Dengue poses a growing threat in endemic countries where industrial expansion intersects with Aedes vector-breeding habitats. Factories and manufacturing premises often generate a multitude of unmanaged water-holding containers-including water storage tanks, machinery components, landscaping features, and recyclable waste-that favor perennial reservoirs for Aedes aegypti vectors. Despite substantial public health burdens, occupational dengue prevention in the workplace remains largely reactive, fragmented, and insufficiently aligned with safety, health, and environment (SHE) management systems. This narrative review synthesizes evidence on dengue epidemiology in industrial contexts, larval source ecology in factory environments, workers' dengue risk perception, and the regulatory landscape governing occupational health in dengue-endemic countries. Drawing on these evidence domains, we propose the conceptual foundations of a proactive "Dengue-Free Factory Assessment Framework" (D-FAF) designed to prevent and reduce Ae. aegypti breeding and high dengue risk in workplaces in industrial areas, safeguard employee health, minimize work loss, and achieve a sustained reduction in dengue incidence. The framework integrates the "Plan-Do-Check-Act" (PDCA) logic of ISO 45001 and ISO 14001 into a scalable, standards-aligned tool applicable across diverse industrial sectors in dengue high-risk areas.
Meropenem is a broad-spectrum carbapenem antibiotic essential for treating serious infections including urinary tract infections, pneumonia, sepsis, and meningitis. This narrative review examines meropenem resistance trends and prescribing practices for severe infections in Pakistan highlighting how inappropriate use drives local antimicrobial resistance. Relevant literature was identified through a structured search of PubMed, Scopus, Web of Science, and Google Scholar using predefined keywords. Antimicrobial resistance (AMR) is a global health crisis that complicates treatment of infections caused by multidrug-resistant Gram-negative pathogens, including Acinetobacter baumannii, Klebsiella pneumoniae, and E. coli. Pharmacokinetic studies of meropenem show extensive tissue penetration, time-dependent bactericidal activity, and rapid renal clearance, which contribute to its effectiveness. In critically ill patients, specialized dosing strategies like continuous or extended infusions are recommended to maintain adequate drug levels. Emerging evidence also supports combination therapies (e.g., pairing meropenem with fosfomycin) to improve outcomes against carbapenem-resistant strains. In Pakistan, these concerns are especially acute: many key pathogens show high resistance rates due to widespread antibiotic overuse and misuse. Regional surveillance indicates that E. coli often remains relatively sensitive to meropenem, whereas Acinetobacter species exhibit alarmingly low susceptibility. Such resistance largely stems from the spread of extended-spectrum beta-lactamases (ESBLs) and carbapenemase-producing organisms, posing serious challenges to clinicians. This underscores the need for data-driven, context-specific strategies to guide therapy. Robust surveillance systems are needed to guide empirical therapy, and real-time resistance monitoring can help prevent treatment failures. The review emphasizes targeted antimicrobial strategies and judicious meropenem use. Ongoing education for healthcare providers and coordinated stewardship programs at local and national levels are also essential to preserve the antibiotic’s clinical utility. Ultimately, sustaining meropenem’s effectiveness in the face of rising AMR requires combined public health efforts, including tailored dosing protocols and localized resistance management, to keep meropenem a reliable option worldwide for treating life-threatening infections.
In early March 2020, the World Health Organization (WHO) declared COVID‐19 a pandemic. In South Africa, the first case was confirmed in early March 2020. According to the WHO, disruptions in essential services due to the COVID‐19 pandemic occurred worldwide. The COVID‐19 pandemic affected access to maternal and child health (MCH) services in many countries, including South Africa. The study aimed to map and describe the existing evidence on the impact of the COVID‐19 pandemic on the access to and delivery of maternal, neonatal, and child health (MNCH) services in South Africa. This was a scoping review of studies published between 2020 and 2023. We searched databases such as PubMed, MEDLINE, EBSCOhost, and Google Scholar. Data were exported to the Rayyan software, where screening, checking of duplicates, and selection of final studies for review were performed. The information from the identified studies was exported to ATLAS.ti 23.1 software for analysis. Content analysis was performed, and data were presented in predetermined themes using the MCH cascade. The results from 25 articles showed a mixed view, whereby some studies showed a decrease at the beginning of the pandemic in April 2020, in the uptake of family planning, antenatal care, labor and delivery, postnatal care, under‐five immunizations, and cervical cancer screening services. However, other studies found increased uptake of family planning, antenatal care, labor and delivery, and under‐five immunization services. Some studies showed resilience in the overall first antenatal visits, adolescents’ visits to family planning, and postnatal care, as they remained constant. The findings show both positive and negative impacts of the COVID‐19 pandemic on MNCH services in South Africa. While the pandemic significantly disrupted access to essential services, some areas demonstrated resilience, with increased visits for antenatal care, adolescent family planning, and postnatal services. These insights are critical for guiding decision‐makers, health managers, and frontline healthcare workers in preparing for future public health emergencies. Ensuring continuity of MNCH services during crises must be a priority. Strengthening the health system and building resilience are essential to safeguard MCH, even in the face of disruptions.
Trypanosomatids, including the genera Trypanosoma and Leishmania, are protozoan parasites of significant medical and veterinary relevance. These organisms cause African trypanosomiasis, Chagas disease, and leishmaniasis, which are classified as neglected tropical diseases (NTDs). NTDs continue to present major public health challenges, particularly in sub-Saharan Africa, Latin America, and parts of Asia, resulting in substantial morbidity, mortality, and socioeconomic impacts. Chemotherapeutic interventions remain constrained by toxicity, high cost, limited accessibility, and the increasing prevalence of drug resistance. Significantly, there is a tight relationship between pathogenesis and drug resistance because processes that facilitate intracellular persistence, immunological evasion, and metabolic adaptation can also decrease drug sensitivity and increase treatment failure. This interaction makes it easier for more pathogenic and resilient strains to arise, which makes disease treatment and control more difficult. The absence of effective vaccines underscores the urgent need for novel therapeutic strategies. Advances in molecular parasitology have elucidated unique organellar structures, immune evasion mechanisms, and metabolic pathways in trypanosomatids, providing new therapeutic targets. Additionally, artificial intelligence and computational methodologies are facilitating drug discovery, predicting resistance, and improving diagnostics. In this review, we provide a narrative overview of current knowledge of trypanosomatid biology, prevalence, drug resistance mechanisms, and emerging control strategies. By integrating classical parasitology with computational approaches, new opportunities are identified to address resistance, enhance therapy, and mitigate the global health burden of trypanosomatid infections.
Background:Healthcare-associated infections (HAIs) pose a significant threat to patient safety in Belize, with prevalence rates far exceeding global averages. Allied health students represent the future frontline in infection prevention, yet their preparedness in high-burden, resource-limited settings like Belize-where HAI prevalence approaches 40%-remains unassessed. This study aimed to conduct the first multidimensional analysis of the knowledge, attitudes, and preventive practices (KAP) regarding HAIs among allied health students at the University of Belize (UB). Methods:A descriptive cross-sectional study was conducted among 210 randomly selected nursing, pharmacy, and medical laboratory science students, yielding an 85% response rate. Data were collected via a structured, self-administered electronic questionnaire. Analysis included descriptive statistics, inferential tests (chi-square, t-tests, and ANOVA), multivariable regression, and latent class analysis to identify distinct student profiles. Results:The mean knowledge score was 3.84 out of 7 (54.9%), indicating moderate overall understanding. While students demonstrated strength in general transmission routes (81.9% correct) and basic prevention, critical deficits were identified. Only 24.3% recognized mechanical ventilation as a risk factor for ventilator-associated pneumonia (a common HAI), and just 56.7% correctly identified common bacterial agents. A significant knowledge-practice gap was observed; while knowledge did not differ by academic program, practice scores varied significantly (p < 0.001). In-service training was strongly associated with better practice scores (p < 0.001) but not with knowledge. Latent class analysis revealed three distinct profiles: "High Performers" (60.2%), "Motivated Learners" (36.1%) with good practice but lower knowledge, and a "Disengaged" group (3.7%) with poor scores across all domains. Conclusion:UB allied health students possess foundational HAI knowledge but appear critically underprepared in key clinical areas, with a clear disconnect between theory and practice. This evidence suggests an urgent need to consider a shift from uniform curricula to tailored, competency-based education integrating robust theory with mandatory simulation and clinical practice. Such a reform could contribute to mitigating Belize's high HAI burden.
Background:The global spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) represents a major challenge for the management of urinary tract infections (UTIs), limiting therapeutic options and increasing the risk of treatment failure. This study aimed to characterize the epidemiological profile and antimicrobial resistance patterns of ESBL-producing uropathogenic Enterobacteriaceae in a Moroccan hospital setting. Methods:A retrospective descriptive study was conducted in the bacteriology department of the Moulay Ismail Military Hospital in Meknes, Morocco, over a 2-year period (2021-2023). Data were extracted from archived urine cytobacteriological examinations. Bacterial identification was performed using chromogenic media and biochemical methods, while antimicrobial susceptibility testing was carried out using the disk diffusion method according to CA-SFM guidelines. ESBL production was detected using the double-disk synergy test. Results:Among 9867 urine samples analyzed, 1676 cases of UTIs were identified, corresponding to a prevalence of 17%. Enterobacteriaceae accounted for 56.8% of isolates, among which ESBL-producing strains represented the majority of multidrug-resistant bacteria. Escherichia coli was the predominant species (69.9%), followed by Klebsiella pneumoniae (17.6%) and Klebsiella oxytoca (11%). High resistance rates were observed to third-generation cephalosporins (up to 96% for ceftriaxone) and fluoroquinolones (93% for ciprofloxacin). In contrast, carbapenems, amikacin, and fosfomycin retained good activity, with resistance rates below 10%. Conclusions:This study highlights the increasing burden of ESBL-producing Enterobacteriaceae in UTIs and the alarming levels of resistance to commonly used antibiotics. These findings underscore the need for continuous surveillance, rational antibiotic use, and strengthened antimicrobial stewardship programs to limit the spread of multidrug-resistant bacteria and preserve the effectiveness of available treatments.
This rapid review aims to examine the potential zoonotic risks associated with exotic pets. This systematic review explores various aspects of zoonotic diseases and their transmission through exotic pets. We followed the PRISMA methodology, applying four inclusion and exclusion criteria. All records included in this systematic review were retrieved from three databases: Google Scholar, Web of Science, and Scopus. A total of 70 records (research article or review article) published after 2010 were selected for analysis. Our findings indicate that exotic pets serve as significant vectors of zoonotic diseases. Several zoonotic bacteria, including Escherichia coli, Salmonella spp., Yersinia enterocolitica, Staphylococcus spp., Streptococcus spp., and Pseudomonas spp., have been strongly implicated in transmission. In addition, recent studies highlight the antimicrobial resistance exhibited by these zoonotic bacteria. Habitat fragmentation, landscape changes, environmental shifts, and the wildlife trade further contribute to the risk of zoonotic spillover. The One Health approach is crucial for enhancing capacity building and mitigating the spread of zoonotic diseases and antimicrobial resistance at the human−animal interface.
Timely detection of emerging public health threats is challenging because the surveillance infrastructure is not yet tuned to the emerging threat. We attempt to identify three nonspecific early signals that might be common across emerging events: public health authority communication, zoonotic exposure mentions, and other pathogen exposure mentions. Methods:Data from U.S. Department of Veterans Affairs emergency department visits between 2004 and 2024 were used to construct training and validation sets from reportable or emerging infectious diseases identified by historical diagnoses and laboratories. Not all early signal types were extracted using the same method. Rule-based and transformer models were used in a way to minimize developer and chart reviewer time. We then extracted cases from historic documents among selected diseases. Results:Positive predictive values for public health authority communication, zoonotic exposure, and other pathogen exposure ranged from 0.615 to 1.0. Target concepts were extracted from over 33 million emergency department visits. Distributions of extracted exposures generally matched expectations for the identified pathogen. Conclusion:Automated natural language processing methods allow surveillance scaling to large amounts of clinical documents to identify relevant cases. Initial validation compared to manual text review shows that accuracy is acceptable for initial feasibility exploration in biosurveillance efforts.
Background:The global monkeypox (Mpox) outbreak prompted heightened surveillance in regions with significant travel links. Fars Province, Iran, implemented a structured telemedicine response to manage patients presenting with Mpox-like symptoms. Objectives:This study aimed to describe and evaluate the impact of a tiered, hub-and-spoke telemedicine model on the triage, differential diagnosis, and cost efficiency of managing suspected Mpox cases in a setting with no confirmed Mpox. Materials and Methods:In this observational study conducted from August 27 to September 22, 2024, 150 patients presenting with fever and vesiculopustular rash across Fars Province were managed via a mandated protocol. Cases unresolved by local physicians were escalated via asynchronous (store-and-forward) WhatsApp consultations to a central specialist hub. Diagnostic testing, including Orthopoxvirus (Mpox) PCR, varicella zoster virus PCR, and herpes simplex virus testing, was performed based on telemedicine triage. A cost-consequence analysis compared the implemented pathway to a hypothetical standard referral scenario. Results:Among 150 teleconsultations, 28 patients (18.7%) were triaged as high suspicion for Mpox; three had relevant international travel history. No Mpox cases were confirmed. Final diagnoses were varicella (56.7%), herpes zoster (27.3%), herpes simplex (8.0%), and other conditions (8.0%). The telemedicine model prevented 122 (81.3%) unnecessary in-person specialist referrals. The median consultation response time was 95 min. The cost analysis showed a 76% reduction in direct costs, saving an estimated 1,087,500,000 Iranian Rials compared to standard care. Conclusion:A tiered telemedicine model proved effective for outbreak preparedness, enabling rapid expert triage, accurate differential diagnosis, and significant resource savings in a high-alert, zero-prevalence setting. This approach might yield a scalable blueprint for managing future alerts of emerging infectious diseases with cutaneous manifestations.
Background:In early March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. In South Africa, the first case was confirmed in early March 2020. According to the WHO, disruptions in essential services due to the COVID-19 pandemic occurred worldwide. The COVID-19 pandemic affected access to maternal and child health (MCH) services in many countries, including South Africa. The study aimed to map and describe the existing evidence on the impact of the COVID-19 pandemic on the access to and delivery of maternal, neonatal, and child health (MNCH) services in South Africa. Methodology:This was a scoping review of studies published between 2020 and 2023. We searched databases such as PubMed, MEDLINE, EBSCOhost, and Google Scholar. Data were exported to the Rayyan software, where screening, checking of duplicates, and selection of final studies for review were performed. The information from the identified studies was exported to ATLAS.ti 23.1 software for analysis. Content analysis was performed, and data were presented in predetermined themes using the MCH cascade. Results:The results from 25 articles showed a mixed view, whereby some studies showed a decrease at the beginning of the pandemic in April 2020, in the uptake of family planning, antenatal care, labor and delivery, postnatal care, under-five immunizations, and cervical cancer screening services. However, other studies found increased uptake of family planning, antenatal care, labor and delivery, and under-five immunization services. Some studies showed resilience in the overall first antenatal visits, adolescents' visits to family planning, and postnatal care, as they remained constant. Conclusion:The findings show both positive and negative impacts of the COVID-19 pandemic on MNCH services in South Africa. While the pandemic significantly disrupted access to essential services, some areas demonstrated resilience, with increased visits for antenatal care, adolescent family planning, and postnatal services. These insights are critical for guiding decision-makers, health managers, and frontline healthcare workers in preparing for future public health emergencies. Ensuring continuity of MNCH services during crises must be a priority. Strengthening the health system and building resilience are essential to safeguard MCH, even in the face of disruptions.
Background and aim:Black and Asian healthcare workers (HCWs) faced heightened COVID-19 exposure early in the pandemic due to overrepresentation on the frontline compared to other ethnic groups. This study explored the experiences of Black and Asian household members in the United Kingdom living with these HCWs during the COVID-19 pandemic, focussing on the impact of increased risks and challenges. Method:This study utilised one-on-one interviews with six HCWs' household members. Participants were recruited through a snowballing sampling strategy. The study employed interpretative phenomenological analysis (IPA) to explore and interpret the meanings participants attributed to their experiences. Results:The findings highlighted emotional and mental impacts experienced by household members, linked to their ethnic background and living with HCWs. The research found that FMs feared contracting the virus from their HCWs, along with feelings of vulnerability, hopelessness and helplessness. While participants took precautions, they relied on faith and called for specific support, policy changes and reassurance to reduce anxiety. Conclusion:This study underscores the importance of healthcare organisations addressing the concerns of HCWs from Black and Asian communities and their household members in future pandemics. It recommends establishing platforms within healthcare settings for these workers to voice safety and protection concerns. The study highlights the need for representative channels to listen to their issues and suggests educational seminars to help families manage fears and emotional distress. Ultimately, the research aims to guide policy changes and interventions that offer comprehensive support, ensuring HCWs and their household members are prepared to face health crises with resilience and well-being.
Background:Methicillin-resistant Staphylococcus aureus (MRSA) has been the most common cause of community-acquired infections and nosocomial infections worldwide. A higher risk of nosocomial infections is associated with colonization of the anterior nares of paramedical trainees who are continuously exposed to MRSA. The purpose of this study is to ascertain the prevalence of MRSA nasal carriage in paramedical students, as well as the antibiogram and inducible clindamycin resistance patterns. Method:Nasal swabs were taken from 246 paramedical students enrolled in Pokhara University's School of Health and Allied Sciences in Nepal. Following the isolation of S. aureus from nasal swabs, bacteria were tested for antibiotic susceptibility using a modified Kirby-Bauer disc diffusion test. A cefoxitin disc (30 μg) was used to identify MRSA, and the D-test was carried out in accordance with CLSI standards. SPSS version 25 was utilized for data collection and analysis. Result:MRSA accounted for 80 (36.7%) of the 217 Staphylococcus aureus isolates, while 137 (63.3%) were methicillin-sensitive S. aureus (MSSA). The total nasal carriage rate of MRSA was reported to be 32.5% (80/246), and males (46.0%) and those over 30 years old (55.6%) had rates of MRSA that were higher, respectively. There were 112 (51.6%) multidrug-resistant (MDR) isolates, but all isolates were vancomycin-sensitive. Inducible clindamycin resistance was found in 17.1% of isolates according to the D-test. Conclusion:MRSA and S. aureus nasal carriage rates were high among paramedical students; therefore, care must be taken to prevent nosocomial infections brought on by MRSA nasal carriage.
Background:Even though childhood tuberculosis (TB) is of public health significance in Cameroon, reports on childhood TB and its risk factors are limited. The objective of this study was to identify the risk factors for TB among children in the Centre Region, Cameroon. Methods:An unmatched case-control study was conducted at ten health facilities in the Centre Region from February 12 to July 31, 2022. Children under 15 years who attended these health facilities for TB treatment were considered as cases. Controls were children attendees who presented in the outpatient department (OPD) of the same health facility for non-TB health problems. For each case, two consecutive controls were sampled systematically. Data were collected using pretested and structured questionnaires through face-to-face interviews with parents/guardians. Logistic regression analyses were employed to identify risk factors for TB. Results:A total of 120 cases and 231 controls were enrolled in the study, and the median (interquartile range) age among both cases and control was 3 years (IQR = 1-3). The odds of TB were seven times (AOR = 7.24; 95% CI: 1.76-18.98) more likely among children with the absence of BCG vaccination compared with being vaccinated for BCG. A child's previous history of TB, family history with a TB patient, duration of contact with a TB patient, and child's HIV status were the other risk factors of childhood TB with AOR 20.01 (4.77-33.87), 4.90 (1.10-21.83), 4.76 (1.02-12.14), and 2.73 (1.55-19.10), respectively. Conclusion:The absence of BCG vaccination, the child's previous history of TB, family history with a TB patient, duration of contact with a TB patient, and HIV-positive status are the independent risk factors for childhood TB in the Centre Region. Contact tracing and contact screening should be enhanced and correctly implemented by the National TB Control Program.
RNA viruses, characterized by their RNA-based genomes, have garnered significant concern due to their role in numerous lethal pandemics and remain a significant global health threat. Their predominance among emerging pathogens underscores the need for rapid detection and molecular characterization. PCR has been proven to be an indispensable tool for monitoring the emergence and spread of RNA viruses, but its success requires efficient viral RNA isolation. Poor RNA recovery may lead to failed detection, limiting downstream applications such as genome sequencing and molecular epidemiology. This review provides an overview of major RNA extraction strategies, including TRIzol-based, spin column–based, and magnetic bead–based methods, as well as novel and automated platforms. We compared their advantages, limitations, and trade-offs, emphasizing compatibility with downstream processes such as PCR and next-generation sequencing. Challenges related to sample collection, transport, storage, and RNA integrity are discussed, particularly in resource-limited settings where cold-chain and biosafety infrastructure may be limited. Additionally, we discussed applications of extracted RNA for diagnostics, viral characterization, and public health interventions, as well as advances in point-of-care (POC) technologies that integrate extraction with detection. Future directions focus on developing robust, cost-effective, and scalable extraction methods that are adaptable to both high-throughput laboratories and portable POC systems, ensuring global preparedness against emerging RNA viruses.
Influenza, categorized as one of the emergent infectious diseases, presents a substantial public health concern due to its capacity to trigger extensive epidemics and global pandemics. Every recent pandemic of human influenza has been attributed to avian influenza viruses (AIVs), underscoring their pandemic potential and the associated public health risks. Interestingly, there remains a significant knowledge gap concerning the mechanisms that sustain the survival and proliferation of these viruses within their natural avian reservoirs. Migratory waterfowl, in particular mallard (Anas platyrhynchos), plays a crucial role as potential reservoirs, facilitating the spread of the virus through their migratory patterns. In order to better understand the factors that contribute to AIV spillover and hotspots, we built a mechanistic transmission model and investigated the likelihood of an AIV hotspot for the animal-to-human spillover of the virus in a region in Kansas. Our findings challenge the notion that the size of the overall mallard population is a reliable predictor of spillover hazard. To study this aspect, we systematically evaluated weekly trends in both the total population density and the total infected population density. In more than 70% of the locations studied, these two indicators showed periods with opposite trends. This conclusion stresses the importance of developing and calibrating compartmental models that can capture the diffusion of the virus within the reservoir and its spatiotemporal distribution due to animal movement.
Chikungunya virus (CHIKV), an arbovirus transmitted by Aedes mosquitoes, has caused massive global epidemics, where it causes periodic outbreaks of febrile illness. In recent years, it has afflicted populations of Africa, South America, and Southeast Asia. Aedes albopictus and Aedes aegypti mosquitoes are the carriers of the virus causing severe clinical manifestations with multiorgan involvement which can last for years and have a significant negative impact on the health, quality of life, and ability to work and are the hallmarks of chikungunya fever. The effects of climate change as well as increased globalization of trade and travel have led to growth of the habitat of Aedes mosquitoes. As a result, increasing numbers of people will be at risk of chikungunya fever in the coming years. In the absence of specific antiviral treatments and with vaccines still in development, surveillance and vector control are essential to suppress re-emergence and epidemics. This review discusses the role of oxidative stress and inflammation in pathogenesis, therapeutic potential of antioxidants, preventive methods like vector control, public health education, and molecular techniques for early detection. A holistic review of literature from 2002 to 2024 was carried out using the Web of Science database to observe disease prevention and diagnostic advancements, particularly in vaccine research highlighting the continuous global public health initiatives aimed at reducing the virus’s effects. To prevent epidemics from resurfacing, however, constant monitoring and vector control are necessary.
Background:The purpose of this study was to investigate the knowledge, attitude, and performance of the first secondary-level students in preventing COVID-19 in the schools of Khorramabad in 2022. Methods:In our study, the information, knowledge, attitude, and performance of 370 first-grade secondary school students were recorded using a standard questionnaire. Data were analyzed using SPSS Version 26 software and descriptive statistical methods (mean and standard deviation) and appropriate inferential tests to compare groups and examine the correlation between knowledge, attitude, and performance. Findings:The average score of knowledge, attitude, and performance was 59.11 ± 20.51, 81.25 ± 13.68, and 65.4 ± 23.1. The average score of knowledge in students over 14 years of age, ninth-grade students and good academic status, the score of knowledge and attitude of students with mothers with university education, and finally, the average score of knowledge, attitude, and performance of students with underlying disease were significantly higher than other students. Also, knowledge had a direct and significant relationship with attitude and performance. In addition, attitude and performance also had a direct and significant relationship. Conclusion:The level of knowledge of the people was average, and attitude and performance were positive. Based on the importance of performance, people's attitude towards COVID-19 should be improved, because knowledge alone cannot improve people's performance.
Background:Typhoidal Salmonella infections remain a significant public health concern in low- and middle-income countries, with antimicrobial resistance (AMR) posing a major challenge. This study aimed to assess the prevalence and AMR patterns of Salmonella species in clinical samples from a tertiary care center in Nepal. Methods:The study was conducted at the microbiology department in the country's largest public tertiary care hospital, TUTH, Nepal. A retrospective analysis was performed on 16,579 clinical specimens with culture-confirmed Salmonella isolates. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Resistance and susceptibility trends were analyzed. Results:Among 16,579 clinical samples analyzed, enteric fever was identified in 114 cases (0.7%). Of these, Salmonella Typhi accounted for 77.2%, while Salmonella Paratyphi comprised 22.8%. No multidrug resistance was observed, and all isolates were susceptible to third- and fourth-generation cephalosporins (e.g., cefixime, ceftriaxone, and cefepime) and β-lactamase inhibitors (e.g., piperacillin-tazobactam).Salmonella Paratyphi showed 100% sensitivity to ampicillin, amoxicillin, and cotrimoxazole, while susceptibility to chloramphenicol was high for both S. Typhi (88.9%) and S. Paratyphi (92.9%). Gentamicin exhibited comparatively lower sensitivity, with rates of 78.3% for S. Typhi and 80% for S. Paratyphi. Ciprofloxacin showed the lowest susceptibility, at 47.6% for S. Typhi and 60% for S. Paratyphi. Conclusion:Our study identified a lower prevalence of culture-confirmed typhoidal Salmonella infections, with Salmonella Typhi predominating over Salmonella Paratyphi. High resistance to ciprofloxacin and gentamicin was observed, while susceptibility to ampicillin, chloramphenicol, and cotrimoxazole re-emerged, suggesting their potential for reintroduction in treatment. No multidrug resistance or resistance to third- and fourth-generation cephalosporins (e.g., cefixime, ceftriaxone, cefepime) and β-lactamase inhibitors (e.g., piperacillin-tazobactam) was noted, supporting their reliability for empirical therapy. These findings underscore the need for ongoing antimicrobial surveillance to guide effective treatment strategies.
Introduction:On August 14, 2024, the World Health Organization (WHO) declared monkeypox (mpox) a Public Health Emergency of International Concern (PHEIC). Shortly thereafter, Thailand reported Asia's first confirmed case of the Clade Ib strain. Given Thailand's high international travel volume, anticipating short-term case trajectories is essential for situational awareness. Methods:We forecast monthly mpox cases using the Department of Disease Control (DDC) data from July 2022 to September 2024 and evaluate Poisson and negative binomial generalized linear models (GLMs), Holt-Winters exponential smoothing, NeuralProphet, and a stacked ensemble. Rolling-origin cross-validation was used to assess out-of-sample accuracy (MAE, RMSE, and MAPE) and empirical interval coverage (80% and 95%). Results:Holt-Winters provided the most accurate single-model forecasts by RMSE, while the stacked ensemble yielded the most reliable uncertainty calibration. Forecasts for October-December 2024 suggest relatively low case counts with non-negligible uncertainty, indicating the need for continued vigilance. Discussion:These findings are exploratory decision-support inputs that complement ongoing surveillance and may help inform adaptive planning under both low- and high-incidence scenarios.
Background:Dengue fever (DF), an illness caused by the dengue virus and mainly spread by Aedes mosquitoes, has become a global health concern. Objective:With the considerable increase in the incidence of DF in recent decades, there is a need for a comprehensive scientometric analysis to map the landscape of scientific research in this field. Methods:This descriptive study utilized scientometric techniques for scientific analysis. The population consisted of all scientific publications on DF indexed in the Scopus database. Data were analyzed using Biblioshiny, a web-based graphical interface for the Bibliometrix package in the R programming language. Results:The study identified 3172 publications on DF from the Scopus database, with a significant growth observed since the early 1990s and peak publication years in 2019 (n = 202) and 2020 (n = 203). India, China, and the United States emerged as the most productive countries, forming the core of the international research collaboration network. Keyword co-occurrence analysis revealed dominant research focuses on "dengue virus," "Aedes aegypti," and "vector control." Thematic mapping showed that foundational themes such as "dengue fever" and "Aedes aegypti" are central but underdeveloped, while niche themes like "rainfall" and "temperature" are highly developed but less central. Thematic evolution analysis showed a clear shift from virology-centered topics (pre-2005) to predictive modeling, climate impact, and machine learning applications (2020-2024). Conclusion:The comprehensive scientometric analysis shows that scientific production in the field of DF has significantly increased in recent decades. International collaborations play a vital role in advancing research and combating DF. Thematic analysis and mapping of research topics highlight significant advancements and the need for further research in specific areas. Continued collaborations and innovations are essential for effectively addressing the challenges of DF.
