Recent Cholera Publications on PubMed

Subscribe to Recent Cholera Publications on PubMed feed Recent Cholera Publications on PubMed
NCBI: db=pubmed; Term=cholera epidemiology
Updated: 1 hour 40 min ago

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations.

1 hour 40 min ago
Related Articles

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations.

Int J Mol Sci. 2017 Mar 08;18(3):

Authors: Ohlsson B, Orho-Melander M, Nilsson PM

Abstract
Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI) symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring (n = 363) of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV) were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference (p = 0.003), diastolic blood pressure (p = 0.003), and glucose levels (p = 0.036). Higher zonulin levels were associated with increased risk of overweight (p < 0.001), obesity (p = 0.047), and hyperlipidemia (p = 0.048). We cannot detect altered zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

PMID: 28282855 [PubMed - indexed for MEDLINE]

Vaccination against cholera in Juba - Authors' reply.

April 28, 2017

Vaccination against cholera in Juba - Authors' reply.

Lancet Infect Dis. 2017 May;17(5):480-481

Authors: Ciglenecki I, Azman AS, Rumunu J, Cabrol JC, Luquero FJ

PMID: 28447952 [PubMed - in process]

Successful comeback of the single-dose live oral cholera vaccine CVD 103-HgR.

April 22, 2017
Related Articles

Successful comeback of the single-dose live oral cholera vaccine CVD 103-HgR.

Travel Med Infect Dis. 2016 Jul-Aug;14(4):373-7

Authors: Herzog C

Abstract
Effective and easy to administer cholera vaccines are in need more than ever, for at risk populations and travellers alike. In many parts of the world cholera is still endemic, causing outbreaks and constituting repeatedly serious public health problems. The oral live cholera vaccine CVD 103-HgR (Orochol, Mutachol), the first genetically modified organism (GMO) used as vaccine, was in its time (launched 1993, Switzerland) the ideal cholera vaccine: single-dose, protective efficacy of 80-100% against moderate to severe cholera, acting within 8 days and exhibiting excellent safety, indiscernible from placebo. However, there were strong headwinds: In the 1990s the indication for cholera vaccines was generally downplayed by experts and in 1997 the European Commission called for a moratorium of GMOs which blocked the registration in the European Union. Thus, demand for this vaccine remained low and in 2003 it was taken off the market for economic reasons. After a decade in obscurity it (Vaxchora) has resurfaced again, now produced in the U.S. and equipped with a U.S. FDA license (June 10, 2016). What had happened? This commentary gives a critical account of an almost unbelievable string of misadventures, emerging adverse circumstances and man-made failures which nearly killed this single-dose live oral cholera vaccine. The good news is that patience and persistence lead to success in the end, allowing good science to prevail for the benefit of those in need.

PMID: 27425792 [PubMed - indexed for MEDLINE]

Contributions to the phytotherapies of digestive disorders: Traditional knowledge and cultural drivers of Manoor Valley, Northern Pakistan.

April 22, 2017
Related Articles

Contributions to the phytotherapies of digestive disorders: Traditional knowledge and cultural drivers of Manoor Valley, Northern Pakistan.

J Ethnopharmacol. 2016 Nov 04;192:30-52

Authors: Rahman IU, Ijaz F, Afzal A, Iqbal Z, Ali N, Khan SM

Abstract
ETHNO PHARMACOLOGICAL RELEVANCE: Ethno medicinal traditional knowledge regarding the uses of indigenous medicinal plants used for various human digestive disorders are mostly known to the elder community members. As the young generation is not much aware about such vital traditional medicinal practice because they rely on elders.
AIM OF STUDY: To document, accumulate and widely disseminate the massive indigenous knowledge of century's practiced therapeutic uses of medicinal plants by the local people living in this remote area.
MATERIALS AND METHODS: A total of 63 local inhabitants (39 males and 24 females) were interviewed through a structured questionnaire. The data obtained were quantitatively analyzed through the use value (UVi), fidelity level index (FL%) and relative frequency citations (RFCs), consensus index (CI%) and informant consensus factor (FIC). For novel uses all the plants were checked with previously published articles on same disease by analyzing through Jaccard index (JI) and Sorensen's similarity index (QS). Plants specimen were preserved, mounted and labeled on the herbarium sheets, cataloged and deposited with voucher numbers in Hazara University Herbarium, Mansehra, Pakistan (HUP).
RESULTS: 44 plant species belonging to 44 genera and 28 families were documented in the current study. These medicinal plant species were used commonly as an ethno medicine against 26 various digestive disorders out of which most frequently occurred are; stomach ache, diarrhea, indigestion, constipation and inflammation etc. Herbaceous plant species were the dominant among plants studied which were 64% of the total plants, followed by trees (20%) and shrubs (16%). Lamiaceae was the leading family among collected medicinal plant species (13.6%). Maximum medicinal plant species were used for treatment of stomach ache (11.7%), diarrhea and indigestion (10.9% each). Most widely used parts were leaves (41% citations), fruit and whole plant (12% citations each) for medication of various digestive problems by the traditional drivers. Dominated medicinal plants with most use values were Ficus carica having (UVi=0.90) and Trifolium repens (UVi=0.84). Based on the RFC values, the most cited medicinal plant species by the traditional drivers were Ficus carica (0.43) and Berberis lycium (0.41), while most respondents percentage was noticed for same plant species calculated through consensus index (CI%=42.9% and 41.3%) respectively. The medicinal plant species with highest fidelity level was of Grewia optiva, Juglans regia and Sorbaria tomentosa each cited 100% for anthelmintic, easy digestion and Diarrhea respectively. Due to representation by only single medicinal plant taxa (Nt=1), the digestive diseases viz. cholera, colon cancer, emetic, internal injuries, kill microorganisms, Soothing, tumor and urine suppression had maximum FIC value. The analytical result reveals that 57% of medicinal plant species were reported for the first time regarding their uses. new medicinal uses of Anaphalis contorta, Caltha palustris, Pinus wallichiana, Plantago himalaica were recorded for the first time from Pakistan and Aralia cachemirica, Bupleurum longicaule, Pleurospermum stellatum, Potentilla argentea and Juglans regia across the globe for currently reported medicinal uses. Besides this, all the mentioned plant species were reported for the first time for digestive disorders from Manoor Valley as no single study up-till now has been conducted ethno medicinally.
CONCLUSION: The present study revealed the importance to document and launch list of all the possible plants that are used in traditional medicinal practices against digestive disorders in the unexplored study area and to show the important medicinal plants for future biological, phytochemical and pharmacological experimentation regarding digestive problems.

PMID: 27353866 [PubMed - indexed for MEDLINE]

Cholera threatens Haiti after Hurricane Matthew.

April 21, 2017
Related Articles

Cholera threatens Haiti after Hurricane Matthew.

BMJ. 2016 Oct 11;355:i5516

Authors: Ferreira S

PMID: 27729331 [PubMed - indexed for MEDLINE]

Microbiological quality of water in a city with persistent and recurrent waterborne diseases under tropical sub-rural conditions: The case of Kikwit City, Democratic Republic of the Congo.

April 19, 2017
Related Articles

Microbiological quality of water in a city with persistent and recurrent waterborne diseases under tropical sub-rural conditions: The case of Kikwit City, Democratic Republic of the Congo.

Int J Hyg Environ Health. 2017 Mar 30;:

Authors: Nienie AB, Sivalingam P, Laffite A, Ngelinkoto P, Otamonga JP, Matand A, Mulaji CK, Biey EM, Mpiana PT, Poté J

Abstract
The availability of safe drinking water in sub-Saharan countries remains a major challenge because poor sanitation has been the cause of various outbreaks of waterborne disease due to the poor microbiological quality of water used for domestic purposes. The faecal indicator bacteria (FIB) used in the present study included Escherichia coli (E. coli) and Enterococcus (ENT). FIB and aerobic mesophilic bacteria (AMB) were quantified during July 2015 (dry season) and November 2015 (rainy season) in order to assess the quality of drinking water from wells (n=3; P1-P3), and two rivers, the River Lukemi (RLK, n=3) and River Luini (RLN, n=2) in the city of Kikwit, which is located in the province of Kwilu in the Democratic Republic of the Congo. Kikwit is well known for its outbreaks of persistent and recurrent waterborne diseases including Entamoeba, Shigella, typhoid fever, cholera, and Ebola Viral Hemorrhagic Fever. Consequently, E. coli, ENT, and AMB were quantified in water samples according to the standard international methods for water quality determination using the membrane filtration method. The FIB characterization was performed for human-specific Bacteroides by PCR using specific primers. The results obtained revealed high FIB concentrations in river samples collected during both seasons. For example, E. coli respectively reached 4.3×10(4) and 9.2×10(4) CFU 100mL(-1) in the dry season and the wet season. ENT reached 5.3×10(3) CFU 100mL(-1) during the dry season and 9.8×10(3) CFU 100mL(-1) in the wet season. The pollution was significantly worse in the wet season compared to the dry season. Surprisingly, no faecal contamination was observed in well water samples collected in the dry season while E. coli and ENT were detected in all wells in the wet season with values of 6, 7, and 11CFUmL(-1) for E. coli in wells P1-P3, respectively and 3, 5, 9 CFU mL(-1)for ENT in the same wells. Interestingly, the PCR assays for human-specific Bacteroides HF183/HF134 indicated that 97-100% captured in all analyses of isolated FIB were of human origin. The results indicate that contamination of E. coli, ENT, and AMB in the studied water resources increases during the wet season. This study improves understanding of the microbiological pollution of rivers and wells under tropical conditions and will guide future municipal/local government decisions on improving water quality in this region which is characterised by persistent and recurrent waterborne diseases. Although the epidemiology can be geographically localised, the effects of cross border transmission can be global. Therefore, the research results presented in this article form recommendations to municipalities/local authorities and the approach and procedures can be carried out in a similar environment.

PMID: 28416464 [PubMed - as supplied by publisher]

O-Specific Polysaccharide-Specific Memory B Cell Responses in Young Children, Older Children, and Adults Infected with Vibrio cholerae O1 Ogawa in Bangladesh.

April 14, 2017
Related Articles

O-Specific Polysaccharide-Specific Memory B Cell Responses in Young Children, Older Children, and Adults Infected with Vibrio cholerae O1 Ogawa in Bangladesh.

Clin Vaccine Immunol. 2016 05;23(5):427-35

Authors: Aktar A, Rahman MA, Afrin S, Faruk MO, Uddin T, Akter A, Sami MI, Yasmin T, Chowdhury F, Khan AI, Leung DT, LaRocque RC, Charles RC, Bhuiyan TR, Mandlik A, Kelly M, Kováč P, Xu P, Calderwood SB, Harris JB, Qadri F, Ryan ET

Abstract
Cholera caused by Vibrio cholerae O1 confers at least 3 to 10 years of protection against subsequent disease regardless of age, despite a relatively rapid fall in antibody levels in peripheral blood, suggesting that memory B cell responses may play an important role in protection. The V. cholerae O1-specific polysaccharide (OSP) component of lipopolysaccharide (LPS) is responsible for serogroup specificity, and it is unclear if young children are capable of developing memory B cell responses against OSP, a T cell-independent antigen, following cholera. To address this, we assessed OSP-specific memory B cell responses in young children (2 to 5 years, n = 11), older children (6 to 17 years, n = 21), and adults (18 to 55 years, n = 28) with cholera caused by V. cholerae O1 in Dhaka, Bangladesh. We also assessed memory B cell responses against LPS and vibriocidal responses, and plasma antibody responses against OSP, LPS, and cholera toxin B subunit (CtxB; a T cell-dependent antigen) on days 2 and 7, as well as days 30, 90, and 180 after convalescence. In all age cohorts, vibriocidal responses and plasma OSP, LPS, and CtxB-specific responses peaked on day 7 and fell toward baseline over the follow-up period. In comparison, we were able to detect OSP memory B cell responses in all age cohorts of patients with detectable responses over baseline for 90 to 180 days. Our results suggest that OSP-specific memory B cell responses can occur following cholera, even in the youngest children, and may explain in part the age-independent induction of long-term immunity following naturally acquired disease.

PMID: 27009211 [PubMed - indexed for MEDLINE]

El Niño and the shifting geography of cholera in Africa.

April 12, 2017
Related Articles

El Niño and the shifting geography of cholera in Africa.

Proc Natl Acad Sci U S A. 2017 Apr 10;:

Authors: Moore SM, Azman AS, Zaitchik BF, Mintz ED, Brunkard J, Legros D, Hill A, McKay H, Luquero FJ, Olson D, Lessler J

Abstract
The El Niño Southern Oscillation (ENSO) and other climate patterns can have profound impacts on the occurrence of infectious diseases ranging from dengue to cholera. In Africa, El Niño conditions are associated with increased rainfall in East Africa and decreased rainfall in southern Africa, West Africa, and parts of the Sahel. Because of the key role of water supplies in cholera transmission, a relationship between El Niño events and cholera incidence is highly plausible, and previous research has shown a link between ENSO patterns and cholera in Bangladesh. However, there is little systematic evidence for this link in Africa. Using high-resolution mapping techniques, we find that the annual geographic distribution of cholera in Africa from 2000 to 2014 changes dramatically, with the burden shifting to continental East Africa-and away from Madagascar and portions of southern, Central, and West Africa-where almost 50,000 additional cases occur during El Niño years. Cholera incidence during El Niño years was higher in regions of East Africa with increased rainfall, but incidence was also higher in some areas with decreased rainfall, suggesting a complex relationship between rainfall and cholera incidence. Here, we show clear evidence for a shift in the distribution of cholera incidence throughout Africa in El Niño years, likely mediated by El Niño's impact on local climatic factors. Knowledge of this relationship between cholera and climate patterns coupled with ENSO forecasting could be used to notify countries in Africa when they are likely to see a major shift in their cholera risk.

PMID: 28396423 [PubMed - as supplied by publisher]

Distribution of resistance genetic determinants among Vibrio cholerae isolates of 2012 and 2013 outbreaks in IR Iran.

April 7, 2017
Related Articles

Distribution of resistance genetic determinants among Vibrio cholerae isolates of 2012 and 2013 outbreaks in IR Iran.

Microb Pathog. 2017 Mar;104:12-16

Authors: Rezaie N, Bakhshi B, Najar-Peerayeh S

Abstract
The objective of this study was to characterize antimicrobial resistance determinants in relation to antimicrobial susceptibility and genotyping profile in 20 clinical isolates of Vibrio cholerae. All of the isolates were resistant to streptomycin. The second most prevalent resistance was observed to trimethoprim (75%), co-trimoxazole (60%), tetracycline (50%), and minocycline (45%). About 50% of the isolates fulfilled the criteria of Multi Drug Resistance (MDR) phenotype. None of the isolates carried tet A, B, C, and, D determinants. This finding shows that tetracycline resistance determinants recognized so far, does not satisfactorily describe the 50% tetracycline resistance phenotype in this study, suggesting the possible contribution of other not yet characterized resistance mechanisms involved. Class 1 integron, widely distributed among enteric bacteria, was not detected among V. cholerae strains under study. Conversely, 100% of the isolates harbored SXT constin(int), among which 70% were positive for dfrA1, strA, and strB genes. The sul1gene was present in 60% of the isolates while none of them contained floR gene. All the isolates uniformly appeared to be identical in fingerprinting profiles expected from outbreak strains. In conclusion, SXT element with its mosaic structure was the exclusive antimicrobial resistance determinant of clonal V. cholerae isolates taken from outbreaks of 2012 and 2013 in Iran.

PMID: 28062293 [PubMed - indexed for MEDLINE]

Cross-protection against Vibrio cholerae infection by monoclonal antibodies against Vibrio vulnificus RtxA1/MARTXVv.

April 7, 2017
Related Articles

Cross-protection against Vibrio cholerae infection by monoclonal antibodies against Vibrio vulnificus RtxA1/MARTXVv.

Microbiol Immunol. 2016 Nov;60(11):793-800

Authors: Lee TH, Cha SS, Lee CS, Rhee JH, Woo HR, Chung KM

Abstract
Gram-negative Vibrio species secrete multifunctional autoprocessing repeats-in-toxin (MARTX) toxins associated with bacterial pathogenesis. Here, the cross-reactivity and cross-protectivity of mAbs against V. vulnificus RtxA1/MARTXVv was evaluated. Passive administration of any of these mAbs (21RA, 24RA, 46RA, 47RA and 50RA) provided strong protection against lethal V. cholerae infection. Interestingly, 24RA and 46RA, which map to the cysteine protease domain of V. cholerae MARTXVc , inhibited CPD autocleavage in vitro; this process is involved in V. cholerae pathogenesis. These results generate new insight into the development of broadly protective mAbs and/or vaccines against Vibrio species with MARTX toxins.

PMID: 27921342 [PubMed - indexed for MEDLINE]

Antibody Secreting Cell Responses following Vaccination with Bivalent Oral Cholera Vaccine among Haitian Adults.

March 31, 2017
Related Articles

Antibody Secreting Cell Responses following Vaccination with Bivalent Oral Cholera Vaccine among Haitian Adults.

PLoS Negl Trop Dis. 2016 06;10(6):e0004753

Authors: Matias WR, Falkard B, Charles RC, Mayo-Smith LM, Teng JE, Xu P, Kováč P, Ryan ET, Qadri F, Franke MF, Ivers LC, Harris JB

Abstract
BACKGROUND: The bivalent whole-cell (BivWC) oral cholera vaccine (Shanchol) is effective in preventing cholera. However, evaluations of immune responses following vaccination with BivWC have been limited. To determine whether BivWC induces significant mucosal immune responses, we measured V. cholerae O1 antigen-specific antibody secreting cell (ASC) responses following vaccination.
METHODOLOGY/PRINCIPAL FINDINGS: We enrolled 24 Haitian adults in this study, and administered doses of oral BivWC vaccine 14 days apart (day 0 and day 14). We drew blood at baseline, and 7 days following each vaccine dose (day 7 and 21). Peripheral blood mononuclear cells (PBMCs) were isolated, and ASCs were enumerated using an ELISPOT assay. Significant increases in Ogawa (6.9 cells per million PBMCs) and Inaba (9.5 cells per million PBMCs) OSP-specific IgA ASCs were detected 7 days following the first dose (P < 0.001), but not the second dose. The magnitude of V. cholerae-specific ASC responses did not appear to be associated with recent exposure to cholera. ASC responses measured against the whole lipolysaccharide (LPS) antigen and the OSP moiety of LPS were equivalent, suggesting that all or nearly all of the LPS response targets the OSP moiety.
CONCLUSIONS/SIGNIFICANCE: Immunization with the BivWC oral cholera vaccine induced ASC responses among a cohort of healthy adults in Haiti after a single dose. The second dose of vaccine resulted in minimal ASC responses over baseline, suggesting that the current dosing schedule may not be optimal for boosting mucosal immune responses to V. cholerae antigens for adults in a cholera-endemic area.

PMID: 27308825 [PubMed - indexed for MEDLINE]

Reporting measles case fatality due to complications from a tertiary care hospital of Kolkata, West Bengal 2011-2013.

March 30, 2017
Related Articles

Reporting measles case fatality due to complications from a tertiary care hospital of Kolkata, West Bengal 2011-2013.

J Family Med Prim Care. 2016 Oct-Dec;5(4):777-779

Authors: Indwar P, Debnath F, Sinha A

Abstract
INTRODUCTION: Measles is affecting millions of people in the developing countries particularly in India with significant morbidity and responsible for thousands of death in spite of having a safe, effective, and cheap vaccine. Pulmonary complications account for 90% measles-related death. The objectives of this study were to describe age distribution, clinical features, complications, and clinical outcomes of measles cases in a referral infectious disease hospital of West Bengal.
METHODS: We conducted a retrospective descriptive study including 584 patients and collected information from record section on demographics, clinical features, complications, and clinical outcomes using data abstraction form.
RESULTS: The mean age of 584 measles cases was 3.7 years (±1.2 years). The most common complication was pneumonia (149 cases) followed by diarrhea and encephalopathy. Very severe pneumonia occurred in 34 cases requiring intensive care out of which 13 patients died. The average duration of stay in the hospital was 5.7 days (±3.2 days). Surprisingly, 45 cases admitted to this hospital were <9 months of age with subsequent death in 5 cases.
CONCLUSION: Substantial number of measles cases was seen in zero to <9 months of age group and fatality due to complication was more among them.

PMID: 28348989 [PubMed - in process]

The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS).

March 30, 2017
Related Articles

The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS).

PLoS Negl Trop Dis. 2016 05;10(5):e0004729

Authors: Sow SO, Muhsen K, Nasrin D, Blackwelder WC, Wu Y, Farag TH, Panchalingam S, Sur D, Zaidi AK, Faruque AS, Saha D, Adegbola R, Alonso PL, Breiman RF, Bassat Q, Tamboura B, Sanogo D, Onwuchekwa U, Manna B, Ramamurthy T, Kanungo S, Ahmed S, Qureshi S, Quadri F, Hossain A, Das SK, Antonio M, Hossain MJ, Mandomando I, Nhampossa T, Acácio S, Omore R, Oundo JO, Ochieng JB, Mintz ED, O'Reilly CE, Berkeley LY, Livio S, Tennant SM, Sommerfelt H, Nataro JP, Ziv-Baran T, Robins-Browne RM, Mishcherkin V, Zhang J, Liu J, Houpt ER, Kotloff KL, Levine MM

Abstract
BACKGROUND: The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.
METHODS: Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated.
FINDINGS: Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative.
CONCLUSIONS: The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.

PMID: 27219054 [PubMed - indexed for MEDLINE]

Health-related quality of life (HRQoL) and its correlates among community-recruited children living with HIV and uninfected children born to HIV-infected parents in West Bengal, India.

March 28, 2017
Related Articles

Health-related quality of life (HRQoL) and its correlates among community-recruited children living with HIV and uninfected children born to HIV-infected parents in West Bengal, India.

Qual Life Res. 2017 Mar 25;:

Authors: Das A, Detels R, Afifi AA, Javanbakht M, Sorvillo FJ, Panda S

Abstract
PURPOSE: Helping children living with HIV (CLH) to attain an optimum quality of life is an important goal for HIV programs around the world. Our principal objectives were to determine the association of HIV infection with different domains of health-related quality of life (HRQoL) among 8- to 15-year-old CLH in India and to compare the HRQoL parameters between CLH and HIV-negative children born to HIV-infected parents ("HIV-affected"). We also assessed whether antiretroviral therapy (ART) and CD4 lymphocyte counts were associated with HRQoL among CLH.
METHODS: Using the "Quality of Life (health-related) of Children Living with HIV/AIDS in India" instrument, we interviewed 199 CLH and 194 HIV-affected children from three districts of West Bengal, India. Participants were asked to quantify the difficulties faced by them in six HRQoL domains: physical, emotional, social, school functioning, symptoms, and discrimination.
RESULTS: The mean age of the participants was 11.6 (SD ± 2.5) years. CLH, compared to HIV-affected children, had poorer scores on all HRQoL domains except 'discrimination.' Among CLH, there were no significant differences in HRQoL domain scores (except in the 'discrimination' domain) between ART-treated and -untreated groups. CD4 lymphocyte count was found to be a significant positive predictor of the 'symptom' scale score.
CONCLUSIONS: In India, interventions for CLH mostly focus on biological disease. However, the current study revealed that HRQoL among CLH was much poorer than that of a socio-demographically comparable group. Culturally and developmentally appropriate psychosocial support measures for Indian CLH are urgently needed.

PMID: 28343351 [PubMed - as supplied by publisher]

Multi-locus variable number tandem repeat analysis of Vibrio cholerae isolates from 2012 to 2013 cholera outbreaks in Iran.

March 28, 2017
Related Articles

Multi-locus variable number tandem repeat analysis of Vibrio cholerae isolates from 2012 to 2013 cholera outbreaks in Iran.

Microb Pathog. 2016 Aug;97:84-8

Authors: Ranjbar R, Sadeghy J, Shokri Moghadam M, Bakhshi B

Abstract
Cholera remains to be an international threat, with high rates of illness and death. In 2012 and 2013, two cholera outbreak happened in Iran, affecting lots of people. Vibrio cholerae O1 was confirmed as the etiological agent. Source identification and controlling the spread of the cholera disease are two critical approaches in cholera outbreaks. In this study, thirty V. cholerae O1 isolates were selected and has been evaluated for antimicrobial resistant as well as molecular typing by multilocus variable-number tandem-repeat analysis (MLVA) method. Twenty-nine (97%) isolates were sero-grouped as El Tor (one isolate was classical) and 100% were related to Inaba serotype. All of the isolates were susceptible to ciprofloxacin, chloramphenicol, ampicillin and gentamicin. On the other hand, 60% of the isolates were MDR (resistant to 3 or more classes). There were three resistance patterns. The most prevalent pattern was resistance to streptomycin, erythromycin, trimethoprim-sulfamethoxazole, and tetracycline (ST-SXT-E-T) which was seen in 50% of isolates. Using MLVA method 14 MLVA types were identified. MLVA type 2 (5-7-7-16-15) accounted for 43% of isolates. Isolates with the same genotype often did not have the same antibiogram. Overall, the data indicate that the Iranian V. cholerae were MDR and clonaly related. Furthermore, the results of this study shows that MLVA can be used as useful method for V. cholerae genotyping in epidemiological investigations.

PMID: 27247094 [PubMed - indexed for MEDLINE]

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

March 23, 2017
Related Articles

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

PLoS Negl Trop Dis. 2016 05;10(5):e0004679

Authors: Sauvageot D, Njanpop-Lafourcade BM, Akilimali L, Anne JC, Bidjada P, Bompangue D, Bwire G, Coulibaly D, Dengo-Baloi L, Dosso M, Orach CG, Inguane D, Kagirita A, Kacou-N'Douba A, Keita S, Kere Banla A, Kouame YJ, Landoh DE, Langa JP, Makumbi I, Miwanda B, Malimbo M, Mutombo G, Mutombo A, NGuetta EN, Saliou M, Sarr V, Senga RK, Sory F, Sema C, Tante OV, Gessner BD, Mengel MA

Abstract
BACKGROUND: Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org).
METHODS/ PRINCIPAL FINDINGS: During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1%) by country.
CONCLUSIONS/SIGNIFICANCE: Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

PMID: 27186885 [PubMed - indexed for MEDLINE]

Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection.

March 23, 2017
Related Articles

Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection.

Jpn J Infect Dis. 2017 Jan 24;70(1):111-114

Authors: Koley H, Ghosh P, Sinha R, Mitra S, Mukherjee P, Howlader DR, Chaki C, Nag D

Abstract
Diabetes mellitus and diarrhea are becoming increasingly burdensome worldwide, particularly in developing countries such as India. Diabetic patients are susceptible to infection with pathogenic bacteria, particularly those causing invasive enteric infections. In this study, we observed changes in the pathophysiological features of mice with streptozotocin-induced hyperglycemia. In our experiments, both hyperglycemic and control mice were infected with pathogenic enteric bacteria-non-typhoidal Salmonella, Shigella flexneri, or Vibrio parahaemolyticus. Morbidity, mortality, and bacterial load were all higher in the diabetic mice than in the control mice, and the phagocytic and bactericidal activities of peritoneal macrophages isolated from hyperglycemic mice were lower than they were in the controls. We hypothesize that hyperglycemia leads to a downregulation of the innate immune response, which in turn increases vulnerability to enteric bacterial infection.

PMID: 27169940 [PubMed - indexed for MEDLINE]

Induction of immunomodulatory miR-146a and miR-155 in small intestinal epithelium of Vibrio cholerae infected patients at acute stage of cholera.

March 21, 2017
Related Articles

Induction of immunomodulatory miR-146a and miR-155 in small intestinal epithelium of Vibrio cholerae infected patients at acute stage of cholera.

PLoS One. 2017;12(3):e0173817

Authors: Bitar A, De R, Melgar S, Aung KM, Rahman A, Qadri F, Wai SN, Shirin T, Hammarström ML

Abstract
The potential immunomodulatory role of microRNAs in small intestine of patients with acute watery diarrhea caused by Vibrio cholerae O1 or enterotoxigenic Escherichia coli (ETEC) infection was investigated. Duodenal biopsies were obtained from study-participants at the acute (day 2) and convalescent (day 21) stages of disease, and from healthy individuals. Levels of miR-146a, miR-155 and miR-375 and target gene (IRAK1, TRAF6, CARD10) and 11 cytokine mRNAs were determined by qRT-PCR. The cellular source of microRNAs in biopsies was analyzed by in situ hybridization. The ability of V. cholerae bacteria and their secreted products to cause changes in microRNA- and mRNA levels in polarized tight monolayers of intestinal epithelial cells was investigated. miR-146a and miR-155 were expressed at significantly elevated levels at acute stage of V. cholerae infection and declined to normal at convalescent stage (P<0.009 versus controls; P = 0.03 versus convalescent stage, pairwise). Both microRNAs were mainly expressed in the epithelium. Only marginal down-regulation of target genes IRAK1 and CARD10 was seen and a weak cytokine-profile was identified in the acute infected mucosa. No elevation of microRNA levels was seen in ETEC infection. Challenge of tight monolayers with the wild type V. cholerae O1 strain C6706 and clinical isolates from two study-participants, caused significant increase in miR-155 and miR-146a by the strain C6706 (P<0.01). One clinical isolate caused reduction in IRAK1 levels (P<0.05) and none of the strains induced inflammatory cytokines. In contrast, secreted factors from these strains caused markedly increased levels of IL-8, IL-1β, and CARD10 (P<0.001), without inducing microRNA expression. Thus, miR-146a and miR-155 are expressed in the duodenal epithelium at the acute stage of cholera. The inducer is probably the V. cholerae bacterium. By inducing microRNAs the bacterium can limit the innate immune response of the host, including inflammation evoked by its own secreted factors, thereby decreasing the risk of being eliminated.

PMID: 28319200 [PubMed - in process]

Notes from the Field: Ongoing Cholera Epidemic - Tanzania, 2015-2016.

March 18, 2017
Related Articles

Notes from the Field: Ongoing Cholera Epidemic - Tanzania, 2015-2016.

MMWR Morb Mortal Wkly Rep. 2017 Feb 17;66(6):177-178

Authors: Narra R, Maeda JM, Temba H, Mghamba J, Nyanga A, Greiner AL, Bakari M, Beer KD, Chae SR, Curran KG, Eidex RB, Gibson JJ, Handzel T, Kiberiti SJ, Kishimba RS, Lukupulo H, Malibiche T, Massa K, Massay AE, McCrickard LS, Mchau GJ, Mmbaga V, Mohamed AA, Mwakapeje ER, Nestory E, Newton AE, Oyugi E, Rajasingham A, Roland ME, Rusibamayila N, Sembuche S, Urio LJ, Walker TA, Wang A, Quick RE

PMID: 28207686 [PubMed - indexed for MEDLINE]

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

March 14, 2017

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015.

PLoS Negl Trop Dis. 2017 Mar 13;11(3):e0005407

Authors: Bwire G, Munier A, Ouedraogo I, Heyerdahl L, Komakech H, Kagirita A, Wood R, Mhlanga R, Njanpop-Lafourcade B, Malimbo M, Makumbi I, Wandawa J, Gessner BD, Orach CG, Mengel MA

Abstract
BACKGROUND: The communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions on cholera and contribute to its elimination from those communities.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective study between 2011-15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5-10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5-9 years had increased risk. Cholera was endemic in some villages with well-defined "hotspots". Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty.
CONCLUSIONS/SIGNIFICANCE: Cholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities.

PMID: 28288154 [PubMed - as supplied by publisher]

Pages