Search Results (128)

The development of new diagnostic technologies is accelerating, and budgetary constraints in the health sector necessitate a systematic decision-making process to acquire emerging technologies. Health Technology Assessment methodologies integrate technology, clinical efficacy, patient safety, and organizational and financial factors in this context. However, these methodologies do not include the learning curve, a critical factor in operator-dependent technologies. This study presents an evaluation model incorporating the learning curve, developed from the domains of the AdHopHTA project. Using System Dynamics (SD), the model was validated and calibrated as a case study to evaluate the use of Point-of-Care Ultrasound (POCUS) in identifying dengue. This approach allowed for the analysis of the impact of the learning curve and patient demand on the revenues and costs of the healthcare system and the cost–benefit indicator associated with dengue detection. The model assesses physician competency and how different training strategies and frequencies of use affect POCUS adoption. The findings underscore the importance of integrating the learning curve into decision-making. This study highlights the need for further investigation into the barriers that limit the effective use of POCUS, particularly in resource-limited settings. It proposes a framework to improve the integration of this technology into clinical practice for early dengue detection. Full article

Arboviruses are a growing concern in many nations. Several reports of arboviral outbreaks have been recorded globally in the past decade alone. Repeated arboviral outbreaks in developing countries have consistently highlighted vulnerabilities in disease surveillance and response systems, exposing critical gaps in early detection, contact tracing, and resource allocation. The 2024 Dengue fever outbreak in Ghana, which recorded 205 confirmed cases out of 1410 suspected cases, underscored the urgent need to evaluate the country’s preparedness for arboviral outbreaks, given the detection of competent vectors in the country. A retrospective analysis of Ghana’s 2009–2013 pandemic influenza response plan revealed significant deficiencies in emergency preparedness, raising concerns about the country’s ability to manage emerging arboviral threats. This review assessed Ghana’s current arboviral outbreak response and preparedness by examining (a) the effectiveness of vector control measures, (b) the role of early warning systems in mitigating outbreaks, (c) laboratory support and diagnostic capabilities, and (d) community engagement strategies. It highlights the successes made in previous outbreaks and sheds light on several gaps in Ghana’s outbreak response efforts. This review also provides recommendations that can be implemented in many countries across Africa as they brace themselves for any arboviral outbreak. Full article

Co-infections of dengue serotypes and dengue with other flaviviruses pose substantial hurdles in disease diagnosis, treatment options, and disease management. The overlapping geographic distributions and mosquito vectors significantly enhance the probability of co-infections. Co-infections may result in more severe disease outcomes due to elevated viral loads, modulation of the immune response, and antibody enhancement. Cross-reactivity in serological assays and the likeness of clinical presentations add to the ongoing challenges in disease diagnosis. Molecular diagnostics such as reverse transcription polymerase chain reaction (RT-PCR) and next-generation sequencing (NGS) are, therefore, employed for more specific disease diagnosis although requiring substantial resources. Despite the advancements, specific anti-flaviviral therapy is still limited, hence the urgency for further investigative research into various therapeutic approaches, including peptide inhibitors, host-targeted therapies, and RNA-based interventions. This review discusses the epidemiology, clinical ramifications, and diagnostic obstacles associated with flavivirus co-infections whilst assessing prospective strategies for better disease prevention, treatment, and management. Addressing these critical gaps is essential for disease mitigation whilst improving patient management especially in regions where co-circulation of flaviviruses is common and their diseases are highly endemic. Full article

SNX11, a sorting nexin protein localized on the endosomal membrane, is an important protein closely related to protein sorting and endosomal trafficking. Previously, through a genome-wide CRISPR screening, we identified SNX11 as a critical protein for the entry of Dabie bandavirus. SNX11 deletion significantly inhibits the replication of Dabie bandavirus. We further discovered that the loss of SNX11 alters endosomal pH, potentially affecting the release process of Dabie bandavirus from endosomes to the cytoplasm. However, the mechanism by which SNX11 modulates endosomal pH and whether SNX11 deletion similarly inhibits other viruses remain to be elucidated. This study reveals that SNX11 can interact with the V1 subunit of the endosomal proton pump V-ATPase, affecting the expression level of this subunit on the endosomal membrane and thereby disrupting the assembly of V-ATPase. Additionally, we found that SNX11 deletion significantly inhibits the replication of dengue virus, hantavirus, and influenza virus. These findings suggest that SNX11 may be a key protein in the process of viral infection and could serve as a broad-spectrum antiviral target. Full article

Orthoflaviviruses (formerly flaviviruses) are known for their role in numerous diseases affecting both humans and animals. Despite the worldwide distribution of orthoflaviviruses, individual species are only found in endemic or epidemic regions. However, in recent decades, certain orthoflaviviruses have spread beyond their traditional geographic boundaries, even crossing continents. Given the long-distance movements of birds, the knowledge of zoonotic orthoflaviviruses associated with birds is essential because of their possible introduction into new regions, as was the case with West Nile virus and Usutu virus. A thorough literature review was conducted on zoonotic orthoflaviviruses related to birds, including lesser-known (re-)emerging and neglected orthoflaviviruses that are limited to specific regions and/or avian hosts but have the potential to spread to a wider geographical area and pose a higher risk of transmission to humans. Several of these viruses possess significant zoonotic potential and can cause a wide spectrum of diseases in humans, ranging from mild febrile illnesses (Zika virus) to severe neuroinvasive diseases (tick-borne encephalitis, West Nile, Japanese encephalitis virus) and hemorrhagic fevers (yellow fever, dengue virus). Geographic distribution, hosts, vectors, incidence of human infections, and impact on human and animal health of zoonotic flaviviruses related to birds are critically reviewed. The viruses have been categorized based on the role of birds as an orthoflavivirus host and the clinical presentation in human infections. Full article

Dengue virus (DENV) remains a critical global health challenge, with no approved antiviral treatments currently available. The growing prevalence of DENV infections highlights the urgent need for effective therapeutics. Antiviral peptides (AVPs) have gained significant attention due to their potential to inhibit viral replication. However, traditional drug discovery methods are often time-consuming and resource-intensive. Advances in artificial intelligence, particularly deep generative models (DGMs), offer a promising approach to accelerating AVP discovery. This report provides a comprehensive assessment of the role of DGMs in identifying novel AVPs for DENV. It presents an extensive survey of existing antimicrobial and AVP datasets, peptide sequence feature representations, and the integration of DGMs into computational peptide design. Additionally, in vitro and in silico screening data from previous studies highlight the therapeutic potential of AVPs against DENV. Variational autoencoders and generative adversarial networks have been extensively documented in the literature for their applications in AVP generation. These models have demonstrated a remarkable capacity to generate diverse and structurally viable compounds, significantly expanding the repertoire of potential antiviral candidates. Additionally, this report assesses both the strengths and limitations of DGMs, providing valuable insights for guiding future research directions. As a data-driven and scalable framework, DGMs offer a promising avenue for the rational design of potent AVPs targeting DENV and other emerging viral pathogens, contributing to the advancement of next-generation therapeutic strategies. Full article

Generating fine-scale risk maps for mosquito-borne diseases vectors is an essential tool for guiding spatially targeted vector control interventions in urban settings, given the limited public health resources. This study aimed to generate fine-scale risk maps for dengue vectors using routine vector surveillance data collected at the township scale. We integrated monthly township-specific Breteau Index (BI) data from Guangzhou city (2019 to 2020) with covariates extracted from remote sensing imagery and other geospatial datasets to develop an original random forest (RF) model for predicting hotspot areas (BI ≥ 5). We implemented three data resampling techniques (undersampling, oversampling, and hybrid sampling) to improve the model’s performance and evaluate it using the ROC-AUC, Recall, Specificity, and G-means metrics. Finally, we generated a downscaled risk maps for BI hotspot areas at a 1000 m grid scale by applying the optimal model to fine-scale input data. Our findings indicate the following: (1) data resampling techniques significantly improved the prediction accuracy of the original RF model, demonstrating robust spatial downscaling capabilities for fine-scale grids; (2) the spatial distribution of BI hotspot areas within townships exhibits significant heterogeneity. The fine-scale risk mapping approach overcomes the limitations of previous coarse-scale risk maps and provides critical evidence for policymakers to better understand the distribution of BI hotspot areas, facilitating pixel-level spatially targeted vector control interventions in intra-urban areas. Full article

Dengue fever remains a major global health threat, and mathematical models are crucial for predicting its spread and evaluating control strategies. This study introduces a highly flexible dengue transmission model using a novel piecewise fractional derivative framework, which can capture abrupt changes in epidemic dynamics, such as those caused by public health interventions or seasonal shifts. We conduct a rigorous comparative analysis of four widely used but distinct mechanisms of disease transmission (incidence rates): Harmonic Mean, Holling Type II, Beddington–DeAngelis, and Crowley–Martin. The model’s well-posedness is established, and the basic reproduction number (${\Re }_0$) is derived for each incidence function. Our central finding is that the choice of this mathematical mechanism critically alters predictions. For example, models that account for behavioral changes (Beddington–DeAngelis, Crowley–Martin) identify different key drivers of transmission compared to simpler models. Sensitivity analysis reveals that vector mortality is the most influential control parameter in these more realistic models. These results underscore that accurately representing transmission behavior is essential for reliable epidemic forecasting and for designing effective, targeted intervention strategies. Full article

Dengue, an acute infectious disease caused by the dengue virus, remains a major public health problem in the 21st century. This study investigated the global dengue burden, identified high-risk regions, evaluated the long-term incidence trends, and can inform evidence-based control strategies. Using GBD 2021 data, we analysed the dengue incidence from 1992 to 2021 using age–period–cohort models. We determined the net drift (overall annual percentage change), local drift (annual percentage change for each age group), longitudinal age curves (expected longitudinal age-specific rates), and periods’ (cohorts’) relative risks. In 2021, the global age-standardised incidence rate reached 752.04/100,000 (95% UI: 196.33–1363.35), a 47.26% increase since 1992. High-risk regions included eastern sub-Saharan Africa, Southeast Asia, South Asia, and Latin America and the Caribbean. Southeast Asia experienced the largest rise (65.43%), with a net drift of 2.47% (1992–2021). While individuals aged 5–39 years bore the highest burden, those over 80 faced an elevated risk. Dengue remains a critical public health threat, disproportionately affecting younger populations but increasingly endangering older adults. Targeted interventions in high-risk regions and age groups, coupled with precision public health strategies, are essential to enhance prevention and control efforts. Full article

Ecuador, a tropical country with frequent dengue outbreaks, including a surge from 16,017 cases in 2022 to 61,329 in 2024, was the focus of this study. The study was conducted in Borbon, a semi-urban rural town in the Esmeraldas province. Genomic analysis, alongside entomo-virological surveillance, provides valuable insights into DENV-2 genotypes. Five pools of female Aedes aegypti mosquitoes from Borbon tested positive for DENV serotype 2 through RT-qPCR. One positive pool (CT = 16.13) was sequenced using Illumina MiSeq, and genotyping was conducted via the Dengue Typing Tool and Maximum Likelihood phylogenetic tree. The genotype assigned was III Southern Asian-American. Comparison with other genomes revealed genetic similarity to a human dengue genome sequenced in 2021, also from Esmeraldas, clustering with genomes reported across the Americas, particularly from Colombia and Venezuela. This study enhances our understanding of dengue virus epidemiology in rural areas, emphasizing the critical role of clinical case surveillance and vector monitoring in guiding evidence-based interventions. Full article

Black flies (Diptera: Simuliidae) are important vectors of pathogens, including filarial nematodes, protozoans, and arboviruses, which significantly impact human and animal health. Although their role in arbovirus transmission has not been as thoroughly studied as that of mosquitoes and ticks, advances in molecular tools, particularly metagenomics, have enabled the identification of non-cultivable viruses, significantly enhancing our understanding of black-fly-borne viral diversity and their public and veterinary health implications. However, these methods can also detect insect-specific viruses (i.e., viruses that are unable to replicate in vertebrate hosts), which may lead to the incorrect classification of black flies as potential vectors. This underscores the need for further research into their ecological and epidemiological roles. This systematic review, conducted following the PRISMA protocol, compiled and analyzed evidence on arbovirus detection in Simuliidae from scientific databases. Several arboviruses were identified in these insects, including vesicular stomatitis virus New Jersey serotype (VSVNJ), Venezuelan equine encephalitis virus (VEEV), and Rift Valley fever virus. Additionally, in vitro studies evaluating the vector competence of Simuliidae for arboviruses such as dengue virus, Murray Valley encephalitis virus, and Sindbis virus were reviewed. These findings provide critical insights into the potential role of black flies in arbovirus transmission cycles, emphasizing their importance as vectors in both public and veterinary health contexts. Full article

Dengue virus is the most prevalent arthropod-borne viral disease in humans. Severe dengue, defined by hemorrhagic fever and dengue shock syndrome, can develop quickly in people who have warning indications such as abdominal pain, mucosal bleeding, and a significant decrease in platelet count. Laboratory markers such as hematocrit, platelet count, liver enzymes, and coagulation tests are critical for early diagnosis and prognosis. This retrospective study was carried out from January 2023 to December 2024 at a super-specialty tertiary care hospital. There were 283 adult patients with dengue with warning signs, who were categorized into 102 with platelet transfusion and 181 with no platelet transfusion. Data on patient demographics, clinical history, laboratory values, and radiological findings were systematically obtained from hospital records at the time of admission. Laboratory parameters such as white blood cell (OR = 2.137), hemoglobin (OR = 2.15), aPTT (OR = 5.815), AST²/ALT (OR = 2.431), platelet count (OR = 26.261) and NS1 (OR = 4.279) were found to be significantly associated (p < 0.01) with platelet transfusion. Similarly, an increased prothrombin time (OR = 2.432) contributed to prolonged hospital stays and the presence of ascites (OR = 5.059), gallbladder wall thickening (OR = 4.212), and pleural effusion (OR = 2.917), contributing to the severity of the dengue infection. These significant laboratory markers help with identifying patients with dengue who may develop severe dengue, requiring platelet transfusion, thereby prioritizing patient care and enabling the implementation of targeted interventions. Full article

Background: Dengue virus (DENV) infection poses a serious and growing public health threat in many tropical and subtropical regions worldwide, including Ghana. Despite the heightened risks due to suitable climatic conditions and the presence of competent vectors, the epidemiology of DENV in Ghana remains poorly understood, underscoring the critical need for a comprehensive assessment of the burden and circulation of the virus in the country. Methods: The review was conducted in accordance with the PRISMA guidelines. A literature search was conducted using the PubMed, Web of Science, and Scopus databases from inception to 24 September 2024. Studies presenting primary DENV seroprevalence data among Ghanaian populations were included. Quality was assessed using JBI tools. Meta-analyses estimated pooled prevalence with 95% CIs using random-effects models. Heterogeneity was evaluated using I² statistic. Results: A total of nine studies met the selection criteria, with eight studies involving febrile patients and one involving blood donors. The pooled seroprevalence rates were 33.3% (95% CI: 16.2–50.4%) for IgG, 5.9% (95% CI: 0–12.5%) for IgM, 1.5% (95% CI: 0.4–2.6%) for DENV RNA, and 32.3% (95% CI: 0–68.5%) for IgG/IgM combined. Notably, the IgG seroprevalence exhibited substantial heterogeneity (I² = 99%). DENV-2 and DENV-3 were the predominant serotypes identified. There was potential bias in seroprevalence estimates from hospital-based febrile samples. Conclusions: This review has established the prevalence and circulation of DENV serogroups in Ghana. The higher seropositivity and heterogeneity underscore the need for standardized large-scale surveillance to optimize disease characterization and guide control. Integrating dengue prevention into existing vector control programs could help reduce risks in Ghana. Full article

Background: Genetic control tools, such as the sterile insect technique (SIT) and genetically modified mosquitoes (GMMs), require releasing males comparable to their wild counterparts. Ensuring that released males do not exhibit higher insecticide resistance is critical. This study assessed the phenotypic characteristics and insecticide susceptibility of key dengue and malaria vector species. Methods: Phenotypic resistance to deltamethrin (0.05%) was tested in two-to-five-day-old male and female Aedes aegypti (Linnaeus, 1762) (Borabora and Bobo strains) and Anopheles coluzzii (Coetzee & Wilkerson, 2013) (Vallee du Kou strain) using WHO susceptibility guidelines. Wing measurements of live and dead mosquitoes were used to assess body size. Results: Mortality rates were similar between male and female Ae. aegypti (Bobo strain) and An. coluzzii, while Ae. aegypti Borabora was fully susceptible in both sexes. Females were consistently larger than males, with significantly larger live females than dead ones in the Ae. aegypti Bobo strain. Conclusion: This study highlights sex-specific differences in body size and insecticide susceptibility. Integrating these analyses into vector management programs is essential for the success and sustainability of SIT- and GMM-based interventions targeting malaria and dengue vectors. Implications for integrating genetic control strategies are discussed. Full article

Microalgae have emerged as a sustainable and efficient source of protein, offering a promising alternative to conventional animal and plant-based proteins. Species such as Arthrospira platensis and Chlorella vulgaris contain protein levels ranging from 50% to 70% of their dry weight, along with a well-balanced amino acid profile rich in essential amino acids such as lysine and leucine. Their cultivation avoids competition for arable land, aligning with global sustainability goals. However, the efficient extraction of proteins is challenged by their rigid cell walls, necessitating the development of optimized methods such as bead milling, ultrasonication, enzymatic treatments, and pulsed electric fields. These techniques preserve functionality while achieving yields of up to 96%. Nutritional analyses reveal species-dependent digestibility, ranging from 70 to 90%, with Spirulina platensis achieving the highest rates due to low cellulose content. Functionally, microalgal proteins exhibit emulsifying, water-holding, and gel-forming properties, enabling applications in baking, dairy, and meat analogs. Bioactive peptides derived from these proteins exhibit antioxidant, antimicrobial (inhibiting E. coli and S. aureus), anti-inflammatory (reducing TNF-α and IL-6), and antiviral activities (e.g., Dengue virus inhibition). Despite their potential, commercialization faces challenges, including regulatory heterogeneity, high production costs, and consumer acceptance barriers linked to eating habits or sensory attributes. Current market products like Spirulina-enriched snacks and Chlorella tablets highlight progress, but food safety standards and scalable cost-effective extraction technologies remain critical for broader adoption. This review underscores microalgae’s dual role as a nutritional powerhouse and a source of multifunctional bioactives, positioning them at the forefront of sustainable food and pharmaceutical innovation. Full article