehiro Hashimoto
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
- Infection Control Center, Oita University Hospital, Yufu 879-5593, Oita, Japan
| | - Akira Nishizono
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
- Research Center for Global and Local Infectious Diseases, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan
- Correspondence: (S.K.); (A.N.); Tel.: +81-97-586-5712 (S.K. & A.N.); Fax: +81-97-586-5719 (S.K. & A.N.)
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Saita S, Maeakhian S, Silawan T. Temporal Variations and Spatial Clusters of Dengue in Thailand: Longitudinal Study before and during the Coronavirus Disease (COVID-19) Pandemic. Trop Med Infect Dis 2022; 7:tropicalmed7080171. [PMID: 36006263 PMCID: PMC9414305 DOI: 10.3390/tropicalmed7080171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
The efforts towards effective control of the COVID-19 pandemic may affect the incidence of dengue. This study aimed to investigate temporal variations and spatial clusters of dengue in Thailand before and during the COVID-19 pandemic. Reported dengue cases before (2011–2019) and during (2020–2021) the COVID-19 pandemic were obtained from the national disease surveillance datasets. The temporal variations were analyzed using graphics, a seasonal trend decomposition procedure based on Loess, and Poisson regression. A seasonal ARIMA model was used to forecast dengue cases. Spatial clusters were investigated using the local indicators of spatial associations (LISA). The cyclic pattern showed that the greatest peak of dengue cases likely changed from every other year to every two or three years. In terms of seasonality, a notable peak was observed in June before the pandemic, which was delayed by one month (July) during the pandemic. The trend for 2011–2021 was relatively stable but dengue incidence decreased dramatically by 7.05% and 157.80% on average in 2020 and 2021, respectively. The forecasted cases in 2020 were slightly lower than the reported cases (2.63% difference), whereas the forecasted cases in 2021 were much higher than the actual cases (163.19% difference). The LISA map indicated 5 to 13 risk areas or hotspots of dengue before the COVID-19 pandemic compared to only 1 risk area during the pandemic. During the COVID-19 pandemic, dengue incidence sharply decreased and was lower than forecasted, and the spatial clusters were much lower than before the pandemic.
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Affiliation(s)
- Sayambhu Saita
- Faculty of Public Health, Thammasat University, Lampang 25190, Thailand
- Thammasat University Research Unit in One Health and Ecohealth, Thammasat University, Pathum Thani 12120, Thailand
| | - Sasithan Maeakhian
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Tassanee Silawan
- Department of Community Health, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +66-085-410-2985
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Ndeh NT, Tesfaldet YT, Budnard J, Chuaicharoen P. The secondary outcome of public health measures amidst the COVID-19 pandemic in the spread of other respiratory infectious diseases in Thailand. Travel Med Infect Dis 2022;:102348. [PMID: 35523394 DOI: 10.1016/j.tmaid.2022.102348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 01/10/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has promoted stringent public health measures such as hand hygiene, face mask wearing, and physical distancing to contain the spread of the viral infection. In this retrospective study, the secondary outcomes of those public health measures on containing other respiratory infections among the Thai population were investigated. Hospitalization data spanning from 2016 to 2021 of six respiratory infectious diseases, namely influenza, measles, pertussis, pneumonia, scarlet fever, and tuberculosis (TB), were examined. First, the expected respiratory infectious cases where no public health measures are in place are estimated using the seasonal autoregressive integrated moving average (SARIMA) model. Then the expected number of cases and the observed cases were compared. The results showed a significant drop in the incidence of respiratory infectious diseases by an average of 61%. The reduction in hospitalization is significant for influenza, measles, pertussis, pneumonia, and scarlet fever (p < 0.05), while insignificant for TB (p = 0.54). The notable decrease in the incidence of cases is ascribed to the implementation of public health measures that minimized the opportunity for spread of disease. This decline in cases following relaxation of pandemic countermeasure is contingent on its scope and nature, and it is proof that selective physical distancing, hand hygiene, and use of face masks in public places is a viable route for mitigating respiratory morbidities.
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