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Tuddenham S, Shafiq M, Mathad JS, Alexander M, Naik S, Kulkarni V, Deshpande P, Humphrys MS, Holm JB, Khan N, Yadana S, Cheedalla A, Bhosale R, Ghanem KG, Wang T, Wang S, Ma B, Ravel J, Gupta A, Shivakoti R. Association of Pregnancy and HIV Status With Molecular-Bacterial Vaginosis in Indian Women. J Acquir Immune Defic Syndr 2023; 93:422-430. [PMID: 37155962 PMCID: PMC10524256 DOI: 10.1097/qai.0000000000003215] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Bacterial vaginosis (BV) is a highly prevalent disorder of the cervicovaginal microbiota. Molecular-BV may put women at increased risk for adverse reproductive and obstetric outcomes. We investigated the association of HIV and pregnancy on the vaginal microbiota and associations with molecular-BV in women of reproductive age from Pune, India. SETTING We studied vaginal samples from N = 170 women, including N = 44 nonpregnant HIV seronegative, N = 56 pregnant seronegative, N = 47 nonpregnant women with HIV (WWH), and N = 23 pregnant WWH, and collected data on clinical, behavioral, and demographic factors. METHODS We used 16S rRNA gene amplicon sequencing to characterize the composition of the vaginal microbiota. We classified the vaginal microbiota of these women into community state types based on bacterial composition and relative abundance and further categorized them into molecular-BV versus Lactobacillus -dominated states. To determine associations between pregnancy and HIV status with outcome of molecular-BV, logistic regression models were used. RESULTS There was a high prevalence of molecular-BV (30%) in this cohort. We found that pregnancy was associated with decreased odds of molecular-BV (adjusted OR = 0.35, 95% CI: 0.14 to 0.87), while HIV was associated with increased odds of molecular-BV (adjusted OR = 2.76, 95% CI: 1.33 to 5.73), even when controlling for multiple relevant factors such as age, number of sexual partners, condom use, and douching. CONCLUSION Larger and longitudinal studies are needed to further characterize molecular-BV and the vaginal microbiota in pregnant women and WWH and relate these factors to infectious, reproductive, and obstetric outcomes. In the long term, these studies may lead to novel microbiota-based therapeutics to improve women's reproductive and obstetric health.
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Affiliation(s)
- Susan Tuddenham
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mehr Shafiq
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | - Jyoti S. Mathad
- Department of Medicine, Weill Cornell Medical College, New York, USA
| | - Mallika Alexander
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Shilpa Naik
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Vandana Kulkarni
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Prasad Deshpande
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Mike S. Humphrys
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Johanna B. Holm
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Nawshaba Khan
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Su Yadana
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | | | - Ramesh Bhosale
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Khalil G. Ghanem
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Tian Wang
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - Shuang Wang
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - Bing Ma
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Jacques Ravel
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Amita Gupta
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Rupak Shivakoti
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
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Yadana S, Valitutto MT, Aung O, Hayek LAC, Yu JH, Myat TW, Lin H, Htun MM, Thu HM, Hagan E, Francisco L, Murray S. Assessing Behavioral Risk Factors Driving Zoonotic Spillover Among High-risk Populations in Myanmar. Ecohealth 2023:10.1007/s10393-023-01636-9. [PMID: 37256491 DOI: 10.1007/s10393-023-01636-9] [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] [Grants] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/22/2023] [Indexed: 06/01/2023]
Abstract
The increasing global emergence of zoonoses warrants improved awareness of activities that predispose vulnerable communities to greater risk of disease. Zoonotic disease outbreaks regularly occur within Myanmar and at its borders partly due to insufficient knowledge of behavioral risks, hindering participatory surveillance and reporting. This study employed a behavioral surveillance strategy among high-risk populations to understand the behavioral risks for zoonotic disease transmission in an effort to identify risk factors for pathogen spillover. To explore behavioral mechanisms of spillover in Myanmar, we aimed to: (1) evaluate the details around animal contact and types of interaction, (2) assess the association between self-reported unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) and animal contact activities and (3) identify the potential risk factors including behavioral practices of self-reported illness. Participants were enrolled at two community sites: Hpa-An and Hmawbi in Southern Myanmar. A behavioral questionnaire was administered to understand participants' animal exposures, behaviors and self-reported illnesses. From these responses, associations between (1) animal contact activities and self-reported unusual illnesses, and (2) potential risk factors and self-reported unusual illness were tested. Contact with poultry seemed to be very frequent (91.1%) and many participants reported raising, handling and having poultry in their houses as well as slaughtering or being scratched/bitten by them, followed by contact with rodents (57.8%) and swine (17.9%). Compared to participants who did not have any unusual symptoms, participants who had unusual symptoms in the past year were more likely to have sold dead animals (OR = 13.6, 95% CI 6.8-27.2), slaughtered (OR = 2.4, 95% CI 1.7-3.3), raised (OR = 3.4, 95% CI 2.3-5.0) or handled animals (OR = 2.1, 95% CI 1.2-3.6), and had eaten sick (OR = 4.4, 95% CI 3.0-6.4) and/or dead animals (OR = 6.0, 95% CI 4.1-8.8) in the same year. Odds of having reported unusual symptoms was higher among those involved in animal production business (OR = 3.4, 95% CI 1.9-6.2) and animal-involved livelihoods (OR = 3.3, 95% CI 1.5-7.2) compared to other livelihoods. The results suggest that there is a high level of interaction between humans, livestock and wild animals in communities we investigated in Myanmar. The study highlights the specific high-risk behaviors as they relate to animal contact and demographic risk factors for zoonotic spillover. Our findings contribute to human behavioral data needed to develop targeted interventions to prevent zoonotic disease transmission at human-animal interfaces.
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Affiliation(s)
- Su Yadana
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Marc T Valitutto
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA.
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA.
| | - Ohnmar Aung
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Lee-Ann C Hayek
- National Museum of Natural History, Smithsonian Institution. 10th St. & Constitution Ave NW, Washington DC, 20560, USA
| | - Jennifer H Yu
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Theingi Win Myat
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Htin Lin
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Moh Moh Htun
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Hlaing Myat Thu
- Department of Medical Research. No 5, Ziwaka Road, Dagon, Yangon, 1119, Myanmar
| | - Emily Hagan
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Leilani Francisco
- EcoHealth Alliance, 520 Eighth Avenue Ste 1200, New York, NY, 10018, USA
| | - Suzan Murray
- Global Health Program, Smithsonian's National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
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3
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Yadana S, Cheun-Arom T, Li H, Hagan E, Mendelsohn E, Latinne A, Martinez S, Putcharoen O, Homvijitkul J, Sathaporntheera O, Rattanapreeda N, Chartpituck P, Yamsakul S, Sutham K, Komolsiri S, Pornphatthananikhom S, Petcharat S, Ampoot W, Francisco L, Hemachudha T, Daszak P, Olival KJ, Wacharapluesadee S. Behavioral-biological surveillance of emerging infectious diseases among a dynamic cohort in Thailand. BMC Infect Dis 2022; 22:472. [PMID: 35578171 PMCID: PMC9109443 DOI: 10.1186/s12879-022-07439-7] [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: 08/12/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Interactions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts. Objective This study employed an integrated behavioral–biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures. Method Participants were enrolled at two community-based sites (n = 472) in eastern and western Thailand and two hospital (clinical) sites (n = 206) in northeastern and central Thailand. A behavioral questionnaire was administered to understand participants’ demographics, living conditions, health history, and animal-contact behaviors and attitudes. Biological specimens were tested for coronaviruses, filoviruses, flaviviruses, influenza viruses, and paramyxoviruses using pan (consensus) RNA Virus assays. Results Overall 61/678 (9%) of participants tested positive for the viral families screened which included influenza viruses (75%), paramyxoviruses (15%), human coronaviruses (3%), flaviviruses (3%), and enteroviruses (3%). The most salient predictors of reporting unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) in the past year were having other household members who had unusual symptoms and being scratched or bitten by animals in the same year. Many participants reported raising and handling poultry (10.3% and 24.2%), swine (2%, 14.6%), and cattle (4.9%, 7.8%) and several participants also reported eating raw or undercooked meat of these animals (2.2%, 5.5%, 10.3% respectively). Twenty four participants (3.5%) reported handling bats or having bats in the house roof. Gender, age, and livelihood activities were shown to be significantly associated with participants’ interactions with animals. Participants’ knowledge of risks influenced their health-seeking behavior. Conclusion The results suggest that there is a high level of interaction between humans, livestock, and wild animals in communities at sites we investigated in Thailand. This study highlights important differences among demographic and occupational risk factors as they relate to animal contact and zoonotic disease risk, which can be used by policymakers and local public health programs to build more effective surveillance strategies and behavior-focused interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07439-7.
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Affiliation(s)
- Su Yadana
- EcoHealth Alliance, New York, NY, USA
| | - Thaniwan Cheun-Arom
- Department of Biology, Faculty of Science, Ramkhamhaeng University, Bangkok, Thailand
| | | | | | | | - Alice Latinne
- Wildlife Conservation Society, Viet Nam Country Program, Ha Noi, Viet Nam.,Wildlife Conservation Society, Health Program, Bronx, NY, USA
| | | | - Opass Putcharoen
- Division of Infectious Diseases, Faculty of Medicine, Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | | | - Supalak Yamsakul
- The Office of Disease Prevention and Control 5, Ratchaburi, Thailand
| | - Krairoek Sutham
- The Office of Disease Prevention and Control 5, Ratchaburi, Thailand
| | | | | | - Sininat Petcharat
- Thai Red Cross Emerging Infectious Diseases-Health Science Centre, Faculty of Medicine, World Health Organization Collaborating Centre for Research and Training On Viral Zoonoses, Chulalongkorn Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Weenassarin Ampoot
- Thai Red Cross Emerging Infectious Diseases-Health Science Centre, Faculty of Medicine, World Health Organization Collaborating Centre for Research and Training On Viral Zoonoses, Chulalongkorn Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Leilani Francisco
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Thiravat Hemachudha
- Thai Red Cross Emerging Infectious Diseases-Health Science Centre, Faculty of Medicine, World Health Organization Collaborating Centre for Research and Training On Viral Zoonoses, Chulalongkorn Hospital, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Supaporn Wacharapluesadee
- Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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4
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Shafiq M, Mathad JS, Naik S, Alexander M, Yadana S, Araújo-Pereira M, Kulkarni V, Deshpande P, Kumar NP, Babu S, Andrade BB, Leu CS, Khwaja S, Bhosale R, Kinikar A, Gupta A, Shivakoti R. Association of Maternal Inflammation During Pregnancy With Birth Outcomes and Infant Growth Among Women With or Without HIV in India. JAMA Netw Open 2021; 4:e2140584. [PMID: 34935918 PMCID: PMC8696571 DOI: 10.1001/jamanetworkopen.2021.40584] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
IMPORTANCE The association of elevated levels of specific inflammatory markers during pregnancy with adverse birth outcomes and infant growth could indicate pathways for potential interventions. OBJECTIVE To evaluate whether higher levels of certain inflammatory markers during pregnancy are associated with preterm birth (PTB), low birth weight (LBW), and infant growth deficits. DESIGN, SETTING, AND PARTICIPANTS In this cohort study of pregnant women with or without HIV, 218 mother-infant pairs were followed up from pregnancy through 12 months post partum from June 27, 2016, to December 9, 2019. Pregnant women aged 18 to 40 years and between 13 and 34 weeks of gestation who were receiving antenatal care were enrolled in a cohort stratified by HIV status; sampling was based on convenience sampling from women receiving antenatal care at Byramjee Jeejeebhoy Government Medical College. EXPOSURES Levels of multiple circulating inflammation markers during the third trimester of pregnancy. MAIN OUTCOMES AND MEASURES The primary study outcome was PTB (<37 weeks' gestation). Secondary outcomes were LBW (<2500 g) and repeated measures (delivery; 6 weeks post partum; and 3, 6, and 12 months post partum using multivariable generalized linear models) of infant growth outcomes (length-for-age, weight-for-age, and weight-for-length z scores). RESULTS The median age of the 218 women at enrollment was 23 years (IQR, 21-27 years). In multivariable models, higher pregnancy levels of interleukin 17A were associated with increased odds of both PTB (adjusted odds ratio [aOR], 2.62; 95% CI, 1.11-6.17) and LBW (aOR, 1.81; 95% CI, 1.04-3.15). Higher levels of interleukin 1β were associated with increased PTB (aOR, 1.47; 95% CI, 1.15-1.89) and infant growth deficits (lower length-for-age z score: adjusted β = -0.10; 95% CI, -0.18 to -0.01; lower weight-for-age z score: adjusted β = -0.07; 95% CI, -0.14 to 0.001). CONCLUSIONS AND RELEVANCE This study suggests that increased levels of certain systemic inflammatory markers, including interleukin 1β and interleukin 17A, during pregnancy were associated with adverse birth outcomes and infant growth deficits. Future studies should evaluate whether potential interventions to modulate specific inflammatory pathways during pregnancy could improve birth outcomes and infant growth.
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Affiliation(s)
- Mehr Shafiq
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Jyoti S. Mathad
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Shilpa Naik
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Mallika Alexander
- Byramjee Jeejeebhoy Government Medical College–Johns Hopkins University Clinical Research Site, Pune, India
| | - Su Yadana
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Mariana Araújo-Pereira
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Vandana Kulkarni
- Byramjee Jeejeebhoy Government Medical College–Johns Hopkins University Clinical Research Site, Pune, India
| | - Prasad Deshpande
- Byramjee Jeejeebhoy Government Medical College–Johns Hopkins University Clinical Research Site, Pune, India
| | - Nathella Pavan Kumar
- National Institutes of Health, National Institute for Research in Tuberculosis, International Center for Excellence in Research, Chennai, India
| | - Subash Babu
- National Institutes of Health, National Institute for Research in Tuberculosis, International Center for Excellence in Research, Chennai, India
| | - Bruno B. Andrade
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Brazil
- Universidade Salvador, Laureate Universities, Salvador, Brazil
- Curso de Medicina, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York
| | - Saltanat Khwaja
- Byramjee Jeejeebhoy Government Medical College–Johns Hopkins University Clinical Research Site, Pune, India
| | - Ramesh Bhosale
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Aarti Kinikar
- Department of Paediatrics, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Amita Gupta
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rupak Shivakoti
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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5
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Naik S, Alexander M, Kumar P, Kulkarni V, Deshpande P, Yadana S, Leu CS, Araújo-Pereira M, Andrade BB, Bhosale R, Babu S, Gupta A, Mathad JS, Shivakoti R. Systemic Inflammation in Pregnant Women With Latent Tuberculosis Infection. Front Immunol 2021; 11:587617. [PMID: 33584652 PMCID: PMC7873478 DOI: 10.3389/fimmu.2020.587617] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022] Open
Abstract
Background Recent studies in adults have characterized differences in systemic inflammation between adults with and without latent tuberculosis infection (LTBI+ vs. LTBI−). Potential differences in systemic inflammation by LTBI status has not been assess in pregnant women. Methods We conducted a cohort study of 155 LTBI+ and 65 LTBI− pregnant women, stratified by HIV status, attending an antenatal clinic in Pune, India. LTBI status was assessed by interferon gamma release assay. Plasma was used to measure systemic inflammation markers using immunoassays: IFNβ, CRP, AGP, I-FABP, IFNγ, IL-1β, soluble CD14 (sCD14), sCD163, TNF, IL-6, IL-17a and IL-13. Linear regression models were fit to test the association of LTBI status with each inflammation marker. We also conducted an exploratory analysis using logistic regression to test the association of inflammatory markers with TB progression. Results Study population was a median age of 23 (Interquartile range: 21–27), 28% undernourished (mid-upper arm circumference (MUAC) <23 cm), 12% were vegetarian, 10% with gestational diabetes and 32% with HIV. In multivariable models, LTBI+ women had significantly lower levels of third trimester AGP, IL1β, sCD163, IL-6 and IL-17a. Interestingly, in exploratory analysis, LTBI+ TB progressors had significantly higher levels of IL1β, IL-6 and IL-13 in multivariable models compared to LTBI+ non-progressors. Conclusions Our data shows a distinct systemic immune profile in LTBI+ pregnant women compared to LTBI− women. Data from our exploratory analysis suggest that LTBI+ TB progressors do not have this immune profile, suggesting negative association of this profile with TB progression. If other studies confirm these differences by LTBI status and show a causal relationship with TB progression, this immune profile could identify subsets of LTBI+ pregnant women at high risk for TB progression and who can be targeted for preventative therapy.
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Affiliation(s)
- Shilpa Naik
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.,Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Mallika Alexander
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Pavan Kumar
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai, India
| | - Vandana Kulkarni
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Prasad Deshpande
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - Su Yadana
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Mariana Araújo-Pereira
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research, Fundação José Silveira, New York, NY, Brazil.,Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Bruno B Andrade
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research, Fundação José Silveira, New York, NY, Brazil.,Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.,Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Brazil.,Escola de Medicina, Universidade Salvador (UNIFACS), Laureate International Universities, Salvador, Brazil.,Curso de Medicina, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Ramesh Bhosale
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.,Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Subash Babu
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai, India
| | - Amita Gupta
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jyoti S Mathad
- Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Rupak Shivakoti
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
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6
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Yadana S, Talegawkar SA, Mathad JS, Alexander M, Rajagopalan K, Kumar P, Naik S, Leu CS, Kulkarni V, Deshpande P, Araujo-Pereira M, Bhosale R, Babu S, Andrade BB, Caulfield LE, Gupta A, Shivakoti R. Association of Vegetable and Animal Flesh Intake with Inflammation in Pregnant Women from India. Nutrients 2020; 12:E3767. [PMID: 33302378 PMCID: PMC7762525 DOI: 10.3390/nu12123767] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022] Open
Abstract
In pregnant women, studies are lacking on the relationship of vegetable and animal flesh (poultry, red meat and seafood) intake with inflammation, especially in low- and middle-income countries. We conducted a cohort study of pregnant women receiving antenatal care at BJ Medical College in Pune, India. The dietary intake of pregnant women was queried in the third trimester using a validated food frequency questionnaire. Twelve inflammatory markers were measured in plasma samples using immunoassays. Only 12% of the study population were vegetarians, although animal flesh intake levels were lower compared to Western populations. In multivariable models, higher intakes of total vegetables were associated with lower levels of the T-helper (Th) 17 cytokine interleukin (IL)-17a (p = 0.03) and the monocyte/macrophage activation marker soluble CD163 (sCD163) (p = 0.02). Additionally, higher intakes of poultry were negatively associated with intestinal fatty-acid binding protein (I-FABP) levels (p = 0.01), a marker of intestinal barrier dysfunction and Th2 cytokine IL-13 (p = 0.03), and higher seafood was associated with lower IL-13 (p = 0.005). Our data from pregnant women in India suggest that a higher quality diet emphasizing vegetables and with some animal flesh is associated with lower inflammation. Future studies should confirm these findings and test if modulating vegetables and animal flesh intake could impact specific aspects of immunity and perinatal health.
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Affiliation(s)
- Su Yadana
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
- EcoHealth Alliance, New York, NY 10018, USA
| | - Sameera A. Talegawkar
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA;
| | - Jyoti S. Mathad
- Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA;
| | - Mallika Alexander
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune 380016, India; (M.A.); (V.K.); (P.D.); (A.G.)
| | - Kripa Rajagopalan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14850, USA;
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Pavan Kumar
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai 600031, India; (P.K.); (S.B.)
| | - Shilpa Naik
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune 380016, India; (S.N.); (R.B.)
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | - Vandana Kulkarni
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune 380016, India; (M.A.); (V.K.); (P.D.); (A.G.)
| | - Prasad Deshpande
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune 380016, India; (M.A.); (V.K.); (P.D.); (A.G.)
| | - Mariana Araujo-Pereira
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (M.A.-P.); (B.B.A.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research, Salvador 45204-040, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40110-100, Brazil
| | - Ramesh Bhosale
- Department of Obstetrics and Gynecology, Byramjee Jeejeebhoy Government Medical College, Pune 380016, India; (S.N.); (R.B.)
| | - Subash Babu
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai 600031, India; (P.K.); (S.B.)
| | - Bruno B. Andrade
- Instituto Goncalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (M.A.-P.); (B.B.A.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research, Salvador 45204-040, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40110-100, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador 41741-590, Brazil
- Universidade Salvador (UNIFACS), Laureate Universities, Salvador 41720-200, Brazil
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador 40290-000, Brazil
| | - Laura E. Caulfield
- Center for Human Nutrition, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Amita Gupta
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune 380016, India; (M.A.); (V.K.); (P.D.); (A.G.)
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Rupak Shivakoti
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
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7
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Coleman KK, Wong CC, Jayakumar J, Nguyen TT, Wong AWL, Yadana S, Thoon KC, Chan KP, Low JG, Kalimuddin S, Dehghan S, Kang J, Shamsaddini A, Seto D, Su YCF, Gray GC. Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted? J Infect Dis 2020; 221:566-577. [PMID: 31563943 PMCID: PMC7107482 DOI: 10.1093/infdis/jiz489] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/25/2019] [Indexed: 01/09/2023] Open
Abstract
Background A number of serious human adenovirus (HAdV) outbreaks have been recently reported: HAdV-B7 (Israel, Singapore, and USA), HAdV-B7d (USA and China), HAdV-D8, -D54, and -C2 (Japan), HAdV-B14p1 (USA, Europe, and China), and HAdV-B55 (China, Singapore, and France). Methods To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. Genome sequencing and phylogenetic analyses were performed to identify HAdV genotypes, clonal clusters, and recombinant or novel HAdVs. Results The most prevalent genotypes identified were HAdV-B3 (35.6%), HAdV-B7 (15.4%), and HAdV-E4 (15.2%). We detected 4 new HAdV-C strains and detected incursions with HAdV-B7 (odds ratio [OR], 14.6; 95% confidence interval [CI], 4.1–52.0) and HAdV-E4 (OR, 13.6; 95% CI, 3.9–46.7) among pediatric patients over time. In addition, immunocompromised patients (adjusted OR [aOR], 11.4; 95% CI, 3.8–34.8) and patients infected with HAdV-C2 (aOR, 8.5; 95% CI, 1.5–48.0), HAdV-B7 (aOR, 3.7; 95% CI, 1.2–10.9), or HAdV-E4 (aOR, 3.2; 95% CI, 1.1–8.9) were at increased risk for severe disease. Conclusions Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine.
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Affiliation(s)
- Kristen K Coleman
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Chui Ching Wong
- Department of Microbiology, Singapore General Hospital, Singapore
| | - Jayanthi Jayakumar
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Tham T Nguyen
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Abigail W L Wong
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Su Yadana
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Koh C Thoon
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore
| | - Kwai Peng Chan
- Department of Microbiology, Singapore General Hospital, Singapore.,Academic Clinical Programme for Pathology, Duke-NUS Medical School, Singapore
| | - Jenny G Low
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore.,Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Shirin Kalimuddin
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Shoaleh Dehghan
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA.,Chemistry Department, American University, Washington, District of Columbia, USA
| | - June Kang
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Amirhossein Shamsaddini
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Donald Seto
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Yvonne C F Su
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Gregory C Gray
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore.,Division of Infectious Diseases, Global Health Institute, and Nicholas School of the Environment, Duke University, Durham, North Carolina, USA.,Global Health Center, Duke Kunshan University, Kunshan, China
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8
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Yadana S, Coleman KK, Nguyen TT, Hansen-Estruch C, Kalimuddin S, Thoon KC, Low JGH, Gray GC. Monitoring for airborne respiratory viruses in a general pediatric ward in Singapore. J Public Health Res 2019; 8:1407. [PMID: 31857987 PMCID: PMC6902309 DOI: 10.4081/jphr.2019.1407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/18/2018] [Accepted: 10/29/2019] [Indexed: 01/05/2023] Open
Abstract
There is an increasing body of evidence suggesting that transmission of respiratory viruses occurs through the inhalation of virus-laden particles. Our study describes the use of an aerosol sampling system to monitor the prevalence of airborne viruses in a hospital setting. Using SKC AirCheck Touch pumps, with National Institute for Occupational Safety and Health (NIOSH) bioaerosol samplers and SKC filter cassette blanks, 28 aerosol samples were collected in a hospital ward in Singapore. Following DNA/RNA extraction, real-time RT-PCR/PCR was used for the detection of influenza A, B and D viruses, coronaviruses, enteroviruses, and adenoviruses. Airborne virus was detected in nine (32%) of 28 samples. Among the nine positive samples, eight were PCR-positive for adenovirus and one for influenza A virus. Our data suggest that bioaerosol sampling could be valuable in monitoring for airborne respiratory viruses in clinical environments to better understand the risk of infection during a hospital visit. Significance for public health We demonstrated the potential for airborne respiratory viruses to circulate among hospitalized children, nursing staff and visitors. We argue that bioaerosol sampling could serve as a noninvasive and low-cost method to monitor for novel respiratory virus incursions in clinical settings, and better understand the risk of acquiring a respiratory illness during a hospital visit.
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Affiliation(s)
- Su Yadana
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | | | - Tham Thi Nguyen
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | | | - Shirin Kalimuddin
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Koh Cheng Thoon
- Department of Pediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore
| | - Jenny Guek Hong Low
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.,Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Gregory Charles Gray
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.,Division of Infectious Diseases, School of Medicine and Global Health Institute, Duke University, Durham, NC, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China
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9
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Coleman KK, Nguyen TT, Yadana S, Hansen-Estruch C, Lindsley WG, Gray GC. Bioaerosol Sampling for Respiratory Viruses in Singapore's Mass Rapid Transit Network. Sci Rep 2018; 8:17476. [PMID: 30504827 PMCID: PMC6269463 DOI: 10.1038/s41598-018-35896-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/10/2018] [Indexed: 12/12/2022] Open
Abstract
As a leading global city with a high population density, Singapore is at risk for the introduction of novel biological threats. This risk has been recently reinforced by human epidemics in Singapore of SARS coronavirus, 2009 pandemic H1N1 influenza A virus, and enterovirus 71. Other major threats to Singapore include MERS-coronavirus and various avian and swine influenza viruses. The ability to quickly identify and robustly track such threats to initiate an early emergency response remains a significant challenge. In an effort to enhance respiratory virus surveillance in Singapore, our team conducted a pilot study employing a noninvasive bioaerosol sampling method to detect respiratory viruses in Singapore's Mass Rapid Transit (MRT) network. Over a period of 52 weeks, 89 aerosol samples were collected during peak MRT ridership hours. Nine (10%) tested positive for adenovirus, four (4.5%) tested positive for respiratory syncytial virus type A, and one (1%) tested positive for influenza A virus using real-time RT-PCR/PCR. To our knowledge, this is the first time molecular evidence for any infectious respiratory agent has been collected from Singapore's MRT. Our pilot study data support the possibility of employing bioaerosol samplers in crowded public spaces to noninvasively monitor for respiratory viruses circulating in communities.
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Affiliation(s)
- Kristen K Coleman
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore, Singapore.
| | - Tham T Nguyen
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Su Yadana
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore, Singapore
| | | | - William G Lindsley
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Gregory C Gray
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore, Singapore
- Division of Infectious Diseases, School of Medicine and Global Health Institute, Duke University, Durham, North Carolina, USA
- Global Health Research Center, Duke Kunshan University, Kunshan, China
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