Inkoo And Sindbis Viruses In Semi-Domesticated Reindeer And Mosquitoes In Norway

Background: Mosquito-borne viruses pose a serious threat to humans worldwide. There has been an upsurge in the number of mosquito-borne viruses in Europe, mostly belonging to the families Togaviridae (Sindbis, Chikungunya), Flaviviridae (West Nile, Usutu, Dengue), and Peribunyaviridae (Inkoo, Batai, Tahyna). The principal focus of this study was Inkoo (INKV) and Sindbis (SINV) virus circulating in Norway because there is a knowledge gap regarding reservoirs and transmission. Therefore, we aimed to determine the prevalence of SINV and INKV in mosquitoes and seroprevalence of INKV in semi-domesticated Eurasian tundra reindeer (Rangifer tarandus tarandus).Methods: In total, 213 pools containing about 25 mosquitoes each and 480 reindeer sera were collected in eight Norwegian reindeer summer pasture districts during 2013-2015. The mosquito pools were analysed for INKV and SINV RNA, with reverse transcriptase (RT)-real time quantitative PCR (RT-qPCR), and pyrosequencing. Reindeer sera were analysed for INKV-specific IgG by Indirect Immunofluorescence Assay (IIFA) and Plaque Reduction Neutralization Test (PRNT).Results: Aedes spp. were the most dominant species among the collected mosquitoes. Two of the mosquito pools were positive for INKV-RNA by RT-PCR and were confirmed by pyrosequencing. The overall estimated pool prevalence (EPP) of INKV in Norway was 0.04%. IgG seroprevalence in reindeer revealed 60% positive for INKV by IIFA. Of the 55 borderline reindeer sera, 24% were positive on cytopathic effect (CPE)-neutralization test. Among 80% of 60 reindeer sera analysed with PRNT for INKV had a titre ≥ 20, and there was no cross-reactivity with the closely related Tahyna virus (TAHV) and Snow Shoe Hare virus (SSHV). None of the analysed mosquito pools were positive for SINV.Conclusions: The occurrence and prevalence of INKV in Aedes mosquitoes and its high seroprevalence among semi-domesticated reindeer in Norway indicate that further studies are required for monitoring this virus. SINV was not detected in the mosquitoes in this study, however, human cases of SINV infection have yearly been reported from Rjukan. Therefore, it is essential to investigate SINV among human population. Our findings are important to raise awareness regarding the geographical distribution of these mosquito-borne viruses in Northern Europe.

Prevalence of Avian Influenza H5N6 in Birds: A Systematic Review and Meta-analysis of Other Viral Zoonosis

Avian influenza viruses (AIV) are zoonotic pathogens that can potentially affect humans and potentially be epidemic in a region. Birds (such as poultry and wild birds) serve as potential reservoirs for these viruses, highlighting the importance of determining AIV prevalence in the avian population. No systematic reviews have been published on this issue in the world so far. The present systematic literature review following the PRISMA standard, with meta-analysis, used three databases to globally assess the Influenza H5N6 infection in birds (including poultry and wild birds). A model of random-effects meta-analysis was performed to calculate the pooled prevalence and 95% Confidence Interval (95% CI) for the prevalence of Influenza H5N6 infection in birds. A total number of 14,605 articles published from 2015 to 2020 were retrieved. After screening the abstract/title, 37 articles were selected for full-text assessment, and 15 were included for qualitative and quantitative analyses. Of the total number of birds (n = 13,416 birds), the pool prevalence by RT-PCR was 3.5% (95% CI: 2.8-4.3%). From the total, 39.67% of the birds assessed were ducks (family Anatidae), in which pool prevalence was 7.7% (95% CI: 4.4-11.0). In chickens (Gallus gallus domesticus), the pool prevalence was 3.3% (95% CI 1.9-4.8). Vietnam was the country with the highest pool prevalence; 7.9% (95% CI 4.0-11.7%). Bangladesh was the country with the lowest pool prevalence of 0.4% (95% CI 0.2-0.7%). A considerable proportion of infected birds tested positive highlighted the relevance of individual animals as reservoirs of H5N6. Ducks and chickens were found to be positive by RT-PCR in over 3% of the cases. These data suggest their relevance in maintaining zoonotic transmission and their potential implications for epidemics and even pandemics in the near future.

Registry-Based Study of Prevalence of Cleft Lip/Palate in Thailand from 2012 to 2015

Objective: Two main objectives were established. First objective was to determine the prevalence of the cleft lip and/or cleft palate (CL/P) in Thailand from 2012 to 2015 using the orofacial clefts (OFCs) registry and civil registration. Second objective was to conduct a quality control of this OFC registry especially for the Birth Defects Registration (BDR). Design: Registry-based survey. Setting: Analyzing data from the Thailand National Health Security Office. Participants: Registered patients with CL/P in Thailand from 2012 to 2015. Intervention: None Main Outcome Measure: Duplicated records were verified using National Identity Number (Thai ID#) and date of birth. The prevalence of CL/P and specific phenotypes was then calculated. From this prevalence estimate method, quality assurance of the OFCs registry was possible. Results: For the main outcome, the population-weighted pool prevalence of CL/P was 2.14 per 1000 live births (95% confidence interval of 2.08-2.20). Thai ID# and expense reimbursement systems were the main factors driving this cases capturing. However, this OFCs registration still requires active case finding with clinical verification, improvement of staff training and databases networking. Conclusions: This study reported a very high CL/P prevalence of Thailand. Strengths and limitations of these OFCs registry and BDR were described.

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Background Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM, reporting sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-h ABPM as the reference standard, were 74% (95% CI: 65–82%), 79% (95% CI: 69%, 87%), and 11.11 (95% CI: 6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI 0.19, 0.29) and 0.29 (95% CI 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71% (95% CI 61%, 80%), 82% (95% CI 77%, 87%), and 11.60 (95% CI 8.98, 15.13), respectively. Conclusions Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-h ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

Spatial patterns of pathogen prevalence in questing Ixodes ricinus nymphs in southern Scandinavia, 2016

Tick-borne pathogens cause diseases in animals and humans, and tick-borne disease incidence is increasing in many parts of the world. There is a need to assess the distribution of tick-borne pathogens and identify potential risk areas. We collected 29,440 tick nymphs from 50 sites in Scandinavia from August to September, 2016. We tested ticks in a real-time PCR chip, screening for 19 vector-associated pathogens. We analysed spatial patterns, mapped the prevalence of each pathogen and used machine learning algorithms and environmental variables to develop predictive prevalence models. All 50 sites had a pool prevalence of at least 33% for one or more pathogens, the most prevalent being Borrelia afzelii, B. garinii, Rickettsia helvetica, Anaplasma phagocytophilum, and Neoehrlichia mikurensis. There were large differences in pathogen prevalence between sites, but we identified only limited geographical clustering. The prevalence models performed poorly, with only models for R. helvetica and N. mikurensis having moderate predictive power (normalized RMSE from 0.74–0.75, R2 from 0.43–0.48). The poor performance of the majority of our prevalence models suggest that the used environmental and climatic variables alone do not explain pathogen prevalence patterns in Scandinavia, although previously the same variables successfully predicted spatial patterns of ticks in the same area.

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:69%, 87%), and 11.11(95%CI:6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%, 80%), 82%(95%CI:77%, 87%), and 11.60(95% CI: 8.98, 15.13), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem of white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:61%-87%), and 11.11(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%-80%), 82%(95%CI:77%-87%), and 11.60(95%CI:8.55.0-22.03), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

MERS-CoV and SARS-CoV Infections in Animals: A Systematic Review and Meta-Analysis of Prevalence Studies

Introduction: Coronaviruses are zoonotic viruses that include human epidemic pathogens such as the Middle East Respiratory Syndrome virus (MERS-CoV), and the Severe Acute Respiratory Syndrome virus (SARS-CoV), among others (e.g., COVID-19, the recently emerging coronavirus disease). The role of animals as potential reservoirs for such pathogens remains an unanswered question. No systematic reviews have been published on this topic to date. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess MERS-CoV and SARS-CoV infection in animals and its diagnosis by serological and molecular tests. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 6,493articles were retrieved (1960-2019). After screening by abstract/title, 50 articles were selected for full-text assessment. Of them, 42 were finally included for qualitative and quantitative analyses. From a total of 34 studies (n=20,896 animals), the pool prevalence by RT-PCR for MERS-CoV was 7.2% (95%CI 5.6-8.7%), with 97.3% occurring in camels, in which pool prevalence was 10.3% (95%CI 8.3-12.3). Qatar was the country with the highest MERS-CoV RT-PCR pool prevalence, 32.6% (95%CI 4.8-60.4%). From 5 studies and 2,618 animals, for SARS-CoV, the RT-PCR pool prevalence was 2.3% (95%CI 1.3-3.3). Of those, 38.35% were reported on bats, in which the pool prevalence was 14.1% (95%CI0.0-44.6%). Discussion: A considerable proportion of infected animals tested positive, particularly by nucleic acid amplification tests (NAAT). This essential condition highlights the relevance of individual animals as reservoirs of MERS-CoV and SARS-CoV. In this meta-analysis, camels and bats were found to be positive by RT-PCR in over 10% of the cases for both; thus, suggesting their relevance in the maintenance of wild zoonotic transmission.

MERS-CoV and SARS-CoV Infections in Animals: A Systematic Review and Meta-Analysis of Prevalence Studies

Introduction: Coronaviruses are zoonotic viruses that include human epidemic pathogens such as the Middle East Respiratory Syndrome virus (MERS-CoV), and the Severe Acute Respiratory Syndrome virus (SARS-CoV), among others (e.g., COVID-19, the recently emerging coronavirus disease). The role of animals as potential reservoirs for such pathogens remains an unanswered question. No systematic reviews have been published on this topic to date. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess MERS-CoV and SARS-CoV infection in animals and its diagnosis by serological and molecular tests. We performed a random-effects model meta-analysis to calculate the pooled prevalences and 95% confidence interval (95%CI). Results: 6,493articles were retrieved (1960-2019). After screening by abstract/title, 50articles were selected for full-text assessment. Of them, 42 were finally included for qualitative and quantitative analyses. From a total of 34 studies (n=20,896 animals), the pool prevalence by RT-PCR for MERS-CoV was 7.2% (95%CI 5.6-8.7%), with 97.3% occurring in camels, in which pool prevalence was 10.3% (95%CI 8.3-12.3). Qatar was the country with the highest MERS-CoV RT-PCR pool prevalence, 32.6% (95%CI 4.8-60.4%). From 5 studies and 2,618 animals, for SARS-CoV, the RT-PCR pool prevalence was 2.3% (95%CI 1.3-3.3). Of those, 38.35% were reported on bats, in which the pool prevalence was 14.1% (95%CI0.0-44.6%). Discussion: A considerable proportion of infected animals tested positive, particularly by nucleic acid amplification tests (NAAT), an essential condition that highlights the relevance of individual animals as reservoirs of MERS-CoV and SARS-CoV. In this meta-analysis, camels and bats were found to be positive by RT-PCR in over 10% of the cases for both; thus, suggesting their relevance in the maintenance of wild zoonotic transmission.

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Background: Currently, clinic blood pressure measurement(CBPM) is most commonly used for screening hypertension, but it is facing with white coat hypertension(WCHT) and masked hypertension(MHT). Home blood pressure measurement(HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline and Scopus databases were searched up to 23 rd January 2020. Studies having diagnostic test as CBPM or HBPM, reference standard as ABPM, and reported sensitivity and specificity of either or both tests and/or proportion of white coat or masked hypertension were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 70%(95%CI:63%-76%), 81%(95%CI:73%-81%), and 9.84(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 28%(95%CI:25%-32%) and 27%(95%CI:22%-31%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 74%(95%CI:66%-80%), 83%(95%CI:76%-89%), and 13.73(95%CI:8.55.0-22.03), respectively. Pooled WCHT and MHT were 17%(95%CI:11%-22%) and 30%(95%CI:19%-42%), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of MHT was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.