Asian Pacific Journal of Tropical Medicine

381-382

Authors: Giao Huynh, Kimberly H. Nguyen, Han Thi Ngoc Nguyen, Tuan Diep Tran, Pham Le An

None.

385-386

Authors: Yusra Mashkoor, Faryal Rafique, Amraha Zubair

None.

400-409

Authors: Serap Argun Baris, Oya Baydar Toprak, Pelin Duru Cetinkaya, Fusun Fakili, Nurdan Kokturk, Seval Kul, Ozgecan Kayalar, Yildiz Tutuncu, Emel Azak, Mutlu Kuluozturk, Pinar Aysert Yildiz, Pelin Pinar Deniz, Oguz Kilinc, Ilknur Basyigit, Hasim Boyaci, Ismail Hanta, Neslihan Kose, Gulseren Sagcan, Caglar Cuhadaroglu, Hacer Kuzu Okur, Hasan Selcuk Ozger, Begum Ergan, Mehtap Hafizoglu, Abdullah Sayiner, Esra Nurlu Temel, Onder Ozturk, Tansu Ulukavak Ciftci, Ipek Kivilcim Oguzulgen, Vildan Avkan Oguz, Firat Bayraktar, Ozlem Ataoglu, Merve Ercelik, Pinar Yildiz Gulhan, Aysegul Tomruk Erdem, Muge Meltem Tor, Oya Itil, Hasan Bayram

Objective: To evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry. Methods: Thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: In the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% CI 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% CI 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% CI 1.52- 5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19.

418-424

Authors: Tharaka Wijerathna, Nayana Gunathilaka, Saveen Semege, Nishantha Pathirana, Wasana Rodrigo, Deepika Fernando

Objective: To compare the DNA sequences of Leishmania (L.) donovani isolated from individuals in two districts of the Northern Province with other parts of Sri Lanka and neighboring countries. Methods: Samples were collected from military personnel at the Army Hospital, Narahenpita, Sri Lanka from November 2018 to March 2020. A portion of the samples was fixed, stained with Giemsa and observed under the light microscope. The genomic The DNA was extracted from the remaining portion of the samples using DNEasy blood tissue kit (Qiagen, Germany) and amplified using Leishmania genus-specific primers for molecular diagnosis initially. DNA was amplified using L. donovani species-specific primers by PCR and the amplified product was sequenced for comparison of nucleotide sequences. Results: Out of 76 suspected patients, at least one biological sample of 45 (59.2%) was positive for L. amastigotes upon microscopy. Overall, 33 (43.4%) were positive in Leishmania genus-specific PCR, but only 23 (30.3%) were positive in L. donovani specific PCR. The dendrogram indicates that the current sequences clustered together with those from Nepal and Gampaha districts (Western Province), Sri Lanka, while the Indian and Eastern African sequences clustered separately. Conclusions: The genetic diversity was low among the isolates, indicating a single and possibly a local point of origin. However, the similarity of Sri Lankan and Nepal strains indicate a possibility of a shared point of origin, which needs more extensive evidence to confirm.

427-428

Authors: Faheem Anwar, Abdullah, Shazma Wahab, Komal Aman, Ihteshamul Haq

None.

335-336

Authors: Claudio Bruno Silva de Oliveira, Joelma Maria de Araújo Andrade, Jonas Ivan Nobre Oliveira

None.

339-340

Authors: Susanta Kumar Ghosh, Chaitali Ghosh

None.

343-353

Authors: Aamir Bashir, Gautam Sahu, Ishfaq Rashid, Pramil Tiwari

Objective: To compare the efficacy and safety outcomes of different antileishmanial agents used in visceral leishmaniasis clinical trials. Methods: A systematic literature search in PubMed/MEDLINE, EMBASE, Cochrane, and Google Scholar was done using keywords “randomized controlled trials”, “antileishmanial” and “visceral leishmaniasis”. The outcomes included were cure rate, overall withdrawals, relapse rate, and treatment-emergent adverse events. Effect estimates through the frequentist network meta-analysis approach were presented as OR with 95% CI. Rankogram plots were used for identifying the “best intervention” based on p-scores obtained using the surface under the cumulative ranking. The risk of bias was evaluated by using Pedro Scale. Results: Seventeen randomized controlled trials with 5 143 visceral leishmaniasis patients who received different antileishmanial agents (amphotericin B, miltefosine, paromomycin, meglumine antimoniate, sodium stibogluconate, sitamaquine, and pentavalent antimonials) and met the inclusion criteria were included. For efficacy outcomes of the treatments, the rankogram of the network meta-analysis revealed that paromomycin (p-score=0.814 8) has the highest probability of being best in the pool, followed by sodium stibogluconate (OR 0.82, 95% CI 0.24-2.79, p-score=0.758 0), amphotericin B+miltefosine (OR 0.66, 95% CI 0.02-19.04, p-score=0.732 9) as compared to the remaining treatments; however, the most of the treatment-emergent adverse events were reported with sitamaquine. Conclusions: Paromomycin reported the highest cure rates, while the maximum treatment-emergent adverse events were seen with sitamaquine.

361-366

Authors: Aprianta Agus, Somia Agus, Aryana Suka

Objective: To identify the relationship between interleukin (IL)-15 levels and sarcopenia in human immunodeficiency virus (HIV)- infected patients who have received antiretroviral therapy. Methods: This study was a cross-sectional design with 70 participants conducted from January to March 2021. All the participants were assessed for sarcopenia and the IL-15 levels. Sarcopenia was established based on the the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Plasma IL-15 was determined. This analysis was carried out by means of 2×2 tabulation and the statistical test used is Chi-square. Results: Seventy patients received antiretroviral therapy >6 months and showed a good clinical response. Among them, 36 (51.4%) took zidovudine-based antiretroviral therapy with a median duration of illness of 5 years. The proportion of sarcopenia in patients with HIV infection was 32.9%. The median CD4 cell count was 395.5 cells/L (range: 203-937 cells/L). Logistic regression analysis revealed that age>50 years (aOR 8.3, 95% CI 1.6-44.5), underweight (aOR 7.7, 95% CI 1.5-40.5), IL-15≥150.5 ng/L (aOR 4.9, 95% CI 1.3-19.0) and female (aOR 4.8, 95% CI 1.2-18.3 were significant and independent adverse predictors of sarcopenia in subjects with HIV infection. Conclusions: There is an association between high levels of IL-15 and sarcopenia in HIV-infected patients on antiretroviral therapy for more than 6 months with good clinical response.

374-378

Authors: Ceren Cetin, Ugurgul Arslan

Objective: To report an outbreak of Burkholderia (B.) cepacia related to contaminated surface cleaner in the pediatric ward of a tertiary hospital in Turkey. Methods: This study retrospectively reported the outbreak occurred between January 16, 2018 and January 23, 2018. Twelve immunocompetent patients who developed a bloodstream infection a few days after the hospitalization and who were positive for B. cepacia were included. Environmental samples were collected from various areas in the hospital to find the source of the outbreak. Results: All patients had clinical and biochemical evidence of sepsis. None of the patients had an underlying disease or had a central venous catheter as a risk factor. B. cepacia was isolated from the samples taken from the surface cleaners. The antibiotic susceptibilities of B. cepacia isolates were identical in the surface cleaners with the isolates from the patients’ blood cultures. The outbreak was controlled after removing the surface cleaners from use. None of the infected patients died during the outbreak. Conclusions: Nosocomial B. cepacia outbreak may occur in immunocompetent children as well. Rapid identification of the outbreak, defining the source and taking appropriate measures to control the outbreak are the key points in the management.

287-289

Authors: Gaurav Kumar, Jaspreet Kaur, Shweta Pasi

None.

293-307

Authors: Soumya Ranjan Satapathy, Rudra Narayan Sahoo

Visceral leishmaniasis (VL), also known as Kala-azar, is caused by Leishmania (L.) donovani complex, which includes L. donovani and L. infantum and is associated with a high death rate as compared to the cutaneous and subcutaneous form. Treatment of VL includes chemotherapeutic agents which are associated with some major hurdles like toxicities, parenteral administration, high cost, parasite resistance and stability. Hence, there is an urgent requirement to develop novel chemotherapeutic agents or repurposing of existing drugs against VL. Developing formulation of new chemical entity for the treatment of VL is laborious, time consuming and associated with huge financial burden. However, screening of existing chemotherapeutic agents is a good alternative to avail cost-effective treatment option for VL. Non-PEGylated liposome encapsulated doxorubicin (Myocet®) is proposed as an alternative treatment option for VL in this review article. Here, we covered the fundamental aspects of VL, loophole associated with available current treatment strategies and non-PEGylated liposome encapsulated doxorubicin as a novel alternative formulation for treating VL, as this liposomal delivery system of doxorubicin might passively target the intra-cellular regions of macrophage.

314-321

Authors: Thunyarat Surasiang, Sirilak Chumkiew, Pongsakorn Martviset, Pathanin Chantree, Mantana Jamklang

Objective: To determine the prevalence of mosquito larvae in campus areas and the infection rate of endosymbiotic bacteria, Wolbachia in mosquito larvae. Method: The mosquito larvae samples were collected in residential areas and academic buildings of Suranaree University of Technology located in Northeastern Thailand during 2017-2018. Mosquito species identification was performed using GLOBE mosquito protocols and Rattanarithikul & Panthusiri’s keys. The gene encoding for the surface protein of Wolbachia was amplified by PCR and confirmed by DNA sequencing. Results: Armigeres sp. is the highest proportion of mosquito larvae followed by Culex spp., Aedes albopictus, Aedes aegypti, and Toxorynchites spp., respectively. Aedes aegypti have breeding sites mostly in the containers found indoors, whereas the main breeding sites of Aedes albopictus were found in both outdoors and indoors. The House Index and Breteau Index for Aedes spp. was more than 5% and 20%, respectively, in both areas, indicating that these areas are dengue sensitive. The highest proportion of Wolbachia infection was found in the larvae of Culex spp. (86.21%), followed by Aedes albopictus (69.23%) and rarely detected in Aedes aegypti (9.09%). Conclusion: The present study reported the first natural infection of Wolbachia in mosquito larvae in Thailand. Our result suggested that the mosquito species containing higher proportion of Wolbachia are less likely to be vectors for dengue. Therefore, Wolbachia transfection in mosquito larvae could be applied as a biocontrol for dengue and other mosquito-borne disease prevention.

332-334

Authors: Minu George, Neena Baby, Pradeep Mathew Koshy, Rajendran Ullatil, Sureshkumar Radhakrishnan

Rationale: To report a case of cervicobrachial variant of acute inflammatory demyelinating polyneuropathy presenting with papilledema and GQ1b positivity. Patient concern: A 35-year-old female, 68 days postpartum, presented with headache, vomiting, and gait difficulty in swallowing with bilateral upper limb weakness and difficulty in walking, 13 days after ChAdOx1 nCoV-19 vaccination. Diagnosis: Guillain-Barre syndrome with GQ1b positivity. Intervention: Five cycles of plasmapheresis were given. Outcome: The patient’s clinical condition improved. Palatal weakness improved and she could walk without support. There were mild sensory symptoms involving upper limbs which gradually improved. Lessons: AIDP should be considered in case of weakness following ChAdOx1 nCoV-19 vaccination. Albumino-cytological dissociation and anti-GQ1b positivity are needed to confirmed the diagnosis.

239-240

Authors: Yan Lei, Qiao Zhang, Yin Pan

None.

245-265

Authors: Afsaneh Farjami, Soheila Montazersaheb, Saiedeh Razi Soofiyani, Parvin Akbarzadehlaleh, Sara Salatin

The COVID-19 epidemic caused by SARS-CoV-2 virus has turned into a worldwide pandemic. Therefore, health officials all around the world have strived for developing efficient preventive and treatment methods to deal with this global crisis. Amongst them, monoclonal antibodies, anti-TNFs, and convalescent plasma appear to be effective against this disease. In addition, clinical trials are currently being conducted for viral targeting vaccines. This review summarizes major advances using biopharmaceuticals in the treatment and prevention strategies against COVID-19 that have occurred in the global medicinal system from its introduction until March 2022.

274-282

Authors: Hakan Tüzün, Cansu Özbaş, Burkay Budak, Gizem Altunay, F. N. Baran Aksakal

Objective: To determine the change in the quality of life (QoL) of patients who applied to a tertiary outpatient clinic according to their COVID-19 status. Methods: This cross-sectional study comprised 1 370 participants. Short form-12 (SF-12), which includes Physical Component Summary (PCS) and Mental Component Summary (MCS) domains, was used to evaluate the QoL. Different linear regression models created using PCS-12 and MCS-12 were dependent variables. Results: A total of 19.2% of participants had acute COVID-19, and 8.4% had long COVID-19. The most common sypmtoms were fatigue (72.6%), headache (42.5%), and joint pain (39.8%) in patients with long COVID-19. The model including all participants showed that long COVID-19 reduced the QoL in multivariate analysis for both MCS and PCS, while acute COVID-19 had no significant effect on the QoL comparing with those without COVID-19. Model that included participants with COVID-19 showed that long COVID-19 negatively affected the QoL in the multivariate model for PCS-12 and MCS-12. Variables that were significant in the multivariate model for those who had long COVID-19 were having a chronic disease and presence of ongoing symptoms. Females were disadvantaged for PCS-12 and MCS-12 in the multivariate models including all participants, and models including participants who have had COVID-19. Low educational group were disadvantaged for PCS-12 in the multivariate model including all participants. This group were also disadvantaged for PCS-12 and MCS-12 in the multivariate models including participants who had COVID-19. Conclusions: In studies, acute COVID-19 and long COVID-19 should be treated as separate categories. The effects of long COVID-19 should be considered when providing and planning health services. The effect of gender, and education, on QoL shows that health inequalities continue to be effective during the pandemic period.

191-192

Authors: Abdullahi Tunde Aborode, Abideen Opeyemi Olasupo, Taibat Aduragba Hussain, Abayomi Oyeyemi Ajagbe

None.

196-205

Authors: Rasit Dinc

Leishmaniasis, including the cutaneous form, poses an important public health threat around the world, while no vaccine is currently available against any form of leishmaniasis. The drugs used in the first line treatment of cutaneous leishmaniasis (CL) are commonly pentavalent antimonials despite their toxicities, long-term treatment duration and increasing resistance rates. Other alternatives are amphotericin B, pentamidine, miltefosine and paromomycine. Movement of the population, especially in endemic regions, increases the spread of the parasite and affectes the distribution of causative species, which requires re-evaluation the treatment regimen. Extensive researches are carried out on the treatment of leishmaniasis. The immunotherapeutic and targeted therapeutic approaches, formulations of carrier-loaded active drugs, local thermotherapeutic applications, the combination of antileishmanial drugs/compounds, the use of new synthetic and natural products are promising therapeutic options in the future. Herein, the author reviews the potential treatment modalities of CL with a brief overview of current treatments in the light of ongoing studies around the world.

213-219

Authors: Siew-Keah Lee, Jin Wei Ma, Khai Ying Chan, Yi Song Cheong, Wan Ting Hong, Regine Chew Yi Ong, Wei Cheng Tay, Ang-Lim Chua

Objective: To determine the degree of knowledge in the usage of pulse oximeter as a home assessment tool among the community in Malaysia. Methods: A cross-sectional survey was conducted in November 2021. The questionnaire assessed the knowledge in using pulse oximeters, user experience and opinions in using pulse oximeter as a home assessment tool during the pandemic. Results: A total of 504 respondents were included in the study, and the mean score in knowledge related to application of pulse oximetry was 73.00%, while the mean score in knowledge related to factors affecting pulse oximetry readings was only 38.51%. A total of 90.5% of the respondents recognised normal pulse rate and 88.5% knew the blood oxygen saturation levels of a healthy adult, while 69.4% recognised the definition of silent hypoxia. In addition, the majority of the respondents agreed that factors such as poor blood circulation (71.2%), excessive movements (69.8%), and hand position (60.7%) affected oximetry readings. However, 61.7%, 81.7%, 77.2% and 76.8% of the respondents could not identify nail polish, skin colour, skin thickness and tattoos as factors that may affect oximetry readings respectively. Conclusions: The respondents showed a satisfactory level of knowledge related to application of pulse oximetry, but a poor level of knowledge related to factors affecting pulse oximetry readings among the community in Malaysia. Continuous efforts in educating the community on the correct use of pulse oximeters are crucial for appropriate home assessment and avoiding unnecessary stress.

230-231

Authors: Neha Srivastava, Hirawati Deval, Nikhat Khan, Rajni Kant, Aparup Das

None.

236-238

Authors: Kia Jahanbin, Mohammad Jokar, Vahid Rahmanian

None.