Host Transcription Profile in Nasal Epithelium and Whole Blood of Hospitalized Children Under 2 Years of Age With Respiratory Syncytial Virus Infection.

BACKGROUND: Most insights into the cascade of immune events after acute respiratory syncytial virus (RSV) infection have been obtained from animal experiments or in vitro models. METHODS: In this study, we investigated host gene expression profiles in nasopharyngeal (NP) swabs and whole blood samples during natural RSV and rhinovirus (hRV) infection (acute versus early recovery phase) in 83 hospitalized patients <2 years old with lower respiratory tract infections. RESULTS: Respiratory syncytial virus infection induced strong and persistent innate immune responses including interferon signaling and pathways related to chemokine/cytokine signaling in both compartments. Interferon-α/β, NOTCH1 signaling pathways and potential biomarkers HIST1H4E, IL7R, ISG15 in NP samples, or BCL6, HIST2H2AC, CCNA1 in blood are leading pathways and hub genes that were associated with both RSV load and severity. The observed RSV-induced gene expression patterns did not differ significantly in NP swab and blood specimens. In contrast, hRV infection did not as strongly induce expression of innate immunity pathways, and significant differences were observed between NP swab and blood specimens. CONCLUSIONS: We conclude that RSV induced strong and persistent innate immune responses and that RSV severity may be related to development of T follicular helper cells and antiviral inflammatory sequelae derived from high activation of BCL6

Survey Tool for Rapid Assessment of Socio-Economic Vulnerability of Fishing Communities in Vietnam to Climate Change

Climate change will likely affect the effectiveness of future management of coastal ecosystems, impacting communities that reside within the coastal area. In order to formulate appropriate adaptation counter-measures it is important to understand the actual vulnerability of the communities that depend on these ecosystems. The present research proposes a tool for assessing the vulnerability of coastal communities to climate change by combining survey results with secondary and observed data available from national and local governments. The study focused on fisheries, given that they constitute the source of livelihood for many communities in developing countries such as Vietnam. The results showed that two coastal wards in Binh Thuan province, Vietnam, are highly vulnerable to the impacts of climate change, mainly because of their dependence on fisheries and the topography of the area. The seasonality of their source of livelihood affects the adaptive capacity of residents, making it less likely that they will be able to successfully adapt to changes in fishery resources that could be brought about by climate change. The results also showed that the communities are particularly vulnerable to sea level rise, given that they are both located in the immediate vicinity of the sea and are particularly low in elevation

Symptom prevalence, bother, and treatment satisfaction in men with lower urinary tract symptoms in Southeast Asia: a multinational, cross-sectional survey

Purpose: The overall objective of the survey was to systematically examine patients’ perspectives on lower urinary tract symptoms (LUTS) and their treatment in Southeast Asia. Methods: A multinational cross-sectional survey involving adult men seeking consultation at urology outpatient clinics because of LUTS in Southeast Asia was conducted using convenience sampling. Self-reported prevalence, bother, treatment and treatment satisfaction of selected LUTS including urgency, nocturia, slow stream, and post-micturition dribble were evaluated. Results: In total, 1535 eligible patients were enrolled in the survey. A majority of respondents were aged 56–75 years, not employed, and had not undergone prostate operation before. Overall, the self-reported prevalence of nocturia was 88% (95% CI 86–90%), slow stream 61% (95% CI 59–63%), post micturition dribble 55% (95% CI 52–58%), and urgency 52% (95% CI 49–55%). There were marked differences in the country specific prevalence of LUTS complaints. Frequently, symptoms coexisted and were combined with nocturia. More than half of patients felt at least some degree of bother from their symptoms: 61% for urgency, 57% for nocturia, 58% for slow stream, and 60% for post-micturition dribble. Before seeing the present urologists, nearly half of patients have received some form of prescribed treatment and more than 80% of patients indicated they would like to receive treatment. Conclusion: Men who sought urologist care for LUTS often presented with multiple symptoms. Nocturia emerged as the most common symptom amongst the four core symptoms studied

Direct whole-genome deep-sequencing of human respiratory syncytial virus A and B from Vietnamese children identifies distinct patterns of inter- and intra-host evolution.

Human respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infections in children ,2 years of age. Little is known about RSV intra-host genetic diversity over the course of infection or about the immune pressures that drive RSV molecular evolution. We performed whole-genome deep-sequencing on 53 RSV-positive samples (37 RSV subgroup A and 16 RSV subgroup B) collected from the upper airways of hospitalized children in southern Vietnam over two consecutive seasons. RSV A NA1 and RSV B BA9 were the predominant genotypes found in our samples, consistent with other reports on global RSV circulation during the same period. For both RSV A and B, the M gene was the most conserved, confirming its potential as a target for novel therapeutics. The G gene was the most variable and was the only gene under detectable positive selection. Further, positively selected sites inG were found in close proximity to and in some cases overlapped with predicted glycosylation motifs, suggesting that selection on amino acid glycosylation may drive viral genetic diversity. We further identified hotspots and coldspots of intra-host genetic diversity in the RSV genome, some of which may highlight previously unknown regions of functional importance

Respiratory Syncytial Virus and Other Viral Infections among Children under Two Years Old in Southern Vietnam 2009-2010: Clinical Characteristics and Disease Severity

<div><p>Background</p><p>Despite a high burden of respiratory syncytial virus (RSV) infections among children, data on demographic and clinical characteristics of RSV are scarce in low and middle income countries. This study aims to describe the viral etiologies, the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a lower respiratory tract infections (LRTI), focusing on RSV (prevalence, seasonality, subgroups, viral load) and its association with disease severity.</p><p>Methods</p><p>A prospective study among children under two years of age, hospitalized with LRTI was conducted in two referral pediatric hospitals in Ho Chi Minh City, Vietnam, from May 2009 to December 2010. Socio-demographic, clinical data and nasopharyngeal swabs were collected on enrolment and discharge. Multiplex real-time RT-PCR (13 viruses) and quantitative RSV RT-PCR were used to identify viral pathogens, RSV load and subgroups.</p><p>Results</p><p>Among 632 cases, 48% were RSV positive. RSV infections occurred at younger age than three other leading viral infections i.e rhinovirus (RV), metapneumovirus (MPV), parainfluenza virus (PIV-3) and were significantly more frequent in the first 6 months of life. Clinical severity score of RSV infection was significantly higher than PIV-3 but not for RV or MPV. In multivariate analysis, RV infection was significantly associated with severity while RSV infection was not. Among RSV infections, neither viral load nor viral co-infections were significantly associated with severity. Young age and having fever at admission were significantly associated with both RSV and LRTI severity. A shift in RSV subgroup predominance was observed during two consecutive rainy seasons but was not associated with severity.</p><p>Conclusion</p><p>We report etiologies, the epidemiological and clinical characteristics of LRTI among hospitalized children under two years of age and risk factors of RSV and LRTI severity.</p></div

Comparison of demographic and clinical characteristics among patients with RSV, RV, MPV and PIV-3.

<p>Comparison of demographic and clinical characteristics among patients with RSV, RV, MPV and PIV-3.</p

Viral single and co-infections among all enrolled patients.

<p>Viral single and co-infections among all enrolled patients.</p

Factors independently predicting disease severity or long hospitalization among LRTI hospitalized children and among RSV-infected children.

<p>Factors independently predicting disease severity or long hospitalization among LRTI hospitalized children and among RSV-infected children.</p

Number of cases enrolled and total numbers of LRTI children hospitalized in two referral pediatric hospitals in southern Vietnam, May 2009 to December 2010.

<p>A total of 106/632 (17%)of cases met at least one clinical criterion for severe disease, and 43% (271/632) were hospitalized for >7 days. Among the children requiring supplemental oxygen or ventilatory support, 16/93 (17%) received NCPAP, 2/93 (2%) were intubated.</p