Endemic Zone Research Articles

Variation of Serum Zinc Concentrations Among Kala-Azar Endemic and Nonendemic Population in Bangladesh

Background & objectives: Visceral Leishmaniasis (VL) or Kala-azar is a deadly disease putting 350 million people from 88 countries at risk. In Bangladesh, 45 districts are endemic. Zinc is an essential trace element and its relevance for proper functioning of the entire immune system is already well documented. Though low serum zinc levels have been reported in many parasitic diseases, limited information is available regarding zinc status in human leishmaniasis. This study was conducted to evaluate the zinc level in endemic and non-endemic population of kalaazar. Methods: This cross-sectional study was conducted to assess the serum zinc concentrations in kala-azar endemic and non- endemic population of 06 to 60 years of age range during the period of July 2014 to June 2015.Venous blood was collected from 92 subjects to estimate serum zinc concentrations. Results: Mean Serum zinc levels were found 63.66 microgm/dl in kala-azar patients of endemic area, 69.44 microgm/dl in kala-azar endemic populations and77.34 microgm/dl in non-endemic populations. Conclusion: The average serum zinc concentrations is lower in populations of kala-azar endemic zone compared to populations from kala-azar nonendemic zone. It was also found that kala-azar patient had lower zinc concentrations compared to non-kala-azar patients. There may have potential association of low zinc level and occurrence of kala-azar. J Dhaka Med Coll. 2021; 29(1): 111-117

Real-World HbF Status in Sickle Cell Disease from an Endemic Zone

Real-World HbF Status in Sickle Cell Disease from an Endemic Zone

Isolated Spinal Intramedullary Neurocysticercosis

Cysticercosis is the most common parasitic disease of the central nervous system but an isolated spinal intramedullary involvement is very rare. We present one such case of a 68-year-old female who had spastic paraplegia with bladder involvement. Magnetic resonance imaging (MRI) revealed D3 intramedullary space-occupying lesion. She was treated with surgical excision and her diagnosis was confirmed to be cysticercosis by histopathological examination. With appropriate post-operative rehabilitation and medical management, she was found to have significant recovery. At final follow-up, she was walking with aid and regained her bladder control. A high index of suspicion is required in endemic zones, like India, when the MRI shows an unusual picture of space-occupying intramedullary lesions. With early diagnosis and initiation of treatment, neurocysticercosis (NCC) shows better prognosis than what was previously known.

Knowledge and Prevention of Vertical Transmission of Hepatitis B Infection: A Cross-Sectional Study among Pregnant Females in Varanasi, India.

300 million individuals worldwide suffer from chronic HBV infection. India, an intermediate endemicity zone, has a 3-4% HBsAg prevalence in the general population and 0.9-11.2% among pregnant women. As 95% of infantile infections progress to chronicity, vertical transmission is a vital intervention area. To assess the knowledge of pregnant women and post-natal mothers concerning Hepatitis-B infection transmission and prevention. A cross-sectional study was conducted with 143 participants (124 pregnant females and 19 postnatal mothers) attending the antenatal clinic at the rural block primary health center. A semi-structured questionnaire was used. Blood samples were evaluated for HBsAg using RAPIKIT. SPSS-22 was utilized for descriptive statistical analysis. 91.6% of respondents had heard of Hepatitis. 1.4% stated that it can be caused by a virus, whereas 40% identified consumption of oily, spicy, and unhygienic food as causative. 67.1% of respondents underwent blood tests but could not specify what they were screened for. 5.2% were HBsAg positive. ~40% were aware of vertical transmission. 59.4% of respondents were unaware of any preventive modality, and 7.7% said vaccination is preventive. 97.9% had never been counseled during their antenatal period by health workers. 41.1% said that their newborns were vaccinated within 24 hours of birth. Findings emphasize the paucity of knowledge possessed by pregnant women and post-natal mothers concerning Hepatitis B causation, transmission, and prevention regardless of age, education, or socioeconomic status. Misconceptions were prevalent, and counseling was inadequate.

Situation analysis of urogenital bilharzia in West Africa (2010-2021) and control strategies and prospects: systematic review and meta-analysis.

Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts (freshwater molluscs). Their recrudescence in endemic areas is no longer in question and remains a crucial public health problem in the world in general and in West Africa in particular. In order to eradicate bilharzia, many control strategies and policies have been implemented on both sides. The objective of this systematic literature review is to synthesize the existing evidence on control strategies implemented by West African countries. To achieve this, data were collected from PubMed, Direct Science, Web of Sciences, Google Scholar, PloS and Banque de Données de Santé Publique (BDSP), using appropriate keywords. Academic articles and theses written in French or English that evaluated the analysis of a bilharzia situation in West Africa were selected. Sixteen scientific papers were selected for the study, ten of which were used for a meta-analysis. The systematic review revealed that bilharzia is still an endemic disease in West Africa. Clearly, it continues to wreak havoc on the population, especially among school children. Rural areas are the most affected by the disease. Strategies to control bilharzia are based on preventive and curative treatment of the infection with chemotherapy and vector control of soil molluscs (host and vector of bilharzia eggs). Praziquantel is the main known antibilharzian. Also, the species most frequently found in analyses are S. haematobiumand S. mansonii. This review has allowed to evaluate the control strategies carried out and to deduce the strengths and weaknesses, in order to define the perspectives for the efficiency of the anti-bilharzia control for the eradication of bilharzia in the endemic zones of West Africa.

РАЗРАБОТКА ОПТИМАЛЬНЫХ ПАРАМЕТРОВ ПОЛУЧЕНИЯ И КОНТРОЛЯ КАЧЕСТВА ИНАКТИВИРОВАННОЙ ЭМУЛЬГИРОВАННОЙ ВАКЦИНЫ ДЛЯ ПРОФИЛАКТИКИ САЛЬМОНЕЛЛЕЗА ПТИЦ

The article presents data on the development of optimal parameters for the production and quality control of an inactivated emulsified vaccine for the prevention of salmonellosis in birds, the isolation and selection of immunogenically effective vaccine strains of Salmonella. The data on the isolation of pathogens for the formation of vaccine strains in the conditions of poultry farms of the Republic of Belarus are given. The importance and relevance of this work lies in the fact that the selection of vaccine strains, taking into account the circulating Salmonella strains in each individual endemic zone, is necessary to create the most immunogenically effective vaccines.

Canine parasitoses in north Patagonia (Argentina): comparison between different social and environmental factors.

In many countries, urban areas are commonly contaminated with canine feces that spread parasites, a situation related to the natural and social environment. Dogs having free access to public areas therefore constitutes a health risk. Because in Patagonia there are no records of city comparisons that consider the number of free-roaming dogs and the local environmental and socioeconomic characteristics, in this study we analyse and compare canine parasitoses in two cities of Rio Negro province, Argentina. Canine feces were collected from public areas of El Bolsón and Cipolletti cities and examined using enrichment methods, Kinyoun stain and immunoassay (Copro-Elisa). The total percentage of positive feces in El Bolsón was 68.95% and 16 parasite taxa being identified, whereas in Cipolletti the total positive feces was 41.1%, with 11 taxa. Both cities presented more helminth species than protozoans. The variables that explained the occurrence of all parasites were rainfall and socioeconomic stratum with the highest values being found in low-income areas.Soil moisture is conditioned by rainfall. This study highlights the presence of the zoonotic Echinococcus sp. in dogs in urban areas of the Rio Negro province. The occurrence of this parasite in Cipolletti is unexpected, given that this city is not considered an endemic zone for this disease, which is not included in local monitoring and control plans.

Fluid Management in Dengue Critical Phase: Which, When, How Much?

Dengue is a very common viral infection in tropical zones, it is transmitted by vectors to humans by mosquito bites of the genre: Aedes. Oriental Mediterranean, Americas, Southeast Asia, Pacific, and Africa are all known as endemic zones for dengue.

A Very High Ca-125 Level Is Not Always Malignant: A Case-Based Experience From Tuberculosis Patient

CA-125 is a serum marker that is raised in various malignant and non- malignant conditions, but a very high rise (>1000 U/mL) almost always suggests ovarian malignancy. Here we report a rare case of tuberculous peritonitis in a 58-year-old woman who presented with gradually progressive abdominal distension and weight loss, and her CA-125 level was >1000 U/mL. Initially suspecting this as a case of ovarian malignancy, ascitic fluid study to detect malignant cells and a contrast CT scan of the abdomen was done, but the results didn’t suggest any malignancy. Finally, diagnostic laparoscopy was done and tuberculous peritonitis was diagnosed by peritoneal biopsy and histopathology. This case is an excellent example showcasing the importance of tissue diagnosis over indirect supportive tests, and it also suggests that clinical suspicion of tuberculosis in an endemic zone should always be there even if the patient has very high CA-125 level. Bangladesh J Medicine 2022; 33: 49-51

1426. Characterization of Patients with Iatrogenic Mycobacterial Infections: A Hospital-Based Survey

Abstract Background Tuberculosis (TB) is a chronic granulomatous inflammation usually involving the lung parenchyma and hilar lymph nodes. Extra-pulmonary involvement is seen in ∼20% of all TB cases. Developing tuberculosis following treatment for another primary medical condition is a rare occurrence. Iatrogenic literally means illness caused by medical examination or treatment. Mycobacteria have been used to treat a few medical conditions and the therapeutic use has been validated extensively in literature. The mycobacteria used for therapeutic purposes are supposed to be either attenuated or non pathogenic strains. Growth and dissemination of this mycobacterium is a rare but serious possibility. Reactivation of latent mycobacterial infection following therapy is also a part of iatrogenic mycobacterial infection. Methods We report a retrospective study investigating adverse events manifesting with development of iatrogenic tuberculosis. The data was obtained from a tertiary care centre over a period of 2 years. Diagnosis of tuberculosis was established based on clinical, radiological(chest X-Ray and High resolution CT scan), sputum smear microscopy and skin/tissue biopsy and Xpert MTB/RIF. Tuberculin skin test(TST) and Interferon gamma release assay (IGRA) were used as additional diagnostic tests. Results The search yielded 26 cases of iatrogenic tuberculosis, with a median age of 56.5 years. Most common cause was reactivation of latent tuberculosis due to use of anti-TNF alpha biologic agents(53.8%). Development of Tuberculosis verrucosa cutis following BCG inoculation for verruca vulgaris was noted in about 19.2% of cases and Tubercular abscess due to Mycobacterium w or BCG inoculation for Covid-19 was noted in 11.5% cases. Bacillus Calmette Guérin(BCG) induced balanitis secondary to therapy for Carcinoma urinary bladder was noted in 7.69%of cases. Bacillus Calmette-Guerin or BCG induced balanitis following use of intravesical immunotherapy for treating early-stage urinary bladder cancer and successful clearance of lesions post therapy Tuberculosis Verrucosa Cutis following Immunotherapy for plantar warts Conclusion All patients were managed successfully with anti tubercular therapy. These observations indicate that tuberculosis infection can develop in previously healthy individuals in endemic zones following biologic therapy of use of mycobacterial agents for other therapeutic indications. Disclosures All Authors: No reported disclosures.

Distribution and frequency of common mutations in rpoB gene of Mycobacterium tuberculosis detected by Xpert MTB/RIF and identification of residential areas of rifampicin resistant-TB cases: A first retrospective study from Mizoram, Northeast India

BackgroundRifampicin resistance (RR) is a surrogate marker of multidrug-resistant tuberculosis. The aim of this study is to determine the frequency of the commonly mutated probes for rpoB gene and locate the residential areas of the Rifampicin Resistant-TB (RR-TB) patients in a high endemic zone of Northeast India. MethodsArchived data of 13,454 Xpert MTB/RIF reports were evaluated retrospectively between 2014 and 2021. Socio-demographic and available clinical information were reviewed and analyzed for RR-TB cases only. Logistic Regression was used to analyze the parameters with respect to probe types. P-value ≤ 0.05 was considered to be statistically significant. Results2,894 patients had Mycobacterium tuberculosis infection out of which 460 were RR-TB, which was most prevalent among 25–34 years. The most common mutation occurred in probe A (25.9 %) followed by E (23.5 %), D (9.8 %), B (2.6 %) and the least in C (0.2 %). High prevalence (34.3 %) of probe mutation combinations were also found: probes AB (0.4 %), AD (32.8 %), AE (0.4 %), DE (0.2 %) and ADE (0.4 %). Seventeen patients (3.7 %) were found without any missing probes. RR-TB patients were mostly located in Aizawl North –III, South –II and East –II constituencies. ConclusionThis study provides genetic pattern of drug resistance accountable for RR over the past years in Mizoram which will help local clinicians in the initiation of correct treatment. Also, our findings provide a baseline data on the magnitude of RR-TB within the state and identification of the residential areas can help local health authorities in planning surveillance programs to control the spread of RR-TB.

Bridging the Gap in Malaria Parasite Resistance, Current Interventions, and the Way Forward from in Silico Perspective: A Review.

The past decade has seen most antimalarial drugs lose their clinical potency stemming from parasite resistance. Despite immense efforts by researchers to mitigate this global scourge, a breakthrough is yet to be achieved, as most current malaria chemotherapies suffer the same fate. Though the etiology of parasite resistance is not well understood, the parasite's complex life has been implicated. A drug-combination therapy with artemisinin as the central drug, artemisinin-based combination therapy (ACT), is currently the preferred malaria chemotherapy in most endemic zones. The emerging concern of parasite resistance to artemisinin, however, has compromised this treatment paradigm. Membrane-bound Ca2+-transporting ATPase and endocytosis pathway protein, Kelch13, among others, are identified as drivers in plasmodium parasite resistance to artemisinin. To mitigate parasite resistance to current chemotherapy, computer-aided drug design (CADD) techniques have been employed in the discovery of novel drug targets and the development of small molecule inhibitors to provide an intriguing alternative for malaria treatment. The evolution of plasmepsins, a class of aspartyl acid proteases, has gained tremendous attention in drug discovery, especially the non-food vacuole. They are expressed at multi-stage of the parasite's life cycle and involve in hepatocytes' egress, invasion, and dissemination of the parasite within the human host, further highlighting their essentiality. In silico exploration of non-food vacuole plasmepsin, PMIX and PMX unearthed the dual enzymatic inhibitory mechanism of the WM382 and 49c, novel plasmepsin inhibitors presently spearheading the search for potent antimalarial. These inhibitors impose structural compactness on the protease, distorting the characteristic twist motion. Pharmacophore modeling and structure activity of these compounds led to the generation of hits with better affinity and inhibitory prowess towards PMIX and PMX. Despite these headways, the major obstacle in targeting PM is the structural homogeneity among its members and to human Cathepsin D. The incorporation of CADD techniques described in the study at early stages of drug discovery could help in selective inhibition to augment malaria chemotherapy.

Risk Assessment and Impact of Floods on the Transmission of Vector Borne Diseases

Floods are the result of natural disasters in an area due to prolonged continued and heavy rains and are frequently followed by a proliferation of mosquitoes due to the creation of a large number of breeding habitats. In the endemic zones for VBDs, vector mosquito species require special attention for planning immediate control measures as these areas may pose a threat to public health. Natural disasters continue to strike unabated, flash floods due to heavy rains, riverine floods,coastal floods and cloud burst floods. In general, floods are witnessed due to the concentrated spells of heavy rains during the monsoon months and seasonal disturbances. The low lying areas are submerged under water and remain water logged for a long duration. Slowly, the low lying water bodies thus created after receding of flood water, act as a breeding potential source for the vector mosquitoes. Some of the areas receive water from flushing of water from high altitude areas due to heavy rains or melting of ice. There is definite need for public health preparedness and response for the flood affected areas to reduce the transmission of VBDs with proper risk assessment. There are chances for the onset of transmission of VBDs to the population shifted to temporary shelter homes away from homes. Given the situation with the presence of congenial conditions owing to presence of favourable climatic variables for propagation of vectors, pathogens and susceptible population, there are chances of disease outbreaks. Therefore, the risk assessment of the flood affected area with the vulnerable population is essential to make preparedness and response to any onset of VBDs transmission. Disease and vector surveillance are the key elements to be in place for such flood affected areas during and after the floods.

Spinal Cord Paracoccidioidomycosis: Case Report

AbstractParacoccidioidomycosis (PCM) is a systemic mycosis caused by fungi Paracoccidioides brasiliensis and Paracoccidiodes Lutzii. Its distribution is limited to subtropical regions of Central and South America, where it is endemic, and Brazil accounts for ∼ 80% of the reported cases. Even in endemic zones, its incidence is low, ranging from 3 to 4 new cases per million to 1 to 3 new cases per 100 thousand inhabitants per year. Granulomas in the spinal cord are rare, and they account for 0,6% of all cases of systemic PCM. The authors report a case of a woman with crural paraparesis caused by dorsal spinal cord PCM granulomasin T7-T8 and T8-T9, with no evidence of systemic disease. The patient was submitted to microsurgery, with total excision of the lesions, and is experiencing positive neurological recovery. Though rare, PCM intramedullary granulomas must be considered in differential diagnosis of the tumoral expansive process of the spinal cord, especially in patients coming from endemic rural zones.

P197 Infant-juvenile paracoccidioidomycosis. Two Argentine endemic zones with different epidemiological and clinical aspects? What influences this situation?

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMArgentina has two endemic areas of paracoccidioidomycosis (PCM). It is noteworthy that epidemiological characteristics differ in both areas, especially in frequency, and clinical aspects of infant-juvenile PCM form (I-JF). In this work, we have reviewed and analyzed 10 years of juvenile PCM form (JF) in both areas emphasizing in acute/subacute I-JF cases. From January 2012 to December 2021 data of epidemiological characteristics, clinical history and laboratory results of I-JF cases were recorded on standardized protocols and entered into a database that helped consolidate the information. Although the more extensive area of PCM historically with the highest incidence is located in Northeast Argentina (NEA), the major number of I-JF was observed in the smaller PCM endemic area, located in the Northwest of the country (NWA).In NWA, 32 JF were recorded including 20 cases of I-JF form in children from 1-13 years old. No outbreak was registered. Cases were equally distributed over the 10 years.In NEA, 28 JF were recorded including 8 cases of I-JF form in children from 7-14 years old. Of these cases, 6/8 (75%) presented as an outbreak in 2012. The rest were only registered in 2018-2020.More frequent clinical manifestation of I-JF:NWA: 70% hepatosplenomegaly with peritonitis and ascites, 33% gastrointestinal symptoms including diarrhea. Adenomegaly (70% cervical, 15% mediastinal).Serology (ID) non-reactive: 32%NEA: 62% cutaneous, 37% hepatosplenomegaly, 25% osteolytic lesions, 25% pulmonary nodules, 25% pericardial effusion, 25% mucocutaneous. Adenomegaly (75% cervical, 62% mediastinal-retroperitoneal).Serology (ID) non-reactive: 12.5%NWA records most cases of I-JF with a constant frequency and with a lower median age. NEA seems to only occur in outbreaks. Are striking the different epidemiological characteristics observed? Predominantly hepatosplenomegaly and intestinal forms in NWA, being with fecal material the first sample where Paracoccidioides is detected in many cases. In contrast, more diverse clinical manifestations are observed in NEA. Most cases with cutaneous/mucocutaneous lesions and the presence of pulmonary and pericardial forms characterized I-JF in this zone. Considering serological tests are important in the PCM diagnosis and to follow up the treatment success, no-reactive tests obtained (32% in NWA, 12.5% in NEA) show a serious diagnostic problem emphasize the need to work on more sensitive tools to reduce the high mortality of this clinical form. The variable expression of gp43 among isolates of Paracoccidioides species may suggest not to use a single antigen preparation for serological tests and include autochthonous isolates. Our group reported climatic and anthropogenic changes influencing the appearance of I-JF outbreaks in the NEA, a region where the observation of these cases was historically very rare. Probably, NWA provides a different ecological niche for Paracoccidioides, which favors its constant appearance over time. We have already started a multicenter molecular epidemiological, probably include soil studies of NWA would be important to try to better understand this situation.

Burden of malaria infection among individuals of varied blood groups in Kenya

BackgroundThe ABO blood groups consist of A, B, and H carbohydrate antigens, which regulate protein activities during malaria infection in humans. Understanding the interplay between the malaria parasite and blood group antigens is essential in understanding new interventions to reduce the global burden of malaria. This study assessed the burden of malaria infection among individuals with varying blood groups seeking treatment at selected hospitals in Kenya.MethodsA total of 366 samples from an ongoing malaria surveillance study were diagnosed for malaria by microscopy and further typed for blood group using ABO blood grouping. Age and sex were recorded in a data sheet, and analysed using R software version 4. Groups’ proportions (blood group, malaria infection, age and sex) were compared using Pearson’s Chi-square and Fischer exact tests. Wilcoxon and Kruskal-Wallis tests were performed and P-value < 0.05 was considered significant after Bonferroni correction for multiple comparisons. To understand the effect of each blood group on parasitaemia, multivariate logistic regression was used to model ABO blood group in relation to parasitaemia.ResultsOf the 366 samples analysed, 312 were malaria positive, mean age was 9.83 years (< 5 years n = 152 (48.41%), 6 to 17 years n = 101 (32.16%) and > 18 years n = 61 (19.43%)). Malaria prevalence was higher among females than males, 54.46% and 45.54%, respectively. Kisumu enrolled the highest number 109 (35%)) of malaria cases, Kombewa 108 (35%), Malindi 32 (10%), Kisii 28 (9%), Marigat 23 (7%), and Kericho 12 (4%). Blood group O+ was the most prevalent among the enrolled individuals (46.50%), A+ (27.71%), B+ (21.02%) and AB+ (4.78%) respectively. Compared to blood group O+, blood group B+ individuals were (14%) were more likely to habour Plasmodium falciparum infection as opposed to A+ and AB+ individuals, that were 7% and 20%, respectively,. Those living in malaria-endemic zones presented with higher parasite densities compared to those living in malaria-epidemic (p = 0.0061). Individuals bearing B + blood group are more likely to habour high parasitaemia compared to O + blood group bearers (OR = 4.47, CI = 1.53–13.05, p = 0.006).ConclusionIndividuals of blood group B harbour high parasitaemia compared with the blood group O, Additionally, blood group A and B present with symptoms at lower parasitaemia than blood group O. Regardles of malaria transmission zones, individuals from endemic zones showed up with high parasitaemia and among them were more individuals of blood groups A and B than individuals of blood group O. Implying that these individuals were more at risk and require additional attention and effective case management.Garphical

Metagenomic detection of eumycetoma causative agents from households of patients residing in two Sudanese endemic villages in White Nile State.

Eumycetoma is a chronic debilitating fungal disease endemic to tropical and subtropical regions, with Sudan featuring the highest eumycetoma incidence. Among the 50 species of fungi most commonly associated with eumycetoma Madurella mycetomatis (M. mycetomatis) is often referenced as the most common pathogen. However, there is an enormous knowledge gap related to this neglected disease and its pathogenesis, epidemiological features, and host-specific factors that could contribute to either the host susceptibility and resistance. In this study, we were able to utilize a metagenomic approach and samples collected from clinical black grains (BG) and familiar household environments aimed to assay both the habitat of eumycetoma-associated fungi and its possible connection with eumycetoma patients living in two different eumycetoma endemic villages within the White Nile State of Sudan. DNA sequencing targeting the fungal ITS2 domain was performed on soil, animal dung, housing walls and roofs, and Acacia-species thorn samples and compared with culture-dependent methods of fungal isolation. Additionally, we compared the soil samples obtained in the endemic zone with that from non-endemic zones, including Wagga village in Kassala State and Port Sudan suburb in Port Sudan State. Overall, a total of 392 Amplicon Sequence Variants (ASVs) were detected by ITS2 metagenomics Eumycetoma causative organisms accounted for 10% of total ASVs which included 11 genera: Exserohilum (2%), Aspergillus (1.7%), Curvularia (1%), Alternaria (0.9%), Madurella (0.5%), Fusarium (0.4%), Cladosporium (0.2%) Exophiala (0.15%), and, in a lesser extent, Microascus (0.05%) Bipolaris and Acremonium (0.01%) for each. Only five genera were identified by culture method, which included Fusarium (29%), Aspergillus (28%), Alternaria (2.5%), Bipolaris (1.6%), and Chaetomium (0.8%). M. mycetomatis was detected within all the studied patients' houses, accounting for 0.7% of total sequences. It was the first common eumycetoma-associated agent detected in soil samples and the third common in the dung and wall samples. In contrast, it was not detected in the roof or thorn samples nor in the soils from non-endemic regions. Exserohilum rostratum, Aspergillus spp and Cladosporium spp were detected in all samples. M. mycetomatis and other eumycetoma-associated fungal identified in the patients' black grains (BG) samples by metagenomics were identified in the environmental samples. Only Acremonium alternatum and Falciformispora senegalensis, responsible for eumycetoma in two patients were not detected, suggesting the infections in these patients happened outside these endemic areas. The soil, animal dung, and houses built from the same soil and dung are the main risk factors for M. mycetomatis infection in these endemic villages. Furthermore, the poor hygienic and environmental conditions, walking barefooted, and the presence of animals within the houses increase the risk of M. mycetomatis and other fungi causing eumycetoma.

Monkeypox: The Re-emerging Terror.

Monkeypox is a zoonotic Orthopoxvirus called human Monkeypox. It has symptoms that resemble or are pretty similar to smallpox. Monkeypox virus belongs to the genus Orthopoxvirus, which also includes cowpox, vaccinia, and variola viruses. The World Health Organization confirmed in 1970 that the primary virus is the Orthopoxvirus infecting humans after smallpox elimination. Clinically distinguishing the condition from varicella and smallpox is challenging for a clinician. Although the mortality rate of this disease is low, new tests are being tried and studied, which are required for a more accurate and quick diagnosis because the lab diagnosis is the key to the detection of illness and its monitoring. The illness or the virus is endemic to parts of western and central Africa. Surveillance in underdeveloped rural regions is challenging but manageable with evidence-based techniques and training materials for public health professionals. However, as in the present scenario, the disease is having a worldwide outbreak in various countries, and recently India detected its first case on 15 July 2022 in New Delhi. The widespread disease is due to trading exotic pets and international travel. Since smallpox vaccinations are not administered to people regularly, epidemiological studies are required. New medications and vaccines provide hope for treating and preventing Monkeypox; however, further study is required before they can be used effectively. Also, there is a requirement for advanced scientific studies in the etiology, epidemiology, and biological structure of the virus in the endemic zones to know and halt the spread of infection to humans.

Modelling relative abundance of Oligoryzomys flavescens, an Orthohantavirus reservoir, in an endemic hantavirus pulmonary syndrome zone.

Hantavirus pulmonary syndrome (HPS) is a zoonotic emerging infectious disease caused by New World orthohantaviruses (family Hantaviridae) hosted by rodents of the family Cricetidae. In Argentina, one of its main hosts is the sigmodontine rodent Oligoryzomys flavescens, a widely distributed mouse of the Pampas, Delta and Espinal ecoregions of central-east Argentina. Because the abundance of the reservoir and its proportion in the rodent community affects both virus prevalence and human exposure risk, its estimation throughout its known geographical distribution is of key importance for the design of public health strategies to prevent HPS. The aim of this study was therefore to model the relative abundance of O.flavescens in most of the Pampas ecoregion within Buenos Aires Province, Argentina, where hantavirus pulmonary syndrome is endemic. To do this we used owl-pellet samples collected between 2006 and 2008 from 51 sites distributed throughout most of Buenos Aires province. Mammalian prey in each pellet was identified to the lowest possible taxonomic level by examination of the skulls, dentaries and molars. We modelled the frequency of O.flavescens found in each sample as a function of climatic, environmental, and topographic data of each site. The two best models were applied to a Geo referential Information System to build maps of estimated frequency (as a proxy of relative abundance) within Buenos Aires province. Estimated relative abundance of O.flavescens in Buenos Aires province was significantly associated with annual mean temperature, annual precipitation and presence of freshwater bodies, and varied among sub-regions, with the Inland and Rolling Pampas being the regions with highest frequencies. Knowing in which areas O.flavescens abundance is expected to be higher can be used to concentrate limited sanitary efforts in those areas that are most needed in order to reduce transmission and increase detection.

Understanding the reasons for refusal of polio vaccine by families in Quetta Block, Pakistan.

Global polio eradication is a goal yet to be achieved in countries like Pakistan. In recent years, the Polio Eradication Initiative has been making steady progress with good campaign coverage and low numbers of polio cases. However, in 2019 Pakistan reported 146 cases compared to 12 in 2018. A major factor cited for this regression was a surge in vaccine refusals by parents and caretakers. To assess the reasons for the refusal of polio vaccination in Quetta Block, Balochistan. The study was conducted using data acquired from 2 polio vaccination campaigns over 3 months in 2019. The data were collected in Quetta Block, a highly endemic zone having continuous transmission of the polio virus over several years. The data were analysed using the statistical software, SPSS, version 20. We used descriptive statistics to demonstrate the characteristics of the study population. Categorical variables were measured as frequencies and percentages. Refusal rates were almost 8.6% for the polio campaign of April and 8.1% for June 2019. Misconceptions about vaccines made up 56.4% of reasons for refusals, followed by religion 16%. Misconceptions about the vaccine are the main driving force behind vaccine refusals in the study setting. Efficient strategies are required to address misconceptions in this red zone of poliovirus transmission in Balochistan.