Objective: To investigate the prevalence, mechanisms, and trends of knockdown resistance (kdr) in Anopheles (An.) culicifacies and its impact on the efficacy of organochlorine and other insecticides.

Methods: A systematic review was conducted based on PRISMA guidelines, extracting data from biooan.org, Embase, ProQuest, PubMed, Scopus, and Web of Science without a time limit until the end of 2022. Articles meeting the inclusion criteria were assessed using the STROBE checklist. Data on kdr mutations, insecticide resistance, and effectiveness were analyzed across eight selected studies from various regions.

Results: The review revealed widespread kdr-mediated resistance in An. culicifacies, primarily against dichloro-diphenyl-trichloroethane (DDT), persisting even decades after discontinued use. Key kdr mutations, including L1014F and L1014S, were identified. Resistance to deltamethrin was less stable, with increased sensitivity observed after short-term discontinuation. The findings underscore the vector's sustained resistance to organochlorine insecticides and relative sensitivity to pyrethroids.

Conclusions: Stable kdr resistance in An. culicifacies to organochlorine insecticides highlights the need for periodic susceptibility assessments and strategic rotation or combination of insecticides to combat malaria effectively and prevent the development of resistance.

Objective：To ascertain the prevalence and distribution of malaria parasites among the three monkeys species from three provinces in Sumatra Island, Indonesia.

Methods：Infections with Plasmodium spp. were determined morphologically from the blood smears which were stained with Giemsa solution and molecularly through nested polymerase chain reaction (PCR) in DNA samples from 68 primates, which were captured at three locations: Jambi (Bungo district), Bengkulu (Muko-Muko district), and Riau Islands (Lingga district).

Results： Out of 68 samples analyzed, 46 were positive for various Plasmodium species, including Plasmodium knowlesi, Plasmodium cynamolgi, Plasmodium inui, and Plasmodium coatneyi. Over one-third of the population exhibited multiple infections, with Plasmodium inui being the most predominant strain.

Conclusions： The high prevalence of multiple malaria infections in monkeys, coupled with the rising reports of primate malaria cases in human raises questions about the potential for human transmission. These findings emphasize the necessity for ongoing monitoring and endeavors to comprehend and alleviate the risk of zoonotic malaria transmission, particularly in areas experiencing environmental changes.

Objective: To characterize mosquito larval habitats and the influence of meteorological factors on their prevalence, and to suggest alternatives for vector control in Makkah Al-Mukarramah.

Methods: A mosquito survey was conducted within the 16 municipalities of Makkah Al-Mukarramah, from November 2022 to October 2023. The characteristics of larval habitats used by all reported species as oviposition sites were determined. Seasonal house, container, and breteau indices were used to determine larval abundance.

Results: 16 Species belonging to five genera [Aedes (3 spp.), Anopheles (3 spp.), Culex (8 spp.), Culiseta (1 sp.), and Lutzia (1 sp.)] were collected. A total of 185 608 potential mosquito larval habitats were surveyed. Of these, 95 853 (67.4%) were Aedes, 45 522 (32%) were Culex, 718 (0.5%) were Anopheles, and 38 (0.03%) were other species; 154 726 (83.4%) were water sources for mosquito larvae, and among these sources, 7 663 (5.0%) were positive for larvae, with 45.9% indoors and 54.1% outdoors. Most of the positive larval habitats were recorded in Al-Shawqiya (1 093, 14.3%), Al-Sharayia (1 003, 13.1%) and Al-Umrah (984, 12.8%). A total of 142131 mosquito larvae and pupae were collected. The majority number of positive residences for all mosquito larvae was observed in January 2023 (1 658, 21.6%).

Conclusions: New appropriate alternatives for vector control are proposed, such as mechanical, biological, and environmental control.

Objective： To determine the incidence, risk factors, antibiotic resistance patterns, and outcomes of various nosocomial infections in Intensive Care Unit (ICU) patients.

Methods: The present prospective observational study was conducted in the multidisciplinary ICU of a tertiary care hospital for 6 months. Incidence, risk factors, and outcome parameters were calculated using Mann Whitney U test, Chi-square test, and stepwise univariate and multivariate logistic regression analysis.

Results： The overall incidence of nosocomial infections was 23.5% (74/314). Ventilator-associated pneumonia was the most common infection (54.1%, 52/96), followed by catheter-related bloodstream infections (22.9%, 22/96). Stress ulcer prophylaxis (aOR 7.691, 95% CI 2.202-26.860, P=0.001), endotracheal intubation (aOR 3.251, 95% CI 1.251-8.420, P=0.015), Foley’s catheter (aOR 11.917, 95% CI 1.335-106.410, P=0.027), and ICU stay > 7 days (aOR 30.915, 95% CI 10.062-94.980, P=0.001) were statistically significant risk factors associated with nosocomial infection in ICU patients. Gramnegative bacteria showed a high degree of resistance to most of antibiotics except colistin and tigecycline. Infected group's mortality was significantly greater than the uninfected group (21.62% vs. 5.83% P<0.001) and had considerably longer ICU length of stay [21 (12) vs. 7 (4) days, P<0.001)] and duration of mechanical ventilation [20 (11) days vs. 0 (5) days, P<0.001].

Conclusions： This study highlights the high incidence rate of ventilator-associated pneumonia, with extensive drug resistance in ICU patients, highlighting the need for an optimized antimicrobial stewardship program to develop effective strategies for the management of nosocomial infections. Multifaceted interventions targeting modifiable risk factors are essential to reduce the occurences of these nosocomial infections in ICU patients.

Rationale: Dengue fever is a mosquito-bome viral infection, which commonly presents as an acute febrile illness. As the number of cases increases, rare manifestations including neurological manifestations are occasionally encountered.

Patient concerns: A 20-year-old female presented with fever for 3 days with slurring of speech and unsteady gait, which were developed from the third day of illness. On examination, she had bilateral cerebellar signs. Dengue non-structural protein 1 antigen and dengue IgM in serum were positive. Her cerebrospinal fluid analysis and magnetic resonance image brain were normal.

Diagnosis： Dengue cerebellitis.

Intervention： Supportive management with fluids including oral rehydration solutions and intravenous fluids and paracetamol.

Outcome： Cerebellar symptoms and signs completely resolved by the 20th day of illness.

Lesson： Dengue cerebellitis is an unusual neurological manifestation of dengue infection.