Recent advances on pathogenesis,diagnosis,prevention,immunological aspects,and vectors of dengue:A review

Dengue is a vector-borne disease caused by the dengue virus(DENV)of family Flaviviridae.Dengue fever is common in both developed and developing countries.Globally,approximately 400 million cases of dengue fever are reported annually,resulting in approximately 22000 fatalities.Dengue cases in India have progressively increased in the last decade.In recent years,substantial progress has been made in understanding various aspects of dengue,including its pathogenesis,diagnosis,prevention strategies,immunological responses,and the role of vectors in its transmission.The transmission of a positive RNA virus occurs through Aedes mosquitoes,specifically Aedes aegypti and Aedes albopictus.This virus is associated with a wide spectrum of symptoms,ranging from mild undifferentiated fever to severe hemorrhagic fever and shock,posing a potential threat to human health.There are 4 types of antigenically distinct dengue serotypes(DENV-1 to DENV-4)and among them,DENV-2 is more lethal and extremely severe.To overcome the severity of dengue,Dengvaxia is administered to children 9 to 16 years old with evidence of previous dengue infection.The diagnosis of dengue is carried out by ELISA-based non-structural protein(NS1)and immunoglobulin tests.However,there are no specific biomarkers to identify severe disease progression.Climatic factors and temperature play an important role in complex interaction among host,vector,and virus to manifest the severity of dengue.There is a need for the refinement of climate-based disease forecasting models in India to effectively control the spread of dengue.The mosquito repellent should be used periodically to kill or repel the Aedes mosquito to prevent the spread of dengue in humans.

One Health: navigating plague in Madagascar amidst COVID-19

Background Africa sees the surge of plague cases in recent decades,with hotspots in the Democratic Republic of Congo,Madagascar,and Peru.A rodent-borne scourge,the bacterial infection known as plague is transmitted to humans via the sneaky bites of fleas,caused by Yersinia pestis.Bubonic plague has a case fatality rate of 20.8%with treatment,but in places such as Madagascar the mortality rate can increase to 40–70%without treatment.Main text Tragedy strikes in the Ambohidratrimo district as three lives are claimed by the plague outbreak and three more fight for survival in the hospitals,including one man in critical condition,from the Ambohimiadana,Antsaharasty,and Ampanotokana communes,bringing the total plague victims in the area to a grim to five.Presently,the biggest concern is the potential plague spread among humans during the ongoing COVID-19 pandemic.Effective disease control can be achieved through training and empowering local leaders and healthcare providers in rural areas,implementing strategies to reduce human–rodent interactions,promoting water,sanitation and hygiene practices(WASH)practices,and carrying out robust vector,reservoir and pest control,diversified animal surveillance along with human surveillance should be done to more extensively to fill the lacunae of knowledge regarding the animal to human transmission.The lack of diagnostic laboratories equipped represents a major hurdle in the early detection of plague in rural areas.To effectively combat plague,these tests must be made more widely available.Additionally,raising awareness among the general population through various means such as campaigns,posters and social media about the signs,symptoms,prevention,and infection control during funerals would greatly decrease the number of cases.Furthermore,healthcare professionals should be trained on the latest methods of identifying cases,controlling infections and protecting themselves from the disease.Conclusions Despite being endemic to Madagascar,the outbreak’s pace is unparalleled,and it may spread to non-endemic areas.The utilization of a One Health strategy that encompasses various disciplines is crucial for minimizing catastrophe risk,antibiotic resistance,and outbreak readiness.Collaboration across sectors and proper planning ensures efficient and consistent communication,risk management,and credibility during disease outbreaks.

Mass drug administration for lymphatic filariasis elimination in a coastal state of India: a study on barriers to coverage and compliance

Background:Lymphatic filariasis is targeted for elimination in India through mass drug administration(MDA)with diethylcarbamazine(DEC)combined with albendazole(ABZ).For the strategy to be effective,>65%of those living in endemic areas must be covered by and compliant to MDA.Post the MDA 2011 campaign in the endemic district of Odisha,we conducted a survey to assess:(i)the filariasis knowledge in the community,(ii)the coverage and compliance of MDA from the community perspective,and(iii)factors affecting compliance,as well as the operational issues involved in carrying out MDA activities from the drug distributor’s perspective.Methods:A sample of 691 participants-both male and female,aged two years or above-were selected through multistage stratified sampling and interviewed using a semi-structured questionnaire.Additionally,drug distributors and the medical officers in charge of the MDA were also interviewed to understand some of the operational issues encountered during MDA.Results:Ninety-nine percent of the study participants received DEC and ABZ tablets during MDA,of which only just above a quarter actually consumed the drugs.The cause of non-compliance was mostly due to fear of side effects,lack of awareness of the benefits of MDA,and non-attendance of health staff in the villages.Lack of adequate training of drug distributors and poor health communication activities before the MDA campaign commenced and the absence of follow-up by health workers following MDA were a few of the operational difficulties encountered during the MDA campaign.Conclusion:Currently MDA is restricted to the distribution of drugs only and the key issues of implementation in compliance,health education,managing side effects,and logistics are not given enough attention.It is therefore essential to address the issues linked to low compliance to make the program more efficient and achieve the goal of filariasis elimination.

Distribution of and associated factors for dengue burden in the state of Odisha,India during 2010-2016

This study is aimed to estimate the epidemiological burden of dengue in Odisha,India using the disability adjusted life year(DALY)methods and to explore the associated factors in the year 2010-2016.During the period of 2010-2016,27772 cases(68.4%male)were reported in the state.Mean age(years)of male and female was 31.63 and 33.82,respectively.Mean district wise disability adjusted life years(DALY)per 100000 people was higher in the year 2016(0.45)and mean DALY lost per person was highest in the year 2015(34.90 years).Adjusted regression model indicates,every unit increase in humidity and population density increases DALY by 1.05 and 1.02 units respectively.Whereas,unit change in sex ratio(females per 1000 males)and forest coverage increases the DALY by 0.98 units.Our results indicate geographical variation of DALY in Odisha,which is associated with population density,humidity and forest cover.Discrepancies identified between standard incidence and DALY maps suggests,latter can be used to present disease burden more effectively.More prevalence among young males suggests the need of strengthening the targeted prevention and control measures.

Disconnect between primary care and cancer follow-up care: An exploratory study from Odisha, India

Objective:There has been a steady increase in the demand for cancer follow-up care in India.Compared with Western countries,there is little evidence on the capacity of the Indian primary care workforce to accommodate such tasks.We explored the perceptions of oncologists,general practitioners,and patients with regard to the involvement of primary care in cancer follow-up care.Methods:We undertook semistructured focus-group discussions with eight oncologists,nine general practitioners,and 17 cancer patients to gain an understanding of their perceived roles and responsibilities with regard to primary care in delivering follow-up care and the potential concerns.Data from the focus groups were transcribed verbatim,translated,and analyzed with use of a the-matic approach.Results:Most general practitioners felt that their job is to see‘normal’patients,and cancer patients were exceptions to routine care.Oncologists were apprehensive with regard to the com-petence of general practitioners and patient trust.Patients consult oncologists for cancer follow-up care as they perceive it to be very specialized.Patients expressed difficulty in accessing follow-up care and want specialized oncological care by trained personnel in their vicinity.Conclusion:Despite the growing number of cancer survivors,we found a disconnect between primary care and cancer follow-up care.