Objective: To analyze the trends of dengue virus infection case distribution and dengue virus (DENV) serotype dynamics in Indonesia over the last decade through a spatio-temporal analysis and systematic literature review.
Methods: A mixed-methods approach was used, combining a descriptive spatio-temporal analysis of national dengue surveillance data from 2014-2023 and a systematic literature review of the DENV serotypes distribution in Indonesia. The national dengue surveillance data from 2014-2023 were analyzed through spatio-temporal analysis using QGIS 3.28.3 to visualize the distribution of dengue hemorrhagic fever cases and mortality. The articles for systematic literature review were retrieved from three databases (Scopus, PubMed, and Garuda) within the same period, and their quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional and experimental studies.
Results: The highest number of cases occurred in 2016, and the lowest in 2018. The geographic spread of DENV transmission increased over time, reaching 484 affected districts in 2022. The highest case burden consistently occurred on Java Island (>10 ООО cases per year). All four serotypes were detected across regions with varying dominance, and DENV-3 was identified as the predominant serotype during the study period. High population density and human mobility were key factors influencing regional differences in serotype distribution, while the strong transovarial transmission capability of DENV-3 may contribute to its persistence within mosquito populations.
Conclusions: Dengue virus infection in Indonesia demonstrates fluctuating trends with an expanding geographic distribution over the past decade. All four DENV serotypes continue to circulate nationwide, with DENV-3 remaining the predominant serotype. Variations in serotype dominance are likely influenced by population density, mobility, as well as the persistence of transovarial transmission within mosquito vectors. These findings highlight the importance of strengthening surveillance systems and implementing targeted control strategies to reduce dengue transmission in Indonesia.
Objective: To evaluate the effects of fresh frozen plasma transfusion in dengue patients.
Methods: In this randomised, double blind, parallel, controlled trial, we included 200 patients with activated partial thromboplastin time (APTT) ≥40 seconds and platelet count ≤50×109/L, randomly assigning them to experimental (10-15 mL/kg fresh frozen plasma transfusion) or control (standard management) groups. The principal aim was to assess the alteration in APTT at 24 hours among such patients. Between-group comparisons were restricted to the initial 24 hours post-intervention. Owing to ethical concerns regarding bleeding necessitating rescue therapy, the control group was removed, and subsequent follow-up (48 hours and 7 days post-transfusion) continued only for the experimental group.
Results: Baseline characteristics in both groups were comparable. Mean age was (34.1±8.1) years and (36.1±7.8) years in the experimental and control groups, respectively. Within 24 hours, the experimental group had a significant drop in APTT compared to controls [median 38 (IQR 36-40) seconds vs. 44 (IQR 4046) seconds; P<0.001)]. Platelet count, mean haemoglobin, and haematocrit levels rose significantly in the experimental group (P<0.001). Thirty (30%) control patients developed active bleeding, while none in the experimental group. Follow-up of the experimental arm showed significant sustained APTT reduction and platelet count increase.
Conclusions: Fresh frozen plasma transfusion improves coagulation markers (reducing APTT and thrombocytopenia) at short-term (24 hours). Assessing use of fresh frozen plasma to prophylactically prevent active bleeding in severe dengue needs more studies with long-term follow-up. (ClinicalTrials.gov number, NCT06642493.)
Objective: To describe the effectiveness and safety of treatment for cutaneous leishmaniasis in patients over the age of 44 years treated at a specialized research center in Colombia.
Methods: Clinical profiles of cutaneous leishmaniasis patients were retrospectively described and effectiveness and safety of systemic and local and systemic treatments were compared with Pearson's Chi-square test or Fisher's exact test.
Results: A total of 151 patients were included and 65% were male, 78% were over 50 years of age, 28% had hypertension and 11% had diabetes. The main treatments were systemic glucantime (10%), miltefosine (15%), and local treatments (48%). Treatment effectiveness was 68% for systemic and 64% for local treatments. Patients on systemic treatments had a significantly higher frequency of systemic adverse events. In contrast, those on local treatments only showed a statistically higher proportion of vesicles in application site.
Conclusions: Our findings show moderate effectiveness across treatments. Crucially, while systemic and local treatments had similar effectiveness, systemic treatments were associated with a significantly higher frequency of adverse events. This finding highlights that local therapies offer a safer alternative for older adults, making them a viable and potentially preferable first-line option to minimize toxicity in this vulnerable population.
Objective: To investigate the prevalence, antimicrobial resistance and genetic diversity of Staphylococcus (S.) aureus among healthy young adults of 18 to 25 years in Ho Chi Minh City, Vietnam.
Methods: A cross-sectional, descriptive study was conducted between December 2023 and December 2024. Nasal swabs were processed for S. aureus isolation, antibiotic susceptibility testing, and PCR-based detection of spa, pvl, and mecA genes. Genetic similarity was assessed using the unweighted pair group method with arithmetic mean cluster analysis. Statistical significance was determined by Chi-square test.
Results: In this cross-sectional study of 428 students, the S. aureus carriage rate was 33.9%. Methicillin-resistant S. aureus (MRSA) prevalence was 54.5% (79/145). 10%-17% of MRSA isolates exhibited resistance to three to ten antibiotics, with two strains demonstrating resistance to 11 and 12 drugs, respectively. The pvl gene was detected in 5.8% of isolates. 55.17% S. aureus strains belonged to ten distinct spa types with 300-bp amplicons.
Conclusions: These findings provide valuable insights into S. aureus carriage patterns among youth in Ho Chi Minh City, informing public health strategies for prevention and treatment.