Aedes aegypti and Aedes albopictus are vectors of arboviruses and have different levels of resistance to synthetic insecticides, such as the organophosphate temephos, according to their area of occurrence. As an alternative, there are semisynthetic substances with potential insecticidal effect; however, they need to be fully tested by an effective method for the mosquito control. The semi-synthetic dillapiole n-butyl ether exhibits toxic ovicidal and larvicidal activity in both mosquito species. However, has no proven the mutagenicity and cytotoxicity risks of this larvicide in drinking water effect for consumption by non-target organisms, such as in humans neither in other vertebrates, which access pools of water contain this sprayed substance. In this sense, both of the biomarkers of the genotoxicity, the micronucleus (MN) and comet, using this substance were tested in Balb/C mice to assess the genetic damage and risks of its application as a mitigating measure against Ae. aegypti. Male specimens (n = 60) were exposed to dillapiole n-butyl ether at concentrations of 10, 20 and 40 mg/kg via a comet assay in peripheral blood (n = 30) and a micronucleus test in bone marrow cells (n = 30). The induction of mutagenicity and cytotoxicity of dillapiole n-butyl ether in these animals occurred only at a concentration of 40 mg/kg, in multiple treatments. However, dillapiole n-butyl ether at concentrations of 20 and 10 mg/kg has potential for use against Ae. aegypti in the form of a larvicide in water for consumption by humans and other vertebrates a new vector control measure.

This case series describes the wide spectrum of clinical presentation, laboratory findings, and morbidity/mortality associated with dengue fever in hematopoietic stem cell transplant recipients, treated in a dengue endemic region. The risk of acquiring viral infections increases manifold after transplant due to the severely immunocompromised state amid conditioning toxicity and immunosuppressive therapy. The classical warning signs of dengue viremia are often masked in posttransplant patients, leading to a missed diagnosis of dengue and grave consequences observed in some of the patients. Accurate and timely diagnosis of dengue fever especially in dengue prevalent areas can prevent the unwarranted complications and reduce the morbidity and mortality associated with dengue in allogeneic/autologous transplant recipients.

UNASSIGNED: Dengue virus (DENV) is an RNA virus transmitted by Aides mosquito causing dengue fever. There is growing recognition of neurological symptoms associated with DENV infection, some of which might be lethal if left untreated. Case reports describing sagittal sinus thrombosis, as a serious neurologic consequence of dengue infection, are rare. It is still unknown how often sagittal sinus thrombosis occurs and what variables increase the risk in dengue patients.
UNASSIGNED: Herein the authors presented an elderly Sudanese patient diagnosed with dengue fever. He was admitted, then 2 days after admission, the condition was complicated by atrial fibrillation, sagittal sinus thrombosis complicated by massive left temporal lobe infarction with haemorrhagic transformation and recurrent episodes of status epilepticus. After receiving the necessary care, his condition remained the same and no progress or deterioration was seen.
UNASSIGNED: Sagittal sinus thrombosis can happen due to several underlying causes. DENV can very rarely lead to such condition. The authors\' patient developed this condition, which was later complicated by ischaemic stroke with haemorrhagic transformation and status epilepticus. In addition to a familial history of DVT and a history of myocardial infarction, our patient also acquired cardiac mural thrombus and DVT throughout his illness, which increased the suspicion of a protein C, protein S, or antithrombin 3 deficiency.
UNASSIGNED: Sagittal sinus thrombosis with haemorrhagic infarction associated with thrombocytopenia is a very rare kind of stroke that occurs in dengue. Dengue as a pathogenic mechanism of ischaemic stroke requires validation with further data.

Dengue virus (DENV), from the Flaviviridae family, is the causative agent of dengue fever and poses a significant global health challenge. The virus primarily affects the vascular system and liver; however, a growing body of evidence suggests its involvement in the gastrointestinal (GI) tract, contributing to clinical symptoms such as abdominal pain, vomiting, and diarrhea. However, the mechanisms underlying DENV infection in the digestive system remain largely unexplored. Prior research has detected viral RNA in the GI tissue of infected animals; however, whether the dengue virus can directly infect human enterocytes remains unclear. In this study, we examine the infectivity of human intestinal cell lines to the dengue virus and their subsequent response. We report that the Caco-2 cell line, a model of human enterocytes, is susceptible to infection and capable of producing viruses. Notably, differentiated Caco-2 cells exhibited a lower infection rate yet a higher level of virus production than their undifferentiated counterparts. These findings suggest that human intestinal cells are a viable target for the dengue virus, potentially elucidating the GI symptoms observed in dengue fever and offering a new perspective on the pathogenetic mechanisms of the virus.

UNASSIGNED: Dengue fever, a neglected tropical disease, exhibits a total seroprevalence of 27% in Sudan. During the recent outbreak, medical students actively participated in health education and community outreach programs. This study aims to assess the knowledge, attitude, and practice (KAP) of medical students regarding Dengue Fever (DF) during its current outbreak in Sudan.
UNASSIGNED: We conducted a cross-sectional study involving medical students from more than 15 Sudanese universities, encompassing 11 states. Data collection took place between October 23 and November 10, 2023, utilizing a Google Form questionnaire. A convenient sampling technique was employed to reach students due to its accessibility and feasibility during the ongoing conflict in Sudan. Correlation and regression analyses were used to identify predictors of KAP and establish associations between KAP domains and socio-demographic factors.
UNASSIGNED: Of 694 medical students, 11% reported a previous infection with DF. Among the participants, 58% demonstrated good knowledge, 74.1% exhibited a positive attitude, and less than half (46.7%) demonstrated good preventive practices. There was a positive correlation between knowledge and attitude levels with the practice level (p < 0.001). Gender, age, and previous DF infection emerged as significant predictors (p < 0.05) of the overall KAP level in multiple logistic regression.
UNASSIGNED: Our study revealed a commendable level of knowledge and attitude but a suboptimal level of practice regarding DF among medical students. This inadequacy in practice, particularly among medical students who are expected to set an example, is concerning and warrants further investigation.

Dengue fever, caused by the dengue virus (DENV), poses a significant global health threat, with a dramatic increase in cases driven by climate change, urbanization, and mosquito resistance. In Pakistan, a country with a population of 240 million, the world\'s fifth largest, dengue has emerged as an escalating public health crisis, with seasonal outbreaks severely straining the healthcare system. Despite decades of vector control efforts, there has not been much success, necessitating the introduction of dengue vaccination to boost population immunity. Recent advancements in vaccine development demonstrate promising efficacy and safety profiles, even in dengue-naive individuals. Implementing a dengue vaccination program in Pakistan could significantly reduce the disease burden, lower healthcare costs, and prevent future outbreaks. Integrating vaccination with existing public health initiatives can achieve high coverage and improve overall public health outcomes.

BACKGROUND: Dengue fever is an arboviral disease caused by the dengue virus (DENV). Its geographical distribution and health burden have been steadily increasing through tropical and subtropical climates in recent decades.
METHODS: We developed a temperature- and precipitation-dependent mechanistic model for the global risk of dengue fever outbreaks using the basic reproduction number (R0) as the metric of disease transmission risk. We used our model to evaluate the global risk of dengue outbreaks from 1950 to 2020 and to investigate the impact of annual seasons and El Niño events.
RESULTS: We showed that the global annual risk of dengue outbreaks has steadily increased during the last four decades. Highest R0 values were observed in South America, Southeast Asia, and the Equatorial region of Africa year-round with large seasonal variations occurring in other regions. El Niño was shown to be positively correlated with the global risk of dengue outbreaks with a correlation of 0.52. However, the impact of El Niño on dengue R0 was shown to vary across geographical regions and between El Niño events.
CONCLUSIONS: Strong El Niño events may increase the risk of dengue outbreaks across the globe. The onset of these events may trigger a surge of control efforts to minimize risk of dengue outbreaks.

BACKGROUND: Dengue fever (DF) is one of the most prevalent arboviral infections worldwide. In Iran, the dengue-positive serological cases as well as the presence of the dengue vector Aedes aegypti have raised health concerns, highlighting the need to enhance the dengue surveillance system. This study aims to assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding dengue fever in a large and high-risk region of southeastern Iran.
METHODS: A total of 492 HCPs were recruited using a multi-stage sampling method from May 2022 to July 2023. Data were collected using a self-administered questionnaire. Data analysis was done using independent t-tests, one-way analysis of variance (ANOVA), one-factor and multi-factor general linear models, and simple and multiple regression models.
RESULTS: About two-thirds (71%) of the participants did not receive any training on DF. A small percentage of participants were familiar with ovitrap (32.6%) and only 21.7% knew that destroying larval breeding sites could not eliminate the dengue vector. The knowledge of disease symptoms among HCPs was found to be lower in border areas compared to non-border areas (P = 0.018). However, the practice situation in HCPs working in border areas was better than in non-borders (P = 0.003). According to the multiple regression model, the most influential factors associated with knowledge, attitude, and practice were the type of healthcare facility and passing the DF training course. Additionally, education level, work experience, and gender were identified as other factors associated with it, respectively. Significant correlations were found between knowledge and practice (P < 0.001), indicating that higher knowledge led to better practice. Similarly, a positive attitude was significantly linked to better practice (P < 0.001).
CONCLUSIONS: Regular, targeted, and continuous training courses are necessary to improve the knowledge level of HCPs, particularly those with lower education levels working in low-level health centers. Utilizing comprehensive dengue KAP studies to evaluate the status and impact of health education programs and identify gaps between knowledge and practice should be a research priority.

Background Dengue fever poses a significant health burden globally, particularly in tropical and subtropical regions. Early diagnosis and effective management are crucial in reducing morbidity and mortality associated with the disease. Bedside abdominal ultrasound has emerged as a promising tool for assessing dengue patients, providing real-time imaging of abdominal organs, and aiding clinical decision-making. Materials and methods This cross-sectional study was conducted in 55 adult emergency departments of Manipal Hospital, Bengaluru, from March 2017 to March 2018. Adult patients presenting with signs and symptoms suggestive of dengue fever were included. Clinical data, laboratory investigations, and bedside abdominal ultrasound findings were systematically recorded and analyzed using appropriate statistical methods. Results Descriptive statistics revealed characteristic clinical measurements and symptom ratings observed in dengue fever patients. Frequency distributions highlighted common symptoms encountered, while statistical analyses demonstrated significant associations between ultrasonic parameters, disease severity, and outcomes. The study found notable correlations between ultrasonic findings and dengue severity levels, emphasizing the potential of bedside ultrasound as a diagnostic and prognostic tool. Conclusion Bedside abdominal ultrasound shows promise as a valuable adjunctive tool in assessing dengue fever patients. The significant associations between ultrasonic parameters and disease severity suggest its utility in risk stratification and guiding clinical management decisions. Incorporating bedside ultrasound into routine practice may improve patient care and outcomes in dengue fever management. Further research is warranted to validate these findings and explore additional bedside ultrasound applications in dengue fever diagnosis and prognosis.

A vector-borne disease of concern for global public health, dengue fever has been spreading its endemicity and several cases in recent years, particularly in Lahore Pakistan. Dengue transmission is influenced by geo-climatic conditions. This study aimed to map the spatial prevalence of dengue fever in Lahore and its association with geo-climatic factors during the epidemic of the year 2021. In this study, geo-climatic factors that could potentially encourage the growth of the virus are chosen for this study, and their temporal and spatial changeability relate to dengue cases. The objective of this study is to use meteorological, satellite data and Geographic Information System (GIS) techniques to map dengue outbreaks and identify the risk-prone areas by relating geo-climatic factors with dengue outbreaks. The dengue patients and their locations data were collected from the Directorate General of Health Services (DGHS) Lahore. This study uses Google Earth and Landsat-8 OLI/TIRs images to extract geo-climatic and land use parameters. The dot density maps technique was used to represent the spatiotemporal distribution of dengue cases. The hotspot analysis was applied to show the hotspots of dengue cases in district Lahore at the Union Council (UC) level. The Normalised Difference Vegetation Index (NDVI), Normalised Difference Water Index (NDWI), built-up area, population density, precipitation, and Land Surface Temperature (LST) are the factors employed. In this study, correlation was performed to test the significance between precipitation and the prevalence of dengue fever in Lahore. The results show that the incidence and prevalence of dengue fever month-wise at the UC level in Lahore. The distribution pattern of dengue outbreaks in the Lahore area and its demographic factors were found to be associated. It concludes that the increase in the spread of dengue fever is associated with the monsoon rains. The prevalence of dengue is associated with water bodies and high land surface temperature, but it does not represent any significant relation with vegetation cover and land use in Lahore during the year 2021. The study pinpointed the locations that are most susceptible and require care to prevent such outbreaks in the future.