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Article ; Online: Lack of controlled studies on snakebite prevention: a rapid review.

Rodrigo, Chaturaka / Gnanathasan, Ariaranee

Transactions of the Royal Society of Tropical Medicine and Hygiene

2023 Volume 118, Issue 4, Page(s) 247–252

Abstract: Globally, snakebites cause an estimated 80 000-140 000 deaths annually. While there are evidence-based recommendations for managing snakebite victims, recommendations on the prevention of snakebites are limited to expert opinions. We conducted a rapid ... ...

Abstract	Globally, snakebites cause an estimated 80 000-140 000 deaths annually. While there are evidence-based recommendations for managing snakebite victims, recommendations on the prevention of snakebites are limited to expert opinions. We conducted a rapid review to summarise evidence from human studies with a control group on preventing snakebites. Searching PubMed, Web of Science, Scopus, CINAHL and EMBASE with inclusive search terms without language or time limits only yielded three eligible studies (one case control study and two prospective controlled clinical studies), highlighting a knowledge gap. Two studies in Nepal by the same group showed that health education of stakeholders and sleeping under a bednet can significantly reduce snakebite incidence (p<0.05), but these observations are not confirmed elsewhere, and because of the high risk of bias the certainty of evidence was low. The third study from Sri Lanka, which assessed if sleeping above ground would prevent snakebites, had inconclusive results. This demonstrates an urgent need for studies with a control group to guide evidence-based recommendations for snakebite prevention. Potential interventions tested can range from low-cost measures such as wearing appropriate footwear in resource-limited settings to testing the efficacy of chemical, biological (e.g. rodent control) or device-based methods and community-supported platforms tracking snakebite sightings with real-time geolocation data in highly resourced settings.
MeSH term(s)	Humans ; Snake Bites/epidemiology ; Snake Bites/prevention & control ; Prospective Studies ; Case-Control Studies ; Incidence ; Sri Lanka/epidemiology
Language	English
Publishing date	2023-12-12
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/trad088
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Article ; Online: Early biomarkers for prediction of severe manifestations of dengue fever: a systematic review and a meta-analysis.

Moallemi, Samaneh / Lloyd, Andrew R / Rodrigo, Chaturaka

Scientific reports

2023 Volume 13, Issue 1, Page(s) 17485

Abstract: Early identification of dengue patients at risk of adverse outcomes is important to prevent hospital overcrowding in low- to middle- income countries during epidemics. We performed a systematic review to identify which biomarkers measured in first 96 h ... ...

Abstract	Early identification of dengue patients at risk of adverse outcomes is important to prevent hospital overcrowding in low- to middle- income countries during epidemics. We performed a systematic review to identify which biomarkers measured in first 96 h of fever could predict dengue haemorrhagic fever (DHF, World Health Organization 1997 clinical classification) or severe dengue (SD, WHO 2009, clinical classification). PubMed, Scopus, CINAHL, Web of Science, and EMBASE databases were searched for prospective cohort and nested case-control studies published from 1997 to Feb 27, 2022. The protocol for the study was registered in PROSPERO (ID: CRD42021230053). After screening 6747 publications, and analysing 37 eligible studies reporting on 5925 patients, elevated C-reactive protein, aspartate aminotransferase, interleukin-8 and decreased albumin levels were strongly associated with dengue haemorrhagic fever (by meta-analyses of multiple studies, p < 0.05), while elevated vascular cell adhesion protein 1, syndecan-1, aspartate aminotransferase and C-reactive protein levels were strongly associated with severe dengue (by meta-analyses of multiple studies, p < 0.05). Further 44 and 28 biomarkers were associated with the risk of DHF and SD respectively, but only in a single study. The meta-analyses suggest the importance of early acute inflammation with hepatic involvement in determining the subsequent course of illness in dengue.
MeSH term(s)	Humans ; Severe Dengue/diagnosis ; C-Reactive Protein ; Prospective Studies ; Biomarkers ; Aspartate Aminotransferases ; Dengue/diagnosis
Chemical Substances	C-Reactive Protein (9007-41-4) ; Biomarkers ; Aspartate Aminotransferases (EC 2.6.1.1)
Language	English
Publishing date	2023-10-14
Publishing country	England
Document type	Systematic Review ; Meta-Analysis ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-44559-9
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Article ; Online: Adjunct treatment in snakebite envenoming: a systematic review of randomised controlled trials.

Rodrigo, Chaturaka / Gnanathasan, Ariaranee

Transactions of the Royal Society of Tropical Medicine and Hygiene

2020 Volume 114, Issue 11, Page(s) 847–857

Abstract: Adjunct therapy in snakebite may be lifesaving if administered appropriately or can be harmful if non-judicious use leads to avoidable delays in administering antivenom. This systematic review analyses the evidence from randomised controlled trials (RCTs) ...

Abstract	Adjunct therapy in snakebite may be lifesaving if administered appropriately or can be harmful if non-judicious use leads to avoidable delays in administering antivenom. This systematic review analyses the evidence from randomised controlled trials (RCTs) on the efficacy of adjunct treatment administered with antivenom. PubMed, EMBASE, Scopus, Cochrane library and CINAHL were searched for RCTs enrolling patients with snakebite envenoming where a treatment other than antivenom has been assessed for its efficacy within the last 25 y. Fifteen studies met the inclusion criteria. The interventions assessed were categorised as adjunct therapies (heparin or fresh frozen plasma) to reverse haemotoxicity (three studies), antibiotics to prevent local infections (three studies), steroids to reduce local swelling (one study), premedication (adrenaline, steroids and antihistamines, either alone or in combination) to reduce hypersensitivity reactions to antivenom (five studies) and other interventions (three studies). Apart from a beneficial effect of low-dose adrenaline (1:1000, 0.25 ml administered subcutaneously) in preventing antivenom-induced hypersensitivities (OR: 0.54, 95% CI 0.32 to 0.93, two RCTs, 354 participants, moderate certainty evidence) in Sri Lanka, evidence for any other adjunct therapy is either non-existent or needs confirmation by larger better designed trials.
MeSH term(s)	Anti-Bacterial Agents ; Antivenins/therapeutic use ; Humans ; Plasma ; Randomized Controlled Trials as Topic ; Snake Bites/drug therapy ; Sri Lanka
Chemical Substances	Anti-Bacterial Agents ; Antivenins
Language	English
Publishing date	2020-08-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/traa062
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Article ; Online: Treatment of chikungunya-associated joint pain: a systematic review of controlled clinical trials.

Rodrigo, Chaturaka / Herath, Tharuka / Wickramarachchi, Uchila / Fernando, Deepika / Rajapakse, Senaka

Transactions of the Royal Society of Tropical Medicine and Hygiene

2022 Volume 116, Issue 10, Page(s) 889–899

Abstract: Post-chikungunya joint pain (arthritis or arthralgia) is a clinical concern in endemic regions as it may cause a debilitating illness sometimes years after the acute infection. This systematic review analyses evidence from controlled clinical trials ... ...

Abstract	Post-chikungunya joint pain (arthritis or arthralgia) is a clinical concern in endemic regions as it may cause a debilitating illness sometimes years after the acute infection. This systematic review analyses evidence from controlled clinical trials regarding the efficacy of pharmacological and non-pharmacological interventions to treat post-chikungunya joint pain. PubMed, EMBASE, Scopus, Cochrane library and Web of Science were searched for eligible studies without any language or time limits, excluding retrospective studies, and prospective observational studies without a control group. Eleven studies met the inclusion criteria. Seven assessed pharmacological interventions and four assessed non-pharmacological interventions (exercise, neuromodulation). The number of participants in each intervention arm varied from 10 to 75 and, given the heterogeneity of interventions, a meta-analysis was not possible. Available evidence does not show any added benefit of chloroquine, hydroxychloroquine, stand-alone methotrexate or ribavirin compared with anti-inflammatory drugs or placebo/no treatment. Non-steroidal anti-inflammatory drugs may reduce pain up to 24 wk of treatment but long-term residual impact after stopping treatment is unassessed. Currently, there is also no high certainty evidence to recommend non-pharmacological methods such as exercise and neuromodulation.
MeSH term(s)	Anti-Inflammatory Agents ; Arthralgia/drug therapy ; Arthralgia/therapy ; Chikungunya Fever/complications ; Chikungunya Fever/therapy ; Chloroquine ; Humans ; Hydroxychloroquine ; Methotrexate ; Observational Studies as Topic ; Retrospective Studies ; Ribavirin/therapeutic use
Chemical Substances	Anti-Inflammatory Agents ; Ribavirin (49717AWG6K) ; Hydroxychloroquine (4QWG6N8QKH) ; Chloroquine (886U3H6UFF) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2022-05-18
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/trac045
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Article ; Online: Plasma leakage in dengue: a systematic review of prospective observational studies.

Rodrigo, Chaturaka / Sigera, Chathurani / Fernando, Deepika / Rajapakse, Senaka

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 1082

Abstract: Plasma leakage is a precursor to life-threatening complications of dengue, but this group is poorly defined and not often reported in literature. Patients with Dengue haemorrhagic fever (DHF) as defined in the 1997 World Health Organization ... ...

Abstract	Plasma leakage is a precursor to life-threatening complications of dengue, but this group is poorly defined and not often reported in literature. Patients with Dengue haemorrhagic fever (DHF) as defined in the 1997 World Health Organization classification are often reported, and they all have plasma leakage, but some patients with plasma leakage do not meet the definition of DHF. The study aims to estimate the frequency of plasma leakage and DHF (as a surrogate of plasma leakage) in dengue and its variations based on virus serotype, geography, patient gender and pre-existing immunity to dengue. PUBMED, Scopus, EMBASE, CINAHL and Web of Science were searched for prospective observational studies reporting on plasma leakage or DHF. Quality of data was assessed using the NIH quality assessment tool for cohort studies. Forty-three studies that recruited 15,794 confirmed dengue patients were eligible. Cumulative frequency of plasma leakage was 36.8% (15 studies, 1642/4462, 95% CI 35.4-38.2%), but surprisingly the estimated cumulative frequency of DHF was higher (45.7%, 32 studies, 4758/10417, 95% CI 44.7-46.6%), indicating that current medical literature over-reports DHF or under-reports plasma leakage. Therefore, a reliable estimate for the proportion of dengue patients developing plasma leakage cannot be derived from existing medical literature even after applying rigorous inclusion criteria to select homogenous studies. Plasma leakage is an important marker of "at-risk" dengue patients and standardizing its definition, diagnosis and reporting should be a priority in research and global policy.
MeSH term(s)	Humans ; Serogroup ; Severe Dengue/epidemiology ; World Health Organization ; Observational Studies as Topic
Language	English
Publishing date	2021-10-20
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-021-06793-2
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Article ; Online: Estimation of body weight using anthropometric parameters in Sri Lankan hospitalized adult patients.

Herath, H M M T B / Wijayawardhana, K W S M / Wickramarachchi, U I / Senanayake, Sunethra / Senanayake, Bimsara / Rodrigo, Chaturaka

PloS one

2023 Volume 18, Issue 9, Page(s) e0290895

Abstract: Body weight is an important clinical parameter for accurate dosing of drugs with a narrow therapeutic window, However, it is difficult to measure the body weight of a patient if they cannot stand on a scale. There are several anthropometrics-based ... ...

Abstract	Body weight is an important clinical parameter for accurate dosing of drugs with a narrow therapeutic window, However, it is difficult to measure the body weight of a patient if they cannot stand on a scale. There are several anthropometrics-based equations to estimate the body weight, but most of these are derived from white Caucasian populations and are not validated for South Asians. This study aimed to validate existing anthropometrics-based weight estimation equations and develop a new equation for the same purpose for Sri Lankan adults. This prospective study was conducted at the National Hospital of Sri Lanka over a 6-month period, split into a development and a validation phase. During the development phase, estimated body weight of patients by doctors and nurses and patients themselves were noted and compared against their actual body weight. In addition, 13 anthropometric measurements were taken, which were used to validate 12 anthropometrics-based equations to estimate body weight described in literature previously. Two new gender specific regression models to estimate the body weight in the local population was also derived and validated. A total of 502 (males = 249) and 217 (males = 108) patients were recruited for the development and validation phases respectively. Both doctors and patients had comparable accuracy in predicting body weight (p>0.05). All anthropometric based equations were significantly correlated with actual body weight (correlation coefficients: 0.741-0.869), and the new equations derived from the local data performed similarly to the best performing equation identified from the literature during validation phase. However, even the best of these equations could not outperform patient/physician estimates. When the patient weight cannot be measured, an estimate by the patient or the doctor may be the best substitute.
MeSH term(s)	Adult ; Humans ; Male ; Anthropometry ; Asian People ; Body Weight ; Prospective Studies ; Sri Lanka
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0290895
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Article ; Online: Evolution of within-host variants of the hepatitis C virus.

Riaz, Nasir / Leung, Preston / Bull, Rowena A / Lloyd, Andrew R / Rodrigo, Chaturaka

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases

2022 Volume 99, Page(s) 105242

Abstract: Introduction: Comprehensive investigation of the within-host evolution of hepatitis C virus (HCV) variants has been difficult without high coverage deep sequencing data and bioinformatics tools to characterise these variants. With the advent of high ... ...

Abstract	Introduction: Comprehensive investigation of the within-host evolution of hepatitis C virus (HCV) variants has been difficult without high coverage deep sequencing data and bioinformatics tools to characterise these variants. With the advent of high throughput, long-read sequencing platforms such as Oxford Nanopore Technology (ONT), capturing within-host evolution of HCV using full genome sequences has become feasible. This study aimed to provide the proof of concept that within-host evolutionary analysis of HCV using near-full-length genomes, is achievable. Methods: Five treatment naïve subjects with chronic HCV infection were sampled longitudinally from 6 months to 5 years post-infection, with 3-5 sampling timepoints per subject. Near full-length sequences generated using the ONT platform encompassing within-host HCV variants were analysed using an in-house bioinformatic tool. A 200-sequence proxy alignment of the viral variants was made for each subject and timepoint, proportionately representing the observed within-host variants. This alignment was then used in a Bayesian evolutionary analysis using BEAST software suite (v1.8). Results: The estimated within-host substitution rates ranged between 0.89 and 6.19 × 10 Conclusion: This study demonstrates the feasibility of studying within-host evolution of near-full-length HCV genomes, using long-read sequencing platforms. When considered in conjunction with meta-data such as the host immune response, these methods may offer high resolution insights into immune escape (in vivo or in vitro) to inform vaccine design and to predict spontaneous clearance.
MeSH term(s)	Bayes Theorem ; Evolution, Molecular ; Genome, Viral ; Hepacivirus/genetics ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Sequence Alignment
Language	English
Publishing date	2022-02-09
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2037068-4
ISSN	1567-7257 ; 1567-1348
ISSN (online)	1567-7257
ISSN	1567-1348
DOI	10.1016/j.meegid.2022.105242
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Article: Compliance with Primary Malaria Chemoprophylaxis: Is Weekly Prophylaxis Better Than Daily Prophylaxis?

Rodrigo, Chaturaka / Rajapakse, Senaka / Fernando, Sumadhya Deepika

Patient preference and adherence

2020 Volume 14, Page(s) 2215–2223

Abstract: Background: Chemoprophylaxis is an effective tool for individuals to minimize their risk of contracting malaria and serves an important public health role in preventing imported malaria. Yet, it is only effective if the traveller is fully compliant with ...

Abstract	Background: Chemoprophylaxis is an effective tool for individuals to minimize their risk of contracting malaria and serves an important public health role in preventing imported malaria. Yet, it is only effective if the traveller is fully compliant with the prescribed regimen. For many destinations, a choice of prophylactic agents is available, so historical compliance data can be helpful for both physicians and travellers to make an informed decision. Methods: We analyzed the historical self-reported compliance data for six chemoprophylactic agents currently recommended by CDC for primary malaria chemoprophylaxis by searching PubMed, Embase, CINAHL, Web of Science, and Scopus for observational studies reporting on travelers within the last 25 years. The quality of data was graded as "good" or "poor" using the NIH quality assessment tool for cohort and cross-sectional studies. Cumulative compliance data were compiled for all studies (gross compliance) and the subgroup of studies with "good" quality evidence (refined compliance). Subgroup analyses were performed for weekly vs daily administered regimens, between military and civilian travelers, and across each prophylactic agent. Results: Twenty-four eligible studies assessed compliance for mefloquine (n=20), atovaquone-proguanil (n=11), doxycycline (n=13), and chloroquine (n=3). No studies were found for primaquine or tafenoquine. Both gross and refined compliance were significantly better for weekly regimens than daily regimens ( Conclusion: Malaria chemoprophylaxis for a traveler should depend on prevailing resistance patterns at destination, current national guidelines, and patient preferences. However, when there is a choice, historical compliance data are useful to select a regimen that the traveler is more likely to comply with.
Language	English
Publishing date	2020-11-09
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2455848-5
ISSN	1177-889X
ISSN	1177-889X
DOI	10.2147/PPA.S255561
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Article ; Online: Dynamic interactions between RNA viruses and human hosts unravelled by a decade of next generation sequencing.

Rodrigo, Chaturaka / Luciani, Fabio

Biochimica et biophysica acta. General subjects

2018 Volume 1863, Issue 2, Page(s) 511–519

Abstract: Background: Next generation sequencing (NGS) methods have significantly contributed to a paradigm shift in genomic research for nearly a decade now. These methods have been useful in studying the dynamic interactions between RNA viruses and human hosts.! ...

Abstract	Background: Next generation sequencing (NGS) methods have significantly contributed to a paradigm shift in genomic research for nearly a decade now. These methods have been useful in studying the dynamic interactions between RNA viruses and human hosts. Scope of the review: In this review, we summarise and discuss key applications of NGS in studying the host - pathogen interactions in RNA viral infections of humans with examples. Major conclusions: Use of NGS to study globally relevant RNA viral infections have revolutionized our understanding of the within host and between host evolution of these viruses. These methods have also been useful in clinical decision-making and in guiding biomedical research on vaccine design. General significance: NGS has been instrumental in viral genomic studies in resolving within-host viral genomic variants and the distribution of nucleotide polymorphisms along the full-length of viral genomes in a high throughput, cost effective manner. In the future, novel advances such as long read, single molecule sequencing of viral genomes and simultaneous sequencing of host and pathogens may become the standard of practice in research and clinical settings. This will also bring on new challenges in big data analysis.
MeSH term(s)	Genetic Variation/genetics ; High-Throughput Nucleotide Sequencing ; Host-Pathogen Interactions/genetics ; Humans ; Polymorphism, Single Nucleotide/genetics ; RNA Viruses/genetics
Language	English
Publishing date	2018-12-06
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	60-7
ISSN	1872-8006 ; 1879-2596 ; 1879-260X ; 1879-2642 ; 1879-2618 ; 1879-2650 ; 0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 1570-9639 ; 0925-4439 ; 1874-9399
ISSN (online)	1872-8006 ; 1879-2596 ; 1879-260X ; 1879-2642 ; 1879-2618 ; 1879-2650
ISSN	0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 1570-9639 ; 0925-4439 ; 1874-9399
DOI	10.1016/j.bbagen.2018.12.003
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Article ; Online: Characterization of antibody-dependent cellular phagocytosis in patients infected with hepatitis C virus with different clinical outcomes.

Adhikari, Anurag / Abayasingam, Arunasingam / Brasher, Nicholas A / Kim, Ha Na / Lord, Megan / Agapiou, David / Maher, Lisa / Rodrigo, Chaturaka / Lloyd, Andrew R / Bull, Rowena A / Tedla, Nicodemus

Journal of medical virology

2024 Volume 96, Issue 1, Page(s) e29381

Abstract: Early neutralizing antibodies against hepatitis C virus (HCV) and CD8 + T cell effector responses can lead to viral clearance. However, these functions alone are not sufficient to protect patients against HCV infection, thus undefined additional ... ...

Abstract	Early neutralizing antibodies against hepatitis C virus (HCV) and CD8 + T cell effector responses can lead to viral clearance. However, these functions alone are not sufficient to protect patients against HCV infection, thus undefined additional antiviral immune mechanisms are required. In recent years, Fc-receptor-dependent antibody effector functions, particularly, antibody-dependent cellular phagocytosis (ADCP) were shown to offer immune protection against several RNA viruses. However, its development and clinical role in patients with HCV infection remain unknown. In this study, we found that patients with chronic GT1a or GT3a HCV infection had significantly higher concentrations of anti-envelope 2 (E2) antibodies, predominantly IgG1 subclass, than patients that cleared the viruses while the latter had antibodies with higher affinities. 97% of the patients with HCV had measurable ADCP of whom patients with chronic disease showed significantly higher ADCP than those who naturally cleared the virus. Epitope mapping studies showed that patients with antibodies that target antigenic domains on the HCV E2 protein that are known to associate with neutralization function are also strongly associated with ADCP, suggesting antibodies with overlapping/dual functions. Correlation studies showed that ADCP significantly correlated with plasma anti-E2 antibody levels and neutralization function regardless of clinical outcome and genotype of infecting virus, while a significant correlation between ADCP and affinity was only evident in patients that cleared the virus. These results suggest ADCP was mostly driven by antibody titer in patients with chronic disease while maintained in clearers due to the quality (affinity) of their anti-E2 antibodies despite having lower antibody titers.
MeSH term(s)	Humans ; Hepacivirus ; Hepatitis C Antibodies ; Hepatitis C ; Antibodies, Neutralizing ; Viral Envelope Proteins ; Phagocytosis ; Chronic Disease
Chemical Substances	Hepatitis C Antibodies ; Antibodies, Neutralizing ; Viral Envelope Proteins
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.29381
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