Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have longer stay in hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

In silico Studies on Selected Drug Targets for Combating Drug Resistance in Plasmodium falcifarum

With drug resistance becoming widespread in Plasmodium falciparum infections, the development of the alternative drugs is the desired strategy for prevention and cure of malaria. Three drug targets were selected to screen promising drug molecules from the GSK library of 13469 molecules. Using an in silico structure-based drug designing approach, the differences in binding energies of the substrate and inhibitor were exploited between target sites of parasite and human to design a drug molecule against Plasmodium. The docking studies have shown several promising molecules from GSK library with more effective binding as compared to the already known inhibitors for the drug targets. Though stronger interaction has been shown by several molecules as compared to the reference, few molecules have shown the potential as drug candidates though in vitro studies are required to validate the results. In case of thymidylate synthase-dihydrofolatereductase (TS-DHFR), three compounds have shown promise for future studies as potential drugs.

Mutational Effect to Particular Interaction Energy of Cycloguanil Drug to Plasmodium Plasmodium Falciparum Dihydrofolate Reductase Enzymes

In order to find the particular interaction energy between cylcloguanil and the amino acids surrounding the pocket of wild type and quadruple mutant type PfDHFR enzymes, the MP2 method with basis set 6-31G(d,p) level of calculations was performed. The obtained interaction energies found that Asp54 has the strongest interaction energy to both wild type and mutant type of - 12.439 and -11.250 kcal/mol, respectively and three amino acids; Asp54, Ile164 and Ile14 formed the H-bonding with cycloguanil drug. Importantly, the mutation at Ser108Asn was the key important of cycloguanil resistant with showing repulsive interaction energy.

Effect of the Seasonal Variation in the Extrinsic Incubation Period on the Long Term Behavior of the Dengue Hemorrhagic Fever Epidemic

The incidences of dengue hemorrhagic disease (DHF) over the long term exhibit a seasonal behavior. It has been hypothesized that these behaviors are due to the seasonal climate changes which in turn induce a seasonal variation in the incubation period of the virus while it is developing the mosquito. The standard dynamic analysis is applied for analysis the Susceptible-Exposed- Infectious-Recovered (SEIR) model which includes an annual variation in the length of the extrinsic incubation period (EIP). The presence of both asymptomatic and symptomatic infections is allowed in the present model. We found that dynamic behavior of the endemic state changes as the influence of the seasonal variation of the EIP becomes stronger. As the influence is further increased, the trajectory exhibits sustained oscillations when it leaves the chaotic region.

Modelling Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) Outbreak Using Poisson and Negative Binomial Model

Dengue fever has become a major concern for health authorities all over the world particularly in the tropical countries. These countries, in particular are experiencing the most worrying outbreak of dengue fever (DF) and dengue haemorrhagic fever (DHF). The DF and DHF epidemics, thus, have become the main causes of hospital admissions and deaths in Malaysia. This paper, therefore, attempts to examine the environmental factors that may influence the recent dengue outbreak. The aim of this study is twofold, firstly is to establish a statistical model to describe the relationship between the number of dengue cases and a range of explanatory variables and secondly, to identify the lag operator for explanatory variables which affect the dengue incidence the most. The explanatory variables involved include the level of cloud cover, percentage of relative humidity, amount of rainfall, maximum temperature, minimum temperature and wind speed. The Poisson and Negative Binomial regression analyses were used in this study. The results of the analyses on the 915 observations (daily data taken from July 2006 to Dec 2008), reveal that the climatic factors comprising of daily temperature and wind speed were found to significantly influence the incidence of dengue fever after 2 and 3 weeks of their occurrences. The effect of humidity, on the other hand, appears to be significant only after 2 weeks.

Predicting DHF Incidence in Northern Thailand using Time Series Analysis Technique

This study aimed at developing a forecasting model on the number of Dengue Haemorrhagic Fever (DHF) incidence in Northern Thailand using time series analysis. We developed Seasonal Autoregressive Integrated Moving Average (SARIMA) models on the data collected between 2003-2006 and then validated the models using the data collected between January-September 2007. The results showed that the regressive forecast curves were consistent with the pattern of actual values. The most suitable model was the SARIMA(2,0,1)(0,2,0)12 model with a Akaike Information Criterion (AIC) of 12.2931 and a Mean Absolute Percent Error (MAPE) of 8.91713. The SARIMA(2,0,1)(0,2,0)12 model fitting was adequate for the data with the Portmanteau statistic Q20 = 8.98644 ( x20,95= 27.5871, P>0.05). This indicated that there was no significant autocorrelation between residuals at different lag times in the SARIMA(2,0,1)(0,2,0)12 model.

Seasonal Prevalence of Aedes aegypti and Ae.albopictus in Three Topographical Areas of Southern Thailand

This study investigated the seasonal prevalence of Aedes aegypti and Ae. albopictus larvae in three topographical areas (i.e. mangrove, rice paddy and mountainous areas). Samples were collected from 300 households in both wet and dry seasons in nine districts in Nakhon Si Thammarat province. Ae. aegypti and Ae. albopictus were found in 21 out of 29 types of water containers in mangrove, rice paddy and mountainous areas. Ae. aegypti and Ae. albopictus laid eggs in different container types depending on season and topographical areas. Ae. aegypti larvae were found most in metal box in mangrove and mountainous areas in wet season. Ae. albopictus larvae were also found most in metal box in mangrove and mountainous areas in both wet and dry seasons. All Ae. albopictus larval indices were higher than Ae. aegypti larval indices in all three topographical areas and both seasons. HI and BI did not differ in three topographical areas but differed between Aedes sp. HI for both Ae. aegypti and Ae. albopictus in all three topographical areas in both seasons were greater than 10 %, except Aedes aegypti in rice paddy area in wet season. This indicated high risks of DHF transmission in these areas.

Larval Occurrence and Climatic Factors Affecting DHF Incidence in Samui Islands, Thailand

This study investigated the number of Aedes larvae, the key breeding sites of Aedes sp., and the relationship between climatic factors and the incidence of DHF in Samui Islands. We conducted our questionnaire and larval surveys from randomly selected 105 households in Samui Islands in July-September 2006. Pearson-s correlation coefficient was used to explore the primary association between the DHF incidence and all climatic factors. Multiple stepwise regression technique was then used to fit the statistical model. The results showed that the positive indoor containers were small jars, cement tanks, and plastic tanks. The positive outdoor containers were small jars, cement tanks, plastic tanks, used cans, tires, plastic bottles, discarded objects, pot saucers, plant pots, and areca husks. All Ae. albopictus larval indices (i.e., CI, HI, and BI) were higher than Ae. aegypti larval indices in this area. These larval indices were higher than WHO standard. This indicated a high risk of DHF transmission at Samui Islands. The multiple stepwise regression model was y = –288.80 + 11.024xmean temp. The mean temperature was positively associated with the DHF incidence in this area.