Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
4 results
Search Results
Item Association of Hantavirus infections and Leptospirosis with the occurrence of Chronic Kidney Disease of Uncertain Etiology in the North Central Province of Sri Lanka: A prospective study with patients and healthy persons(Frontiers Media SA, 2020) Sunil-Chandra, N.P.; Jayaweera, J.A.A.S.; Kumbukgolla, W.; Jayasundara, M.V.M.L.ABSTRACT: Chronic Kidney disease of uncertain etiology (CKDu) has become a significant disease burden, affecting farming community of Sri Lanka and the exact etiology, which could be multifactorial, is not hitherto established. This study is aimed to determine the association of past hantavirus infection and leptospirosis with the occurrence of CKDu. A cohort (n = 179) of known CKDu patients living in high-CKDu prevalent areas of Anuradhapura district of Sri Lanka was compared with a group of 49 healthy, sex-matched younger blood relatives of CKDu patients (control-1) and another 48 healthy, age, and sex-matched individuals living in low-CKDu prevalent area (control-2) of the same district where same life style and climate conditions prevail. Fifty out of 179 (27.9%) CKDu patients, 16/49 (32.7%) of control-1 and 7/48 (14.6%) of control-2 were found positive for IgG antibodies to Puumala, Hantaan or both strains of hantaviruses. Hantaan strain specificity was found to be predominant in all study groups. Hantavirus IgG sero-prevalence of healthy individuals living in low-CKDu prevalent area was significantly lower compared to CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas (p = 0.03). Past hantavirus infection possesses a significant risk for the occurrence of CKDu (OR = 4.5; 95% CI-3.1-5.4, p = 0.02). In contrast, IgG seroprevalence to hantaviruses was not significantly different in CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas indicating past hantavirus infection has no association with the occurrence of CKDu or possibly, younger relatives may develop CKDu in subsequent years. Seroprevalence to leptospirosis showed no significant difference between CKDu patients and healthy controls. KEYWORDS: CKDu; chronic kidney disease; hantaviruses; leptospira; sero-prevalence. Erratum in: Front Cell Infect Microbiol. 2020;10:631515Item Leptospirosis versus hantavirus infections in the Netherlands and in Belgium, 2000 to 2014 [Letter to the editor](European Centre for Disease Prevention and Control (ECDC), 2014) Clement, J.; Van Esbroeck, M.; Lagrou, K.; Verschueren, J.; Sunil-Chandra, N.P.; Van Ranst, M.No Abstract Available. Comment on: The hanta hunting study: underdiagnosis of Puumala hantavirus infections in symptomatic non-travelling leptospirosis-suspected patients in the Netherlands, in 2010 and April to November 2011.Goeijenbierm M et al. Euro surveillance.2014;19(38):20878Item Evidence of leptospira and Hanta virus co-infections amongst patients hospitalised for leptospirosis-like illness(Sri Lanka College of Microbiologists, 2003) Sunil-Chandra, N.P.; Premaratna, R.; Somasiri, D.A.D.H.; de Silva, H.J.INTRODUCTION: Hantavirus infection and leptospirosis are zoonoses with similar epidemiology and disease forms. Both infections spread to humans from infected rodents. OBJECTIVES: To assess the frequency and clinical manifestations of hantavirus infection in patients hospitalised with leptospirosis-like illness. METHODS: Two groups of patients admitted with leptospirosis-like illness to the University Medical Unit, Ragama, were investigated for evidence of both hantavirus infection and leptospirosis. Demographic data were obtained prospectively from 39 patients (Group 1) (M:F=34:5, mean age 35 yrs) (1996-1997), and retrospectively from 35 patients (Group 2) (M:F=34:1, mean age 30 yrs) who had been admitted to the unit during the previous year (1995-1996). Paired sera from 31/39 patients in Group 1 were tested for IgM antibodies and a single serum sample from 24/35 patients in Group 2 was tested for IgG antibodies to Hantaan and Puumala serotypes of hantavirus using m-capture ELISA separately. The same panels of sera were also tested for the presence of anti-leptospiral IgM (in Group 1) and IgG (in Group 2) antibodies. RESULTS: In Group 1, 9/31 and 25/31 sera were positive for hantavirus and leptospira IgM antibodies respectively. 5/31 were negative for both antibodies. 8/9 hantavirus IgM positive sera were also positive for leptospira IgM antibodies indicating co-infection. 1/9 showed seroconversion to hantavirus only, and 17/31 showed seroconversion to leptospira only. Based on the reactivity of hantavirus IgM antibody positive sera against recombinant hantavirus neucleocapsid proteins by m-capture ELISA, 5/9 had Puumala-like and 2/9 had Hantaan-like predominant antigenic specificities. The other 2/9 showed specificity to Puumala only. In Group 2, 10/24 and 23/24 sera were positive for hantavirus and leptospira IgG antibodies respectively. 1/24 was negative for both. All 10 hantavirus IgG antibody positive sera were also positive for leptospira IgG antibodies. 7 of 10 had specificity to Puumala, 2 of 10 had predominantly Puumala and 1 had predominantly Hantaan antigen specificity. Male predominance, occupations related to agriculture and farming, and exposure to rodents were risk factors associated with leptospirosis-like illness. Anorexia, nausea, and myalgia were features common to all patients More patients with hantavirus infection or with or without leptospirosis than those with leptospira infections only had hepatic (78% Vs. 17%) and renal (56% Vs. 17%) involvement during the course of their illness. Conclusions: In our study, hantavirus infection or co-infection with leptospirosis occurred in about one third of patients with leptospirosis-like illness admitted to hospital. The majority had hepatic and renal involvement. Three hantavirus serotypes, Puumala, Puumala-like and Hantaan-like, were detected.Item Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: implications for a potentially worldwide underestimated problem(Cambridge University Press, 2015) Sunil-Chandra, N.P.; Clement, J.; Maes, P.; de Silva, H.J.; Van Esbroeck, M.; Van Ranst, M.Two global (re-)emerging zoonoses, leptospirosis and hantavirus infections, are clinically indistinguishable. Thirty-one patients, hospitalized in Sri Lanka for acute severe leptospirosis, were after exclusion of other potentially involved pathogens, prospectively screened with IgM ELISA for both pathogens. Of these, nine (29·0%) were positive for leptospirosis only, one (3·2%) for hantavirus only, seven (22·5%) for both pathogens concomitantly, whereas 13 (41·9%) remained negative for both. Moreover, in a retrospective study of 23 former patients, serologically confirmed for past leptospirosis, six (26·0%) were also positive in two different IgG ELISA hantavirus formats. Surprisingly, European Puumala hantavirus (PUUV) results were constantly higher, although statistically not significantly different, than Asian Hantaan virus (HTNV), suggesting an unexplained cross-reaction, since PUUV is considered absent throughout Asia. Moreover, RT-PCR on all hantavirus IgM ELISA positives was negative. Concomitant leptospirosis-hantavirus infections are probably heavily underestimated worldwide, compromising epidemiological data, therapeutical decisions, and clinical outcome.