The feasibility of identifying children with primary immunodeficiency disorders: Preparation for the polio post-eradication era in Bangladesh

Sazzad, Hossain M.S.; Rainey, Jeanette J.; Mach, Ondrej; Sutter, Roland W.; Diordista, Serguei; Kawser, Choudhury Ali; Mobarak, Reaz; Alam, Didarul; Chowdhury, Mahmood A; Hossain, M. Jahangir; Hasan, A.R.; Luby, Stephen P.

doi:10.1016/j.vaccine.2012.06.017

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Our study in Egypt demonstrates that it is possible to establish a system to detect PID patients and test their stools for polioviruses in a low-middle income country. Prevalence of iVDPV excretion was relatively low and similar to previous observations [22,26,27]. The duration of excretion was generally short, with only with one patient excreting for more than 6 months.…”

Section: Discussionsupporting

confidence: 87%

Poliovirus Excretion among Persons with Primary Immune Deficiency Disorders: Summary of Data from Enhanced Poliovirus Surveillance in Egypt, 2011-2014

El-Sayed¹,

Mach²,

Hossny³

et al. 2016

J Vaccines Vaccin

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Background: If exposed to oral poliovirus vaccine (OPV), persons with primary immune deficiency disorders (PID) are at increased risk of paralytic poliomyelitis; and can chronically excrete poliovirus. However, the risk of excretion of vaccine derived poliovirus among immunodeficient persons (iVDPV) is not well characterized. We present summary of data from poliovirus surveillance project among PID patients collected between 2011 and 2014 from 11 Egyptian Governorates. Methods: Stool was tested for polioviruses in suspected or confirmed PID children regardless of whether Acute Flaccid Paralysis (AFP) was present or not. Those excreting poliovirus were followed until three consecutive negative stool samples were obtained. Results: There were 122 patients with suspected or confirmed PID identified; 13/122 (11%) excreted poliovirus; of these, 6 excreted iVDPVs, the remaining 7 excreted Sabin virus. The duration of iVDPV excretion ranged from 1 to 21 months. AFP was detected in 3/6 (50%) of those excreting iVDPVs. All iVDPV excretors had history of receiving OPV. Conclusions: Chronic poliovirus excretion in PID patients is rare, however, poliovirus eradication requires removal of all polioviruses from circulation; and because PID individuals are not necessarily paralyzed they might be missed by current poliovirus surveillance based on detection of AFP. To achieve poliovirus eradication, surveillance for polioviruses among PID patients should be routinely conducted in all countries, and poliovirus antiviral therapy must be made available for those with chronic excretion.

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Section: Discussionsupporting

confidence: 87%

Poliovirus Excretion among Persons with Primary Immune Deficiency Disorders: Summary of Data from Enhanced Poliovirus Surveillance in Egypt, 2011-2014

El-Sayed¹,

Mach²,

Hossny³

et al. 2016

J Vaccines Vaccin

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“…Implementation of intensified surveillance for VDPVs and special studies of iVDPV excretion among patients with PIDs in developing and middle-income countries began in the mid-2000s, and the results of these efforts as presented in this study are apparent [12,32,34,35]. In other words, countries that have the means to perform VDPV sequencing—either through their own resources or from support provided by others—and the healthcare services to properly diagnosis immune disorders are overrepresented.…”

Section: Discussionmentioning

confidence: 97%

“…Hence, strengthening polio surveillance programs to identify iVDPVs is critical in the post-eradication era, particularly given the suspected iVDPV cases identified in some studies [68–71]. Previous studies launched to identify iVDPVs have demonstrated the practicality of these surveillance programs [34,35,72], and a multinational surveillance study led by the Jeffrey Modell Foundation is currently underway [73]. …”

Section: Discussionmentioning

confidence: 99%

Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases: A systematic review and implications for polio eradication

Guo

Bolivar-Wagers

Srinivas

et al. 2015

Vaccine

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Background Vaccine-derived polioviruses (VDPVs), strains of poliovirus mutated from the oral polio vaccine, pose a challenge to global polio eradication. Immunodeficiency-related vaccine-derived polioviruses (iVDPVs) are a type of VDPV which may serve as sources of poliovirus reintroduction after the eradication of wild-type poliovirus. This review is a comprehensive update of confirmed iVDPV cases published in the scientific literature from 1962 to 2012, and describes clinically relevant trends in reported iVDPV cases worldwide. Methods We conducted a systematic review of published iVDPV case reports from January 1960 to November 2012 from four databases. We included cases in which the patient had a primary immunodeficiency, and the vaccine virus isolated from the patient either met the sequencing definition of VDPV (>1% divergence for serotypes 1 and 3 and >0.6% for serotype 2) and/or was previously reported as an iVDPV by the World Health Organization. Results We identified 68 iVDPV cases in 49 manuscripts reported from 25 countries and the Palestinian territories. 62% of case patients were male, 78% presented clinically with acute flaccid paralysis, and 65% were iVDPV2. 57% of cases occurred in patients with predominantly antibody immunodeficiencies, and the overall all-cause mortality rate was greater than 60%. The median age at case detection was 1.4 years [IQR: 0.8, 4.5] and the median duration of shedding was 1.3 years [IQR: 0.7, 2.2]. We identified a poliovirus genome VP1 region mutation rate of 0.72% per year and a higher median percent divergence for iVDPV1 cases. More cases were reported from high income countries, which also had a larger age variation and different distribution of immunodeficiencies compared to upper and lower middle-income countries. Conclusion Our study describes the incidence and characteristics of global iVDPV cases reported in the literature in the past five decades. It also highlights the regional and economic disparities of reported iVDPV cases.

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“…Madkaikar et al reported 159 PID cases from a tertiary care center in India in 2013 followed by a more recent report describing 778 registered patients. Frequencies of PIDs were as follows: diseases of immune dysregulation (23.1%), phagocytic defects (21.3%) and predominant antibody deficiency Other registries were reported from Oman (140 patients with high proportion of patients with congenital defects of phagocyte 35%) [44], Taiwan (215 patients with 50.6% molecular diagnosis) [13], Malaysia (150 patients) [43,45], Thailand (67 patients) [46], Jordan (53 patients) [47], Singapore (39 patients) [48], UAE (30 patients) [49] and Bangladesh (13 patients) [50].…”

Section: Article Highlightsmentioning

confidence: 99%

Global systematic review of primary immunodeficiency registries

Abolhassani

Azizi

Sharifi

et al. 2020

Expert Review of Clinical Immunology

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Introduction: During the last 4 decades, registration of patients with primary immunodeficiencies (PID) has played an essential role in different aspects of these diseases worldwide including epidemiological indexes, policymaking, quality controls of care/life, facilitation of genetic studies and clinical trials as well as improving our understanding about the natural history of the disease and the immune system function. However, due to the limitation of sustainable resources supporting these registries, inconsistency in diagnostic criteria and lack of molecular diagnosis as well as difficulties in the documentation and designing any universal platform, the global perspective of these diseases remains unclear. Areas covered: Published and unpublished studies from January 1981 to June 2020 were systematically reviewed on PubMed, Web of Science and Scopus. Additionally, the reference list of all studies was hand-searched for additional studies. This effort identified a total of 104614 registered patients and suggests identification of at least 10590 additional PID patients, mainly from countries located in Asia and Africa. Molecular defects in genes known to cause PID were identified and reported in 13852 (13.2% of all registered) patients. Expert opinion: Although these data suggest some progress in the identification and documentation of PID patients worldwide, achieving the basic requirement for the global PID burden estimation and registration of undiagnosed patients will require more reinforcement of the progress, involving both improved diagnostic facilities and neonatal screening.

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The feasibility of identifying children with primary immunodeficiency disorders: Preparation for the polio post-eradication era in Bangladesh

Cited by 9 publications

References 16 publications

Poliovirus Excretion among Persons with Primary Immune Deficiency Disorders: Summary of Data from Enhanced Poliovirus Surveillance in Egypt, 2011-2014

Poliovirus Excretion among Persons with Primary Immune Deficiency Disorders: Summary of Data from Enhanced Poliovirus Surveillance in Egypt, 2011-2014

Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases: A systematic review and implications for polio eradication

Global systematic review of primary immunodeficiency registries

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