Association between nutritional status and dengue severity in Thai children and adolescents.

Most cases of dengue virus infection are mild, but severe cases can be fatal. Therefore, identification of factors associated with dengue severity is essential to improve patient outcomes and reduce mortality. The objective of this study was to assess associations between nutritional status and dengue severity among Thai children and adolescents. This retrospective cross-sectional study was based on the medical records of 355 patients with dengue treated at the Hospital for Tropical Disease (Bangkok, Thailand) from 2017 to 2019. Subjects were Thai children aged less than 18 years with dengue virus infection confirmed by positive NS1 antigen or IgM. The 1997 and 2009 World Health Organization (WHO) dengue classifications were used to define disease severity and body mass index for age while the WHO growth chart was used to classify nutritional status. The proportions of patients with dengue fever who were underweight, normal weight, and overweight were 8.8%, 61.5%, and 29.7%, respectively. The proportions of patients with dengue haemorrhagic fever (DHF) who were underweight, normal weight, and overweight were 10.2%, 66.1%, and 23.7%, respectively. The proportions of patients with non-severe dengue who were underweight, normal weight, and overweight were 8.6%, 60.9%, and 30.5%, respectively; the same proportions of patients with severe dengue were 10.5%, 67.1%, and 22.4%, respectively. Higher proportions of patients with severe plasma leakage (DHF grade III and IV) were overweight compared with those with mild plasma leakage (DHF grade I and II) (45.5% vs. 18.8%). No difference in nutritional status was observed in patients with different dengue severity.

Titer disparity of anti-Spike receptor binding domain SARS-CoV-2 antibody between vaccinated and naturally infected individuals.

In conjunction with other health promotion strategies, vaccination of coronavirus disease 2019 (COVID-19) is a strategy to alleviate the burden of infection. The aim of this study was to determine the differences in antibody response strength between individuals who received COVID-19 vaccination and those who had a natural infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A cross-sectional study was conducted among post-natural confirmed COVID-19 infection and immunized people in Bali, Indonesia. The vaccination was using Sinovac-CoronaVac with two-weeks interval between the two vaccine doses. To measure the level of anti-Spike receptor binding domain (SRBD) of SARS-CoV-2 antibody, we used Roche electro- chemiluminescence immunoassay (ECLIA) platform. Blood samples were obtained before and 28 days after first immunization in the vaccinated group, as well as two weeks after hospital discharge in the confirmed COVID-19 patients based on real-time reverse transcription polymerase chain reaction (RT-PCR). A total of 58 confirmed COVID-19 patients and 60 vaccinated individuals were included. On the 28th day after the initial vaccination, the seroconversion rate among vaccinated individuals was 91.67%. The mean titer of anti-SRBD SARS-CoV-2 antibody among vaccinated participants was 63.62±82.57 IU/mL (ranged between 0 IU/mL and 250 IU/mL). The mean titer among naturally infected group was 188.47±94.57 IU/mL (ranged between 4.25 IU/mL to 250 IU/mL) regardless the severity of COVID-19. Our data suggested that the titer of anti- SRBD SARS-CoV-2 antibody was significantly higher in naturally infected individuals compared to those who received COVID-19 vaccination (p<0.001). These data suggest that not all individuals vaccinated with Sinovac COVID-19 had protective level of anti- SRBD SARS-CoV-2 antibody and booster dose of heterologous vaccine maybe required.

Attitude towards Zika among frontline physicians in a dengue-endemic country: A preliminary cross-sectional study in Indonesia.

In dengue-endemic countries such as Indonesia, Zika may be misdiagnosed as dengue, leading to underestimates of Zika disease and less foreknowledge of pregnancy-related complications such as microcephaly. OBJECTIVE: To assess the attitudes of frontline physicians in a dengue-endemic country toward testing for Zika infection among patients with dengue-like illnesses. METHODS: A cross-sectional online survey was conducted among general practitioners (GPs) in Indonesia. The survey assessed their attitude and also collected sociodemographic data, characteristics of their medical education, professional background, and workplace, and exposure to Zika cases. A two-step logistic regression analysis was used to assess possible variables associated with these attitudes. RESULTS: A total of 370 GPs were included in the final analysis of which 70.8% had good attitude. Unadjusted analyses suggested that GPs who were 30 years old or older and those who had medical experience five years or longer had lower odds of having a positive attitude compared to those who aged younger than 30 years and those who had medical experience less than five years, OR: 0.58; 95%CI: 0.37, 0.91 and OR: 0.55; 95%CI: 0.35, 0.86, respectively. No explanatory variable was associated with attitude in the fully adjusted model. CONCLUSION: Our findings point to younger GPs with a shorter medical experience being more likely to consider testing for Zika infection among their patients presenting with dengue-like illnesses. Strategic initiatives may be needed to enhance older or longer-experienced physicians' capacity in diagnosing Zika infection.

Effects of El Niño Southern Oscillation and Dipole Mode Index on Chikungunya Infection in Indonesia.

The aim of this study was to assess the possible association of El Niño Southern Oscillation (ENSO) and Dipole Mode Index (DMI) on chikungunya incidence overtime, including the significant reduction in cases that was observed in 2017 in Indonesia. Monthly nation-wide chikungunya case reports were obtained from the Indonesian National Disease Surveillance database, and incidence rates (IR) and case fatality rate (CFR) were calculated. Monthly data of Niño3.4 (indicator used to represent the ENSO) and DMI between 2011 and 2017 were also collected. Correlations between monthly IR and CFR and Niño3.4 and DMI were assessed using Spearman's rank correlation. We found that chikungunya case reports declined from 1972 cases in 2016 to 126 cases in 2017, a 92.6% reduction; the IR reduced from 0.67 to 0.05 cases per 100,000 population. No deaths associated with chikungunya have been recorded since its re-emergence in Indonesia in 2001. There was no significant correlation between monthly Niño3.4 and chikungunya incidence with r = -0.142 (95%CI: -0.320-0.046), p = 0.198. However, there was a significant negative correlation between monthly DMI and chikungunya incidence, r = -0.404 (95%CI: -0.229--0.554) with p < 0.001. In conclusion, our initial data suggests that the climate variable, DMI but not Niño3.4, is likely associated with changes in chikungunya incidence. Therefore, further analysis with a higher resolution of data, using the cross-wavelet coherence approach, may provide more robust evidence.

Coronavirus disease 2019 (COVID-19): A literature review.

In early December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan City, Hubei Province, China. On January 30, 2020 the World Health Organization declared the outbreak as a Public Health Emergency of International Concern. As of February 14, 2020, 49,053 laboratory-confirmed and 1,381 deaths have been reported globally. Perceived risk of acquiring disease has led many governments to institute a variety of control measures. We conducted a literature review of publicly available information to summarize knowledge about the pathogen and the current epidemic. In this literature review, the causative agent, pathogenesis and immune responses, epidemiology, diagnosis, treatment and management of the disease, control and preventions strategies are all reviewed.