Every year, millions of people are infected with malaria, resulting in significant economic losses to the developing and developed nations. The malaria parasite pursues a complicated life cycle in an invertebrate, mosquito and vertebrate host with several distinct stages. In the human host, it invades the liver and red blood cells to complete its life cycle. It is surprising that not only these two organs are under pressure and exhibit functional abnormalities; a large number of clinical studies also support the notion that malaria parasite propagation in the host affects several other organs and modulates functional outcomes of individual cells. Moreover, patients recovered from severe malaria may suffer throughout their life from impairments in organ function such as loss of eyesight, kidney failure, and much more. Thus, malaria infection leads to several pathological outcomes involving different organs and individual cells in the host. The sole purpose of the present article was to give an overview of pathological outcomes during severe malaria along with their molecular mechanisms. A large proportion of deaths associated with disease is contributed by the pathological effect in host due to parasite propagation and toxicity of antimalarials or combination of both. Hence, there is a need, not only to develop antiparasitic agents but also to discover lead molecules to take care of pathophysiological effects in the host. This may help a beginner to get involved with the topic and initiate research work towards improving adjuvant therapy or avoiding serious complications.

A comprehensive understanding of the geographic distribution of the tick-borne encephalitis virus (TBEV) complex is necessary due to increasing transboundary movement and cross-reactivity of serological tests. This review was conducted to identify the geographic distribution of the TBEV complex, including TBE virus, Alkhurma haemorrhagic fever virus, Kyasanur forest disease virus, louping-ill virus, Omsk haemorrhagic fever virus, and Powassan virus. Published reports were identified using PubMed, EMBASE, and the Cochrane library. In addition to TBEV complex case-related studies, seroprevalence studies were also retrieved to assess the risk of TBEV complex infection. Among 1406 search results, 314 articles met the inclusion criteria. The following countries, which are known to TBEV epidemic region, had conducted national surveillance studies: Austria, China, Czech, Denmark, Estonia, Finland, Germany, Hungary, Italy, Latvia, Norway, Poland, Romania, Russia, Switzerland, Sweden, Slovenia, and Slovakia. There were also studies/reports on human TBEV infection from Belarus, Bulgaria, Croatia, France, Japan, Kyrgyzstan, Netherland, and Turkey. Seroprevalence studies were found in some areas far from the TBEV belt, specifically Malaysia, Comoros, Djibouti, and Kenya. Kyasanur forest disease virus was reported in southwestern India and Yunnan of China, the Powassan virus in the United States, Canada, and east Siberia, Alkhurma haemorrhagic fever virus in Saudi Arabia and east Egypt, and Louping-ill virus in the United Kingdom, Ireland, and east Siberia. In some areas, the distribution of the TBEV complex overlaps with that of other viruses, and caution is recommended during serologic diagnosis. The geographic distribution of the TBEV complex appears to be wide and overlap of the TBE virus complex with other viruses was observed in some areas. Knowledge of the geographical distribution of the TBEV complex could help avoid cross-reactivity during the serologic diagnosis of these viruses. Surveillance studies can implement effective control measures according to the distribution pattern of these viruses.

Background & objectives: Visceral leishmaniasis or kala-azar is a fatal protozoan disease caused by an obligate intracellular parasite, Leishmania donovani. Susceptibility, establishment of infection and severity of this disease depend upon many factors, but it is the host immune system that plays decisive role in disease progression. Keeping this view into consideration, we investigated the probable relationship between polymorphisms rs2275913 and rs8193036 in IL-17 gene, and its association as a risk factor for kala-azar in an endemic population of Assam, India. Methods: A total of 209 subjects, 76 kala-azar cases (male: 46, female: 30, mean age ± SD: 34.60 ± 12.61) and 133 controls (male: 66, female: 67, mean age ± SD: 33.35 ± 14.48) were included in this study. We analysed the polymorphisms, rs2275913 and rs8193036 by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The data were analysed using logistic regression analysis and SPSS software. Results: The results revealed that the mutant rs8193036 TT genotype conferred 4.7-fold higher risk for kala-azar (p = 0.00991, OR = 4.72, 95% CI = 1.330–16.911). A significant difference was found between the allele frequencies of rs8193036 (p = 0.029, OR = 1.64, 95% CI = 1.04–2.57) when comparisons were done using the genetic models of association. When stratification analysis was done on the basis of active and past cases we found that during active infection rs2275913 A allele was significantly associated with increased risk of kala-azar (p = 0.016, OR = 3.95, 95% CI = 1.21–12.87). Interpretation & conclusion: The findings revealed that IL-17 genetic variant, rs8193036 is an independent risk factor for kala-azar infection and may contribute in pathogenesis of the disease. Further, rs2275913 polymorphism of IL-17 gene is associated with kala-azar during active infection.

Background and objectives: India is an endemic country for lymphatic filariasis (LF). There are no current estimates of the expenditure being borne by LF patients in case of outpatient care or hospitalisation and its impact on households. This study aimed to estimate the household out-of-pocket (OOP) expenditure due to hospitalization or outpatient care as a result of LF in India. Methods: Secondary analysis of nationally representative data for India collected by the National Sample Survey Organization in 2014 was performed, reporting on health service utilization and health care related OOP expenditure by income quintiles and by type of health facility (public or private). Results: The median household OOP expenditure from hospitalization and outpatient care due to LF was US$ 178 and US$ 04, respectively; and was more than two times higher among the richest group compared to the poorest. There was a significantly higher proportion of households affected by catastrophic costs among the rich (30%) compared to the poor households (18%) due to hospitalization. Median private sector OOP hospitalization expenditure was nearly four times higher than the public sector. Less than one-fourth of outpatient visits (22%) were in the public sector. The median expenditure on medicines and indirect cost were US$ 32 (IQR: 17–84) and US$ 23 (IQR: 9–59), respectively in case of hospitalization due to LF; while in case of outpatient care these were US$ 1.5 (IQR: 0–5.8) and US$ 1.5 (IQR: 0–4), respectively. Interpretation & conclusion: Households with LF incur huge cost of patient care, particularly those in the lowest income group and those seeking care in the private sector.

Background & objectives: West Nile virus (WNV) is a positive-sense, single-stranded RNA virion, that belongs to the Flaviviridae family. This virus is preserved in a bird-mosquito cycle that is capable of inducing diseases as a dead-end or endpoint host in humans as well as horses. In 2016, a suspicious case of crow population death was reported by the Department of Environment, Ministry of Health, Iran. Considering the mass migration of birds together with the WNV-related symptoms, including uncoordinated walking, ataxia, inability to fly, lack of awareness, and abnormal body posture, it was necessary to further investigate the possible causes of this incident. The objective of this study was molecular detection of WNV in crows utilizing the real-time PCR method in the northern provinces of Iran. Methods: A total of 12 crows (8 dead, 4 alive) with a possible WNV infection, were collected from the northern provinces of Iran (Golestan, Mazandaran, and Guilan). A tissue sample of the liver, kidney, or lung was collected from all the crows, and RNA was isolated using an RNA extraction kit. A one-step real-time PCR method using a TaqMan probe was used for virus detection. Results: All the infected crows were positive for WNV. The 132-bp real-time PCR amplicon of the genome was detected in all the samples. Comparative phylogenetic analysis revealed that WNV isolated from Iran clustered with strains from the USA, Hungary, and Culex pipiens. Interpretation & conclusion: The WNV genome sequence was detected in all the infected crows. The results confirmed the connection of this isolation with clade1a strains. Hence, determining the epidemiologic and prevalence characteristics of the WNV for transmission control is of critical importance in Iran.

Background & objectives: Rickettsial and other zoonotic diseases are a latent risk for workers of veterinary clinics. The objective of this study was to evaluate the prevalence and the associated risk factors of parasitosis caused by Rhipicephalus sanguineus, and to estimate the seroprevalence of rickettsial diseases in workers of urban veterinary clinics of Juárez city, México. Methods: The participants of the study were recruited from 63 private veterinary clinics and hospitals. The serological analysis of the blood samples collected was carried out using immunofluorescence assay (IFA). The statistical analysis for prevalences, risk factors, and correlation was performed with the SAS program. Results: In total, 167 veterinary workers were included in the study. The prevalence of tick bites was 40% (67/167), and the risk factors associated with the occurrence of bites included the activities performed in the clinic and the number of labour hours spent per week. About 21% (35/167) of participants were seropositive to R. rickettsii, 28% (47/167) to Ehrlichia chaffeensis, and 24% (40/167) to Anaplasma phagocytophilum. A correlation was observed between: the number of workers in the clinics and the proportion of tick bites (r² = 0.865); the prevalence of bites and the seropositivity of the participants to at least one pathogen (r² = 0.924); and the number of bites per individual and infection to pathogens (r² = 0.838). Interpretation & conclusion: Workers in urban veterinary clinics are highly exposed to tick bites and, therefore, to the diseases they transmit. Hence, it is important to implement prevention measures and perform constant monitoring of these diseases.

Background & objectives: Insecticides are the most important means of controlling pests in Iran especially for Culex pipiens complex species. The rational use of insecticides largely depends on understanding the susceptibility levels of these species. The study was designed to determine the susceptibility levels of Cx. pipiens complex (field and insectary strains) to various insecticides in the city of Tehran. Methods: The mortality rates of the field strain of Cx. pipiens complex after different exposure times to DDT (4%), bendiocarb (0.1%), propoxur (0.1%), malathion (5%), fenitrothion (1.0%), permethrin (0.75%), deltamethrin (0.05%), lambda-cyhalothrin (0.05%), etofenprox (0.5%), and cyfluthrin (0.15%) were determined. The mortality rates at the lethal time 50% (LT₅₀) and lethal time 90% (LT₉₀) values were calculated by plotting the regression line using Microsoft Office Excel software. Results: The mortality rates of the Cx. pipiens complex after 1 h exposure to the diagnostic doses of DDT (4%), bendiocarb (0.1%), propoxur (0.1%), malathion (5%), fenitrothion (1.0%), permethrin (0.75%), deltamethrin (0.05%), lambda-cyhalothrin (0.05%), etofenprox (0.5%), and cyfluthrin (0.15%) were 12, 58, 54, 82, 54, 34, 49, 40, 17, and 44%, respectively. According to the WHO classification of susceptibility levels, both field and insectary strains of Cx. pipiens complex in Tehran were resistant to these insecticides. Interpretation & conclusion: The results of this study showed that field Cx. pipiens complex is resistant to all the groups of insecticides used.

Background & objectives: Leishmania major and L. tropica are the main pathogens of cutaneous leishmaniasis (CL) in several rural and some urban regions of Iran, respectively. The aim of this study was to detect Leishmania species, and update the distribution data of these species in humans suspected to CL in two endemic foci in southern Iran. Methods: From March 2016 to March 2017, 276 positive samples from of 350 suspected cases were diagnosed and compared by different diagnostic methods, viz. microscopy, culture, and PCR. In PCR assay, four different gene identifications were performed including minicircle kDNA, and cysteine protease B genes for Leishmania detection, and glyceraldehyde-3-phosphate dehydrogenase, and internal transcribed spacer 1 genes for Crithidia detection. Results: In total, 68% (235/350) and 65.3% (177/271) of patients suspected of leishmaniasis were positive by microscopy and cultivation methods. In PCR assay, L. major, and L. tropica were detected in 86.2% (238/276), and 13.1% (36/276) of CL cases, respectively. Also, dermal L. infantum strain was isolated from 0.7% (2/276) of post-kala-azar dermal leishmaniasis patients. In addition, Crithidia fasciculata was detected in two CL patients chronically infected with L. major. Interpretation & conclusion: It appears that the epidemiology of CL has changed during the last decades and can complicate the control strategy aspects of CL in southern Iran. Therefore, more epidemiological, ecological, and gene polymorphism studies are needed to understand the pathogenic role of these species in human, as a main host of leishmaniasis in Iran.

Background & objectives: Dengue and chikungunya are two mosquito-borne viral diseases transmitted by Aedes mosquito species and are a great public health concern in India. The present study was aimed to check the influence of antagonistic crustaceans, especially Mesocyclops aspericornis and Daphnia magna on Ae. aegypti L. mosquito population. Method: Variable ratios of these crustaceans (Aedes: Mesocyclops: Daphnia) against Ae. aegypti larvae were tested by putting them in plastic beakers having dechlorinated water along with yeast stock solution provided as food, and kept in BOD incubator at a temperature of 26 ±1°C. Results: Out of all tested concentrations, 1:1:3 where the number of D. magna was thrice the number of Mesocyclops and Aedes; larvae showed a significant delay of 5–6 days in the developmental period. Maximum reduction in the emergence of females was recorded in the ratio 1:1:3, i.e. only 6.5 ± 0.47 females emerged when Daphnia used thrice the number of Aedes larvae. Body size of both males and females emerged from treated sets was found to be significantly reduced. The longevity of adults was also reduced from 8–17 days to 5–8 days in the case of males and from 14–26 days to 5–9 days in females. Interpretation & conclusion: Among variable ratios tested under laboratory conditions, 1:1:2 and 1:1:3 ratios were found to be the effective ratios that greatly reduced the development duration, survivorship of larvae, and the number of larvae emerging into adulthood. Thus, antagonistic crustaceans specifically Mesocyclops and Daphnia can be used as biocontrol agents for the sustainable control of container breeding mosquitoes.

Background & objectives: Mosquitoes are vectors of several important vector-borne diseases (VBDs) like malaria, dengue, chikungunya, Japanese encephalitis (JE) and lymphatic filariasis (LF). Globally, these VBDs are of major public health concern including India. The information on vector mosquitoes from Thiruvarur district in Tamil Nadu state remains largely either unknown or undocumented. The present study was, therefore, undertaken to find out the seasonal variation in mosquitoes with special reference to dengue vectors in rural areas of Thiruvarur district, Tamil Nadu, India. Methods: Surveillance of immature vector mosquitoes was undertaken from March 2018 to February 2019. The emerged adults were identified to find out the composition of mosquito species prevalent in the district. The seasonal variations of the mosquitoes especially dengue vectors were analysed for summer (March–July) spring (August–November) and winter (December–February) seasons in all the blocks of Thiruvarur district. Results: A total of 4879 mosquitoes emerged from the immature collection and the species identification revealed the prevalence of both vector and non-vector species. Five important mosquito vectors collected were —Aedes albopictus, Ae. aegypti, Culex tritaeniorhynchus, Cx. gelidus, and Cx. quinquefasciatus. Other mosquito species collected were Lutzia fuscana, Anopheles barbirostris, An. subpictus, and Armigeres (Armigeres) subalbatus. During the spring season, the dengue vectors showed high indices of breateau index (BI), ranging from 16 to 120; besides, container index (CI) ranging from14.29 to 68.57 and pupal index (PI) from 53.33 to 295 among the study blocks. The major breeding sites were discarded plastic containers, discarded tyres, open sintex tanks (water storage tanks), cement tanks, discarded fibre box, pleated plastic sheets, tree holes, bamboo cut stumps, coconut spathe, and coconut shells. Interpretation & conclusion: The immature vector surveillance revealed seasonal variations in the entomological indices of Aedes breeding potential. The high indices observed indicate high Aedes breeding density and, therefore, a higher risk for dengue/chikungunya outbreaks in rural areas of Thiruvarur district. The present finding warrants intensive surveillance and follow up vector control measures to avert outbreaks and prevent vector-borne diseases. Health education and the community participation in awareness camps prior to monsoon and societal commitment will help in strengthening source reduction, anti-larval operations and anti-adult measures to tackle vector-borne diseases especially dengue.

Background & objectives: Cutaneous leishmaniasis (CL) in Marrakesh-Safi region located in the central-south part of Morocco is a public health problem. This study assessed the efficiency of a microscopic examination method in establishing the diagnosis of CL and PCR for the characterization and identification of the circulating Leishmania strains in different CL foci of the study area. Methods: A total of 297 smears obtained from cutaneous lesions of suspected patients with CL were stained with May-Grünwald Giemsa (MGG) for microscopic examination. For each positive smear, genomic DNA was extracted and PCR-analysed, targeting the small subunit ribosomal ribonucleic acid (ssu rRNA) gene to detect Leishmania DNA. Then, the internal transcribed spacer 1 (ITS1) was amplified and sequenced in order to identify the Leishmania species. The sensitivity and specificity of the conventional microscopy with ssu rRNA gene were compared by Leishmania nested PCR (LnPCR) and ITS1 gene by ITS-PCR. Results: A total of 257 smears were positive in the microscopic examination, i.e. the detection rate of amastigotes by optical microscopy was 86.53% (257/297). The LnPCR was found to have a specificity and a sensitivity of 100%, each. Interestingly, the sequencing results showed that 99.61% (256/257) of the isolates had Leishmania tropica and 0.39% (1/257) had L. infantum infection. Interpretation & conclusion: Though, classical microscopic examination is useful and economical, it is not sensitive enough, especially in endemic regions where several Leishmania species coexist. In such situations, PCR constitutes a complementary method for the identification of the causal species. The results indicate that both the L. tropica (dominant) and L. infantum are the causative agents of CL in the Marrakesh-Safi region. The rate of CL infection is high in Imintanout, and Chichaoua provinces. Hence, early diagnosis and prompt treatment of CL patients is necessary to prevent its extension to neighboring localities.

Background & objectives: Pentavalent antimonials are the standard treatment for cutaneous leishmaniasis (CL), however, treatment failures are frequent. Nimodipine, a calcium channel blocker is known to show promising antiprotozoal effects. Here, we investigated the antileishmanial effect of Nimodipine in both in vitro and in vivo BALB/c mice model of CL. We also compared the in vivo effect with amphotericin B and meglumine antimoniate in the experimental CL mice model. Methods: Colorimetric alamar blue assay and J774 A.1 mouse macrophage cells were used to determine the effect of nimodipine on promastigotes and amastigotes viability, respectively. Then, the in vivo activity of nimodipine was compared to that of conventional therapies in both the early and established courses of Leishmania major infection in susceptible non-healing BALB/c mice. Results: Nimodipine was highly active against promastigotes and amastigotes of L. major with IC₅₀ values of 49.40 and 15.03 μM, respectively. In the early model, the combination therapy with meglumine antimoniate and nimodipine showed no parasites in the spleen or footpad of animals. The footpad thickness was significantly lower in mice treated with either nimodipine (1 mg/kg or 2.5 mg/kg) or amphotericin B compared to the control group in the established lesions model. However, no complete remission was observed in the footpad lesion of any of the treatment groups (nimodipine, amphotericin B, meglumine antimoniate, and combination therapy). Interpretation & conclusion: The effect of nimodipine was comparable to that of amphotericin B and meglumine antimoniate in early and established CL lesion models. Since nimodipine is more cost-effective than conventional therapies, our results merit further investigation in other animal models and voluntary human subjects.

Background & objectives: Understanding the effect of biotic and abiotic factors on the biology and ecology of immature stages of anopheline larvae is very important in controlling malaria vector mosquitoes. Therefore, this study was focused on the monitoring of ecological factors affecting the distribution, dynamics, and density of malaria vector mosquitoes in the District of Trincomalee, Sri Lanka. Methods: Permanent and temporary breeding habitats were identified and selected from five possible malaria sensitive sites in the district of Trincomalee. Anopheles larvae and macro-invertebrates were collected using standard methods for 16 months (from October 2013 to January 2015) and they were identified microscopically. Eight physico-chemical parameters of the breeding habitats were measured. Results: Overall, a total of 4815 anopheline larvae belonging to 13 species were collected from 3,12,764 dips from 18 permanent and temporary breeding habitats. The abundance of anopheline larvae showed a significant positive correlation (p <0.05) with physico-chemical parameters in breeding habitats, such as temperature, dissolved oxygen, and turbidity. A total of 35 macro-invertebrate taxa were collected from the anopheline mosquito breeding habitats. Interpretation & conclusion: This study represents the first systematic update of water quality parameters, macro-invertebrate communities associated with Anopheles mosquito oviposition sites in the District of Trincomalee, Sri Lanka. Rainfall intensity and wind speed are critical meteorological factors for the distribution and abundance of malaria vectors. Knowledge generated on the ecology of Anopheles mosquitoes will help to eliminate malaria vectors in the country.

Background & objectives: Sikkim is a part of Eastern Himalayan biodiversity hotspot of India rich in bamboo flora harbouring over 30 different bamboo species. The present study was aimed to investigate the larval mosquito diversity in the bamboo stumps of Gangtok, Sikkim. Besides, efforts were also made to evaluate the propensity of particular species of mosquito towards specific bamboo species (if any). Methods: A total of 75 bamboo stumps of four genera were surveyed and screened at five different sampling sites of Gangtok from July to October 2017. Mosquito species similarity between the five sampling sites and the four varieties of bamboo species was calculated using the Bray-Curtis similarity index. Results: A total of 216 larvae were collected from 25 different bamboo stumps studied. The species identified were Aedes albopictus, Ae. atlanticus, Ae. aegypti, Orthopodomyia signifera, Oclerotatus japonicus, Oc. taeniorhynchus, Armigeres subalbatus, and Toxorhynchites splendens. The Oc. japonicus (34.5%) was found to be the most abundant species having distribution in Phyllostachys assamica, Dendrocalamus hamiltonii and Bambusa nutans. On the other hand, genus Armigeres subalbatus and Tx. splendens were found to breed only in the stumps of P. assamica. Based on Bray-Curtis similarity index highest species similarity was recorded between D. hamiltonii and P. assamica bamboo species. Interpretation & conclusion: The study may help to understand the bioecology of the mosquito larvae which may help to devise suitable mosquito control programmes. Future studies including the survey of large number of bamboo stumps both in urban and rural areas of Sikkim may provide better insight into the mosquito diversity in the bamboo stumps of Sikkim.