Journal of Vector Borne Diseases

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Dengue fever complicated with bilateral Psoas hematoma and superadded infection: A case report
(Wolters Kluwer – Medknow, 2025-06) Thockchom, Nonita; Sharma, Rajat; Panda, Prasan Kumar; Gupta, Avneet Kumar
Dengue hemorrhagic fever (DHF) typically presents with various bleeding manifestations such as epistaxis, gum bleeding, and gastrointestinal bleeding. However, spontaneous large muscle hematoma formation is a rare complication. This case report discusses a patient with DHF who developed bilateral psoas muscle hematomas, a very uncommon presentation. The patient experienced acute abdominal pain and was diagnosed with psoas muscle hematomas complicated by bacterial infection. Conservative treatment, including fluid management, blood transfusions, and antibiotics, led to the patient’s full recovery. This case highlights the importance of suspecting muscle hematomas in DHF patients who present with sudden abdominal or flank pain, especially in the context of dropping hemoglobin and platelet counts. Imaging techniques such as ultrasonography and CT scans are critical for diagnosis. Early diagnosis, close monitoring, and appropriate conservative management are essential for preventing serious outcomes. Prompt treatment of any secondary infections is crucial for patient recovery. This case report reminds clinicians to consider a rare complication.
Lethal and sublethal effects of spinosad on dengue vector mosquito, Aedes albopictus and bancroftian filariasis vector mosquito, Culex pipiens pallens
(Wolters Kluwer – Medknow, 2025-03) Zhang, Xiao; Meng, Fange; Xu, Hui; Wei, Ling; Wang, Yongming; Huang, Xiao; Wang, Dong
Background & objectives: Aedes albopictus and Culex pipiens pallens are important vectors of many viruses and have had resistance to chemical pesticides. Spinosad is a selective biological insecticide to control urban mosquitoes. The aim of this study was to reveal the sublethal effects of spinosad on mosquitoes and provide reference basis for integrated mosquito management. Methods: The toxicity of spinosad against Ae. albopictus and Cx. pipiens pallens was determined under laboratory conditions by exposing early third-instar larvae to different concentrations. Results: The LC50 values of spinosad to Ae. albopictus and Cx. pipiens pallens larvaes were were 4.44×10-3 mg?L?1 and 1.93×10-3 mg?L?1 respectively after 72 h exposure. Spinosad at sublethal concentrations has many negative effects on Ae. albopictus and Cx. pipiens pallens larval, pupae, adult and offspring eggs, including significantly reduced their larvae pupation rate by 51.37% and 58.47%, significantly prolonged pupae length by 21.43% and 16.18%, reduced female wing-spans by 20.19% and 14.89%, reduced male wing-spans by 3.84% and 7.54%, reduced female weight by 29.04% and 31.52%, reduced male weight by 7.47% and 9.07%, reduced female and male ratio by 51.98% and 45.21%, reduced individual egg-laying amount by 15.73% and 35.51%. In addition, offspring egg hatchability were dramatically decreased by 25.71% and 34.04%, egg periods were significantly prolonged by 14.42% and 62.82%, respectively. No significant effect on larval period, pupae emergence rate, female bite rates was observed. Interpretation & conclusion: These results suggest that spinosad might affect pest population dynamics significantly and is fairly expected to be a candidate biological pesticide for mosquito control.
Molecular identification and genetic diversity of biting midges (Diptera: Ceratopogonidae) in the tropical environment on Hainan Island, China
(Wolters Kluwer – Medknow, 2025-03) Lu, Yaj; Su, Jie; Cheng, Shi; Hu, Yax; Xia, Qianf
Background & objectives: Biting midges are hematophagous arthropods responsible for zoonotic infectious diseases and have a wide distribution in temperate and tropical latitudes of the world. Methods: The genomic DNA of midge samples was extracted using the Chelex method and the ITS1gene was amplified by PCR to identify the midge species via BLAST. The sequence characteristics and the genetic diversity were analyzed using ClustalOmega, DnaSP, Arlequin, PopART, and TCS software tool. The validity of the ITS1 gene as a DNA barcode marker was evaluated using DAMBE. The phylogenetic relationship was established in the MEGA software. The ABGD web determined the species boundary and the SDT software visualized the pairwise sequence comparisons. Results: A total of 39 midge samples possessed the range from 364 to 429 bp of the ITS1 sequences. The midge samples were identified as Culicoides imicola, Culicoides oxystoma, Culicoides peregrinus, Culicoides jacobsoni, Forcipomyia peregrinator, and Culicoides fulvus, respectively. The ITS1 sequences had 288 conserved sites (60.25%), 167 variable sites (34.94%), 141 parsimony-informative sites (29.50%), and 26 singleton sites (5.44%), with a considerable sequence variation with a high haplotype diversity. Populations in Lingao, Haikou, Tunchang were relatively independent, with a low level of gene flow. A separate population of Forcipomyia genus in Danzhou was observed. Interpretation & conclusion: The biting midges in Hainan, a tropical island in China, had abundant genetic diversity. Timely surveillance is a crucial control measure for the spread of midge-borne diseases.
Assessment of larvicidal, growth-suppressing, and development-altering bioefficacy of Ageratum houstonianum against Aedes aegypti (L.)
(Wolters Kluwer – Medknow, 2025-03) Shah, Vijay Kumar; Gupta, Kamal Kumar
Background & objectives: Aedes aegypti is a major vector responsible for spreading dengue, chikungunya, yellow fever, and Zika viruses worldwide. These illnesses have increased globally due to climate and environmental changes. Vector control and management are the principal tactics for combating mosquitoes-borne diseases in the absence of an effective vaccine. The study aimed to ascertain bioactivities of Ageratum houstonianum leaf acetone extract (AhLAE) against Ae. aegypti. Methods: Bioefficacy of AhLAE was tested against fourth instar larvae (L4) of Ae. aegypti using standard WHO protocol. The mortality, growth, and development of larvae, pupae and adults were recorded after exposure to the extract. Results: The AhLAE showed larvicidal activity against L4 with LC50 and LC90 values of 401.88 and 691.24 mg/L, respectively. The mortality of the larvae further increased on subsequent days. The AhLAE caused a significant reduction in pupae formation and adult emergence. It also increased the larval duration of L4 and development duration of the pupa formed from the treated L4, indicating its growth-suppressing effects. The impact of the AhLAE was dose-dependent; high concentrations caused reduction in survival and growth of L4. Consequently, the L4-pupal and L4-adult growth indexes decreased. Additionally, the AhLAE induced developmental anomalies in the form of larva-pupa (L-P) intermediates. Interpretation & conclusion: The study found that the AhLAE exhibited larvicidal, growth-suppressing, and development-altering activities against Ae. aegypti. The findings suggest the potential of AhALE as a natural insecticidal agent for controlling mosquitoes.
Predominance of DENV-3 among patients in Ouagadougou, Burkina Faso
(Wolters Kluwer – Medknow, 2025-03) Ouattara, Abdoul Karim; Toyin, Bello Shoukrat Ohuwa; Ouédraogo, Alphonsine; Traoré, Lassina; Djigma, Florencia Wendkuuni; Simporé, Jacques
Background & objectives: Dengue is an emerging vector-borne viral disease in tropical and subtropical areas such as Burkina Faso that experienced dengue outbreak in, 2013, 2016, 2017 and more recently in 2023. This study aimed to determine the seroprevalence and dengue serotype in suspected patients in Ouagadougou, Burkina Faso. Methods: The study was conducted during October and November 2023 and included suspected febrile patients seen at HOSCO and CERBA. Plasma or serum samples were used for the detection of non-structural proteins (NS1) and IgM and IgG antibodies against the dengue virus using SD Bioline Dengue Duo rapid detection kit. Viral RNA was extracted using the QIAamp Viral RNA Mini Kit and dengue serotypes were determined by real-time RT-PCR using the Dengue Real-TM Genotype kit. Results: The study population consisted of 896 patients, including 397 (44.3%) men and 499 (55.7%) women. Dengue seroprevalence was 16.5% (148/896) with 14.1% (126/896) of patients positive for the NS1 antigen, 1.3% (12/896) positive for IgM, and 2.7% (24/896) positive for IgG. Serotyping among 40 out of 45 positive patients revealed 77.5% (31/40) DENV-3, 17.5% (7/40) DENV-1, and 5.0% (2/40) DENV-2. Interpretation & conclusion: The present study reports a high seroprevalence of dengue virus infection among patients during the months considered as the peak of infection in Burkina Faso. The results revealed a predominance of DENV-3. Continuous surveillance of dengue virus serotypes circulating in Burkina Faso is crucial.
Reworking the treatment of Indian Post kala-azar dermal leishmaniasis: A two-step therapy
(Wolters Kluwer – Medknow, 2025-06) Kathuria, Sushruta; Gautam, Yugansh; Khunger, Niti; Sharma, Shruti; Singh, Ruchi
In the current scenario, treatment of Post kala-azar dermal leishmaniasis (PKDL) is intravenous liposomal amphotericin B or oral miltefosine. Over the years, there has been a gradual decline in the efficacy of miltefosine and a rise in permanent loss of vision. Moreover, in non-endemic states of India, miltefosine is not freely available. In view of this, we attempted a two-step regimen of liposomal amphotericin B and itraconazole to treat two patients of PKDL diagnosed on histopathology as well as PCR. We found this treatment to be highly effective with complete recovery.
Insecticide resistance status and bar-coding of dengue vectors in three districts of Tamil Nadu, India
(Wolters Kluwer – Medknow, 2025-03) Anbalagan, Rajalakshmi; Srivastava, P, K; Baruah, Kalpana; Krishnan, Jayalakshmi
Background & objectives: Occurrence and distribution of vector population are crucial for entomological study in context of prevention, control and elimination of vector-borne diseases. To update some entomological aspects the study was undertaken in three districts of Tamil Nadu state namely Kumbakonam, Nagapattinam and Thriuvarur. The objective of the study was to understand the prevalence of mosquitoes; to assess insecticide resistance and phylogenetic analysis of dengue vectors (Aedes aegypti and Ae. albopictus). Methods: The immature stages of mosquitoes were collected from different localities by standard WHO methods marking with GPS and mapping was done using ArcGIS 10.4 software for all three districts. Insecticide resistance test was conducted using WHO susceptibility test kits. The F1 generation of female adult mosquitoes of Ae. aegypti and Ae. albopictus were exposed to DDT 4% and malathion 5% with the control paper of Risella oil and olive oil, respectively. Further, genomic DNA of individual mosquito was isolated, and sequencing was done through Eurofins, Bangalore, India. The FASTA sequence was analyzed and phylogenic tree was constructed using the Maximum likelihood method in Molecular Evolutionary Genetics Analysis (MEGA) software (version 10.0). Results: A total 5307 specimens were collected through expanded survey in all three study areas. The collection yielded 16 species from six genera of mosquitoes. In total collection, Ae. albopictus was the dominant species in Kumbakonam and Thiruvarur districts and Ae. aegypti was dominant in Nagapattinam. The predominant breeding sources were discarded tyres with rainwater, plastic cups, coconut shells, aluminum vessels, sliver containers, bottles, grinding stones and earthen pots. The study revealed high pupal indices in all three study areas. Insecticide resistance monitoring revealed possible resistance in Ae. aegypti against DDT in all three districts whereas against malathion, possible resistance was recorded in Kumbakonam and Nagapattinam and Thiruvarur district, the species was found to be susceptible. Ae. albopictus showed resistance against DDT in all three districts but susceptible to malathion. The sequences obtained for dengue vectors showed 99% similar with GenBank. The phylogenetic tree was constructed using COI region sequences. Certainly, we observed the different genetic relationship among Ae. aegypti and Ae. albopictus between the study areas. Interpretation & conclusion: The study confirmed the presence of Ae. aegypti and Ae. albopictus in all three districts. The study further revealed that these vectors are susceptible to malathion but resistant to DDT. The continued surveillance of dengue vector and monitoring of insecticide resistance will strengthen the control programme for appropriate vector control measurements.
Bridging the gaps: Prioritizing research strategies for enhanced malaria control and elimination
(Wolters Kluwer – Medknow, 2025-03) Alghamdi, Rashed
Malaria continues to be a significant global health challenge, with millions of cases and hundreds of thousands of deaths reported annually. To combat this disease effectively, it is imperative to identify and address significant research gaps in malaria control and elimination efforts. This review covers current knowledge and highlights critical gaps in several crucial areas of malaria research. Firstly, we discuss the complexities of vector biology and control, emphasizing the need for a deeper understanding of vector behavior, particularly in urban settings. Secondly, the study examines the challenges posed by drug resistance and the urgent need for alternative treatment strategies and novel drug targets. Thirdly, the review explores the ongoing quest for an effective malaria vaccine, underscoring the importance of understanding immunological correlates of protection. The study also explores medication resistant genes and genomic epidemiology, highlighting the need for more investigations into potential targets for drugs and vaccine candidates. Furthermore, it addresses the socioeconomic and environmental determinants of malaria transmission, highlighting the importance of integrating multidisciplinary approaches to address transmission dynamics. The study concludes with a discussion on how malaria transmission is impacted by climate change and the necessity of research to guide adaptation measures.
Japanese encephalitis virus: An overview
(Wolters Kluwer – Medknow, 2025-03) Li, Qiuyang; Cheng, Xiaoling; Luo, Min; Shi, Jinrong
Japanese encephalitis (JE) is a mosquito-borne infectious disease caused by the Japanese encephalitis virus (JEV), posing a substantial threat to human health and property and safety. Until now, there has been a lack of specific therapeutic options for treating JEV infections. In this review, we provide a comprehensive discussion of JEV’s characteristics, diagnostic methodologies, vaccine development efforts, and potential anti-JEV pharmaceuticals to provide insights that could be used to inform and enhance strategies for the prevention and control of Japanese encephalitis.
Detection of chikungunya virus in Aedes aegypti in Ciudad Juárez, Chihuahua, Mexico
(Wolters Kluwer – Medknow, 2025-06) Hernández-Acosta, Eduardo; Covarrubias, Antonio De la Mora; Fernández-Salas, Idelfonso; Escárcega-Ávila, Angélica; Olivera, Isabel Passalacqua; Jiménez-Vega, Florinda
Background & objectives: Chikungunya fever is caused by an arbovirus transmitted primarily by Aedes aegypti mosquito, which is prevalent in Mexico along with other pathogens carried by this vector. This study aimed to detect the presence of the chikungunya virus (CHIKV) in Ae. aegypti in a vulnerable area of Ciudad Juárez, Chihuahua. Methods: Mosquitoes were collected from both indoor and outdoor areas of 87 households using BG-GAT and Gravid traps during the fall of 2015. The presence of CHIKV was determined molecularly using reverse transcriptase polymerase chain reaction, and the infection rate was calculated using the PooledInfRate program. Results: A total of 328 female Ae. aegypti mosquitoes were captured, grouped into 131 pools. 66% of them tested positive for CHIKV. The infection rate, as measured by Minimum Infection Rate (MIR), was 26%, and Maximum Likelihood Estimation (MLE) was 15.2%. Interpretation & conclusion: The presence of the infected vector was confirmed in the study area. This first report in the region highlights the need for active epidemiological surveillance to prevent potential chikungunya outbreaks in this border population.
Haematological parameters as predictors of severe dengue: A study from northern districts of West Bengal, India
(Wolters Kluwer – Medknow, 2025-06) Roy, Sudipta K; Ghosh, Bappaditya; Chakraborty, Ayan; Hazra, Santanu; Goswami, Bidyut K; Bhattacharjee, Soumen
Background & objectives: A hike in dengue cases was recorded in last two years, resulting from both single and multiple-serotypes of dengue virus (DENV) and secondary infections, culminating in significant hospitalizations and deaths in India. This study focuses on evaluating symptomatic and haematological parameters in acute dengue patients of the northern part of West Bengal to predict disease severity early on and to analyze the correlation between circulating DENV serotypes with severity. Methods: Dengue patients (N=540) diagnosed as NS1 positives were categorized into 13.7% severe DHF (N=74) and 86.3% mild DF (N=466) and prediction of risk was done using logistic regression. DENV RNA was isolated from blood, converted to cDNA, and detected/serotyped via RT-qPCR by using DENV specific primers. Results: Only 14.48% (N=11) patients showed single serotypic (DENV2 or DENV3) infection of dengue. In contrast, multi-serotypic infections (N=65) with the prevalence of DENV-2 and DENV-3 co-infections were found among the dengue patients, affecting severe changes in the most critical haematological parameters such as haematocrit and platelet count. The multivariate binary logistic regression model revealed that only six parameters viz., age (p=0.032), presence of joint pain (p=0.015), Haemoglobin level (p<0.001), total RBC count (p=0.024), total WBC count (p=0.003), lymphocyte% (p=0.019) were found to be significantly associated with the risk of DHF. Interpretation & conclusion: Most prevalent DENV-2 and DENV-3 infections significantly impact haematocrit and platelet counts in the study region. Our prediction model, incorporating age, joint pain, haemoglobin, RBC, WBC, and lymphocyte, may effectively predict dengue severity.
Application of artificial intelligence for quantifying Plasmodium berghei in blood samples of infected mice
(Wolters Kluwer – Medknow, 2025-06) Zelai, Noha Talal
Background & objectives: In malaria infection, quantifying blood parasitemia is a critical step for evaluating the severity of the disease. This has generally been conducted manually, and thus its accuracy depends on technician expertise. There is an urgent need for an automated technique to overcome manual errors. The aim of this study was to find an alternative method for counting malaria blood parasitemia. Methods: This study evaluated the accuracy of automated counting using QuPath compared to manual counting. GraphPad Kappa evaluated agreement between high and low parasitemia in both counting methods using Cohen’s test. Results: QuPath was revealed to be a promising method that has fair agreement and no statistically significant differences compared to manual counting. Interpretation & conclusion: Automated quantification is suggested to be a time and effort-saving technique and therefore is a worthwhile alternative to manual counting.
Impact of diverse musical genres on blood-feeding and mating behavior in Aedes aegypti mosquitoes
(Wolters Kluwer – Medknow, 2025-06) Ni Chew, Yan; Kassim, Nur Faeza Abu; Ayub, Noor Moukhni; Abuelmaali, Sara Abdelrahman; Mashlawi, Abadi M.; Dieng, Hamady
Background & objectives: Sound plays an important role in mosquito foraging and sexual interactions. Mosquitoes utilize acoustic signals for host location, sexual recognition, and mating, which is achieved through the rhythmic beating of their wings to generate distinct sounds characterized by specific flight tone frequencies. Methods: In this study, electronic music (Tremor by Dimitri Vegas, Martin Garrix and Like Mike) and country music (Country Road by John Denver) were played in high and low volumes to investigate the influence of different genres of music on the blood feeding and mating responses of Aedes aegypti. The observations encompassed monitoring the landing attempts, blood-feeding endeavors, and mating behavior of Ae. aegypti. Results: High-volume electronic and country music with elevated pitch and amplitude significantly reduced host attacks and blood-feeding attempts by female mosquitoes compared to low-volume or music-off conditions. Interpretation & conclusion: However, significant reduction of successful copula was only observed in Ae. aegypti mosquitoes exposed under electronic music with high volume. As transmission of dengue is through blood feeding and mating, this discovery may open new possibilities for developing music-based control strategies against mosquito-borne diseases.
Demographic trend in dengue infection
(Wolters Kluwer – Medknow, 2025-06) Rajeswari, Raja; Raman, Radhika; Nivek, N P; Rasheed, R Syed; Raajasri, R D Niranjhana
Background & objectives: Dengue fever is one of the most common causes of undifferentiated tropical fevers in hospitalized children across India with the highest recorded morbidity and mortality in children less than 15 years of age. Although common, there is still a knowledge gap regarding its epidemiological factors. The aim of this work was to study the clinical profile and demographic trend over the past 5 years in children with confirmed dengue infection. Methods: This was an observational study of children admitted as in-patients over the past 5 years and diagnosed with dengue infection by serology. Categorical data were presented as percentages. Data regarding rainfall was collected from rainfall statistics from the Indian Meteorological department and correlated based on the T-test. The incidence of dengue infection in COVID-19 predominant years was analyzed using the correlation plot and trend of severe dengue infection over the years was noted by a line plot. Results: The study showed a positive correlation between rainfall and an increase in the incidence of cases. There were relatively reduced number of cases during COVID-19 which was interpreted from the correlation plot. The line plot determined the trend of severity of presentation and more severe cases presented in the years 2019, 2021 and 2022. Interpretation & conclusion: Other than the pathophysiology, studies to understand the change in the severity of clinical presentation every year could help in augmenting vector control measures
Clinical evaluation of AYUSH-SL in patients receiving mass drug administration for treatment of chronic inflammatory lymphedema: A doubleblind placebo-controlled multicentric study
(Wolters Kluwer – Medknow, 2025-06) Mitra, Achintya; Bhuyan,, Gurucharan; Muralikrisha, C; Naser, SM; Ratha, KK; Babu, G; Venkateswarlu, B; Dhoke, Sujata; Bagchi, Chiranjib; Singh, Renu; Tripathi, Arunabh; Rana, Rakesh; Sharma, BS; Khanduri, Shruti; Gupta, Bharti; Rao, BCS; Kumar, Adarsh; Padhi, MM; Srikanth, N; Dhiman, KS; Tripathi, Santanu K
Background & objectives: A 2.5-year placebo-controlled double-blind trial was conducted to investigate the safety and efficacy of AYUSH-SL, a poly-herbal ayurvedic formulation on filarial lymphedema in different endemic areas of India. Lymphatic filariasis (LF) is caused by parasitic nematodes from Wuchereria bancrofti, Brugia malayi, or B. timori that are transmitted through mosquitoes. In Ayurveda, LF has been elaborately narrated under the heading Shlipada and literature also includes detailed therapeutic measures. Methods: The multicenter, prospective, parallel group interventional study in which 180 participants were recruited within the duration through competitive enrollment. Diagnosed cases of Grade I and Grade II filarial lymphedema of Grade I and Grade II (lower extremities) were included in the trial. The study group was treated with mass drug administration and AYUSH-SL or its placebo tablet. Results: The control group had received mass drug administration and a matching placebo. The primary outcome measure was the reduction in edema calculated for analysis by percentage reduction from baseline at the 4th, 12th and 24th week. Secondary outcome measures included improved quality of life (QoL), which was assessed using the Lymphatic Filariasis Specific QoL Questionnaire, and prevention of recurrence of acute episodes, which was evaluated by investigating the presence and severity of episodes in the past four weeks. The water displacement method for the evaluation of the efficacy of the intervention was shown to be highly significant compared to the baseline value (right leg; 3071.60±970.482, 2828.40±829.339, p<0.001and left leg; 3158.69±1136.391, 2890.73±1077.475, p<0.001). Interpretation & conclusion: There was significant improvement of Quality of Life in the LF QoL Questionnaire (p<0.001) at each follow-up visit in both groups. Safety estimations on hematologic and biochemical parameters were within limits and or changes were not significant. The results revealed that AYUSH-SL is safe and effective for lymphatic filariasis due to its comprehensive anti-inflammatory, antimicrobial, and anti-allergic activities.
Characterization of Anopheles mosquito breeding habitats for malaria vector control in Mazowe and Shamva districts, Zimbabwe
(Wolters Kluwer – Medknow, 2025-06) Nyasvisvo, David Singleton; Nhiwatiwa, Tamuka; Sithole, Rudo; Sande, Shadreck
Background & objectives: Area-specific identification and studies of Anopheles breeding habitat diversity, distribution, and productivity in different seasons are important in designing and advancing effective malaria vector control according to the local context and needs. This study identified and characterized Anopheles breeding habitats for targeted control of malaria vectors in Mazowe and Shamva districts of Zimbabwe. Methods: Repeated cross-sectional surveys were conducted in Mazowe and Shamva districts between April and December 2023. Habitat productivity and physicochemical parameters were measured. Anopheles larvae were collected, reared to adults, and identified using morphological keys. SPSS software was used for data analysis. One-way ANOVA, Fisher’s exact, Pearson’s correlation, and simple linear regression tests were conducted. Results: Seven different types of Anopheles breeding habitats were identified from 56 sites. The highest mean density of larvae was recorded in stream edge pools during the post-rainfall period. Anopheles pretoriensis (67.4%), An. gambiae s.l. (23.1%), An. rufipes (9.2%) and An. coustani (0.38%) were breeding in the study area. An. pretoriensis bred in all habitat types, An. coustani in swamps only while An. gambiae s.l. and An. rufipes preferred stream edge pools, roadside pools, and hoof prints. There was a significant positive correlation between larval density and dissolved oxygen (r = 0.535; p < 0.001) and conductivity (r = 0.288; p = 0.032). Interpretation & conclusion: Size, origin, and type of breeding habitat were positive indicators for different Anopheles species in the study area. Potential malaria vector breeding habitats should be targeted for larval control under the current malaria control and elimination phases in the two districts.
Predictors of severity factors associated with severe scrub typhus among children in a tertiary care hospital
(Wolters Kluwer – Medknow, 2025-06) Panda, Subhasmita; Panda, Kalpana; Swain, Subrat Kumar; Gupta, Medha; Sarangi, Rachita
Background & objectives: Scrub typhus is an acute febrile zoonotic disease caused by the obligate intracellular gram-negative bacteria Orientia tsutsugamushi. Growing data over the last few years from the Indian subcontinent suggest that it is one of the most widespread but under-reported diseases. This study aimed to document the clinical and paraclinical profiles and evaluate complications of scrub typhus in severe and non-severe pediatric age groups. Methods: A prospective observational study was conducted in pediatric patients. Frequency, mean, percentage and standard deviation were included in the descriptive statistical analysis calculations. Multivariate analysis was conducted to predict the severity factor. Results: A total of 189 patients met the eligibility criteria and were included in the final analysis. The mean and standard deviation (mean ± SD) age of the cohort was 5.54 ± 3.9 years, with a male predominance of 68.2%. The mean ± SD duration of fever was 6.64 ± 1.43 days. Patients with severe scrub typhus experienced complications including hepatic involvement (42, 64.6%), respiratory distress (23, 46.1%), neurological involvement (14, 24.6%), acute kidney injury (10, 15.4%), myocarditis (9, 13.8%), and (16, 24.6%) have multi-organ dysfunction. Patients with raised transaminases (> 180 IU/L) have a 3.7 to 4.1 times greater chance of developing severity. Thrombocytopenia is found to be another independent predictor of severe scrub typhus. Interpretation & conclusion: Clinical signs of hepatomegaly, skin rash, and lymphadenopathy were significant predictors of severity. Delay in treatment is a key contributor to the severity of pediatric scrub typhus.
Coverage and evaluation survey of post-mass drug administration for lymphatic filariasis in four endemic districts of Uttar Pradesh: Are we on the track?
(Wolters Kluwer – Medknow, 2025-06) Paul, Sourabh; Seth, Aswani Kumar; Pawar, Neeraj; Singh, Abhay; Shukla, Mukesh; Nath, Bhola
Background & objectives: There is a persistent high microfilaria rate and variable reporting of coverage of Mass Drug Administration (MDA). This study aims to estimate the coverage, effective coverage, and compliance of drugs administered under MDA and determine the predictors affecting effective coverage. Methods: A community-based cross-sectional study was conducted in Amethi, Lucknow, Raebareli and Sultanpur districts of Uttar Pradesh, India. The study participants were selected using multi-stage random sampling using Probability Proportional to Estimated Size (PPES). The coverage, effective coverage and compliance of drugs were presented as proportion. The multivariable logistic regression model was applied to identify the significant predictors for effective coverage. Results: Of 4151 participants, 997 (24.0%), 340 (8.2%), 1158 (27.9%) and 1656 (39.9%) belonged to Amethi, Lucknow, Raebareli and Sultanpur districts, respectively. The coverage ranged from 49.8% to 87.9% and effective coverage ranged from 51.8% to 73.2% across districts. The compliance was the poorest (70.7%) in Sultanpur. The source of information about MDA, gender of the study participants and area of residence emerged as predictors for effective coverage in the districts. Interpretation & conclusion: The effective coverage was poor with good drug compliance across the districts. There is a need for a well-designed pre-MDA campaign addressing the fear of side effects of drugs and emphasizing the presence of the community during the MDA round along with monitoring and evaluation of the round.
Effect of dexamethasone therapy in Crimean-Congo hemorrhagic fever in Giresun: An analytical study
(Wolters Kluwer – Medknow, 2025-06) Çetin, Sinan; ?ahin, Ahmet Melih; Ata?, Emrullah; Ayd?n, Emsal; ?enel, ?lknur; Yetkin, Meltem Arzu
Background & objectives: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease and significant health concern particularly in endemic regions. We aimed to evaluate the efficacy in dexamethasone treatment on clinical outcomes in CCHF patients. Methods: We included adult patients diagnosed with CCHF and those whose platelet count dropped to 70,000/mm3 or lower. The efficacy of dexamethasone on clinical outcomes was evaluated. It was a retrospective analytical study. Results: All 55 patients received standard supportive treatment, and none of them received ribavirin therapy. It was observed that 23 (41.8%) patients were treated with dexamethasone. No significant differences were observed between patients treated with dexamethasone and without, regarding factors such as bleeding incidents during hospitalization, the need for blood product transfusions, thrombocyte recovery status, intensive care unit admission, and in-hospital mortality. In-hospital mortality was observed in two patients (3.6%). Interpretation & conclusion: Our study found that dexamethasone treatment did not lead to a significant improvement in the clinical outcomes for CCHF patients.
Climatic and ecological factors responsible for distribution of Phlebotomine sandflies and occurrence of cutaneous leishmaniasis, in Himachal Pradesh, India
(Wolters Kluwer – Medknow, 2025-06) Lata, Suman; Kumar, Gaurav; Bhakuni, Bharat; Kumari, Sandhya; Dhiman, Ramesh C
Background & objectives: Subalpine valley along the Sutlej River has been identified as an endemic focus for cutaneous leishmaniasis (CL) in Himachal Pradesh (H.P.) state in India. The present study was undertaken with the aim to find out the climatic and ecological determinants responsible for distribution of sandflies and occurrence of CL in Himachal Pradesh. Methods: Collections of sandflies were made in the Shimla, Kullu, and Kinnaur districts of H.P. during 2017 and 2019. The climatic data were procured from Indian Meteorological centre, Shimla (H.P). The satellite images (Indian remote sensing satellite (IRS)-Linear imaging self-scanner (LISS)-IV sensor multispectral data) having resolution of 5.8m were procured from National Remote Sensing Centre, Hyderabad, India. The relationship between the incidence of CL and Land Use was analysed. Results: A total of 332 sandflies were collected. The transmission of CL was favoured by temperatures exceeding 20°C over a period of six months, specifically from April to September. The valley with an elevation ranging between 1000 to 1250 meters reported 90% of the CL cases. The correlation between CL incidence and land use patterns revealed a notable rise in barren land (8%) and scrub land (5%) from 2013 to 2017. Interpretation & conclusion: The findings reveals that specific meteorological conditions and land cover play a significant role in determining the presence of sandflies in Himachal Pradesh. To effectively control CL, it is recommended to implement control programs primarily between June and September, focusing particularly on regions with elevations ranging from 1000 to 1250 meters.

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