An important public health problem in India is dengue infection, with every year seeing an increase in cases of dengue fever. Dengue affects all individuals irrespective of their gender and age, although the infection rate is higher among males and younger people. Despite low severity in general, dengue virus can cause severe health conditions in some individuals. Genetic characterization of circulating endemic dengue virus (DENV) serotypes plays a significant role in providing epidemiological knowledge and subsequent vaccine development. In the present study, over a 4 year period, we assessed DENV transmission dynamics in major regions of western Uttar Pradesh in North India. ELISA tests were used to diagnose dengue, and PCRs were used to determine the circulating serotype. We found that dengue infection peaks after the rainy season and affects all sexes and ages. A total of 1277 individuals were found positive for dengue; among them, 61.7 % were male and 38.3 % were female. DEN-1 was found in 23.12 %, DEN-2 in 45 %, DEN-3 in 29.06 % and DEN-4 in 1.5 % of the dengue-infected individuals. All four DENV serotypes were circulating in the study area, and DENV serotype-2 (DEN-2) was the most prevalent serotype.

Dengue fever poses a significant global health threat, with symptoms including dengue hemorrhagic fever and dengue shock syndrome. Each year, India experiences fatal dengue outbreaks with severe manifestations. The primary cause of severe inflammatory responses in dengue is a cytokine storm. Individuals with a secondary dengue infection of a different serotype face an increased risk of complications due to antibody-dependent enhancement. Therefore, it is crucial to identify potential risk factors and biomarkers for effective disease management. In the current study, we assessed the prevalence of dengue infection in and around Aligarh, India, and explored the role of cytokines, including CXCL5, CXCL9, and CCL17, in primary and secondary dengue infections, correlating them with various clinical indices. Among 1,500 suspected cases, 367 tested positive for dengue using Real-Time PCR and ELISA. In secondary dengue infections, the serum levels of CXCL5, CXCL9, and CCL17 were significantly higher than in primary infections (P < 0.05). Dengue virus (DENV)-2 showed the highest concentrations of CXCL5 and CCL17, whereas DENV-1 showed the highest concentrations of CXCL9. Early detection of these cytokines could serve as potential biomarkers for diagnosing severe dengue, and downregulation of these cytokines may prove beneficial for the treatment of severe dengue infections.

Brucellosis is a common zoonotic infection in India, caused by a facultative intracellular bacterium, Gram-negative coccobacillus, and frequently presents with nonspecific symptoms. This study aimed to assess serum cytokine levels (IL-6, IL-10, IFN-γ, and IL-2) by ELISA and to correlate them with inflammatory markers (ESR and CRP) in patients with suspected brucellosis presenting with rheumatoid arthritis-like manifestations and polyarthralgia. This study included 111 patients, comprising 72 brucellosis-positive arthritis patients and 39 brucellosis-negative arthritis patients as controls. In this study, we investigated the variation in levels of four cytokines (IL-2, IL-6, IL-10 and IFN-γ) among brucellosis-positive and brucellosis-negative arthritis patients and their relationship with clinical parameters. The mean serum levels of IL-2 and IL-10 were numerically higher in brucellosis-positive arthritis patients compared to controls; however, these differences were not statistically significant (p > 0.05). Similarly, no statistically significant differences were observed for IL-6 and IFN-γ between the groups. Inflammatory markers such as ESR and CRP were elevated in brucellosis-positive patients, although these differences did not reach statistical significance. These findings indicate variability in cytokine and inflammatory marker levels between groups. The observed associations with raw dairy consumption, contact with unvaccinated livestock, and direct animal exposure highlight the need for early diagnosis, effective livestock immunisation programs, and strengthened One Health-based public health interventions to reduce disease burden.

Emerging viruses causing Acute Encephalitis Syndrome (AES) can be more damaging due to irreversible brain damage, irrespective of the identical medical characteristics created by all agents. We report two cases of acute encephalitis syndrome caused by Japanese encephalitis virus from a usually under-reported geographic region of India. Both patients were managed conservatively with favourable outcome in one of them.There should be considerable effort to identify the particular causative agent that triggers AES, bearing in mind the various clinical manifestations of Japanese encephalitis virus. Although there is no significant impact on management, it is possible to prevent transmission to healthy contacts and the community through vector control and vaccination.

India carries a high burden of neglected tropical diseases (NTDs), yet the extent to which essential diagnostic services align with local disease burden across public health facilities remains unclear. We conducted a cross-sectional assessment of diagnostic availability for major NTDs in 332 public health facilities across seven states and one union territory, including sub-centers, primary health centers, community health centers, and district hospitals. Diagnostic availability for malaria, dengue, Japanese encephalitis, chikungunya, lymphatic Filariasis, Leishmaniasis, helminthic infections, and HIV was evaluated using the ICMR National Essential Diagnostics List (2019), and a Diagnostic Readiness Index (DRI) was calculated at the facility, district, and state levels. Big three diseases like tuberculosis, malaria, and HIV are not neglected anymore in terms of funding and research, but their interaction with classic NTDs highlights how these diseases, though different in classification, create a dual burden in vulnerable populations, like in India. Diagnostic readiness increased with higher levels of care but showed limited concordance with disease burden. Malaria diagnostics were widely available across all tiers (mean district DRI: 84.34%), reflecting sustained programmatic prioritization. In contrast, diagnostic availability for dengue (40.36%), lymphatic Filariasis (29.22%), helminthic infections (25.30%), Japanese encephalitis (8.13%), and Leishmaniasis (5.72%) remained low, including in districts reporting substantial disease burden. The greatest mismatch between burden and diagnostic availability was observed at sub-centers and primary health centers, whereas district hospitals showed a more favorable alignment. These findings indicate that essential diagnostic deployment for NTDs in India remains uneven and weakly responsive to epidemiological need. Strengthening burden-informed, decentralized access to point-of-care diagnostics—particularly at peripheral and primary care levels—is critical to improve early case detection, surveillance accuracy, and progress toward national NTD control and elimination targets. Author Summary: Neglected tropical diseases (NTDs) continue to affect millions of people in India, particularly those living in underserved and resource-limited settings. Early and accurate diagnosis is essential for timely treatment, surveillance, and control; however, the availability of essential diagnostic services across different levels of the public health system remains poorly understood. In this study, we assessed the availability of diagnostics for major NTDs across 332 public health facilities, including sub-centers, primary health centers, community health centers, and district hospitals in seven states and one union territory, using the ICMR National Essential Diagnostics List (2019) and a Diagnostic Readiness Index. We found that diagnostic readiness generally increased with higher levels of care but showed limited alignment with local disease burden. Malaria diagnostics were widely available, reflecting sustained programmatic prioritization, whereas diagnostics for dengue, lymphatic filariasis, helminthic infections, Japanese encephalitis, and leishmaniasis were markedly limited, even in areas with substantial reported burden. The largest gaps were observed at peripheral and primary care facilities, which are often the first point of contact for vulnerable populations. Our findings highlight a critical mismatch between disease burden and diagnostic deployment for NTDs in India. Strengthening decentralized, burden-informed access to point-of-care diagnostics—especially at sub-centers and primary health centers—could improve early case detection, enhance surveillance accuracy, and support more effective control and elimination efforts. This study provides policy-relevant evidence to guide health system strengthening and equitable diagnostic access for NTD-endemic regions.