Afghanistan Journal of Infectious Diseases

Packed Cell Volume Levels of Pregnant Women Screened for Urinary Schistosomiasis Attending Antenatal Clinic at Vom Christian Hospital, Vom, Plateau State, Nigeria

Kinjir Hauwa — 2026-01-08

Background: Urinary schistosomiasis remains a public health concern in many endemic settings associated with adverse maternal hematological outcomes. Packed Cell Volume (PCV) is an important indicator of anemia in pregnancy. We assessed the PCV levels of pregnant women attending antenatal clinic at Vom Christian Hospital, Vom, Plateau State, Nigeria and evaluated their screening outcomes in relation to Schistosoma haematobium infection.

Methods: This cross-sectional study involving 100 pregnant women was conducted between April and May 2019. Blood samples were analyzed for PCV using the microhematocrit method, and urine samples were examined for S. haematobium using centrifugation techniques. A structured questionnaire was administered to obtain demographic data and potential risk factors related to urinary schistosomiasis. Data were analyzed descriptively.

Results: No case of S. haematobium infection was detected (0.0% prevalence). PCV values ranged from 33.7% to 38.4% across participants. The highest mean PCV was recorded among housewives (36.9%) and the lowest among civil servants (35.2%). Women aged 26–30 years had the highest PCV (38.4%), while those aged 36–40 years recorded the lowest (33.7%). Participants with tertiary education showed a mean PCV of 36.5%. Second-trimester women had the highest mean PCV (36.9%), compared to 35.8% in the first trimester. Knowledge of schistosomiasis was generally low, with many respondents unaware of key symptoms or transmission routes.

Conclusion: Although no urinary schistosomiasis infection was detected, variations in PCV levels were observed across demographic groups. These findings underscore the need for continuous hematological monitoring during pregnancy, particularly in settings with potential exposure to parasitic infections.

Trends the Future Burden of Visceral Leishmaniasis in Afghanistan, Iran, and Pakistan: A Regional Epidemiological Modeling Study

Meysam Olfatifar — 2026-01-08

Background: Visceral leishmaniasis (VL) remains one of the world’s most severe neglected tropical diseases, causing substantial morbidity and mortality in low-resource settings. Despite regional control efforts, the disease persists as a major health challenge in the Middle East and South Asia. We aimed to estimate and forecast the sex-specific and national burden of VL in three neighboring countries of Afghanistan, Iran, and Pakistan through 2040.

Methods: To estimate the future prevalence of VL we applied an illness–death model using sex-specific data from the Global Burden of Disease 2021. Historical data from 1990–2021 were used to calibrate the model and forecast national trajectories of VL prevalence to 2040.

Results: In 2023, Afghanistan had the highest age-standardized VL prevalence (0.0176), followed by Iran (0.0159) and Pakistan (0.0093). Projections indicate strikingly divergent trends by 2040: prevalence is expected to rise to 0.045 (95% CI: 0.03–0.08) in Afghanistan and 0.211 (95% CI 0.10–0.45) in Pakistan representing increases of 156% and over 2,100%, respectively while Iran is projected to experience a sustained decline to 0.002 (95% CI: 0–0), an 87% reduction compared with 2021. These patterns are consistent across both sexes, though male prevalence remains roughly twice that of females.

Conclusion: Afghanistan’s decline likely reflects under-detection due to health system fragility, while Pakistan’s surge may result from both improved surveillance and genuine spread. Iran’s continued reduction demonstrates the impact of sustained public health investment. Strengthening surveillance and incorporating health system indicators into predictive models are crucial for accurate projections and effective regional control.

Acaricidal Effect of Propolis against Hyalomma Spp. Ticks and Assessment of Its Toxicity with the MTT Assay

Roghayeh Norouzi — 2026-01-08

Background: The Hyalomma species is one of the most important vectors of pathogens responsible for human and animal diseases. The use of substances of natural source has been proposed as a safe way to control ticks. We aimed to evaluate the acaricidal activity of hydroalcoholic extract of honey bee propolis against the Hyalomma spp. in vitro and to determine its toxicity by MTT assay.

Methods: The acaricidal activity of propolis in concentrations of 50, 100, 150, and 200 mg/ml was investigated after 15, 30 and 60 minutes by two spray and contact methods. The main compounds of propolis were carried out with Gas Chromatography-Mass Spectrometry (GC–MS). Then the toxicity of each concentration was evaluated by MTT assay. Data were analyzed by GraphPad Prism 6 software.

Results: The concentration of 200 mg/ml of propolis had the highest acaricidal effect (90%) in the exposure time of 60 minutes and spray method was more effective than the contact method. The GC-MS analysis identify that Hexane (CAS); n-Hexane (17.32%) is the main ingredient of propolis. The results of the MTT toxicity test showed that toxicity increases with increasing concentration, and low concentrations of propolis have very little toxicity.

Conclusion: The hydroalcoholic extract of propolis contains potent acaricidal compounds and it might be used as a natural acaricide compound to against Hyalomma spp. However, further studies are needed to evaluate the effectiveness of the propolis.

Comparison of Laboratory Factors in COVID-19 Patients with and Without Mucormycosis

Farshid Safdarian — 2026-01-08

Background: There is increasing evidence that COVID-19 infection increases the patient's risk of secondary fungal infections. We aimed to compare the role of blood factors and inflammatory markers during COVID-19 infection in patients with and without mucormycosis.

Materials: The current research is cross-sectional and descriptive-analytical. The statistical population of this research included hospitalized patients with mucormycosis related to COVID-19 (as case group) and hospitalized patients with COVID-19 without mucormycosis (as control group) in Booali Sina and Velayat hospitals, Qazvin, Iran. Demographic information (age, gender) and laboratory findings were recorded in the prepared draft.

Results: We enrolled 69 patients as case group and 82 patients as control group. The mean age of the surveyed patients was 56.89 ± 16.06 years. Seventy-nine (52.3%) people from the patients, were male and 72 (47.7%) people were female. The mean of hemoglobin and WBC was higher in patients without mucormycosis and these differences were statistically significant (P<0.05). The trend of CRP changes in patients without mucormycosis decreased more than patients with mucormycosis (P<0.001).

Conclusion: Differences in hematologic and inflammatory markers between COVID-19 patients with and without mucormycosis suggest that routine monitoring of parameters such as WBC, hemoglobin, CRP, and blood glucose may help identify patients at higher risk for mucormycosis and enable earlier diagnosis and intervention.

Present and Future Trajectory of Tuberculosis Globally and In Afghanistan from 1990 to 2040: A Modelling Study

Majid Khosravi — 2026-01-08

Background: Tuberculosis (TB) continues to disproportionately affect vulnerable populations in conflict zones like Afghanistan, remaining a significant global health concern. We aimed to analyze TB trends in Afghanistan from 1990 to 2021 and projects the future burden to 2040, informing evidence-based public health planning.

Methods: Using sex-specific epidemiological data from the Global Burden of Disease (GBD) study (1990–2021), we projected the future prevalence of TB in Afghanistan and globally through 2040. We employed an illness-death model (IDM), calibrated to the GBD data to generate these projections.

Results: From 1990 to 2021, the global age-standardized prevalence rate (ASPR) of TB decreased by 23%, with projections indicating a further 6% decline by 2040. Afghanistan demonstrated a more substantial historical reduction of 43% and is forecast to achieve an additional 41% decrease by 2040. Although starting from a lower baseline than the global average, Afghanistan’s rate of improvement is significantly more rapid. Projections for Afghanistan are associated with greater uncertainty, largely due to unique socio-political challenges. Nonetheless, these trends highlight the considerable progress made by the country despite major operational constraints.

Conclusion: While projections suggest potential progress in TB control, recent increases in case notifications and wide uncertainty intervals highlight that epidemiological outcomes in fragile states depend on political and economic factors as much as biomedical interventions, especially where case detection is suboptimal.

Human Fascioliasis in Northern Iran: Clinical Features and Treatment

Abdolhossein Dalimi — 2026-01-08

Background: Fascioliasis is a zoonotic parasitic disease, caused by the liver fluke Fasciola spp.. We aimed to investigate the clinical signs of human fasciolosis before and after treatment with triclabendazole. The drug efficacy and its side effects were also assessed.

Methods: Fifty confirmed fasciolosis patients, 15 males and 35 females, were chosen for parasitological and serological examinations pre-therapy as well as 1- and 6-months post-therapy. For stool examination formalin-ether and modified Telemann methods and for Fasciola antibody detection Elisa technique was applied.

Results: Overall, 100% and 18% of patients had positive ELISA and stool exams before treatment, respectively. The most frequent sign was abdominal pain (96%). The cure rate of the patient based only on stool examination was 100% after consumption of single dose of triclabendazole (10 mg/kg of body weight). Transient abdominal pain (mild and moderate) was the most frequent adverse sign following treatment with triclabendazole.

Conclusion: A single dose of triclabendazole (10 mg/kg) proved to be a successful therapeutic intervention, effectively eliminating the infection with manageable side effects.

Molecular Prevalence and Risk Factors of Hepatitis B Virus Infection Among the Patients Attending the Human Medical Laboratories in Kabul, Afghanistan

Muhammad Farooq Haider — 2026-01-08

Background: Hepatitis B virus (HBV) can cause acute and/or chronic hepatitis, responsible for over one million deaths annually. We aimed to estimate the prevalence of hepatitis B and its risk factors among the patients attending the Human Medical Laboratories (HML) in Kabul, Afghanistan.

Methods: This retrospective study was conducted on samples received between January 2022 and September 2023. We tested 2062 blood samples using a Geneproof Amplification Kit and Rotor-Gene Real-Time PCR. Descriptive and analytical statistics (Chi-square test and logistic regression) were analyzed using SPSS version 26.

Results: The prevalence of HBV was 51.2% (1056/2062), with 59.3% males and a mean (SD) age of 32.0 (14.9) years. The majority of the HBV-positive patients (792/1056 or 74.8%) were from the age group of 16–45 years. The highest and lowest prevalence of HBV was observed in Kandahar (29/48 or 60.4%) and Nangarhar (107/235 or 45.5%), respectively. The mean overall HBV viral load was 39,587,427.2 IU/mL, with the highest and lowest mean viral load observed in patients from Takhar (71,940,575.8 IU/mL) and Kandahar (1,419,819.0 IU/mL), respectively. The statistically significant risk factors associated with HBV were blood transfusion, dental extraction, and syringe sharing.

Conclusion: HBV is highly prevalent among the Afghans attending HML in Kabul, Afghanistan. The Afghanistan Ministry of Public Health and international donor agencies should help in conducting more studies of HBV in all 34 provinces of Afghanistan. This will help in finding the real burden and risk factors of HBV in different regions and ethnicities of Afghanistan.

Comparative Assessment of Helicobacter pylori stool Ag and serum Antibodies Tests with Urea Breath Test among Symptomatic Patients at a Tertiary Hospital in Kabul, Afghanistan

Noor Ahmad Noori — 2026-01-08

Background: Helicobacter pylori infection is a major cause of gastrointestinal disorders. Accurate diagnosis is essential for proper management, particularly in resource-limited settings. We compared the diagnostic performance of stool antigen (Ag) and serum antibody (Ab) tests with the Urea Breath Test (UBT), the gold standard for detecting H. pylori infection, among symptomatic patients at a tertiary hospital in Kabul, Afghanistan, in 2023.

Methods: This case series study included dyspeptic patients attending the outpatient department of Cure Hospital, Kabul, Afghanistan, who had not used proton pump inhibitors in the previous two weeks or antibiotics in the past four weeks. All patients underwent stool antigen testing, serum antibody testing, and UBT. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated to assess diagnostic accuracy.

Results: Of the 66 patients enrolled (mean age = 36.4 ± 13.2 years; 68.2% were female), abdominal pain (93%) was the most common symptom. The stool antigen test showed high sensitivity (96%) and specificity (97.5%), while the serum antibody test exhibited lower sensitivity (73%) and specificity (67.5%). Sex-stratified analysis showed consistently high accuracy across for the stool antigen test across both sexes, while the performance of the antibody test varied by sex.

Conclusion: The stool antigen test shows high sensitivity and specificity and performs better than the serum antibody test for diagnosing H. pylori infection among symptomatic patients. It can be considered a reliable alternative to UBT in resource-limited settings.

Comparative Analysis of Runge–Kutta and Backward Euler Methods for Modeling Monkeypox Transmission Dynamics

Zabihullah Movaheedi — 2026-01-08

Background: Monkeypox (Mpox) is a re-emerging zoonotic viral disease that poses an increasing threat to global public health. Mathematical modeling is a key tool for understanding transmission dynamics of diseases like Mpox and supporting effective control strategies. Reliable numerical methods are essential for solving the nonlinear differential equations arising from such models.

Materials: We developed a deterministic compartmental model to describe Mpox transmission between human and small mammal populations. Human compartments include susceptible, exposed, infected, isolated, and recovered individuals, with corresponding classes for small mammals. We solved the system of nonlinear ordinary differential equations using the fourth-order Runge–Kutta (RK4) method and the Backward Euler method. We validated the model using real outbreak data from the U.S. Clade II Mpox cases reported by the Centers for Disease Control and Prevention (CDC, 2025).

Results: Simulation results demonstrate that RK4 provides higher accuracy and faster convergence in non-stiff scenarios, making it suitable for short-term epidemic predictions. The Backward Euler method exhibits superior numerical stability for stiff systems, allowing reliable long-term simulations with larger time steps. Error and computational analyses confirm RK4’s efficiency, while Backward Euler ensures robustness in unstable dynamic regions. Data fitting verifies that RK4 produces closer short-term approximations, whereas Backward Euler yields smoother long-term trends.

Conclusion: Both numerical methods are effective for modeling Mpox transmission. RK4 is recommended for accurate short-term analysis, while Backward Euler is preferable for stiff epidemic dynamics requiring high stability. These results highlight the importance of appropriate numerical method selection in computational epidemiology.

COVID-19 Transmission Dynamics in Afghanistan: Insights from Compartmental Models on Vaccination and Control

Amanullah Nabavi — 2026-01-08

Background: The COVID-19 pandemic has created substantial public health challenges worldwide, with Afghanistan facing unique vulnerabilities due to limited healthcare infrastructure and uneven vaccine coverage. Understanding the transmission dynamics of COVID-19 in this context is essential for designing effective intervention strategies.

Methods: Epidemiological data, including confirmed cases, mortality, and vaccination rates, were obtained from Our World in Data. Vaccination data were available from February 22, 2021, to December 31, 2023, and mortality rate estimation was based on data spanning April 1, 2020, to June 29, 2025. We developed a deterministic SEVIR compartmental model capturing susceptible, exposed, vaccinated, infectious, and recovered populations. The model was analyzed for biological feasibility, and key parameters, including the vaccination and mortality rates, were estimated from the data. Sensitivity analyses were conducted to determine the influence of parameters on disease progression. The basic reproduction number ( ) was derived analytically, and stability analysis of the disease-free equilibrium was performed.

Results: Model simulations indicate that the current vaccination rate in Afghanistan is insufficient to eliminate COVID-19. Doubling vaccination coverage could significantly reduce infection prevalence, while achieving herd immunity would require vaccinating approximately 86% of the population. Sensitivity analyses highlighted the critical role of vaccination and transmission rates in controlling disease spread. The disease-free equilibrium is locally stable whenever , confirming the theoretical feasibility of disease elimination.

Conclusion: These findings provide comprehensive insights into COVID-19 dynamics in Afghanistan and offer evidence-based guidance for public health policymakers to optimize vaccination strategies and mitigate the ongoing impact of the pandemic.

Phage-Antibiotic Combination Therapy for Antibiotic-Resistant Bacteria; Synergistic Mechanisms and Clinical Applications: A Systematic Review

Seyed Jalil Mousavi — 2026-01-08

Background: Antimicrobial resistance (AMR) is a major global health challenge requiring innovative therapeutic strategies. Phage–antibiotic combination therapy has emerged as a potential approach for treating multidrug-resistant (MDR) bacterial infections. This systematic review summarizes reported synergistic effects and clinical outcomes of this combined strategy.

Methods: This review was conducted according to PRISMA guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for studies published between January 2000 and December 2024 assessing combined bacteriophage and antibiotic therapy against MDR bacteria. Eligible studies focused on therapeutic synergy, bacterial resensitization, and clinical outcomes, with results synthesized narratively.

Results: A total of 25 studies were included, comprising 10 in vitro studies, 7 in vivo animal studies, and 8 clinical investigations. Phage–antibiotic combinations demonstrated synergistic effects in more than 70% of cases, resulting in enhanced bacterial eradication, improved biofilm disruption, and reduced resistance development compared with monotherapy. The mean Fractional Inhibitory Concentration Index (FIC-I) for synergistic combinations in in vitro studies was 0.29±0.11. Animal studies reported protection or survival rates ranging from 64% to 100%. Clinical reports, including case studies and one phase 2 trial, documented successful treatment of refractory MDR infections without major safety concerns, although adverse events were inconsistently reported.

Conclusion: Phage–antibiotic combination therapy appears to be a promising approach for managing MDR bacterial infections. Despite encouraging evidence of enhanced efficacy, challenges such as phage resistance, host immune responses, and variability in interactions remain. Larger, well-designed clinical trials and individualized testing are necessary to confirm clinical efficacy and optimize therapeutic application.