BackgroundTransmission dynamics, vectorial capacity, and co-infections have substantial impacts on vector-borne diseases (VBDs) affecting urban and suburban populations. Reviewing key factors can provide insight into priority research areas and offer suggestions for potential interventions.Main bodyThrough a scoping review, we identify knowledge gaps on transmission dynamics, vectorial capacity, and co-infections regarding VBDs in urban areas. Peer-reviewed and grey literature published between 2000 and 2016 was searched. We screened abstracts and full texts to select studies. Using an extraction grid, we retrieved general data, results, lessons learned and recommendations, future research avenues, and practice implications. We classified studies by VBD and country/continent and identified relevant knowledge gaps. Of 773 articles selected for full-text screening, 50 were included in the review: 23 based on research in the Americas, 15 in Asia, 10 in Africa, and one each in Europe and Australia. The largest body of evidence concerning VBD epidemiology in urban areas concerned dengue and malaria. Other arboviruses covered included chikungunya and West Nile virus, other parasitic diseases such as leishmaniasis and trypanosomiasis, and bacterial rickettsiosis and plague. Most articles retrieved in our review combined transmission dynamics and vectorial capacity; only two combined transmission dynamics and co-infection. The review identified significant knowledge gaps on the role of asymptomatic individuals, the effects of co-infection and other host factors, and the impacts of climatic, environmental, and socioeconomic factors on VBD transmission in urban areas. Limitations included the trade-off from narrowing the search strategy (missing out on classical modelling studies), a lack of studies on co-infections, most studies being only descriptive, and few offering concrete public health recommendations. More research is needed on transmission risk in homes and workplaces, given increasingly dynamic and mobile populations. The lack of studies on co-infection hampers monitoring of infections transmitted by the same vector.ConclusionsStrengthening VBD surveillance and control, particularly in asymptomatic cases and mobile populations, as well as using early warning tools to predict increasing transmission, were key strategies identified for public health policy and practice.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0475-7) contains supplementary material, which is available to authorized users.
Tuberculosis (TB) is a major cause of mortality in the HIV-infected population, with growing concern about increasing incidence in extensively drug-resistant (XDR) TB worldwide. We describe the first published case of XDR TB and HIV co-infection in the UK. The case describes a patient newly diagnosed with smear-positive pulmonary TB and HIV. The isolate was found to be XDR TB, requiring use of third-line TB drugs alongside antiretroviral medication, causing multiple complications due to drug toxicity and interactions. After culture conversion was achieved directly observed treatment with close community support was organized for the patient. Despite these arrangements the patient required readmission for new-onset headaches after poor adherence to treatment. Investigations confirmed lymphocytic meningitis. The patient eventually deteriorated and died from acute cerebral infarction. This case highlights the complexity of managing drug-resistant TB in HIV-infected individuals, due to difficult adherence, drug toxicity and potential public health risks.
The mosquito-borne Zika flavivirus (ZIKV) causes a mild or asymptomatic dengue-like disease that usually lasts two to seven days. Symptoms may include fever, headache and rash that are often either unrecognized or misdiagnosed as dengue, West Nile fever (WNF), chikungunya or other viral infections. ZIKV infection may also be associated with a risk for development of neurologic complications including Guillain-Barré syndrome (GBS). Zika infection is often associated to infectome, diseasome and comorbidity.Methods & Materials: We present a quantitative framework to compare and explore infectome, diseasome and comorbidity of Zika infection. We have analysed several gene expression microarray data from Zika, WNF, chikungunya, dengue, other flaviviruses and GBS, with respect to healthy and control data sets.Results: The differential gene expression profiling of ZIKV infection shows that a large number of genes (1197 genes) are statistically dysregulated. We also observed that 47 genes are commonly highly expressed between ZIKV and dengue infections. However, ZIKV shares only 12, 15 and 10 significant genes with chikungunya, WNF and GBS respectively. Notably, one significant gene SELENBP1 is commonly dysregulated among ZIKV, Dengue and GBS, 2 significant genes AF5 and BAMB1 are commonly dysregulated among ZIKV, Dengue and WNF and 2 significant genes NAMPT and PMAlP1 are commonly dysregulated among ZIKV, GBS and WNF. By using neighbourhood based benchmark and multi layer network topology methods, we have built infectome, diseasome and comorbidity relationships network based on the OMIM and our identified significant genes. Then based on the gene expression, PPI and signalling pathways data, we investigate the infectome, diseasome and comorbidity association among the Zika, chikungunya, WNS, dengue infections and GBS.Conclusion: Here, we describe the infectome and diseasome of ZIKV with dengue, chikungunya, WNS and GBS. We believe that our results will be important for comprehensive modelling and analysis of the systems level properties associated to Zika virus infections, molecular association analysis of these five symtomatic and pathological similar infections and disorders and for translational medicine aims. Our methods and pipeline will be useful for advancing our current knowledge on disease mechanism and predicting infectome, diseasome and disease comorbidities in a quantitative way.
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