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Dental caries experience of 7 to 12-year old West Malaysian aborigines (Temuan tribe)

Abdul Kadir R, Adnan NM

Odontostomatol Trop, 1989 Mar;12(1):7-11.
PMID: 2631083

A preliminary survey on sixty-nine 7 to 12 year old Temuan tribe school children living some 30 kilometers from Kuala Lumpur was conducted. The examinations were carried out using a chair-table set up with natural daylight as the source of light. The DMF index of klein, Palmer and Knutson was used to assess the dental caries status. In spite of low fluoride content in their water supply, the findings revealed a generally low prevalence of caries experience (DMFT 1.26). The highest DMFT was in the 11 year olds. The relationship between these findings and their possible causes are discussed.
Fulltext Effect of thermal treatment on the biochemical composition of tropical honey samples

Chua, L. S., Adnan, N. A., Abdul-Rahaman, N. L., Sarmidi, M. R.

International Food Research Journal, 2014;21(2):773-778.
MyJurnal

Honey is usually subjected to filtration and heating for bottling before commercialization. However, there is no standard procedure available for thermal treatment on honey. Honey is thermally heated at various temperature and duration based on individual experience to prolong the shelf life of honey in the market. The heating methods might decrease the biochemical components such as nutrients, enzymatic activities and vitamins to certain extent. In addition to water reduction, thermal treatment on sugar rich honey usually accompanied by the formation of 5-hydroxymethylfurfural (HMF). In the present study, the biochemical components in three commonly consumed honey in Malaysia, namely tualang, gelam and acacia honey were investigated before and after thermal treatment at 90oC for 30 min. The short period of heating time was found to degrade nutrients, enzymatic activities and water soluble vitamins in honey. The degradation of protein and enzyme via proteolytic digestion had attributed to the increase of free amino acids in honey. Based on the multivariate analysis, the most thermally affected biochemical components are crude fat, panthotenic acid (Vitamin B5) and diastase activity which explain for 86.4% of the total variance. The kinetic studies on the HMF formation revealed that the honey samples followed zero order kinetic model for the first 60 min of heating at 90oC. The findings indicate that the temperature and duration of heating during honey processing is essential to be investigated according to the honey origin. The initial biochemical composition of honey would affect the kinetic profile of HMF formation.
Fulltext How COVID 19 effect Malaysian paddy industry? Adoption of green fertilizer a potential resolution

Adnan N, Nordin SM

Environ Dev Sustain, 2021;23(6):8089-8129.
PMID: 33020694 DOI: 10.1007/s10668-020-00978-6

The COVID-19 pandemic resulted in more than 4.3 million confirmed cases and more than 2,90,000 deaths worldwide. It has also given rise to fears of an imminent economic crisis and recession. Social distance, self-isolation, and travel restrictions have led to a reduction in the workforce across all economical sectors and have led to a loss of many jobs. Schools have closed down, and the need for commodities and manufactured goods has decreased. On the other hand, the need for medical supplies has increased significantly. The food sector is also facing increased demand as a result of panic buying and storing food products. In response to this global outbreak, we summarize the socioeconomic effects of COVID-19 on the various aspects of the world economy. In Malaysia, the COVID-19 epidemic has checked the resilience of the agriculture sector. Especially the Malaysian paddy industry as country imports 30% of its overall consumption from different parts of the world. The real price of rice triplicating for the consumers, which was alarming for nations in this pandemic situation. The Government of Malaysia introduced the National Agrofood Policy 2011-2020 (NAP4) in 2010 as a guidance document for the implementation of agricultural sector development programs and projects in Malaysia. The NAP4 's 10-year term is to be finished by the end of 2020. Several sectors demonstrate substantial success after approximately 8 years of introduction, while the other classes often lag behind the goal and progress quite slowly. Agricultural sector performance is affected by many problems and challenges. In acknowledgment of the poor success of this field, the Ministry of Agriculture and Agri-Based Industry has launched new approaches, policies, and programs that can change the agricultural sector more rapidly. The new direction is aimed at ensuring national food security and boosting farm and revenues. The authorized government agency needs to revise the policy formulation where Malaysia needs to set stages to revolutionize and modernize the rice farming to address the problem faced by the paddy sector in this pandemic situation to adopt GF. In this study, the researcher focuses on the improvisation of the policy to increase the paddy production sustainably.
A possible resolution of Malaysian sunset industry by green fertilizer technology: factors affecting the adoption among paddy farmers

Adnan N, Nordin SM, Rasli AM

Environ Sci Pollut Res Int, 2019 Sep;26(26):27198-27224.
PMID: 31321721 DOI: 10.1007/s11356-019-05650-9

One of the innovations introduced toward tackling the heightening of environmental impact is green technology. In the agricultural industry, the implementation of green fertilizer technology (GFT) for the modern development of environmentally friendly technology is a necessity. Within the Malaysian agriculture sector, the GFT application is needed to increase production levels among all crops. One of the essential commodities of all crops has always been paddy, given its status as the staple food among the country's population. Paddy production with the adoption of GFT potentially opens the path toward sustainable development in the industry as well as it also provides the food safety aspect. Moreover, this helps farmers to improve their productivity on paddy production in Malaysia. This paper attempts to evaluate the contributing socio-psychological factors, innovation attributes of environmental factors, and channels of communication to decision-making among farmers in Malaysia on GFT. Furthermore, this research also aims to assess the moderating role of cost between the farmer's behavioral intention and the adoption of GFT. The sampling process followed the stratified sampling technique-overall, 600 survey questionnaires were dispersed and 437 effective responses were received. The structural analysis results obtained have revealed significant positive effect for perceived awareness, attitude, group norm, perceived behavioral control, environmental concern, agro-environmental regulations, relative advantage, compatibility, trialability, and observability, and on farmer's behavioral intention, a significant effect for paddy farmer's behavioral intention in order to adopt of GFT. Further, the interaction effects of cost on the link between farmer's behavioral intention and adoption of GFT are statistically significant. Though, the finding could not back an outcome for the subjective norm, complexity, and mass media on farmer's behavioral intention. Finally, critical outcomes obtained in this research contribute to deepening the thoughtfulness of paddy farmers' adoption of GFT. This study concludes with policy recommendations and future directions of the research.
A market modeling review study on predicting Malaysian consumer behavior towards widespread adoption of PHEV/EV

Adnan N, Nordin SM, Rahman I, Amini MH

Environ Sci Pollut Res Int, 2017 Aug;24(22):17955-17975.
PMID: 28612311 DOI: 10.1007/s11356-017-9153-8

With the rising concern about climate change, there has been an increased public awareness that has resulted in new government policies to support scientific research for mitigating these problems. Malaysia is among the major energy-intense countries and is under an excessive burden to advance its energy efficiency and to also work towards the reduction of its carbon emission. Plug-in hybrid electric vehicles (PHEVs) have the potential to lessen the carbon emission and gasoline consumption in order to alleviate environmental problems. Most of the energy problems linked to the increasing transportation pollution are now being reduced with the solution of the adoption of PHEVs. PHEVs are seen as a solution to cut carbon emission, which prevents environmental damages. Furthermore, PHEVs' driving range and performance can be comparable to the other hybrid vehicles as well as the conventional IC engines that have gasoline and diesel tanks. Thus, many efforts are being initiated to promote the use of PHEVs as an innovative and affordable transportation system. In order to achieve making the consumers aware of the adoption of PHEVs, we used a model which is based on the extended theory of planned behavior (TPB). This review is based on the factors affecting the adoption of PHEVs among Malaysian consumers. The model takes into account the ten key features that influence the adoption of PHEVs, such as environmental concern, personal norm, attitude, vehicle ownership costs, driving range, charging time, intention, subjective norm, perceived behavioral control, and personal norm. All these constructs are drivers towards the adoption of PHEVs. These factors affect the relationship between the adoption of PHEVs and how consumers intend to protect the environment. This review is based on improving how the "attitude-action" gap is understood as it is an important element for further studies on PHEVs. The aim of the research is to come up with a framework that examines how to modify the consumer's environmental concerns in acquiring PHEVs. This will pave the way for more academic research and future works that can emphasize how to obtain empirical results. The authors' recommendation is that, before a consumer's behavior is assessed and considered, an observation of the current technology is needed with methods and knowledge of the existing technology adoption aspect.
Fulltext Human adenovirus type 7 outbreak in Police Training Center, Malaysia, 2011

Yusof MA, Rashid TR, Thayan R, Othman KA, Hasan NA, Adnan N, et al.

Emerg Infect Dis, 2012 May;18(5):852-4.
PMID: 22515984 DOI: 10.3201/eid1805.110865

In March 2011, an outbreak of acute respiratory disease was reported at the Kuala Lumpur (Malaysia) Police Training Centre. Approximately 100 trainees were hospitalized and 5 were admitted to the intensive care unit. Three of these 5 trainees died. Human adenovirus type 7 was identified as the etiologic agent.
Fulltext Electrolyte Imbalance Among Bangladeshi Patients With COVID-19

Sharmin Moutushi S, Akter T, Haq MA, Ahmad R, Sinha S, Adnan N, et al.

Cureus, 2023 Feb;15(2):e35352.
PMID: 36860825 DOI: 10.7759/cureus.35352

Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in serum electrolyte imbalance. Monitoring serum electrolyte levels and parameters of liver and kidney function is essential to understand disease prognosis. Objectives This study aimed to determine the effect of imbalances in serum electrolytes and other parameters on COVID-19 severity. Material and method This retrospective study comprised 241 patients, ages 14 years and older, including 186 patients who were moderately affected and 55 who were categorized as severely affected by COVID-19. Serum electrolytes (sodium (Na+), potassium (K+), and chloride (Cl-)) and biomarkers of kidney and liver function (creatinine and alanine aminotransferase (ALT)) were measured and correlated with disease severity. This research was conducted among admitted patients of Holy Family Red Crescent Medical College Hospital designated into two groups based on retrospective hospital records. Individuals with moderate illness had evidence of lower respiratory tract infection (cough, cold, breathless, etc.) during clinical assessment or imaging (chest X-ray and computed tomography (CT) scan of the lungs) and have an oxygen saturation by pulse oximetry (SpO2) ≥ 94% on room air at sea level. The severely ill group involved individuals with SpO2 ≤94% on room air at sea level and respiratory rate ≥ 30 breaths/minute, and critically ill patients are those who needed mechanical ventilation or required intensive care unit (ICU) care. This categorization was based on the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines (https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/). Results Average Na+ and creatinine increased by 2.30 parts (95% confidence interval (CI) = 0.20, 4.81, P = 0.041) and 0.35 units (95% CI = 0.03, 0.68, P = 0.043) in severe cases compared with moderate cases. Older participants had relatively Na+ lowered to -0.06 parts (95% CI = -0.12, -0.001, P = 0.045), significant Cl- reduction by 0.09 units (95% CI = -0.14, -0.04, P = 0.001), and ALT by 0.47 units (95% CI = -0.88, -0.06, P = 0.024), whereas serum creatinine was increased by 0.01 parts (95% CI = 0.001, 0.02, P = 0.024). The creatinine and ALT of COVID-19 participants were significantly higher in males by 0.34 units and 23.2 units, respectively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion Serum electrolyte and biomarker levels can serve as good indicators of the condition and disease prognosis of patients with COVID-19. Our purpose in this study was to determine the association between serum electrolyte imbalance and disease severity. We collected data from ex post facto hospital records and did not intend to assess the mortality rate. Consequently, this study expects that the prompt diagnosis of electrolyte disparity or disturbance possibly minimizes COVID-19-related morbidity and mortality.
Fulltext Classic and Current Opinions in Human Organ and Tissue Transplantation

Oli AN, Babajide Rowaiye A, Adejumo SA, Anazodo FI, Ahmad R, Sinha S, et al.

Cureus, 2022 Nov;14(11):e30982.
PMID: 36337306 DOI: 10.7759/cureus.30982

Graft tolerance is a pathophysiological condition heavily reliant on the dynamic interaction of the innate and adaptive immune systems. Genetic polymorphism determines immune responses to tissue/organ transplantation, and intricate humoral and cell-mediated mechanisms control these responses. In transplantation, the clinician's goal is to achieve a delicate equilibrium between the allogeneic immune response, undesired effects of the immunosuppressive drugs, and the existing morbidities that are potentially life-threatening. Transplant immunopathology involves sensitization, effector, and apoptosis phases which recruit and engages immunological cells like natural killer cells, lymphocytes, neutrophils, and monocytes. Similarly, these cells are involved in the transfer of normal or genetically engineered T cells. Advances in tissue transplantation would involve a profound knowledge of the molecular mechanisms that underpin the respective immunopathology involved and the design of precision medicines that are safe and effective.
Fulltext Application of Rapid Biological Indicators Coupled With Auto-Reader for the Quality Assurance of Surgical Instruments After Sterilization at a Cardiac Hospital in Bangladesh

Zaman SU, Sadia I, Yasmin N, Islam KN, Rahman MM, Haq A, et al.

Cureus, 2021 Nov;13(11):e19428.
PMID: 34926019 DOI: 10.7759/cureus.19428

Background Sterilization failure is one of the main reasons for surgical site infections (SSIs). The biological indicator (BI) test is the most reliable test to check sterilization efficiencies. But 48 hours BI test result makes the monitoring process time-consuming. Rapid BI testing can be time demanding in this regard. Therefore, the objective is to determine the importance of rapid BI monitoring for the quality assurance of sterile surgical instruments. Methods This study was conducted in the Labaid Cardiac Hospital, Bangladesh from April 1, 2021, to July 8, 2021. A total of 100 steam and 100 ethylene oxide (EO) rapid BIs and an auto reader incubator were used to conduct this research. Quick BI of steam and EO were used once per day and tested by the auto reader. Later, all the tested BIs were incubated for 48 hours by a conventional incubator to confirm the auto reader's rapid BI test results. Result All the EO BI results were found negative, but the BI was found positive twice in steam sterilization. Surgical items of those two loads were re-sterilized. Again, after checking the BI result, the items were released. All BIs except positive steam rapid BIs were found with no growth after 48 hours of incubation for cross-checking of auto reader results. In positive rapid BI of steam, growth was found after 48 hours of incubation. Conclusion When sterilization failure occurred, process recall could not be possible at that time if rapid BI tests were not performed. So, integration of a rapid BI test with an auto reader can save the patient from critical SSI.
Fulltext Dielectrophoresis of Amyloid-Beta Proteins as a Microfluidic Template for Alzheimer's Research

Al-Ahdal SA, Ahmad Kayani AB, Md Ali MA, Chan JY, Ali T, Adnan N, et al.

Int J Mol Sci, 2019 Jul 23;20(14).
PMID: 31340481 DOI: 10.3390/ijms20143595

We employed dielectrophoresis to a yeast cell suspension containing amyloid-beta proteins (Aβ) in a microfluidic environment. The Aβ was separated from the cells and characterized using the gradual dissolution of Aβ as a function of the applied dielectrophoretic parameters. We established the gradual dissolution of Aβ under specific dielectrophoretic parameters. Further, Aβ in the fibril form at the tip of the electrode dissolved at high frequency. This was perhaps due to the conductivity of the suspending medium changing according to the frequency, which resulted in a higher temperature at the tips of the electrodes, and consequently in the breakdown of the hydrogen bonds. However, those shaped as spheroidal monomers experienced a delay in the Aβ fibril transformation process. Yeast cells exposed to relatively low temperatures at the base of the electrode did not experience a positive or negative change in viability. The DEP microfluidic platform incorporating the integrated microtip electrode array was able to selectively manipulate the yeast cells and dissolve the Aβ to a controlled extent. We demonstrate suitable dielectrophoretic parameters to induce such manipulation, which is highly relevant for Aβ-related colloidal microfluidic research and could be applied to Alzheimer's research in the future.
Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Prodhan AHMSU, Islam DZ, Khandker SS, Jamiruddin MR, Abdullah A, Godman B, et al.

Breast Cancer (Dove Med Press), 2023;15:51-89.
PMID: 36733464 DOI: 10.2147/BCTT.S390296

During the COVID-19 pandemic, several priority diseases were not getting sufficient attention. Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients' conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient's mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.
Fulltext A Systematic Review on COVID-19 Vaccine Strategies, Their Effectiveness, and Issues

Khandker SS, Godman B, Jawad MI, Meghla BA, Tisha TA, Khondoker MU, et al.

Vaccines (Basel), 2021 Nov 24;9(12).
PMID: 34960133 DOI: 10.3390/vaccines9121387

COVID-19 vaccines are indispensable, with the number of cases and mortality still rising, and currently no medicines are routinely available for reducing morbidity and mortality, apart from dexamethasone, although others are being trialed and launched. To date, only a limited number of vaccines have been given emergency use authorization by the US Food and Drug Administration and the European Medicines Agency. There is a need to systematically review the existing vaccine candidates and investigate their safety, efficacy, immunogenicity, unwanted events, and limitations. The review was undertaken by searching online databases, i.e., Google Scholar, PubMed, and ScienceDirect, with finally 59 studies selected. Our findings showed several types of vaccine candidates with different strategies against SARS-CoV-2, including inactivated, mRNA-based, recombinant, and nanoparticle-based vaccines, are being developed and launched. We have compared these vaccines in terms of their efficacy, side effects, and seroconversion based on data reported in the literature. We found mRNA vaccines appeared to have better efficacy, and inactivated ones had fewer side effects and similar seroconversion in all types of vaccines. Overall, global variant surveillance and systematic tweaking of vaccines, coupled with the evaluation and administering vaccines with the same or different technology in successive doses along with homologous and heterologous prime-booster strategy, have become essential to impede the pandemic. Their effectiveness appreciably outweighs any concerns with any adverse events.
Fulltext AuNP Coupled Rapid Flow-Through Dot-Blot Immuno-Assay for Enhanced Detection of SARS-CoV-2 Specific Nucleocapsid and Receptor Binding Domain IgG

Sil BK, Jamiruddin MR, Haq MA, Khondoker MU, Jahan N, Khandker SS, et al.

Int J Nanomedicine, 2021;16:4739-4753.
PMID: 34267520 DOI: 10.2147/IJN.S313140

BACKGROUND: Serological tests detecting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widely used in seroprevalence studies and evaluating the efficacy of the vaccination program. Some of the widely used serological testing techniques are enzyme-linked immune-sorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and lateral flow immunoassay (LFIA). However, these tests are plagued with low sensitivity or specificity, time-consuming, labor-intensive, and expensive. We developed a serological test implementing flow-through dot-blot assay (FT-DBA) for SARS-CoV-2 specific IgG detection, which provides enhanced sensitivity and specificity while being quick to perform and easy to use.
METHODS: SARS-CoV-2 antigens were immobilized on nitrocellulose membrane to capture human IgG, which was then detected with anti-human IgG conjugated gold nanoparticle (hIgG-AuNP). A total of 181 samples were analyzed in-house. Within which 35 were further evaluated in US FDA-approved CLIA Elecsys SARS-CoV-2 assay. The positive panel consisted of RT-qPCR positive samples from patients with both <14 days and >14 days from the onset of clinical symptoms. The negative panel contained samples collected from the pre-pandemic era dengue patients and healthy donors during the pandemic. Moreover, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FT-DBA were evaluated against RT-qPCR positive sera. However, the overall efficacies were assessed with sera that seroconverted against either nucleocapsid (NCP) or receptor-binding domain (RBD).
RESULTS: In-house ELISA selected a total of 81 true seropositive and 100 seronegative samples. The sensitivity of samples with <14 days using FT-DBA was 94.7%, increasing to 100% for samples >14 days. The overall detection sensitivity and specificity were 98.8% and 98%, respectively, whereas the overall PPV and NPV were 99.6% and 99%. Moreover, comparative analysis between in-house ELISA assays and FT-DBA revealed clinical agreement of Cohen's Kappa value of 0.944. The FT-DBA showed sensitivity and specificity of 100% when compared with commercial CLIA kits.
CONCLUSION: The assay can confirm past SARS-CoV-2 infection with high accuracy within 2 minutes compared to commercial CLIA or in-house ELISA. It can help track SARS-CoV-2 disease progression, population screening, and vaccination response. The ease of use of the assay without requiring any instruments while being semi-quantitative provides the avenue of its implementation in remote areas around the globe, where conventional serodiagnosis is not feasible.
Fulltext Longitudinal Antibody Dynamics Against Structural Proteins of SARS-CoV-2 in Three COVID-19 Patients Shows Concurrent Development of IgA, IgM, and IgG

Jamiruddin MR, Haq MA, Tomizawa K, Kobatake E, Mie M, Ahmed S, et al.

J Inflamm Res, 2021;14:2497-2506.
PMID: 34163208 DOI: 10.2147/JIR.S313188

BACKGROUND: Dynamics and persistence of neutralizing and non-neutralizing antibodies can give us the knowledge required for serodiagnosis, disease management, and successful vaccine design and development. The disappearance of antibodies, absence of humoral immunity activation, and sporadic reinfection cases emphasize the importance of longitudinal antibody dynamics against variable structural antigens.
METHODS: In this study, twenty-five healthy subjects working in a SARS-COV-2 serodiagnostic assay development project were enrolled, and their sign and symptoms were followed up to six months. Three subjects showed COVID-19-like symptoms, and three subjects' antibody dynamics were followed over 120 days by analyzing 516 samples. We have developed 12 different types of in-house ELISAs to observe the kinetics of IgG, IgM, and IgA against four SARS-CoV-2 proteins, namely nucleocapsid, RBD, S1, and whole spike (S1+S2). For the development of these assays, 30-104 pre-pandemic samples were taken as negative controls and 83 RT-qPCR positive samples as positive ones.
RESULTS: All three subjects presented COVID-19-like symptoms twice, with mild symptoms in the first episode were severe in the second, and RT-qPCR confirmed the latter. The initial episode did not culminate with any significant antibody development, while a multifold increase in IgG antibodies characterized the second episode. Interestingly, IgG antibody development concurrent with IgM and IgA and persisted, whereas the latter two weans off rather quickly if appeared.
CONCLUSION: Antibody kinetics observed in this study can provide a pathway to the successful development of sero-diagnostics and epidemiologists to predict the fate of vaccination currently in place.
Fulltext COVID-19 Pandemic: Review of Contemporary and Forthcoming Detection Tools

Oishee MJ, Ali T, Jahan N, Khandker SS, Haq MA, Khondoker MU, et al.

Infect Drug Resist, 2021;14:1049-1082.
PMID: 33762831 DOI: 10.2147/IDR.S289629

Recent severe acute respiratory syndrome 2 (SARS-CoV-2) known as COVID-19, presents a deadly challenge to the global healthcare system of developing and developed countries, exposing the limitations of health facilities preparedness for emerging infectious disease pandemic. Opportune detection, confinement, and early treatment of infected cases present the first step in combating COVID-19. In this review, we elaborate on various COVID-19 diagnostic tools that are available or under investigation. Consequently, cell culture, followed by an indirect fluorescent antibody, is one of the most accurate methods for detecting SARS-CoV-2 infection. However, restrictions imposed by the regulatory authorities prevented its general use and implementation. Diagnosis via radiologic imaging and reverse transcriptase PCR assay is frequently employed, considered as standard procedures, whereas isothermal amplification methods are currently on the verge of clinical introduction. Notably, techniques such as CRISPR-Cas and microfluidics have added new dimensions to the SARS-CoV-2 diagnosis. Furthermore, commonly used immunoassays such as enzyme-linked immunosorbent assay (ELISA), lateral flow immunoassay (LFIA), neutralization assay, and the chemiluminescent assay can also be used for early detection and surveillance of SARS-CoV-2 infection. Finally, advancement in the next generation sequencing (NGS) and metagenomic analysis are smoothing the viral detection further in this global challenge.
Fulltext Detection of SARS-CoV-2 by antigen ELISA test is highly swayed by viral load and sample storage condition

Adnan N, Khandker SS, Haq A, Chaity MA, Khalek A, Nazim AQ, et al.

Expert Rev Anti Infect Ther, 2021 Sep 11.
PMID: 34477019 DOI: 10.1080/14787210.2021.1976144

BACKGROUND: Rapid increase in COVID-19 suspected cases has rendered disease diagnosis challenging, mainly depending upon RT-qPCR. Reliable, rapid, and cost-effective diagnostic assays that complement RT-qPCR should be introduced after thoroughly evaluating their performance upon various disease phases, viral load, and sample storage conditions.
OBJECTIVE: We investigated the correlation of cycle threshold (Ct) value, which implies the viral load and infection phase, and the storage condition of the clinical specimen with the diagnosis of SARS-CoV-2 through our newly developed in-house rapid enzyme-linked immunosorbent assay (ELISA) system.
METHOD: Naso-oropharyngeal samples of 339 COVID-19 suspected cases were collected and evaluated through RT-qPCR that were stored up to 30 days in different conditions (i.e. -80°C, -20°C and initially at 4°C followed by -80°C). The clinical specimens were evaluated with our in-house ELISA system after finalizing the assay method through checkerboard assay and minimizing the signal/noise ratio.
RESULT: The ELISA system showed the highest sensitivity (92.9%) for samples with Ct ≤30 and preserving at -80°C temperature. The sensitivity reduced proportionally with increasing Ct value and preserving temperature. However, the specificity ranged between 98.3% and 100%.
CONCLUSION: The results indicate the necessity of early infection phase diagnosis and lower temperature preservation of samples to perform rapid antigen ELISA tests.
Fulltext Antibody response to the first dose of AZD1222 vaccine in COVID-19 convalescent and uninfected individuals in Bangladesh

Jamiruddin R, Haq A, Khondoker MU, Ali T, Ahmed F, Khandker SS, et al.

Expert Rev Vaccines, 2021 12;20(12):1651-1660.
PMID: 34503369 DOI: 10.1080/14760584.2021.1977630

BACKGROUND: Vaccination with the Oxford-AstraZeneca COVID-19 vaccine (AZD1222) initially started in the UK and quickly implemented around the Globe, including Bangladesh. Up to date, more than nine million doses administrated to the Bangladeshi public.
METHOD: Herein, we studied the antibody response to the first dose of AZD1222 in 86 Bangladeshi individuals using in-house ELISA kits. Study subjects were categorized into two groups, convalescent and uninfected, based on prior infection history and SARS-CoV-2 nucleocapsid-IgG profiles.
RESULTS: All the convalescent individuals presented elevated spike-1-IgG compared to 90% of uninfected ones after the first dose. Day >28 post-vaccination, the convalescent group showed six times higher antibody titer than the uninfected ones. The most elevated antibody titers for the former and later group were found at Day 14 and Days >28 post-vaccination, respectively. The spike-1-IgA titer showed a similar pattern as spike-1-IgG, although in a low-titer. In contrast, the IgM titer did not show any significant change in either group.
CONCLUSION: High antibody titer in the convalescent group, signify the importance of the first dose among the uninfected group. This study advocates the integration of antibody tests in vaccination programs in the healthcare system for maximizing benefit.
Disproportionate COVID-19 vaccine acceptance rate among healthcare professionals on the eve of nationwide vaccine distribution in Bangladesh

Alam ABMM, Azim Majumder MA, Haque M, Ashraf F, Khondoker MU, Mashreky SR, et al.

Expert Rev Vaccines, 2021 09;20(9):1167-1175.
PMID: 34224292 DOI: 10.1080/14760584.2021.1951248

BACKGROUND: Acceptance of the COVID-19 vaccine by the target groups would play a crucial role in stemming the pandemic. Healthcare professionals (HCPs) are the priority group for vaccination due to them having the highest risk of exposure to infection. This survey aimed to assess their acceptance of COVID-19 vaccines in Bangladesh.
RESEARCH DESIGN AND METHODS: A cross-sectional survey using an online questionnaire was conducted between January 3 to 25, 2021, among HCPs (n = 834) in Bangladesh.
RESULTS: Less than 50% of HCPs would receive the vaccine against COVID-19 if available and 54% were willing to take the vaccine at some stage in the future. Female participants (OR:1.64;95%CI:1.172-2.297), respondents between 18-34 years old (OR:2.42; 95% CI:1.314-4.463), HCPs in the public sector (OR:2.09; 95% CI:1.521-2.878), and those who did not receive a flu vaccine in the previous year (OR:3.1; 95% CI:1.552-6.001) were more likely to delay vaccination.
CONCLUSIONS: The study revealed that, if available, less than half of the HCPs would accept a COVID-19 vaccine in Bangladesh. To ensure the broader success of the vaccination drive, tailored strategies and vaccine promotion campaigns targeting HCPs and the general population are needed.

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