ORCID Profile
0000-0003-1511-883X
Current Organisation
UNSW Sydney
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Publisher: MDPI AG
Date: 21-06-2023
DOI: 10.3390/V15071408
Abstract: All four serotypes of the dengue virus (DENV1–4) cause a phenotypically similar illness, but serial infections from different serotypes increase the risk of severe disease. Thus, genomic surveillance of circulating viruses is important to detect serotype switches that precede community outbreaks of disproportionate magnitude. A phylogenetic analysis was conducted on near full length DENV genomes sequenced from serum collected from a prospective cohort study from the Colombo district, Sri Lanka during a 28-month period using Oxford nanopore technology, and the consensus sequences were analyzed using maximum likelihood and Bayesian evolutionary analysis. From 523 patients, 328 DENV sequences were successfully generated (DENV1: 43, DENV2: 219, DENV3:66). Most circulating sequences originated from a common ancestor that was estimated to have existed from around 2010 for DENV2 and around 2015/2016 for DENV1 and DENV3. Four distinct outbreaks coinciding with monsoon rain seasons were identified during the observation period mostly driven by DENV2 cosmopolitan genotype, except for a large outbreak in 2019 contributed by DENV3 genotype I. This serotype switch did not result in a more clinically severe illness. Phylogeographic analyses showed that all outbreaks started within Colombo city and then spread to the rest of the district. In 2019, DENV3 genotype I, previously, rarely reported in Sri Lanka, is likely to have contributed to a disease outbreak. However, this did not result in more severe disease in those infected, probably due to pre-existing DENV3 immunity in the community. Targeted vector control within Colombo city before anticipated seasonal outbreaks may help to limit the geographic spread of outbreaks.
Publisher: Oxford University Press (OUP)
Date: 13-10-2015
Abstract: Leptospirosis results in significant morbidity and mortality. This study elucidates markers of severity in a cohort of Sri Lankan patients. Patients presenting to three healthcare institutions in the Western province of Sri Lanka with leptospirosis serological confirmed by the microscopic agglutination test (MAT) were included. Prospective data regarding demographic, clinical and laboratory parameters was extracted. Univariate associations and subsequent multivariate logistic regression models were constructed. The study included 232 patients, with 68.5% (159) demonstrating severe disease. Significant associations of severe disease at a significance level of p 38.8°C on presentation, age >40 years, muscle tenderness, tachycardia on admission, highest white cell count >12 350/mm(3) and 84%, haemoglobin >11.2 g/dL and 33.8% and <29.8%, lowest platelet count 70 IU/L and hyponatremia with sodium <131 mEq/L. On multivariate analysis, PCV 70 IU/L (p=0.044 OR 2.639 CI: 1.028-6.774) and hyponatremia <131 mEq/L (p=0.019 OR 6.413 CI: 1.353-30.388) were independent associations of severe disease. Severity associations were demonstrated with both clinical and laboratory parameters. There is a need for novel biomarkers for prediction of severity in leptospirosis.
Publisher: Springer Science and Business Media LLC
Date: 27-10-2015
Publisher: Public Library of Science (PLoS)
Date: 22-06-2016
Publisher: Oxford University Press (OUP)
Date: 04-2016
Publisher: Informa UK Limited
Date: 05-2014
DOI: 10.2147/IDR.S55380
No related grants have been discovered for Sachith Maduranga Wijethunga Arachchige.