Knowledge, attitude, and preventive practices of leptospirosis affected populations in South Andaman, India: A cross-sectional study

Introduction: Leptospirosis is the most common reoccurring zoonosis worldwide. Climatic conditions in tropical and subtropical regions are optimal for Leptospira survival. The pathogen thrives in flood-prone slum settlements of underprivileged areas where waste, open sewers, and standing water are present. Methods: A descriptive cross-sectional study using universal sampling methodology was conducted to determine associationsbetween sociodemographic variables and knowledge, attitudes, and practices of leptospirosis-infected individuals compared with a control group from the South Andaman population. Results: Eight hundred and one (388 cases and 413 controls) subjects were included in the study. Overall, 61.5% of the participants were male, while the main occupation of 43.94% of the subjects was farming or agricultural work. Multilogistic regression assessing the likelihood of good knowledge about leptospirosis showed that leptospirosis-positive subjects were more likely to have good knowledge (adjusted odds ratio [AOR]: 3.5 [95% CI: 2.59–4.97], p < 0.001), better attitude (AOR: 97.30 [95% CI: 41.72–226.9], p < 0.001] than leptospirosis-negative subjects, male population groups were also more likely to have a good attitude (AOR: 3.03 [95% CI: 1.94–4.73], p < 0.001), and those whose main occupation is farming were more likely to have a good attitude (AOR: 3.59 [95% CI: 2.31–5.56], p < 0.001). The leptospirosis seropositive group was more likely to have good practices (AOR: 5.80 [95% CI: 3.58–8.73], p < 0.001), rural residents were 88% less likely to have good practice levels than urban residents (AR: 0.12 [95% CI: 0.07–0.20], p < 0.01). Conclusion: The infected group had better knowledge than the control group. The integration of knowledge and attitudes to maintain good practices, along with the provision of an adequate sanitation system, waste disposal system, and availability of essential personal protective equipment is necessary for disease control in these islands

Atypical presentation of Hand foot mouth disease (HFMD) caused by enterovirus serotype Coxsackievirus A6, in India

A 27-year-old male presented in the OPD of Naval Hospital in Port Blair, Andaman Islands, India, in 2011 with a history of low-grade fever associated with malaise and a pruritic skin rash. Case 2 – A 17-year-old male student reported to the OPD at Naval Hospital, Kochi Kerala, India, in August 2015. He presented with eruptions on both the palm and soles with a history of high-grade fever for the past 3–4 days. Clinically, both the cases were diagnosed as hand, foot, and mouth disease (HFMD). Both samples were tested against measles virus and varicella-zoster IgM antibodies by enzyme immunoassay and found negative. Stool sample (case 1) and lesion swab (case 2) were processed by enterovirus reverse transcription polymerase chain reaction and phylogenetic analysis, and both were positive for enterovirus human coxsackievirus A6 (CVA6) (untranslated region [UTR]). Phylogenetic analysis also confirmed that both the CVA6 etiology belonged to the genotype F. HFMD in adults often asymptomatic and very few patients get atypical symptoms. Clinical diagnosis is often troublesome to identify HFMD in such cases. An epidemiological surveillance/vigilance is essential to document these atypical cases in near future in developing countries like India

Prevalence of pulmonary tuberculosis among the tribal populations in India

IMPORTANCE: There is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity. OBJECTIVE: To estimate the prevalence of TB among the tribal populations in India. DESIGN, PARTICIPANTS, SETTING: A survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old. MAIN OUTCOME AND MEASURES: Eligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening. RESULTS: A total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496–754] in the central zone and least 153 [95% CI: 24–281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504–1101] and Jammu and Kashmir the lowest 127 [95% CI: 0–310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m(2), h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever. CONCLUSION AND RELEVANCE: The overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs

A DNA Vaccine against Chikungunya Virus Is Protective in Mice and Induces Neutralizing Antibodies in Mice and Nonhuman Primates

Chikungunya virus (CHIKV) is an emerging mosquito-borne alphavirus indigenous to tropical Africa and Asia. Acute illness is characterized by fever, arthralgias, conjunctivitis, rash, and sometimes arthritis. Relatively little is known about the antigenic targets for immunity, and no licensed vaccines or therapeutics are currently available for the pathogen. While the Aedes aegypti mosquito is its primary vector, recent evidence suggests that other carriers can transmit CHIKV thus raising concerns about its spread outside of natural endemic areas to new countries including the U.S. and Europe. Considering the potential for pandemic spread, understanding the development of immunity is paramount to the development of effective counter measures against CHIKV. In this study, we isolated a new CHIKV virus from an acutely infected human patient and developed a defined viral challenge stock in mice that allowed us to study viral pathogenesis and develop a viral neutralization assay. We then constructed a synthetic DNA vaccine delivered by in vivo electroporation (EP) that expresses a component of the CHIKV envelope glycoprotein and used this model to evaluate its efficacy. Vaccination induced robust antigen-specific cellular and humoral immune responses, which individually were capable of providing protection against CHIKV challenge in mice. Furthermore, vaccine studies in rhesus macaques demonstrated induction of nAb responses, which mimicked those induced in convalescent human patient sera. These data suggest a protective role for nAb against CHIKV disease and support further study of envelope-based CHIKV DNA vaccines

Association of dengue virus infection susceptibility with polymorphisms of 2′-5′-oligoadenylate synthetase genes: a case–control study

Oligoadenylate synthetases play an important role in the immune response against dengue virus. Single nucleotide polymorphisms in the oligoadenylate synthetases genes are known to affect oligoadenylate synthetases activity and are associated with outcome of viral infections. Polymorphisms in the OAS1 SNPs (rs1131454), OAS2 SNPs (rs1293762, rs15895 and rs1732778) and OAS3 SNPs (rs2285932 and rs2072136) genes were studied using PCR followed by restriction fragment length polymorphism methods in 30 patients for dengue infection and 40 control group who have no documented evidence of symptomatic dengue. An increase in the frequency of OAS2 gene rs1293762 SNP G/T heterozygotes (p = 0.012), decrease in the frequency of SNP G/G homozygotes (p = 0.005) and decrease in the frequency of OAS2 gene rs1732778 SNP G/G homozygotes (p = 0.000017) and A/A homozygotes (p = 0.0000012) were observed among the dengue patients compared with control group. Our results suggest that OAS2 haplotypes are associated with differential susceptibility to clinical outcomes of dengue virus infection. Keywords: Dengue, 2′-5′-Oligoadenylate synthetase, Polymorphisms, Genotype

Risk estimation of chronic kidney disease in a leptospirosis endemic area: A case-control study from south Andaman Islands of India

Objective: To estimate the risk of chronic kidney disease in patients with leptospirosis. Methods: All reported (41 890) and later confirmed leptospirosis (1 990) cases from 2010-2020 were traced by universal sampling. 386 Laboratory-confirmed leptospirosis cases were enrolled and 413 age, gender, area, and occupation matched healthy persons were included as controls. Variables including socio-demographic characteristics, medical history, and health-related behaviours were compared between the two groups and association between these variables and reduced estimated glomerular filtration rate (eGFR) was analyzed with multiple linear regression. Results: The median of eGFR was 49.0 (27.0, 75.0) mL/min/1.73 m2 in the cases and 96.0 (72.0, 121.0) mL/min/1.73 m2 in the controls, showing significant differences (P <0.001). Bivariate analysis showed that leptospirosis seropositivitiy, repeat leptospirosis infection, diabetes, male gender, working in field (sun exposure), COVID-19 infection and smoking had statistically significant association with reduced eGFR. Leptospirosis seropositivity had negative effects on eGFR. Multiple linear regression confirmed that leptospirosis seropositivity had negative effects on eGFR (unstandardised p coefficients= −30.86, 95% CI −49.7 to −11.9, P <0.001). Conclusions: Chronic kidney disease is a complex disease with multiple risk factors involved. Exposure to leptospirosis is one of the essential factors in accelerating its progression