Serological evidence indicates widespread distribution of rickettsioses in Myanmar.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 04 11 2020
revised: 04 12 2020
accepted: 07 12 2020
pubmed: 15 12 2020
medline: 5 5 2021
entrez: 14 12 2020
Statut: ppublish

Résumé

Little research has been published on the prevalence of rickettsial infections in Myanmar. This study determined the seroprevalence of immunoglobulin G (IgG) antibodies to rickettsial species in different regions of Myanmar. Seven hundred leftover blood samples from patients of all ages in primary care clinics and hospitals in seven regions of Myanmar were collected. Samples were screened for scrub typhus group (STG), typhus group (TG) and spotted fever group (SFG) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Immunofluorescence assays were performed for the same rickettsial groups to confirm seropositivity if ELISA optical density ≥0.5. Overall IgG seroprevalence was 19% [95% confidence interval (CI) 16-22%] for STG, 5% (95% CI 3-7%) for TG and 3% (95% CI: 2-5%) for SFG. The seroprevalence of STG was particularly high in northern and central Myanmar (59% and 19-33%, respectively). Increasing age was associated with higher odds of STG and TG seropositivity [per 10-year increase, adjusted odds ratio estimate 1.68 (p < 0.01) and 1.24 (p = 0.03), respectively]. Rickettsial infections are widespread in Myanmar, with particularly high seroprevalence of STG IgG antibodies in central and northern regions. Healthcare workers should consider rickettsial infections as common causes of fever in Myanmar.

Sections du résumé

BACKGROUND BACKGROUND
Little research has been published on the prevalence of rickettsial infections in Myanmar. This study determined the seroprevalence of immunoglobulin G (IgG) antibodies to rickettsial species in different regions of Myanmar.
METHODS METHODS
Seven hundred leftover blood samples from patients of all ages in primary care clinics and hospitals in seven regions of Myanmar were collected. Samples were screened for scrub typhus group (STG), typhus group (TG) and spotted fever group (SFG) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Immunofluorescence assays were performed for the same rickettsial groups to confirm seropositivity if ELISA optical density ≥0.5.
RESULTS RESULTS
Overall IgG seroprevalence was 19% [95% confidence interval (CI) 16-22%] for STG, 5% (95% CI 3-7%) for TG and 3% (95% CI: 2-5%) for SFG. The seroprevalence of STG was particularly high in northern and central Myanmar (59% and 19-33%, respectively). Increasing age was associated with higher odds of STG and TG seropositivity [per 10-year increase, adjusted odds ratio estimate 1.68 (p < 0.01) and 1.24 (p = 0.03), respectively].
CONCLUSION CONCLUSIONS
Rickettsial infections are widespread in Myanmar, with particularly high seroprevalence of STG IgG antibodies in central and northern regions. Healthcare workers should consider rickettsial infections as common causes of fever in Myanmar.

Identifiants

pubmed: 33310022
pii: S1201-9712(20)32536-4
doi: 10.1016/j.ijid.2020.12.013
pmc: PMC7862081
pii:
doi:

Substances chimiques

Antibodies, Bacterial 0
Immunoglobulin G 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

494-501

Informations de copyright

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Philip N D Elders (PND)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Myo Maung Maung Swe (MMM)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Aung Pyae Phyo (AP)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Alistair R D McLean (ARD)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.

Htet Naing Lin (HN)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Kyaw Soe (K)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Wei Yan Aung Htay (WYA)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.

Ampai Tanganuchitcharnchai (A)

Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Thel K Hla (TK)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Medical Action Myanmar, Yangon, Myanmar.

Ni Ni Tun (NN)

Medical Action Myanmar, Yangon, Myanmar.

Thin Thin Nwe (TT)

Magway General Hospital and University of Medicine, Magway, Myanmar; University of Medicine 2, Yangon, Myanmar.

Myat Myat Moe (MM)

Magway General Hospital and University of Medicine, Magway, Myanmar.

Win May Thein (WM)

Mandalay General Hospital and University of Medicine, Mandalay, Myanmar.

Ni Ni Zaw (NN)

Mandalay General Hospital and University of Medicine, Mandalay, Myanmar.

Wai Mon Kyaw (WM)

Monywa General Hospital, Monywa, Myanmar.

Htun Linn (H)

Monywa General Hospital, Monywa, Myanmar.

Yin Yin Htwe (YY)

National Health Laboratory, Yangon, Myanmar.

Frank M Smithuis (FM)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Medical Action Myanmar, Yangon, Myanmar.

Stuart D Blacksell (SD)

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Elizabeth A Ashley (EA)

Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic. Electronic address: liz@tropmedres.ac.

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