Yaqub Tahir, Shabbir Muhammad Zubair, Mukhtar Nadia, Tahir Zarfishan, Abbas Tariq, Amir Ehab, Defang Gabriel
University of Veterinary and Animal Sciences, Lahore, Pakistan.
University of Veterinary and Animal Sciences, Lahore, Pakistan.
Acta Trop. 2017 Dec;176:34-38. doi: 10.1016/j.actatropica.2017.07.019. Epub 2017 Jul 25.
Surveillance is a valuable tool for understanding prevailing and previously undiagnosed infections in a geographic area. We examined 480 archived serum samples from patients with history of persistent fever (>40°C, 60-72h) who were referred to hospitals in Rawalpindi/Islamabad, Lahore, and Faisalabad districts for dengue antibody detection in 2014-15. Each sample was processed for detection of antigens and seroconversion, using real-time polymerase chain reaction and enzyme linked immunosorbent assay, respectively, against dengue haemorrhagic fever (DHF) virus serotypes 1-4, West Nile virus fever (WNVF), Crimean-Congo haemorrhagic fever (CCHF), and Chikungunya virus (CGV). The presence of antigens and antibodies to at least one of the studied viral haemorrhagic fevers (VHFs) was detected in 465 (96.8%, 95% CI: 94.9-98.1) and 442 samples (92.1%, 95% CI: 89.3-94.2), respectively. No sera were found positive to CCHF. There was a significant association between gender and positivity to at least one of the VHFs (χ=8.12, df=1, p<0.005). Except for DHF serotype 2 and 3 (ττ=0.41), Goodman and Kruskal's Tau statistic revealed no significant association for occurrence of different viruses within the studied population (ττ=0-0.06). Cosinor analysis confirmed significant seasonality, with a higher number of cases of persistent fever in August through November, peaking in October. The study suggests circulation of multiple arthropod-borne viral infections and, in addition to DHF, ascertain the needs for screening patients for CGV and WNVF too. It also demonstrates the necessity of well-integrated disease surveillance in several geographic regions and at-risk populations in Pakistan to develop appropriate disease and vector control strategies.
监测是了解某一地理区域内流行的和先前未被诊断出的感染情况的一项重要工具。我们检测了2014 - 2015年期间转诊至拉瓦尔品第/伊斯兰堡、拉合尔和费萨拉巴德地区医院的480份有持续发热（>40°C，60 - 72小时）病史患者的存档血清样本，以检测登革热抗体。分别使用实时聚合酶链反应和酶联免疫吸附测定法对每份样本进行处理，以检测针对登革出血热（DHF）病毒1 - 4型、西尼罗河病毒热（WNVF）、克里米亚 - 刚果出血热（CCHF）和基孔肯雅病毒（CGV）的抗原和血清转化情况。在465份样本（96.8%，95%可信区间：94.9 - 98.1）和442份样本（92.1%，95%可信区间：89.3 - 94.2）中分别检测到至少一种所研究的病毒性出血热（VHF）的抗原和抗体。未发现血清样本对CCHF呈阳性。性别与至少一种VHF呈阳性之间存在显著关联（χ = 8.12，自由度 = 1，p < 0.005）。除了DHF 2型和3型（ττ = 0.41），古德曼和克鲁斯卡的 Tau 统计量显示在所研究人群中不同病毒的发生情况无显著关联（ττ = 0 - 0.06）。余弦分析证实存在显著的季节性，8月至11月持续发热病例数较多，10月达到峰值。该研究表明多种节肢动物传播的病毒感染在传播，除了DHF外，还确定了对患者进行CGV和WNVF筛查的必要性。它还证明了在巴基斯坦几个地理区域和高危人群中进行良好整合的疾病监测对于制定适当的疾病和病媒控制策略的必要性。
