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Background Fever in under-five children (U5) is the commonest presenting complaint in general practice and mothers’ recognition is an entry point for fever treatment, including malaria. This study describes rural–urban disparity in fever prevalence in U5, mothers’ malaria knowledge, care-seeking, testing for malaria before anti-malarial medication and the associated factors. Methods A cross-sectional survey was conducted among 630 mother–child pairs [rural (300) and urban (330)] selected randomly using a multi-stage sampling from 63 villages in Igabi LGA, Kaduna State, Nigeria. Trained female data collectors administered a pre-tested structured questionnaire to collect information on mother–child demographic profiles, malaria knowledge, fever episodes in birth order last child in two weeks prior to survey, blood testing before anti-malarial use, and delayed care-seeking defined as care sought for fever > 48 h of onset. Malaria knowledge was categorized into good, average, and poor if the final scores were ≥ 75th, 50th–74th, and < 50th percentiles, respectively. Frequency, proportions, and odds ratio were calculated. Statistically significant was set at p-value < 0.05. Results The median age (interquartile range) of rural mothers was 30 (IQR, 10) years compared to 27 (IQR, 6) years in urban. Of the 70.0% (441/629) U5 children with fever, 58.5% (258/441) were in rural settlements. A third of the mothers whose child had fever sought care. Mothers in rural settlements were 2.8 (adjusted OR: 2.8, CI 1.8–4.2, p < 0.01) times more likely to delay care-seeking for fever. Other significant factors were poor or no knowledge of malaria transmission, poor perception of malaria as a major health problem, and household size > 5. Also, mothers who had no formal education were four times more likely to receive anti-malarial medications without testing for malaria compared to their educated counterpart (adjusted OR: 4.0, 95% CI 1.6–9.9, p < 0.000). Conclusions Rural–urban disparities existed between fever prevalence in U5 children, care-seeking practices by their mothers, and factors associated with delayed care-seeking and testing the fever for malaria before anti-malarial medication. Fever treatment for high impact malaria elimination in Nigeria needs a context-specific intervention rather than ‘one-size-fits-all’ approach.

Like the Ebola virus itself, the fear surrounding it has an ecology that must be understood if the current epidemic is to be brought under control. The local population's fears reflect, in part, the scars and painful memories of past medical encounters in West Africa. “Bush meat?” I asked. The food in front of me smelled delicious, but the mention of bush meat in the stew evoked a twinge of fear. Could it be fruit bat? Chimpanzee? Both can harbor Ebola virus. Our four-member team had just filmed a documentary in a remote rural village near the Guinea border. Shaded by the thatched roof of an open-air rice kitchen, we were sitting down to share a communal meal. Awaiting us was a tempting Liberian stew of cassava, pepper — and bush meat. My hosts smiled. Even here, an hour's trek from the nearest road, and . . .

As the SARS-COV-2 becomes a global pandemic, many researchers have a concern about the long COVID-19 complications. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a persistent, debilitating, and unexplained fatigue disorder. We investigated psychological morbidities such as CFS and post-traumatic stress disorder (PTSD) among survivors of COVID-19 over 6 months. All COVID-19 survivors from the university-affiliated hospital of Tehran, Iran, were assessed 6 months after infection onset by a previously validated questionnaire based on the Fukuda guidelines for CFS/EM and DSM-5 Checklist for PTSD (The Post-traumatic Stress Disorder Checklist for DSM-5 or PCL-5) to determine the presence of stress disorder and chronic fatigue problems. A total of 120 patients were enrolled. The prevalence rate of fatigue symptoms was 17.5%. Twelve (10%) screened positive for chronic idiopathic fatigue (CIF), 6 (5%) for CFS-like with insufficient fatigue syndrome (CFSWIFS), and 3 (2.5%) for CFS. The mean total scores in PCL-5 were 9.27 ± 10.76 (range:0–44), and the prevalence rate of PTSD was 5.8%. There was no significant association after adjusting between CFS and PTSD, gender, comorbidities, and chloroquine phosphate administration. The obtained data revealed the prevalence of CFS among patients with COVID-19, which is almost similar to CFS prevalence in the general population. Moreover, PTSD in patients with COVID-19 is not associated with the increased risk of CFS. Our study suggested that medical institutions should pay attention to the psychological consequences of the COVID-19 outbreak.

T cells clear virus from the CNS and dynamically regulate brain functions, including spatial learning, through cytokine signaling. Here we determined whether hippocampal T cells that persist after recovery from infection with West Nile virus (WNV) or Zika virus (ZIKV) impact hippocampal-dependent learning and memory. Using newly established models of viral encephalitis recovery in adult animals, we show that in mice that have recovered from WNV or ZIKV infection, T cell-derived interferon-γ (IFN-γ) signaling in microglia underlies spatial-learning defects via virus-target-specific mechanisms. Following recovery from WNV infection, mice showed presynaptic termini elimination with lack of repair, while for ZIKV, mice showed extensive neuronal apoptosis with loss of postsynaptic termini. Accordingly, animals deficient in CD8+ T cells or IFN-γ signaling in microglia demonstrated protection against synapse elimination following WNV infection and decreased neuronal apoptosis with synapse recovery following ZIKV infection. Thus, T cell signaling to microglia drives post-infectious cognitive sequelae that are associated with emerging neurotropic flaviviruses.

Malaria and typhoid fever pose significant health risks, leading to severe morbidity and mortality when inadequately treated. Understanding the role of stress-related inflammatory cytokines is crucial, as they mediate immune responses that affect pathogen clearance and recovery. This study investigated the cytokine profiles in patients with malaria and/or typhoid fever attending the Obala District Hospital in Yaoundé, Cameroon. We conducted a cross-sectional observational study measuring cortisol and inflammatory cytokines in blood samples from 55 infected patients and a control group of 15 healthy individuals using ELISA kits. We also evaluated psychological stress over the past 30 days using a 10-item Perceived Stress Scale (PSS) questionnaire to explore the link between stress and immune response. Psychological stress levels were notably higher in the typhoid fever group (18.20 ± 5.5) compared to the other groups, although these differences were statistically insignificant. Cortisol levels were significantly elevated (p < 0.001) across all patient groups compared to controls, with the typho-malaria group demonstrating a 2.5-fold increase. Notably, cytokine levels were elevated in patients with malaria and typhoid comorbidity, particularly IL-1β, IL-2, TNF-α, and IFN-γ. While IL-6 concentrations were significantly higher in malaria and typho-malaria co-infected patients, IL-10 levels were reduced in the typho-malaria group but remained elevated compared to controls. The TNF-α/IL-10 ratio was significantly higher in the co-infected group, suggesting a heightened inflammatory response. Additionally, there was a positive correlation between perceived stress scores and IL-2 (r = 0.365, p = 0.002), IFN-γ (r = 0.248, p = 0.03), and IL-6 (r = 0.412, p = 0.0001) in the typho-malaria group. Beyond IL-6, no significant correlations were observed between stress indices and the anti-inflammatory cytokines IL-4 (r = 0.204, p = 0.09) and IL-10 (r = 0.153, p = 0.20) among co-infected individuals. These results suggest that stress response may play a crucial role in shaping the inflammatory landscape during malaria and typhoid fever. Exposure to severe stressors may disrupt immune response and contribute to negative health outcomes. Understanding the immunopathogenesis of these diseases could potentially pave the way for the development of novel therapeutic strategies targeting the stress-cytokine axis.

Fevers are considered an adaptive response by the host to infection. For gregarious animals, however, fever and the associated sickness behaviors may signal a temporary loss of capacity, offering other group members competitive opportunities. We implanted wild vervet monkeys (Chlorocebus pygerythrus) with miniature data loggers to obtain continuous measurements of core body temperature. We detected 128 fevers in 43 monkeys, totaling 776 fever-days over a 6-year period. Fevers were characterized by a persistent elevation in mean and minimum 24-h body temperature of at least 0.5 °C. Corresponding behavioral data indicated that febrile monkeys spent more time resting and less time feeding, consistent with the known sickness behaviors of lethargy and anorexia, respectively. We found no evidence that fevers influenced the time individuals spent socializing with conspecifics, suggesting social transmission of infection within a group is likely. Notably, febrile monkeys were targeted with twice as much aggression from their conspecifics and were six times more likely to become injured compared to afebrile monkeys. Our results suggest that sickness behavior, together with its agonistic consequences, can carry meaningful costs for highly gregarious mammals. The degree to which social factors modulate the welfare of infected animals is an important aspect to consider when attempting to understand the ecological implications of disease.

To investigate whether people who think they have had COVID-19 are less likely to report engaging with lockdown measures compared with those who think they have not had COVID-19. On-line cross-sectional survey. Data were collected between 20th and 22nd April 2020. 6149 participants living in the UK aged 18 years or over. Perceived immunity to COVID-19, self-reported adherence to social distancing measures (going out for essential shopping, nonessential shopping, and meeting up with friends/family; total out-of-home activity), worry about COVID-19 and perceived risk of COVID-19 to oneself and people in the UK. Knowledge that cough and high temperature / fever are the main symptoms of COVID-19. We used logistic regression analyses and one-way ANOVAs to investigate associations between believing you had had COVID-19 and binary and continuous outcomes respectively. In this sample, 1493 people (24.3%) thought they had had COVID-19 but only 245 (4.0%) reported having received a positive test result. Reported test results were often incongruent with participants' belief that they had had COVID-19. People who believed that they had had COVID-19 were: more likely to agree that they had some immunity to COVID-19; less likely to report adhering to lockdown measures; less worried about COVID-19; and less likely to know that cough and high temperature / fever are two of the most common symptoms of COVID-19. At the time of data collection, the percentage of people in the UK who thought they had already had COVID-19 was about twice the estimated infection rate. Those who believed they had had COVID-19 were more likely to report leaving home. This may contribute to transmission of the virus. Clear communications to this growing group are needed to explain why protective measures continue to be important and to encourage sustained adherence.

Background Fever is a common childhood symptom and a frequent source of parental concern. Despite medical advances, misconceptions and inappropriate management strategies remain widespread. This study aimed to describe maternal knowledge, attitudes, and practices regarding childhood fever in Türkiye and to identify areas that may benefit from targeted education. Methods We conducted a cross-sectional, online survey using snowball sampling. A total of 3,133 mothers provided complete responses. The questionnaire assessed thermometer use, fever definitions, attitudes, and management practices. Descriptive statistics were reported, with exploratory comparisons conducted where relevant. Results The mean age of the participants was 33.4 ± 6.0 years, and the average age at which they became mothers was 27.6 ± 6.7 years. Digital thermometers were the most commonly used devices (83.1%), while 13% reported use of mercury thermometers, likely reflecting legacy devices or misclassification. Fever was most frequently defined as ≥ 38 °C (42.7%). Parental anxiety scores were high (mean 7.7/10), with febrile seizures being the most feared complication (73.1%). Antipyretics were often given early and at short intervals, with 39% of mothers administering them every 4 h or less. While most mothers relied on physicians for information, some used unvalidated practices such as vinegar or alcohol rubs. Conclusions This large descriptive survey suggests that fever phobia and misconceptions persist among mothers in Türkiye. Findings should be interpreted cautiously due to the study’s design limitations, including non-representative sampling and lack of child-level age data. These results provide a baseline for future, representative studies and may help inform parental counseling strategies.

Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic to Uganda and has caused numerous outbreaks in recent years. This study explored local perceptions of YF outbreaks among vulnerable groups in Uganda to inform future public health campaigns. A qualitative study examined community perceptions of YF and its treatment practices. Data were collected in six districts where YF outbreaks were reported in 2010 and 2016. A total of 76 individuals participated, comprising 43 semi-structured interviews, 10 expert interviews, and 4 focus group discussions, including vulnerable groups of older adults ≥ 65 years and pregnant women. Data were analyzed using grounded theory. Participants often recognized jaundice but did not distinguish YF from other causes of jaundice, such as newborn jaundice, severe malaria or hepatitis. Nevertheless, participants still considered YF a deadly disease. It was perceived to be transmitted through multiple pathways, including mosquito bites, airborne transmission, close contact with sick individuals, sexual intercourse, vertical transmission during pregnancy, poor hygiene, and certain foods. Treatments ranged from herbal remedies to visiting health centers. Several YF survivors shared first-hand experience, often relying on traditional medicine due to limited access to health facilities, diagnostic options, and no specific treatment for YF. In remote areas, participants often did not know the cause of the outbreak, as awareness campaigns focused on symptoms, prevention, and mass vaccination. If YF is not seen as a distinct disease entity, implementing diagnostic and preventive measures may be impeded. Moreover, failure to diagnose YF in clinical settings can hamper timely outbreak response. We recommend strengthening health literacy through health education and public participation in vulnerable communities with programs tailored to local needs, given that other infectious diseases are prevalent in the region. Furthermore, we propose that access to diagnostic testing for YF may be enhanced.

Rift Valley Fever (RVF) is a zoonotic disease that affects both livestock and humans. Men and women in pastoralist communities are vulnerable to RVF risk exposure because of their different roles and reliance on livestock products. This study sought to understand how ownership and decision-making in pastoralist male and female-headed households influence coping mechanisms and resilience to Rift Valley fever (RVF), using the three resilience capacities of absorptive, adaptive, and transformative. This study was conducted in two sub-counties (Garbatulla) and Merti), Isiolo County, Kenya. Data were collected through 16 focus group discussions and 13 key informant interviews with pastoralists and animal and human health stakeholders. The findings indicate that traditionally, men have the final say on decisions related to livestock ownership and make overall household decisions. Pastoralist men and women employ different approaches, including hygiene practices and mosquito nets, community knowledge dissemination, establishment of new businesses, utilization of healthcare, and indigenous medicines, to reduce the effects of RVF in both humans and livestock. They also collaborated with community disease surveillance initiatives to strengthen disease surveillance networks and gain access to county government support. This process fosters resilience, community empowerment, and transformative and sustainable adaptation responses to RVF.