Asian meet on Dengue, Malaria and Vector Borne diseases August 26-27, 2020 Kyoto, Japan

Vector-borne diseases are infections transmitted by the bite of infected arthropod species, such as mosquitoes, ticks, triatomine bugs, sandflies, and blackflies. Arthropod vectors are cold-blooded (ectothermic) and thus especially sensitive to climatic factors. Weather influences survival and reproduction rates of vectors, in turn influencing habitat suitability, distribution and abundance; intensity and temporal pattern of vector activity (particularly biting rates) throughout the year; and rates of development, survival and reproduction of pathogens within vectors. However, climate is only one of many factors influencing vector distribution, such as habitat destruction, land use, pesticide application, and host density.

Great progress has been made in recent years to reduce the high level of suffering caused by malaria worldwide. Notably, the use of insecticide-treated mosquito nets for malaria prevention and the use of artemisinin-based combination therapy (ACT) for malaria treatment have made a significant impact. Nevertheless, the development of resistance to the past and present anti-malarial drugs highlights the need for continued research to stay one step ahead. New drugs are needed, particularly those with new mechanisms of action. Here the range of anti-malarial medicines developed over the years are reviewed, beginning with the discovery of quinine in the early 1800s, through to modern day ACT and the recently-approved tafenoquine. A number of new potential anti-malarial drugs currently in development are outlined, along with a description of the hit to lead campaign from which it originated. Finally, promising novel mechanisms of action for these and future anti-malarial medicines are outlined.

These are the most common type of drug interaction. The more medications you take, the greater the chance for your drug interacting with another medicine. Drug-drug interactions can decrease how well your medications work, may increase minor or serious unexpected side effects, or even increase the blood level and possible toxicity of a certain drug. For example, if you take a pain medication, like Vicodin, and a sedating antihistamine, such as Benadryl, at the same time you will have an additive amount of drowsiness as both medications cause this side effect.

Adverse drug reaction as "an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention or specific treatment, or alteration of the dosage regimen, or withdrawal of the product." Such reactions are currently reported by use of WHO's Adverse Reaction Terminology, which will eventually become a subset of the International Classification of Diseases. Adverse drug reactions are classified into six types (with mnemonics): dose-related (Augmented), non-dose-related (Bizarre), dose-related and time-related (Chronic), time-related (Delayed), withdrawal (End of use), and failure of therapy (Failure). Timing, the pattern of illness, the results of investigations, and rechallenge can help attribute causality to a suspected adverse drug reaction. Management includes withdrawal of the drug if possible and specific treatment of its effects. Suspected adverse drug reactions should be reported. Surveillance methods can detect reactions and prove associations.

The 4 major drug classes currently used to treat malaria include quinoline-related compounds, antifolates, artemisinin derivatives, and antimicrobials. No single drug that can eradicate all forms of the parasite's life cycle has been discovered or manufactured yet. Therefore, 1 or more classes of drugs often are given at the same time to combat malarial infection synergistically. Treatment regimens are dependent on the geographic location of infection, the likely Plasmodium species, and the severity of disease presentation.

Beware of counterfeit antimalarial drugs being taken by patients that may have been purchased overseas or via the Internet. They may not contain any active ingredients at all and may contain dangerous materials.

Severe dengue is a leading cause of serious illness and death among children and adults in some Asian and Latin American countries. It requires management by medical professionals in hospitals. There is no specific treatment for dengue/severe dengue. Early detection of disease progression associated with severe dengue, and access to proper medical care lowers fatality rates of severe dengue to below 1%. Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. Even rural areas are beginning to be affected in some countries. Dengue fever can sometimes lead to severe dengue. 

The diagnosis of dengue is usually made clinically. The classic picture is high fever with no localising source of infection, a petechial rash with thrombocytopenia and relative leukopenia (low platelet and white blood cell count). Care has to be taken as diagnosis of Dengue Haemorrhagic Fever (DHF) can mask end stage liver disease and vice versa. If one has persistent fever for more that 2 days then one should go for a complete blood checkup (CBC). If the platelet count and WBC count are below than their usual range one should go for Dengue Antigen test.

Dengue fever, an Aedes mosquito-borne viral infection, is a self-limiting or asymptomatic viral infection. In its severe form, severe dengue, the symptoms include organ failure, life-threatening bleeding, and shock. Patients with obesity were found to be at higher risks of developing complications and severe dengue infection compared to non-obese patients. Our systematic review and meta-analysis critically compared the available shreds of evidence related to obesity and severe forms of dengue infection. A total of fifteen studies that include nine cohort studies, five case-control studies, and one cross-sectional study were reviewed to explore the association between obesity and dengue severity. The results indicated that obese patients have higher odds of developing severe dengue infection compared to non-obese patients.

Host–parasite coevolution is a special case of coevolution, the reciprocal adaptive genetic change of a host and a parasite through reciprocal selective pressures. It is characterized by reciprocal genetic change and thus changes in allele frequencies within populations. These are determined by three main types of selection dynamics: negative frequency-dependent selection when a rare allele has a selective advantage; overdominance caused by heterozygote advantage; and directional selective sweeps near an advantageous mutation

Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria.

Hepatitis is inflammation of the liver tissue. Some people with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.

Malaria is present in over 100 countries worldwide, including large areas of South America, Africa and Southeast Asia, and it is estimated that over 40% of the world’s population is at risk of infection. The disease is caught through the bite of an infected mosquito carrying plasmodium parasites in its saliva. It is estimated that malaria caused 627 000 deaths in 2012; infections caused by Plasmodium falciparum are the most severe and have the highest mortality rate, but Plasmodium vivax is increasingly recognized as an important cause of clinical symptoms.

Malaria must be recognized promptly in order to treat the patient in time and to prevent further spread of infection in the community via local mosquitoes. Malaria should be considered a potential medical emergency and should be treated accordingly. Delay in diagnosis and treatment is a leading cause of death in malaria patients in the United States. Malaria can be suspected based on the patient’s travel history, symptoms, and the physical findings at examination. However, for a definitive diagnosis to be made, laboratory tests must demonstrate the malaria parasites or their components.

Diagnosis of malaria can be difficult:

• Where malaria is not endemic any more (such as in the United States), health-care providers may not be familiar with the disease. Clinicians seeing a malaria patient may forget to consider malaria among the potential diagnoses and not order the needed diagnostic tests. Laboratorians may lack experience with malaria and fail to detect parasites when examining blood smears under the microscope.
• In some malaria-endemic areas, malaria transmission is so intense that a large proportion of the population is infected but not made ill by the parasites. Such carriers have developed just enough immunity to protect them from malarial illness but not from malarial infection. In that situation, finding malaria parasites in an ill person does not necessarily mean that the illness is caused by the parasites.