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Karshima SN, Ahmed MI, Mohammed KM, Pam VA. Global status of Anaplasma phagocytophilum infections in human population: A 50-year (1970-2020) meta-analysis. J Vector Borne Dis 2023; 60:265-278. [PMID: 37843237 DOI: 10.4103/0972-9062.364756] [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] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND & OBJECTIVES Anaplasma phagocytophilum causes human granulocytic anaplasmosis; a febrile tick-borne bacterial zoonosis of increasing public health importance in many parts of the world which is life threatening in undiagnosed, misdiagnosed and untreated cases. In this study we determined and reported the global status of the pathogen in man. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to perform a systematic review and meta-analysis of data published in six electronic databases between 1970 and 2020. We pooled data using the random-effects model, performed sensitivity analysis by the single study deletion method and assess across study bias by the funnel plot and its statistical significance by the Egger's regression test. RESULTS A total of 7018 cases of A. phagocytophilum were reported from 48,619 individuals examined across 22 countries in three continents. Overall pooled estimate was 8.13% (95% CI: 5.70 - 11.47) with a range of 4.64 (95% CI: 1.78 - 11.54) to 12.18% (95% CI: 7.66 - 18.83) across sub-groups. Regional prevalence was highest in North America 11.07% (95% CI: 3.13 - 32.38), while that in relation to study population was highest among occupationally exposed population 11.41% (95% CI: 5.69 - 21.56). INTERPRETATION & CONCLUSION The study revealed a significant variation in the prevalence of A. phagocytophilum across Asia, Europe and North America, with the highest prevalence in North America and among occupationally exposed population. To curtail the menace of this growing public health crisis, we recommend integrated control programmes involving tick control, the use of appropriate clothing by occupationally exposed population and health education.
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Affiliation(s)
- Solomon Ngutor Karshima
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, Nigeria
| | - Musa Isiyaku Ahmed
- Department of Veterinary Parasitology and Entomology, Federal University of Agriculture Zuru, Nigeria
| | - Kaltume Mamman Mohammed
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, Nigeria
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Kim DM, Yu BJ, Kim DY, Seo JW, Yun NR, Kim CM, Kim YK, Jung SI, Kim UJ, Kim SE, Kim HA, Kim ES, Hur J, Lee SH, Jeong HW, Heo JY, Jung DS, Kim J, Park SH, Kwak YG, Lee S, Lim S, Chatterjee S. Clinically differential diagnosis of human granulocytic anaplasmosis and severe fever with thrombocytopenia syndrome. Sci Rep 2023; 13:6837. [PMID: 37100782 PMCID: PMC10133271 DOI: 10.1038/s41598-023-32061-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
This study analyzed HGA and SFTS in patients with suspected tick-borne infection by focusing on key differences that clinicians can easily recognize. A retrospective analysis was performed on confirmed patients with HGA or SFTS in 21 Korean hospitals from 2013 to 2020. A scoring system was developed by multivariate regression analysis and accuracy assessment of clinically easily discriminable parameters was performed. The multivariate logistic regression analysis revealed that sex (especially male sex) (odds ratio [OR] 11.45, P = 0.012), neutropenia (< 1500) (OR 41.64, P < 0.001), prolonged activated partial thromboplastin time (OR 80.133, P < 0.001), and normal C-reactive protein concentration (≤ 1.0 mg/dL; OR 166.855, P = 0.001) were significantly associated with SFTS but not with HGA. Each factor, such as meaningful variables, was given 1 point, and a receiver-operating characteristic curve with a cutoff value (> 1) in a 5-point scoring system (0-4 points) was analyzed to evaluate the accuracy of differentiation between HGA and SFTS. The system showed 94.5% sensitivity, 92.6% specificity, and an area under the receiver-operating characteristic curve of 0.971 (0.949-0.9). Where HGA and SFTS are endemic, the scoring system based on these four parameters such as sex, neutrophil count, activated partial thromboplastin time, and C-reactive protein concentration will facilitate the differential diagnosis of HGA and SFTS in the emergency room in patients with suspected tick-borne infectious diseases.
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Affiliation(s)
- Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.
| | - Byung Jun Yu
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Young Keun Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Sook In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Uh Jin Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Eun Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyun Ah Kim
- Division of Infectious Diseases, Keimyung University Dongsan Hospitial, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jian Hur
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Sun Hee Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Hye Won Jeong
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Dong Sik Jung
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Jieun Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Sun Hee Park
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Sujin Lee
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Seungjin Lim
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Shilpa Chatterjee
- Department of Biomedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Jang WS, Lim DH, Choe YL, Nam J, Moon KC, Kim C, Choi M, Park I, Park DW, Lim CS. Developing a multiplex loop-mediated isothermal amplification assay (LAMP) to determine severe fever with thrombocytopenia syndrome (SFTS) and scrub typhus. PLoS One 2022; 17:e0262302. [PMID: 35171943 DOI: 10.1371/journal.pone.0262302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) and scrub typhus are endemic zoonotic diseases that pose significant public health threats in East Asia. As these two diseases share common clinical features, as well as overlapping disease regions, it is difficult to differentiate between SFTS and scrub typhus. A multiplex reverse-transcription loop‑mediated isothermal amplification (RT-LAMP) assay was developed to detect large segments and GroES genes for SFTS virus (SFTSV) and Orientia tsutsugamushi (OT). The performance of the RT-LAMP assay was compared and evaluated with those of commercial PowerChek™ SFTSV real-time PCR and LiliF™ TSUTSU nested PCR for 23 SFTS and 12 scrub typhus clinical samples, respectively. The multiplex SFTSV/OT/Internal control (IC) RT-LAMP assay showed comparable sensitivity (91.3%) with that of commercial PowerChek™ SFTSV Real-time PCR (95.6%) and higher sensitivity (91.6%) than that of LiliF™ TSUTSU nested PCR (75%). In addition, the multiplex SFTSV/OT RT-LAMP assay showed 100% specificity and no cross-reactivity for blood from uninfected healthy patients and samples from patients infected with other fever viruses. Thus, the multiplex SFTSV/OT/IC RT-LAMP assay could serve as a useful point-of-care molecular diagnostic test for SFTS and scrub typhus.
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Kim DY, Seo JW, Yun NR, Kim CM, Kim DM. Human granulocytic anaplasmosis in a Single University Hospital in the Republic of Korea. Sci Rep 2021; 11:10860. [PMID: 34035378 DOI: 10.1038/s41598-021-90327-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/30/2021] [Indexed: 11/09/2022] Open
Abstract
To date, only a few studies have analyzed the clinical characteristics and genetic features of human granulocytic anaplasmosis (HGA) in South Korea. Thus, in this study, we investigated the clinical characteristics of HGA and methods used for clinical diagnosis. The clinical characteristics of patients with HGA were studied retrospectively. We reviewed the medical charts of 21 confirmed patients with HGA admitted to the Chosun University Hospital, located in Gwangju, South Korea. Twenty-one HGA patients visited the hospital 2-30 days (median 7 days) after the onset of symptoms. Fourteen patients (66.7%) had fever, which was alleviated 2 h (range 0-12.75 h) after starting treatment with doxycycline. Of the 18 patients who underwent peripheral blood (PB) smear test, only one (5.6%) had morulae. Additionally, only 4/17 patients (23.5%) had morulae in the PB smear reconducted after the confirmation of anaplasmosis. All 21 patients recovered without significant complications. As per results of the blood tests conducted at the time of admission, 7/21 (33.3%) and 5/21 (23.8%) patients showed at least 1:16 and 1:80 of IgM and IgG titers, respectively. Most HGA patients in Korea recovered without significant complications. The indirect immunofluorescence antibody diagnosis or morulae identification for HGA in this study had low sensitivity in the early stage of the disease.
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