BackgroundRecent increased activity of the mosquito-borne Murray Valley encephalitis virus (MVEV) in Australia has renewed concerns regarding its potential to spread and cause disease.Methodology/Principal FindingsTo better understand the genetic relationships between earlier and more recent circulating strains, patterns of virus movement, as well as the molecular basis of MVEV evolution, complete pre-membrane (prM) and Envelope (Env) genes were sequenced from sixty-six MVEV strains from different regions of the Australasian region, isolated over a sixty year period (1951–2011). Phylogenetic analyses indicated that, of the four recognized genotypes, only G1 and G2 are contemporary. G1 viruses were dominant over the sampling period and found across the known geographic range of MVEV. Two distinct sub-lineages of G1 were observed (1A and 1B). Although G1B strains have been isolated from across mainland Australia, Australian G1A strains have not been detected outside northwest Australia. Similarly, G2 is comprised of only Western Australian isolates from mosquitoes, suggesting G1B and G2 viruses have geographic or ecological restrictions. No evidence of recombination was found and a single amino acid substitution in the Env protein (S332G) was found to be under positive selection, while several others were found to be under directional evolution. Evolutionary analyses indicated that extant genotypes of MVEV began to diverge from a common ancestor approximately 200 years ago. G2 was the first genotype to diverge, followed by G3 and G4, and finally G1, from which subtypes G1A and G1B diverged between 1964 and 1994.Conclusions/SignificanceThe results of this study provides new insights into the genetic diversity and evolution of MVEV. The demonstration of co-circulation of all contemporary genetic lineages of MVEV in northwestern Australia, supports the contention that this region is the enzootic focus for this virus.
We studied the clinical and epidemiologic features of an outbreak of Crimean-Congo hemorrhagic fever in Herat Province, Afghanistan. The study comprised 63 patients hospitalized in 2017. The overall case-fatality rate was 22.2%; fatal outcome was significantly associated with a negative IgM test result, longer prothrombin time, and nausea.
Background and AimsPregnancy is an important and natural event in a woman's life. It represents a time of substantial social and bio‐psychological challenges for a pregnant woman that may increase vulnerability to emotional disturbances such as depression, anxiety, and stress (DAS). This study aims to assess the prevalence and associated factors of DAS among pregnant women in Herat city of Afghanistan.MethodsThis hospital‐based cross‐sectional study was conducted between July and November 2019, on 691 Dari‐speaking pregnant women aged 15‐49 years, who attended the antenatal clinic of Herat Razaei Maternity Hospital. The interview process involved the use of a structured questionnaire that collected data on sociodemographic characteristics of participants, as well as the validated Dari‐translated version of DASS‐42 questionnaire. A χ2 test was used to test for association between categorical data. Forward likelihood ratio was used to assess the strength of association between sociodemographic variables and DAS; independently. The significance level was set to 0.05 and the confidence interval to 95% in all statistical analyses. Statistical analyses were performed in IBM SPSS Statistics (version 27).ResultsThe mean age of participants was 26.17 ± 6.06. The overall prevalence of DAS among study participants were 42.8%, 40.0%, and 59.5%, respectively. Planning of current pregnancy, women's health, husband's health, women's nutrition, family support, husband's support, women's education, women's employment, and family economy were significantly associated with DAS, while gestational age was not significantly associated with DAS.ConclusionThe prevalence of DAS among pregnant women in Herat city of Afghanistan is very high. Considering scientific evidence on high prevalence and associated factors of DAS among pregnant women, policymakers, public health authorities, and medical practitioners must devote significant attention in reducing the magnitude of these mental disorders and/or reducing their impact on women, their families, and the society.
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