Serologic evidence for hepatitis E virus infection among patients with undifferentiated acute febrile illness in Kibera,Kenya |
| |
| Institution: | 1. Department of Medicine, University of Washington, Seattle, WA, USA;2. Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Center for Global Health, Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya;4. Kenya Medical Research Institute, Center for Global Health Research, Nairobi, Kenya;1. Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Str.74, 20359 Hamburg, Germany;2. University Medical Centre Hamburg-Eppendorf (UKE), Martinist. 52, 20246 Hamburg, Germany;3. German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany;4. Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana;5. Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana;6. International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 Republic of Korea;1. Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria;2. Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, FCT Abuja, Nigeria;3. Department of Medical Laboratory Science, University of Maiduguri, Maiduguri, Nigeria;4. Department of Family Medicine, University of Abuja Teaching Hospital, Gwagwalada, FCT Abuja, Nigeria;1. Department of Virology, College of Medicine, University of Ibadan, Nigeria;2. World Health Organization Collaborative Centre for Arbovirus Reference and Research, Ibadan, Nigeria;1. KU Leuven, Department of Microbiology and Immunology, Laboratory of Clinical and Epidemiological Virology (Rega Institute), Herestraat 49, B-3000 Leuven, Belgium;2. University Hospital of Kinshasa, Faculty of Medicine, Department of Microbiology, Kinshasa, Congo;3. National Institute for Biomedical Research (INRB), Kinshasa, Congo;4. University Hospital of Kinshasa, Faculty of Medicine, Department of Paediatrics, Kinshasa, Congo;5. Sokoine University of Agriculture, Department of Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Morogoro, Tanzania |
| |
| Abstract: | BackgroundHepatitis E (HEV) is an emerging cause of viral hepatitis mainly transmitted through the fecal-oral route. Residents of the Kibera slum of Nairobi, Kenya are at risk for fecal-orally transmitted infections.ObjectiveTo quantify the incidence and prevalence of HEV infection among acute febrile illness (AFI) cases using a population-based infectious disease surveillance network.Study designCross-sectional serum samples from AFI case-patients between 2009 and 2012 were matched to the age and gender distribution of the Kibera population and tested by IgM and IgG enzyme immunoassays (EIA) and nucleic acid testing (NAT). Serum from healthy residents was also tested by EIA.ResultsOf the 482 AFI serum samples tested, 124 (25.7%) and 182 (37.8%) were IgM and IgG reactive, respectively. On multivariate analysis, IgM reactivity was associated with HIV (RR 1.66, 95%CI 1.07, 2.60; p = 0.024) while IgG reactivity was associated with increasing age (p < 0.001) and HIV (RR 1.93, 95%CI 1.52, 2.46; p < 0.001). AFI case-patients were more likely to be IgM (p = 0.002) and IgG (p<0.001) reactive compared to healthy residents. The seroincidence by HEV-specific IgM was 84.0 per 1000 person years, however, all 482 samples were negative by NAT.ConclusionsSerologic evidence for HEV in Kibera suggests a high burden of infection, but NAT did not confirm HEV viremia. Additional testing is needed to determine whether EIAs are susceptible to false positivity in undifferentiated AFI populations before their widespread use. |
| |
| Keywords: | Hepatitis E Kibera Kenya Acute febrile illness Enzyme immunoassay Nucleic acid testing |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
