Confirming cerebral malaria deaths in resource-limited settings

Infectious diseases and the role of needle biopsy post-mortem

Post-mortem examinations continue to play a crucial role in understanding the epidemiology and pathogenesis of infectious diseases. However, the perceived infection risk can preclude traditional, invasive, complete diagnostic autopsy. Post-mortem examination is especially important in emerging infectious diseases with potentially unknown infection risks, but rapid acquisition of good quality tissue samples is needed as part of the scientific and public health response. Needle biopsy post-mortem is a minimally invasive, rapid, closed-body autopsy technique that was originally developed to minimise the infection risk to practitioners. Since its inception, needle biopsy post-mortem has also been used as a technique to support complete diagnostic autopsy provision in poorly resourced regions and to facilitate post-mortem examinations in communities that might have religious or cultural objections to an invasive autopsy. This Review analyses the evolution and applicability of needle biopsy post-mortem in investigating endemic and emerging infectious diseases.

The role of natural recovery category in malaria dynamics under saturated treatment

In the process of malaria transmission, natural recovery individuals are slightly infectious compared with infected individuals. Our concern is whether the infectivity of natural recovery category can be ignored in areas with limited medical resources, so as to reveal the epidemic pattern of malaria with simpler analysis. To achieve this, we incorporate saturated treatment into two-compartment and three-compartment models, and the infectivity of natural recovery category is only reflected in the latter. The non-spatial two-compartment model can admit backward bifurcation. Its spatial version does not possess rich dynamics. Besides, the non-spatial three-compartment model can undergo backward bifurcation, Hopf bifurcation and Bogdanov-Takens bifurcation. For spatial three-compartment model, due to the complexity of characteristic equation, we apply Shengjin's Distinguishing Means to realize stability analysis. Further, the model exhibits Turing instability, Hopf bifurcation and Turing-Hopf bifurcation. This makes the model may admit bistability or even tristability when its basic reproduction number less than one. Biologically, malaria may present a variety of epidemic trends, such as elimination or inhomogeneous distribution in space and periodic fluctuation in time of infectious populations. Notably, parameter regions are given to illustrate substitution effect of two-compartment model for three-compartment model in both scenarios without or with spatial movement. Finally, spatial three-compartment model is used to present malaria transmission in Burundi. The application of efficiency index enables us to determine the most effective method to control the number of cases in different scenarios.