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A decade-long temporal analyses of human group-A rotavirus among children with gastroenteritis: pre-vaccination scenario in West Bengal, eastern India.

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A decade-long temporal analyses of human group-A rotavirus among children with gastroenteritis: pre-vaccination scenario in West Bengal, eastern India.

J Med Virol. 2020 Feb 19;:

Authors: Chawla-Sarkar M, Banerjee A, Lo M, Mitra S, Okamoto K, Deb A, Dutta S

Abstract
Despite the significant reduction in global infantile death toll due to rotaviral diarrhea, India still contributes substantially to rotavirus-related hospitalization as well as mortality rates. The rotavirus surveillance study conducted from 2008 through 2017 among children (≤5 years) with moderate to severe gastroenteritis seeking healthcare facilities at two hospitals in eastern India, revealed a change in the proportion of rotavirus positivity, seasonality and age-group specificity along with the cycling of different usual and unusual genotypes in this endemic setting. G1 strains predominated during 2008-10, while G2 and G9 genotypes eventually upsurged during 2011-13. G1 strains re-established their lead during 2013-15, while G3 emerged for the first time in eastern India in 2015 and rooted itself as the cardinal strain 2016 onwards. Evolutionary analyses of all the predominant genotypes (G1, G2, G3 and G9) revealed that they were mostly phylogenetically distant to the rotavirus vaccine strains as depicted in the phylogenetic dendrogram. These decade-long epidemiological study during the pre-vaccination period in West Bengal (eastern India) underscore the co-circulation of multiple rotavirus genotypes in addition to sporadic occurrence of zoonotic strains like G10P[6] and G11P[25]. This article is protected by copyright. All rights reserved.

PMID: 32073164 [PubMed - as supplied by publisher]

Psychiatric Comorbidity of Unipolar Mood, Anxiety, and Trauma Disorders Prior to HIV Testing and the Effect on Linkage to Care Among HIV-Infected Adults in South Africa.

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Psychiatric Comorbidity of Unipolar Mood, Anxiety, and Trauma Disorders Prior to HIV Testing and the Effect on Linkage to Care Among HIV-Infected Adults in South Africa.

AIDS Behav. 2019 Dec;23(12):3444-3451

Authors: Belus JM, Cholera R, Miller WC, Bassett J, Gaynes BN

Abstract
Psychiatric comorbidity, the presence of two or more psychiatric disorders, leads to worse HIV outcomes in the United States; this relationship has not been studied in sub-Saharan Africa. We conducted a preliminary study to describe the prevalence of psychiatric comorbidity (unipolar mood, anxiety, and trauma disorders) among 363 adults prior to HIV testing at Witkoppen Health and Welfare Centre, a primary care clinic in Johannesburg, South Africa. We also examined whether psychiatric comorbidity predicted subsequent linkage to HIV care 3 months later. Prevalence of psychiatric comorbidity prior to HIV testing was approximately 5.5%. In the final HIV-positive subsample (n = 76), psychiatric comorbidity of unipolar mood, anxiety, and trauma disorders did not predict linkage to care [adjusted relative risk = 1.01 (0.59, 1.71)] or number of follow-up appointments (adjusted relative risk = 0.86 (0.40, 1.82)]. A similar psychiatric profile emerged for HIV-positive and HIV-negative individuals before becoming aware of their HIV status. The psychiatric burden typically seen in HIV-positive individuals may manifest over time.

PMID: 31297682 [PubMed - indexed for MEDLINE]

Incubation periods impact the spatial predictability of cholera and Ebola outbreaks in Sierra Leone.

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Incubation periods impact the spatial predictability of cholera and Ebola outbreaks in Sierra Leone.

Proc Natl Acad Sci U S A. 2020 Feb 13;:

Authors: Kahn R, Peak CM, Fernández-Gracia J, Hill A, Jambai A, Ganda L, Castro MC, Buckee CO

Abstract
Forecasting the spatiotemporal spread of infectious diseases during an outbreak is an important component of epidemic response. However, it remains challenging both methodologically and with respect to data requirements, as disease spread is influenced by numerous factors, including the pathogen's underlying transmission parameters and epidemiological dynamics, social networks and population connectivity, and environmental conditions. Here, using data from Sierra Leone, we analyze the spatiotemporal dynamics of recent cholera and Ebola outbreaks and compare and contrast the spread of these two pathogens in the same population. We develop a simulation model of the spatial spread of an epidemic in order to examine the impact of a pathogen's incubation period on the dynamics of spread and the predictability of outbreaks. We find that differences in the incubation period alone can determine the limits of predictability for diseases with different natural history, both empirically and in our simulations. Our results show that diseases with longer incubation periods, such as Ebola, where infected individuals can travel farther before becoming infectious, result in more long-distance sparking events and less predictable disease trajectories, as compared to the more predictable wave-like spread of diseases with shorter incubation periods, such as cholera.

PMID: 32054785 [PubMed - as supplied by publisher]

Evolution of the World Health Organization's programmatic actions to control diarrheal diseases.

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Evolution of the World Health Organization's programmatic actions to control diarrheal diseases.

J Glob Health. 2019 Dec;9(2):020802

Authors: Wolfheim C, Fontaine O, Merson M

Abstract
The Program for the Control of Diarrheal Diseases (CDD) of the World Health Organization (WHO) was created in 1978, the year the Health for All Strategy was launched at the Alma Ata International Conference on Primary Health Care. CDD quickly became one of the pillars of this strategy, with its primary goal of reducing diarrhea-associated mortality among infants and young children in developing countries. WHO expanded the previous cholera-focused unit into one that addressed all diarrheal diseases, and uniquely combined support to research and to national CDD Programs. We describe the history of the Program, summarize the results of the research it supported, and illustrate the outcome of the Program's control efforts at country and global levels. We then relate the subsequent evolution of the Program to an approach that was more technically broad and programmatically narrow and describe how this affected diarrheal diseases-related activities globally and in countries.

PMID: 31673346 [PubMed - indexed for MEDLINE]

Cholera in the time of likes. Inspirational pathogens and an important pump.

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Cholera in the time of likes. Inspirational pathogens and an important pump.

Microbes Infect. 2019 Oct - Nov;21(8-9):341-342

Authors: Häfner S

PMID: 31004789 [PubMed - indexed for MEDLINE]

Cuban Public Health History: The 19th Century Board of Health in the City of Holguín.

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Cuban Public Health History: The 19th Century Board of Health in the City of Holguín.

MEDICC Rev. 2019 Apr-Jul;21(2-3):69-74

Authors: Calzadilla-González A, Calzadilla-Anido IM, Calzadilla-González A

Abstract
INTRODUCTION In 19th century colonial Cuba, Boards of Health (Juntas de Sanidad) were created to administer public health, in tandem with and later replacing the older Royal Protomedicato Court (Real Tribunal de Protomedicato). Development of the Board of Health in the northeastern city of Holguín reflected local historical processes, as well as class relations and social issues characteristic of this period. Among the highlights of the Board's activities were epidemic control during cholera and smallpox outbreaks, monitoring the city's sanitary conditions, and support for charitable work. Studying the history of such epidemiological surveillance activities may benefit design and implementation of related current research and prevention/control campaigns. OBJECTIVE Describe the development of the 19th century Board of Health in the city of Holguín. EVIDENCE ACQUISITION The research was conducted through a critical analysis of primary sources contained in the Historical Archives of (today's) Holguín Province, specifically relevant documents from the regional and city government (Fondo Tenencia de Gobierno y Ayuntamiento) and town council (Cabildo). Cuban and international scientific publications were also consulted. DEVELOPMENT The Board of Health was the main institution conducting health and hygiene control and charitable activities in the city of Holguín during the 19th century. It was created mainly to take preventive measures against diseases affecting the population, an effort it undertook with support from the Urban Health Police. Its efforts to confront smallpox and cholera epidemics greatly helped to reduce the toll of these diseases on the population, albeit not sufficiently to prevent their reccurrence. Beginning in the 1870s, weakened government support eroded the Board's position, and health-related measures were implemented mainly by the Board of Charity, which focused on matters concerning the city's Civil Hospital. CONCLUSIONS Although established in 1820, Holguín's Board of Health carried out preventive actions most actively from 1850 to 1865, with support from the Urban Health Police. Its gradual disappearance from the health policy arena beginning in the 1870s reflects its failure as an institution, in large part due to weak government support. KEYWORDS Board of Health, prevention, epidemics, Cuba.

PMID: 31401639 [PubMed - indexed for MEDLINE]

Cognate T and B cell interaction and association of follicular helper T cells with B cell responses in Vibrio cholerae O1 infected Bangladeshi adults.

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Cognate T and B cell interaction and association of follicular helper T cells with B cell responses in Vibrio cholerae O1 infected Bangladeshi adults.

Microbes Infect. 2019 Apr - May;21(3-4):176-183

Authors: Rashu R, Bhuiyan TR, Hoq MR, Hossain L, Paul A, Khan AI, Chowdhury F, Harris JB, Ryan ET, Calderwood SB, Weil AA, Qadri F

Abstract
Vibrio cholerae O1 can cause life threatening diarrheal disease if left untreated. T cells can play critical roles in inducing B cell mediated immunity. As the mechanism of T cell dependent B cell maturation is not well established, we hypothesized that a specific population of T (follicular helper T, Tfh) cells, are involved in B cell maturation following cholera. We found flowcytometrically that V. cholerae infection induces significant increases in circulating Tfh cells expressing B cell maturation associated protein CD40L early in disease. The increased Tfh cells expressing CD40L recognize cholera toxin most prominently, with lessened responses to V. cholerae membrane preparation (MP) and V. cholerae cytolysin (VCC). We further showed that early induction of Tfh cells and CD40L was associated with later memory B cell responses to same antigens. Lastly, we demonstrated in vitro that Tfh cells isolated after cholera can stimulate class switching of co-cultured, isolated B cells from patients with cholera, leading to production of the more durable IgG antibody isotype colorimetrically. These studies were conducted on circulating Tfh cells; future studies will be directed at examining role of Tfh cells during cholera directly in gut mucosa of biopsied samples, at the single cell level if feasible.

PMID: 30580014 [PubMed - indexed for MEDLINE]

High cholera vaccination coverage following emergency campaign in Haiti: Results from a cluster survey in three rural Communes in the South Department, 2017.

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High cholera vaccination coverage following emergency campaign in Haiti: Results from a cluster survey in three rural Communes in the South Department, 2017.

PLoS Negl Trop Dis. 2020 Jan 31;14(1):e0007967

Authors: Sharp A, Blake A, Backx J, Panunzi I, Barrais R, Nackers F, Luquero F, Deslouches YG, Cohuet S

Abstract
Oral cholera vaccine (OCV) has increasingly been used as an outbreak control measure, but vaccine shortages limit its application. A two-dose OCV campaign targeting residents aged over 1 year was launched in three rural Communes of Southern Haiti during an outbreak following Hurricane Matthew in October 2016. Door-to-door and fixed-site strategies were employed and mobile teams delivered vaccines to hard-to-reach communities. This was the first campaign to use the recently pre-qualified OCV, Euvichol. The study objective was to estimate post-campaign vaccination coverage in order to evaluate the campaign and guide future outbreak control strategies. We conducted a cluster survey with sampling based on random GPS points. We identified clusters of five households and included all members eligible for vaccination. Local residents collected data through face-to-face interviews. Coverage was estimated, accounting for the clustered sampling, and 95% confidence intervals calculated. 435 clusters, 2,100 households and 9,086 people were included (99% response rate). Across the three communes respectively, coverage by recall was: 80.7% (95% CI:76.8-84.1), 82.6% (78.1-86.4), and 82.3% (79.0-85.2) for two doses and 94.2% (90.8-96.4), 91.8% (87-94.9), and 93.8% (90.8-95.9) for at least one dose. Coverage varied by less than 9% across age groups and was similar among males and females. Participants obtained vaccines from door-to-door vaccinators (53%) and fixed sites (47%). Most participants heard about the campaign through community 'criers' (58%). Despite hard-to-reach communities, high coverage was achieved in all areas through combining different vaccine delivery strategies and extensive community mobilisation. Emergency OCV campaigns are a viable option for outbreak control and where possible multiple strategies should be used in combination. Euvichol will help alleviate the OCV shortage but effectiveness studies in outbreaks should be done.

PMID: 32004316 [PubMed - as supplied by publisher]

Improving Cross-Border Preparedness and Response: Lessons Learned from 3 Lassa Fever Outbreaks Across Benin, Nigeria, and Togo, 2017-2019.

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Improving Cross-Border Preparedness and Response: Lessons Learned from 3 Lassa Fever Outbreaks Across Benin, Nigeria, and Togo, 2017-2019.

Health Secur. 2020 Jan;18(S1):S105-S112

Authors: Kakaī CG, Okunromade OF, Dan-Nwafor CC, Chabi AIB, Martial GTP, Dalhat MM, Ward S, Tante O, Nguku PM, Hamadi A, Ilori E, Lokossou V, Brito C, Ojo OE, Kone I, Agbeko TT, Ihekweazu C, Merrill RD

Abstract
Long-standing cultural, economic, and political relationships among Benin, Nigeria, and Togo contribute to the complexity of their cross-border connectivity. The associated human movement increases the risk of international spread of communicable disease. The Benin and Togo ministries of health and the Nigeria Centre for Disease Control, in collaboration with the Abidjan Lagos Corridor Organization (a 5-country intergovernmental organization) and the US Centers for Disease Control and Prevention, sought to minimize the risk of cross-border outbreaks by defining and implementing procedures for binational and multinational public health collaboration. Through 2 multinational meetings, regular district-level binational meetings, and fieldwork to characterize population movement and connectivity patterns, the countries improved cross-border public health coordination. Across 3 sequential cross-border Lassa fever outbreaks identified in Benin or Togo between February 2017 and March 2019, the 3 countries improved their collection and sharing of patients' cross-border travel histories, shortened the time between case identification and cross-border information sharing, and streamlined multinational coordination during response efforts. Notably, they refined collaborative efforts using lessons learned from the January to March 2018 Benin outbreak, which had a 100% case fatality rate among the 5 laboratory-confirmed cases, 3 of whom migrated from Nigeria across porous borders when ill. Aligning countries' expectations for sharing public health information would assist in reducing the international spread of communicable diseases by facilitating coordinated preparedness and responses strategies. Additionally, these binational and multinational strategies could be made more effective by tailoring them to the unique cultural connections and population movement patterns in the region.

PMID: 32004125 [PubMed - in process]

Public health round-up.

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Public health round-up.

Bull World Health Organ. 2019 Aug 01;97(8):517-518

Authors:

PMID: 31384068 [PubMed - indexed for MEDLINE]

Assessment of laboratory capacity of public secondary health facilities in performing assay of selected epidemic-prone diseases in Oyo State, Nigeria.

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Assessment of laboratory capacity of public secondary health facilities in performing assay of selected epidemic-prone diseases in Oyo State, Nigeria.

Diagn Microbiol Infect Dis. 2019 Oct;95(2):191-194

Authors: Bankole OT, Ajayi IO

Abstract
This study assessed the capacity of public secondary facility-based laboratories in conducting diagnostic tests for selected epidemic-prone diseases in Oyo State, Nigeria. A descriptive cross-sectional study was conducted in 17 secondary facility-based laboratories in Oyo State. Capacity was assessed on a 100-point scale in which scores were rated low (≤49%), fair (50-79%) and good (≥80%). Diagnostic testing capacity for bacterial meningitis, cholera, and measles was "low" in all the laboratories. The reasons reported for laboratories not conducting diagnostic tests for the selected diseases included inadequate instruments, unavailable reagents, and clinicians' failure to request those diagnostic tests. Laboratory capacity to perform diagnostic tests for the selected diseases was low in Oyo State secondary hospitals. There is a need for the provision of modern instruments and reagents, as well as clinician laboratorian quality assurance programs, to improve diagnostic services relating to the selected diseases.

PMID: 31296359 [PubMed - indexed for MEDLINE]

Post-infection irritable bowel syndrome in the tropical and subtropical regions: Vibrio cholerae is a new cause of this well-known condition.

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Post-infection irritable bowel syndrome in the tropical and subtropical regions: Vibrio cholerae is a new cause of this well-known condition.

Indian J Gastroenterol. 2019 04;38(2):87-94

Authors: Ghoshal UC, Rahman MM

PMID: 31073702 [PubMed - indexed for MEDLINE]

The history of OCV in India and barriers remaining to programmatic introduction.

The history of OCV in India and barriers remaining to programmatic introduction.

Vaccine. 2020 Jan 22;:

Authors: Mogasale V, Kanungo S, Pati S, Lynch J, Dutta S

Abstract
Cholera-endemic Eastern India has played an important role in the development of oral cholera vaccines (OCV) through conduct of pivotal trials in Kolkata which led to the registration of the first low-cost bivalent killed whole cell OCV in India in 2009, and subsequent prequalification by the World Health Organization prequalification in 2011. Odisha hosted an influential early demonstration project for use of the vaccine in a high-risk population and provided data and lessons that were crucial input in the Vaccine Investment Strategy developed by Gavi, the Vaccine Alliance in 2013. With Gavi's decision to finance an OCV stockpile, the demand for OCV surged and vaccine has been deployed with great success worldwide in areas of need in response to outbreaks and disasters, most notably in Africa. However, although India is considered one of the highest burden countries, no further use of OCV has occurred since the demonstration project in Odisha in 2011. In this paper we will summarize the important contributions of India to the development and use of OCV and discuss the possible barriers to OCV introduction as a public health tool to control cholera.

PMID: 31982258 [PubMed - as supplied by publisher]

Frontier Warriors-Combating Cholera in Rural India.

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Frontier Warriors-Combating Cholera in Rural India.

Am J Trop Med Hyg. 2019 05;100(5):1071-1072

Authors: Viswanathan R, Kumar A

PMID: 31088605 [PubMed - indexed for MEDLINE]

Feasibility of a Comprehensive Targeted Cholera Intervention in The Kathmandu Valley, Nepal.

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Feasibility of a Comprehensive Targeted Cholera Intervention in The Kathmandu Valley, Nepal.

Am J Trop Med Hyg. 2019 05;100(5):1088-1097

Authors: Roskosky M, Acharya B, Shakya G, Karki K, Sekine K, Bajracharya D, von Seidlein L, Devaux I, Lopez AL, Deen J, Sack DA

Abstract
A comprehensive targeted intervention (CTI) was designed and deployed in the neighborhoods of cholera cases in the Kathmandu Valley with the intent of reducing rates among the neighbors of the case. This was a feasibility study to determine whether clinical centers, laboratories, and field teams were able to mount a rapid, community-based response to a case within 2 days of hospital admission. Daily line listings were requested from 15 participating hospitals during the monsoon season, and a single case initiated the CTI. A standard case definition was used: acute watery diarrhea, with or without vomiting, in a patient aged 1 year or older. Rapid diagnostic tests and bacterial culture were used for confirmation. The strategy included household investigation of cases; water testing; water, sanitation, and hygiene (WASH) intervention; and health education. A CTI coverage survey was conducted 8 months postintervention. From June to December of 2016, 169 cases of Vibrio cholerae O1 were confirmed by bacterial culture. Average time to culture result was 3 days. On average, the CTI Rapid Response Team (RRT) was able to visit households 1.7 days after the culture result was received from the hospital (3.9 days from hospital admission). Coverage of WASH and health behavior messaging campaigns were 30.2% in the target areas. Recipients of the intervention were more likely to have knowledge of cholera symptoms, treatment, and prevention than non-recipients. Although the RRT were able to investigate cases at the household within 2 days of a positive culture result, the study identified several constraints that limited a truly rapid response.

PMID: 30887946 [PubMed - indexed for MEDLINE]

Machine Learning Model for Imbalanced Cholera Dataset in Tanzania.

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Machine Learning Model for Imbalanced Cholera Dataset in Tanzania.

ScientificWorldJournal. 2019;2019:9397578

Authors: Leo J, Luhanga E, Michael K

Abstract
Cholera epidemic remains a public threat throughout history, affecting vulnerable population living with unreliable water and substandard sanitary conditions. Various studies have observed that the occurrence of cholera has strong linkage with environmental factors such as climate change and geographical location. Climate change has been strongly linked to the seasonal occurrence and widespread of cholera through the creation of weather patterns that favor the disease's transmission, infection, and the growth of Vibrio cholerae, which cause the disease. Over the past decades, there have been great achievements in developing epidemic models for the proper prediction of cholera. However, the integration of weather variables and use of machine learning techniques have not been explicitly deployed in modeling cholera epidemics in Tanzania due to the challenges that come with its datasets such as imbalanced data and missing information. This paper explores the use of machine learning techniques to model cholera epidemics with linkage to seasonal weather changes while overcoming the data imbalance problem. Adaptive Synthetic Sampling Approach (ADASYN) and Principal Component Analysis (PCA) were used to the restore sampling balance and dimensional of the dataset. In addition, sensitivity, specificity, and balanced-accuracy metrics were used to evaluate the performance of the seven models. Based on the results of the Wilcoxon sign-rank test and features of the models, XGBoost classifier was selected to be the best model for the study. Overall results improved our understanding of the significant roles of machine learning strategies in health-care data. However, the study could not be treated as a time series problem due to the data collection bias. The study recommends a review of health-care systems in order to facilitate quality data collection and deployment of machine learning techniques.

PMID: 31427903 [PubMed - indexed for MEDLINE]

Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania.

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Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania.

Am J Trop Med Hyg. 2019 06;100(6):1335-1341

Authors: Rajasingham A, Hardy C, Kamwaga S, Sebunya K, Massa K, Mulungu J, Martinsen A, Nyasani E, Hulland E, Russell S, Blanton C, Nygren B, Eidex R, Handzel T

Abstract
In August 2015, an outbreak of cholera was reported in Tanzania. In cholera-affected areas of urban Dar es Salaam and Morogoro, many households obtained drinking water from vendors, who sold water from tanks ranging in volume from 1,000 to 20,000 L. Water supplied by vendors was not adequately chlorinated. The Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children and the U.N. Children's Fund, Tanzania, collaborated to enroll and train vendors to treat their water with 8.68-g sodium dichloroisocyanurate tablets (Medentech, Ireland). The Centers for Disease Control and Prevention (CDC) provided monitoring and evaluation support. Vendors were provided a 3-month supply of chlorine tablets. A baseline assessment and routine monitoring were conducted by ward environmental health officers. Approximately 3 months after chlorine tablet distribution, an evaluation of the program was conducted. The evaluation included a full enumeration of all vendors, an in-depth survey with half of the vendors enumerated, and focus group discussions. In total, 797 (88.9%) vendors were included in the full enumeration and 392 in the in-depth survey. Free residual chlorine (FRC) was detected in 12.0% of tanks at baseline and 69.6% of tanks during the evaluation; however, only 17.4% of these tanks had FRC ≥ 0.5 mg/L. The results suggest high acceptability and use of the chlorine tablets by water vendors. However, given variation in the water source used and longer storage times, dosing could be increased in future programming. Bulk chlorination using chlorine tablets offers an efficient community-level approach to treating water closer to the point of use.

PMID: 31017078 [PubMed - indexed for MEDLINE]

Detection of Haitian ctxB7 & tcpA alleles in Vibrio cholerae O1 El Tor biotype in Puri, Odisha, India.

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Detection of Haitian ctxB7 & tcpA alleles in Vibrio cholerae O1 El Tor biotype in Puri, Odisha, India.

Indian J Med Res. 2019 04;149(4):558-560

Authors: Kerketta AS, Kar SK, Khuntia HK

PMID: 31411182 [PubMed - indexed for MEDLINE]

Geographical distribution of primary & secondary dengue cases in India - 2017: A cross-sectional multicentric study.

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Geographical distribution of primary & secondary dengue cases in India - 2017: A cross-sectional multicentric study.

Indian J Med Res. 2019 04;149(4):548-553

Authors: Rao C, Kaur H, Gupta N, Sabeena SP, Ambica R, Jain A, Yadav A, Dwibedi B, Malhotra B, Kakru DK, Biswas D, Savargaonkar D, Ganesan M, Sabat J, Dhingra K, Lalitha S, Valecha N, Madhavilatha P, Barde PV, Joshi PD, Sharma P, Gupta R, Ratho RK, Sidhu S, Shrivastava SS, Dutta S, Shantala GB, Imtiaz S, Sethi S, Kalawat U, Vijayachari P, Raj V, Vijay N, Borkakoty B, Barua P, Majumdar T, Arunkumar G

Abstract
Background & objectives: Dengue virus infection is endemic in India with all the four serotypes of dengue virus in circulation. This study was aimed to determine the geographic distribution of the primary and secondary dengue cases in India.
Methods: A multicentre cross-sectional study was conducted at Department of Health Research / Indian Council of Medical Research (DHR)/(ICMR) viral research and diagnostic laboratories (VRDLs) and selected ICMR institutes located in India. Only laboratory-confirmed dengue cases with date of onset of illness less than or equal to seven days were included between September and October 2017. Dengue NS1 antigen ELISA and anti-dengue IgM capture ELISA were used to diagnose dengue cases while anti-dengue IgG capture ELISA was used for identifying the secondary dengue cases.
Results: Of the 1372 dengue cases, 897 (65%) were classified as primary dengue and 475 (35%) as secondary dengue cases. However, the proportion varied widely geographically, with Theni, Tamil Nadu; Tirupati, Andhra Pradesh and Udupi-Manipal, Karnataka reporting more than 65 per cent secondary dengue cases while Srinagar, Jammu and Kashmir reporting as low as 10 per cent of the same. The median age of primary dengue cases was 25 yr [interquartile range (IQR 17-35] while that of secondary dengue cases was 23 yr (IQR 13.5-34). Secondary dengue was around 50 per cent among the children belonging to the age group 6-10 yr while it ranged between 20-43 per cent among other age groups.
Interpretation & conclusions: Our findings showed a wide geographical variation in the distribution of primary and secondary dengue cases in India. It would prove beneficial to include primary and secondary dengue differentiation protocol in the national dengue surveillance programme.

PMID: 31411180 [PubMed - indexed for MEDLINE]

Emerging/re-emerging viral diseases & new viruses on the Indian horizon.

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Emerging/re-emerging viral diseases & new viruses on the Indian horizon.

Indian J Med Res. 2019 04;149(4):447-467

Authors: Mourya DT, Yadav PD, Ullas PT, Bhardwaj SD, Sahay RR, Chadha MS, Shete AM, Jadhav S, Gupta N, Gangakhedkar RR, Khasnobis P, Singh SK

Abstract
Infectious diseases remain as the major causes of human and animal morbidity and mortality leading to significant healthcare expenditure in India. The country has experienced the outbreaks and epidemics of many infectious diseases. However, enormous successes have been obtained against the control of major epidemic diseases, such as malaria, plague, leprosy and cholera, in the past. The country's vast terrains of extreme geo-climatic differences and uneven population distribution present unique patterns of distribution of viral diseases. Dynamic interplays of biological, socio-cultural and ecological factors, together with novel aspects of human-animal interphase, pose additional challenges with respect to the emergence of infectious diseases. The important challenges faced in the control and prevention of emerging and re-emerging infectious diseases range from understanding the impact of factors that are necessary for the emergence, to development of strengthened surveillance systems that can mitigate human suffering and death. In this article, the major emerging and re-emerging viral infections of public health importance have been reviewed that have already been included in the Integrated Disease Surveillance Programme.

PMID: 31411169 [PubMed - indexed for MEDLINE]

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