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1.
J Infect Dis ; 2021 Sep 22.
Article in English | MEDLINE | ID: covidwho-1627209

ABSTRACT

BACKGROUND: Hepatitis E virus, typically genotypes 1 and 2, is a major cause of avoidable morbidity and mortality in South Asia. Although case fatality risk among pregnant women can reach as high as 25%, a lack of population-level disease burden data has been cited as a primary factor in key global policy recommendations against the routine use of licensed hepatitis E vaccines, one of the only effective tools available for preventing disease and death. METHODS: We tested serum from a nationally-representative serosurvey in Bangladesh for anti-HEV IgG. We estimated the proportion of the population with evidence of historical HEV infection and used Bayesian geostatistical models to generate high-resolution national maps of seropositivity. We examined variability in seropositivity by individual-level, household-level, and community-level risk factors using spatial logistic regression. RESULTS: We tested serum samples from 2924 individuals from 70 communities representing all divisions of Bangladesh and estimated a national seroprevalence of hepatitis E of 20% (95% CI 17-24%). Seropositivity increased with age and male sex (Odds Ratio: 2.2 male vs. female, 95% Confidence Interval: 1.8-2.8). Community-level seroprevalence ranged from 0-78% with the seroprevalence in urban areas being higher, including Dhaka, the capital, with 3.0-fold (95% Credible Interval 2.3-3.7) higher seroprevalence than the rest of the country. CONCLUSION: Hepatitis E infections are common throughout Bangladesh. Strengthening clinical surveillance for hepatitis E, especially in urban areas may help generate additional evidence needed to appropriately target interventions like vaccines to the populations most likely to benefit.

2.
PLoS Negl Trop Dis ; 16(1): e0010102, 2022 01.
Article in English | MEDLINE | ID: covidwho-1603353

ABSTRACT

BACKGROUND: COVID-19 caused by SARS-CoV-2 ranges from asymptomatic to severe disease and can cause fatal and devastating outcome in many cases. In this study, we have compared the clinical, biochemical and immunological parameters across the different disease spectrum of COVID-19 in Bangladeshi patients. METHODOLOGY/PRINCIPAL FINDINGS: This longitudinal study was conducted in two COVID-19 hospitals and also around the community in Dhaka city in Bangladesh between November 2020 to March 2021. A total of 100 patients with COVID-19 infection were enrolled and classified into asymptomatic, mild, moderate and severe cases (n = 25/group). In addition, thirty age and sex matched healthy participants were enrolled and 21 were analyzed as controls based on exclusion criteria. After enrollment (study day1), follow-up visits were conducted on day 7, 14 and 28 for the cases. Older age, male gender and co-morbid conditions were the risk factors for severe COVID-19 disease. Those with moderate and severe cases of infection had low lymphocyte counts, high neutrophil counts along with a higher neutrophil-lymphocyte ratio (NLR) at enrollment; this decreased to normal range within 42 days after the onset of symptom. At enrollment, D-dimer, CRP and ferritin levels were elevated among moderate and severe cases. The mild, moderate, and severe cases were seropositive for IgG antibody by day 14 after enrollment. Moderate and severe cases showed significantly higher IgM and IgG levels of antibodies to SARS-CoV-2 compared to mild and asymptomatic cases. CONCLUSION/SIGNIFICANCE: We report on the clinical, biochemical, and hematological parameters associated with the different severity of COVID-19 infection. We also show different profile of antibody response against SARS-CoV-2 in relation to disease severity, especially in those with moderate and severe disease manifestations compared to the mild and asymptomatic infection.


Subject(s)
Antibodies, Viral/immunology , COVID-19/diagnosis , COVID-19/immunology , Severity of Illness Index , Adult , Antibody Formation , Bangladesh , COVID-19 Testing , Cohort Studies , Female , Fibrin Fibrinogen Degradation Products , Humans , Immunoglobulin G , Longitudinal Studies , Lymphocytes , Male , Middle Aged , Neutrophils , Risk Factors , SARS-CoV-2 , Viral Load
3.
Preprint in English | Other preprints | ID: ppcovidwho-295561

ABSTRACT

Background The COVID-19 pandemic has resulted in a need for rapid identification of infectious cases. Testing barriers have prohibited adequate screening for SARS COV2, resulting in significant delays in treatment provision and commencement of outbreak control measures. This study aimed to generate evidence on the performance and implementation characteristics of the BD Veritor rapid antigen test as compared to the gold standard test for diagnosis of SARS COV2 in Kenya. Methods This was a field test performance evaluation in symptomatic and asymptomatic adults undergoing testing for SARS COV2. Recruited participants were classified as SARS-CoV2-positive based on the locally implemented gold standard reverse transcription polymerase chain reaction (RT-PCR) test performed on nasopharyngeal swabs. 272 antigen tests were performed with simultaneous gold standard testing, allowing us to estimate sensitivity, specificity, positive and negative predictive values for the BD Veritor rapid antigen test platform. Implementation characteristics were assessed using the Consolidated Framework for Implementation Research for feasibility, acceptability, turn-around time, and ease-of-use metrics. Results and Discussion We enrolled 97 PCR negative symptomatic and 128 PCR negative asymptomatic, and 28 PCR positive symptomatic and 19 PCR positive asymptomatic participants. Compared to the gold standard, the sensitivity of the BD Veritor antigen test was 94% (95% confidence interval [CI] 86.6 to 100.0) while the specificity was 98% (95% confidence interval [CI] 96 to 100). The sensitivity of BD Veritor antigen test was higher among symptomatic (100%) compared to asymptomatic (84%) participants, although this difference was not statistically significant. There was also a lack of association between cycle threshold value and sensitivity of BD Veritor test. The BD Veritor test had quick turnaround time and minimal resource requirements, and laboratory personnel conducting testing felt that it was easier to use than the gold standard RT-PCR. Conclusion The BD Veritor rapid antigen test exhibited excellent sensitivity and specificity when used to detect SARS-CoV-2 infection among both symptomatic and asymptomatic individuals in varied population settings in Kenya. It was feasible to implement and easy to use, with rapid turnaround time.

4.
Preprint in English | Other preprints | ID: ppcovidwho-294259

ABSTRACT

In a representative serosurvey conducted March–June 2021, 64.1% (95%CrI 60.0– 68.1%) of Sitakunda subdistrict (Bangladesh) had anti-SARS-CoV-2 IgG antibodies after adjusting for age, sex, household clustering and test performance. Before the surge of Delta, most of the population had been infected despite low incidence of virologically-confirmed COVID-19.

5.
Preprint in English | EuropePMC | ID: ppcovidwho-292830

ABSTRACT

Bangladesh recently faced large outbreaks of both COVID-19 and Dengue fever. A 28-year-old woman suffered from symptoms including hemoptysis as first presentation followed by high-grade fever, sore throat, and fatigue. SARS-CoV-2 was confirmed by RT-PCR and also diagnosed dengue later on.COVID-19 and dengue fever could be a harmful combination.

6.
Heliyon ; 7(11): e08455, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1525795

ABSTRACT

The rapid and early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is key to control the current Coronavirus disease 2019 (COVID-19) pandemic. The present study was conducted to clinically evaluate a rapid diagnostic test (RDT) kit, Standard Q COVID-19 Ag Test (SD Biosensor®, Republic of Korea), with reference to the standard real-time RT-PCR for detection of COVID-19 cases in Bangladesh. Nasopharyngeal swabs were taken from 900 COVID-19 suspected patients. Among them, 34.11% (n = 307) were diagnosed as COVID-19 cases by RT-PCR assay, of which 85% (n = 261) were also detectable using the RDT. The overall sensitivity and specificity of the RDT compared to RT-PCR were 85.02% and 100%, respectively, regardless of age, sex, and type of SARS-CoV-2 variants. Most of the RT-PCR positive cases (94%) were found within the first five days of disease onset, and the sensitivity of RDT was 85.91% for the same samples. The positive predictive value (PPV) of the RDT was 100%, and the negative predictive value (NPV) was 92.8%. The Cohen's kappa value of 0.882 indicated excellent agreement between the RDT and RT-PCR assays. The findings of this study showed the potential use of SARS-CoV-2 antigen-based RDT to expedite the diagnostic process and onward COVID-19 management in Bangladesh.

8.
IJID Regions ; 2021.
Article in English | ScienceDirect | ID: covidwho-1466396

ABSTRACT

Objective We aimed to estimate the proportion of symptomatic and asymptomatic laboratory-confirmed COVID-19 cases among Bangladesh's population. Design We conducted a cross-sectional survey in Dhaka City and other districts of Bangladesh between April 18 and October 12, 2020. We randomly selected 32 districts outside Dhaka, where one village and one mahalla from each district, and from Dhaka City, selected 25 mahallas. From each village or mahalla, we enrolled 120 households through systematic random sampling. Results A total of 44,865 individuals were interviewed from 10,907 households. The majority (70%, n-31488) of the individuals were <40 years of age. Almost half of the individuals (49%, n=21,888) reported >4 members in their households. We estimated, 12.6% (n=160) of the households had ≥1 COVID-19 infected individuals, among them, 0.9% (n=404) individuals had at least one COVID-19 like symptom at the national level. Prevalence of COVID-19 was 6.4% among the general population. Among the COVID-19 positive individuals, 87% were asymptomatic. Conclusions The substantial high number of asymptomatic cases all over Bangladesh suggests that community-level containment and mitigation measures to combat COVID-19. Future studies to understand the transmission capability could help to define mitigation and control measures.

9.
Nat Microbiol ; 6(10): 1271-1278, 2021 10.
Article in English | MEDLINE | ID: covidwho-1402078

ABSTRACT

Genomics, combined with population mobility data, used to map importation and spatial spread of SARS-CoV-2 in high-income countries has enabled the implementation of local control measures. Here, to track the spread of SARS-CoV-2 lineages in Bangladesh at the national level, we analysed outbreak trajectory and variant emergence using genomics, Facebook 'Data for Good' and data from three mobile phone operators. We sequenced the complete genomes of 67 SARS-CoV-2 samples (collected by the IEDCR in Bangladesh between March and July 2020) and combined these data with 324 publicly available Global Initiative on Sharing All Influenza Data (GISAID) SARS-CoV-2 genomes from Bangladesh at that time. We found that most (85%) of the sequenced isolates were Pango lineage B.1.1.25 (58%), B.1.1 (19%) or B.1.36 (8%) in early-mid 2020. Bayesian time-scaled phylogenetic analysis predicted that SARS-CoV-2 first emerged during mid-February in Bangladesh, from abroad, with the first case of coronavirus disease 2019 (COVID-19) reported on 8 March 2020. At the end of March 2020, three discrete lineages expanded and spread clonally across Bangladesh. The shifting pattern of viral diversity in Bangladesh, combined with the mobility data, revealed that the mass migration of people from cities to rural areas at the end of March, followed by frequent travel between Dhaka (the capital of Bangladesh) and the rest of the country, disseminated three dominant viral lineages. Further analysis of an additional 85 genomes (November 2020 to April 2021) found that importation of variant of concern Beta (B.1.351) had occurred and that Beta had become dominant in Dhaka. Our interpretation that population mobility out of Dhaka, and travel from urban hotspots to rural areas, disseminated lineages in Bangladesh in the first wave continues to inform government policies to control national case numbers by limiting within-country travel.


Subject(s)
COVID-19/transmission , Cell Phone/statistics & numerical data , Genome, Viral/genetics , SARS-CoV-2/genetics , Social Media/statistics & numerical data , Bangladesh/epidemiology , Bayes Theorem , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Genomics , Health Policy/legislation & jurisprudence , Humans , Phylogeny , Population Dynamics/statistics & numerical data , SARS-CoV-2/classification , Travel/legislation & jurisprudence , Travel/statistics & numerical data
10.
Microbiol Resour Announc ; 10(28): e0056021, 2021 Jul 15.
Article in English | MEDLINE | ID: covidwho-1311058

ABSTRACT

We report the coding-complete genome sequences of 15 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sublineage B.1.617.2 strains that were obtained from Bangladeshi individuals with a history of recent travel to India and from the Bangladeshi community. Genomic data were generated by Nanopore sequencing using the amplicon sequencing approach developed by the ARTIC Network.

13.
Int J Infect Dis ; 101: 220-225, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-813629

ABSTRACT

OBJECTIVES: Studies on serological responses following coronavirus disease-2019 (COVID-19) have been published primarily in individuals who are moderately or severely symptomatic, but there are few data from individuals who are mildly symptomatic or asymptomatic. METHODS: We measured IgG, IgM, and IgA to the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by using enzyme-linked immunosorbent assay in mildly symptomatic (n = 108) and asymptomatic (n = 63) on days 1, 7, 14, and 30 following RT-PCR confirmation in Bangladesh and when compared with pre-pandemic samples, including healthy controls (n = 73) and individuals infected with other viruses (n = 79). RESULTS: Mildly symptomatic individuals developed IgM and IgA responses by day 14 in 72% and 83% of individuals, respectively, while 95% of individuals developed IgG response, and rose to 100% by day 30. In contrast, individuals infected with SARS-CoV-2 but who remained asymptomatic developed antibody responses significantly less frequently, with only 20% positive for IgA and 22% positive for IgM by day 14, and 45% positive for IgG by day 30 after infection. CONCLUSIONS: These results confirm immune responses are generated following COVID-19 who develop mildly symptomatic illness. However, those with asymptomatic infection do not respond or have lower antibody levels. These results will impact modeling needed for determining herd immunity generated by natural infection or vaccination.


Subject(s)
Antibodies, Viral/immunology , COVID-19/immunology , Carrier State/immunology , SARS-CoV-2/immunology , Adult , Antibodies, Viral/blood , Antibody Formation , Bangladesh/epidemiology , COVID-19/blood , COVID-19/epidemiology , COVID-19/virology , Carrier State/blood , Carrier State/epidemiology , Carrier State/virology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Male , Middle Aged , Pandemics , SARS-CoV-2/genetics
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