Leishmaniasis is a serious parasitic disease caused by Leishmania species transmitted by the bite of sandflies. This disease is also an important public health problem. Clinical manifestations can be classified as cutaneous, mucocutaneous, and visceral leishmaniasis, depending on the species of parasite and the host's immune status. Although the cutaneous form is not fatal, it often causes disfiguring scars on the skin[1]. Even the disease is preventable and treatable, there is no currently licensed vaccine or ideal therapeutic drug against any form of leishmaniasis. The therapeutic response is affected by many factors, mainly dependent on the parasite species[1,2]. It is of vital importance to know the epidemiology of Leishmania species and the clinical features of the disease to determine the appropriate treatment approaches for the disease[3]. Following the conflict in Syria, which began in 2011, a marked increase in the number of cutaneous leishmaniasis (CL) cases in Turkey was observed (Figure 1)[4]. One of the most important reasons for this may be the migration of the population, more than 3 million, from Syria to Turkey due to the conflicts in Syria. Due to the variation in the species of vectors carrying the parasite, the most common causative agents of CL are Leishmania (L.) tropica (the vector is Phlebotomus sergenti) and L. major (the vector is Phlebotomus papatasi) in Turkey and Syria, respectively[5]. Not only L. tropica, but also L. major, can become endemic parasitic species that cause the disease in Turkey due to migration of the population mentioned above. Natural disasters, such as earthquakes, often force people to relocate and live in crowded conditions and low hygiene standards. In areas where vector-borne diseases are endemic, the displacement of thousands of people can significantly cause human exposure to vectors, resulting in a dramatically increased incidence of human infection and changes in the distribution of pathogen species[6]. On 6 February 2023, a major earthquake struck southeast of Turkey, near the Syrian border. According to official data, more than 50 000 people died and many more were injured, and about 10 000 aftershocks occurred in the first 20 days of this earthquake. In Turkey, the earthquake affected more than 13.5 million people and more than 500 000 people were evacuated from the earthquake zone. The public was warned about the risk of various epidemics. Crucially, the region where the earthquake caused the greatest damage is the endemic CL region, where 96% of CL cases were detected in Turkey[7]. The region in Syria, where the earthquake caused substantial damage, is also endemic. Earthquakes have dramatic effects on both serious damage to healthcare infrastructure and on the epidemiology of many diseases, including CL[6]. However, at least for now, leishmaniasis associated with the earthquake was not mentioned. This may be because the earthquake happened in winter and the sandfly vectors responsible for the spread of CL disease prefer warm temperatures and are most active from late spring to early autumn. Therefore, careful planning is required for post-earthquake disease control and surveillance. Individual and community-based approaches are of great importance in preventing and treating leishmaniasis[2]. In this context, comprehensive treatment and preventive research on this disease and highlighting up-to-date information play an important role. Therefore, we read with great enthusiasm the article by Dinc, which highlights up-to-date information on treatment[8].

Objective: To access the level of knowledge, perceptions, and practice towards adverse events following immunization (AEFI) surveillance among vaccination workers in Zhejiang province, China. Methods: This was a cross-sectional survey involving 768 vaccination workers. Data were collected using self-administered questionnaires and analyzed by using SAS 9.3 software. Knowledge, perceptions, and practice on AEFI surveillance were summarized using frequency tables. The mean±SD value was used as the cut-off for defining good (values≥mean) and poor (values<mean) knowledge, perceptions or practice. Binary logistic regression analysis was used to determine sociodemographic variables associated with knowledge, perceptions, and practice towards AEFI. Results: The proportions of good knowledge, perceptions and practice on AEFI surveillance were 78.13%, 57.81% and 66.15%, respectively. Having a higher education background, longer years of experience, previous training on AEFI and ≥30 years of age were factors associated with good knowledge, perceptions and practice on AEFI surveillance among vaccination workers. Conclusions: Over half of the respondents had good knowledge, perceptions and practice on AEFI surveillance work. Interventions on improving the vaccination workers’ knowledge, perceptions and practice on AEFI surveillance should be considered in order to develop a more effective surveillance system.

Objective: To evaluate the COVID-19 vaccination status and related characteristics of Turkish healthcare workers practicing chest medicine. Methods: A cross-sectional online survey was conducted among the Turkish Thoracic Society members. The survey was started on May 17, 2021, and kept open for seven weeks. The 39-item survey included the COVID-19 vaccination status and demographic, clinical, and occupational characteristics. Results: Of 378 healthcare workers participated in the survey, 354 (93.7%) reported receiving at least one dose of the COVID-19 vaccine. A total of 323 (91.2%) healthcare workers received CoronaVac vs. BioNTech/Pfizer in 31 (8.8%). In the CoronaVac group, 77 (23.8%) contracted COVID-19 when not fully vaccinated, and 13 (4.0%) when fully vaccinated; however, 16 (51.6%) healthcare workers in the BioNTech/Pfizer group got COVID-19 when not fully vaccinated, but any fully vaccinated participants did not contract COVID-19 (P=0.003). Regarding vaccine dosing, 328 (86.8%) were fully vaccinated, while 50 (13.2%) were not. Multiple regression analysis for being a non-fully vaccinated healthcare worker demonstrated a significant relationship with having any SARS-CoV-2 infection history (adjusted OR 9.57, 95% CI 3.93-23.26, P<0.001) and being a non-physician healthcare worker (adjusted OR 5.86, 95% CI 2.11-16.26, P=0.001), but a significant negative relationship with full-time working at the time of survey (adjusted OR 0.13, 95% CI 0.03-0.56, P=0.006). Conclusions: Although a majority of healthcare workers were fully vaccinated, occupational and non-occupational characteristics were related to being non-fully vaccinated. Active surveillance regarding the COVID-19 vaccination in healthcare workers is necessary to address specific parameters as barriers to vaccination.

Objective: To establish a DNA detection platform based on a tapered optical fiber to detect Leptospira DNA by targeting the leptospiral secY gene. Methods: The biosensor works on the principle of light propagating in the special geometry of the optical fiber tapered from a waist diameter of 125 to 12 μm. The fiber surface was functionalized through a cascade of chemical treatments and the immobilization of a DNA capture probe targeting the secY gene. The presence of the target DNA was determined from the wavelength shift in the optical transmission spectrum. Results: The biosensor demonstrated good sensitivity, detecting Leptospira DNA at 0.001 ng/µL, and was selective for Leptospira DNA without cross-reactivity with non-leptospiral microorganisms. The biosensor specifically detected DNA that was specifically amplified through the loop-mediated isothermal amplification approach. Conclusions: These findings warrant the potential of this platform to be developed as a novel alternative approach to diagnose leptospirosis.

Objective: To assess the clinical anti-inflammatory and antimicrobial efficacy of Nigella sativa oil compared with chlorhexidine in patients with gingivitis. Methods: A double-blind, randomized clinical trial was conducted in patients having chronic generalized gingivitis. Patients were randomly assigned to receive Nigella sativa oil (n=18) or chlorhexidine (n=19). The following assessments were made on day 0 and day 15: plaque index, gingival index, gingival IL-6 and IL-18 levels were measured using ELISA, plaque colony-forming units, and alpha-hemolytic Streptococcus strains. Data were analyzed using parametric and non-parametric tests and Fisher's exact test. Results: Both interventions reduced plaque index and gingival index scores (P<0.000 1). The Nigella sativa oil group was better at lowering IL-6 (P=0.007 6) than the chlorhexidine group (P=0.145), although there was no change in IL-18 levels (P>0.05). The post-intervention plaque index and gingival index scores and inflammatory cytokine levels between the two groups were not significantly different. Both interventions caused a significant reduction in the plaque colony-forming units (P<0.000 1), reducing pathogenic bacteria: Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, and Streptococcus parasanguinis in the chlorhexidine group (50%) (P=0.103 1), and the Nigella sativa oil group (20%) (P=0.739 5). Conclusions: Nigella sativa oil had anti-inflammatory and antibacterial activities, reducing biofilm formation and disrupting the colonization of pathogenic bacteria essential for the progression of periodontal disease. Nigella sativa oil could offer an alternative therapy for treating gingivitis and may prevent associated systemic diseases and improve overall health outcomes.

Rationale: Malaria and dengue are the most prevalent vector-borne diseases in tropical countries. Plasmodium parasite and dengue virus (DENV) concurrent infection is possible and often under-recognized in geographical areas where these infections are both endemic. Patients concern and diagnosis: We describe the first two cases of Plasmodium falciparum and DENV-3 co-infection in travelers returning to northeastern Italy from Burkina Faso during 2013-2014. Interventions: Malaria infection in both patients was treated with mefloquine. Due to the persistence of symptoms despite of the antimalaria treatment, dengue was also investigated; the treatment of dengue was symptomatic. Outcomes: The patients were discharged in good general condition. Lessons: The need for surveillance of potential malaria and dengue co-infection in travelers returning to Europe from endemic areas is highlighted, as infection with Plasmodium does not exclude arboviral co-infection.

In the last decade, Pakistan has experienced multidemics of HIV in key populations, namely: injecting drug users, male sex with male, female sex workers, transgender sex workers, and transgenders. According to recent reports, in Pakistan, 210 000 people with HIV accounts for less than 0.2% of the general population. Among documented cases, 32 972 (61%) received anti-retroviral therapy in 51 centers[1,2]. The incidence of HIV in the key population is men who have sex with men (MSM) (25%) followed by injecting drug users (IDUs-24%), transgender sex workers (7.5%), 2% in transgenders, and female sex workers (2%), respectively. As of 2022, more than 1 000 cases per area were reported from different parts of the country[3]. Consequently, during the last ten months of 2022, upsurges of new cases in Pakistan have seen raising questions on prevention and control of HIV, and signifying the morbidity from key to non-key population[3]. The highest ratio of people affected with HIV has noted in Punjab with more than 70 000, and Sindh with 60 000 cases[2]. According to the National AIDS Control Program (NACP), in 2022, Punjab province documented 6 106 new cases of HIV, followed by Sindh with 2 096, Khyber Pakhtunkhwa 815 (13 000 HIV-AIDS in total), Islamabad Capital Territory 496, and Baluchistan with 316 cases from January-October 2022[4]. The specialists of infectious diseases and HIV experts said certain reasons in the increase of HIV cases in Pakistan: 1) the increase in HIV detection tests, 2) MSM, and 3) improper prevention and control system of communicable infectious diseases[3]. The United Nations Programme on HIV/AIDS statistics claimed 2010 to date, the number of HIV/AIDS cases increased by 75% within Pakistan, of which 23% are unaware[5]. These outbreaks followed the pattern of Asian regions, which means the disease grows exponentially within the population via injecting drug users before reaching plateau, afterward spreads in general population through sexual networks[1]. In line with the National AIDS Control Program, reports in 2017 claimed 38% of HIV infection in IDUs, of which 8% female spouses were seen positive due to their drug abuser husbands[2]. There are some reasons behind these outbreaks, which could be 1) impromptu healthcare set up, 2) inappropriate screening and treatment, 3) political uncertainty, poverty, and social stigma could also expose the healthcare system of Pakistan against HIV infection[6]. In order to prevent the country from HIV infection, the government should take strict actions. Awareness should be expanded to the high-risk population including IDUs and sex workers through governmental and non-governmental organizations, especially in large cities of the country. Campaigns regarding HIV transmission should be undertaken, prompting tolerance toward people with HIV[7] and these communications should provide accurate knowledge about transmission and prevention of HIV. The government of Pakistan should also update HIV/AID control programs, and build anti-retroviral therapy centers in every district with state of the art facilities.