Asian Pacific Journal of Tropical Biomedicine

Issue 7,2016 Table of Contents

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  • 1  Emerging Zika virus infection: What should we know?
    Viroj Wiwanitkit
    2016(7):551-553. DOI: 10.1016/j.apjtb.2016.03.014
    [Abstract](17) [HTML](0) [PDF 311.47 K](86)
    Abstract:
    Zika virus infection is a new emerging viral disease that becomes the present public health threat. At present, this infection can be seen in several countries. The clinical presentation of this infection is a dengue-like illness. Nevertheless, the new information shows that the disease can be sexually transmitted and transplacentally transmitted. In addition, the recent evidence from the recent epidemic in South America shows that the infection in pregnancy can cause neonatal neurological defect. In this short review, the author summarizes and presents interesting data on clinical features of this new emerging infection.
    2  Larvicidal activities of chinaberry, neem and Bacillus thuringiensis israelensis (Bti) to an insecticide resistant population of Anopheles arabiensis from Tolay, Southwest Ethiopia
    Assalif Demissew Meshesha Balkew Melaku Girma
    2016(7):554-561. DOI: 10.1016/j.apjtb.2016.03.013
    [Abstract](12) [HTML](0) [PDF 387.46 K](78)
    Abstract:
    Objective: To elucidate the larvicidal potency of neem, chinaberry and Bacillus thuringiensis israelensis (Bti) to larvae of Anopheles arabiensis under semi-field condition and adult susceptibility/resistance to the conventionally used insecticides in Tolay, Southwestern Ethiopia. Methods: Wild collected 3rd and 4th stage larvae were exposed to neem, and chinaberry seed powder dissolved in water and Bti in artificial containers at three treatment levels: 0.2, 0.1 and 0.05 g/m2 and controls were free of treatments. Larval and pupal mortalities were monitored daily and residual activities were determined. The experiments were replicated three times. The World Health Organization tube test for all classes of insecticides was conducted on adult Anopheles arabiensis reared from field collected larvae and pupae. Data were analyzed using STATA software version 11. Results: In the first application, neem powder caused 88.9%, 87.9% and 79.4% larval and pupal mortality at 0.2, 0.1 and 0.05 g/m2 after 4.3, 6.0 and 5.7 days, respectively. The corresponding killing effect of chinaberry was 80.3%, 62.1% and 30.3% after 7.0, 7.7 and 8.3 days respectively. Bti at all treatments killed 100% after 24 h except 2.7 days for 0.05 g/m2. Adult mosquitoes were susceptible only for fenitrothion and pirimiphos-methyl with 100% mortality while resistant to deltamethrin, alpha-cypermethrin, etofenprox and dichloro-diphenyl-tricgloroethane with only 9.0%, 3.0%, 5.1% and 2.0% mortalities respectively. Conclusions: Neem, chinaberry and Bti showed potent larvicidal and pupicidal activities. However, in the area, high level of mosquito resistance to pyrethroids and dichloro-diphenyl-tricgloroethane was seen which will pose serious challenge to vector control in the future. Therefore, using integrated approach including these botanical larvicides is warranted to manage insecticide resistance.
    3  Community knowledge, attitude and practice towards cutaneous leishmaniasis endemic area Ochello, Gamo Gofa Zone, South Ethiopia
    Nigatu Kebede Alemayehu Worku Ahmed Ali Abebe Animut Yohannes Negash Wondwossen Abebe Gebreyes Abhay Satoskar
    2016(7):562-567. DOI: 10.1016/j.apjtb.2016.01.018
    [Abstract](24) [HTML](0) [PDF 815.93 K](81)
    Abstract:
    Objective: To assess the knowledge, attitude and practice of the community related to cutaneous leishmaniasis (CL) in an endemic area Ochello, Gamo Gofa Zone, South Ethiopia. Methods: We conducted community based cross-sectional survey among residents in Ochello from November to December 2014. The study area was purposely selected based on previous reports on endemicity of CL. Using simple random sampling technique, a total of 392 household participants were selected in the study area Ochello. Structured questionnaire was used to collect the data. Regarding the responses given to knowledge, attitude and practice, a score of 1 was given for each right response and 0 for unsure responses. Data were double entered and analysis was conducted using SPSS version 20 statistical software. Descriptive statistics that include frequency and percentage were used to analyze the results. Results: In total, 392 individuals were participated in our study where 225 (57.4%) of the participants were males and 167 (42.6%) were females. Of all the total participants, 265 (67.6%) had heard of the disease, and 127 (32.4%) responded that they did not know CL. Based on the scoring results, 265 (67.6%) participants were knowledgeable about CL. Out of 265 participants who heard about CL, most of them [215 (54.8%)] had the attitude that CL was a problem in their area and had no positive attitude towards the treatment of CL. Approximately, 215 (54.8%) replied that CL was preventable. Majority of the respondents did not sleep outdoors and did not practice sleeping near vegetation with or without bed net. Conclusions: The current finding indicated that the inhabitants of Ochello developed good awareness and encouraging attitude regarding CL. However, their prevention and control practice was very low. Hence, the result of this study calls for organized community awareness creation through various means.
    4  Immunopotentiality of Ayurvedic polyherbal formulations “Saribadi” and “Anantamul Salsa” with augmentation of IgM production and lymphocytes proliferation: A preliminary study
    Md. Moklesur Rahman Sarker Long Chiau Ming Md. Zaidul Islam Sarker M Shahabuddin Kabir Choudhuri
    2016(7):568-573. DOI: 10.1016/j.apjtb.2016.05.004
    [Abstract](25) [HTML](0) [PDF 684.09 K](78)
    Abstract:
    Objective: To assess the immunopotentiality of Ayurvedic polyherbal preparations, “Saribadi” and “Anantamul Salsa”. Methods: Freshly prepared BALB/c mice splenocytes were cultured with “Saribadi” or “Anantamul Salsa” treatment [doses of 0.25%, 0.50%, 0.75%, 1.00%, 1.50%, 2.00%, 3.00% and 4.00% (v/v)] at 37 ℃ for 5 days. The immunoglobulin M (IgM) production and lymphocytes proliferation were determined by ELISA and MTT methods, respectively. Endotoxin contamination was assessed by treating the preparations with polymyxin B. Results: The doses of “Saribadi” [0.25%, 0.50%, 0.75% and 1.00% (v/v)] significantly increased IgM productions (0.966, 0.728, 0.695 and 0.615 μg/mL vs. control 0.265 μg/mL) and lymphocytes proliferation [absorbance 0.311, 0.394, 0.372 and 0.334 optical density (OD) vs. control 0.162 OD]. Similarly, the doses of “Anantamul Salsa” [0.50%, 0.75%, 1.00% and 1.50% (v/v)] promoted IgM productions (0.933, 0.919, 0.917 and 0.892 μg/mL vs. control 0.502 μg/mL) and the doses of “Anantamul Salsa” [0.50%, 0.75%, 1.00%, 1.50%, 2.00%, and 3.00% (v/v)] stimulated lymphocytes proliferation (absorbance 0.395, 0.326, 0.440, 0.398, 0.452 and 0.355 OD vs. control 0.199 OD). The activity of “Saribadi” and “Anantamul Salsa” was not retarded by the treatment of preparations with polymyxin B. Conclusions: Immunomodulatory activity of “Saribadi” and “Anantamul Salsa” was unveiled for the first time. “Saribadi” and “Anantamul Salsa” possess immunostimulating potential acting through the induction of lymphocyte proliferation and IgM production. These preparations may be useful in strengthening immune responses. However, further cellular and in vivo studies are required.
    5  In vivo assessment of the toxic potential of Dissotis rotundifolia whole plant extract in Sprague–Dawley rats
    Charles Ansah Michael Buenor Adinortey Jerry Asiedu-Larbi Benjamin Aboagye Du-Bois Asante Alexander Kwadwo Nyarko
    2016(7):574-579. DOI: 10.1016/j.apjtb.2016.04.010
    [Abstract](30) [HTML](0) [PDF 1.14 M](89)
    Abstract:
    Objective: To assess the toxic potential of Dissotis rotundifolia (D. rotundifolia) whole plant extract in Spraque–Dawley rats within a 2-week period of administration. Methods: Methanolic extract of D. rotundifolia was administered orally once daily at dose levels of 0, 100, 300 and 1 000 mg/kg body weight for 14 days. Toxicity was assessed using mortality, clinical signs, body and organ weights, hematological indices, serum chemistry parameters and histopathological analyses. Results: There were no treatment-related mortalities or differences in clinical signs, hematology and serum biochemistry. This was confirmed by micrographs obtained from histopathological analysis. Conclusions: The results obtained from the sub-acute toxicological assessment of D. rotundifolia extract suggest that the extract is non-toxic at doses up to 1 000 mg/kg/day administered for a period of 14 days.
    6  Modulatory effects of the fruits of Tribulus terrestris L. on the function of atopic dermatitis-related calcium channels, Orai1 and TRPV3
    Joo Hyun Nam Hyo Won Jung Young-Won Chin Woo Kyung Kim Hyo Sang Bae
    2016(7):580-585. DOI: 10.1016/j.apjtb.2016.05.006
    [Abstract](26) [HTML](0) [PDF 619.84 K](83)
    Abstract:
    Objective: To examine the effects of Tribulus terrestris L. (T. terrestris) extract on the modulation of calcium channels to evaluate its use in topical agents for treatment of atopic dermatitis. Methods: The 70% methanol extract of T. terrestris was prepared. Human HEK293T cells with over-expressed calcium release-activated calcium channel protein 1 (Orai1), transient receptor potential vanilloid 1, or transient receptor potential vanilloid 3 (TRPV3) were treated with T. terrestris extract. Modulation of ion channels was measured using a conventional whole-cell patch-clamp technique. Results: T. terrestris extract (100 mg/mL) significantly inhibited Orai1 activity in Orai1- stromal interaction molecule 1 co-overexpressed HEK293T cells. In addition, T. terrestris extract significantly increased the TRPV3 activity compared with 2-Aminoethyl diphenylborinate (100 μmol/L), which induces the full activation of TRPV3. Conclusions: Our results suggest that T. terrestris extract may have a therapeutic potential for recovery of abnormal skin barrier pathologies in atopic dermatitis through modulating the activities of calcium ion channels, Orai1 and TRPV3. This is the first study to report the modulatory effect of a medicinal plant on the function of ion channels in skin barrier.
    7  Influence of peanut skin extract on shelf-life of sheep patties
    Paulo Eduardo Sichetti Munekata Rafaella de Paula Paseto Fernandes Mariza Pires de Melo Marco Antonio Trindade Jose Manuel Lorenzo
    2016(7):586-596. DOI: 10.1016/j.apjtb.2016.05.002
    [Abstract](15) [HTML](0) [PDF 937.66 K](83)
    Abstract:
    Objective: To evaluate the phenolic profile and antioxidant activity in vitro of peanut skin extract (PSE) and effect of PSE on characteristics of sheep patties during storage. Methods: PSE phenolic profile was evaluated in LC–MS analysis and by total phenolic content, 1,1-diphenyl-2-picrylhydrazyl radical scavenging capacity and ferric reducing/ antioxidant power. Patties elaborated with sheep meat were packaged in modified atmosphere and storage at (2 ± 1) ℃. The analyses were performed every 5 days for 20 days on microbial counts, physico-chemical properties, lipid oxidation, protein stability and sensory characteristics. Results: The major group of phenolic compounds in PSE was the proanthocyanidins followed by other flavonoids, which are related to potential phenolic content and antioxidant activity. The addition of PSE and butyl hydroxytoluene (BHT) reduced the microbial counts during the storage time, caused reduction on the loss of redness and sensory properties over time. The lipid and protein oxidation in sheep patties was effectively inhibited by PSE and BHT. Conclusions: The present results showed the potential application of PSE as a natural alternative to replace synthetic antioxidants (BHT) for increasing the quality and extending the shelf-life of sheep patties.
    8  Precise identification of different stages of a tick, Ixodes granulatus Supino, 1897 (Acari: Ixodidae)
    Ernieenor Faraliana Che Lah Salmah Yaakop Mariana Ahamad Ernna George Shukor Md Nor
    2016(7):586-596. DOI: 10.1016/j.apjtb.2016.05.002
    [Abstract](29) [HTML](0) [PDF 987.06 K](83)
    Abstract:
    Objective: To evaluate the phenolic profile and antioxidant activity in vitro of peanut skin extract (PSE) and effect of PSE on characteristics of sheep patties during storage. Methods: PSE phenolic profile was evaluated in LC–MS analysis and by total phenolic content, 1,1-diphenyl-2-picrylhydrazyl radical scavenging capacity and ferric reducing/ antioxidant power. Patties elaborated with sheep meat were packaged in modified atmosphere and storage at (2 ± 1) ℃. The analyses were performed every 5 days for 20 days on microbial counts, physico-chemical properties, lipid oxidation, protein stability and sensory characteristics. Results: The major group of phenolic compounds in PSE was the proanthocyanidins followed by other flavonoids, which are related to potential phenolic content and antioxidant activity. The addition of PSE and butyl hydroxytoluene (BHT) reduced the microbial counts during the storage time, caused reduction on the loss of redness and sensory properties over time. The lipid and protein oxidation in sheep patties was effectively inhibited by PSE and BHT. Conclusions: The present results showed the potential application of PSE as a natural alternative to replace synthetic antioxidants (BHT) for increasing the quality and extending the shelf-life of sheep patties.
    9  CTX-M producing Escherichia coli isolated from cattle feces in Bogor slaughterhouse, Indonesia
    Mirnawati Bachrum Sudarwanto Denny Widaya Lukman Hadri Latif Herwin Pisestyani Eddy Sukmawinata Omer Akineden Ewald Usleber
    2016(7):605-608. DOI: 10.1016/j.apjtb.2016.05.001
    [Abstract](20) [HTML](0) [PDF 321.39 K](82)
    Abstract:
    Objective: To determine the occurrence of CTX-M producing Escherichia coli (E. coli) from cattle feces in Bogor slaughterhouse, Indonesia. Methods: A total of 220 cattle feces samples were collected from Bogor slaughterhouse from March to April 2015. Presence of extended-spectrum beta-lactamase (ESBL) producing E. coli was detected by disc diffusion test based on the recommendation from Clinical and Laboratory Standards Institute (2014). Bacterial strains which were confirmed as producing ESBLs were further analyzed for the presence of bla genes of the ESBL by PCR. Results: The results showed that CTX-M producing E. coli isolates were detected in 19 samples from 220 samples (8.6%). The β-lactamase genes detected were CTX-M-1 (n = 10) and CTX-M-9 (n = 9). All of the CTX-M producing E. coli isolates showed multidrug resistance phenotypes to at least four antibiotics. The highest incidence of antibiotics resistance was showed to ampicillin (100.0%), cefotaxime (100.0%), and cefpodoxime (100.0%), followed by streptomycin (84.3%), trimethoprim-sulfamethoxazole (73.7%), erythromycin (52.6%), kanamycin (26.3%), doxycycline (10.5%), and ceftazidime (0.0%). Conclusions: Detection of CTX-M-producing E. coli in cattle feces raises important questions as they can represent a potential risk factor to public health.
    10  Seroprevalence of HDV among non-hospitalized HBsAg positive patients from KPK-region of Pakistan
    Ismail Jalil Muhammad Arshad Zara Rafaque Fazle Raziq Robina Wazir Sajid Malik Javid Iqbal Dasti
    2016(7):609-613. DOI: 10.1016/j.apjtb.2016.05.007
    [Abstract](44) [HTML](0) [PDF 328.32 K](83)
    Abstract:
    Objective: To study the seroprevalence of hepatitis B virus (HBV) and hepatitis delta virus (HDV) infections in patients visiting outpatient department of a major tertiary care hospital in Khyber Pakhtunkhwa region of Pakistan. Methods: Blood samples were collected from non-hospitalized patients. Serological analysis was done by ELISA and viral DNA was amplified by PCR. The amplified DNA was analyzed by agarose gel electrophoresis. Results: Altogether, 946 blood samples were screened, overall percentage of HBsAg-positive patients remained 22.41% (prevalence: 224.10/1 000; CI: 0.197 5 ± 0.250 7) with the highest incidence rates among relatively younger age groups (20–29 years). The prevalence of HBV–HDV co-infection was found to be 46.75/1 000; CI: 0.031 8 ± 0.061 7. In HBsAg-positive patients, anti-HBc-total was detected in 86.79% while 25.00% were positive for anti-HBc-immunoglobulin M. Similarly, among these patients, HBV DNA was detected in 64.13% and 10.85% were co-infected with HDV. Different symptoms were associated with the prevailing infection, including malaise (62%), anorexia (66%) and fatigue (73%). The most commonly associated symptom was abdominal discomfort. Among these patients, certain risk factors, including surgery, visit to dentist and intravenus infusions were frequently associated with the infection (χ2 = 95.23; df = 11; P < 0.000 1). Conclusions: Overall, this study confirmed higher prevalence of active HBV/HDV infection, among young patients from Khyber Pakhtunkhwa region having no prior history of viral hepatitis.
    11  Cutaneous leishmaniasis in Iran: Results from an epidemiological study in urban and rural provinces
    Faezeh Norouzinezhad Fatemeh Ghaffari Abbas Norouzinejad Farzad Kaveh Mohammad Mehdi Gouya
    2016(7):614-619. DOI: 10.1016/j.apjtb.2016.05.005
    [Abstract](24) [HTML](0) [PDF 741.01 K](82)
    Abstract:
    Objective: To examine the prevalence and clinical manifestations of cutaneous leishmaniasis (CL) in Iran. Methods: This study was conducted in Iran between 2011 and 2013. Sampling, preparing, developing, and fixing of suspicious skin lesions were completed in healthcare centers in 31 Iranian provinces as well as in the Academic Reference Laboratory and the National Reference Laboratory. The information was then analyzed at the Ministry of Health's Information Management Center of Contagious Diseases. Results: Over a three-year period, the number of people identified with CL was 56 546. The highest incidence was reported in 2011 (27.5 per 100 000). Wet CL accounted for 43.7% of cases while 43.3% resulted from sporotrichoid leishmaniasis. The results showed that there was a higher incidence of CL due to Leishmania major (50.2%) than to Leishmania tropica. The results of this study found that the highest incidence of CL had happened respectively in Ilam, Fars and, Khorasan Razavi Provinces between 2011 and 2013. Conclusions: Although the incidence of the disease is declining, CL is still a public health concern and disease control protocols need to be established. Therefore, further studies are needed to identify the vectors, reservoirs, and disease species as well as to develop appropriate disease control strategies.
    12  Increased uptake of intermittent preventive treatment for malaria in pregnant women in Zambia (2006–2012): Potential determinants and highlight of lessons learnt
    Freddie Masaninga Mary Katepa Bwalya Sarai Malumo Busiku Hamainza Peter Songolo Mulakwa Kamuliwo Martin Meremikwu Lawrence Kazembe Jacob Mufunda Olusegun Ayorinde Babaniyi
    2016(7):620-624. DOI: 10.1016/j.apjtb.2016.01.010
    [Abstract](21) [HTML](0) [PDF 674.12 K](81)
    Abstract:
    Objective: To assess potential determinants of uptake and highlight lessons learnt from the implementation of intermittent preventive treatment (IPTp), given to pregnant women as early as possible during the second trimester in Zambia. Methods: Data from four national malaria surveys (2006, 2008, 2010, 2012) were reviewed, and proportions of pregnant women attending antenatal clinics (ANCs) who received two or more doses of sulfadoxine–pyrimethamine (IPTp2) were compared by place of residence, education level, and wealth status. Malaria cases and deaths in pregnant women, from Health Information Management System 2011–2013, were analyzed to determine malaria burden in pregnancy in Zambia. A multiple logistic regression model was applied to identify potential determinants of IPTp uptake. Results: The proportion of pregnant women who took IPTp at ANCs increased from near zero at inception in 2001 to 61.9% in 2006; and to 72% by 2012 (P < 0.001), and overall the uptake was 1.41 times higher in 2012 compared to 2006. From 2006 to 2012, IPTp2 uptake among women with no formal education increased from 51% to 68% (P < 0.1). Likewise, uptake among pregnant women with the lowest wealth index increased from 58.2% to 61.2%. By 2012, IPTp uptake among pregnant women within the lowest wealth index increased to a similar level as the women with high wealth index (P = 0.05). Incidence of malaria cases, hospital admissions and mortality during pregnancy decreased between 2011 and 2013. Overall, increased IPTp uptake was associated with being in urban areas (OR = 1.56, 95% CI: 1.39–1.74), having college (OR = 1.83, 95% CI: 1.25–2.75) or secondary education (OR = 1.68, 95% CI: 1.44–1.96) or of being of higher wealth status (OR = 1.86, 95% CI: 1.60–2.17). Conclusions: Zambia has increased IPTp uptake through ANC for all women. The malaria control program has contributed to increasing access to health services and reducing demographic and socioeconomic disparities.
    13  Skin problems in children under five years old at a rural hospital in Southern Ethiopia
    Jose Manuel Ramos Paula Moles-Poveda Dalu Tessema Mubarack Kedir Gamadi Safayo Abraham Tesfasmariam Francisco Reyes Isabel Belinchon
    2016(7):625-629. DOI: 10.1016/j.apjtb.2016.05.009
    [Abstract](22) [HTML](0) [PDF 329.33 K](84)
    Abstract:
    Objective: To examine the prevalence of cutaneous disorders in children under 5 years old who attended a rural hospital in Southern Ethiopia. Methods: A prospective cross-sectional study was conducted from January 26 to February 20, 2015 in children under 5 years old who attended Gambo Rural Hospital in West Arsi of the Oromia Region, Ethiopia. Results: A total of 324 children were included (59.6% male) whose median age was 16.4 months. In total, 147 children [45.4%; 95% confidence interval (CI): 40.0%–50.8%] under 5 years had a skin problem, of which 101 (68.7%) consulted for that reason. The other 46 (31.3%) consulted for a general health problem and the dermatological condition was a secondary finding during the physical exploration. In 93 children (28.7%; 95% CI: 20%–33.8%), it was the main disease, and in 54 children (16.5%; 95% CI: 13.0%–21.1%) it was concomitant with other diseases. The most common dermatological disease was scabies (n = 44, 13.6%; 95% CI: 10.3%–17.7%). Impetigo was diagnosed in 32 children (9.9%; 95% CI: 7.1%–13.3%), of which 23 (71.9%) had complicated impetigo. Nineteen children (5.9%; 95% CI: 3.8%–9.0%) had eczema, 10 (3.1%) had eczema associated to other conditions. The following most frequent skin problems were tinea (n = 9; 2.8%), infected wound and ulcer (n = 7; 2.2%), and burns (n = 6; 1.9%). Conclusions: Skin problems, mainly scabies, impetigo, and eczema were common in young children attended at a rural hospital in Southern Ethiopia. Children under 5 years should be examined thoroughly to rule out skin diseases, especially scabies.
    14  Unusual presentation of metastatic adenocarcinoma of the lung
    Blerina Resuli Roberto Lisi Daniela Musio Vincenzo Tombolini
    2016(7):630-632. DOI: 10.1016/j.apjtb.2016.02.001
    [Abstract](21) [HTML](0) [PDF 286.95 K](82)
    Abstract:
    On September 2013, a 62-year-old man with metastatic adenocarcinoma of the lung complained tenderness and pain of the first terminal phalange of his right hand. The biopsy confirmed metastatic adenocarcinoma of the lung to the finger. A single 8-Gy fraction of palliative radiotherapy was delivered to the patient's right hand. The patient received magnetic resonance-guided focused ultrasound surgery treatment to the phalange because he showed few improvement of clinical symptoms and persistence of moderate pain after radiotherapy. After magnetic resonance-guided focused ultrasound surgery, the clinical symptoms improved significantly. No serious adverse effects were reported and the patient compliance was very high. Our patient showed improvement of clinical symptoms after combined treatment. The patient remains in good health conditions.
    15  A review of concurrent infections of malaria and dengue in Asia
    Aruchana A/P Selvaretnam Priyadarshi Soumyaranjan Sahu Madhusmita Sahu Stephen Ambu
    2016(7):633-638. DOI: 10.1016/j.apjtb.2016.05.008
    [Abstract](22) [HTML](0) [PDF 361.31 K](90)
    Abstract:
    Concurrent infections of malaria and dengue are when both of these mosquito-borne diseases occur simultaneously in an individual. In this review, reported cases with these co-infections in Asia are discussed. The focus is on the overlapping clinical presentations and the difficulties encountered in differential diagnosis. Also, cases reported in some special conditions, viz., pregnancy, foetal infections, and co-infections with one or more other infectious agents are highlighted. Due to similar clinical presentations of malaria and dengue, these co-infections may give rise to an incorrect diagnosis. Moreover, the treatment regimens for these co-infections are not the same as those for mono-infections. Hence, a delay in implementing the appropriate treatment regimen for these concurrent infections due to poor diagnosis can be fatal. The present review is intended to increase awareness about the clinical significance and the importance of these co-infections among clinicians, public health workers and health authorities in the Asian region. Though malaria-dengue concurrent infections are seldom reported from the Asian region, it is probably increasing particularly in the countries known to be endemic for both of the above diseases. A compulsory reporting of the incidences of malaria-dengue concurrent infections is recommended.

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