Welcome to the WSPID 2022 Virtual Congress Calendar

Background

Dengue is a potentially life-threatening viral infection. Early prognostic markers of severe complications may improve case management and reduce dengue-related mortalities.

Aims

This study aimed to identify circulating microRNAs (miRNAs) as biomarkers for predicting severe dengue.

Methods

Serum samples from dengue-infected patients were collected on the first day of admission. Patients were followed up to 14 days after admission to find out the final diagnosis. The participants were divided into non-severe and severe dengue, as defined by WHO 2009 criteria. Circulating microtranscriptome analysis was performed using the NanoString miRNA Expression Assay. The expression level of candidate miRNAs was then validated by quantitative reverse transcription-PCR (qRT-PCR) method.

Results

The discovery cohort (N=19) identified 37 differentially expressed miRNAs between the two groups. Among these, miR122-5p, miR1246, miR1303, miR574-5p, miR30d-5p, and miR424-5p were selected and further validated in the larger cohort (N=135). The qRT-PCR analysis confirmed that six selected miRNAs expression levels were significantly higher in the severe dengue group than in the non-severe group. Based on receiver operating characteristic (ROC) analysis, miR574-5p and miR1246 displayed the highest diagnostic performance in discriminating severe dengue from non-severe (area under the ROC curve =0.83). Additionally, miR574-5p and miR1246 had high sensitivity and high negative predictive value for detecting severe dengue. Multivariate analysis suggested that serum miR574-5p was an independent predictor of severe dengue (odds ratio 3.30, 95% CI 1.81-6.04; p<0.001).

Conclusions

Together, our study indicated that circulating miRNAs, especially miR574-5p and miR1246, could be promising diagnostic and prognostic biomarkers for severe dengue.

Background

Background: Diarrhea disease is a leading cause of child mortality and morbidity in the world. The effect of point-of-use (POU) water treatment in improving the quality of water in areas where POU is not provided free of charge were not studied.

Aims

The objective of this study was to evaluate the effectiveness of drinking water disinfection by chlorination in diarrhea disease reduction among children under the age of five years in rural eastern Ethiopia.

Methods

We carried out a cluster randomized controlled trial in rural Dire Dawa between October 2018 and January 2019. The 405 households were randomized to intervention and control arms and intervention materials were distributed after conducting the baseline survey. Intervention households received 1.25% sodium hypochlorite with demonstration. Participants in the control households were allowed to continue with their usual habits of water collection and water storage. Generalized estimation equation (GEE) was used to compute adjusted incidence rate ratio and the corresponding 95% confidence intervals.

Results

In the intervention households, a total of 281 cases of diarrhea were documented, but in the control households a total of 446 cases of diarrhea were documented. A 36% (adjusted IRR = 0.64, 95% CI 0.57 – 0.73) reduction in incidence of diarrhea was observed in the intervention arm when compared with the control arm.

Conclusions

Chlorinating drinking water at the household level may be a valuable interim solution until potable water is made accessible to the majority of the populations in Dire Dawa Administration and other Ethiopian communities.

Background

Congenital cytomegalovirus (cCMV) is the most common congenital infection globally. Around 25% of infants with cCMV develop permanent sequelae.

Aims

This cross-sectional study aimed to describe the health-related quality of life (HRQoL) of children with cCMV and that of their parents.

Methods

Families of children with cCMV in the UK were approached through the charity CMV Action. Parents completed questionnaires about their own HRQoL and that of their child. Children who were able to self-report completed questionnaires about their own HRQoL.

Demographic characteristics of the sample were described using descriptive statistics. Questionnaire responses were scored, and domain and summary scores calculated and compared with UK population norms, where available.

Results

Seventy families participated, with children aged between 5 months and 18 years. Children with cCMV had poorer HRQoL compared to children from UK population data. HRQoL of children whose health was more severely affected by cCMV was poorer than that of children whose health was less severely affected.

Parents of children whose health was moderately or severely affected by cCMV had greater psychological morbidity and poorer HRQoL in Physical, Emotional, Social, and Cognitive Functioning domains than parents of less severely affected children.

Conclusions

cCMV has a significant effect on the HRQoL of children with cCMV and their parents, with the children with the most significant health needs having the poorest HRQoL compared to those children with little or no effects on their health. This data could contribute to health economic analyses, informing resource allocation to potential interventions for the prevention and treatment of cCMV.

Background

Despite accumulating data on the nature and burden of post-tuberculosis (TB) lung disease (PTLD) in adults, little is known about PTLD in adolescents.

Aims

To assess lung function in adolescents with pulmonary TB (PTB) during anti-tuberculosis treatment.

Methods

In a prospective cohort study, we enrolled adolescents aged 10-20 years routinely diagnosed with bacteriologically confirmed PTB and healthy TB-exposed adolescent controls, between October 2020 and July 2021 in Cape Town, South Africa. Spirometry, plethysmography and diffusion capacity lung function tests were completed according to ERS/ATS guidelines following 2 months of TB treatment (cases) and in healthy controls. Global initiative reference ranges were used to calculate z-scores.

Results

Eighty-six adolescents were enrolled; 42 (49%) with PTB and 44 (51%) healthy controls. The mean age was 14.9 years (SD 2.7), 6 (5.5%) were living with HIV and 9 (10.5%) had a previous history of TB. Post bronchodilation, spirometry z-scores for Forced Expiratory Volume in 1 second (FEV1), Forced Vital capacity (FVC) and FEV1/FVC were significantly lower in TB cases compared to controls. Plethysmography showed a significantly lower vital capacity in TB cases vs. controls, with slightly lower total lung capacity. Diffusion capacity was similar between TB cases and healthy controls.

Conclusions

The lung function in adolescents with PTB following the intensive phase of TB treatment was significantly impaired compared to that of healthy peers. Further follow-up is important to assess the long-term impact of PTB on lung function in adolescents and to correlate these findings with symptoms, imaging, functional assessments and disease severity at diagnosis.

Background

Little is known about long-term impact of COVID-19 in children in low- middle income countries.

Aims

To determine long-term consequences in SARS-CoV-2 PCR positive children versus SARS-CoV-2 negative children.

Methods

In this prospective observational cohort study, children aged 0-13 years were recruited from Tygerberg Hospital in Cape Town, South Africa between June 2020 and September 2021, presenting with either 1) an acute respiratory illness, 2) confirmed COVID-19 PCR or 3) a COVID-19 contact. Clinical data and serum samples were obtained at baseline and children were followed 3 months and 1 year later.

Results

A total of 100 children were enrolled, median age 7 months (interquartile range 2.0-31.5 months), 61 (61%) male; 2 (2%) HIV-infected and 25 (25 %) HIV-exposed. A total of 44 (44%) children tested COVID-19 positive on PCR. Underlying comorbidities were seen more frequently in COVID PCR positive cases (40.9%) compared to COVID negative cases (33.9%). One year after initial enrolment 12/41 (29.3%) children had persistent or recurrent symptoms and were more likely to be COVID-19 PCR positive (p=0.01). A total of 40/100 (40%) children were readmitted, with no significant difference between children with or without previous COVID-19 diagnosis. At baseline SARS-CoV-2 antibodies were found in 43/85 (50.6%) and after 1 year 31/39 (79.5%) were SARS-CoV-2 antibody positive.

Conclusions

Children who had confirmed SARS-CoV-2 infection were more likely to have symptoms 1 year later. The vast majority of this cohort had evidence of SARS-CoV-2 infection by 1 year after enrolment.