Asian Pacific Journal of Tropical Medicine

429-430

Authors: Mehmet UÇAR

None.

442-450

Authors: Vasily Y. Marchenko, Natalia P. Kolosova, Alexey V. Danilenko, Maria K. Bragina, Tran Thi Nhai, Alexander B. Ryzhikov

Objective: To investigate the genetic diversity of coronaviruses in wild and domestic birds in the bird park and live poultry markets of Ca Mau province in Vietnam in 2020. Methods: A total of 228 samples (121 from wild birds and 107 from poultry) were collected in the territory of Ca Mau province of Vietnam in 2020. The avian samples were tested for the presence of the four genera of coronaviruses using reverse transcription and nested PCR. Molecular genetic analysis using targeted NGS sequencing of RdRp gene was performed for 29 representative samples (12 samples from wild birds and 17 from poultry). Phylogenetic analysis was performed using the neighbour joininig method with 1 000 bootstrap replications using MEGA X software. Results: Among wild birds, 21.5% samples were positive for the genetic material of coronaviruses and 38.3% samples were positive for coronaviruses among poultry. Genetic analysis of the partial sequence of RdRp gene from representative samples revealed that wild birds were carriers of gammacoronaviruses and deltacoronaviruses. Among poultry, three genotypes of infectious bronchitis virus (QX, Mass and Q1) were detected in chickens, with QX genotypes being predominant, and viruses of DCoV group were detected in domestic ducks. There was no detection of alphacoronaviruses or betacoronaviruses in the studied birds. Conclusions: Coronaviruses of genera Gammacoronavirus and Deltacoronavirus were detected in wild birds. A high percentage of infectious bronchitis virus was detected in poultry. Thus, there is a need for broader surveillance of coronaviruses in birds, which can be used for evaluation of diversity, evolution and distribution of coronaviruses in Vietnam. Continuous surveillance of coronaviruses circulation in wild and domestic animals is necessary for implementing strategic measures for poultry and domestic animal protection and for evaluation of possible risk of circulating coronaviruses to human health.

461-467

Authors: Galvin Sim Siang Lin, Wen Wu Tan, Daryl Zhun Kit Chan, Kai Shen Ooi, Hasnah Hashim

Objective: To evaluate the awareness, knowledge, and attitude on monkeypox viral infection among preclinical and clinical dental students in Malaysia. Methods: A cross-sectional study was conducted among 229 preclinical and clinical dental students via an online self-reported questionnaire. The questionnaire included 3 items on awareness, 15 items on knowledge, 9 items on attitude and 2 open-ended questions. Data were presented as frequencies and percentages. Chi-square test was used to compare knowledge and awareness scores between preclinical and clinical dental students and content analysis was performed for open-ended responses. Results: Preclinical and clinical dental students were aware of the existence of monkeypox (89.5% and 94.4%, respectively), that the disease emerged in non-endemic countries (81.0% and 87.1%, respectively) and that it was declared a public health emergency of international concern by the World Health Organization (73.3% and 79.0%, respectively). Clinical dental students’ overall knowledge level was significantly higher than preclinical dental students (P=0.014). Both preclinical (95.2%) and clinical (96.8%) dental students demonstrated positive attitudes toward monkeypox with no significant difference (P=0.736) noted between them. Three themes emerged from the open-ended questions: (1) reimplementation of nationwide lockdown, (2) impact on the economy and health, and (3) disruption to the educational system. Students also anticipated their face-to-face learning to be reduced should there be a new outbreak. Conclusions: Both preclinical and clinical dental students showed comparable awareness and attitudes, while the latter demonstrated greater satisfactory knowledge toward the re-emergence of monkeypox during the COVID-19 pandemic. Nonetheless, efforts to improve dental students’ understanding of this alarming outbreak are required, to safeguard their health and minimise transmission.

474-476

Authors: Thanyalak Amornpojnimman, Song Srisilpa, Pornchai Sathirapanya

Rationale: To report neurological paradox in a non-HIV patient with pulmonary tuberculosis. Patient concerns: A 26-year-old non-human immunodeficiency virus immunosuppressed female patient presented with diffused headache, diplopia, ascending paraparesis with loss of bowel and bladder control. Diagnosis: Disseminated neurological paradoxical reaction developed during tuberculosis treatment in a non-human immunodeficiency virus patient. Intervention: High-dose intravenous corticosteroid was added to the anti-tuberculous drugs, followed by tapered dose of oral prednisolone in 3 months. Outcome: A favorable neurological outcome was obtained 6 months later. Lessons: Neurological paradoxical reaction cannot be overlooked among the tuberculosis-treated cases who present with newly emerged neurological disorders.

1-3

Authors: Balamurugan Shanmugaraj, Narach Khorattanakulchai, Waranyoo Phoolcharoen

N/A

7-16

Authors: Nur Ellene Mat Luwi, Suhana Ahmad, Ahmad Suhaimi Nurfatihah Azlyna, Asyikin Nordin1, Maria Elena Sarmiento2, Armando Acosta, Mohd Nor NorAzmi, Vuk Uskoković, Rohimah Mohamud, Ramlah Kadir

Liposomes are phospholipid bilayer vesicles, which are biocompatible, biodegradable and nontoxic vehicles suitable for numerous drug and gene delivery applications. In this review, we discuss the prospect of using liposome technology in the development of a vaccine for tuberculosis. Tuberculosis remains an important health problem that requires the development of an effective vaccine, especially since the only approved vaccine for it continues to be the Bacille Calmette-Geurin (BCG) one developed 100 years ago. This review focuses on the different applications of liposomes toward achieving this goal. Numerous liposomal formulations showing prospect in the research stage and in clinical trials are discussed.

26-34

Authors: Yanfeng Gong, Jiaxin Feng, Zhuowei Luo, Jingbo Xue, Zhaoyu Guo, Lijuan Zhang, Shang Xia, Shan Lv, Jing Xu, Shizhu Li

Objective: To determine the spatiotemporal distribution of Schistosoma (S.) japonicum infections in humans, livestock, and Oncomelania (O.) hupensis across the endemic foci of China. Methods: Based on multi-stage continuous downscaling of sentinel monitoring, county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019. The data included S. japonicum infections in humans, livestock, and O. hupensis. The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model, with a standard deviational ellipse (SDE) tool, which determined the central tendency and dispersion in the spatial distribution of schistosomiasis. Further, more spatiotemporal clusters of S. japonicum infections in humans, livestock, and O. hupensis were evaluated by the Poisson model. Results: The prevalence of S. japonicum human infections decreased from 2.06% to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019, with a reduction from 9.42% to zero for the prevalence of S. japonicum infections in livestock, and from 0.26% to zero for the prevalence of S. japonicum infections in O. hupensis. Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan, Hubei, Jiangxi, and Anhui, as well as in the Poyang and Dongting Lake regions. Poisson model revealed 11 clusters of S. japonicum human infections, six clusters of S. japonicum infections in livestock, and nine clusters of S. japonicum infections in O. hupensis. The clusters of human infection were highly consistent with clusters of S. japonicum infections in livestock and O. hupensis. They were in the 5 provinces of Hunan, Hubei, Jiangxi, Anhui, and Jiangsu, as well as along the middle and lower reaches of the Yangtze River. Humans, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the north of the Hunan Province, south of the Hubei Province, north of the Jiangxi Province, and southwestern portion of Anhui Province. In the 2 mountainous provinces of Sichuan and Yunnan, human, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the northwestern portion of the Yunnan Province, the Daliangshan area in the south of Sichuan Province, and the hilly regions in the middle of Sichuan Province. Conclusions: A remarkable decline in the disease prevalence of S. japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019. However, there remains a long-term risk of transmission in local areas, with the highestrisk areas primarily in Poyang Lake and Dongting Lake regions, requiring to focus on vigilance against the rebound of the epidemic. Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection, wild animal infection, and O. hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.

44-46

Authors: Hakan Yildirim, Mehmet Balbaba, Turgut Yilmaz, Zülal Asci Toraman

Rationale: Endophthalmitis is an uncommon but serious ocular infection often resulting in probable visual loss. Bacteroides fragilis is a rare cause of endophthalmitis. Patient concerns: A 46-year-old male patient complained of eye pain and low vision after pars plana vitrectomy. Diagnosis: Bacteroides fragilis endophthalmitis after pars plana vitrectomy was diagnosed. Interventions: Pars plana vitrectomy and silicone oil implantation were performed. Outcomes: Early treatment and choice of tamponade in endophthalmitis after pars plana vitrectomy may possibly prevent evisceration and progression of endophthalmitis. Lessons: Bacteroides fragilis can be seen in cases of endophthalmitis after pars plana vitrectomy.

381-382

Authors: I Md Ady Wirawan, I Nyoman Sutarsa, Putu Ayu Swandewi Astuti

None.

385-400

Authors: Langui Song, Qingxing Xie, Zhiyue Lv

Objective: Foodborne parasitic diseases, although with a declining overall incidence rate, are still endangering local public safety. This review aims to describe the current situation and epidemiological trends of foodborne parasitic diseases in China in order to explore possible reasons contributors to its high prevalence in some areas, and propose strategies for prevention and control accordingly. Methods: A scoping review was conducted by searching PubMed, CNKI, Wanfang, CQVIP, Embase, and the Cochrane Library using search formula “foodborne parasitic diseases (or foodborne parasites)” AND “China”. Studies on foodborne parasitic diseases in China were considered, but only articles in English or Chinese published between January 1980 and June 2020 were retrieved. Included studies were screened according to the eligibility criteria: 1) diseases consistent with the WHO definition of foodborne parasitic diseases; 2) the food carriers were included in the WHO food classification; 3) data related to epidemiology, pathogenicity, and prevention and control; 4) Foodborne parasitic diseases cases or outbreaks in China. Results: A total of 111 out of 665 records were included and summarized. The prevalence of clonorchiasis, angiostrongyliasis, echinococcosis, trichinellosis and cysticercosis was still increasing although the infection rate of soil-transmitted nematodes has substantially decreased in recent years. Diverse eating habits, close contact with animals, and urbanization were contributing factors to the increase. Conclusions: Foodborne parasitic diseases remain an important public health issue in China with the progress of economic globalization and food diversification. We should manage to raise public awareness about the prevention and control of foodborne parasitic diseases, improve health and safety inspections, as well as public health practice.

410-416

Authors: Jannatin Nisa Arnindita, Muhammad Miftahussurur, Bagus Setyoboedi, Juniastuti

Objective: To determine the proportion of HBV surface antigen (anti-HBs) antibody positive children under five years of age born to HBsAg-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago. Methods: Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series. Anti-HBs antibodies were determined by using rapid test. Data of age, gender, nutritional status, vaccination timing or vaccination compliance, and booster vaccination were collected from vaccination card. Results: Ninety children were enrolled, consisting of 47 females and 43 males with a mean age of 2.3 years. Twenty two (24.4%) children received booster vaccine between 18 and 24 months and 55 (61.1%) were anti-HBs positive. Among factors of age, gender, nutritional status, compliance to vaccination and booster vaccine, only administration of booster vaccine was significantly associated with anti-HBs status (OR 5.45, 95% CI 1.45, 20.52). Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine. Conclusions: Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity. Booster vaccination may be required to improve anti-HBs seropositivity.

333-340

Authors: Ana Carolina Marinho Monteiro Lima, Greice Carolina Santos da Silva, Fernanda Khouri Barreto, Filipe Ferreira de Almeida Rego, Luana Leandro Gois, Luciane Amorim Santos

Human T-cell lymphotropic virus type 1 (HTLV-1) is associated with the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It has been reported that the HTLV-1 proteins (specifically TAX and HBZ) can modulate FOXp3, resulting in an immune imbalance that can favor the progression of HAM/TSP. This review aims to summarize the literature in order to clarify the relationship between the expression of HTLV-1 mRNAs and/or viral proteins (TAX and HBZ) with the expression of mRNA and/or protein FOXp3 and their correlation with HAM/ TSP development. This systematic review was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The search strategy was performed on the Medical Literature Analysis and Retrieval System Online and Latin American and Caribbean Literature in Health Sciences Platform using subject descriptors. After screening, six articles were included in this review. The studies suggested that TAX and HBZ have a directly proportional correlation with FOXp3 in individuals with HAM/TSP, which also presented an increased expression of FOXp3 compared to asymptomatic controls and/or healthy donors. This systematic review indicates that TAX and HBZ can interact with FOXp3 and that interaction may influence HAM/ TSP development.

350-355

Authors: Cesarius Singgih Wahono, Hani Susianti, Tri Wahyudi Iman Dantara, Perdana Aditya Rahman1 , Mirza Zaka Pratama1 , Indah Adhita Wulanda, Khoirunisah Dwi Hartanti, Elvira Sari Dewi, Kusworini Handono

Objective: To describe the prevalence of antiphospholipid antibodies in coronavirus disease-19 (COVID-19) and to find potential associations between antiphospholipid antibody positivity and clinical outcomes. Methods: From September to November 2020, clinical and laboratory data were collected from 50 COVID-19 patients hospitalized at Saiful Anwar General Hospital in Malang, Indonesia. Antiphospholipid antibodies were measured by finding IgM anti- β2 glycoprotein, lupus anticoagulant, and IgM/IgG anticardiolipin. Clinical characteristics, thrombotic events, ICU admission, and mortality during hospitalization were recorded. Disease severity was defined by the Guidelines for the Prevention and Control of COVID-19, Indonesia. Results: Among 50 patients, 5 patients (10.0%) were positive for antiphospholipid antibodies: 4 patients (80.0%) had IgM anti- β2 glycoprotein and 1 patient had IgG anti-cardiolipin (20.0%) and IgM anti-cardiolipin (20.0%), none of lupus anticoagulant was detected. Antiphospholipid antibodies were associated with anosmia (OR 8.1; 95% CI 1.1-57.9; P=0.018), nausea and vomiting (OR 12.4; 95% CI 1.2-122.6; P=0.010), diarrhea (OR 9.8; 95% CI 1.3-70.9; P=0.010), cardiovascular disease (OR 1.4; 95% CI 1.0- 1.9; P=0.001), chronic kidney disease (OR 12.0; 95% CI 1.6-90.1; P=0.05), acute coronary syndrome (OR 29.3; 95% CI 2.0-423.7; P=0.001), moderate (OR 0.11; 95% CI 0.01-1.10; P=0.031) and severe (OR 18.5; 95% CI 1.8-188.4; P=0.002) disease severity, and in-hospital mortality (OR 8.1; 95% CI 1.1-57.9; P=0.018). However, there is no correlation between the presence of antiphospholipid antibody and ICU admission. Conclusions: In summary, the prevalence of antiphospholipid antibodies in COVID-19 patients is low, mainly against IgM anticardiolipin, and is associated with an acute coronary syndrome, gastrointestinal manifestations, moderate and severe disease severity, and increased risk of mortality.

364-374

Authors: Areepong Yupaporn, Sunthornwat Rapin

Objective: To define the alert levels for the total number of COVID- 19 cases derived by using quantile functions to monitor COVID-19 outbreaks via an exponentially weighted moving-average (EWMA) control chart based on the first hitting time of the total number of COVID-19 cases following a symmetric logistic growth curve. Methods: The cumulative distribution function of the time for the total number of COVID-19 cases was used to construct a quantile function for classifying COVID-19 alert levels. The EWMA control chart control limits for monitoring a COVID-19 outbreak were formulated by applying the delta method and the sample mean and variance method. Samples were selected from countries and region including Thailand, Singapore, Vietnam, and Hong Kong to generate the total number of COVID-19 cases from February 15, 2020 to December 16, 2020, all of which followed symmetric patterns. A comparison of the two methods was made by applying them to a EWMA control chart based on the first hitting time for monitoring the COVID-19 outbreak in the sampled countries and region. Results: The optimal first hitting times for the EWMA control chart for monitoring COVID-19 outbreaks in Thailand, Singapore, Vietnam, and Hong Kong were approximately 280, 208, 286, and 298 days, respectively. Conclusions: The findings show that the sample mean and variance method can detect the first hitting time better than the delta method. Moreover, the COVID-19 alert levels can be defined into four stages for monitoring COVID-19 situation, which help the authorities to enact policies that monitor, control, and protect the population from a COVID-19 outbreak.

378-380

Authors: Kemmapon Chumchuen, Theerakamol Pengsakul, Edward B McNeil, Natthaphon Nanakorn, Virasakdi Chongsuvivatwong

None.

287-298

Authors: Vikas Kushwaha, Puvvada Kalpana Murthy

Objective: To evaluate the effect of short-term and long-term immunization of recombinant disorganized muscle protein-1 (rDIM-1) in rodents against human filarial parasite Brugia malayi. Methods: Recombinant Brugia malayi DIM-1 (rDIM-1bm) protein was cloned, expressed and purified using a Ni-NTA affinity column. Mastomys coucha were immunized with rDIM-1bm in three immunization schedules: short-term (3-dose of rDIM-1bm), and long-term (booster doses till 3- and 6-week) and subsequently challenged with infective third-stage larvae of filarial parasite Brugia malayi (L3). Microfilaraemia was monitored in L3 exposed groups on day 90 post larval inoculation (p.l.i.) and continued till day 205 p.l.i. On day 205 p.l.i. all the infected animals were killed and total worm burden was estimated. Cellular proliferative response, macrophage activity, nitric oxide (NO) release, specific IgG and its subtypes, IgE, IgA and Th1 (IFN-γ, TNF-ααand IL-2) and Th2 (IL-4, IL-5, IL-6, IL-10 and IL-13) cytokine release were determined. Results: Of the 3 different immunization schedules, short term immunization (3-dose schedule) showed better reduction in microfilarial burden (36%-63%) in the peripheral circulation, adult worm load (52%), whereas long-term immunization (3- and 6-week schedule) exerted less effect on peripheral microfilariae count (9%-58%), and adult worm burden (9%-12.5%). Short-term immunization resulted in upregulation of cellular proliferation, macrophages activity, NO release, specific IgG, IgG1, IgG2a, IgG2b, IgE and IgA levels and both Th1 (IFN-γ, TNF-α and IL-2) and Th2 (IL-4, IL-5, IL-6, IL-10 and IL-13) cytokine release whereas long-term immunization (3- and 6-week schedule) exerted less effect on parasite burden and showed mixed immunological responses. None of the rDIM-1bm administration schedules induced any pathology in lymphoid tissues, or alteration in mast cell number and granularity. Conclusions: The short-term immunization with rDIM-1bm (3-dose schedule) induces robust immune responses and protects the host from filarial parasite infection.

309-305

Authors: Nima Ghalekhani, Saied Bokaie, Sana Eybpoosh, Hesameddin Akbarein

Objective: To delineate the H9N2 influenza virus circulation within Iran and its neighboring countries, the potential source of the epidemic in these countries, and its date of origin. Methods: We obtained all hemagglutinin (HA) and neuraminidase (NA) nucleotide sequences of influenza H9N2 available up to December 25, 2020 from Iran and its neighboring countries (i.e., Pakistan, Afghanistan, Turkmenistan, Armenia, Azerbaijan, Turkey, and Iraq). We also performed a Bayesian Markov chain Monte Carlo method to infer the evolutionary dynamic and the most recent common ancestor for the HA and NA sequences. Results: H9N2 epidemic may have started in Iran and Pakistan much earlier than the other investigated countries in the region, and an ongoing bidirectional dispersion of the virus between the investigated countries was also observed. The mean time of the most recent common ancestor of H9N2 viruses was 1988 for HA, and 1992 for NA. Conclusions: Strains from investigated countries rooted in Pakistan and Iran. Regular surveillance of H9N2 viruses, especially in the live bird markets, enhancing the biosecurity of poultry industry and screening newly arriving immigrants and tourists from neighboring countries at border should be considered to control spread of the virus. Furthermore, surveillance of viral molecular evolution should be initiated for effective prevention of epidemic and pandemic spreads.

323-329

Authors: Dmitry A. Kovalev, Dmitriy G. Ponomarenko, Sergey V. Pisarenko, Nikolay A. Shapakov, Anna A. Khachaturova, Natalia S. Serdyuk, Olga V. Bobrysheva, Alexander N. Kulichenko

Objective: To study Brucella (B.) abortus strains isolated in the Russian Federation, in order to identify their detailed position in the phylogenetic structure of the species global population as well as to determine genetic relationships for isolates from different geographical areas. Methods: Based on Bayesian method, the whole genome single nucleotide polymorphism (SNP) analysis of 258 B. abortus strains from different geographical areas of the world including 20 B. abortus strains isolated in Russia was carried out. Results: The core genome SNP analysis of the B. abortus isolates allowed describing the main genetic lineages. The Russian strains entered two separate clades, including the basal branch and the C1 branch that is widely spread in Eurasia. The data on the isolation time was used for the dating of phylogenetic tree, and also the estimated time frame for the B. abortus genotype diversification was determined. There were sets of specific SNPs identified, which defined each of the genotypes and sub-genotypes. Conclusions: A significant genetic diversity of the brucellosis pathogen strains from Russia has been proven. The sets of unique specific SNPs described in our study may become one of the elements within a bio-informational analysis algorithm to be used for epidemiological study of brucellosis outbreaks, including those caused by new (atypical) genetic variants of B. abortus.