Objective:To assess public knowledge,practices and perceptions on typhus fevers in Sri Lanka.Methods:A descriptive study was done in four selected typhus-prone areas in Southern Sri Lanka.A mixed-method was employed u...Objective:To assess public knowledge,practices and perceptions on typhus fevers in Sri Lanka.Methods:A descriptive study was done in four selected typhus-prone areas in Southern Sri Lanka.A mixed-method was employed using face-to-face interviews and questionnaire-based surveys among confirmed cases of typhus and at-risk populations,respectively.Frequencies,percentages,and means were used to characterize socio-demography and evaluate disease awareness.Results:The lay terms for typhus fevers reported in the studied region were“peacock fever”,“tick fever”and“bird fever”.A total of 499 subjects participated[mean±SD,(45±16)years]in the questionnaire-based survey,and 13.6%(n=68)reported past experience of typhus fever,1.2%(n=6)identified the disease as“typhus”while 58.7%(n=293)and 11.8%(n=59)knew it as‘peacock fever’and‘tick fever’,respectively.The etiological agent was unknown to 95.2%(n=475),but 53.5%(n=267)were aware that it was vector-borne.Fever(57.3%,n=286),eschar(35.7%,n=178),headache(22.0%,n=267)and myalgia(19.2%,n=96)were identified as key symptoms.Past disease experience was significantly associated with higher awareness of the main disease symptoms(fever:χ^(2)=15.713,P<0.001;headache:χ^(2)=19.447,P<0.001;lymphadenopathy:Fisher’s exact test,P=0.023;eschar:χ^(2)=12.049,P<0.001).None knew of any disease prevention methods.Participants with a past history of typhus fever had sought treatment at state hospitals(55.9%,38/68)and private sector hospitals(5.9%,4/68).Conclusions:Public awareness on preventive practices for typhus fevers was rare among the participants though vector-borne aspect was known to many.Clinical disease awareness was deficient among those without past experience of typhus fever.Community sensitization on vector avoidance strategies is highly recommended.展开更多
Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicin...Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicine department of the “G” Point University Hospital in Bamako. Included were all records of hospitalized patients with a central temperature greater than 37°C in the morning and 37°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment. We include all the patients of the study period with fever greater than 37.5°C in the morning and 37.8°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment, which have more than 21 days and measured on several occasions. The data were collected on a survey sheet. Data entry and analysis was done on SPSS software. Results: We recorded 243 fever cases out of 2155 hospitalizations, a prevalence rate of 11.2%. There were 128 men and 115 women with an average age of 43 years (range, 15 to 84 years), a modal class of 37 to 47 years, and a sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic causes 09.6% and inflammatory 01.2% of cases. HIV infection was found in 26.4% of patients, malaria 13.5% and urinary tract infections 10.2%). Gram negative bacilli 88% consisted mainly of Escherichia coli (56%) and Klebsiella pneumoniae (20%).展开更多
Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of e...Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.展开更多
Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed...Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed using “viral hemorrhagic fever, Case Report, Renal Failure” as the subject. The inclusion criteria were the following: 1) case report and case series of two or more patients;2) the report detailed the clinical presentation and reported the status of the renal system;3) the report described the management of renal failure if any;and 4) the etiology of the infection is known and is one of the known agents of viral hemorrhagic fever, listed on the centers of disease control website. We excluded infections related to vaccination related to viral hemorrhagic fever. Result: We found the mean age of these patients was 41.5. The male to female ratio was about 3.5:1. Dengue and Hantaviruses constituted 70.5% of patients. The overall mortality of the study cohort was 32.2%. Half of the patients had acute kidney injury and required renal replacement therapy. The chi-square statistic is 0.41;The p-value is 0.51;The chi-square statistic is 6.4254. Overall mortality was 32.3% in one cohort of 78 patients. The illness goes through several stages [1] [2] of clinical features and some viruses in the group have a high case fatality rate. Conclusions: Early diagnosis with aggressive supportive care is critical for improving clinical outcomes. Renal involvement is common. Amongst the cohort reviewed, of patients who had acute kidney injury, half of the patients required renal replacement support. However, some viruses cause greater kidney injury than others, for instance, kidney injury is more severe in Dengue hemorrhagic fevers when compared to Hantaviruses. Simultaneous management of public health by prevention and control of outbreaks is particularly important.展开更多
After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. ...After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab;Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants;of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years;stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001);OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.展开更多
The applied value of serum hepcidin in differential diagnosis of infection fevers versus tumor fevers was explored.A total of 432 fever patients were selected according to the domestic fever of unknown origin（FUO） d...The applied value of serum hepcidin in differential diagnosis of infection fevers versus tumor fevers was explored.A total of 432 fever patients were selected according to the domestic fever of unknown origin（FUO） diagnostic criteria from our hospital between June 2010 and November 2013.Venous blood samples were taken on the day 1,5,10 after admission.The infection group（98 cases） and the tumor group（50 cases） were set up based on the clinical and laboratory findings.ELISA was used to determine the serum hepcidin and IL-6 levels.SPSS 13.0 was used for statistical analysis.Hepcidin showed obvious descending trend on the 10 th day in both the bacterial infection group（66 cases） and the virus infection group（32 cases）,and the descending trend was similar to that of inflammatory indexes such as procalcitonin（PCT）,hypersensitive C-reactive protein（h-CRP）,erythrocyte sedimentation rate（ESR）,white blood cell（WBC）,and ferritin.Serum hepcidin showed no obvious differences in the tumor group on the day 1,5,10 after admission.In the infection groups,serum hepcidin was positively correlated with IL-6（r=0.687,P=0.000） and CRP（r=0.487,P=0.026）,but had a poor correlation with blood sedimentation,ferritin,PCT and WBC（P〉0.05）.Monitoring dynamic changes of hepcidin and related inflammatory factors in patients with fever is expected to be used for clinical identification of infection fever and tumor fever.展开更多
Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necros...Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necrosis factor (TNF), IL-6 and IL-8 levels in 56 patients with HFRS. Results Serum IL-6, urine TNF, IL-6 and IL-8 concentrations in HFRS patients were significantly higher than those in control group, respectively (P<0.001). The concentrations increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL-6, urine TNF, IL-6 and IL-8 increased in accord with the severity of the disease and differed greatly among different types of the disease. Serum IL-6 had remarkable relationships with serum specific antibodies. It was positively related to serum β_2-microglobulin (β_2-MG), blood ureanitrogen (BUN) and creatinine (Cr). Significant positive relationships were also found both between urine IL-6 and TNF, and between IL-6 and IL-8 (r=0.5768, P<0.05; r=0.3760, P<0.01). Conclusion TNF, IL-6 and IL-8 activated during the course of the disease. IL-6 is associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL-6, IL-8 and TNF are involved in the renal immune impairment. Determining them might, in certain extent, be used in predicting the prognosis and outcome of patients with HFRS.展开更多
Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, ...Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.展开更多
The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%...The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%,the most common ways that the disease may spread to humans are via tick bites or coming into touch with infected animals'blood or tissues.Furthermore,the transfer of bodily fluids between individuals is another potential route of infection.There is a wide range of symptoms experienced by patients throughout each stage,from myalgia and fever to extreme bruising and excess bleeding.Tick management measures include minimising the spread of ticks from one species to another and from people to animals via the use of protective clothing,repellents,and proper animal handling.In order to prevent the spread of illness,healthcare workers must adhere to stringent protocols.Despite the lack of an authorised vaccine,the main components of treatment now consist of preventative measures and supportive care,which may include the antiviral medicine ribavirin.We still don't know very much about the virus's mechanisms,even though advances in molecular virology and animal models have improved our understanding of the pathogenesis of CCHFV.A critical need for vaccination that is both safe and effective,as well as for quick diagnosis and efficient treatments to lessen the disease's impact in areas where it is most prevalent.Important steps towards lowering Crimean-Congo hemorrhagic fever mortality and morbidity rates were to anticipatethe future availability of immunoglobulin products.展开更多
Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the p...Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the past decades,these infections have proven to be a significant challenge to health systems worldwide,particularly following the considerable geographic expansion of the dengue virus(DENV)and its most recent outbreak in Latin America as well as the difficult-tocontrol outbreaks of yellow fever virus(YFV),chikungunya virus(CHIKV),and Zika virus(ZIKV),leaving behind a substantial portion of the population with complications related to these infections.Currently,the world is experiencing a period of intense globalization,which,combined with global warming,directly contributes to wider dissemination of arbovirus vectors across the globe.Consequently,all continents remain on high alert for potential new outbreaks.Thus,this review aims to provide a comprehensive understanding of the pathogenesis of the four main arboviruses today(DENV,ZIKV,YFV,and CHIKV)discussing their viral characteristics,immune responses,and mechanisms of viral evasion,as well as important clinical aspects for patient management.This includes associated symptoms,laboratory tests,treatments,existing or developing vaccines and the main associated complications,thus integrating a broad historical,scientific and clinical approach.展开更多
Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in p...Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in patients with other comor-bidities.We have explored the impact of an Ayurvedic medicine,Fevogrit,in an endo-toxin(lipopolysaccharide)-induced fever model in Wistar rats.Methods:Active phytoconstituents of Fevogrit were identified and quantified using ultra-high-performance liquid chromatography(UHPLC)platform.For the in-vivo study,fever was induced in male Wistar rats by the intraperitoneal administration of lipopolysaccharide(LPS),obtained from Escherichia coli.The animals were allocated to normal control,disease control,Paracetamol treated and Fevogrit treated groups.The rectal temperature of animals was recorded at different time points using a digital thermometer.At the 6-h time point,levels of TNF-α,IL-1βand IL-6 cytokines were analyzed in serum.Additionally,the mRNA expression of these cytokines was deter-mined in hypothalamus,24 h post-LPS administration.Results:UHPLC analysis of Fevogrit revealed the presence of picroside I,picroside II,vanillic acid,cinnamic acid,magnoflorine and cordifolioside A,as bioactive constitu-ents with known anti-inflammatory properties.Fevogrit treatment efficiently reduces the LPS-induced rise in the rectal temperature of animals.The levels and gene ex-pression of TNF-α,IL-1βand IL-6 in serum and hypothalamus,respectively,was also significantly reduced by Fevogrit treatment.Conclusion:The findings of the study demonstrated that Fevogrit can suppress LPS-induced fever by inhibiting peripheral or central inflammatory signaling pathways and could well be a viable treatment for infection-induced increase in body temperatures.展开更多
Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the preven...Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.展开更多
Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has ...Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.展开更多
BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment...BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.展开更多
Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential di...Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential diagno‑sis a challenge.The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania.Methods:This facility-based cross-sectional study was carried out between June and November 2018 in Buhigwe,Kalambo,Kyela,Kilindi,Kinondoni,Kondoa,Mvomero,and Ukerewe districts in Tanzania.The study involved febrile patients seeking health care from primary healthcare facilities.Blood samples were collected and tested for infections due to malaria,Crimean-Congo haemorrhagic fever(CCHF),Ebola virus disease(EVD),Marburg virus disease(MVD),Rift Valley fever(RVF)and yellow fever(YF).Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immuno‑sorbent assays.The Chi-square test was used to compare the proportions.Results:A total of 308 participants(mean age=35±19 years)were involved in the study.Of these,54(17.5%)had malaria infection and 15(4.8%)were positive for IgM antibodies against VHFs(RVF=8;CCHF=2;EBV=3;MBV=1;YF=1).Six(1.9%)individuals had both VHF(RVF=2;CCHF=1;EVD=2;MVD=1)and malaria infections.The highest co-infection prevalence(0.6%)was observed among individuals aged 46‒60 years(P<0.05).District was signifcantly associated with co-infection(P<0.05)with the highest prevalence recorded in Buhigwe(1.2%)followed by Kinondoni(0.9%)districts.Headache(100%)and muscle,bone,back and joint pains(83.3%)were the most signifcant complaints among those infected with both VHFs and malaria(P=0.001).Conclusions:Co-infections of VHF and malaria are prevalent in Tanzania and afect more the older than the younger population.Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis,adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.展开更多
Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December...Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.展开更多
Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and...Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and treatment(Wang et al. 2023). Due to its enormous economic and social impact, it is listed as a notifiable animal disease by the World Organization for Animal Health(Costard et al. 2013). Although ASF has been present in Sub-Saharan Africa since its first discovery in Kenya.展开更多
BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this m...BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.展开更多
Dear Editor,Lassa virus(LASV)is the causative agent of the acute viral hemorrhagic Lassa fever(LF),which is classified into Mammarenavirus within the Arenaviridae family,with a single-stranded,negative-sense,bisegment...Dear Editor,Lassa virus(LASV)is the causative agent of the acute viral hemorrhagic Lassa fever(LF),which is classified into Mammarenavirus within the Arenaviridae family,with a single-stranded,negative-sense,bisegmented RNA genome.Due to its high pathogenicity and lethality,LASV is considered as a priority threat to public health,with an estimated cases of 300,000 infections and 5000 deaths annually.LASV was first isolated and described as a clinical entity in 1969 in Lassa,Nigeria(Garry,2023).LASV isolates of different geographic and host origins are highly diverse in genomic sequences and phylogenetically classified into up to seven lineages,with each lineage predominately localized in specific countries.Although the research on LF has been carried out for decades since the pathogen first characterized,there is no approved antiviral drugs or vaccines for clinical use against LASV to date(Grant et al.,2023).One possible reason that hindered the development of countermeasures is that the preclinical studies on authentic LASV are restricted in high bio-containment biosafety level 4(BSL-4)facilities.In this letter,we describe isolation,and characterization of the LASV from the clinical samples.And we applied a coadministration assay of antiviral drugs for LASV by using a clinically isolated Mammarenavirus lassaense strain in the BSL-4 facility,aiming to investigate new therapeutic strategies for LASV infection.展开更多
Summer has heated up China’s already red-hot“museum fever,”with popular institutions requiring bookings weeks in advance.Museums are responding by extending their hours,adding nighttime openings,and providing tech-...Summer has heated up China’s already red-hot“museum fever,”with popular institutions requiring bookings weeks in advance.Museums are responding by extending their hours,adding nighttime openings,and providing tech-driven experiences designed to captivate younger visitors.There are over 100,000 museums globally,according to UNESCO data,with nearly 7,000 registered in China alone.展开更多
基金financed in part by the National Research Council,Sri Lanka[NRC18-008]Research Grant No.[RP/03/04/06/02/2018]of University of Kelaniya,Sri Lanka.
文摘Objective:To assess public knowledge,practices and perceptions on typhus fevers in Sri Lanka.Methods:A descriptive study was done in four selected typhus-prone areas in Southern Sri Lanka.A mixed-method was employed using face-to-face interviews and questionnaire-based surveys among confirmed cases of typhus and at-risk populations,respectively.Frequencies,percentages,and means were used to characterize socio-demography and evaluate disease awareness.Results:The lay terms for typhus fevers reported in the studied region were“peacock fever”,“tick fever”and“bird fever”.A total of 499 subjects participated[mean±SD,(45±16)years]in the questionnaire-based survey,and 13.6%(n=68)reported past experience of typhus fever,1.2%(n=6)identified the disease as“typhus”while 58.7%(n=293)and 11.8%(n=59)knew it as‘peacock fever’and‘tick fever’,respectively.The etiological agent was unknown to 95.2%(n=475),but 53.5%(n=267)were aware that it was vector-borne.Fever(57.3%,n=286),eschar(35.7%,n=178),headache(22.0%,n=267)and myalgia(19.2%,n=96)were identified as key symptoms.Past disease experience was significantly associated with higher awareness of the main disease symptoms(fever:χ^(2)=15.713,P<0.001;headache:χ^(2)=19.447,P<0.001;lymphadenopathy:Fisher’s exact test,P=0.023;eschar:χ^(2)=12.049,P<0.001).None knew of any disease prevention methods.Participants with a past history of typhus fever had sought treatment at state hospitals(55.9%,38/68)and private sector hospitals(5.9%,4/68).Conclusions:Public awareness on preventive practices for typhus fevers was rare among the participants though vector-borne aspect was known to many.Clinical disease awareness was deficient among those without past experience of typhus fever.Community sensitization on vector avoidance strategies is highly recommended.
文摘Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicine department of the “G” Point University Hospital in Bamako. Included were all records of hospitalized patients with a central temperature greater than 37°C in the morning and 37°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment. We include all the patients of the study period with fever greater than 37.5°C in the morning and 37.8°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment, which have more than 21 days and measured on several occasions. The data were collected on a survey sheet. Data entry and analysis was done on SPSS software. Results: We recorded 243 fever cases out of 2155 hospitalizations, a prevalence rate of 11.2%. There were 128 men and 115 women with an average age of 43 years (range, 15 to 84 years), a modal class of 37 to 47 years, and a sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic causes 09.6% and inflammatory 01.2% of cases. HIV infection was found in 26.4% of patients, malaria 13.5% and urinary tract infections 10.2%). Gram negative bacilli 88% consisted mainly of Escherichia coli (56%) and Klebsiella pneumoniae (20%).
文摘Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.
文摘Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed using “viral hemorrhagic fever, Case Report, Renal Failure” as the subject. The inclusion criteria were the following: 1) case report and case series of two or more patients;2) the report detailed the clinical presentation and reported the status of the renal system;3) the report described the management of renal failure if any;and 4) the etiology of the infection is known and is one of the known agents of viral hemorrhagic fever, listed on the centers of disease control website. We excluded infections related to vaccination related to viral hemorrhagic fever. Result: We found the mean age of these patients was 41.5. The male to female ratio was about 3.5:1. Dengue and Hantaviruses constituted 70.5% of patients. The overall mortality of the study cohort was 32.2%. Half of the patients had acute kidney injury and required renal replacement therapy. The chi-square statistic is 0.41;The p-value is 0.51;The chi-square statistic is 6.4254. Overall mortality was 32.3% in one cohort of 78 patients. The illness goes through several stages [1] [2] of clinical features and some viruses in the group have a high case fatality rate. Conclusions: Early diagnosis with aggressive supportive care is critical for improving clinical outcomes. Renal involvement is common. Amongst the cohort reviewed, of patients who had acute kidney injury, half of the patients required renal replacement support. However, some viruses cause greater kidney injury than others, for instance, kidney injury is more severe in Dengue hemorrhagic fevers when compared to Hantaviruses. Simultaneous management of public health by prevention and control of outbreaks is particularly important.
文摘After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab;Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants;of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years;stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001);OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.
文摘The applied value of serum hepcidin in differential diagnosis of infection fevers versus tumor fevers was explored.A total of 432 fever patients were selected according to the domestic fever of unknown origin（FUO） diagnostic criteria from our hospital between June 2010 and November 2013.Venous blood samples were taken on the day 1,5,10 after admission.The infection group（98 cases） and the tumor group（50 cases） were set up based on the clinical and laboratory findings.ELISA was used to determine the serum hepcidin and IL-6 levels.SPSS 13.0 was used for statistical analysis.Hepcidin showed obvious descending trend on the 10 th day in both the bacterial infection group（66 cases） and the virus infection group（32 cases）,and the descending trend was similar to that of inflammatory indexes such as procalcitonin（PCT）,hypersensitive C-reactive protein（h-CRP）,erythrocyte sedimentation rate（ESR）,white blood cell（WBC）,and ferritin.Serum hepcidin showed no obvious differences in the tumor group on the day 1,5,10 after admission.In the infection groups,serum hepcidin was positively correlated with IL-6（r=0.687,P=0.000） and CRP（r=0.487,P=0.026）,but had a poor correlation with blood sedimentation,ferritin,PCT and WBC（P〉0.05）.Monitoring dynamic changes of hepcidin and related inflammatory factors in patients with fever is expected to be used for clinical identification of infection fever and tumor fever.
文摘Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necrosis factor (TNF), IL-6 and IL-8 levels in 56 patients with HFRS. Results Serum IL-6, urine TNF, IL-6 and IL-8 concentrations in HFRS patients were significantly higher than those in control group, respectively (P<0.001). The concentrations increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL-6, urine TNF, IL-6 and IL-8 increased in accord with the severity of the disease and differed greatly among different types of the disease. Serum IL-6 had remarkable relationships with serum specific antibodies. It was positively related to serum β_2-microglobulin (β_2-MG), blood ureanitrogen (BUN) and creatinine (Cr). Significant positive relationships were also found both between urine IL-6 and TNF, and between IL-6 and IL-8 (r=0.5768, P<0.05; r=0.3760, P<0.01). Conclusion TNF, IL-6 and IL-8 activated during the course of the disease. IL-6 is associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL-6, IL-8 and TNF are involved in the renal immune impairment. Determining them might, in certain extent, be used in predicting the prognosis and outcome of patients with HFRS.
文摘Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.
文摘The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%,the most common ways that the disease may spread to humans are via tick bites or coming into touch with infected animals'blood or tissues.Furthermore,the transfer of bodily fluids between individuals is another potential route of infection.There is a wide range of symptoms experienced by patients throughout each stage,from myalgia and fever to extreme bruising and excess bleeding.Tick management measures include minimising the spread of ticks from one species to another and from people to animals via the use of protective clothing,repellents,and proper animal handling.In order to prevent the spread of illness,healthcare workers must adhere to stringent protocols.Despite the lack of an authorised vaccine,the main components of treatment now consist of preventative measures and supportive care,which may include the antiviral medicine ribavirin.We still don't know very much about the virus's mechanisms,even though advances in molecular virology and animal models have improved our understanding of the pathogenesis of CCHFV.A critical need for vaccination that is both safe and effective,as well as for quick diagnosis and efficient treatments to lessen the disease's impact in areas where it is most prevalent.Important steps towards lowering Crimean-Congo hemorrhagic fever mortality and morbidity rates were to anticipatethe future availability of immunoglobulin products.
基金Supported by the Permanecer Program(part of the actions of the Office of Affirmative Actions)Education and Diversity of the Dean of Student Assistance at the Federal University of Bahia(UFBA)and CNPq Research Productivity Fellow.
文摘Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the past decades,these infections have proven to be a significant challenge to health systems worldwide,particularly following the considerable geographic expansion of the dengue virus(DENV)and its most recent outbreak in Latin America as well as the difficult-tocontrol outbreaks of yellow fever virus(YFV),chikungunya virus(CHIKV),and Zika virus(ZIKV),leaving behind a substantial portion of the population with complications related to these infections.Currently,the world is experiencing a period of intense globalization,which,combined with global warming,directly contributes to wider dissemination of arbovirus vectors across the globe.Consequently,all continents remain on high alert for potential new outbreaks.Thus,this review aims to provide a comprehensive understanding of the pathogenesis of the four main arboviruses today(DENV,ZIKV,YFV,and CHIKV)discussing their viral characteristics,immune responses,and mechanisms of viral evasion,as well as important clinical aspects for patient management.This includes associated symptoms,laboratory tests,treatments,existing or developing vaccines and the main associated complications,thus integrating a broad historical,scientific and clinical approach.
基金This study was supported by internal funds from Patanjali Research Foundation Trust,Haridwar,India。
文摘Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in patients with other comor-bidities.We have explored the impact of an Ayurvedic medicine,Fevogrit,in an endo-toxin(lipopolysaccharide)-induced fever model in Wistar rats.Methods:Active phytoconstituents of Fevogrit were identified and quantified using ultra-high-performance liquid chromatography(UHPLC)platform.For the in-vivo study,fever was induced in male Wistar rats by the intraperitoneal administration of lipopolysaccharide(LPS),obtained from Escherichia coli.The animals were allocated to normal control,disease control,Paracetamol treated and Fevogrit treated groups.The rectal temperature of animals was recorded at different time points using a digital thermometer.At the 6-h time point,levels of TNF-α,IL-1βand IL-6 cytokines were analyzed in serum.Additionally,the mRNA expression of these cytokines was deter-mined in hypothalamus,24 h post-LPS administration.Results:UHPLC analysis of Fevogrit revealed the presence of picroside I,picroside II,vanillic acid,cinnamic acid,magnoflorine and cordifolioside A,as bioactive constitu-ents with known anti-inflammatory properties.Fevogrit treatment efficiently reduces the LPS-induced rise in the rectal temperature of animals.The levels and gene ex-pression of TNF-α,IL-1βand IL-6 in serum and hypothalamus,respectively,was also significantly reduced by Fevogrit treatment.Conclusion:The findings of the study demonstrated that Fevogrit can suppress LPS-induced fever by inhibiting peripheral or central inflammatory signaling pathways and could well be a viable treatment for infection-induced increase in body temperatures.
基金supported by Public Health Talent Training and Surport Plan(National Administration of Disease Prevention and Control)Research and application of new technology for rapid monitoring and tracing of emergent infectious diseases among entry-exit population(2024YFFK0056)Monitoring,Early warning and Response of Major Infectious Diseases(2022ZDZX0017).
文摘Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.
基金supported by the National Natural Science Foundation of China(32170144 and 32470146).
文摘Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.
基金Supported by The INCT-CNPq Program,No.465425/2014-3.
文摘BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.
文摘Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential diagno‑sis a challenge.The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania.Methods:This facility-based cross-sectional study was carried out between June and November 2018 in Buhigwe,Kalambo,Kyela,Kilindi,Kinondoni,Kondoa,Mvomero,and Ukerewe districts in Tanzania.The study involved febrile patients seeking health care from primary healthcare facilities.Blood samples were collected and tested for infections due to malaria,Crimean-Congo haemorrhagic fever(CCHF),Ebola virus disease(EVD),Marburg virus disease(MVD),Rift Valley fever(RVF)and yellow fever(YF).Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immuno‑sorbent assays.The Chi-square test was used to compare the proportions.Results:A total of 308 participants(mean age=35±19 years)were involved in the study.Of these,54(17.5%)had malaria infection and 15(4.8%)were positive for IgM antibodies against VHFs(RVF=8;CCHF=2;EBV=3;MBV=1;YF=1).Six(1.9%)individuals had both VHF(RVF=2;CCHF=1;EVD=2;MVD=1)and malaria infections.The highest co-infection prevalence(0.6%)was observed among individuals aged 46‒60 years(P<0.05).District was signifcantly associated with co-infection(P<0.05)with the highest prevalence recorded in Buhigwe(1.2%)followed by Kinondoni(0.9%)districts.Headache(100%)and muscle,bone,back and joint pains(83.3%)were the most signifcant complaints among those infected with both VHFs and malaria(P=0.001).Conclusions:Co-infections of VHF and malaria are prevalent in Tanzania and afect more the older than the younger population.Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis,adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.
文摘Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.
基金supported by the National Key Research and Development Program of China (2021YFD1800100)the earmarked fund for China Agriculture Research System (CARS-35)。
文摘Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and treatment(Wang et al. 2023). Due to its enormous economic and social impact, it is listed as a notifiable animal disease by the World Organization for Animal Health(Costard et al. 2013). Although ASF has been present in Sub-Saharan Africa since its first discovery in Kenya.
文摘BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.
基金supported by the National Key Research and Development Program of China(2022YFC2303300,2023YFC2605504)the National Natural Science Foundation of China(82172273 and 31670165)the Open Research Fund Program of the State Key Laboratory of Virology of China(2023JZZD-01).
文摘Dear Editor,Lassa virus(LASV)is the causative agent of the acute viral hemorrhagic Lassa fever(LF),which is classified into Mammarenavirus within the Arenaviridae family,with a single-stranded,negative-sense,bisegmented RNA genome.Due to its high pathogenicity and lethality,LASV is considered as a priority threat to public health,with an estimated cases of 300,000 infections and 5000 deaths annually.LASV was first isolated and described as a clinical entity in 1969 in Lassa,Nigeria(Garry,2023).LASV isolates of different geographic and host origins are highly diverse in genomic sequences and phylogenetically classified into up to seven lineages,with each lineage predominately localized in specific countries.Although the research on LF has been carried out for decades since the pathogen first characterized,there is no approved antiviral drugs or vaccines for clinical use against LASV to date(Grant et al.,2023).One possible reason that hindered the development of countermeasures is that the preclinical studies on authentic LASV are restricted in high bio-containment biosafety level 4(BSL-4)facilities.In this letter,we describe isolation,and characterization of the LASV from the clinical samples.And we applied a coadministration assay of antiviral drugs for LASV by using a clinically isolated Mammarenavirus lassaense strain in the BSL-4 facility,aiming to investigate new therapeutic strategies for LASV infection.
文摘Summer has heated up China’s already red-hot“museum fever,”with popular institutions requiring bookings weeks in advance.Museums are responding by extending their hours,adding nighttime openings,and providing tech-driven experiences designed to captivate younger visitors.There are over 100,000 museums globally,according to UNESCO data,with nearly 7,000 registered in China alone.
