Tropical Medicine and Infectious Disease

13 pages, 3593 KB

Open AccessArticle

Environmental Conditions and Mite Vectors Shape the Spatiotemporal Patterns of Scrub Typhus in Guangdong Province, Mainland China

by Peiwei Fan, Tian Ma, Ze Meng, Fangyu Ding, Shuai Chen, Mengmeng Hao, Jiaqi Li, Jun Zhuo, Jiping Dong, Wenqi Xie, Qian Wang, Tingting Kang, Kai Sun, Genan Wu, Yongqing Bai, Canjun Zheng and Dong Jiang

Trop. Med. Infect. Dis. 2025, 10(11), 326; https://doi.org/10.3390/tropicalmed10110326 - 20 Nov 2025

Viewed by 393

Abstract

Scrub typhus has emerged as a life-threatening and increasingly prevalent vector-borne disease. While the spatial and temporal distributions of scrub typhus have been studied by the research community, the main driving factors that influence the spatiotemporal patterns of the disease remain under investigation. [...] Read more.

Scrub typhus has emerged as a life-threatening and increasingly prevalent vector-borne disease. While the spatial and temporal distributions of scrub typhus have been studied by the research community, the main driving factors that influence the spatiotemporal patterns of the disease remain under investigation. Using Guangdong Province as a case study, we combined monthly scrub typhus case data from 2010 to 2019 and environmental and vector-related datasets with a Bayesian hierarchical mixed model to elucidate the spatiotemporal characteristics of the disease. This study revealed that the most highly endemic areas of scrub typhus are concentrated in the western and southern parts of Guangdong Province. A distinct bimodal pattern of scrub typhus was observed, with peaks typically occurring from May to July and October to November. The fitted model indicated that forest, cropland, and chigger mites were positively associated with scrub typhus transmission. Furthermore, climate and vectors were identified as key factors shaping the bimodal seasonal patterns of scrub typhus. Despite data-related limitations, including the treatment of population as a time-invariant variable and the binary simplification of vector suitability, sensitivity analyses confirmed the robustness of the model, offering valuable insights for scrub typhus prevention in Guangdong. Full article

(This article belongs to the Section Vector-Borne Diseases)

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20 pages, 9854 KB

Open AccessArticle

In Vitro and Ultrastructural Evaluation of the Cytotoxic and Antileishmanial Activities of Thiosemicarbazone Compounds Against Promastigotes and Axenic Amastigotes of Leishmania infantum

by Janderson Weydson Lopes Menezes da Silva, Andréa Regina Alves da Rocha Diniz, Alberon Ribeiro de Araújo, Gabriel Gazzoni Araújo Gonçalves, Dyana Leal Veras, Marton Kaique de Andrade Cavalcante, Jana Messias Sandes, Iranildo José da Cruz Filho, Diego Santa Clara Marques, Maria do Carmo Alves de Lima, Ana Paula Sampaio Feitosa, Luiz Carlos Alves and Fábio André Brayner

Trop. Med. Infect. Dis. 2025, 10(11), 325; https://doi.org/10.3390/tropicalmed10110325 - 19 Nov 2025

Viewed by 357

Abstract

Leishmaniasis remains a global health challenge, and the search for effective and selective therapeutic agents is crucial. This study evaluated the in vitro antileishmanial and cytotoxic activities of thiosemicarbazone compounds (LT-70, LT-73, LT-75, and LT-89) against Leishmania infantum promastigote and axenic amastigote forms. [...] Read more.

Leishmaniasis remains a global health challenge, and the search for effective and selective therapeutic agents is crucial. This study evaluated the in vitro antileishmanial and cytotoxic activities of thiosemicarbazone compounds (LT-70, LT-73, LT-75, and LT-89) against Leishmania infantum promastigote and axenic amastigote forms. The compounds demonstrated strong leishmanicidal activity, with IC₅₀ values ranging from 10.5 to 14 µM. At the lowest tested concentration (20 µM) the compounds produced percent inhibitions of 100% (LT-70), 100% (LT-73), 100% (LT-75) and 100% (LT-89). Cytotoxicity assays on J774.A1 macrophages revealed CC₅₀ values from 60 µM to >75 µM, with LT-73 and LT-75 showing low toxicity (CC₅₀ > 75µM). Selectivity index (SI) ranged from 7.1 for LT-75 and 5.8 for LT-73, indicating potential for further development. Ultrastructural analysis by SEM and TEM revealed cellular and organelle damage, including membrane rupture and mitochondrial swelling, especially after LT-73 and LT-75 treatment. Immunomodulatory assays indicated induction of TNF-α and IFN-γ production, with significant IL-6 reduction. Flow cytometry data suggest mitochondrial dysfunction and apoptosis-like features, particularly for LT-73. Membrane potential assays suggested mitochondrial depolarization by LT-73. LT thiosemicarbazone derivatives present specific structural modifications that enhance antileishmanial selectivity and reveal a dual mechanism of action combining mitochondrial dysfunction and immunomodulatory effects. These findings support the potential of thiosemicarbazone derivatives as promising antileishmanial agents with selective cytotoxicity and immunomodulatory effects. Full article

(This article belongs to the Special Issue New Strategies for the Diagnosis, Treatment and Risk Assessment of Parasitic Disease)

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17 pages, 712 KB

Open AccessArticle

Prevalence of Intestinal Protozoa Among Patients Living with HIV in the Peruvian Amazon

by Silvia Otero-Rodriguez, Viviana Pinedo-Cancino, Martin Casapia-Morales, Victoria-Ysabel Villacorta-Pezo, Seyer Mego-Campos, Jorge Parráguez-de-la-Cruz, Esperanza Merino, Eva H. Clark and José-Manuel Ramos-Rincón

Trop. Med. Infect. Dis. 2025, 10(11), 324; https://doi.org/10.3390/tropicalmed10110324 - 18 Nov 2025

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Abstract

Intestinal protozoa are a common cause of morbidity in people living with HIV (PWH), particularly in tropical regions with poor sanitation. We conducted a cross-sectional study in 315 PWH from Iquitos, Peru, between October 2023 and May 2024, to assess their prevalence and [...] Read more.

Intestinal protozoa are a common cause of morbidity in people living with HIV (PWH), particularly in tropical regions with poor sanitation. We conducted a cross-sectional study in 315 PWH from Iquitos, Peru, between October 2023 and May 2024, to assess their prevalence and risk factors. Stool samples were examined using Lugol’s iodine, modified Ziehl–Neelsen (MZN) staining, and immunochromatography (ICT). The mean age was 41 years, with a median CD4+ count of 431 cells/µL; 12.4% were in the AIDS stage, and 21.5% had a detectable viral load. 51.4% of the participants tested positive for any intestinal protozoa. The overall Cryptosporidium spp. prevalence (by combining MZN and ICT results) was 25.7%. The overall Giardia spp. and Entamoeba spp. prevalences (by combining Lugol’s iodine and ICT results) were 2.9% and 1.9%, respectively. Blastocystis spp. was frequently isolated, though its pathogenicity remains uncertain. Diagnostic agreement was almost perfect between Lugol and ICT for Giardia and Entamoeba (κ = 0.87; p < 0.001 and κ = 0.91; p < 0.001, respectively), but only slight between MZN and ICT. Homosexual practices were identified as a significant risk factor for pathogenic protozoa infection (AOR 2.52; 95% CI: 1.04–6.12). In conclusion, the high prevalence of protozoa infection reflects ongoing fecal–oral exposure, underscoring the need for public health education, routine diagnosis, and treatment in similar settings. Full article

(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)

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14 pages, 350 KB

Open AccessArticle

Assessment of Awareness, Knowledge, and Self-Reported Prevalence of Toxoplasmosis in the Tropical Zone of Saudi Arabia: A Cross-Sectional Study

by Hassan N. Moafa, Ahmad Mobarki, Sultan Moafa, Ziyad Asiri, Ahmed Hadadi, Osama M. Abualgasem, Rama M. Chandika, Jobran M Moshi, Ashwaq M Al Nazawi, Raad Shibli and Hammad Ali Fadlalmola

Trop. Med. Infect. Dis. 2025, 10(11), 323; https://doi.org/10.3390/tropicalmed10110323 - 17 Nov 2025

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Abstract

Background: Toxoplasmosis, caused by the parasite Toxoplasma gondii, is a zoonotic disease that poses significant health risks to immunocompromised individuals, pregnant women, and infants. Transmission occurs primarily through infected cat feces or contaminated food. Awareness of transmission routes, prevention strategies, and health [...] Read more.

Background: Toxoplasmosis, caused by the parasite Toxoplasma gondii, is a zoonotic disease that poses significant health risks to immunocompromised individuals, pregnant women, and infants. Transmission occurs primarily through infected cat feces or contaminated food. Awareness of transmission routes, prevention strategies, and health consequences remains limited in high-prevalence humid regions such as Jazan, Saudi Arabia. Methods: This cross-sectional study was conducted in Jazan, Saudi Arabia, between April and May 2025, surveying 485 adults using a five-section questionnaire covering demographics, knowledge, practices, medical history, and recommendations. The survey was distributed in both English and Arabic. Self-reported previous diagnoses were used to estimate prevalence, with risk factors presented as frequencies and percentages. Binary logistic regression analyzed categorical variables, and independent t-tests assessed continuous variables to identify predictors of awareness and knowledge regarding toxoplasmosis. Results: Participants comprised 58.6% females, 97.3% Saudis, and 69.1% individuals aged ≤30 years; 49.7% had heard of toxoplasmosis. Females (adjusted odds ratio [AOR]: 1.67, 95% CI: 1.13–2.5, p < 0.01) and those >30 years old (AOR: 1.8, 95% CI: 0.80–4.29, p > 0.05) demonstrated greater awareness and knowledge, though this was not statistically significant. No significant differences were observed based on marital status (p > 0.05). Risk behaviors included consuming unwashed fruits and vegetables (27.6%) and unpasteurized dairy products (28.2%), with 62.7% always washing hands after handling raw meat or soil. Cat ownership (20.6%) was not associated with knowledge (p = 0.97). Self-reported diagnosis prevalence was 1.9%. Conclusions: Low awareness and prevalent risky behaviors underscore the urgent need for targeted public health education interventions focusing on hygiene practices and zoonotic disease prevention in Jazan. Serological studies are recommended to obtain more accurate prevalence estimates and guide evidence-based interventions. Full article

(This article belongs to the Special Issue Advances in Toxoplasma gondii Infection Research)

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9 pages, 233 KB

Open AccessBrief Report

Human Pathogenic Bacteria Within the Nasal and Rectal Microbiome of Macropus giganteus

by David Arroyo, Amy Peart, Brian Vesely, Andrew Trudgian and Jessica Chellappah

Trop. Med. Infect. Dis. 2025, 10(11), 322; https://doi.org/10.3390/tropicalmed10110322 - 17 Nov 2025

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Abstract

This study represents the first investigation into the prevalence of pathogenic bacteria in isolated, free-ranging Eastern Grey Kangaroos (Macropus giganteus) inhabiting a human-shared environment. Samples were collected from the nasal and rectal passages of state-authorised culls of M. giganteus within a [...] Read more.

This study represents the first investigation into the prevalence of pathogenic bacteria in isolated, free-ranging Eastern Grey Kangaroos (Macropus giganteus) inhabiting a human-shared environment. Samples were collected from the nasal and rectal passages of state-authorised culls of M. giganteus within a military training area, where recruits had reported recurrent cases of skin and soft tissue infections. The objective was to identify clinically relevant pathogenic microorganisms present in the nasal and rectal flora of these kangaroos. Analysis revealed carriage rates of 11% for methicillin-sensitive Staphylococcus aureus (MSSA) and 2% for methicillin-resistant S. aureus (MRSA). Other potentially pathogenic bacteria isolated included Pseudomonas spp., Streptococcus (Groups B and D), Acinetobacter spp., and multiple coagulase-negative Staphylococcus (CoNS) species. Notably, CoNS species were present in 17% of nasal isolates, with Mammaliicoccus sciuri (formerly Staphylococcus sciuri) detected in 41% of these isolates, suggesting a potential reservoir for antibiotic resistance genes and virulence factors. These findings support a One Health perspective, highlighting the interconnectedness of pathogenic bacteria, M. giganteus, humans, and their shared environment. Full article

(This article belongs to the Section One Health)

30 pages, 5433 KB

Open AccessSystematic Review

Strongyloides stercoralis Infection in Humans in West Africa, 1975–2024: Systematic Review and Meta-Analysis

by Rufin K. Assaré, Mamadou Ouattara, Sören L. Becker, Fidèle K. Bassa, Nana R. Diakité, Jürg Utzinger and Eliézer K. N’Goran

Trop. Med. Infect. Dis. 2025, 10(11), 321; https://doi.org/10.3390/tropicalmed10110321 - 17 Nov 2025

Viewed by 433

Abstract

Strongyloidiasis is an underappreciated helminth infection that belongs to a group of neglected tropical diseases. The aim of this systematic review and meta-analysis was to determine the pooled prevalence of Strongyloides stercoralis infection in humans in 16 West African countries. We searched African [...] Read more.

Strongyloidiasis is an underappreciated helminth infection that belongs to a group of neglected tropical diseases. The aim of this systematic review and meta-analysis was to determine the pooled prevalence of Strongyloides stercoralis infection in humans in 16 West African countries. We searched African Journals Online, Embase, Horizon, Google Scholar, ProQuest, PubMed, Scopus, and Web of Science to identify articles assessing S. stercoralis prevalence data. The search was restricted to articles published between 1 January 1975 and 31 December 2024 without language restriction. We followed the PRISMA guidelines. A total of 21,250 articles were identified, 336 of which met the inclusion criteria. The most frequently used diagnostic tools were Kato-Katz (35.1%) and formol-ether coprological methods (23.4%). Strongyloidiasis was reported in 15 of the 16 West African countries; Mali was the only country where it was absent. The S. stercoralis regional prevalence was 4.4%, ranging from 0.2% in Burkina Faso to 18.9% in The Gambia. S. stercoralis infection prevalence decreased from 14.0% (1975–1984) to 4.1% (2015–2024). S. stercoralis prevalence showed strong heterogeneity with the highest prevalence mainly observed in countries in the Gulf of Guinea. Most of the employed diagnostic techniques were inappropriate; the reported S. stercoralis prevalence is, thus, likely an underestimation of the true situation. Our observations call for more sensitive S. stercoralis diagnostic tools and strategies for strongyloidiasis control that are tailored to the different social-ecological settings of West Africa. Full article

(This article belongs to the Special Issue Research Advances and New Perspectives on Helminthic Diseases)

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16 pages, 324 KB

Open AccessArticle

Underreporting of Adverse Events Following COVID-19 Vaccination Among Healthcare Professionals in Poland: Potential Implications for Vaccine Hesitancy

by Jakub Grabowski, Anna Niebrzydowska, Aleksandra Brzozowska, Przemysław Waszak, Paweł Zagożdżon, Shan Ali, Tomasz Brancewicz, Monika Wolff, Aleksandra Macul-Sanewska and Leszek Bidzan

Trop. Med. Infect. Dis. 2025, 10(11), 320; https://doi.org/10.3390/tropicalmed10110320 - 13 Nov 2025

Viewed by 2635

Abstract

This study aimed to assess the prevalence and reporting rate of adverse events following immunization (AEFIs) among healthcare professionals (HCPs) and students of health-related disciplines after COVID-19 vaccination. It was conducted at the beginning of the vaccination campaign in Poland (February 2021), when [...] Read more.

This study aimed to assess the prevalence and reporting rate of adverse events following immunization (AEFIs) among healthcare professionals (HCPs) and students of health-related disciplines after COVID-19 vaccination. It was conducted at the beginning of the vaccination campaign in Poland (February 2021), when vaccines were only available to limited groups of recipients, mainly those related to healthcare. Questionnaires were distributed among HCPs in the Pomeranian voivodeship (N = 1063) and students at the Medical University of Gdańsk (N = 1506). The primary objective was to compare respondents’ self-reported AEFI notifications with official reports published by the National Sanitary Inspectorate. A total of 240 participants declared having reported at least one AEFI, whereas official reports from the same period indicated that only 194 individuals had reported AEFIs in the entire voivodeship. This translates into significant differences in notification rates (14.9% and 0.09%, respectively). A detailed breakdown into local and systemic AEFIs also revealed significant discrepancies with official reports (850 vs. 329 and 1137 vs. 46, respectively). The most common reasons for not reporting were managing the symptoms on one’s own and perceiving the symptoms as not severe enough to report. Underreporting of AEFIs is an issue that requires attention from both the scientific community and public health authorities, as it may hinder reliable vaccine safety assessment and contribute to increased vaccine hesitancy. Full article

(This article belongs to the Special Issue Post-Pandemic Challenges: Endemic COVID-19, Vaccine Hesitancy, and Viral Resurgence)

16 pages, 2701 KB

Open AccessReview

Non-Coding RNAs as Emerging Biomarkers in Leishmaniasis and Chagas Disease

by Eduardo Ramos Juárez, Eduardo Pérez-Campos Mayoral, Laura Pérez-Campos Mayoral, Adriana Moreno Rodríguez, Carlos Romero-Díaz, Miriam Emily Avendaño-Villegas, Tania Sinaí Santiago Ramírez, Margarito Martínez Cruz, José Luis Hernández-Morales, Lilian Guadalupe Bolaños-Hilario, Iam Kevin Suárez Luna, Jesús Elizarrarás-Rivas, Aldo Abel García González, Hector Alejandro Cabrera-Fuentes, María Teresa Hernández-Huerta and Eduardo Pérez-Campos

Trop. Med. Infect. Dis. 2025, 10(11), 319; https://doi.org/10.3390/tropicalmed10110319 - 13 Nov 2025

Viewed by 463

Abstract

Leishmaniasis and Chagas disease, caused by Leishmania spp. and Trypanosoma cruzi, are neglected tropical diseases with significant global health burden, particularly in resource-limited regions. Despite their impact, diagnosis and treatment remain challenging due to limited diagnostic tools and the toxicity of available [...] Read more.

Leishmaniasis and Chagas disease, caused by Leishmania spp. and Trypanosoma cruzi, are neglected tropical diseases with significant global health burden, particularly in resource-limited regions. Despite their impact, diagnosis and treatment remain challenging due to limited diagnostic tools and the toxicity of available therapies. Our objective is to propose the incorporation of markers for the diagnosis of leishmaniasis and Chagas disease using ncRNA. This narrative review evaluates studies published between 2010 and 2024 (PubMed, Scopus, Google Scholar) using the SANRA scale to assess the potential of non-coding RNAs (ncRNAs) as biomarkers for these infections. Both parasites release small RNAs via extracellular vesicles that modulate host–pathogen interactions and gene expression. Although RNA interference machinery is absent in T. cruzi and most Leishmania species, it persists in early-diverging lineages. In leishmaniasis, distinct miRNA expression profiles—including miR-155-5p, miR-5011-5p, miR-6785-5p, and miR-361-3p—demonstrate high diagnostic accuracy for detecting infection (AUC up to 1.0). Serum long ncRNAs such as MALAT1 and NUTM2A-AS1 show potential diagnostic value, though clinical validation remains pending. For Chagas disease, the available evidence on ncRNAs primarily addresses the diagnosis of clinical manifestations rather than initial infection. Host miRNAs, including miR-21, miR-145, miR-146a/b, and miR-19a-3p, correlate with cardiac involvement, immune dysregulation, and inflammation during chronic T. cruzi infection. Circulating miRNAs exhibit modest sensitivity (57–67%) and specificity (57–80%) for diagnosing chronic Chagas cardiomyopathy, indicating their utility in assessing disease progression and organ damage rather than detecting early infection. This review distinguishes between ncRNAs that diagnose infection and those that evaluate disease severity or organ involvement. Altered ncRNA expression profiles represent promising biomarkers for species differentiation, treatment monitoring, and assessing cardiac complications in Chagas disease, with broader diagnostic applications emerging for leishmaniasis. Full article

(This article belongs to the Section Neglected and Emerging Tropical Diseases)

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30 pages, 1077 KB

Open AccessReview

A Contemporary Multidimensional Insight into the Clinical and Pathological Presentation of Urological Conditions Associated with HIV: A Narrative Review

by Hannah Faherty, Jamshaid Nasir Shahid, Yousef Abu Osba, Maryam Jamshaid, Dushyant Mital and Mohamed H. Ahmed

Trop. Med. Infect. Dis. 2025, 10(11), 318; https://doi.org/10.3390/tropicalmed10110318 - 11 Nov 2025

Viewed by 563

Abstract

Human Immunodeficiency Virus (HIV) infection is associated with a wide spectrum of urological manifestations, reflecting both the direct effects of viral infection and the indirect consequences of immunosuppression, opportunistic infections, malignancies and long-term combined antiretroviral therapy (cART). This narrative review provides a contemporary, [...] Read more.

Human Immunodeficiency Virus (HIV) infection is associated with a wide spectrum of urological manifestations, reflecting both the direct effects of viral infection and the indirect consequences of immunosuppression, opportunistic infections, malignancies and long-term combined antiretroviral therapy (cART). This narrative review provides a contemporary, multifaceted overview of the clinical and pathological presentations of urological conditions in people living with HIV (PLWHIV), based on articles published between 1989 and 2025. Conditions discussed include HIV-associated nephropathy (HIVAN), opportunistic genitourinary infections, malignancies such as Kaposi sarcoma and lymphoma, as well as non-infectious complications such as HIV-associated nephropathy and erectile dysfunction (ED). The review highlights the evolving epidemiology of these conditions in the cART era, with a noted decline in opportunistic infections but a rising burden of chronic kidney disease and malignancies, largely due to improved survival and ageing of the HIV-positive population. Pathological insights are explored and discussed, including mechanisms of HIV-associated renal injury, such as direct viral infection of renal epithelial cells and genetic predispositions linked to Apolipoprotein L1 (APOL1) variants. In addition, psychosocial factors, including anxiety, stress, stigma, and alcohol use, are discussed, as they may contribute to late presentation to clinical urology services. The review also considers the challenges faced in low and middle-income countries, the impact of HIV on urological services, and the important role of palliative care in advanced disease. Ultimately, this review underscores the need for early recognition, comprehensive diagnostic and surgical evaluation, and integrated social, psychological, and palliative management strategies tailored to the unique needs of PLWHIV. A deeper understanding of the interplay between HIV, cART, psychosocial determinants, and urological health is essential for improving patient outcomes and guiding future research in this evolving field. Full article

(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)

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20 pages, 4334 KB

Open AccessArticle

Impact of Wuchereria bancrofti Infection on Cervical Mucosal Immunity and Human Papillomavirus Prevalence in Women from Lindi and Mbeya Regions, Tanzania

by Maureen Mosoba, Thomas F. Marandu, Lucas Maganga, Jacklina Mhidze, Anifrid Mahenge, Jonathan Mnkai, Agatha Urio, Nhamo Chiwarengo, Liset Torres, Winfrida John, Abdallah Ngenya, Akili Kalinga, Upendo J. Mwingira, Manuel Ritter, Achim Hoerauf, Sacha Horn, Christof Geldmacher, Michael Hoelscher, Mkunde Chachage and Inge Kroidl

Trop. Med. Infect. Dis. 2025, 10(11), 317; https://doi.org/10.3390/tropicalmed10110317 - 10 Nov 2025

Viewed by 456

Abstract

We previously described an increased incidence of HIV among individuals infected with Wuchereria bancrofti (WB). However, no host, parasite, or viral factors were reported as directly associated with the increase in HIV incidence in this group. To investigate this, we compared T cell [...] Read more.

We previously described an increased incidence of HIV among individuals infected with Wuchereria bancrofti (WB). However, no host, parasite, or viral factors were reported as directly associated with the increase in HIV incidence in this group. To investigate this, we compared T cell phenotypes between WB+ and WB− women. Flow cytometry analysis of activation and differentiation markers on CD4 T cells, as well as HIV entry receptor CCR5 was performed on cervical and peripheral blood samples from 54 women living without HIV (WLWoH). Additionally, HPV testing was performed on their specimens and for 13 WLWH. WB infection was associated with a significantly increased frequency of CD3⁺γδ2⁺ T cells in the cervical mucosa (median 4.0% vs. 1.4%, p = 0.012). Contrary to our expectations, we found lower frequencies of CCR5 on total, memory and activated memory CD4 T cells in the WB+ group. However, differences diminished after accounting for age and site of recruitment. WB and HIV infections were associated with an increased likelihood of high-risk human papillomavirus (HR HPV) positivity. (WB status: odds ratio (OR) 4.1, p = 0.066; HIV status: OR 5.5, p = 0.068). Our findings suggest immunological mechanisms by which WB increases the risk for other infections, e.g., HIV and HR HPV, albeit independent of the CCR5 receptor. Full article

(This article belongs to the Special Issue Filarial Infections in Humans: Advances in Epidemiology and Immunological Insights)

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17 pages, 595 KB

Open AccessReview

Strategies for Tuberculosis Prevention in Healthcare Settings: A Narrative Review

by Ahmad Faris Daradkeh, Basil Alawyia, Hassan Ballas, Nikolaos Spernovasilis and Danny Alon-Ellenbogen

Trop. Med. Infect. Dis. 2025, 10(11), 316; https://doi.org/10.3390/tropicalmed10110316 - 6 Nov 2025

Viewed by 1212

Abstract

Tuberculosis continues to represent a major occupational risk in healthcare environments, particularly for healthcare workers who have persistent contact with patients who may be infectious. Despite the high occupational burden of tuberculosis among healthcare workers, there remains a lack of focused reviews that [...] Read more.

Tuberculosis continues to represent a major occupational risk in healthcare environments, particularly for healthcare workers who have persistent contact with patients who may be infectious. Despite the high occupational burden of tuberculosis among healthcare workers, there remains a lack of focused reviews that comprehensively evaluate preventive interventions across all levels of prevention within healthcare settings. In this literature review, effective preventive interventions relevant to tuberculosis transmission have been examined. Primary preventive interventions seek to diminish exposure through protective interventions such as respirators, improvements in ventilation systems, and implementation of educational programs regarding infection control protocols. Secondary preventive interventions target early diagnosis and routine screening with efforts to detect cases and latent infections early, before they progress to active disease. Enhancements in diagnostic technology have improved both the accuracy and speed of detection, further aiding the efforts of controlling nosocomial transmission. Tertiary preventive interventions target enhancing compliance with treatment protocols, managing complications of active infection, and controlling resistant strains through individualized follow-up and interventions. Barriers like stigma and lack of resources, however, often impede such interventions’ effectiveness in many cases. This narrative literature review highlights the imperative for strengthened workplace policies, an expansion of educational programs, and continued research in new and emerging interventions like new vaccine and diagnostics technology development. All these factors aim to optimize intervention effectiveness for tuberculosis and protect the health and welfare of workers in the medical field. Full article

(This article belongs to the Collection Infection Prevention and Control: Practical and Educational Advances)

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15 pages, 1544 KB

Open AccessArticle

Assessment of One Health Initiatives from a Veterinary Public Health Approach in Latin America and the Caribbean

by Baldomero Molina-Flores, Marco Antonio Natal Vigilato, Felipe Rocha, Ottorino Cossivi, Margarita Corrales, Germán Andrés Vásquez Niño, Álvaro A. Faccini-Martínez, Wagner Antonio Chiba de Castro, Alexander Welker Biondo and Natalia Cediel-Becerra

Trop. Med. Infect. Dis. 2025, 10(11), 315; https://doi.org/10.3390/tropicalmed10110315 - 6 Nov 2025

Viewed by 653

Abstract

The Pan American Health Organization (PAHO) launched the One Health policy in September 2021. To respond to this regional policy, a baseline was generated regarding the use of One Health intersectoral actions aimed at preventing, controlling, and eliminating zoonotic, foodborne diseases and antimicrobial [...] Read more.

The Pan American Health Organization (PAHO) launched the One Health policy in September 2021. To respond to this regional policy, a baseline was generated regarding the use of One Health intersectoral actions aimed at preventing, controlling, and eliminating zoonotic, foodborne diseases and antimicrobial resistance. For this purpose, in July 2022, the Pan American Food and Mouth Disease and Veterinary Public Health Center, Pan American, Health Organization/World Health Organization (PANAFTOSA/VPH-PAHO/WHO), organized a meeting in Rio de Janeiro, Brazil, to bring together recognized public health and animal health and food safety officers from ministries of health and agriculture from nine different countries of the region: Argentina, Belize, Bolivia, Brazil, Chile, Cuba, Honduras, México, and Uruguay, including the three representatives of the Americas in the Quadripartite Panel of One Health High Level Expert Panel (OHHLEP 2021–2024). Several good practice examples and lessons learned of multisectoral communication, collaboration, coordination, and capacity building regarding control and prevention of zoonoses, food safety, and antimicrobial resistance programs were identified in these countries. The establishment of governance mechanisms and legal frameworks were the main aspects discussed, followed by the importance of the environmental sector, which often is poorly articulated in One Health initiatives. The leadership of PAHO for more than seven decades is part of the good health governance practices to create the ground for the One Health implementation in Latin America and the Caribbean. Full article

(This article belongs to the Special Issue Advancing One Health Approaches for Public Health and Zoonotic Neglected Tropical Diseases Control in Latin America and the Caribbean)

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27 pages, 3635 KB

Open AccessSystematic Review

Communicable Disease Surveillance in South Africa and LMICs: A Systematic Review of Systems, Challenges, and Integration with Environmental Health

by Ledile Francina Malebana, Maasago Mercy Sepadi and Matlou Ingrid Mokgobu

Trop. Med. Infect. Dis. 2025, 10(11), 314; https://doi.org/10.3390/tropicalmed10110314 - 3 Nov 2025

Viewed by 864

Abstract

Communicable disease surveillance systems are crucial for global health security, particularly in low- and middle-income countries (LMICs) where infectious disease burdens remain high. Despite disease surveillance systems being in place, the evidence on their implementation, challenges, and integration with environmental health remains fragmented. [...] Read more.

Communicable disease surveillance systems are crucial for global health security, particularly in low- and middle-income countries (LMICs) where infectious disease burdens remain high. Despite disease surveillance systems being in place, the evidence on their implementation, challenges, and integration with environmental health remains fragmented. This systematic review assesses the design, implementation, and challenges of these systems across LMICs, with a focus on South Africa and the broader Sub-Saharan African region. Using PRISMA guidelines and the PICOS framework, searches across four databases identified 325 articles published between 2010 and 2025, of which 56 (17%) were included for analysis. Thematic synthesis revealed key trends, disease priorities, and surveillance tools. South Africa contributed the highest number of articles (25%), while Sub-Saharan Africa accounted for 54% overall. COVID-19 was the most frequently studied disease (20%), followed by cholera, typhoid, and measles. The Integrated Disease Surveillance and Response (IDSR) framework appeared in 25% of articles, while District Health Information Systems 2 (DHIS2) was referenced in 11%, reflecting modest adoption of digital platforms. Reported challenges included underreporting, inconsistent case definitions, limited digital infrastructure, and weak feedback mechanisms. Although integration of environmental health was widely recommended, it was marginally implemented. Overall, LMICs surveillance systems remain constrained by operational and structural limitations, underscoring the need for digital investment, environmental indicators integration, and community-based approaches to strengthen epidemic preparedness. Full article

(This article belongs to the Collection Infection Prevention and Control: Practical and Educational Advances)

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15 pages, 1219 KB

Open AccessSystematic Review

Epidemiology of Human Cryptosporidiosis in Brazil: A Systematic Review Highlighting Cryptosporidium parvum

by João Victor Inácio Santos, Welitânia Inácia Silva, Basílio Felizardo Lima Neto, Thais Ferreira Feitosa and Vinícius Longo Ribeiro Vilela

Trop. Med. Infect. Dis. 2025, 10(11), 313; https://doi.org/10.3390/tropicalmed10110313 - 31 Oct 2025

Viewed by 559

Abstract

Cryptosporidiosis is a zoonotic disease of medical and veterinary importance caused by Cryptosporidium spp. This study conducted a systematic review to assess the occurrence and distribution of Cryptosporidium spp. in humans in Brazil, with emphasis on C. parvum. Following the PRISMA (Preferred [...] Read more.

Cryptosporidiosis is a zoonotic disease of medical and veterinary importance caused by Cryptosporidium spp. This study conducted a systematic review to assess the occurrence and distribution of Cryptosporidium spp. in humans in Brazil, with emphasis on C. parvum. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol and using five databases, 3689 articles were screened, and 48 met the inclusion criteria. Most studies were concentrated in the Southeast Region, particularly São Paulo, while major gaps were identified in the North and Midwest Regions. The mean prevalence was 8.9% using direct methods and 52.2% using indirect methods, with the highest positivity reported in the Northeast Region. Microscopy was the most frequently employed diagnostic tool, although it showed limited ability to differentiate species. When combined with molecular approaches, C. parvum and C. hominis were identified as the predominant species. Infection was most common among children and immunocompromised individuals, especially those with HIV and kidney diseases. Overall, the findings highlight substantial research gaps regarding cryptosporidiosis in Brazil and its disproportionate impact on vulnerable populations. Expanding regional studies, integrating molecular methods for species characterization, and implementing targeted public health strategies are essential to improve epidemiological knowledge and guide prevention and control measures. Full article

(This article belongs to the Special Issue Emerging and Reemerging Zoonotic Diseases: From Past Lessons to Future Preparedness)

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5 pages, 500 KB

Open AccessEditorial

Operational Research on Operational Research: Assessing the Impact of the Structured Operational Research and Training Initiative on Tackling Antimicrobial Resistance in Ghana

by Rony Zachariah, Pruthu Thekkur, Fiona Braka, Nienke Bruinsma, Anthony D. Harries, Christine M. Halleux and Kwame Ohene Buabeng

Trop. Med. Infect. Dis. 2025, 10(11), 312; https://doi.org/10.3390/tropicalmed10110312 - 31 Oct 2025

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Abstract

“If research is to have impact and improve outcomes, it must be locally relevant and the findings actionable to shape policy and/or practice [...] Full article

(This article belongs to the Special Issue Field Impact of the SORT IT Initiative on Combating Antimicrobial Resistance Through a One Health Approach in Ghana)

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11 pages, 353 KB

Open AccessArticle

Comparison of Interferon-Gamma Release Assay and Tuberculin Skin Test in Screening for Latent Tuberculous Infection Among Students from High-Burden Areas: A Prospective Head-to-Head Study in Qingdao, China

by Zhongdong Wang, Kun Zhang, Haiyan Sun, Xuekui Li, Song Song, Meng Chen, Honghong Xu, Huaqiang Zhang, Yu Pang and Xiaoqi Dai

Trop. Med. Infect. Dis. 2025, 10(11), 311; https://doi.org/10.3390/tropicalmed10110311 - 31 Oct 2025

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Abstract

Background: Identifying latent tuberculosis infection (LTBI) is critical for pediatric TB control in China, especially among students from high-burden areas. With no gold-standard test, we compared the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), focusing on factors related to test discordance. [...] Read more.

Background: Identifying latent tuberculosis infection (LTBI) is critical for pediatric TB control in China, especially among students from high-burden areas. With no gold-standard test, we compared the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), focusing on factors related to test discordance. Materials and Methods: TST was administered to 1047 local and 900 migrant students; all migrants also received IGRA. TST cutoffs of 5 mm and 10 mm were applied. Agreement was measured using Cohen’s Kappa, and determinants of discordance were analyzed with binary logistic regression. Results: Migrant students had higher TST positivity than locals (28.89% vs. 19.67%, p < 0.001). The agreement between IGRA and TST-12 mm (k = 0.491) was higher than that observed for TST-10 mm (k = 0.466) and TST-5 mm (k = 0.356). Subgroup analyses across sex, residence, ethnicity, BMI, TB contact, and BCG history confirmed superior consistency for TST-12 mm. Individuals without BCG vaccination were less likely to show discordance between IGRA and TST-12 mm (OR = 0.32, 95% CI: 0.10–0.81). Conclusions: Using a 12 mm cutoff improves TST accuracy for students from high-burden areas. IGRA should be preferred for individuals with BCG vaccination history. Full article

(This article belongs to the Special Issue Tuberculosis Diagnosis: Current, Ongoing and Future Approaches)

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8 pages, 316 KB

Open AccessCase Report

Travel-Related Malaria Diagnosis on Karius Test Despite Negative Blood Smear

by Joseph Eugene Weigold, Shankar Lal and Dima Ahmad Youssef

Trop. Med. Infect. Dis. 2025, 10(11), 310; https://doi.org/10.3390/tropicalmed10110310 - 31 Oct 2025

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Abstract

Malaria remains a considerable challenge to international health, especially in returning travelers from endemic regions where exposure risk may be downplayed. Prompt and accurate diagnosis is crucial, especially when conventional diagnostic techniques are insufficient. This case report presents a 59-year-old man who developed [...] Read more.

Malaria remains a considerable challenge to international health, especially in returning travelers from endemic regions where exposure risk may be downplayed. Prompt and accurate diagnosis is crucial, especially when conventional diagnostic techniques are insufficient. This case report presents a 59-year-old man who developed fever, rash, and myalgia after returning from the Amazon rainforest. Initial laboratory tests demonstrated leukopenia, thrombocytopenia, transaminitis, and hyperbilirubinemia. Despite these abnormal results and a clinically suspicious presentation, malaria smears were negative. Since the symptoms did not resolve, a Karius test—a plasma-based microbial cell-free DNA sequencing assay—successfully detected the presence of Plasmodium vivax, thus establishing the diagnosis. The patient needed several treatment regimens for the recurrent attacks, including chloroquine and primaquine, artemether-lumefantrine, and eventually a combination of quinine and doxycycline together with a prolonged course of primaquine. His symptoms resolved completely after the last treatment regimen, along with the normalization of the blood counts and liver function tests. This case demonstrates the limitations of smear microscopy diagnosis in P. vivax infections, highlights the role of molecular diagnostics like the Karius test, and stresses the importance of preventing relapses with adequate hypnozoite clearance. It further highlights the importance of clinician awareness and diligent follow-up in cases of travel-related Malaria, especially those with unusual presentations or recurrent symptoms. Full article

(This article belongs to the Special Issue Challenges and Prevention Strategies for Travel-Related Infectious Diseases)

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36 pages, 953 KB

Open AccessReview

Dengue Fever Resurgence in Iran: An Integrative Review of Causative Factors and Control Strategies

by Seyed Hassan Nikookar, Saeedeh Hoseini, Omid Dehghan, Mahmoud Fazelidinan and Ahmadali Enayati

Trop. Med. Infect. Dis. 2025, 10(11), 309; https://doi.org/10.3390/tropicalmed10110309 - 31 Oct 2025

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Abstract

Dengue fever, a mosquito-borne viral disease, has become a significant global health concern in recent decades, particularly in Iran. This integrative review provides a comprehensive assessment of the epidemiological trends of dengue fever in Iran from its initial emergence to the present, identifying [...] Read more.

Dengue fever, a mosquito-borne viral disease, has become a significant global health concern in recent decades, particularly in Iran. This integrative review provides a comprehensive assessment of the epidemiological trends of dengue fever in Iran from its initial emergence to the present, identifying and evaluating factors contributing to both the emergence and re-emergence of the disease at national and international levels. The review highlights critical global determinants influencing dengue transmission, including climate change, environmental modifications, unplanned urbanization, increased international travel and trade, and the pivotal roles of public awareness and healthcare infrastructure. Climatic variables, such as rising temperatures and altered precipitation patterns, create favorable conditions for mosquito breeding, enabling vectors like Aedes aegypti and Aedes albopictus to expand into new regions. We also explore how environmental changes, unplanned urbanization and other factors further exacerbate the situation. Control strategies addressing these factors are presented. In Iran, the incidence of dengue fever is increasing, yet research remains limited. The highest number of local cases has been reported in Chabahar and Bandar Lengeh, Hormozgan and Sistan and Baluchestan Provinces, respectively. Eleven key factors—culminating in socio-cultural practices, climate change, unplanned urbanization, cross-border mobility, and gaps in vector control and healthcare infrastructure—have been identified as contributing to recent outbreaks in Iran. In conclusion, our review underscores that mitigating dengue vulnerability in Iran requires an urgent, multi-faceted strategy targeting improved urban water management, enhanced cross-border surveillance, and strengthened healthcare system capacity. Full article

(This article belongs to the Section Vector-Borne Diseases)

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14 pages, 916 KB

Open AccessArticle

Limited Spectroscopy Data and Machine Learning for Detection of Zika Virus Infection in Aedes aegypti Mosquitoes

by Leonardo Reigoto, Rafael Maciel-de-Freitas, Maggy T. Sikulu-Lord, Gabriela A. Garcia, Gabriel Araujo and Amaro Lima

Trop. Med. Infect. Dis. 2025, 10(11), 308; https://doi.org/10.3390/tropicalmed10110308 - 29 Oct 2025

Viewed by 476

Abstract

This study presents a technique for categorizing Aedes aegypti mosquitoes infected with the Zika virus under laboratory conditions. Our approach involves the utilization of the near-infrared spectroscopy technique and machine learning algorithms. The model developed utilizes the absorption of light from 350 to [...] Read more.

This study presents a technique for categorizing Aedes aegypti mosquitoes infected with the Zika virus under laboratory conditions. Our approach involves the utilization of the near-infrared spectroscopy technique and machine learning algorithms. The model developed utilizes the absorption of light from 350 to 1000 nm. It integrates Linear Discriminant Analysis (LDA) of the signal’s windowed version to exploit non-linearities, along with Support Vector Machine (SVM) for classification purposes. Our proposed methodology can identify the presence of the Zika virus in intact mosquitoes with a balanced accuracy of 96% (row C2HT, average of columns TPR (%) and SPC (%)) when heads/thoraces of mosquitoes are scanned at 4, 7, and 10 days post virus infection. The model was 97.1% (10 DPI, row C2AB, column ACC (%)) accurate for mosquitoes that were used to test it, i.e., mosquitoes scanned 10-days post-infection and mosquitoes whose abdomens were scanned. Notable benefits include its cost-effectiveness and the capability for real-time predictions. This work also demonstrates the role played by different spectral wavelengths in predicting an infection in mosquitoes. Full article

(This article belongs to the Special Issue Beyond Borders—Tackling Neglected Tropical Viral Diseases)

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20 pages, 2861 KB

Open AccessArticle

High-Resolution Geospatial Analysis of Dengue Vulnerability in Urban and Rural Areas of San Luis Potosí, Mexico

by Darío Gaytán Hernández, Daniel Sánchez Hernández, Luis Eduardo Hernández Ibarra, Enrique Ibarra Zapata, Omar Parra Rodríguez, Verónica Gallegos García, Omar Medina de la Cruz and Marisol Gallegos García

Trop. Med. Infect. Dis. 2025, 10(11), 307; https://doi.org/10.3390/tropicalmed10110307 - 28 Oct 2025

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Abstract

Objective: The aim was to analyze the temporal evolution and spatial distribution of classic and hemorrhagic dengue in the Mexican state of San Luis Potosí at the basic geostatistical area (BGA) level and to develop multivariate models to estimate the population’s degree of [...] Read more.

Objective: The aim was to analyze the temporal evolution and spatial distribution of classic and hemorrhagic dengue in the Mexican state of San Luis Potosí at the basic geostatistical area (BGA) level and to develop multivariate models to estimate the population’s degree of vulnerability. Methodology: Classic and hemorrhagic dengue cases for 2015–2020 were obtained from the Mexican Ministry of Health, georeferenced at the pixel level, and subsequently grouped by BGA. Environmental, proximity, and social variables were obtained from official sites: IMTA, SMN, USGS, and INEGI. Multivariate logistic regression models were developed using PASW Statistics v. 18 software to estimate the degree of vulnerability, and the receiver operating characteristic curve was used to validate them. Results: A total of 125, 128, 109, 624, 1580, and 1817 dengue cases were identified for 2015, 2016, 2017, 2018, 2019, and 2020, respectively. The major factors contributing to the vulnerability of classic dengue fever included population, temperature, and distance to agricultural areas. For hemorrhagic dengue, the contributing factors were temperature, population, and mean annual rainfall. Vulnerability prediction was determined by taking the area under the curve values, which were 0.957 for classic dengue fever and 0.930 for hemorrhagic dengue, both indicating a “very good ability” to predict. Conclusions: These results can be used to design and implement targeted strategies, particularly for modifiable factors, such as prevention measures directed towards populated areas and the improvement of sewage systems, in addition to non-modifiable factors, such as temperature and rainfall. This method can be replicated as an additional tool to address this public health issue. Full article

(This article belongs to the Special Issue Spatial Epidemiology and Infectious Diseases in the Context of Changing Climate)

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13 pages, 451 KB

Open AccessArticle

Evaluation of Performance of C-Reactive Protein (CRP) and Interferon-Gamma-Inducible Protein 10 (IP-10) as Screening for Active Tuberculosis

by Rotimi Samuel Owolabi, Russel Dacombe, Konstantina Kontogianni, Olusegun M. Akinwande, Lovett Lawson and Luis E. Cuevas

Trop. Med. Infect. Dis. 2025, 10(11), 306; https://doi.org/10.3390/tropicalmed10110306 - 27 Oct 2025

Viewed by 805

Abstract

Background: Most of the currently approved TB diagnostics are sputum-based. However, due to unusual clinical presentations of TB among HIV patients, they may not have TB symptoms and be able to produce sputum. Hence, these diagnostics may not be able to detect as [...] Read more.

Background: Most of the currently approved TB diagnostics are sputum-based. However, due to unusual clinical presentations of TB among HIV patients, they may not have TB symptoms and be able to produce sputum. Hence, these diagnostics may not be able to detect as many TB cases as possible among these patients. Therefore, this study assessed the performance of C-reactive protein (CRP) and interferon-gamma-inducible protein 10 (IP-10) as a screening tool for TB. Methods: This prospective study was conducted by consecutively recruiting patients with TB symptoms, collecting their sputum and blood samples, using sputum culture as the reference standard, and determining the best cut-off point of serum levels of CRP and IP-10 (separately and in combination) for TB diagnosis. Findings: CRP and IP-10 were measured in 408 patients with TB symptoms, of which 21% had culture-confirmed TB. CRP’s sensitivity and specificity were (91.4% and 33.2%), (95.3% and 42.6%) and (84.8% and 22.1%) for the whole study population, HIV-negative and HIV-positive patients, respectively. The sensitivity and specificity of IP-10 were (87.3% and 40.9%), (87.5% and 50.3%) and (79.4% and 47.2%) for the patients’ categories, respectively. Combination of CRP and IP-10 slightly improved the performance of the biomarkers among HIV-negative patients, with sensitivity of 97.5% and specificity of 43.3%. Interpretation: Though CRP and IP-10 performed better in HIV-negative patients than among people living with HIV (PLHIV), the performance of the biomarkers is lower than what is recommended by the WHO (sensitivity ≥ 90% and specificity ≥ 70%) for a TB screening tool. Hence, there is a need for better non-sputum-based TB diagnostics. Full article

(This article belongs to the Special Issue Innovative Approaches to Combat Infectious Diseases in Low and Middle Income Countries (LMICs): Epidemiology, Diagnosis, and Interventions)

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17 pages, 2247 KB

Open AccessArticle

Retrospective Analysis and Cross-Validated Forecasting of West Nile Virus Transmission in Italy: Insights from Climate and Surveillance Data

by Francesco Branda, Mohamed Mustaf Ahmed, Dong Keon Yon, Giancarlo Ceccarelli, Massimo Ciccozzi and Fabio Scarpa

Trop. Med. Infect. Dis. 2025, 10(11), 305; https://doi.org/10.3390/tropicalmed10110305 - 27 Oct 2025

Viewed by 701

Abstract

Background. West Nile Virus (WNV) represents a significant public health concern in Europe, with Italy—particularly its northern regions—experiencing recurrent outbreaks. Climate variables and vector dynamics are known to significantly influence transmission patterns, highlighting the need for reliable predictive models to enable timely outbreak [...] Read more.

Background. West Nile Virus (WNV) represents a significant public health concern in Europe, with Italy—particularly its northern regions—experiencing recurrent outbreaks. Climate variables and vector dynamics are known to significantly influence transmission patterns, highlighting the need for reliable predictive models to enable timely outbreak detection and response. Methods. We integrated epidemiological data on human WNV infections in Italy (2012–2024) with high-resolution climate variables (temperature, humidity, and precipitation). Using advanced feature engineering and a gradient boosting framework (XGBoost), we developed a predictive model optimized through time-series cross-validation. Results. The model achieved high predictive accuracy at the national level (R² = 0.994, MAPE = 5.16%) and maintained robust performance across the five most affected provinces, with R² values ranging from 0.896 to 0.996. SHAP analysis identified minimum temperature as the most influential climate predictor, while maximum temperature and rainfall demonstrated considerably weaker associations with case incidence. Conclusions. This machine learning approach provides a reliable framework for forecasting WNV outbreaks and supports evidence-based public health responses. The integration of climate and epidemiological data enhances surveillance capabilities and enables informed decision-making at regional and local levels. Full article

(This article belongs to the Special Issue Global Perspectives on the Role of Invasive Mosquito Species and Emerging Vector-Borne Diseases)

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17 pages, 2971 KB

Open AccessArticle

Web-Based Dashboard for Tracking Cryptococcosis-Related Deaths in Brazil (2000–2022)

by Eric Renato Lima Figueiredo, Lucca Nielsen, João Simão de Melo-Neto, Claudia do Socorro Carvalho Miranda, Nelson Veiga Gonçalves, Rita Catarina Medeiros Sousa and Anderson Raiol Rodrigues

Trop. Med. Infect. Dis. 2025, 10(11), 304; https://doi.org/10.3390/tropicalmed10110304 - 27 Oct 2025

Viewed by 595

Abstract

Background: Cryptococcosis, a systemic mycosis, remains a neglected disease in Brazil due to the absence of systematic national surveillance. This study developed an interactive dashboard to analyze cryptococcosis-related deaths (2000–2022) and forecast trends through regional ARIMA modeling. Methodology: The Cross-Industry Standard Process for [...] Read more.

Background: Cryptococcosis, a systemic mycosis, remains a neglected disease in Brazil due to the absence of systematic national surveillance. This study developed an interactive dashboard to analyze cryptococcosis-related deaths (2000–2022) and forecast trends through regional ARIMA modeling. Methodology: The Cross-Industry Standard Process for Data Mining framework was employed to extract mortality data from the Brazilian Mortality Information System, utilizing the microdatasus package in R Studio software, with R version 3.4.0. The records were then filtered using the International Classification of Diseases, Tenth Revision codes (B45 series) to identify primary and associated causes of death. After data extraction, a series of data preprocessing steps was implemented, including deduplication, variable recoding, and the management of missing values. The Shiny framework was employed to construct an interactive dashboard, incorporating Plotly and DT packages, with time-series visualizations, demographic variables, and multilingual support (Portuguese/English). Results: Among 12,308 deaths (2227 primary; 10,081 associated causes), most occurred in males aged 21–60 years. Data completeness was high for age/residence (100%) but lower for education (82%). The dashboard enables dynamic exploration of trends, demographic patterns, and open-data downloads. Regional ARIMA models revealed heterogeneous forecasts, with the Southeast projecting a decline (193 deaths in 2025; 95% CI: 146–240) and the South showing stability (141 deaths; 95% CI: 109–173). Conclusions: This tool bridges a critical gap in cryptococcosis surveillance, enabling dynamic mortality trend analysis, identification of high-risk demographics, and regional forecasting to guide public health resource allocation. While the absence of HIV serostatus data limits etiological analysis, the dashboard’s open-source framework supports adaptation for other neglected diseases. Full article

(This article belongs to the Special Issue Tracking Infectious Diseases, 2nd Edition)

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18 pages, 2767 KB

Open AccessArticle

Tuberculosis Preventive Treatment in People Living with HIV in Uganda: Facilitators and Barriers for Initiation and Completion

by Ritah Mande, Pruthu Thekkur, Denis Mudoola, Joseph Nsonga, John Paul Dongo, Simon Muchuro, Stavia Turyahabwe, Henry Luzze, Proscovia Namuwenge, Selma Dar Berger, Deus Lukoye, Macarthur Charles, Odile Ferroussier-Davis and Riitta A. Dlodlo

Trop. Med. Infect. Dis. 2025, 10(11), 303; https://doi.org/10.3390/tropicalmed10110303 - 27 Oct 2025

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Abstract

Tuberculosis preventive treatment (TPT) is a mainstay for reducing the tuberculosis (TB) burden among people living with human immunodeficiency virus (PLHIV). Context-specific challenges hinder TPT uptake and completion among PLHIV. During 2022–2024, a mixed-methods design was used to evaluate the TPT cascade and [...] Read more.

Tuberculosis preventive treatment (TPT) is a mainstay for reducing the tuberculosis (TB) burden among people living with human immunodeficiency virus (PLHIV). Context-specific challenges hinder TPT uptake and completion among PLHIV. During 2022–2024, a mixed-methods design was used to evaluate the TPT cascade and explore its facilitators and barriers among PLHIV availing care from 12 PEPFAR-supported health facilities in Uganda. The quantitative component included analysis of routine programmatic data, and the qualitative component included focus group discussions and in-depth interviews with healthcare workers and PLHIV. A total of 1349 PLHIV were enrolled in the evaluation. Among PLHIV newly initiated on ART (≤3 months), 74% started TPT, and 98% of them completed it. In PLHIV already on ART, 87% had initiated TPT (76% before and 11% during this evaluation), with a treatment completion rate of 98%. The facilitators for TPT implementation included access to shorter TPT regimens, integration of services, and adherence counseling. Barriers included knowledge gaps, pill burden, TPT drug stock-outs, and documentation inconsistencies. The TPT completion rate was higher than the national target (90%), but the TPT initiation remains low. Improved access to shorter regimens, adherence counseling, better documentation, and service integration can sustain the completion rate and improve the initiation rate in Uganda and possibly elsewhere. Full article

(This article belongs to the Special Issue New Perspectives in Tuberculosis Prevention and Control)

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19 pages, 1748 KB

Open AccessArticle

Seroprevalence and Associated Risk Factors of Human Brucellosis in a Farming and Animal Health Community in South Africa, 2015–2016

by Jennifer Rossouw, Anastasia N. Trataris-Rebisz, Stefano Tempia, Melinda K. Rostal, William B. Karesh and Veerle Msimang

Trop. Med. Infect. Dis. 2025, 10(11), 302; https://doi.org/10.3390/tropicalmed10110302 - 23 Oct 2025

Viewed by 358

Abstract

Brucellosis is a widespread zoonotic disease and a major contributor to febrile illness, often underdiagnosed. This study investigated the seroprevalence of brucellosis and the associated exposure factors within South African farming and animal health communities. A cross-sectional survey was conducted across 40,000 km [...] Read more.

Brucellosis is a widespread zoonotic disease and a major contributor to febrile illness, often underdiagnosed. This study investigated the seroprevalence of brucellosis and the associated exposure factors within South African farming and animal health communities. A cross-sectional survey was conducted across 40,000 km² in the Free State and Northern Cape provinces from 2015 to 2016. Interviews and serum samples were collected from 847 volunteers on randomly selected farms and veterinary professionals listed in a regional register. Samples were tested using a commercial Brucella IgG ELISA. Risk factors were assessed using logistic regression, accounting for within-farm clustering. The seroprevalence was higher among veterinary professionals (11.6%; 16/138) than farm-based participants (7.0%; 50/711); p = 0.095. Multivariable analysis identified several exposure factors within the farm-based population: age over 40 years (aOR = 5.35; 95% CI: 1.68–17.02), White population group (aOR = 4.60; 95% CI: 1.64–12.91), contact with diseased animals (aOR = 2.01; 95% CI: 1.05–3.84), and working 4–8 h daily with ungulates (aOR = 2.90; 95% CI: 1.25–6.76). Among veterinary professionals, odds of exposure were higher with more than 5 years of work (OR = 1.82; 95% CI: 1.21–2.72) and extended ungulate contact (OR = 4.85; 95% CI: 1.27–18.52). Occupational exposure highlights the need for improved brucellosis prevention strategies. Full article

(This article belongs to the Special Issue Neglected Zoonotic Diseases in Sub-Saharan Africa)

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14 pages, 525 KB

Open AccessArticle

Improved Antibiotic Prescribing for Acute Conjunctivitis After Operational Research: A Before-and-After Study in a Ghanaian Eye Hospital

by Henry Kissinger Ansong, Divya Nair, Joana Abokoma Koomson, Obed Kwabena Offe Amponsah, Jane Frances Acquah, James Buckman, Andrew Ramsay and Paa Kwesi Fynn Hope

Trop. Med. Infect. Dis. 2025, 10(11), 301; https://doi.org/10.3390/tropicalmed10110301 - 22 Oct 2025

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Abstract

Empirical antibiotic treatment is common in acute conjunctivitis despite most cases being non-infectious or viral infections. Operational research (OR) at an eye hospital in Ghana (January–December 2021) identified appropriate antibiotic prescription in 71% of cases. Research dissemination and the sensitisation of key stakeholders [...] Read more.

Empirical antibiotic treatment is common in acute conjunctivitis despite most cases being non-infectious or viral infections. Operational research (OR) at an eye hospital in Ghana (January–December 2021) identified appropriate antibiotic prescription in 71% of cases. Research dissemination and the sensitisation of key stakeholders followed, including communication of findings and implications to hospital prescribers. We conducted this OR covering January–December 2024 to test the hypothesis that the appropriateness of antibiotic prescriptions will improve, and to investigate the types of antibiotics prescribed and their AWaRe classification. There were 220 acute conjunctivitis cases in 2024, comparable to 2021 (201 cases). Antibiotics were prescribed in 67% of cases in 2024 and 55% in 2021 (aOR 2.51, 95% CI: 1.51–4.19, p < 0.001). Antibiotic prescription appropriateness was higher in 2024 than in 2021: 87% and 71%, respectively (95% CI for change: 5.99–25.99%, p = 0.001). In 2021, only ACCESS and WATCH antibiotics were prescribed. However, 15% of prescriptions in 2024 were RESERVE antibiotics, and multiple antibiotic prescriptions increased from 10% to 22%. This research demonstrates that regular operational research and interventions have the potential to improve antibiotic prescribing in ophthalmic practice in Ghana. It is imperative that the recommendations made by the initial researchers are fully implemented to protect the efficacy of available antibiotics. Full article

(This article belongs to the Special Issue Field Impact of the SORT IT Initiative on Combating Antimicrobial Resistance Through a One Health Approach in Ghana)

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Trop. Med. Infect. Dis., Volume 10, Issue 11 (November 2025) – 26 articles

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