Asian Pacific Journal of Tropical Medicine

525-527

Authors: Qiao Zhang, Yin Pan

N/A

543-554

Authors: Petros Galanis, Irene Vraka, Despoina Fragkou, Angeliki Bilali, Daphne Kaitelidou

Considering medical and economic burden of coronavirus disease 2019 (COVID-19), a high COVID-19 vaccination coverage among healthcare workers (HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched PubMed, MEDLINE, Scopus, Web of Science, ProQuest, CINAHL and medRxiv until July 14, 2021. The heterogeneity between results was very high; thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5% (95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs’ willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.

564-574

Authors: Zahra Ramezani, Seyed Abbas Mousavi, Ghasem Oveis, Mohammad Reza Parsai, Fatemeh Abdollahi, Jamshid Yazdani Charati

Objective: To predict the daily incidence and fatality rates based on long short-term memory (LSTM) in 4 age groups of COVID-19 patients in Mazandaran Province, Iran. Methods: To predict the daily incidence and fatality rates by age groups, this epidemiological study was conducted based on the LSTM model. All data of COVID-19 disease were collected daily for training the LSTM model from February 22, 2020 to April 10, 2021 in the Mazandaran University of Medical Sciences. We defined 4 age groups, i.e., patients under 29, between 30 and 49, between 50 and 59, and over 60 years old. Then, LSTM models were applied to predict the trend of daily incidence and fatality rates from 14 to 40 days in different age groups. The results of different methods were compared with each other. Results: This study evaluated 5 0826 patients and 5 109 deaths with COVID-19 daily in 20 cities of Mazandaran Province. Among the patients, 25 240 were females (49.7%), and 25 586 were males (50.3%). The predicted daily incidence rates on April 11, 2021 were 91.76, 155.84, 150.03, and 325.99 per 100 000 people, respectively; for the fourteenth day April 24, 2021, the predicted daily incidence rates were 35.91, 92.90, 83.74, and 225.68 in each group per 100 000 people. Furthermore, the predicted average daily incidence rates in 40 days for the 4 age groups were 34.25, 95.68, 76.43, and 210.80 per 100 000 people, and the daily fatality rates were 8.38, 4.18, 3.40, 22.53 per 100 000 people according to the established LSTM model. The findings demonstrated the daily incidence and fatality rates of 417.16 and 38.49 per 100 000 people for all age groups over the next 40 days. Conclusions: The results highlighted the proper performance of the LSTM model for predicting the daily incidence and fatality rates. It can clarify the path of spread or decline of the COVID-19 outbreak and the priority of vaccination in age groups.

477-478

Authors: Cokorda Agung Wahyu Purnamasidhi, I Komang Hotra Adiputra, Giovanca Verentzia Purnama, Richard Christian Suteja, I Gede Purna Weisnawa

N/A

486-504

Authors: Mehdi Khoobdel, Amir Sajad Jafari, Zakkyeh Telmadarraiy, Mohammad Mehdi Sedaghat, Hasan Bakhshi

Objective: Different studies have been performed on the prevalence of tick-borne pathogens in different areas of Iran; however, as far as our knowledge, there is no regional meta-analysis available for consideration and estimation of tick species infected with different pathogens in Iran. Methods: In this review, among different databases, a total of 95 publications were included, and the infection of different tick species to different tick-borne pathogens was determined; furthermore, presence of pathogens (with 95% confidence intervals) in tick vectors was calculated separately for each province, using Comprehensive Meta-Analysis version 2 (Biostat, USA). Results: Totally, among all 95 studies, 5 673 out of 33 521 investigated ticks were positive according to different detection methods. Overall estimated presence of pathogens in tick vectors in Iran was 8.6% (95% CI 7.0%-10.6%, P<0.001). Of all 46 species of ticks in 10 genera in Iran, 28 species in 9 genera, including Alveonasus, Argas, Boophilus, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, Ornithodoros, and Rhipicephalus were infected with at least 20 pathogens in 10 genera including Aegyptianella, Anaplasma, Babesia, Borrelia, Brucella, Orthonairovirus [Crimean- Congo hemorrhagic fever virus (CCHFV)], Coxiella, Ehrlichia, Rickettsia and Theileria in 26 provinces of Iran. The presence of pathogens in ticks collected in western Iran was more than other regions. Hyalomma anatolicum (20.35%), Rhipicephalus sanguineus (15.00%), and Rhipicephalus bursa (14.08%) were the most prevalent infected ticks for different pathogens. In addition, most literatures were related to CCHFV and Theileria/Babesia spp. Conclusions: Public health and veterinary professionals should be aware of diagnosing possible diseases or outbreaks in vertebrates.

517-524

Authors: Mala Vinod Kaneria, Kallappa Baligeri, Abhijeet Budhe

Objective: To evaluate the associated factors between COVID-19 and mucormycosis. Methods: Twenty-two patients of COVID-19 associated mucormycosis (including 3 asymptomatic patients who were cured of COVID-19) from a single medical unit of our institute were included. A detailed history was noted, with special emphasis on the time of onset of mucormycosis symptoms, presence of comorbidities, including new onset diabetes, severity of COVID-19, oxygen requirement, details of receipt of steroids and immunomodulators such as tocilizumab, imaging findings, including the number of sinuses involved, bony erosions, orbital and cerebral involvement, microscopy, culture and histopathology reports and antifungals given. Surgical interventions including number of debridements, orbital exenteration, maxillectomy, and the vaccination status were noted. Results: All 22 patients had rhino-orbital cerebral mucormycosis, 27.27% in the first wave and 72.73% during the second wave. Diabetes was the commonest comorbidity, and 40.91% patients were newly detected diabetics. The time of presentation in relation to their COVID-19 symptoms was 8-15 days (average 12.5 days). Ten out of 22 (45.45%) had asymptomatic or mild COVID-19 and 40.91% did not require supplemental oxygen. Five out of 22 (22.73%) did not receive steroids. Twelve out of 22 (54.55%) had orbital involvement, 3 (13.64%) had palatal ulcer and 4 (18.18%) had cerebral involvement and all these had progressed in spite of treatment with appropriate antifungals. Conclusions: COVID-19 associated mucormycosis is a frequent, lethal, post COVID-19 complication, occurring even in mild and asymptomatic cases who have not received steroids or oxygen.

429-430

Authors: Giao Huynh, Han Thi Ngoc Nguyen, An Le Pham

N/A

433-439

Authors: Dao Ngoc Hien Tam, Ahmad T Qarawi, Mai Ngoc Luu, Morgan Turnage, Linh Tran, Gehad Mohamed Tawfik, Le Huu Nhat Minh, Nguyen Tien Huy, Tatsuo Iiyama, Kyoshi Kita, Kenji Hirayama

The COVID-19 pandemic has caused millions of deaths and hundreds of millions of confirmed infections worldwide. This pandemic has prompted researchers to produce medications or vaccines to reduce or stop the progression and spread of this disease. A variety of previously licensed and marketed medications are being tested for the treatment and recurrence of SARS-CoV2, including favipiravir (Avigan). Favipiravir was recognized as an influenza antiviral drug in Japan in 2014, and has been known to have a potential in vitro activity against SARS-CoV-2, in addition to its broad therapeutic safety scope. Favipiravir was recently approved and officially used in many countries worldwide. Our review provides insights and up-to-date knowledge of the current role of favipiravir in the treatment of COVID-19 infection, focusing on preclinical and ongoing clinical trials, evidence of its efficacy against SARS-CoV-2 in COVID-19, side effects, anti-viral mechanism, and the pharmacokinetic properties of the drug in the treatment of COVID-19. Due to its teratogenic effects, favipiravir cannot be offered to expectant or pregnant mothers. The practical efficacy of such an intervention regimen will depend on its dose, treatment duration, and cost as well as difficulties in application.

451-455

Authors: Saman Ayoubi, Parissa Farnia, Poopak Farnia, Jafar Aghajani, Jalaledin Ghanavi, Ali Akbar Velayati

Objective: To investigate the prevalence of non-tuberculosis mycobacteria (NTM) among the samples deposited from the National Tuberculosis Reference Laboratory of Iran between 2011 and 2018. Methods: The study evaluated the prevalence of NTM among specimens from patients with pulmonary tuberculosis symptoms (n=15 771) deposited at the National Tuberculosis Reference Laboratory of Iran from 2011 to 2018. Detection of Mycobacterium (M.) tuberculosis was based on presence of a 190-bp amplicon from IS6110 insertion sequence using Tb1 and Tb2 primers, and amplicon-negative specimens were tested for NTM and M. tuberculosis (refractory to IS6110 amplification) using restriction fragment length polymorphism PCR of hsp65 amplicon fragment. Results: A total of 7 307 (46.33%) M. tuberculosis and 658 (4.17%) NTM specimens were found, the latter mainly comprising M. abscessus (10.18%), M. avium (2.28%), M. chelonae (8.97%), M. intracellulare (10.49%), M. kansasii (4.71%), and M. simiae (56.08%). Conclusions: As treatment for NTM differs from that for M. tuberculosis, accurate detection of Mycobacterium sp. is of public health significance.

463-470

Authors: Hamid Reza Tohidinik, Hossein Keshavarz, Mehdi Mohebali, Mandana Sanjar, Gholamreza Hassanpour

Objective: To predict future trends in the incidence of malaria cases in the southeast of Iran as the most important area of malaria using Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to check the effect of meteorological variables on the disease incidence. Methods: SARIMA method was applied to fit a model on malaria incidence from April 2001 to March 2018 in Sistan and Baluchistan province in southeastern Iran. Climatic variables such as temperature, rainfall, rainy days, humidity, sunny hours and wind speed were also included in the multivariable model as covariates. Then, the best fitted model was adopted to predict the number of malaria cases for the next 12 months. Results: The best-fitted univariate model for the prediction of malaria in the southeast of Iran was SARIMA (1,0,0)(1,1,1)12 [Akaike Information Criterion (AIC)=307.4, validation root mean square error (RMSE)=0.43]. The occurrence of malaria in a given month was mostly related to the number of cases occurring in the previous 1 (p=1) and 12 (P=1) months. The inverse number of rainy days with 8-month lag (β=0.329 2) and temperature with 3-month lag (β=-0.002 6) were the best predictors that could improve the predictive performance of the univariate model. Finally, SARIMA (1,0,0)(1,1,1)12 including mean temperature with a 3-month lag (validation RMSE=0.414) was selected as the final multivariable model. Conclusions: The number of malaria cases in a given month can be predicted by the number of cases in the prior 1 and 12 months. The number of rainy days with an 8-month lag and temperature with a 3-month lag can improve the predictive power of the model.

1-4

Authors: Olutosin Ademola Otekunrin, Folorunso Oludayo Fasina, Abiodun Olusola Omotayo, Oluwaseun Aramide Otekunrin, Muhammad Akram

None.

10-16

Authors: Seyed Abbas Mousavi, Hamed Rouhanizadeh, Majid Saeedi, Mahmood Moosazadeh4, Abolqasem Ajami5, Afsaneh Fendereski6,7, Jamshid Yazdani-Charati7, Seyed Mohsen Soleimani, Nader Ahangar, Seyed Hossein Seyedpour, Zahra Bandalizaeh

Objective: To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomatic, mild, and severe infections. Methods: We chose 1 588 inhabitants of Mazandaran province with cluster sampling. We measured their SARS-CoV-2 immunoglobulin M (IgM) and immunoglobulin G (IgG) serum levels. Demographics, risk factors, and symptoms were collected. The seroprevalence of SARS-CoV-2 was calculated by age and city and the World Health Organization (WHO) protocol and further stratified by demographic variables and risk factors. Finally, we identified the symptoms and factors related to COVID-19 with logistic regression. Results: Two hundred subjects (12.59%) were tested positive for either IgG or IgM. Until May 23, 2020, the prevalence of COVID-19 was 15.26% (95% CI: 12.97%-17.79%) based on direct standardization and WHO’s standardized age groups. Based on multivariate logistic regression, the incidence of getting an infection increased by an average of 11.6% for every 10-year increase in age (OR=1.116, 95% CI: 1.008-1.236, P=0.035). Furthermore, those in contact with COVID-19 patients had a 66.1% higher risk of developing the disease (OR=1.661, 95% CI: 1.104-2.497, P=0.015). In addition, the chance of getting SARS-CoV-2 infection was almost four times higher in people who had consulted a doctor during the pandemic than those who had not (OR=3.942, 95% CI: 2.813-5.524, P<0.001). Conclusions: The prevalence of COVID-19 in Mazandaran province could be higher than the officially reported statistics based on diagnostic tests and clinical cases. There seems to be more asymptomatic or mild symptom cases than what was previously reported.

27-33

Authors: Kingsley Uchenna Ozioko, Chris Ikem Okoye, Fabian Chukwuemenam Okafor, Rose Nduka Obiezue

Objective: To screen phytochemicals in ethanolic leaf extracts of Phyllanthus amarus collected from three different geographical zones in Nigeria and evaluate their effects on larva and adult of Anopheles gambiae. Methods: The sample extracts of Phyllanthus amarus prepared with ethanol solvent were tested against Anopheles gambiae at two important developmental stages of its life cycle using slightly modified WHO protocols. Results: Alkaloids, saponins, tannins, flavonoids, glycosides, phenols, and terpenes were detected in each extract. Among these samples, the extract from northwest exhibited the highest larvicidal activity (LC50=263.02 ppm), followed by southeast and southwest extracts (LC50=288.40 and 295.12 ppm, respectively after 48 h), while the extract from southwest exhibited the highest adulticidal activity (LC50=275.42 ppm), followed by northwest and southeast extract (LC50=301.99 and 316.22 ppm, respectively after 24 h). A 50% larva mortality was almost attained at 600 ppm after 48 h duration of exposure to the northwest extract. Conclusions: The tested samples possess strong larvicidal and adulticidal property against Anopheles gambiae which depends on their chemical composition and localities of collection. Further studies are needed to explore the insecticidal activity against a wider range of mosquito species, and to identify active ingredient(s) of the extract responsible for such activity.

44-46

Authors: Jie He, Qiang Zhang

Rational: Brucellosis is a globally prevalent zoonotic disease. Any part of the body can be affected by active brucellosis but osteoarticular involvement are the most common symptoms which was reported to vary from 10% to 85%. The spine is the most common site of brucellosis in the bones. However, noncontiguous brucellar spondylitis is rare, only few cases have been reported in the literature. Patient concerns: A 62-year-old woman with brucellar spondylitis presented with lower back pain and pain in the right lower extremity for six months. Diagnosis: Brucella agglutination test (1:320) and the result of polymerase chain reaction (PCR) confirmed the diagnosis of noncontiguous brucellar spondylitis. Intervention: During hospital stay, the women received intravenous treatment for brucellosis (A combination of doxycycline 200 mg/d, rifampicin 900 mg/d, levofloxacin 0.5 g/QD, and ceftriaxone 2 g/QD was administered for 1 week), The L4-S1 vertebral body was fixed by posterior lumbar debridement. Outcome: Six months after discharge, the follow-up radiographic images showed stable vertebral height and good lumbar stability. She complained no discomfort. Lessons: Multi-level involvement is an exceptional form of brucellar spondylitis. To the best of our knowledge, only few similar cases have been reported. PCR and bacterial culture is necessary for confirmed diagnosis.

381-383

Authors: Issa Atanda Muraina

None.

397-401

Authors: Khuong Quynh Long, Hoang Hong Hanh, Tran Thi Tuyet Hanh, La Ngoc Quang, Hoang Van Minh

Objective: To describe the recovery time and related factors among COVID-19 patients in Vietnam. Methods: We used the secondary data obtained from the official database of the Ministry of Health of Vietnam and other public data sources that were available by April 9th, 2020. Cox proportional hazards model was carried out to identify factors related to recovery time among COVID-19 patients. Results: By April 9th, 2020, the cumulative number of COVID-19 cases detected in Vietnam was 255, of which 129 (50.6%) patients had fully recovered. The median recovery time of patients was 17 (95% CI=16-19) days. Older patients had a lower likelihood of recovery (HR=0.98, 95% CI=0.97-0.99, P<0.001), whereas patients with a history of international incoming travel had a higher likelihood of recovery (HR=1.57, 95% CI=1.03-2.40, P=0.036). There was no statistically significant difference in the recovery time of patients treated in different hospital settings. Conclusions: More attention is needed for older patients and who did not have international travel history. Patients confirmed with COVID-19 could be treated at local health facilities to avoid unnecessary referrals and burdens to specialized hospitals at the central level.

409-414

Authors: James Owen C. Delaluna, Mary Jane C. Flores, Vicente Y. Belizario Jr., Jose Isagani B. Janairo, Derick Erl P. Sumalapao

Objective: To provide baseline data on the prevalence and intensity of soil-transmitted helminthiasis egg contamination in the soil among indigenous communities. Methods: A total of 317 soil samples from three barangays of indigenous communities communities in Tigaon, Camarines Sur, Philippines were examined for soil-transmitted helminthiasis egg contamination using optimized sugar flotation method. Results: Of the soil samples examined, 141 (44.48%) were contaminated by Ascaris spp., Toxocara spp., and Trichuris spp. with cumulative prevalence varying across the study sites (P<0.01). Ascaris spp. was predominant in all study sites, followed by Toxocara spp. and Trichuris spp. with a prevalence of 41.96%, 7.57%, and 5.36%, respectively. Interestingly, Toxocara pp. has the highest intensity of contamination, followed by Ascaris spp. and Trichuris spp. in term of geometric mean soil-transmitted helminthiasis eggs recovered per one gram soil sample (34.25, 21.45, and 11.85 respectively). Each study site harbors significant amount of soiltransmitted helminthiasis eggs and zoonotic Toxocara eggs, which present high risk of soil-transmitted helminthiasis infection, particularly among children observed to play and cohabitate with animals known to be hosts of these parasites. Conclusions: The alarming rate of soil-transmitted helminthiasis and Toxocara egg contamination reported in this study suggests that additional measures should be undertaken to control soil-transmitted helminthiasis and zoonotic intestinal infections in the country.

423-425

Authors: Keswadee Lapphra, Paninun Srinuchasart, Sansnee Senawong, Utane Rungpanich, Pinklow Umrod, Alan Maleesatharn, Nantaka Kongstan, Watcharee Lermankul,Kulkanya Chokephaibulkit

Objective: To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children. Methods: A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis. QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test were performed in each patient. Results: Of the 60 children, median age 3.3 years, 17 had tuberculosis and 43 had recent tuberculosis exposure. Overall, 15 (25.0%) children had tuberculin skin test reaction ≥10 mm; 8 (13.3%) were positive by QuantiFERON-TB Gold In-Tube test, and 12 (20.0%) by T-SPOT.TB. Nineteen (31.7%) children had at least one positive test. There was a moderate agreement between interferon gamma release assays and tuberculin skin test. Conclusions: The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis, supporting the management strategy of not testing children younger than 5 years.