Background: Dengue is a widely spread mosquito-borne infection in humans, which in recent decades declared is public health problem globally. The dengue virus contains 4 different serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) which belong to the genus Flavivirus. Aims: A descriptive experimental study was conducted to determine the epidemiology, types of Dengue serotypes, clinical features, laboratory probe, and markers for primary diagnosis of dengue virus infection in hospitalized patients. Methodology: A total of 691 suspects were diagnosed from August to October 2019 in district Shangla KP, Pakistan. Serological tests were used for nonstructural protein-1 antigen (NS1), and antibodies (immunoglobulin-M (IgM) & Immunoglobulin-G (IgG)) while real-time PCR was used to confirm the cases. The data was statistically analyzed using IBM-SPSS Statistics 20 version. Results: The dengue virus infection was more prevalent in the male group (68.09%) than the female group (31.1%). A large number of patients were from rural areas (63.5%) while from urban areas were (36.4%), whereas Besham tehsil was found the most affected compared to other regions. The most prevalent serotype observed in our study was DENV-3 (56.60%) while DENV-4 was the least prevalent serotype (1.88%). Among the age-wise analysis of dengue-virus-infected individuals, the age group of 19–37 years (64.07%) was found the most affected group. The month-wise analysis revealed that the highest number of infections (49.8%) were recorded in September. Significant differences were noticed among blood parameters. Conclusion: The possible reasons for the dengue overwhelming in the study area could be less or lack of awareness particularly regarding the transmission of viral infections, improper sewage management, and no effective vector control strategies that lead the dengue outbreaks in the study population. Keywords: Dengue; Outbreak; DENV; real-time PCR; RNA Virus; Pakistan.

Purpose Seroprevalence surveys from different countries have reported SARS CoV-2 antibodies below 20% even in the most adversely affected areas and herd immunity cannot be predicted till more than half of the population gets the disease. The purpose of this survey was to estimate the magnitude of community-based spread of the infection, associated immunity, and the future prospects and proximity to a 'herd community'. Methods The study was undertaken as a cluster randomized, cross-sectional countrywide survey. This largest communitybased seroprevalence data of SARS-CoV-2 were collected between 15th and 31st July, 2020 from seven randomly selected cities belonging to the three most populous provinces of Pakistan. The FDA approved kit of ROCHE was used for detection of SARS-CoV-2 antibodies. Results Serum samples of 15,390 participants were tested for SARS CoV-2 antibodies with an overall seroprevalence of 42.4%. The seroprevalence ranged from 31.1% to 48.1% in different cities with the highest in Punjab province (44.5%). In univariable analysis, the odds of seropositivity was higher in men compared to women (OR: 1.10, 95% CI: 1.01-1.19, P < 0.05). In multivariable analysis, the risk of being seropositive was lower (OR 0.72, 95% CI: 0.60-0.87, P < 0.01) in younger group (≤ 20 years) than in those aged above 60 years. ConclusionThe study concluded that despite a reasonable seroprevalence, the country is yet to reach the base minimum of estimations for herd immunity. The durability of immunity though debated at the moment, has shown an evidenced informed shift towards longer side.

Background: Hepatitis C is a noteworthy public health issue around the globe, resulting in liver-related problems. The disease is caused Hepatitis C virus a positive sense RNA virus belongs to Flaviviridae family. Approximately 6% population of Pakistan is infected with HCV. Due to genetic variation, HCV is categorized into 7 genotypes and 67 subtypes. Methodology: In this study total 1100 ICT positive samples were collected from December 2016 to May 2017 from Tehsil Dagger District Buner. RNA was extracted from ICT positive serum samples of 1100 patients and, were screened for HCV-RNA by using Reverse Transcriptase-Nested polymerase chain reaction (RT-nested PCR) and, then the positive samples were subjected for HCV genotyping. Statistical analysis was carried on SPSS version 10.0. Results: Out of 1100 ICT positive samples, HCV RNA was detected in 375 individuals, of which 14.9% were males and, 19.2% females. The frequency of HCV genotypes Untypable was 43.5%), followed by 3a (29.6%), 3 b was 9.6%, 2a was 5.9%, 1a was 5.3%, 1 b (4.0%) and, 2 b was 1.9% in these patients. Both genotypes untypable and 3a were the most prevalent genotypes in patients of all age groups and its prevalence was found high among patients with increasing age (>30years). The prevalence rate of HCV in age of 21-30 years (30.1%), of 31-40 years the percentage of positive cases are 24.85% and 11-20 years of age group is (11.4%). Furthermore, genotypes untypable, 3a and 3 b were found to be the most common genotypes in patients with history of barber shops, dental surgery, and receiving multiple injections. Conclusion:The current study reveals HCV untypable variants as the most frequent genotypes in the HCV patients of district Buner KP, Pakistan, with most patients in the age group 21-30 years. HCV various isolates were associated with different routes of transmission. The predominant factors of HCV included shaving in barber shops and intra-venous drugs use. These findings may suggest anti-HCV therapy and monitoring HCV infections.

Background: High number of SARS CoV2 infected patients has overburdened healthcare delivery system, particularly in low-income countries. In the recent past many studies from the developed countries have been published on the prevalence of SARS CoV2 antibodies and the risk factors of COVID 19 in healthcare-workers but little is known from developing countries. Methods: This cross-sectional study was conducted on prevalence of SARS CoV2 antibody and risk factors for seropositivity in HCWs in tertiary care hospitals of Peshawar city, Khyber Pakhtunkhwa province Pakistan. Findings: The overall seroprevalence of SARS CoV2 antibodies was 30.7% (CI, 27.8 to 33.6) in 1011 HCWs. Laboratory technicians had the highest seropositivity (50.0%, CI, 31.8 to 68.1). Risk analysis revealed that wearing face-mask and observing social-distancing within a family could reduce the risk (OR:0.67. p<0.05) and (OR:0.73. p<0.05) while the odds of seropositivity were higher among those attending funeral and visiting local-markets (OR:1.83. p<0.05) and (OR:1.66. p<0.01). In Univariable analysis, being a nursing staff and a paramedical staff led to higher risk of seropositivity (OR:1.58. p< 0.05), (OR:1.79. p< 0.05). Fever (OR:2.36, CI, 1.52 to 3.68) and loss of smell (OR:2.95, CI: 1.46 to 5.98) were significantly associated with increased risk of seropositivity (p<0.01). Among the seropositive HCWs, 165 (53.2%) had no symptoms at all while 145 (46.8%) had one or more symptoms. Interpretation: The high prevalence of SARS CoV2 antibodies in HCWs warrants for better training and use of protective measure to reduce their risk. Early detection of asymptomatic HCWs may be of special importance because they are likely to be potential threat to others during the active phase of viremia. Funding: Prime Foundation Pakistan.

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Background: With the drastic spread of COVID-19 and mass mortality of people globally, detection of the progression of this disease has stood out to be a necessity. Hence, we set out to identify the prevalence of COVID-19 antibodies in Bangladesh using the in-house rapid pan-immunoglobulin dot-blot test kit and evaluate the performance of this kit. Methods: In this cross-sectional study, we tested serum collected between mid-May and mid-June 2020 for COVID-19 antibodies by using the in-house rapid pan-immunoglobulin dot-blot test kit in RTPCR confirmed patients with symptoms for 1-7 days (Group Ia; n =100) and 8-14 days (Group Ib; n = 100); symptomatic RT-PCR negative patients (Group II; n = 100) and convalescent patients (Group III; n = 109) while comparing with pre-pandemic sera samples collected prior two years to December-2019 (Group IV; n = 100). Results: Our kit detected that almost 70% of the convalescent patients produced antibodies against COVID-19 compared to other groups. However, the group with individuals at the end phase of COVID-19 exhibited the second-highest percentage of seroprevalence (41%). We also observed that though Group II was RT-PCR negative, 20% of them showed COVID-19 antibodies. Conclusion: With a specificity of 96% in our kit, we can say that our kit will be a potential device for the detection of SARS-CoV-2 antibodies and to understand herd immunity in Bangladesh. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.131-139

Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania and is spread by vectors. This is a new threat that is endemic to the tropics and subtropics and has a broad geographic distribution. The current research was carried out in all tribal districts of Khyber Pakhtunkhwa province to 2020. The prevalence of Cutaneous Leishmaniasis was found to be higher in children aged 5 to 10 years old in the current research, due to a weakened immune system. In the province, 23 species of phlebotomine sand-flies belonging to the genera Phlebotomus Sergentomyia and grassomiya were discovered. Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania, which are transmitted via the bite of a mosquito. This is an emergent threat and endemic in areas of tropic and sub-tropics and has the epidemiological aspects of Cutaneous Leishmaniasis during the recent epidemic in tribal districts of Khyber Pakhtunkhwa in 2020. The suspected patients of Leishmaniasis from different areas of tribal districts were examined. We came across 700 cases during 3-month period from may to july2020. A major portion G2 ([41.1%; n = 290) of these patients were in age 6 to–10 years. The infection rate was higher in male (75.3%; n = 525) compared to females (25%;n = 125). Both gender and age showed a significant effect on the occurrence of infection. The current study report CL outbreak in the tribal districts of Khyber Pakhtunkhwa which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreak. Keywords: Cutaneous Leishmaniasis, outbreak

Objective: The objective of this study was to evaluate the magnitude and durability of the anti-nucleocapsid-IgG antibody titer in healthcare workers previously infected with SARS-CoV-2 for a period of 12 months. Methods: This study examined blood samples for SARS-CoV-2-specific IgG collected periodically from 120 healthcare workers previously infected with SARS-CoV-2 (confirmed by RT-PCR) and followed longitudinally up to 12 months from their enrolment into the study. Results: The median anti-N-IgG antibody level identified at 3 months was 23.7 CO-index (IQR: 9.13–50.27) and increased to 32.9 CO-index (IQR: 11.8–84.4) at 6 months. At 9 months, the median anti-N-IgG antibody level started to wane in the subsequent time and was dropped to 14 CO-index (IQR: 3.4–37.6) and declined further to 9.8 CO-index at 12 months (IQR: 2.8–9.8). When classified by age groups, the only statistically significant difference in anti-N-IgG between the two age groups (≤30 years and >30 years) was identified at 12 month time point (median difference 8.06, p = 0.035). Spearman correlation coefficient was negatively associated between anti-N-IgG and time interval ( r = −0.255, p = 0.000) but was not statistically significant with age of a patient ( p > 0.05). Conclusions: In conclusion, SARS-CoV-2 antibody levels started declining after 6 months but remained detectable in the majority of patients up to 12 months.