Role of Plasma Exchange and Combining Therapies in Dengue-Associated Acute Liver Failure: A Systematic Review of Individual Cases.

Background/Aims: Dengue-associated acute liver failure (ALF) poses a significant risk for mortality, especially in regions lacking access to liver transplantation. Although Plasma Exchange (PLEX) is recognized as a potential therapeutic intervention for dengue-associated ALF, data on its efficacy remain limited. This systematic review aimed to comprehensively examine the literature on PLEX and other combination therapies for dengue-associated ALF. It focused on assessing their effectiveness, safety profile, and potential implications for therapeutic interventions. Methods: In this study, we conducted a systematic review to assess the efficacy and safety of PLEX and other combination therapies in patients with dengue-associated ALF. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were used to search the PubMed, Scopus, Embase, Ovid, and Google Scholar databases. Studies published in English between 2019 and May 2024 were included. The titles and abstracts were reviewed for discrepancies, and any differences were resolved through discussion. Results: Among the 713 studies assessed for review, 9 met the eligibility criteria. Studies have demonstrated that PLEX, both alone and in combination with other therapies, such as continuous renal replacement therapy (CRRT), improves liver function, survival rates, and neurological outcomes in patients with dengue virus. Both high- and low-volume plasma exchanges were effective. Conclusion: This systematic review highlights the beneficial role of PLEX and the potential benefits of combination therapies in the treatment of rare and severe forms of dengue-associated ALF. However, given the limited sample sizes and the necessity for well-designed studies, further investigations are needed to determine the optimal volume of PLEX and the efficacy of additional therapeutic strategies.

In Vitro Cleavage Assay to Characterize DENV NS2B3 Antagonism of cGAS.

cGAS is a key cytosolic dsDNA receptor that senses viral infection and elicits interferon production through the cGAS-cGAMP-STING axis. cGAS is activated by dsDNA from viral and bacterial origins as well as dsDNA leaked from damaged mitochondria and nucleus. Eventually, cGAS activation launches the cell into an antiviral state to restrict the replication of both DNA and RNA viruses. Throughout the long co-evolution, viruses devise many strategies to evade cGAS detection or suppress cGAS activation. We recently reported that the Dengue virus protease NS2B3 proteolytically cleaves human cGAS in its N-terminal region, effectively reducing cGAS binding to DNA and consequent production of the second messenger cGAMP. Several other RNA viruses likely adopt the cleavage strategy. Here, we describe a protocol for the purification of recombinant human cGAS and Dengue NS2B3 protease, as well as the in vitro cleavage assay.

Dengue Outbreak Caused by Multiple Virus Serotypes and Lineages, Colombia, 2023-2024.

Dengue cases rose to record levels during 2023-2024. We investigated dengue in Valle del Cauca, Colombia, to determine if specific virus serotypes or lineages caused its large outbreak. We detected all 4 serotypes and multiple lineages, suggesting that factors such as climatic conditions were likely responsible for increased dengue in Colombia.

A mixed method evaluation of knowledge, attitude and practice on dengue fever among Lalitpur Metropolitan City residents: a cross-sectional investigation.

BACKGROUND: Dengue poses a significant global public health challenge, including in Nepal. Understanding community's knowledge, attitudes, and behaviors concerning dengue fever is imperative to developing effective prevention and control strategies. This study aimed to assess the knowledge, attitude, and practices related to dengue fever among residents of Lalitpur Metropolitan City. METHODS: A descriptive cross-sectional household study was conducted using a mixed-method approach, which included quantitatively studying 636 individuals and conducting 20 qualitative interviews. The data was collected between April 2023 and June 2023. The multistage cluster sampling method was applied for household selection during the quantitative study and a purposive judgmental sampling method was used to identify participants for the qualitative interviews. Face-to-face interviews were conducted using a structured questionnaire for the quantitative study and an interview guide for the qualitative study. Quantitative data were analysed using logistic regression in STATA version 13, and thematic analysis was applied to the qualitative data. The findings were validated through triangulation of results from both the qualitative and quantitative study. RESULTS: Regarding knowledge, 64.94% (n = 413/636) reported being informed about dengue fever. In terms of attitude, a substantial majority, 91.51% (n = 582/636), expressed a positive attitudes toward dengue fever, indicating a favorable perception and knowledge of its significance. Concerning practice, 49.84% (n = 317/636) of respondents reported actively engaging in dengue fever prevention measures. The variables gender, previous history of dengue fever and residency were the determinants of dengue fever knowledge. Additionally, gender, residency, and attitude were predictors of preventive practices concerning dengue fever. CONCLUSION: Our study revealed that while the community demonstrated good knowledge of dengue fever and positive attitudes toward prevention, their preventive practices were inconsistent, indicating a gap between knowledge and action. A positive attitude was linked to better adherence to preventive measures. To address this gap, it is crucial to promote a positive attitude toward dengue prevention through initiatives like education efforts and social mobilization programs. Implementing Social and Behavior Change Communication (SBCC) programs focused on dengue prevention and control measures can help bridge this knowledge-action gap.

Evaluation of Wolbachia infection in Aedes aegypti suggests low prevalence and highly heterogeneous distribution in Medellín, Colombia.

Dengue virus, transmitted mainly by Aedes aegypti mosquitoes, is a significant public health challenge in tropical and subtropical countries, with an incidence that is growing at an alarming rate. The release of Wolbachia-carrying mosquitoes has been suggested as a strategy to reduce the incidence of multiple arboviruses. In Medellín, Colombia, large-scale releases of Wolbachia-infected Ae. aegypti mosquitoes were performed between 2017 and 2022 by the World Mosquito Program to facilitate population replacement. In this study, we evaluated the prevalence and distribution of Wolbachia-infected Ae. aegypti two years after completion of these releases. We conducted the sampling across 19 communes in Medellín, using 416 ovitraps to collect Ae. aegypti eggs from epidemiological weeks 26 to 41 in 2023. Upon hatching the collected eggs, we identified and pooled adult female Ae. aegypti for DNA extraction. Subsequently, we conducted PCR assays for the detection of Wolbachia infection in these mosquitoes. We used maximum likelihood estimation (MLE) and Bayesian methods to estimate the prevalence of Wolbachia infection, while using QGIS to analyze spatial distribution of infection in the region. A total of 774 female Ae. aegypti mosquitoes from 182 pools were evaluated. We detected Wolbachia in 33.5 % of pools, with an estimated individual minimum infection rate of 9.5 % and a maximum of 33.2 %. The prevalence varied significantly across communes, with the highest rates observed in the northeastern and southwestern areas. Spatial analysis revealed a highly heterogeneous island-like distribution of Wolbachia across Medellín with a few hotspots. The observed Wolbachia prevalence in this work was lower than previously reported. We suspect a decline in the prevalence of Wolbachia-infected Ae. aegypti mosquitoes in Medellín following the completion of their release.

Movement disorders in dengue encephalitis: a case report and literature review.

Dengue is a mosquito-borne viral disease caused by the dengue virus (DENV). The clinical manifestations of DENV infection range from mild febrile illness to severe dengue shock syndrome and dengue hemorrhagic fever. Recently, its neurological manifestations have been reported. The mechanisms of neurological complications in DENV infection are often attributed to neurotropism or may be immune-mediated. A double-doughnut sign is a radiological pattern of signal changes in the bilateral thalami, resembling a doughnut. Although this sign has been reported with dengue encephalitis, Japanese encephalitis, and other neurotropic infections, its co-occurrence with mixed movement disorders is rare. We report a case of dengue encephalitis involving a spectrum of movement disorders in the form of jaw opening dystonia, stereotypies, parkinsonism, and tremors during recovery. Magnetic resonance imaging showed bilateral thalami involvement with a double-doughnut sign. The patient was managed with pulse steroid therapy and benzodiazepines and showed gradual improvement in symptoms. Movement disorders with DENV infection are rare and self-limiting.

Safety signal detected: Anaphylaxis after attenuated dengue vaccine (TAK-003) - Brazil, march 1, 2023-march 11, 2024.

The aim was to describe cases of anaphylaxis following the Attenuated Dengue Vaccine (TAK-003) in Brazil, from March 1, 2023, to March 11, 2024. A descriptive study of anaphylaxis cases following TAK-003 was conducted, as reported in the National System of Surveillance of Adverse Events Following Immunization (AEFI). Percentages and notification rates of AEFI per million doses administered (DA) were calculated. In total, 380,358 doses of TAK-003 were administered, and 626 AEFI were reported. Of these, 85 were cases of immediate hypersensitivity, with 24 (63.1 cases per million) being anaphylaxis, including three anaphylactic shock. For 10 (41.7 %) cases, reactions began within 15 min after vaccination. No deaths related to anaphylaxis were reported. In light of the safety signal identification (increased frequency of anaphylaxis post-dengue vaccination), the Ministry of Health of Brazil published recommendations for intensifying actions for safe vaccination, including healthcare professional training and post-vaccination observation.

Impact of compound warm and wet events on dengue fever infection in South and Southeast Asian countries.

BACKGROUND: Multiple studies have reported the profound influence of various climate factors on dengue fever infection, while the effects of joint exposure to warm and wet environment, a condition favouring dengue vectors, on disease transmission were less evaluated. This study aims to investigate the impact of various compound temperature, rainfall, and relative humidity exposures on dengue fever infection in the South and Southeast Asia regions. METHODS: Weekly dengue fever surveillance data from 2012 to 2020 were collected from 48 locations in four countries named Singapore (1 location), Sri Lanka (15 locations), Malaysia (9 locations), and Thailand (23 locations, with 11 locations having different study periods). The distributed lag non-linear models were built to assess the impacts of compound temperature, rainfall, and relative humidity on dengue fever infection risks. RESULTS: A total of 1,359,993 dengue fever cases were reported with 9.33%, 24.02%, 48.73, and 17.91% cases were contributed by Singapore, Sri Lanka, Malyaia, and Thailand, respectively. Compared to non-warm-non-wet, compound warm-wet was associated with an increased dengue risk (RR:1.36, 95% CI:1.24-1.44). Compared to moderate temperature-humidity, warm-wet environment was also associated with an increase in dengue risk (RR:1.37, 95% CI:1.22-1.55). In comparison to weeks with moderate temperature-rainfall, warm-wet weeks was linked to an elevated dengue risk (RR:1.39, 95% CI:1.27-1.52), whereas cold-dry weather would significantly reduce the infection risk (RR:0.62, 95% CI:0.62-0.80). Modification effects showed that the hot effect on dengue infection was more pronounced under higher humidity, while the impact of rainfall increased with warmer temperature. CONCLUSION: Warm-wet events were associated with increased dengue fever risk, while the infection risk would decline in cold-dry environment, and modification effects exist among exposures . Findings from this study highlight the importance of considering joint temperature, humidity, and rainfall dependency of dengue fever infection in disease prevention and control.

Genome resequencing and genome-wide polymorphisms in mosquito vectors Aedes aegypti and Aedes albopictus from south India.

Aedes aegypti and Aedes albopictus mosquitoes spread major vector-borne viral diseases in tropical and sub-tropical regions of the globe. In this study, we sequenced the genome of Indian Ae. aegypti and Ae. albopictus and mapped to their reference genomes. Comparative genomics were performed between our strain and the reference strains. A total of 14,416,484 single nucleotide polymorphisms (SNPs) and 156,487 insertions and deletions (InDels) were found in Ae. aegypti, and 28,940,433 SNPs and 188,987 InDels in Ae. albopictus. Particular emphasis was given to gene families involved in mosquito digestion, development, and innate immunity, which could be putative candidates for vector control. Serine protease cascades and their inhibitors called serpins, play a central role in these processes. We extracted high-impact variants in genes associated with serine proteases and serpins. This study reports for the first time a high coverage genome sequence data of an Indian Ae. albopictus mosquito. The results from this study will provide insights into Indian Aedes specific polymorphisms and the evolution of immune related genes in mosquitoes, which can serve as a resource for future comparative genomics and those pursuing the development of targeted biopesticides for effective mosquito control strategies.

Changes in the Liver Function and Hematological Parameters in Dengue Patients at a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Liver is most commonly affected in dengue often resulting in changes in the liver function test parameters. Alterations in hematological parameters are also reported which could serve as early prognostic markers especially in resource limited settings where serological tests for the diagnosis of dengue is not available. This study aims to analyze liver function test and hematological parameter changes in dengue infected patients. METHODS: A descriptive cross-sectional study was conducted from December 2022 to October 2023 in serologically dengue positive patients. Liver function parameters and blood parameters were analyzed from 220 patients. The purposive sampling technique was employed during the selection of participants. RESULTS: Out of 220 study participants, 113 (51.36%) were males and 107 (49.64%) were females. The median age of the participants was 35 years (IQR: 26 - 48 years). Elevated serum AST and ALT levels were present in 121 (55%) and 80 (36.36%) of the participants respectively. Thrombocytopenia and leukopenia were observed in 92 (41.82%) and 88 (40%) of the study participants respectively. The median hemoglobin level was 14.4 (IQR: 13-15.47) g/dl. Low hemoglobin level was found in 31 (14.09%) participants. The median red blood cell count was 4.91 (IQR: 4.49 - 5.28) millions/mm3 with decreased red blood cell count noted in 27 (12.27%) participants. CONCLUSIONS: Increased serum transaminases levels, thrombocytopenia and leukopenia are common laboratory findings in dengue patients.

Dengue in Pune city, India (2017-2019): a comprehensive analysis.

Objectives: To understand the dynamics of dengue disease with special reference to (1) age (2) primary/secondary infections (3) serostatus and (4) serotypes examined during three consecutive years. Methods: During 3 dengue seasons (2017-19), NS1/IgM ELISAs were used for dengue diagnosis in one of the 15 administrative wards of Pune City, India. Predefined symptoms were recorded at the time of diagnosis/hospitalization. IgG-capture ELISA (Panbio) was used to differentiate primary/secondary infections. DENV serotypes were determined for 260 viral RNA-positive patients. Results: During the 3 years, 3,014/6,786 (44.4%, 41.4-49.9%) suspected cases were diagnosed as dengue. Use of either NS1 or IgM would have missed 25.5% or 43% of the confirmed dengue cases, respectively. Notably, a higher proportion of secondary dengue cases remained mild while a substantial proportion of primary infections developed warning signs. The symptoms among Dengue/non-dengue patients and primary/secondary infections varied and influenced by age and serostatus. The number and proportion of dengue serotypes varied yearly. A remarkable decline in dengue cases was observed during the COVID-19 pandemic years. Conclusion: A substantial proportion of primary and secondary dengue patients progress to warning signs/severity or mild infection respectively, underscoring the possible role of non-ADE mechanisms in causing severe dengue that requires hospitalization. Both NS1 and IgM should be used for efficient diagnosis.

Manic Episode Following Dengue Fever: A Case Report.

Dengue fever, a mosquito-borne viral disease, can present with a variety of symptoms, ranging from mild flu-like illness to more severe conditions such as dengue hemorrhagic fever and dengue shock syndrome. Although neurological symptoms such as headaches, dizziness, and altered sensorium are more frequently observed, psychiatric symptoms such as euphoria, delusions, hallucinations, and aggression, though rare, can occur. We present the case of a previously healthy 22-year-old male from South Asia who developed manic and psychotic symptoms, including insomnia, irritability, grandiosity, and auditory hallucinations, following his recovery from dengue fever. His psychiatric symptoms emerged shortly after discharge and necessitated psychiatric intervention with olanzapine, a second-generation antipsychotic, chosen for its suitability in managing manic symptoms. This case underscores the importance of considering psychiatric evaluations in the management of dengue fever, especially in endemic areas. The pathophysiology of dengue's neuropsychiatric effects remains complex and multifactorial, necessitating further research. This case report aims to highlight the potential for significant psychiatric manifestations post-dengue fever, advocate for increased clinical awareness and research to investigate any potential correlation between dengue fever and psychiatric symptoms, and improve patient outcomes.

A Rare Intersection: Managing Thrombotic Thrombocytopenic Purpura in the Context of Dengue Fever.

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening condition that can lead to severe morbidity and mortality if untreated. This case report discusses a 31-year-old male with dengue fever who developed TTP, resulting in fatality despite timely diagnosis and comprehensive treatment. The patient presented with worsening symptoms, including body aches, gastrointestinal bleeding, and neurological issues. Initial treatment focused on managing dengue hemorrhagic fever, but TTP was later suspected, leading to the cessation of platelet transfusions and initiation of plasma exchange, steroids, and rituximab. Despite these efforts, the patient's condition deteriorated. This case underscores the challenges in managing TTP, especially when triggered by infections like dengue. The use of the PLASMIC score can be highly effective in suspecting TTP in these patients, allowing for the initiation of early management. While standard treatments include plasma exchange and immunosuppressive therapy, emerging treatments such as caplacizumab and the potential use of splenectomy may offer hope for better outcomes in the future.

Efficacy of human interleukin-11 analogs for treating dengue fever-associated thrombocytopenia: a prospective cohort.

AIM: Dengue fever (DF), carried by Aedes mosquitoes, affects millions worldwide. Platelet-inducing human IL-11 analogues may be effective in treating DF-associated thrombocytopenia. METHODOLOGY: A prospective study was done at Dr. Ziauddin Hospital, a tertiary care hospital in Karachi, Pakistan, from September 2023 to April 30, 2024. RESULTS: This study recruited 300 DF patients characterized by thrombocytopenia (platelet count < 30,000), including 159 in the treatment and 141 in the control group. The median age of patients was 34 ± 11.05 years, with 187 males (62.3%) and 113 females (37.7%). The treatment group had a higher proportion of fever (80%, p < 0.0001) and headache (96%, p = 0.012) compared to the control group; however, no significant changes were observed in other clinical parameters between the two groups. Following treatment for 5 days, platelet counts of the treatment group increased significantly in response to IL-11 treatment compared to the control group at all time intervals (day 0, day 1, day 2, day 3, day 4, and day 5). Following treatment, males consistently exhibited higher platelet counts than females (all p < 0.05). In addition, patients admitted on day 3 of their course of illness showed a significantly slow response to the treatment compared to those admitted on day 5. Although young individuals exhibited a significant increase in platelet count, the age showed no significant intergroup differences. CONCLUSIONS: IL-11 analogs have promising potential for treating DF-associated thrombocytopenia. Additional investigation is necessary to refine administration protocols and examine the wider therapeutic ramifications of IL-11 in managing DF.

Spontaneous Auricular Hematoma - An Unusual Complication of Dengue fever.

Dengue is humans' most prevalent and crucial arthropod-borne viral illness. The majority of dengue fever patients have no symptoms, but certain individuals may progress to dengue shock syndrome or dengue hemorrhagic fever. Spontaneous auricular hematoma is a rare complication of dengue fever. We report a unique case of spontaneous pinna hematoma in a young, healthy patient who presented with an unprovoked pinna swelling while being treated for dengue fever. The patient underwent aspiration, drainage, and compression dressing over the auricular hematoma with antibiotic coverage and was discharged well. Early identification of this potential warning symptom may avoid permanent ear deformity. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04867-6.

Early intervention of 5% albumin shown superior control of vascular integrity and function compared to ringer's lactatein hospitalized adult with grade I & II Dengue hemorrhagic fever: a multicenter randomized controlled trial in Indonesia.

BACKGROUND: Dengue virus remains a major public health problem with one of the hallmark pathologies is the vascular leakage caused by endothelial dysfunction which can lead to Dengue Hemorrhagic Fever (DHF) manifestation. In the status quo, no specific therapy has been discovered but rather heavily relies on judicious and frequent monitoring of intravenous fluids administration. The current guideline has discussed the roles of fluid therapy during the Dengue Shock Syndrome (DSS) stage, however, administration of early fluid intervention for DHF grade I and II remains uncharted territory. In addition, the choice and timing of colloid administration remains underexplored. As one of the widely available colloids, 5% albumin has known physiological properties that potentially minimize plasma leakage. Therefore, this study aimed to evaluate the benefit of early intervention of 5% albumin in adults with DHF in the hope of preventing the lethal progression to DSS and further, shorten the length of stay (LOS) for patients. METHODS: We conducted a multicenter, open-labeled, randomized controlled trial in Jakarta and Banten to compare the effect of early intervention with 5% albumin in adult patients with DHF compared to Ringer's Lactate (RL). Statistical analyses were conducted using unpaired t-test and Mann-Whitney for normally and abnormally distributed data respectively. RESULTS: Adult patients with a diagnosis of DHF grade I and II that being hospitalized to receive the early intervention of 5% albumin had significantly lower levels of hemoconcentration 4, 12, and 24 h (p = 0.002, 0.001, 0.003, respectively), higher platelet counts 4 h (p = 0.036), higher serum albumin levels 48 h (p = 0.036), lower proteinuria 24 and 48 h post-albumin administration (p < 0.001, < 0.001, respectively), and shorter LOS (p < 0.001) when compared to the RL group. CONCLUSION: Early intervention of 5% albumin showed better control on vascular integrity and function compared to ringer lactate in hospitalized adults with grade I & II DHF, thus halting the progression of DHF into DSS and other related complications which leads to faster recovery and shorter length of stay. TRIAL REGISTRATION: The study was registered to www. CLINICALTRIAL: gov with trial registration number NCT04076254, and registration date October 31st 2016.

Space-time scanning statistics in the prediction and evaluation of dengue epidemic clusters.

Objectives: To detect clusters of dengue hemorrhagic fever in an urbanized district of Hai Phong City, Vietnam using Poisson space-time retrospective and prospective analysis. Methods: A cross-sectional and retrospective study analyzed dengue surveillance data in the period from January 01, 2018, to December 31, 2022. Spatial-temporal scanning statistics were performed using the free software SatScan v10.1.2. Results: A total of 519 cases were recorded. The cumulative incidence per 100,000 inhabitants was 3.37, 127.36, 10.96, 0, and 296.04 in 2018, 2019, 2020, 2021, and 2022, respectively. By retrospective Poisson model-based analysis, seven clusters were detected. Six of these seven detected outbreaks occurred in November and December 2022. The largest cluster had a relative risk (RR) of 1539.5 (P <0.00001). The smallest cluster has a RR of 316.1 (P = 0.006). Prospective analysis using the Poisson model significantly detected four active case clusters at the time of the study. The largest cluster of cases with RR was 47.7 (P <0.00001) and the smallest cluster with RR was 18.2 (P <0.00001). Conclusions: This study provides a basis for improving the effectiveness of interventions and conducting further investigations into risk factors in the study area, as well as in other urban and suburban areas nationwide.

Dengue outbreak 2023 in Bangladesh: From a local concern to a global public health issue.

Dengue, a viral infection transmitted by mosquitoes, has become a substantial public health issue in Bangladesh. The high population density and subtropical-tropical climate of the nation create conducive environments for the transmission of the virus. The recent increase in dengue cases in Bangladesh prompts an inquiry into the potential for the virus to progress into an epidemic manifestation. Bangladesh is prone to dengue outbreaks due to a multitude of contributing factors. To commence, the virus is endemic to tropical and subtropical regions, and climate change is contributing to the expansion of its range. Additionally, the high population density in Bangladesh amplifies the vulnerability to dengue transmission. Intimate human proximity elevates the probability of contracting mosquito stings and transmitting viruses. The escalating incidence of dengue in Bangladesh is substantiated by the growing count of documented cases. The emergence of severe dengue is a contributing aspect that raises concerns about the potential worldwide consequences of the disease. It could potentially head from Bangladesh to neighboring nations via an infected individual. There exist apprehensions due to the substantial employment of Bangladeshi laborers overseas, compounded by the presence of foreign laborers within Bangladesh. The endeavor to control dengue in Bangladesh continues to face ongoing challenges. This review addresses the complexities of dengue transmission, assesses Bangladesh's readiness for managing epidemics, analyzes risk factors associated with dengue, and suggests preventive measures to mitigate the possibility of worldwide consequences of dengue originating within the nation.

Beyond the biting - limited impact of explicit mosquito dynamics in dengue models.

Mathematical models play a crucial role in assisting public health authorities in timely disease control decision-making. For vector-borne diseases, integrating host and vector dynamics into models can be highly complex, particularly due to limited data availability, making system validation challenging. In this study, two compartmental models akin to the SIR type were developed to characterize vector-borne infectious disease dynamics. Motivated by dengue fever epidemiology, the models varied in their treatment of vector dynamics, one with implicit vector dynamics and the other explicitly modeling mosquito-host contact. Both considered temporary immunity after primary infection and disease enhancement in secondary infection, analogous to the temporary cross-immunity and the Antibody-dependent enhancement biological processes observed in dengue epidemiology. Qualitative analysis using bifurcation theory and numerical experiments revealed that the immunity period and disease enhancement outweighed the impact of explicit vector dynamics. Both models demonstrated similar bifurcation structures, indicating that explicit vector dynamics are only justified when assessing the effects of vector control methods. Otherwise, the extra equations are irrelevant, as both systems display similar dynamics scenarios. The study underscores the importance of using simple models for mathematical analysis, initiating crucial discussions among the modeling community in vector-borne diseases.