Dataset Information

Polymorphisms of Transporter Associated with Antigen Presentation, Tumor Necrosis Factor-? and Interleukin-10 and their Implications for Protection and Susceptibility to Severe Forms of Dengue Fever in Patients in Sri Lanka.

ABSTRACT:

Context

To date, a clear understanding of dengue disease pathogenesis remains elusive. Some infected individuals display no symptoms while others develop severe life-threatening forms of the disease. It is widely believed that host genetic factors influence dengue severity.

Aims

This study evaluates the relationship between certain polymorphisms and dengue severity in Sri Lankan patients.

Settings and design

Polymorphism studies are carried out on genes for; transporter associated with antigen presentation (TAP), promoter of tumor necrosis factor-? (TNF-?), and promoter of interleukin-10 (IL-10). In other populations, TAP1 (333), TAP2 (379), TNF-? (-308), and IL-10 (-1082, -819, -592) have been associated with dengue and a number of different diseases. Data have not been collected previously for these polymorphisms for dengue patients in Sri Lanka.

Materials and methods

The polymorphisms were typed by amplification refractory mutation system polymerase chain reaction in 107 dengue hemorrhagic fever (DHF) patients together with 62 healthy controls.

Statistical analysis used

Pearson's Chi-square contingency table analysis with Yates' correction.

Results

Neither the TAP nor the IL-10 polymorphisms considered individually can define dengue disease outcome with regard to severity. However, the genotype combination, IL-10 (-592/-819/-1082) CCA/ATA was significantly associated with development of severe dengue in these patients, suggesting a risk factor to developing DHF. Also, identified is the genotype combination IL-10 (-592/-819/-1082) ATA/ATG which suggested a possibility for protection from DHF. The TNF-? (-308) GG genotype was also significantly associated with severe dengue, suggesting a significant risk factor.

Conclusions

The results reported here are specific to the Sri Lankan population. Comparisons with previous reports imply that data may vary from population to population.

SUBMITTER: Fernando AN

PROVIDER: S-EPMC4693307 | biostudies-literature | 2015 Oct-Dec

REPOSITORIES: biostudies-literature

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Publications

Polymorphisms of Transporter Associated with Antigen Presentation, Tumor Necrosis Factor-α and Interleukin-10 and their Implications for Protection and Susceptibility to Severe Forms of Dengue Fever in Patients in Sri Lanka.

Fernando Anira N AN Malavige Gathsaurie Neelika GN Perera Kuda Liyanage Nandika KL Premawansa Sunil S Ogg Graham S GS De Silva Aruna Dharshan AD

Journal of global infectious diseases 20151001 4

<h4>Context</h4>To date, a clear understanding of dengue disease pathogenesis remains elusive. Some infected individuals display no symptoms while others develop severe life-threatening forms of the disease. It is widely believed that host genetic factors influence dengue severity.<h4>Aims</h4>This study evaluates the relationship between certain polymorphisms and dengue severity in Sri Lankan patients.<h4>Settings and design</h4>Polymorphism studies are carried out on genes for; transporter ass ...[more]

PMID: 26752870

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Project description:BackgroundThe World Health Organization (WHO) has ranked dengue as one of the top ten threats to Global health in 2019. Sri Lanka faced a massive dengue epidemic in 2017, the largest outbreak in the country during the last three decades, consisting of 186,101 reported cases, and over 320 deaths. The epidemic was controlled by intense measures taken by the health sector. However, the reported dengue cases and dengue deaths in 2019 were significantly higher than that of 2018. Deaths were mostly due to delay in hospitalization of severe dengue patients. The mortality of dengue hemorrhagic fever is 2-5% if detected early and treated promptly, but is high as 20% if left untreated.MethodsA descriptive cross-sectional study was done among patients with dengue fever presenting to the Sri Jayawardenepura General Hospital during October 2019. Data was collected using a questionnaire comprising 20 questions based on knowledge, attitudes and practices on dengue, which were categorized into questions on awareness of mortality and severity of dengue burden, prevention of dengue vector mosquito breeding and acquiring the infection, patient's role in dengue management, and warning signs requiring prompt hospitalization.ResultsThe mean KAP score on all questions was 55%, while a majority of 65.2% patients scored moderate KAP scores (50-75%) on all questions, and only 7.6% had high KAP scores (> 75%). The highest categorical mean score of 62% was on awareness of dengue prevention, followed by 54% on awareness of dengue burden, and only 51% on dengue management. Only 5.3% patients scored high scores on awareness of dengue management, followed by 28.5%, and 40.9% patients scoring high scores on awareness of dengue burden, and awareness of prevention of dengue respectively. The mean KAP scores on all questions increased with increasing age category.ConclusionThe population relatively has a better awareness of dengue prevention, as compared to awareness of dengue mortality and dengue management. The identified weak point is patient awareness of the patients' role in dengue management, and identifying warning signs requiring prompt hospitalization. This results in delay in treatment, which is a major cause for increased mortality. There was a correlation between those who had good knowledge on dengue burden and those who were aware of patients' role in dengue management. An action plan should be implemented to improve public awareness through education programs on the role of the public and patients in dengue management to drive a better outcome.