Journal of Communicable Diseases (E-ISSN: 2581-351X & P-ISSN: 0019-5138)

Editorial Board

Journal of Communicable Diseases — 2026-03-30

Analysis of Acute Encephalitis Syndrome in Paediatric Patients: Clinical Profile, Etiology and Outcomes in a Tertiary Care Hospital of Nuh, Haryana

Babita Khichar — 2026-03-31

Introduction:-Acute encephalitis syndrome (AES) is a major public health concern in India,particularly among the pediatric population. Understanding the clinical profile,etiological spectrum,and outcomes of AES in children is essential for timely diagnosis,targeted management,and effective public health interventions.This study aims to retrospectively analyze pediatric AES cases in a tertiary care center in Nuh,Haryana,to elineate their clinical presentation,causative agents,and treatment outcomes.
Methods:-This retrospective observational study was conducted in Department of Pediatrics at Shaheed Hasan Khan Mewati Government Medical College,Nuh, Haryana after obtaining ethical approval from Institutional ethical committee.Medical records of children aged 1 month to 14 years,admitted with a diagnosis of AES from August 2024 to February 2025,were reviewed.AES was defined according to the World Health Organization criteria.Information regarding demographic data,clinical features,laboratory parameters,neuroimaging findings,treatment modalities,and outcomes were collected.Frequency and percentage were used for data analysis.
Results :-A total of 75 pediatric patients with AES were included in the study.The majority were under 5 years of age (66.7%),with a male-to female ratio of 1.14:1.Fever & altered sensorium were universal symptoms (100%),followed by seizures (90.7%) & vomiting (37.3%).Etiology was identified in 59 cases(78.7%),with scrub typhus (20%),pyogenic bacterial meningitis (16%),and viral encephalitis (9.3%) being the most common.CSF examination was performed in 68 patients,showing pleocytosis in 77.9%,elevated protein in 70.6%, and low glucose in 52.9%.Neuroimaging was performed in 45 patients,with cerebral oedema being the most common abnormality (46.7%).ICU admission was required in 74.7% of patients,and 33.3% required mechanical ventilation.Full recovery was observed in 33.3% of patients.

Keywords: Acute Encephalitis Syndrome, Paediatrics, Scrub Typhus, Outcomes, Meningoencephalitis, Haryana

DOI: https://doi.org/10.24321/0019.5138.202601

How to cite this article:
Khichar B, Dhingra A, Gautam S P. Analysis of Acute Encephalitis Syndrome in Paediatric Patients: Clinical Profile, Etiology and Outcomes in a Tertiary Care Hospital of Nuh, Haryana. J Commun Dis. 2026;58(1):1-8.

Anosmia in Covid-19 Patients: Prognosis, Symptom Associations, and Recovery Follow-up

Zeena Jamal Alkhazraji — 2026-03-31

Background: Anosmia and loss of taste are among the cardinal symptoms of active COVID-19 infection. Fever, as well as respiratory symptoms with different percentages of gastrointestinal symptoms, were common clinical manifestations of these viral infections. The study aimed to describe anosmia/hyposmia in confirmed COVID-19 patients and its association with other systemic symptoms and patterns of recovery.

Methods: A cross-sectional study was conducted at Al-Imamain Al-Kadimain Teaching Hospital, Baghdad, Iraq. In 2021. (218) COVID-19 patients that attended outpatient of E.N.T department at this hospital were confirmed by RT-PCR test.

Results: Out of 218 positive cases, 130 patients (59.6%) were suffering from anosmia. The most common symptoms among patients were fever (64.7%), headache (49.5%), fatigue (46.8%), dizziness (4.4%), and myalgia (38.1%). 54 (41%) anosmic patients recovered within less than three months, and 40 (31%) anosmic patients recovered within three to six months. There was a significant association between anosmia, time of recovery with age and gender of patients. Anosmia is a common presentation in COVID-19 confirmed cases, and it's usually associated with other clinical manifestations like fever, diarrhea, cough, and fatigue.

Conclusion: This study concluded that Anosmia and other smell issues are among the most often reported symptoms in COVID-19 patients.

Keywords: Anosmia, Covid-19, Olfactory Dysfunction, Diarrhoea

DOI: https://doi.org/10.24321/0019.5138.202602

How to cite this article:
Alkhazraji Z J, Alhaideri A J, Alshami S A, Salim I D, Anosmia in COVID-19 Patients: Prognosis, Symptom Associations, and Recovery Follow-up. J Commun Dis. 2026;58(1):9-17.

Association between Reproductive Hormones and Inflammatory Cytokines in Iraqi COVID-19 Patients

Hiba S Ahmed — 2026-03-31

Introduction: Due to the COVID-19 pandemic and the lack of well-defined factors to control the disease, various indicators, such as reproductive hormones and inflammatory markers, have been explored. This study investigates the relationships among serum levels of luteinising hormone (LH), follicle-stimulating hormone (FSH), testosterone, and key inflammatory cytokines.

Methods: This study included 100 patients aged 25 to 40 years with COVID-19 at the Baghdad Teaching Hospital, Medical City, in Baghdad, Iraq, from October 2022 to April 2023. Reverse transcriptase polymerase chain reaction testing confirmed the infection in nasal swab samples from all eligible individuals. They were compared with 100 healthy individuals who served as the control group.

Results: COVID-19 patients showed significantly elevated levels of interleukin-1, -6, -18, tumour necrosis factor-alpha, and C-reactive protein compared with controls. They also exhibited higher serum LH and FSH levels, and markedly lower testosterone levels. Within the patient group, males had significantly lower LH and FSH levels but higher testosterone levels than females. In the control group, females showed higher LH and FSH levels and significantly lower testosterone levels. Immunoglobulin G and M levels were significantly increased in COVID-19 patients.

DOI- https://doi.org/10.24321/0019.5138.202603
How to cite this article
Ahmed H S, Association between Reproductive Hormones and Inflammatory Cytokines in Iraqi COVID-19 Patients. J Commun Dis. 2026;58(1):18 25.

Clinico-Bacteriological Profile and Antibiotic Resistance Pattern in Patients with Acute Exacerbation of COPD in a Tertiary Care Hospital

Rajeev P Thomas — 2026-03-31

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading respiratory illness characterised by frequent infectious exacerbations
that increase morbidity and mortality.
Aim: To identify bacterial pathogens responsible for acute exacerbations of COPD (AECOPD) and analyse antibiotic resistance patterns and
prescribing trends.
Methods: A prospective observational study was conducted among 93 AECOPD patients in Kerala. Sputum samples were processed for microbial culture and antimicrobial susceptibility testing using CLSI guidelines. Demographic and prescription data were statistically analysed.
Results: Males comprised 75.3% of participants with a mean age of 64.5 years. Klebsiella pneumoniae (42%) was the predominant isolate, followed by Streptococcus pneumoniae and Pseudomonas aeruginosa. Gram-negative pathogens exhibited marked resistance to cephalosporins, aminoglycosides, and Beta-lactams. Clarithromycin and cefoperazone–sulbactam were most frequently prescribed empirically. Post-culture adjustments improved clinical outcomes in resistant
infections.
Conclusion: Gram-negative bacteria dominate AECOPD aetiology in Kerala, showing extensive resistance. Rationalised antibiotic use and culture-guided therapy are vital to control emerging resistance.
Keywords: COPD, acute exacerbation, bacteriological profile, antibiotic resistance, prescription pattern.

DOI: https://doi.org/10.24321/0019.5138.202604

How to cite this article:
Thomas R P, Rajappa M C, Venkatasubramaniam N, Gnanamoorthi S, Venkatachari K M, Clinico Bacteriological Profile and Antibiotic Resistance Pattern in Patients with Acute Exacerbation of COPD in a Tertiary Care Hospital. J Commun Dis. 2026;58(1):26-34.

Detection sand Gene Expression of Regulatory Gene (icaR), and Its Control of the Expression of Biofilm Genes (icaA and icaD) in Staphylococcus aureus

Zahraa Mohammed Wannas — 2026-03-31

Introduction: The development of biofilms in Staphylococcus aureus (S. aureus) is heavily influenced by environmental factors and governed by multiple regulatory mechanisms, posing difficulties in the treatment of infections. S. aureus relies on the polysaccharide intercellular adhesin expressed by the icaADBC operon. A gene that influences the ica operon expression is the icaR gene, which is situated next to the icaADBC operon. The icaR gene encodes a negative regulator of icaADBC.

Aim: To investigate the correlation between the regulatory gene icaR and biofilm genes in S. aureus

Methods: Different clinical samples (n = 250) were collected from patients who attended Al-Husain Medical City and Al Imam Al Hassan Al Mujtaba Teaching Hospital in Karbala City from December 2021 to June 2022 for the isolation of S. aureus. The isolates were identified as S. aureus using cultural and biochemical assays. The susceptibility of S. aureus isolates to antibiotics was determined using the Kirby–Bauer disk diffusion method. The potential of S. aureus isolates for biofilm production was quantitatively evaluated using the microtitre plate method. After that, molecular detection of biofilm genes (icaA and icaD) and the regulatory gene (icaR) in bacterial isolates was done using Polymerase Chain Reaction (PCR). Finally, the expression of the biofilm genes and the regulatory gene was assessed using quantitative real-time PCR.

Results: Sixty isolates were identified as S. aureus from the 250 clinical samples. The antibiotic susceptibility of S. aureus isolates indicated multidrug resistance: 100% of isolates were resistant to oxacillin, 98% to penicillin P, 63% to tetracycline, 51% to azithromycin, 43% to doxycycline, 15% to gentamicin, 13.3% to levofloxacin, 13.3% to ciprofloxacin, 11.6% to trimethoprim, 10% to clindamycin, and 3.33% to chloramphenicol. Regarding the ability of S. aureus isolates for biofilm formation, 15 (25%) isolates were strong biofilm producers, 40 (66.6%) were moderate biofilm producers, and 5 (8.3%) were weak biofilm producers. Furthermore, all S. aureus isolates (100%) had biofilm genes (icaA and icaD) and the regulatory gene icaR. The upregulation of regulatory gene icaR was found to be associated with the downregulation of biofilm genes icaA and icaD in the isolates.
Conclusion: There is an inverse relationship between the biofilm ica operon and the regulatory gene icaR in S. aureus isolates.

Keywords: Staphylococcus aureus, Biofilm Formation, Biofilm Genes icaA, icaD, PIA/ica, Regulatory Gene icaR

How to cite this article:
Wannas Z M, Hassani H H. Detection sand Gene Expression of Regulatory Gene (icaR), and Its Control of the Expression of Biofilm Genes (icaA and icaD) in Staphylococcus aureus. J Commun Dis. 2026;58(1):35-46.

DOI: https://doi.org/ 10.24321/0019.5138.202605

Efficacy and Safety of Tenofovir in Preventing Vertical Transmission of Hepatitis B Virus

Myskal Abdikerimova — 2026-03-31

Evaluating Knowledge, Attitudes, and Preventive Practices Regarding Mosquito-Borne Diseases in a Rural Population of Coimbatore, Western Tamil Nadu

Gopalakrishnan Thangavel — 2026-03-31

Introduction: Mosquito-borne diseases remain a significant public health problem in India, particularly in rural communities with poor living conditions. Understanding the knowledge, attitudes, and preventive practices (KAP) of the population is essential for strengthening control programmes and reducing disease transmission.
Aim: To assess the knowledge, attitude, and practices regarding mosquito-borne diseases among residents of a rural area in Coimbatore, Tamil Nadu
Methods: A cross-sectional study was conducted among 500 adults aged 18 years and above between January and May 2024. Systematic random sampling was used to select households. Data were collected using a pre-tested, semi-structured questionnaire and analysed using Microsoft Excel 2019 and SPSS version 21.
Results: All respondents were aware of mosquito-borne diseases. Chikungunya (40%) was the most commonly recognised disease, followed by malaria (29%), dengue (24%), and filariasis (7%). A significant association was found between educational status and knowledge. Fans (39%) and mosquito repellents (16%) were the most commonly used protective measures, while television was the main source of information. Most participants (97.1%) expressed willingness to seek medical help if infected.
Conclusion: The study revealed good awareness and positive attitudes toward mosquito-borne diseases, but limited knowledge of less common diseases such as Zika and Japanese encephalitis. Strengthened community-based education and targeted interventions are required to improve comprehensive knowledge and promote consistent preventive practices.

Keywords: Mosquito-Borne Diseases, Knowledge- Attitude-Practice, Rural Population

How to cite this article:
Thangavel G, Murugaiyan U, Pushpanathan
K V, Munshi M A I, Khanna S S, M Rajasekar,
P E Chandra Mouli, Vinothini K. Evaluating
Knowledge, Attitudes, and Preventive Practices
Regarding Mosquito-Borne Diseases in a Rural
Population of Coimbatore, Western Tamil Nadu.
J Commun Dis. 2026;58(1):55-59.

DOI: https://doi.org/ 10.24321/0019.5138.202607

Evaluating the Impact of Vitamin Supplementation on Recovery from Adenovirus-Associated Cough and Respiratory Symptoms

Suad Hammood Al Bashar — 2026-03-31

Introduction: Adenovirus-associated respiratory infection has a very important impact on worldwide health, usually presenting as prolonged cough and respiratory symptoms. This research intends to assess the efficacy of vitamin supplementation (vitamins A, C, and D, and minerals like zinc) on improvement in recovery time and severity of symptoms in patients with adenovirus-induced respiratory disease.
Methods: A double-blind randomised controlled trial (RCT) was performed on 300 patients between 18 and 65 years of age withadenovirus infection. The patients were allocated into two groups: one was given vitamin supplementation and the other a placebo. Severity of symptoms, time to recovery, viral load decrease, and inflammatorymarkers (C-reactive protein and interleukin-6) were monitored for 14 days. Kaplan-Meier survival analysis and t tests were employed to
determine group differences.
Results: Though vitamin supplementation caused a small decrease in time to recovery, there was no statistically significant improvement in symptom intensity (p > 0.05). Biomarker analysis was suggestive ofimmune modulation effects, but overall, vitamins alone were not a sure fix for symptoms of adenovirus-associated respiratory infection.
Conclusion: This research presents empirical data from a controlled clinical trial, addressing the gap in research on vitamin supplementation in recovery from adenovirus-related respiratory illness. The observations indicate that although vitamin supplementation can complement immune function, it is not an independent therapy for adenovirus induced respiratory manifestations. Future studies should investigate optimal levels of vitamins, any synergistic effects with antiviral medications, and efficacy in high-risk groups.

Keywords: Adenovirus, Vitamin Supplementation, Respiratory Symptoms, Immune Response, Recovery Time, Randomised Controlled Trial

DOI: https://doi.org/ 10.24321/0019.5138.202608

How to cite this article:
Basher S H A, Evaluating the Impact of Vitamin Supplementation on Recovery from Adenovirus Associated Cough and Respiratory Symptoms. J Commun Dis. 2026;58(1):60-71.

Frequency of Metallo-beta-Lactamase-Producing Escherichia coli Bacteria in Urinary Tract Isolates

Abbas Atiya Hammoudi — 2026-03-31

Introduction: The most popular facultative Gram-negative anaerobic bacillus that causes community-acquired urinary tract infection (UTI) illness is Escherichia coli. The present study sought to detect E. coli isolates that produced MBLs in patients who suffered from UTIs and to determine the antibiotic susceptibility pattern in these isolates.
Methods: A total of 210 urine specimens were collected from patients with clinical signs and symptoms of a UTI. only 52 (42.6%) specimens demonstrated Escherichia coli growth. Metallo-lactamase (MBL) enzymes were examined using three separate phenotypic techniques: the Double Disk Synergy Test (DDST), the Combined EDTA Disk Test (CMDT), and the Modified Hodge Test (MHT), all of which included the selection of a 10 microg meropenem antibiotic disk as a positive test. The commercially available antibiotic disks were used in the susceptibility test.
Results: Results demonstrated that 30 out of the 52 isolates (57.7%) tested positive for the production of the MBL enzymes. DDST test demonstrated a significant zone of enhancement between the meropenem disk and the EDTA disk in eight isolates. CMDT test revealed 17 (56.7%) for the 30 E. coli isolates showed zone inhibition widths of at least 7 mm surrounding the meropenem-linked EDTA disk, and 15 out of 30 isolates of carbapenem-resistant E. coli tested positive for MHT. The most resistance of the selected antibiotics were ceftriaxone and co-trimoxazole (76.9%), ceftazidime (73.1%), tobramycin (71.2%), and the most effective against every isolate of E. coli was imipenem (86.5%), followed by meropenem (84.6%) and nitrofurantoin (75.0%).
Conclusion: The findings emphasise the urgent need for routine surveillance of antibiotic resistance, judicious use of broad-spectrum antibiotics, and improved infection control and diagnostic practices. Implementing these strategies can help reduce the burden of MDR infections and guide appropriate treatment to curb the spread of resistant strains in clinical settings.

How to cite this article:
Hammoudi A A. Frequency of Metallo-beta-Lactamase-Producing Escherichia coli Bacteria in Urinary Tract Isolates. J Commun Dis. 2026;58(1):72-79.

DOI: https://doi.org/ 10.24321/0019.5138.202609

Molecular Investigation of Hpiv-1 and Hpiv-3 Viral Types in Patients with Seasonal Respiratory Infections in Iraq

Asmaa Haseeb Hwaid — 2026-03-31

Background: Respiratory tract infections in paediatric and adult populations are associated with four Human Parainfluenza Virus (HPIV) serotypes. HPIV-1 and HPIV-3 rank just behind Human Respiratory Syncytial Virus (HRSV) as significant contributors to severe respiratory tract illnesses. Epidemiological studies employing molecular techniques globally have confirmed the frequent circulation of HPIV-1 and HPIV-3
in humans.
Aims: The focus of this study is to analyse the distribution of HPIV-1 and -3 in patients presenting with respiratory infections, and to analyse co-infection with HMPV and HRSV.Methods: The study was carried out between 2018 and 2020 in the Iraqi province of Diyala. Three hundred and twenty-three patients of various ages who were suspected of having Respiratory Tract Infections (RTIs) were enrolled in the study. A questionnaire created especially for this purpose was used to gather participant data. HPIVs were detected molecularly using the Real-Time PCR assay. Participant privacy was protected by obtaining verbal consent. The Statistical Package for the Social Sciences (SPSS) version 25 was used to perform statistical
analysis on the data.
Results: No HPIV-1 infections were found, and the overall molecular detection rate of HPIV-3 among the participants was 5.3% (17 cases). One (6.3%) participant tested positive for both RSV and HPIV-3, indicating co-infection. The highest detection rate (29.4%) was observed in November, and in children under five, with insignificant differences. Despite the fact that females had a higher HPIV-3 detection rate than males, the difference was not statistically significant.

Conclusion: HPIV-3 is the predominant strain, and dual infection with RSV is possible but rare.

Keywords: Human Parainfluenza Virus Type 1 and 3, Children, RTIs, Diyala

DOI: https://doi.org/10.24321/0019.5138.202612

How to cite this article:
Hwaid A H, Molecular Investigation of Hpiv-1 and Hpiv-3 Viral Types in Patients with Seasonal Respiratory Infections in Iraq. J Commun Dis. 2026;58(1):80-87.

One-Year Retrospective Study of ICU Isolates: Epidemiology and Antibiotic Resistance Patterns

Mohankumar Appadurai — 2026-03-31

Background: Intensive Care Units (ICUs) are environments with high risk for nosocomial infections due to invasive procedures and critically ill patient populations. Understanding the distribution of pathogens and their antibiotic susceptibility patterns is vital for effective infection control and therapeutic strategies.
Aim: This study aimed to analyze the distribution of bacterial isolates across various ICUs and assess their antimicrobial resistance and susceptibility patterns.
Methods: This retrospective study was performed on 496 culture-positive clinical samples collected from six ICUs within the tertiary care hospital. The isolates were characterized and tested for antimicrobial susceptibility using standard conventional methods.
Results: The majority of culture-positive samples originated from the general ICU (83%), followed by the Cardio Thoracic ICU (8%) and CATH ICU (7%). Gram-negative bacilli (70%) were predominant, with Klebsiella spp. (22%) and Escherichia coli (18.5%) being the frequently isolated organisms. Among Gram-positives, Staphylococcus(13.3%) and Enterococcus spp. (8.1%) were common. Meropenem, imipenem, and piperacillin-tazobactam showed higher efficacy against Gram-negative bacterial isolates. Vancomycin, linezolid, and Teicoplanin demonstrated high efficacy against Gram-positive isolates. Alarmingly, high resistance was noted to ampicillin, polymyxins, and certain cephalosporins. Acinetobacter spp. in ET aspirates exhibited pan-resistance.
Conclusion: The predominance of multidrug-resistant Gram-negative organisms, particularly in the general ICU, underscores the need for stringent infection control measures and periodic surveillance of antimicrobial resistance. Tailored antibiotic policies and effective stewardship programs are crucial for curbing ICU-acquired infections.

How to cite this article:
Appadurai M, Selvabai A P, Shanmugam P. One-Year Retrospective Study of ICU Isolates: Epidemiology and Antibiotic Resistance Patterns. J Commun Dis. 2026;58(1):88-96.

DOI: https://doi.org/10.24321/0019.5138.202613

Prevalence and Treatment Outcomes of Drug-Resistant Tuberculosis in the Kyrgyz Republic

Atyrkul Toktogonova — 2026-03-31

Introduction: Tuberculosis (TB) remains a significant health concern in the Kyrgyz Republic, with multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) posing significant challenges. This retrospective study examined the prevalence, epidemiological traits, and treatment outcomes of drug-resistant TB (DR-TB), focusing on XDR-TB, in the Kyrgyz Republic from 2019 to 2022.
Methods: This study used national tuberculosis surveillance data covering all administrative regions, health sectors, and prison systems under the National Tuberculosis Program.
Results: Despite the declining number of TB cases during the study period, one in five patients with TB had MDR/XDR-TB, indicating a persistent burden. Coronavirus disease 2019 has affected TB services, leading to a temporary drop in notifications. The proportion of previously treated DR-TB patients increased after 2020, suggesting treatment interruption, relapse, and program failure. Pediatric and female TB cases increased, indicating community transmission and maternal health concerns. XDR-TB isolates showed resistance to bedaquiline and linezolid, threatening the World Health Organization-recommended treatment regimens. Over 20% of XDR-TB cases occurred in untreated patients, suggesting the primary transmission of resistant strains.
Conclusion: Although treatment success rates for rifampicin-resistant TB/M/XDR-TB have improved, they remain suboptimal for XDR-TB. XDR-TB cases clustered in urban areas, highlighting the influence of population dynamics on the transmission.

How to cite this article:
Toktogonova A, Zhanybekov I, Amanbekov A, Saltanat O, Toktogaziev B. Prevalence and Treatment Outcomes of Drug-Resistant Tuberculosis in the Kyrgyz Republic. J Commun Dis. 2026;58(1):97-103.

DOI: https://doi.org/10.24321/0019.5138.202614

Prevalence, Proteomic Profiling and In Silico Allergenicity Prediction of Cytosolic Proteins of Aspergillus fumigatus Obtained from Respiratory Patients

Priya Koundal — 2026-03-31

Role of Gut Microbiome in Susceptibility to Infection: A Study from Tertiary Care Centre

Himanshu Khangwal — 2026-03-31

Introduction: The gut microbiome is a key regulator of immune function and host defense. Dysbiosis of gut microbial communities has been associated with impaired immune responses and increased susceptibility to infections. This study aimed to assess the relationship between gut microbiome composition and susceptibility to infection.

Materials and Methods: This prospective observational study included 100 adults, comprising 50 infection-susceptible participants and 50 age- and sex-matched healthy controls. Individuals with recent antibiotic or probiotic use were excluded. Stool samples were analyzed using 16S rRNA gene sequencing (V3–V4 regions). Microbial diversity was assessed using Shannon, Simpson, and Chao1 indices, and phylum-level composition was compared between groups.

Results: Infection-susceptible participants showed significantly reduced gut microbial diversity compared with controls (p < 0.001). A dysbiotic microbial profile was observed, characterized by reduced Firmicutes and Bacteroidetes and increased Proteobacteria (p < 0.05). Baseline demographic characteristics were comparable between the two groups.

Conclusion: Reduced gut microbial diversity and altered microbial composition were significantly associated with susceptibility to infection. These findings highlight the gut microbiome’s role in host immune defense and suggest a potential role for microbiome profiling in infection risk assessment.

How to cite this article:
Khangwal H, Kolanu R, Patel Z H, Krishna G S M, Kumari N, Kaur S. Role of gut microbiome in susceptibility to infection: A study from tertiary care centre. J Commun Dis. 2026;58(1):120-125.

DOI: https://doi.org/10.24321/0019.5138.202616

Smarter Decisions for Better Health Outcomes: An Ai-Enabled Financial Decision Intelligence Framework for Dengue Control In Andhra Pradesh

Madhavi Sripathi — 2026-03-31

The problem of dengue fever in Andhra Pradesh, India, is an ongoing public health and financial problem that has very few effective control measures due to the current control strategies, based on reactive surveillance and past budgeting. This paper suggests an engineer assisted financial decision intelligence model based on AI to assist in proactive and economic management of dengue. The framework combines Temporal Graph Neural Networks (TGNNs) and Bayesian hierarchical spatio-temporal models to model the spread of disease in
districts in the context of uncertainty in predictions. The model allows allocating resources more efficiently by connecting epidemiological predictions with financial planning. The outcomes show that the framework identifies outbreak risks 4-6 weeks prior to the conventional practices and minimises misallocation of resources by 18-25 per cent. It, as well, enhances the cost-efficiency of the interventions, including fogging and larval control, and the significance of regionally coordinated actions. In general, the paper shows that AI-based decision support can transform dengue control and preventive measures, from a reactive response in the context of resource constraints to proactive and data driven planning.
Keywords: Dengue control; Financial decision intelligence; temporal graph neural networks; Bayesian hierarchical modelling; public health financing.

DOI: https://doi.org/10.24321/0019.5138.202617

How to cite this article:
Sripathi M, Hanumathu K D, Goud V, Akkala A K, Aminabee S, Yadav T C, Smarter Decisions for Better Health Outcomes: An Ai-Enabled Financial Decision Intelligence Framework for Dengue Control In Andhra Pradesh. J Commun Dis. 2026;58(1):126-131.

Supervised Machine Learning for MDR Detection in Gram-Positive Pathogens: A Cross-Sectional Hospital-Based Dataset Analysis

Umaarasu Thirunavukkarasu — 2026-03-31

Background: Multidrug-resistant (MDR) Gram-positive pathogens are a growing challenge in hospital practice due to limited treatment options and poor clinical outcomes. This study assessed MDR prevalence among major Gram-positive pathogens and evaluated supervised machine learning models for MDR prediction.
Methods: A cross-sectional hospital-based study was conducted on 458 clinical specimens from a tertiary care hospital in Salem, Tamil Nadu, India, including 393 culture-positive Gram-positive isolates. MDR was defined as resistance to three or more antimicrobial classes. Logistic regression, random forest, XGBoost, and multilayer perceptron models were developed using demographic, clinical, and microbiological variables and evaluated using accuracy, precision, recall, F1-score, and AUC-ROC.
Results: Enterococcus was the predominant isolate (67.0%), followed by Streptococcus (15.5%) and MRSA (3.3%). MDR was identified in 82.9% of Enterococcus isolates, 76.9% of Streptococcus isolates, and all MRSA isolates. MDR distribution did not differ meaningfully by age or gender. Random forest and XGBoost showed the most balanced performance, with accuracy of about 0.68-0.70, F1-scores of 0.77-0.80, and AUC-ROC values of 0.58-0.59. The multilayer perceptron achieved the highest recall (1.00) and F1-score (0.91), although with lower discrimination (AUC-ROC 0.46). Older age, culture negativity, and Enterococcus isolation were the strongest predictors of MDR.
Conclusions: Gram-positive pathogens in this setting showed a high burden of multidrug resistance. Machine learning models demonstrated moderate predictive value and may complement routine microbiological surveillance and antimicrobial stewardship efforts.

How to cite this article:
Thirunavukkarasu U, Dharmalingam T, Subramani S, Kumar S S, Thangavel L, Choudhary A K, Supervised Machine Learning for MDR Detection in Gram-Positive Pathogens: A Cross-Sectional Hospital-Based Dataset Analysis. J Commun Dis. 2026;58(1):132-144.

DOI: https://doi.org/10.24321/0019.5138.202618

Collider Bias and Infectious Disease Studies: A Review

Pratap Kumar Jena — 2026-03-31

Collider bias is the distortion of the observed association between an exposure and an outcome that occurs when analysis conditions (by design or adjustment) on a variable that is a common effect of the
exposure and outcome, or their causes, thereby opening a noncausal pathway that induces a spurious association or alters effect estimates. This review explains the mechanism, distinguishes collider bias from
confounding and broader selection bias, and illustrates its impact in infectious disease research, particularly in the context of COVID-19, HIV, tuberculosis (TB), and malaria. During the COVID-19 pandemic, for example, studies restricted to hospitalised patients suggested smoking might protect against severe disease, an artefact later understood as collider bias. Similar issues have emerged in HIV and TB research, where restricting analyses to patients in care or clinical trials created misleading associations, and in malaria studies, where hospital-based sampling distorted genetic findings. We conducted a structured narrative review of the literature published in the past decade, identifying methodological and applied papers that described collider bias in
infectious disease contexts. Key findings show that collider bias can produce false protective effects, reverse expected associations, and either exaggerate or attenuate true effects. Practical solutions include the use of directed acyclic graphs (DAGs) to identify colliders, application of inverse probability weighting, sensitivity analyses, and reweighting with external population data. The broader implications extend beyond
methodology: collider bias can shape public perception, misinform clinical practice, and obscure health disparities. Recognising and addressing collider bias is therefore essential for generating accurate,
equitable, and actionable evidence in infectious disease research.
Keywords: Collider Bias, Infectious Diseases, HIV/TB; COVID-19, Epidemiology, Causal Inference

DOI: https://doi.org/10.24321/0019.5138.202619

How to cite this article:
Jena P K, Kishore J, Shukla S, Mohapatra D, Patel A. Collider Bias and Infectious Disease Studies: A Review. J Commun Dis. 2026;58(1):145-152.

Impact of Declaring Dengue and Malaria as Notifiable Diseases on Surveillance and Control Efforts in Delhi

Saurabh Mishra — 2026-03-31

Introduction: Dengue and Malaria are major vector-borne diseases that cause recurrent outbreaks in Delhi and posing significant health challenges. In order to strengthen surveillance and improve outbreak response, the Government of the National Capital Territory of Delhi declared dengue and malaria as notifiable diseases in October 20211 mandating all clinical establishments to report confirmed cases to the Municipal Corporation of Delhi (MCD). This paper examines the impact of this policy change on reporting patterns, public health responses, and disease control outcomes.
Methods: A retrospective analysis of secondary surveillance data was conducted for the period 2018-2023. Data were obtained from annual Vector-Borne Disease reports of the Municipal Corporation of Delhi (MCD)2 compiled weekly from cases reported through the integrated Health information Platform (IHIP)3 portal and other Hospitals directly reporting to nodal agency ie Municipal corporation of Delhi as earlier. The pre-notification period (2018-2021) was compared with the post-notification period (2022-2023) to evaluate changes in reporting trends, surveillance activities and public health interventions. Data were reorganised and analysed using Microsoft Excel and presented in tabular form.
Results: Following the notification in October 2021, reporting of dengue increased substantially due to mandatory reporting by all healthcare facilities. Reported dengue cases rose to 9,613 in 2021 and 9,266 in 2023, compared with lower numbers during the pre-notification period. Malaria case showed relatively stable reporting trends, with 167 in 2021 increasing to 263 cases in 2022 and 426 cases in 2023. This mandatory reporting led to enhanced surveillance accompanied by intensified vector control measures, increased information, education and communication (IEC) campaigns and stricter legal enforcement against mosquito breeding sources.
Conclusion: Declaring dengue and malaria as notifiable diseases significantly strengthened disease surveillance and reporting mechanism in Delhi. Mandatory reporting improved case detection and enabled timely public health interventions highlighting the importance of policy-driven surveillance systems in the effective and timely containment of vector borne diseases transmission through targeted vector control measures and elimination of mosquito breeding sources.

How to cite this article:
Mishra S, Jain P, Verma L R, Ahir S P, Impact of Declaring Dengue and Malaria as Notifiable Diseases on Surveillance and Control Efforts in Delhi. J Commun Dis. 2026;58(1):153-157.

DOI: https://doi.org/10.24321/0019.5138.202620

Ivermectin: Pleiotropic Drug Continues to be Potent Therapeutic Agent

Awanindra Dwivedi — 2026-03-31

Aims: Ivermectin is a broad-spectrum antiparasitic agent, primarily deployed to combat parasitic worms in veterinary and human medicine. It has primarily been used in humans as an oral medication for the treatment of filarial diseases. It is used to treat onchocerciasis, strongyloidiasis and scabies in many countries. However, very recently, this drug was used in the management and cure of COVID-19. The aim of the present study is to unveil and focus on various pleiotropic aspects of this wonder drug.
Methodology: Relevant studies were searched by two means: (a) by online database searching using different online search engines and (b) from books, printed journals and government reports available in the library of the National Centre for Disease Control, Varanasi, and the Central Library of Banaras Hindu University, Varanasi, India. The restriction was set to include only those studies and reports which were carried out till 2024 and had information globally. The language of publication was not restricted. Abstracts without published articles
were excluded.
Conclusions: Drug delivery mechanisms have impacts upon drug pharmacokinetics, distribution, absorption, metabolism, duration of therapeutic effect and toxicity. The possibility of novel systems for delivering ivermectin has opened up a galore of opportunities for usage of the drug. This unique, multifaceted drug of the past and present has the capability to become a more exceptional drug of the future.
Keywords: Ivermectin, antiparasitic agent, onchocerciasis, pharmacokinetics, COVID-19.

DOI: https://doi.org/10.24321/0019.5138.202611

How to cite this article:
Dwivedi A, Singh P K, Pratima, Bahl A, Das R, Ivermectin: pleiotropic drug continues to be potent therapeutic agent. J Commun Dis. 2026;58(1):158-162.

COVID-19-Associated Rhino-Orbital Mucormycosis with Diabetic Ketoacidosis in a Patient with Recurrent SARS-CoV-2 Positivity: A Case Report

Athulya G — 2026-03-31

The COVID-19 pandemic led to an unprecedented rise in opportunistic fungal infections, particularly mucormycosis, in patients with uncontrolled diabetes. We present a case of a 52-year-old woman with Type 2 diabetes mellitus and hypothyroidism who developed rhino-orbital mucormycosis during a suspected re-infection with SARS-CoV-2, along with diabetic ketoacidosis. The case highlights the syndemic interaction between COVID-19 and chronic metabolic diseases and emphasises the need for early recognition of red flag symptoms. Early diagnosis, antifungal therapy, and multidisciplinary management were crucial in achieving a favourable outcome.

How to cite this article:
Athulya G, Shaji C A, Thomas S K, Koshy A, Vijayan A. COVID-19-Associated Rhino-Orbital Mucormycosis with Diabetic Ketoacidosis in a Patient with Recurrent SARS-CoV-2 Positivity: A Case Report. J Commun Dis. 2026;58(1):163-167.

DOI: https://doi.org/10.24321/0019.5138.202621

Invasive Candida Meningitis in an Immunocompetent Neurosurgical Patient: A Rare Case Report of Post-Traumatic Complication

Nabamita Bhaumik — 2026-03-31

Candida meningitis is a rare but serious central nervous system infection, primarily affecting neurosurgical patients with indwelling devices. It mimics symptoms similar to bacterial or tuberculous meningitis, complicating early diagnosis. We report the case of a 32-year-old male who developed Candida albicans meningitis following ventriculoperitoneal (VP) shunt placement after decompressive craniotomy for traumatic brain injury. Cerebrospinal fluid (CSF) analysis showed pleocytosis, elevated protein, and markedly low glucose levels. Fungal cultures grew Candida albicans, confirmed by the VITEK 2 Compact system, with antifungal susceptibility to amphotericin B, fluconazole, and echinocandins. The patient was started on liposomal amphotericin B and fluconazole, achieving transient clinical improvement; however, he subsequently developed septic shock and succumbed despite intensive management. This case emphasises the rarity of Candida meningitis, the diagnostic difficulties it presents, and the importance of early antifungal therapy and device removal in improving outcomes.

How to cite this article:
Bhaumik N, Easwaran S, Mahadevan L. Invasive Candida Meningitis in an Immunocompetent Neurosurgical Patient: A Rare Case Report of Post-Traumatic Complication. J Commun Dis. 2026;58(1):168-173.

DOI: https://doi.org/10.24321/0019.5138.202610