Cases of dengue fever have been on the rise in the northern part of India over the last decade. Rohtak district of Haryana State in northern India experienced its first large scale outbreak of dengue fever in the year 2006. Out of four serotypes causing dengue fever in the present outbreak, DEN-3 was the predominant serotype. Out of 701 suspected cases of dengue fever, 152 cases (21.7%) tested positive for IgM anti-dengue antibodies and 104 cases (14.8%) for both IgM and IgG anti-dengue antibodies. Fifty per cent of the cases were in the age-group of 11-30 years. We analyzed various contributory factors for the occurrence of the present outbreak. We also identified an important triggering factor, I.e. the inordinate delay in the completion of a rainwater drainage project by civic authorities leading to the collection of rainwater in artificial containers that acted as ideal breeding sites for Aedes mosquito. The present outbreak should serve as an eye-opener for health care authorities as well as the civic administration hoping to prevent future outbreaks in developing countries.

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Several authors have reported genital tract involvement in urinary schistosome infection, resulting in local lesions. Pathological changes in the lower and upper genital tract may affect couple sexuality and lead to infertility. Upon informed consent, 123 female subjects responded to a questionnaire related to infertility and history of urinary schistosome infection. A gynecological examination was carried out to assess lower and upper reproductive tract pathologies. Each participant submitted a urine sample for assessment of current urinary schistosome infection. Almost half of the women examined had signs of primary (21%) or secondary infertility (28%). Similarly, almost half of the urine samples collected (44.8%) were positive for microhematuria. The prevalence of infertility was significantly higher among women with microhematuria or a history of hematuria (χ²=5.42, p=0.06). Women married more than once were 2.64 times more likely to report a history of hematuria than those married only once (p=0.06). Individuals who reported dyspareunia were 2.63 times more likely to report a history of hematuria (p=0.004). There was an association between hematuria, history of hematuria, female genital schistosomiasis and infertility. An in depth assessment of the causal relationship between urinary schistosomiasis and infertility is warranted.

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Objective: Since its establishment in 2003, the Malawi Blood Transfusion Service (MBTS) has co-existed with an earlier decentralised hospital-based system for collecting, testing and distributing blood. The aim of this study was to assess the availability of blood for transfusion in Malawi and explore the challenges facing the current dual system of blood supply.
Methods: A survey of all hospitals (8 hospitals) in three districts in Central Malawi.
Results: MBTS provides two-thirds (66.7%) of the blood used by hospitals, and the hospital-based system provides the other one-third. MBTS centrally tests blood for HIV (ELISA), hepatitis B virus (HBsAg), hepatitis C virus (anti-HCV), syphilis and malaria parasite, and uses standard operating procedures (SOPs) to prevent errors. The hospital-based system does not routinely test for hepatitis C virus and malaria but routinely tests for HIV (rapid tests), hepatitis B virus (HBsAg), and syphilis. The major challenges faced by this dual system include poor communication, inadequate knowledge of the availability and clinical use of blood, difficulties recruiting and retaining donors, difficulties distributing blood, high prevalence of HIV and costs of running the two systems.
Conclusions: The nationally coordinated centralised system provides high quality blood which is insufficient to meet demand and the hospital-based system supplements the deficit in blood supply by providing blood which is not routinely screened for all transfusion-transmitted infections. Both the centralised and decentralised systems of blood transfusion will continue to co-exist until the transition period is over. It is important that the hospital-based system be operated according to the same quality standards as the centralised system and that some form of regulatory control be put in place.

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A community-based survey was conducted to assess the prevalence of G6PD deficiency and malaria in two villages (St. Martins, Dagua) of Wewak district, East Sepik Province, Papua New Guinea. A total of 551 individuals were recruited for the study. Malaria was diagnosed in 96 cases (17.4%), and 28 subjects with G6PD deficiency (5.1%) were identified by the WST-8⁄1-methoxy PMS method. The sequence of the entire G6PD gene was determined in 19 of the 28 G6PD-deficient cases. We found ten cases with the G6PD Jammu variant (871 G>A, 1311 C) and eight cases with the G6PD Vanua Lava variant (383 T>C). A novel mutation (595 A>G) predicting an amino acid change from isoleucine to valine was identified. This mutation has not been reported to date and was named G6PD Dagua. The detection of three G6PD variants indicates the heterogeneity of the studied population, and these variants could be important genetic markers for clarifying the gene flow among the population of Southeast Asian and Pacific Island countries.

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Cutaneous leishmaniasis (CL) is an emerging disease in Sri Lanka, more than 400 cases having been reported since 2001. However, the morphology and taxonomic status of the Sri Lankan strain of Leishmania is not known yet. Therefore, it is important to study the morphology and to analyze the phylogenetic position to predict the risk and expansion of the disease and thereby to develop an effective control programme. Morphology of the amastigote of the Sri Lankan isolate was checked by light microscopy and electron microscopic observation. Presence of amastigotes within macrophages was confirmed in skin biopsy samples. The promastigote had the characteristic appearance of a kinetoplastid cell in cultures. The kinetoplast minicircle DNA has been used for diagnosis of Leishmania for a long time and also for phylogenetic studies on trypanosomatid flagellates. The kinetoplast minicircle was amplified using PCR and subsequently sequenced from samples obtained from Sri Lankan patients with cutaneous lesions. Mitochondrial cytochrome b gene has been recently shown to be useful for identification and phylogenetic analysis of the genus Leishmania. The nucleotide sequence of the cytochrome b gene of Sri Lankan Leishmania was determined using the semi-nested PCR and 620 bp of this gene obtained. Phylogenetic analysis using these sequences unambiguously indicated that Sri Lankan isolate of Leishmania belongs to L. donovani complex. However, the Sri Lankan isolate forms a distinct lineage within the complex and probably represents a new branch.

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Inflammation of the joints is generally considered to be the cause of the severe and prolonged symptoms in CHIKV infection. Disuse atrophy of the muscles due to effusion of the synovial compartments of the dorsal wrist in CHIKV infection has not been reported so for. Studying these atypical cases may shed light on the patho-physiology of CHIKV infection and appropriate individual case management.

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Background: It is estimated that around 120 million people in tropical and subtropical areas of the world are infected by filariasis. In the Southeast and South Asian regions, Wuchereria bancrofti is the most prevalent parasite,causing filariasis in 99.4% of cases. We report a rare case of amyloidosis kidney with an incidental finding of microfilariae.
Case report: An 85 year old male presented with complaints of gradually progressive anasarca and loss of weight for 2 months as well as vomiting and decreased urine output for a week. On clinical examination, aside from mild pallor, there was evidence of bilateral pitting pedal edema and free fluid in the abdomen. Sonography revealed the presence of bilateral renal parenchymal disease and bilateral hydrocele with thickened spermatic cord. Lower lobe consolidation was the only significant finding on the chest skiagram. The patient was rigorously worked up to identify pathology in other systems, but all the data were within normal limits. Histopathological examination of the renal biopsy specimen revealed complete to partial replacement of most of the glomeruli by pink, hyaline eosinophilic material and microfilariae of Wuchereria bancrofti were seen incidentally. Blood vessels showed pink hyaline material in their walls. Tubules and interstitium were unremarkable. The provisional diagnosis of amyloidosis kidney was confirmed by positivity on methyl violet staining.
Conclusion: In the present case, the clinical picture did not provide any clue regarding the association of amyloidosis kidney with filariasis except for mild peripheral eosinophilia. However, renal biopsy revealed amyloidosis with microfilariae of Wuchereria Bancrofti. It is presumed that, in this case, microfilariae entered the glomerular capillaries after breaching the blood renal barrier. This is the first case in which renal amyloidosis was shown to be associated with microfilariae of Wuchereria bancrofti. The possibility of the latter condition, resulting in the genesis or development of the former, needs to be further investigated and discussed.

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