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Woodward M, Ramasubramanian V, Kamarulzaman A, Tantawichien T, Wang M, Song JY, Choi WS, Djauzi S, Solante R, Lee WS, Tateda K, Pan H, Wang NC, Pang T. Addressing Unmet Needs in Vaccination for Older Adults in the Asia Pacific: Insights from the COVID-19 Pandemic. Clin Interv Aging 2023; 18:869-880. [PMID: 37284594 PMCID: PMC10239646 DOI: 10.2147/cia.s406601] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023] Open
Abstract
The impact of vaccinating the older population against vaccine-preventable diseases in terms of health, social and economic benefits has been increasingly recognised. However, there is a gap in the utilisation of vaccines worldwide. The population is ageing at an unprecedented pace in the Asia-Pacific (APAC) region, with the number of persons older than 65 years set to double by 2050 to around 1.3 billion. More than 18% of the population in Japan, Hong Kong, and China is over the age of 65 years. This highlights the importance of prioritising resources to address societal obligations toward the needs of the ageing generation. This review provides an overview of the challenges to adult vaccination in APAC, drivers to increase vaccination coverage, vaccination insights gained through the COVID-19 pandemic, and potential measures to increase the uptake of adult vaccines in the region.
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Affiliation(s)
| | | | - Adeeba Kamarulzaman
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Terapong Tantawichien
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Minggui Wang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, SH, People’s Republic of China
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korean University College of Medicine, Ansan, Korea
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rontgene Solante
- Adult Infectious Diseases and Tropical Medicine, San Lazaro Hospital, Manila, NCR, Philippines
| | - Wen-Sen Lee
- Division of Infectious Diseases, Department of Internal Medicine, New Taipei City Hospital, New Taipei, Taiwan
| | - Kazuhiko Tateda
- Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Tokyo, Japan
| | - HongXing Pan
- Institution of Vaccine Clinical Trials, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, JS, People’s Republic of China
| | - Ning-Chi Wang
- Department of Medicine, Tri-Service Hospital, Taipei, Taiwan
| | - Tikki Pang
- Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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2
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Solante R, Alvarez-Moreno C, Burhan E, Chariyalertsak S, Chiu NC, Chuenkitmongkol S, Dung DV, Hwang KP, Ortiz Ibarra J, Kiertiburanakul S, Kulkarni PS, Lee C, Lee PI, Lobo RC, Macias A, Nghia CH, Ong-Lim AL, Rodriguez-Morales AJ, Richtmann R, Safadi MAP, Satari HI, Thwaites G. Expert review of global real-world data on COVID-19 vaccine booster effectiveness and safety during the omicron-dominant phase of the pandemic. Expert Rev Vaccines 2023; 22:1-16. [PMID: 36330971 DOI: 10.1080/14760584.2023.2143347] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, the emergence of the Omicron variant and subvariants as the globally dominant strains have raised doubts about the effectiveness of currently available vaccines and prompted debate about potential future vaccination strategies. AREAS COVERED Using the publicly available IVAC VIEW-hub platform, we reviewed 52 studies on vaccine effectiveness (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease and death and stratified by vaccine schedule and age. In addition, a non-systematic literature review of safety was performed to identify single or multi-country studies investigating adverse event rates for at least two of the currently available COVID-19 vaccines. EXPERT OPINION Booster shots of the current COVID-19 vaccines provide consistently high protection against Omicron-related severe disease and death. Additionally, this protection appears to be conserved for at least 3 months, with a small but significant waning after that. The positive risk-benefit ratio of these vaccines is well established, giving us confidence to administer additional doses as required. Future vaccination strategies will likely include a combination of schedules based on risk profile, as overly frequent boosting may be neither beneficial nor sustainable for the general population.
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Affiliation(s)
| | - Carlos Alvarez-Moreno
- Infectious Diseases Unit, Facultad de Medicina. Universidad Nacional de Colombia. Clinica Universitaria Colombia, Clínica Colsanitas, Colombia
| | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | | | - D V Dung
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | - Javier Ortiz Ibarra
- Médico Hospital Materno Perinatal Monica Pretelini Sáez, Toluca de Lerdo, México
| | | | | | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | - Anna Lisa Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Alfonso J Rodriguez-Morales
- Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Risaralda, Colombia & Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | - Rosana Richtmann
- Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Brazil
| | | | - Hindra Irawan Satari
- Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, Universitas Indonesia, Cipto Mangunkusumo Hospital, Indonesia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, and The Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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3
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Solante R, Alvarez-Moreno C, Burhan E, Chariyalertsak S, Chiu NC, Chuenkitmongkol S, Do-Van D, Hwang KP, Kiertiburanakul S, Lee PI, Lobo RC, Macias A, Nghia CH, Ong-Lim A, Ortiz Ibarra J, Richtmann R, Rodriguez-Morales AJ, Safadi MAP, Satari HI. Further implications on the global real-world vaccine effectiveness against SARS-CoV-2. Expert Rev Vaccines 2022; 21:1355-1357. [PMID: 35968671 DOI: 10.1080/14760584.2022.2110073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Carlos Alvarez-Moreno
- Infectious Diseases Unit, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | | | - Dung Do-Van
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | - Anna Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | | | - Rosana Richtmann
- Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Sao Paulo, Brazil
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Colombia.,Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | | | - Hindra Irawan Satari
- Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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4
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Chuenkitmongkol S, Solante R, Burhan E, Chariyalertsak S, Chiu NC, Do-Van D, Husin M, Hwang KP, Kiertiburanakul S, Kulkarni PS, Lee PI, Lobo RC, Nghia CH, Ong-Lim A, Sivasampu S, Suah JL, Tok PSK, Thwaites G. Expert Review on global real-world vaccine effectiveness against SARS-CoV-2. Expert Rev Vaccines 2022; 21:1255-1268. [PMID: 35748494 DOI: 10.1080/14760584.2022.2092472] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses. AREAS COVERED We reviewed 79 studies in the publicly available International Vaccine Access Center (IVAC) VIEW-hub platform on vaccine effectiveness (VE) after primary immunizations with two-dose schedules. VE data were reported for SARS-CoV-2 infection, COVID-19-related hospitalizations and deaths, and stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection for mRNA vaccines (BNT162b2, mRNA-1273 and combinations of both), vector vaccines (AstraZeneca, AZD1222 "Vaxzevria") and inactivated virus vaccines (CoronaVac). EXPERT OPINION The most-studied COVID-19 vaccines provide consistently high (>90%) protection against serious clinical outcomes like hospitalizations and deaths, regardless of variant. Additionally, this protection appears equivalent for mRNA vaccines and vector vaccines like AZD1222, as supported by our analysis of local Asian and relevant international data, and by insights from SEA experts. Given the continued impact of COVID-19 hospitalizations and deaths on healthcare systems worldwide, encouraging vaccination strategies that can reduce this burden is more relevant than attempting to prevent broader but milder infections with specific variants, including Omicron.
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Affiliation(s)
| | | | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | - Dung Do-Van
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Masliyana Husin
- Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | | | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | - Anna Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Sheamini Sivasampu
- Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Jing Lian Suah
- Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Peter Seah Keng Tok
- Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, and The Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
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Santos J, Montellano ME, Solante R, Perreras N, Meyer S, Toh ML, Zocchetti C, Vigne C, Mascareñas C. Immunogenicity and Safety of a Tetravalent Dengue Vaccine Administered Concomitantly or Sequentially With Tdap Vaccine: Randomized Phase IIIb Trial in Healthy Participants 9-60 Years of Age in the Philippines. Pediatr Infect Dis J 2021; 40:856-863. [PMID: 34117198 PMCID: PMC8357045 DOI: 10.1097/inf.0000000000003220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Incorporating dengue vaccination into existing childhood vaccination programs could increase vaccine coverage. This study assessed the safety and immunogenicity of concomitant versus sequential administration of the combined tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine and the tetravalent dengue vaccine (CYD-TDV). METHODS This phase IIIb, randomized, open-label, multicenter study was conducted in the Philippines in individuals 9-≤60 years of age (NCT02992418). Participants were to receive 3 CYD-TDV doses 6 months apart, the first dose administered either concomitantly or sequentially (28 days post-Tdap). Antibody levels were measured at baseline and 28 days post-first doses of Tdap vaccine and CYD-TDV, using enzyme-linked immunosorbent assay (pertussis, tetanus), micrometabolic inhibition test-toxin neutralization assay (diphtheria) and plaque reduction neutralization test (dengue). Immunogenicity was assessed for all participants, and statistical analysis reported for baseline dengue seropositive participants. Safety was assessed throughout. RESULTS Among 688 randomized participants, 629 (91.4%) were baseline dengue seropositive (concomitant group, n = 314 and sequential group, n = 315). After the first dose, non-inferiority of immune responses between concomitant and sequential vaccination was achieved; between-group geometric mean antibody concentration ratios were close to 1 for anti-PT, anti-FHA, anti-PRN and anti-FIM, between-group differences in percent achieving seroprotection (titers ≥0.1 IU/mL) were 0.26% (diphtheria) and 0.66% (tetanus), and between-group geometric mean antibody titer ratios were close to 1 for dengue serotypes 1-4. Safety profiles in both study groups were comparable. CONCLUSIONS CYD-TDV and Tdap vaccine administered concomitantly or sequentially in baseline dengue seropositive participants elicited comparable immunogenicity and safety profiles.
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Affiliation(s)
- Jaime Santos
- From the Philippine Children’s Medical Center, Quezon City, The Philippines
| | | | | | - Nicole Perreras
- Research Institute for Tropical Medicine, Alabang Muntinlupa City, The Philippines
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Agrupis KA, Smith C, Suzuki S, Villanueva AM, Ariyoshi K, Solante R, Telan EF, Estrada KA, Uichanco AC, Sagurit J, Calayo J, Umipig D, Dela Merced Z, Villarama F, Dimaano E, Villarama JB, Lopez E, Sayo AR. Correction to: Epidemiological and clinical characteristics of the first 500 confirmed COVID-19 inpatients in a tertiary infectious disease referral hospital in Manila, Philippines. Trop Med Health 2021; 49:58. [PMID: 34256871 PMCID: PMC8275903 DOI: 10.1186/s41182-021-00346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kristal An Agrupis
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. .,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
| | - Shuichi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Annavi Marie Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital, Manila, Philippines
| | - Koya Ariyoshi
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | | | | | | | | | | | - Joy Calayo
- San Lazaro Hospital, Manila, Philippines
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7
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Lee CC, Kwa ALH, Apisarnthanarak A, Feng JY, Gluck EH, Ito A, Karuniawati A, Periyasamy P, Pratumvinit B, Sharma J, Solante R, Swaminathan S, Tyagi N, Vu DM, Zirpe K, Schuetz P. Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting. Clin Chem Lab Med 2021; 58:1983-1991. [PMID: 31926074 DOI: 10.1515/cclm-2019-1122] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023]
Abstract
Introduction Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Methods Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations. Results The group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely. Conclusions Use of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.
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Affiliation(s)
- Chien-Chang Lee
- National Taiwan University Hospital, Emergency Medicine Department and Health Data Science Research Group, Taipei, Taiwan
| | - Andrea Lay Hoon Kwa
- Singapore General Hospital, Singapore, Singapore.,Emerging Infectious Diseases Program, Duke-National University of Singapore Medical School, Singapore, Singapore
| | | | - Jia-Yih Feng
- Taipei Veterans General Hospital, Department of Chest Medicine, Taipei, Taiwan
| | | | - Akihiro Ito
- Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Okayama, Japan
| | - Anis Karuniawati
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Petrick Periyasamy
- Infectious Disease Unit, PPUKM (HCTM), Hospital Canselor Tuanku Muhriz UKM (HCTM), Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - Busadee Pratumvinit
- Faculty of Medicine Siriraj Hospital, Department of Clinical Pathology, Mahidol University, Bangkok, Thailand
| | | | - Rontgene Solante
- San Lazaro Hospital, Adult Infectious Diseases and Tropical Medicine, Manila, Philippines
| | | | - Niraj Tyagi
- Sir Ganga Ram Hospital, Institute of Critical Care and Emergency Medicine, Delhi, India
| | - Dien Minh Vu
- Critical Care Department, National Hospital of Tropical Diseases, Hanoi, Vietnam
| | - Kapil Zirpe
- Department of Neuro Critical Care, Ruby Hall Clinic, Grant Medical Foundation, Pune, India
| | - Philipp Schuetz
- Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland.,University of Basel, Basel, Switzerland
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Agrupis KA, Smith C, Suzuki S, Villanueva AM, Ariyoshi K, Solante R, Telan EF, Estrada KA, Uichanco AC, Sagurit J, Calayo J, Umipig D, Dela Merced Z, Villarama F, Dimaano E, Villarama JB, Lopez E, Sayo AR. Epidemiological and clinical characteristics of the first 500 confirmed COVID-19 inpatients in a tertiary infectious disease referral hospital in Manila, Philippines. Trop Med Health 2021; 49:48. [PMID: 34118992 PMCID: PMC8196293 DOI: 10.1186/s41182-021-00340-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background The Philippines has been one of the most affected COVID-19 countries in the Western Pacific region, but there are limited data on COVID-19-related mortality and associated factors from this setting. We aimed to describe the epidemiological and clinical characteristics and associations with mortality among COVID-19-confirmed individuals admitted to an infectious diseases referral hospital in Metro Manila. Main text This was a single-centre retrospective analysis including the first 500 laboratory-confirmed COVID-19 individuals admitted to San Lazaro Hospital, Metro Manila, Philippines, from January to October 2020. We extracted clinical data and examined epidemiological and clinical characteristics and factors associated with in-hospital mortality. Of the 500 individuals, 133 (26.6%) were healthcare workers (HCW) and 367 (73.4%) were non-HCW, with HCW more likely presenting with milder symptoms. Non-HCW admissions were more likely to have at least one underlying disease (51.6% vs. 40.0%; p = 0.002), with hypertension (35.4%), diabetes (17.4%), and tuberculosis (8.2%) being the most common. Sixty-one (12.2%) died, comprising 1 HCW and 60 non-HCW (0.7% vs. 16.3%; p < 0.001). Among the non-HCW, no death occurred for the 0–10 years age group, but deaths were recorded across all other age groups. Compared to those who recovered, individuals who died were more likely to be older (p < 0.001), male (p = 0.015), report difficulty of breathing (p < 0.001), be HIV positive (p = 0.008), be intubated (p < 0.001), categorised as severe or critical (p < 0.001), have a shorter mean hospital stay (p < 0.001), or have an additional diagnosis of pneumonia (p < 0.001) or ARDS (p < 0.001). Conclusion Our analysis reflected significant differences in characteristics, symptomatology, and outcomes between healthcare and non-healthcare workers. Despite the unique mix of cohorts, our results support the country’s national guideline on COVID-19 vaccination which prioritises healthcare workers, the elderly, and people with comorbidities and immunodeficiency states.
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Affiliation(s)
- Kristal An Agrupis
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. .,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
| | - Shuichi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital-Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Annavi Marie Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital, Manila, Philippines
| | - Koya Ariyoshi
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | | | | | | | | | | | - Joy Calayo
- San Lazaro Hospital, Manila, Philippines
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9
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Lee CC, Hoon Kwa AL, Apisarnthanarak A, Feng JY, Gluck EH, Ito A, Karuniawati A, Periyasamy P, Pratumvinit B, Sharma J, Solante R, Swaminathan S, Tyagi N, Vu DM, Zirpe K, Schuetz P. Corrigendum to: Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting. Clin Chem Lab Med 2020; 59:631-632. [PMID: 33554531 DOI: 10.1515/cclm-2020-1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Andrea Lay Hoon Kwa
- Emerging Infectious Diseases Program, Duke-National University of Singapore Medical School, Singapore, Singapore.,Division of Infectious Diseases, Thammasart University Hospital, Bangkok, Thailand
| | | | - Jia-Yih Feng
- Critical Care Services, Swedish Covenant Hospital, Chicago, IL, USA
| | - Eric Howard Gluck
- Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Okayama, Japan
| | - Akihiro Ito
- Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Okayama, Japan
| | - Anis Karuniawati
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Petrick Periyasamy
- Infectious Disease Unit, PPUKM (HCTM), Hospital Canselor Tuanku Muhriz UKM (HCTM), Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - Busadee Pratumvinit
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Rontgene Solante
- Adult Infectious Diseases and Tropical Medicine, San Lazaro Hospital, Manila, Philippines
| | | | - Niraj Tyagi
- Institute of Critical Care and Emergency Medicine, Sir Ganga Ram Hospital, Delhi, India
| | - Dien Minh Vu
- Critical Care Department, National Hospital of Tropical Diseases, Hanoi, Vietnam
| | - Kapil Zirpe
- Department of Neuro Critical Care, Ruby Hall Clinic, Grant Medical Foundation, Pune, India
| | - Philipp Schuetz
- Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland.,University of Basel, Basel, Switzerland
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10
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Villanueva AMG, Lazaro J, Sayo AR, Myat Han S, Ukawa T, Suzuki S, Takaya S, Telan E, Solante R, Ariyoshi K, Smith C. COVID-19 Screening for Healthcare Workers in a Tertiary Infectious Diseases Referral Hospital in Manila, the Philippines. Am J Trop Med Hyg 2020; 103:1211-1214. [PMID: 32729461 PMCID: PMC7470521 DOI: 10.4269/ajtmh.20-0715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
COVID-19 is an emerging disease threatening the lives of patients and healthcare workers (HCWs) alike. In this article, we present initial results of COVID-19 screening performed among the hospital staff of an infectious diseases referral hospital in Manila, the Philippines. Of 324 HCWs tested, eight were positive; only one was exposed to COVID-19 patients, whereas seven others belonged to two different departments. Routine screening of hospital staff is invaluable for the safety of the HCWs and the patients in hospitals and should be performed on a regular basis. In monitoring HCWs, we protect one of our most valuable assets against COVID-19.
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Affiliation(s)
- Annavi Marie G Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital - Nagasaki University Collaborative Research Office, Manila, Philippines
| | | | | | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Tatsuya Ukawa
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital - Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Shuichi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.,San Lazaro Hospital - Nagasaki University Collaborative Research Office, Manila, Philippines
| | - Saho Takaya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | | | - Koya Ariyoshi
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chris Smith
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Salvana EMT, Samonte GMJ, Telan E, Leyritana K, Tactacan-Abrenica RJ, Ching PR, Arevalo GM, Dungca NT, Peñalosa-Ramos C, Mendoza KAR, Trinidad LF, Tonga AD, Lim J, Destura R, Alejandria M, Solante R, Arcangel L, Palaypayon NS, Schwem BE. High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines. Int J Infect Dis 2020; 95:125-132. [PMID: 32081778 DOI: 10.1016/j.ijid.2020.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The Philippines has the fastest growing HIV epidemic in the Asia-Pacific. This increase was accompanied by a shift in the predominant HIV subtype from B to CRF01_AE. Increasing evidence points to a difference in treatment responses between subtypes. We examined treatment failure and acquired drug resistance (ADR) in people living with HIV (PLHIVs) after one year on antiretrovirals (ARVs). METHODS PLHIV maintained on ARVs for one year were recruited. Treatment failure was defined as a viral load of ≥1000 copies/mL. Sanger sequencing for genotyping and drug resistance mutation (DRM) detection was performed on patients failing treatment. RESULTS 513 PLHIV were enrolled. The most common antiretroviral regimens were TDF+3TC + EFV (269) and AZT+3TC + EFV (155). 53 (10.3%) subjects failed treatment. Among these, 48 (90.6%) had DRMs, 84.9% were subtype CRF01_AE. Tenofovir-based regimens performed worse than zidovudine-based regimens (OR 3.28, 95% CI 1.58-7.52 p < 0.001). Higher rates of NRTI, NNRTI, K65R tenofovir resistance, and multi-class resistance were found compared to those reported in literature. CONCLUSIONS HIV treatment failure at one year of treatment in the Philippines is 10.3%. We found unusually high tenofovir and multiclass resistance, and optimal ARV regimens may need to be reevaluated for CRF01_AE-predominant epidemics.
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Affiliation(s)
- Edsel Maurice T Salvana
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Genesis May J Samonte
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Elizabeth Telan
- STD/AIDS Cooperative Central Laboratory, Bldg 17 San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong City, Philippines
| | | | - Patrick R Ching
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Geraldine M Arevalo
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Niña Theresa Dungca
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Christine Peñalosa-Ramos
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Kevin Anthony R Mendoza
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Lyka F Trinidad
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Angelo Dela Tonga
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Jodor Lim
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Raul Destura
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines
| | - Marissa Alejandria
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
| | - Rontgene Solante
- H4-Out Patient Department, San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Lalaine Arcangel
- H4-Out Patient Department, San Lazaro Hospital, Quiricada St., Sta. Cruz, Manila 1003, Philippines
| | - Noel S Palaypayon
- HIV Surveillance Unit, Epidemiology Bureau, Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila 1003, Philippines
| | - Brian E Schwem
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila 1000, Philippines; Philippine Genome Center, University of the Philippines, Diliman, Quezon City, Philippines.
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Theresa Dungca N, Schwem B, Arevalo G, Francisco C, Penalosa-Ramos C, Ching P, Leyritana K, Destura R, Lim J, Tactacan-Abrenica R, Telan E, Solante R, Samonte G, Trinidad L, Mendoza K, Alejandria MM, Salvana EMT. 2507. Transmitted and Acquired NNRTI Resistance in the Philippines: Are Newer Generation NNRTIs a Viable Option? Open Forum Infect Dis 2019. [PMCID: PMC6810627 DOI: 10.1093/ofid/ofz360.2185] [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] [Indexed: 11/30/2022] Open
Abstract
Background Doravirine, rilpivirine, and etravirine are newer generation non-nucleoside reverse transcriptase inhibitors (NNRTI) that are intended to be more durable alternatives to efavirenz and nevirapine. We examined transmitted drug resistance (TDR) and acquired drug resistance (ADR) to NNRTIs from recent local TDR and ADR data to determine whether these can be useful as first-line or second-line antiretroviral (ARV) agents. Methods We reanalyzed Sanger-Based sequences (SBS) from an ADR surveillance study; and SBS and near-whole-genome next-generation sequences (NGS) from a TDR surveillance study using the Stanford HIV Drug Resistance Database. Results ADR: Out of 513 Filipino PLHIV from an ADR surveillance study on one year of ARV treatment, 53 (10.3%) failed (HIV VL >1,000 copies/mL). Among these, 48 had clinically significant mutations. Table 1 shows NNRTI ADR frequencies. There was no significant ADR difference between first-generation and newer generation NNRTIs. TDR: 298 treatment-naïve Filipino PLHIV underwent baselines sequencing. All 298 had SBS. 266 had successful NGS. Table 1 shows SBS and NGS TDR NNRTI resistance at a 5% minor variant cutoff. There was no significant TDR difference between first-generation and newer generation NNRTIs. Conclusion ADR and TDR rates to the newer NNRTIs are similar to first-generation NNRTIs. High TDR to doravirine on NGS is concerning, but its clinical significance is unclear. Etravirine had the lowest TDR and ADR and may be the most useful new-generation NNRTI. However, integrase strand transfer inhibitor-based regimens will likely be more durable. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Nina Theresa Dungca
- Institute of Molecular Biology and Biotechnology, Manila, National Capital Region, Philippines
| | - Brian Schwem
- Institute of Molecular Biology and Biotechnology, Manila, National Capital Region, Philippines
| | - Geraldine Arevalo
- Institute of Molecular Biology and Biotechnology, Manila, National Capital Region, Philippines
| | - Christian Francisco
- University of the Philippines Manila, Manila, National Capital Region, Philippines
| | | | - Patrick Ching
- University of the Philippines, Manila, National Capital Region, Philippines
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines, Manila, National Capital Region, Philippines
| | - Raul Destura
- University of the Philippines, Manila, National Capital Region, Philippines
| | - Jodor Lim
- University of the Philippines Manila, Manila, National Capital Region, Philippines
| | | | - Elizabeth Telan
- STD AIDS Cooperative Laboraory, Manila, National Capital Region, Philippines
| | - Rontgene Solante
- San Lazaro Hospital, Manila, National Capital Region, Philippines
| | - Genesis Samonte
- Department of Health, Manila, National Capital Region, Philippines
| | - Lyka Trinidad
- Department of Health, Manila, National Capital Region, Philippines
| | - Kevin Mendoza
- Department of Health, Manila, National Capital Region, Philippines
| | - Marissa M Alejandria
- University of the Philippines Manila, National Institutes of Health, Manila, National Capital Region, Philippines
| | - Edsel Maurice T Salvana
- Institute of Molecular Biology and Biotechnology, Manila, National Capital Region, Philippines
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Agdamag DMD, Kageyama S, Solante R, Espantaleon AS, Sangco JCE, Suzuki Y. Characterization of clinical isolates of Mycobacterium tuberculosis resistant to drugs and detection of RpoB mutation in multidrug-resistant tuberculosis in the Philippines. Int J Tuberc Lung Dis 2003; 7:1104-8. [PMID: 14598972] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
SETTING Retrospective study of Mycobacterium tuberculosis isolates at the STD/AIDS Cooperative Central Laboratory, Philippines. OBJECTIVE To describe patterns of M. tuberculosis resistance against first-line anti-tuberculosis drugs, and to analyze the rpoB gene codon mutation of rifampicin (RMP) resistant isolates and correlate genotypic and phenotypic patterns. DESIGN One hundred and sixty-four M. tuberculosis complex isolates were retrieved for phenotypic analysis; 89 were resistant to any anti-tuberculosis drug and 50 were RMP-resistant, whereas 48 were multidrug-resistant (MDR). Of these 48, only 33 were available for genotypic analysis of the rpoB gene. RESULTS Most drug-resistant isolates were phenotypically resistant to isoniazid (INH) (93%), and the probability of an RMP-resistant isolate becoming MDR was 96%. In 33 MDR isolates, 13 types of mutations in nine independent codons were identified; the most frequently mutated codons were S531L (61%) and G510H (15%), which were present in 76% (25/33) of the isolates. S531L was noted in 85.7% of the RMP + INH + SM resistant isolates, while only 80% of the isolates with INH + RMP, EMB + SM resistance showed this mutation. CONCLUSION The high probability of RMP isolates being MDR suggests that genetic analysis of RMP resistance is useful in detecting MDR-TB. Worldwide accumulation of findings on circulating MDR-TB strains provides indispensable information about the re-emergence of TB.
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Affiliation(s)
- D M D Agdamag
- Laboratory, San Lazaro Hospital, Manila, Philippines.
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