Afghanistan Journal of Infectious Diseases

Impact of Environmental Pollution on Infectious Disease Incidence: Challenges and Preventive Solutions: A Review Article

Safiullah fetrat — 2025-01-21

Background: Environmental pollution poses serious threats to public health and contributes significantly to the spread of infectious diseases. This study examined the effects of air, water, and soil pollution on the incidence of infectious diseases while proposing preventive measures and relevant public policies.

Methods: This systematic review was conducted using Google Scholar, PubMed, Science Direct, and Springer Link databases covering 2020 to 2024 to investigate the link between environmental pollution and infectious disease spread. Reputable scientific articles from reliable databases were reviewed to ensure comprehensive coverage.

Results: Twenty six selected studies indicate a significant association between environmental pollution—particularly air, water, and soil pollution—and the increased incidence of infectious diseases.

Conclusion: Environmental pollution has extensive and serious impacts on human health and the spread of infectious diseases. Effective pollution control and reduction can play a crucial role in lowering infectious disease rates. Further research is essential to deepen our understanding of this issue and develop effective strategies.

Comparative Analysis of Growth Media for Cultivating Acanthamoeba: Implications for Laboratory Diagnostics

Abdolhossein Dalimi — 2025-01-21

Background Acanthamoeba, a genus of free-living amoebae found in soil, freshwater, and marine habitats, is crucial in environmental studies and medical microbiology due to its potential to cause severe human infections. Cultivating Acanthamoeba is crucial for diagnosing infections, guiding treatment, and assessing exposure risks to pathogenic strains. This study aims to compare different culture media for cultivating Acanthamoeba under laboratory conditions.

Materials and Methods The study examined ten culture media for Acanthamoeba growth, including TSB, Trypticase soy agar (TSA), Trypticase soy yeast (TSY), Trypticase yeast iron-extracted (TYI), Trypticase, yeast maltose extract (TYM), Pepton Yeast Glucose Extract (PYG), Dulbecco's modified Eagle's medium (DMEM), RPMI 1640, Serum Casein Glucose Yeast Extract (SCGY), Coconut powder suspension in NNA medium, as well as non-nutrient agar (NNA) as the primary & control culture.

Results The results showed varied growth rates of Acanthamoeba when cultured in different media, highlighting important trends in their adaptability and growth based on the nutritional composition of the media provided. In TSB, TSA, DMEM/F12 and SCGY media, no growth was observed, suggesting that the combination may lack essential nutrients or conditions necessary for fostering Acanthamoeba proliferation. TYI showed an excellent growth rate for Acanthamoeba, particularly notable during the first 24-72 hours. The use of maltose as a carbon source and FBS in the NNA environment appears to promote rapid proliferation of Acanthamoeba. Coconut powder suspension in NNA medium led to excellent growth rates of Acanthamoeba.

Conclusion The effective cultivation of Acanthamoeba in TYI, TYM, and coconut powder highlights the significance of refining nutrient composition to enhance culturing methods.

Parasitic Contamination of Fruits Grown in National Veterinary Research Institute, Vom and Environs, Jos South Local Government Area, Plateau State, Nigeria

Ojemudia Theophilus Idahosa — 2025-01-21

Background: Fruits are essential dietary components but can act as vehicles for transmitting parasitic infections, particularly in areas with inadequate sanitation. We investigated the parasitic contamination of mangoes, pawpaw, and avocados grown in the National Veterinary Research Institute (NVRI) and its environs in Vom, Plateau State, Nigeria.

Methods: Overall, 150 fruit samples, comprising mangoes, pawpaw, and avocados (50 each), were randomly collected from five locations within NVRI and its environs. Samples were analyzed using the ordinary centrifugation method and iodine preparation. Data were statistically evaluated using Chi-square analysis, with a significance level set at P≤0.05.

Results: Parasitic contamination was detected in 64% of the fruit samples. Four parasite species were identified: Entamoeba histolytica (52.4%), E. coli (26.6%), Strongyloides stercoralis (20.2%), and Giardia lamblia (0.8%). Mangoes exhibited the highest contamination rate (42.7%), followed by avocados (31.5%) and pawpaw (25.8%). Among the sampling locations, the Vaccine Complex recorded the highest contamination rate (25.0%). The results revealed significant associations between fruit types, contamination rates, and location (P<0.05).

Conclusion: The findings underscore a high prevalence of parasitic contamination, indicating poor environmental hygiene and public health risks. Rigorous washing and proper handling of fruits are recommended to prevent parasitic infections. Public health education and observing strict regulations in agricultural practices are vital to mitigating these risks.

Phenotypic Diversity and Antibiotic Resistance Pattern of Extended-Spectrum Beta-Lactamase (ESBLS) Producing Klebsiella pneumonia Isolated From Patients in Three Selected Centers in Isfahan, Iran

Tahereh Motallebirad — 2025-01-21

Background: Klebsiella pneumoniae is a significant pathogen responsible for a wide range of infections, particularly urinary tract infections (UTIs). We aimed to determine the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella strains and analyze their antibiotic resistance patterns in isolates collected from patients in three hospitals in Isfahan, Iran.

Methods: This study was conducted over a 13-month period (2022–2023) in three educational hospitals in Isfahan, Iran. Out of 350 clinical specimens obtained from patients with UTIs, wounds, blood, and sputum, 142 Klebsiella isolates (40.5%) were identified and isolated according to standard methods. Antibiotic susceptibility was tested using the disk diffusion method according to CLSI standards, and ESBL production was confirmed using the combined disk method.

Results: Among the 142 isolates, 113 (31%) were derived from urine, while 29 (8.2%) were from wounds, sputum, and blood samples. Antibiotic resistance was highest against nitrofurantoin (45.5%), sulfamethoxazole (44.8%), and nalidixic acid (41.3%). In contrast, the most effective antibiotic was amikacin, with an 85.7% susceptibility rate. Additionally, 125 isolates (88%) of were identified as ESBL positive showed resistant to at least 6 antibiotics used in this study.

Conclusion: Amikacin remains the most effective antibiotic against Klebsiella species. However, the increasing prevalence of ESBL-producing strains poses a critical challenge for treating hospital-acquired infections. These findings highlight the need for rigorous antibiotic stewardship and infection control measures to mitigate the spread of resistant Klebsiella strains.

Prevalence of Malaria Parasite among Students of Federal College of Veterinary and Medical Laboratory Technology, Vom, Plateau State, Nigeria

Okeke Ikenna — 2025-01-21

Background: Malaria, an acute febrile illness caused by Plasmodium parasites and transmitted through infected Anopheles mosquitoes, remains a significant public health challenge. Nigeria has a high malaria burden, particularly among vulnerable populations. We aimed to determine the prevalence of malaria among students at Federal College of Veterinary and Medical Laboratory Technology (FCVMLT) in Vom, Plateau State, Nigeria, and assess their knowledge and prevention practices.

Materials: The study involved 134 students from three academic departments at FCVMLT between Apr and Jun 2022. Venous blood samples were collected, and malaria infection was assessed using microscopy with Giemsa-stained thick and thin blood films. A questionnaire was also administered to gather information on malaria awareness and preventive behaviors.

Results: The overall malaria prevalence among students was 35.07%, with a higher infection rate observed among females (42.35%) compared to males (22.45%), a difference that was statistically significant (χ² = 47.38, P<0.001). Malaria prevalence varied slightly across departments, with the Medical Laboratory Science department recording the highest prevalence at 39.13%, followed by Environmental Science and Management (25.00%) and Environmental Health Technology (26.92%), though this variation was not statistically significant (χ² =2.14, P=0.344). Students residing off-campus had a slightly higher prevalence (35.78%) than those living on-campus (32.94%), with no statistically significant difference (χ² = 0.24, P=0.622).

Conclusion: The high prevalence of malaria among students, despite good awareness, highlights the need for improved malaria control measures within educational settings. Asymptomatic infections among students could contribute to sustained malaria transmission within the community. Implementing regular malaria screenings, distributing insecticide-treated bed nets, and conducting educational campaigns on effective preventive practices are recommended.

Sensitivity Pattern of the Candida Species Separated from the Blood and Urine of the Patients with Malignancy in Hospital

Farnaz Naderalvojood — 2025-01-21

Background: Infection with Candida species has been increased globally during the past decade. This can be due to the increase in the number of patients with immunodeficiency problems like cancer, HIV AIDs, organ transplantation and hospitalization in ICUs. We aimed to investigate the prevalence rate of the fungal colonization and related species in chemotherapy-subjected children with malignancy.

Methods: Present analytical-applied research was conducted on 128 chemotherapy-subjected children with malignancy. Blood and urine samples were collected from all the patients; afterwards, the urine samples were cultivated on Saborrads Dextrose Agar and the blood samples in ordinary culture bottles (monophasic culture method and blood culturing). Then, the developed fungi were separated from the culture medium and subjected to identification tests.

Results: There was no significant relationship between the age group and infection with fungus (P=0.998) but there was a significant relationship between gender and fungus infection (P=0.049) in such a way that fungus infection was found more prevalent amongst the females. Overall, 28 individuals (58.33%) were found infected with C. albicans; 9 (18.75%) with C. tropicalis; 5 (10.42%) with C. glabrata; 3 (6.25%) with C. kefir; 2 (4.116%) with C. krusei and 1 (2.09%) with C. parapsilosis.

Conclusion: C. albicans is the most common species in this geographical area. The best treatment for these infectious diseases is voriconazole.

Evaluation of Acute Flaccid Paralysis Surveillance System in Afghanistan during 2020: A Retrospective Secondary Data Analysis

Khwaja Mir Islam Saeed — 2025-01-21

Background: We aimed to evaluate the acute flaccid paralysis (AFP) surveillance system focusing on indicators reflecting the performance of the system in Afghanistan.

Methods: This retrospective study was a secondary analysis of routinely collected AFP surveillance data during 2020 in Afghanistan. The standard WHO indicators were used to evaluate the AFP surveillance.

Results: Afghanistan reported 3972 AFP cases during 2020; of them 2228 (56%) were male while 2835 (71%) were children aged under five years. Of all AFP-reported cases, 56 were wild polio cases and almost half (n= 28, 50%) of them were reported among children aged 12–24 months. Almost 348 (8.8%) had taken zero doses of the vaccine both in routine and supplementary immunization activities (SIA). Approximately 83% (n=3290) had fever at the onset of the disease while 50.4% (n=2001) had asymmetric paralysis. Two southern provinces, i.e., Kandahar and Helmand, reported 30 (54%) wild polio cases. In 2020, the non-polio AFP rate was 17/100,000 in children below 15 years of age. Meanwhile 42 (75%) of wild polio cases patients received zero oral polio vaccine (OPV) through routine immunization while 24 (43%) wild polio cases received zero OPV through NID campaigns. All other indicators met the expected target except that 851 (21.4%) specimens arrived at the laboratory within 3 days and 180 (41.3%) were followed up after onset of paralysis in 60 days.

Conclusion: The AFP surveillance performed well in 2020. However, timely investigation of AFP cases and reaching the specimen to the lab should be improved.

Numerical Analysis of Typhoid Fever Spread Using Runge-Kutta and Nonstandard Finite Difference Methods

Zabihullah Movaheedi — 2025-01-21

Background: Typhoid fever, caused by Salmonella typhi, spreads through food or water contaminated with manure, posing significant individual and public health risks. This study analyzes typhoid fever dynamics using a mathematical model with susceptible, unprotected, infected, and recovered populations.

Methods: The next-generation matrix was employed to compute the threshold quantity, evaluating the existence and stability of equilibrium points. Two numerical schemes were developed: a conditionally stable fourth-order Runge–Kutta (RK-4) scheme and an unconditionally stable nonstandard finite difference (NSFD) scheme. The NSFD scheme was designed to ensure dynamic reliability by preserving the continuous model's key properties. Numerical simulations were conducted using MATLAB R2015b.

Results: The RK-4 scheme maintained reliability only for smaller step sizes and did not preserve all essential properties of the original model. In contrast, the NSFD scheme accurately captured the dynamics of the model, maintaining positivity, boundedness, and monotonicity of solutions. Stability analyses revealed that the NSFD scheme converges locally and globally, irrespective of step size, for both disease-free and endemic equilibrium points.

Conclusion: The NSFD scheme preserves all critical dynamic properties of the continuous model and demonstrates its effectiveness in predicting the spread of typhoid fever. This study highlights the NSFD scheme as a robust numerical tool for modeling infectious disease dynamics, offering accurate and reliable results in alignment with the theoretical model.

Prevalence and Associated Factors of Pediculosis capitis among Male Schoolchildren in Helmand Province, Afghanistan

Abdul Shakur Hashimi — 2025-01-21

Background: Pediculosis capitis (head lice infestation) is a significant public health concern, particularly among schoolchildren, because apart from physical symptoms, it also leads to their psychological distress, social stigma, and negative impacts on their school attendance and learning. Despite its global impact, there is a lack of research on this issue in Afghanistan.

Methods: This descriptive cross-sectional study was performed among male schoolchildren from Jan to Dec 2023, in Helmand Province, Afghanistan. Data were collected through physical examination and a structured questionnaire, which gathered information on participants’ demographics, socioeconomic status, physical characteristics, environmental factors, and hygiene practices. Statistical analysis of the prevalence and associated risk factors was performed using SPSS.

Results: Of the 306 participants, 26 (8.5%) had head lice infestation. Significant associations were observed between longer hair and higher infestation rates, as well as between older bathrooms and higher prevalence. Children from higher-income families had lower infestation rates, as did those with sweaty scalps. No significant associations were found with age, grade level, family size, parental education, physical traits, hair-washing products, or animal contact.

Conclusion: This study offers critical baseline data on pediculosis capitis in Afghanistan and highlights the need for targeted public health interventions. It also establishes the basis for future research on the socio-economic and environmental factors contributing to lice infestations in the region.

Knowledge and Awareness Regarding Hepatitis B among Medical Students in Kabul, Afghanistan: Cross-Sectional Study

Sayed Hussain Amiri — 2025-01-21

Background: Hepatitis B virus (HBV) impose a major public health problem with an increased risk of occupational exposure among unvaccinated health care workers. We aimed to determine the level of knowledge and awareness of medical, midwifery, dentistry and medical technology students regarding hepatitis B virus and vaccination in Kabul, Afghanistan.

Methods: This descriptive cross-sectional study was conducted in three medical institutions and universities using a convenient sampling in Afghanistan in 2023. A Structured self-administered questionnaire were used regarding awareness about prevention, transmission, diagnosis, and treatment and vaccination availability for HBV.

Results: A total of 200 students participated, comprising 106 (53.0%) males and 94 (47.0%) females, with an almost even distribution among the fields of study. 63.5% of participants had correct knowledge regarding prevention, transmission antigen and anti-body, treatment of HBV.

Conclusion: The findings indicate a concerning gap in vaccination coverage and knowledge dissemination among medical students. Enhancing educational programs and implementing comprehensive vaccination initiatives are essential to improve awareness and safety practices related to hepatitis B infection. Future longitudinal studies are needed to evaluate the impact of academic interventions on students' knowledge and vaccination rates.

Nosocomial Outbreak of Crimean-Congo Hemorrhagic Fever (CCHF) among health workers in Kandahar Province, Afghanistan, 2023: A Case-Control Study

Shoaib Naeemi — 2025-01-21

Background: Since 2008, more than 1600 cases of Crimean and Congo Hemorrhagic Fever (CCHF) have been reported in Afghanistan. We aimed to investigate the nosocomial outbreak of CCFH and its associated factors among health workers in Kandahar Province.

Methods: This case-control study was conducted during CCHF outbreak in a private hospital during April 2023 in Kandahar Province with 1:3 ratio of cases to controls. Cases were confirmed for CCHF infection using PCR and ELISA tests. Controls were selected from health workers of the general population. Data were managed and were analyzed using Epi Info v7.2.5 and STATA MP17 with an alpha level of 0.05 as well as 95% confidence. Penalized Logistic Regression (PLR) with firth correction was used.

Results: Fourteen cases and 43 controls were enrolled with mean age of 24±6.25 and 29±11.26 yr respectively. All the cases and two-third of controls were health workers while nine (64%) of cases and 39 (88%) of controls were male. Prominently, fever 64% and agitation/mood swings (64%) were recorded among cases. Multivariate analysis of the exposures showed that contact with CCHF suspected individual without considering Personal Protection Equipment (PPE) (OR 95%: 59.6, 6.02 – 589. 62P=0.001) was significantly associated with CCHF infection risk leading to emergence of this outbreak (P<0.05).

Conclusion: CCHF outbreak in this setting was associated with negligence of preventive measures by health workers. It is recommended for healthcare facilities to ensure the availability and utilization of PPE and enforcement of infection control practices while undertaking health education programs on transmission routes and preventives measures of CCHF.

Extra-Pulmonary Hydatid Cyst from Afghanistan: A Case Report

Mohammad Sayed Behrad — 2025-01-21

Hydatid cysts, caused by the larval stages of Echinococcus tapeworms, are a significant parasitic infection primarily affecting the liver and lungs. This case report presents a rare instance of an extrapulmonary hydatid cyst located in the pleural of a 45-year-old housewife female patient from Afghanistan. The patient exhibited symptoms of chest pain, headaches, dizziness, and a dry cough over three years. Diagnostic CT imaging revealed a mass in the right thoracic region. Following thorough surgical preparation, a right posterior-lateral thoracotomy was performed, leading to the excision of the hydatid cyst. Postoperatively, the patient was prescribed albendazole to facilitate cyst degradation. This case underscores the importance of early diagnosis and an integrated treatment approach, combining medical therapy and surgical excision, to improve patient outcomes and manage the complications of hydatid disease effectively.