Mosquito-borne Infectious Disease Research Articles

Immunophenotyping of Hematopoietic Cells in the Spleen in Hypothyroid Mice.

Hypothyroidism, which is characterized by insufficient production of thyroid hormones, and malaria, a mosquito-borne infectious disease caused by Plasmodium parasites, are significant global health challenges. Studying how these two conditions interact could provide valuable insights into their complex relationship and potential treatment options.To induce hypothyroidism in the research, scientists used drugs to block the production of thyroid hormones. Then, they infected mice with Plasmodium berghei ANKA to mimic cerebral malaria infection. The spleen is essential in the body's immune response to malaria. It is involved in both innate and adaptive immunity, iron recycling, and the removal of old red blood cells or damaged cells infected with Plasmodium. Monitoring disease progression in male mice is crucial for early detection, and techniques like flow cytometry can help identify specific immune system populations within the spleen that are relevant to the research.

Immunophenotyping of Leukocytes in Brain in Hypothyroid Mice.

Hypothyroidism, characterized by inadequate production of thyroid hormones, and malaria, a mosquito-borne infectious disease caused by Plasmodium parasites, are significant health concerns worldwide. Understanding the interplay between these two conditions could offer insights into their complex relationship and potential therapeutic strategies. To induce hypothyroidism, pharmacological inhibition of thyroid hormone synthesis was employed. Subsequently, mice were infected with Plasmodium berghei ANKA to simulate cerebral malaria infection. It needs to monitor the progression of the disease in male mice before it can identify infiltrating immune system populations of interest in the brain by multiparametric techniques such as flow cytometry.

Health-Related Quality of Life due to malaria in the Brazilian Amazon using EQ-5D-3L.

Malaria is a mosquito-borne infectious disease caused by protozoa of the genus Plasmodium. Despite of the progress in malaria control in the last decades, malaria remains a major public health problem, contributing to increased morbidity and mortality in tropical and subtropical countries. Among American countries, Bolivia, Venezuela, and Brazil account for 73% of the cases. In Brazil, the majority of malaria cases is concentrated in Amazon region. This study estimated health-related quality of life (HRQoL) losses due to malaria in endemic areas of the Brazilian Amazon using the EQ-5D-3L instrument. We collected data from a convenience sample of 1,179 individuals aged 18 years or older. To measure the HRQoL loss, we matched individuals from the treatment group (with recent malaria) to those from the control group (without recent malaria) using Propensity Score Matching (PSM) and compared the difference in mean health utility between the groups. The results show a significant loss of HRQoL due to malaria. The mean utility was 0.69 and 0.83 for the treatment and control groups, respectively, representing a loss of quality of life of approximately 16.3% for individuals with recent malaria episodes. These findings underscore the importance of effective malaria prevention and treatment strategies, especially in areas where adverse socioeconomic conditions and a challenging epidemiological context exacerbate the impact of the disease. Continued investment in malaria control programs and improved access to health services are essential to mitigate the negative impact of this disease on the quality of life of affected populations.

THE ROLE OF KNOWLEDGE IN PREVENTING MALARIA INCIDENCE AMONG PADDY FARMERS IN NORTHERN MALAYSIA

The agriculture sector is notoriously associated with hazardous activities and high occupational accident rates, with most studies focusing on physical and chemical hazards. Biological hazards including zoonoses have been less studied due to scarce information and diverse perplexing factors that hinder the development of risk assessment activities by safety professionals. Zoonotic malaria, a communicable disease, has recorded upsurge in the infection rates in Malaysia. Malaria, a mosquito-borne infectious disease, poses significant risks to individuals working in agricultural settings, particular paddy farmers. Paddy farmers are highly vulnerable to these diseases due to their exposure to working environments such as stagnant water in the paddy field. This study aims to explores the relationship between the role of knowledge about malaria in preventing the incidence of malaria, highlighting the specific occupational challenges encounter by paddy farmers in Northern region of Malaysia. We propose the hypothesis that enhanced knowledge and awareness among paddy farmers about malaria and its prevention can contribute to notable reduction in the incidence of malaria. To test this hypothesis, we will conduct a questionnaire survey which will be distributed to collect data from selected paddy farming communities. The survey will evaluate the current level of knowledges associated with malaria prevention. The result of this study will provide valuable insight into the role of education and knowledge dissemination in alleviating biological hazards, with a main focus on malaria among the paddy farmers. Moreover, this research could contribute to the refinement of policy and practical interventions focusing in improving occupational health and safety of agricultural communities, ultimately boosting health outcomes and declining occupational accident rates.

Development of a Recombinase Polymerase Amplification Assay on Digital Microfluidics for Point-of-Care Detection of Plasmodium falciparum

Abstract Malaria is a dangerous mosquito-borne infectious disease that causes millions of death cases each year worldwide, especially in Southeast Asia. Current P. falciparum detection methods (e.g., blood smear, enzyme-linked Immunosorbent assay, polymerase chain reaction (PCR), etc.) have many disadvantages, such as being time-consuming, dependent on the operator's experience, and relying on sophisticated instruments that hinder the point-of-care (POC) application. To overcome those drawbacks, we developed a colorimetric recombinase polymerase amplification (RPA) reaction on a digital microfluidic (DMF) platform using SYBR Green I as the indicator for a simple result readout step, thus simplifying the diagnostic procedure. Using primers specific for the lactate dehydrogenase (LDH) gene, P. falciparum plasmids were successfully detected under optimal conditions for RPA reaction. For the implementation of RPA on the DMF platform, 0.1% Tween-20 was added to support droplet movement on the chip without interfering with the reaction. The droplet pathway was designed so the system can carry out up to five samples simultaneously on one single DMF device, thus providing a time-efficient point-of-care method for detecting P. falciparum and laying a foundation for developing a simple diagnostic procedure for other diseases.

A multistage Plasmodium CRL4WIG1 ubiquitin ligase is critical for the formation of functional microtubule organization centers in microgametocytes.

Malaria is a mosquito-borne infectious disease caused by unicellular eukaryotic parasites of the Plasmodium genus. Protein ubiquitination by E3 ligases is a critical post-translational modification required for various cellular processes during the lifecycle of Plasmodium parasites. However, little is known about the repertoire and function of these enzymes in Plasmodium. Here, we show that Plasmodium expresses a conserved cullin RING E3 ligase (CRL) complex that is functionally related to CRL4 in other eukaryotes. In P. falciparum asexual blood stages, a cullin-4 scaffold interacts with the RING protein RBX1, the adaptor protein DDB1, and a set of putative receptor proteins that may determine substrate specificity for ubiquitination. These receptor proteins contain WD40-repeat domains and include WD-repeat protein important for gametogenesis 1 (WIG1). This CRL4-related complex is also expressed in P. berghei gametocytes, with WIG1 being the only putative receptor detected in both the schizont and gametocyte stages. WIG1 disruption leads to a complete block in microgamete formation. Proteomic analyses indicate that WIG1 disruption alters proteostasis of ciliary proteins and components of the DNA replication machinery during gametocytogenesis. Further analysis by ultrastructure expansion microscopy (U-ExM) indicates that WIG1-dependent depletion of ciliary proteins is associated with impaired the formation of the microtubule organization centers that coordinate mitosis with axoneme formation and altered DNA replication during microgametogenesis. This work identifies a CRL4-related ubiquitin ligase in Plasmodium that is critical for the formation of microgametes by regulating proteostasis of ciliary and DNA replication proteins.IMPORTANCEPlasmodium parasites undergo fascinating lifecycles with multiple developmental steps, converting into morphologically distinct forms in both their mammalian and mosquito hosts. Protein ubiquitination by ubiquitin ligases emerges as an important post-translational modification required to control multiple developmental stages in Plasmodium. Here, we identify a cullin RING E3 ubiquitin ligase (CRL) complex expressed in the replicating asexual blood stages and in the gametocyte stages that mediate transmission to the mosquito. WIG1, a putative substrate recognition protein of this ligase complex, is essential for the maturation of microgametocytes into microgametes upon ingestion by a mosquito. More specifically, WIG1 is required for proteostasis of ciliary proteins and components of the DNA replication machinery during gametocytogenesis. This requirement is linked to DNA replication and microtubule organization center formation, both critical to the development of flagellated microgametes.

Japanese encephalitis virus: An overview.

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 safety. Until now, there has been a lack of specific therapeutic options for treating JEV infections. In this review article, we provide a comprehensive discussion of JEV's characteristics, diagnostic methodologies, vaccine development efforts, and potential anti-JEV pharmaceuticals to provide insights and references that could be used to inform and enhance strategies for the prevention and control of Japanese encephalitis.

Immunogenicity Analysis of Chikungunya Virus DNA Vaccine Based on Mutated Putative N-Linked Glycosylation Sites of the Envelope Protein.

Chikungunya fever is a mosquito-borne infectious disease caused by the chikungunya virus (CHIKV). Recently, CHIKV has spread rapidly worldwide, raising global concerns. However, there is only one approved vaccine is available to prevent CHIKV infection; therefore, different platform vaccines development is a public health priority. The CHIKV genome encodes four non-structural polyproteins (nsP1-4) and one structural polyprotein (capsid, envelope 3, envelope 2, 6 K, and envelope 1). Previous studies have shown that N-linked glycans in viral proteins play important roles in regulating immune responses. Accordingly, in this study, we designed four CHIKV DNA vaccine candidates with mutated N-glycosylation sites in the full-length E and E I/II proteins. Our results indicated that immunization of mice with the vaccine elevated the cytokines levels, including IFN-γ, associated with T cell immune response. Furthermore, the truncated E protein with a deleted E III domain (E I/II) exhibited better immunogenicity than the full-length E protein, and N-linked glycosylation of E I/II protein induced a higher cell-mediated immune response. Overall, our study demonstrates that N-linked glycosylation of the E I/II proteins of CHIKV significantly enhances cell-mediated immune responses, laying the foundation for the development of potential vaccination strategies against CHIKV.

Phytochemicals of Different Medicinal Herbs as Potential Inhibitors Against Dengue Serotype 2 Virus: A Computational Approach.

Dengue is one of the major mosquito-borne infectious diseases of the present century, reported to affect about 100-400 million people globally. The lack of effective therapeutic options has inspired several in vitro and in silico studies for the search of antivirals. Our previous study revealed the anti-dengue activity of different plant extracts from Plumeria alba, Bacopa monnieri, Vitex negundo, and Ancistrocladus heyneanus. Therefore, the current in silico study was designed to identify the phytochemicals present in the aforementioned plants, which are possibly responsible for the anti-dengue activity. Different plant databases as well as relevant literature were explored to find out the major compounds present in the above-stated plants followed by screening of the retrieved phytochemicals for the assessment of their binding affinity against different dengue viral proteins via molecular docking. The best poses of protein-ligand complexes obtained after molecular docking were selected for the calculation of binding free energy via MM-GBSA method. Based on the highest docking score and binding energy, six complexes were considered for further analysis. To analyze the stability of the complex, 100ns molecular dynamics (MD) simulations were carried out using Desmond module in the Schrodinger suite. The MD simulation analysis showed that four compounds viz. liriodendrin, bacopaside VII, isoorientin, and cynaroside exhibited stability with viral targets including the RdRp, NS3 helicase, and E protein indicating their potential as novel anti-dengue antivirals.

Dynamic analysis and optimal control of a mosquito-borne infectious disease model under the influence of biodiversity dilution effect

In this paper, biodiversity and a saturation treatment rate are introduced into a type of mosquito-borne infectious disease model with an incubation time delay. Through the dynamical analysis of the model, conditions for the existence and stability of disease-free and endemic equilibria are determined. The basic reproduction number of the model is calculated, and the condition for the existence of backward bifurcation is outlined. The study finds that under the dual influence of biodiversity and saturation treatment, the threshold characteristic of the basic reproduction number becomes invalidated. When R0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$R_{0}$\\end{document} is less than 1, the model may exhibit four equilibrium states, with both the disease-free equilibrium and the endemic equilibrium being locally stable. In this scenario, whether the virus will become extinct depends on the initial conditions. The study also finds that when the basic reproduction number R0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$R_{0}$\\end{document} is greater than 1, the stability of the model is influenced by the time delay, with Hopf bifurcation occurring at a specific time delay. In addition, another novel contribution of this paper is the formulation of an optimal control problem that takes into account the minimization of damage caused by humans to biodiversity. Based on the Pontryagin’s maximum principle, the specific characteristics of the optimal control measures are given, and the optimal strategy is derived by comparing five groups of control strategies. The optimal control results highlight the synergistic effect of multiple control measures with biodiversity. Under optimal control, a significant complementary effect between medical inputs and the dilution effect of biodiversity is evident. The findings imply that maintaining high biodiversity levels can decrease the demand for medical resources in mosquito-borne disease control efforts.

Surveillance of the population density of adult Aedes albopictus in Guangdong Province from 2018 to 2023

To investigate the fluctuations in the population density of Aedes albopictus and changes in the population density of Ae. albopictus in different geographical areas and different breeding habitats in Guangdong Province from 2018 to 2023, so as to provide insights into prevention and control of mosquito-borne infectious diseases in the province. Ae. albopictus surveillance sites were assigned in 1 609 townships (streets) from 121 districts (counties) of 21 cities in Guangdong Province during the period between March and November from 2018 to 2023. The surveillance of the population density of Ae. albopictus was performed once a month in each surveillance site, and once a month in specific settings in cities where dengue were highly prevalent in Guangdong Province from December to February of the next year during the period from 2018 through 2023. Four streets (villages) were selected in each surveillance site according to the geographic orientation, and mosquito ovitraps were assigned in gardens, rooftops or public green belts at residential areas, parks, hospitals and construction sites. All mosquito ovitraps were collected, and the mosquito ovitrap index (MOI) was calculated. The population density of Ae. albopictus was classified into four grades in each surveillance site according to MOI, including no risk, low risk, medium risk and high risk. The risk classification of the Ae. albopictus density was analyzed in each surveillance site each year from 2018 to 2023, and the population density of Ae. albopictus was analyzed at different months and in different geographical areas and breeding habitats. A total of 118 241 Ae. albopictus surveillance sites were assigned in 21 cities of Guangdong Province from 2018 to 2023, and there were 68.26% of the surveillance sites with the population density of Ae. albopictus that met the requirements for dengue prevention and control, among which low, medium and high risk surveillance sites accounted for 23.61%, 6.67% and 1.47%. The risk classification of the Ae. albopictus density increased rapidly in Guangdong Province since April to May each year from 2018 to 2023, and then gradually reduced since September to October, with the peak during the period between May and July. The mean MOI was 4.21 at each surveillance site in Guangdong Province during the period from 2018 to 2023, with 4.69, 4.80, 4.38, 3.82, 3.38, and 4.33 from 2018 to 2023, respectively. The MOI was 4.35, 4.43, 3.53 and 3.58 in the Pearl River Delta region, and eastern, western, and northern Guangdong Province, respectively, and was 4.18, 5.44, 4.75, 3.24, 4.27 and 3.70 in residential areas, parks, construction sites, hospitals, waste collection stations, and other breeding habitats, respectively. The population density of adult Ae. albopictus peaked in Guangdong Province during the period between May and July from 2018 to 2023, with a high density of Ae. albopictus in the Pearl River Delta region and eastern Guangdong Province. Targeted Ae. albopictus control measures are recommended to be implemented prior to the peak of the Ae. albopictus population density to reduce the development of mosquito-borne infectious diseases.

Approach from the laboratory to the field: New strategies in the control of mosquito-borne infectious diseases.

Approach from the laboratory to the field: New strategies in the control of mosquito-borne infectious diseases.

The Implications of Malaria in Livestock: Reservoirs, Challenges, and Future Directions

Malaria, a mosquito-borne infectious disease caused by the parasite Plasmodium, has been predominantly associated with humans. However, recent studies have uncovered a potential reservoir for Plasmodium spp., within livestock populations. Malaria, caused by the parasitic protozoan Plasmodium spp., is a deadly disease that affects millions of people worldwide. Although human is the primary host for the malaria parasite, it has been discovered that certain animals can also serve as reservoirs. One such potential reservoir is livestock populations, as they have been found to carry Plasmodium spp. parasites. This article will discuss the implications of livestock being potential reservoirs for malaria and the importance of understanding this relationship for effective disease control. Livestock populations have long been overlooked as potential reservoirs for malaria transmission, but recent advancements in diagnostic techniques and surveillance studies have sparked interest in exploring this field. By prioritizing thorough assessments of zoonotic transmission risks, we can gain valuable insights into the role of livestock in malaria transmission and develop effective strategies to reduce the burden of this devastating disease.

Generation of soluble, immunoreactive recombinant JEV E protein through a simplified inclusion body extraction and refolding approach in vitro

Japanese encephalitis (JE) is a mosquito-borne infectious disease caused by the Japanese encephalitis virus (JEV). There is currently no effective treatment for JE, and all approved Japanese encephalitis vaccine products originated from the JEV genotype III (GIII). In recent years, JEV genotype I (GI) has gradually replaced GIII as the dominant genotype, and a new symptom of peripheral nerve injury (PNI) caused by JEV NX1889 strain has attracted wide attention, in which JEV envelope (E) protein may be involved in early peripheral nerve injury. Here, the envelope (E) gene of JEV GIb, NX1889 strain was cloned into pET-32a (+) plasmid, and then the E protein was successfully expressed as the high-yield inclusion body form in Escherichia coli (E. coli) BL21 (DE3). Subsequently, we successfully developed a simplified approach to generate soluble JEV E protein by solubilization, and a stepwise dialysis refolding approach with the introduction of a redox system. The refolding recombinant E protein was identified by anti-JEV-E polyclonal antibody and the serum anti-E titer of mice immunized with refolded E protein was higher than 1: 409,600, which proves it has highly immunoreactive. Moreover, the recombinant E protein could recognize antibodies in samples of multiple species and types, such as mice, rabbits, and humans. The approach described above is economical and does not require complex eukaryotic expression systems to produce immunoreactive JEV E protein, which may be of great significance for the diagnosis and pathogenesis of JEV GI strain.

Design and evaluation of an efficient mosquito trap.

Vector mosquito control is important for preventing and controlling mosquito-borne infectious diseases. This study designed and developed a mosquito killer (MK) with a specific light wavelength, simulated human body temperature, human odor, and a photocatalyst to stimulate CO2 based on the physiological characteristics and ecological habits of mosquitoes. We tested the trapping effect of individual and multiple mosquito-trapping elements of the MK through two-way selection experiments and compared them with several commercial mosquito traps. The 365 nm wavelength MK was significantly more effective than the 395 nm (Cx. quinquefasciatus: 62.00% vs. 34.25%; Ae. albopictus: 50.75% vs 45.00%, An. sinensis: 49.75% vs 39.00%). Mosquitoes captured by the MK with heaters at 365 nm were significantly more than those captured by the MK without heaters at 365 nm. A trap with a 365 nm wavelength, heating element, and lure showed significantly better capture effectiveness than MK with a 365 nm wavelength, heating element, but without lure (Cx. quinquefasciatus: 67.00% vs. 29.75%, Ae. albopictus: 60.25% vs 36.25%, An. sinensis: 49.75% vs 39.75%). The coated photocatalyst trap with a 365 nm wavelength, heating element, and lure showed significantly better capture effectiveness than the trap without coating (Cx. quinquefasciatus: 54.25% vs. 42.50%; Ae. albopictus: 53.50% vs 44.00%, An. sinensis: 50.00% vs 41.25%). This trap demonstrated a significantly better capture advantage for Cx. quinquefasciatus and Ae. albopictus compared to the three commercial products. The developed mosquito trap with multiple attractant factors significantly enhanced the capture effectiveness of common mosquitoes. © 2024 Society of Chemical Industry.

Long-term effects of climate factors on dengue fever over a 40-year period

BackgroundDengue fever stands as one of the most extensively disseminated mosquito-borne infectious diseases worldwide. While numerous studies have investigated its influencing factors, a gap remains in long-term analysis, impeding the identification of temporal patterns, periodicity in transmission, and the development of effective prevention and control strategies. Thus, we aim to analyze the periodicity of dengue fever incidence and explore the association between various climate factors and the disease over an extended time series.MethodsBy utilizing monthly dengue fever cases and climate data spanning four decades (1978–2018) in Guangdong province, China, we employed wavelet analysis to detect dengue fever periodicity and analyze the time-lag relationship with climate factors. Additionally, Geodetector q statistic was employed to quantify the explanatory power of each climate factor and assess interaction effects.ResultsOur findings revealed a prolonged transmission period of dengue fever over the 40-year period, transitioning from August to November in the 1970s to nearly year-round in the 2010s. Moreover, we observed lags of 1.5, 3.5, and 3 months between dengue fever and temperature, relative humidity, and precipitation, respectively. The explanatory power of precipitation, temperature, relative humidity, and the Oceanic Niño Index (ONI) on dengue fever was determined to be 18.19%, 12.04%, 11.37%, and 5.17%, respectively. Dengue fever exhibited susceptibility to various climate factors, with notable nonlinear enhancement arising from the interaction of any two variables. Notably, the interaction between precipitation and humidity yielded the most significant effect, accounting for an explanatory power of 75.32%.ConclusionsConsequently, future prevention and control strategies for dengue fever should take into account these climate changes and formulate corresponding measures accordingly. In regions experiencing the onset of high temperatures, humidity, and precipitation, it is imperative to initiate mosquito prevention and control measures within a specific window period of 1.5 months.

Green synthesized silver nanoparticles of Terminalia bellirica leaves extract: synthesis, characterization, in-silico studies, and antimalarial activity

Malaria is a mosquito-borne infectious disease that is caused by the Plasmodium parasite. Most of the available medication are losing their efficacy. Therefore, it is crucial to create fresh leads to combat malaria. Green silver nanoparticles (AgNPs) have recently attracted a lot of attention in biomedical research. As a result, green mediated AgNPs from leaves of Terminalia bellirica, a medicinal plant with purported antimalarial effects, were used in this investigation. Initially, cysteine-rich proteins from Plasmodium species were studied in silico as potential therapeutic targets. With docking scores between −9.93 and −11.25 kcal/mol, four leaf constituents of Terminalia bellirica were identified. The green mediated silver nanoparticles were afterward produced using leaf extract and were further examined using UV-vis spectrophotometer, DLS, Zeta potential, FTIR, XRD, and FESEM. The size of synthesized TBL-AgNPs was validated by the FESEM results; the average size of TBL-AgNPs was around 44.05 nm. The zeta potential study also supported green mediated AgNPs stability. Additionally, Plasmodium falciparum (3D7) cultures were used to assess the antimalarial efficacy, and green mediated AgNPs could effectively inhibit the parasitized red blood cells (pRBCs). In conclusion, this novel class of AgNPs may be used as a potential therapeutic replacement for the treatment of malaria.

While the priest climbs a post, the devil climbs ten: major biological threats from parasite and vector to malaria control and elimination

Malaria is one of the most serious mosquito-borne infectious diseases in the world. The global malaria control progress has stalled in recent years, which is largely due to the biological threats from the malaria pathogen Plasmodium and the vector Anopheles mosquitoes. This article provides an overview of biological threats to global malaria elimination, including antimalarial drug resistance, deletions in the malaria rapid diagnostic test target P. falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes, vector insecticide resistance and emergence of invasive vector species, so as to provide insights into malaria and vector research and the formulation and adjustment of the malaria control and elimination strategy.

Medicinal Plants Used in Sri Lankan Traditional Medicine for Dengue Fever

Dengue fever, a mosquito-borne viral infectious disease caused by the dengue virus, is a significant global health concern, especially in tropical and subtropical regions. Despite preventive efforts, Sri Lanka faces recurring dengue outbreaks, with the Western province being the most affected. Current treatments primarily focus on supportive care, as specific antiviral therapies remain elusive. This review presents an overview of dengue, its clinical presentations, the dengue burden in Sri Lanka, and the potential of Sri Lankan medicinal plants used in traditional medicine for treating dengue. Several plants, such as Munronia pinnata, Azardirachta indica, Cissampelos pareira L., Carica papaya, Zingiber officinale, Curcuma longa, and Bambusa vulgaris, show antiviral properties against dengue. The utilization of these medicinal plants in dengue treatment could offer a promising avenue for further research and drug development.

Dengue Hemorrhagic Fever: Risk Factors in Pakistani Cohort

Background: Dengue fever is a mosquito-borne infectious disease with potential complications such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) and has fatality risk of greater than 20% if left untreated. There is lot of heterogeneity in factors predicting development of DHF in different populations. Objective: To determine clinical, biochemical and radiological parameters associated with risk of developing DHF in Pakistani population. Methods: This prospective observational study was conducted in Jinnah Hospital Lahore from October 2022 to December 2022. 180 patients with confirmed Dengue fever were included. Detailed history, clinical examination and laboratory/radiological investigations were performed. Patients were followed for development of DHF. Univariate analysis followed by logistic regression analysis was used to determine independent predictors for DHF. Results: Among 180 patients with Dengue fever with mean age of 33.04 (+14.12) and male to female ratio of 1.53/1 (109/71), we identified presence of mucosal bleeding {OR 4.7 (95% CI 2.05-10.78)p value <0.000}, abdominal pain {OR 2.73 (95% CI 1.17-4.38)p value 0.013}, persistent vomiting {OR 3.09 (95% CI 1.51-6.34)p value 0.002}, tender right hypochondrium {OR 3.98 (95% CI 1.94-8.16) p value <0.000} and presence of peri-cholecystic fluid {OR 7.78 (95% CI 3.25-18.63)p value < 0.000} to be significantly associated with risk of developing DHF with 83.6% accuracy on logistic regression analysis. Conclusion: Mucosal bleeding, right hypochondrium pain, persistent vomiting and presence of peri-cholecystic fluid in a patient of dengue fever predict risk of developing dengue hemorrhagic fever.