Plasmodium vivax malaria elimination requires radical cure with chloroquine/primaquine. However, primaquine causes hemolysis in glucose-6-phosphate dehydrogenase-deficient (G6PDd) individuals. Between February 2016 and July 2017 in Odisha State, India, a prospective, observational, active pharmacovigilance study assessed the hematologic safety of directly observed 25 mg/kg chloroquine over 3 days plus primaquine 0.25 mg/kg/day for 14 days in 100 P. vivax patients (≥ 1 year old) with hemoglobin (Hb) ≥ 7 g/dL. Pretreatment G6PDd screening was not done, but patients were advised on hemolysis signs and symptoms using a visual aid. For evaluable patients, the mean absolute change in Hb between day 0 and day 7 was −0.62 g/dL (95% confidence interval [CI]: −0.93, −0.31) for males (N = 53) versus −0.24 g/dL (95%CI: −0.59, 0.10) for females (N = 45; P = 0.034). Hemoglobin declines ≥ 3 g/dL occurred in 5/99 (5.1%) patients (three males, two females); none had concurrent clinical symptoms of hemolysis. Based on G6PD qualitative testing after study completion, three had a G6PD-normal phenotype, one female was confirmed by genotyping as G6PDd heterozygous, and one male had an unknown phenotype. A G6PDd prevalence survey was conducted between August 2017 and March 2018 in the same region using qualitative G6PD testing, confirmed by genotyping. G6PDd prevalence was 12.0% (14/117) in tribal versus 3.1% (16/509) in nontribal populations, with G6PD Orissa identified in 29/30 (96.7%) of G6PDd samples. Following chloroquine/primaquine, notable Hb declines were observed in this population that were not recognized by patients based on clinical signs and symptoms.

Lower respiratory tract infection accounts for nearly 4 million deaths annually. Among different types of viruses causing respiratory infection, human bocavirus (HBoV) is the new emerging viral pathogen affecting mostly adults and children. Scanty knowledge is available about HBoV causing lower and upper respiratory infections as well as gastrointestinal illness. In this review article, the authors attempted to present a comprehensive narration about HBoV, including its virology, epidemiology, clinical manifestations, and diagnostic approaches.

Background: Acute respiratory infections (ARIs) are a leading cause of infant morbidity and hospitalization, with respiratory viruses being the predominant etiological agents. Data on clinical profile and outcomes of viral ARIs in term infants from India remain limited. Our objective was to evaluate the epidemiology, clinical profile, laboratory profile, and outcomes of respiratory syncytial virus (RSV) and other viral ARIs in hospitalized infants (aged ≤ 12 months) born at term (>37 weeks gestation). Methods: This prospective, multicenter, hospital-based observational study was conducted in Eastern India between July 2023 and March 2025. Respiratory viruses were detected using real-time RT-PCR. Demographic, clinical, laboratory, radiological, treatment, and outcome data were analyzed. RSV-positive infants were compared with RSV-negative infants and with infants infected with other respiratory viruses. Results: Among 224 infants, respiratory viruses were detected in 56.3%, with RSV being the most common pathogen (19.6%). Compared with infants infected with other respiratory viruses, RSV-positive infants had a significantly higher frequency of fast breathing (72.7% vs. 53.6%, p = 0.03), higher levels of inflammatory markers, and a longer median hospital stay (8 vs. 6 days, p = 0.02). In exploratory multivariable analysis, RSV infection (adjusted OR [aOR] 2.4, 95% CI 1.3–6.1), low-flow oxygen requirement at admission (aOR 1.9, 95% CI 1.4–5.3), and feeding difficulty (aOR 1.3, 95% CI 1.0–2.9) were independently associated with severe disease. Conclusions: RSV was the leading viral cause of ARI in hospitalized term infants and was associated with greater respiratory involvement, a heightened inflammatory response, and prolonged hospitalization compared with other viruses. These findings highlight the importance of early recognition and appropriate supportive care in hospitalized term infants with RSV infection.