Tropical Medicine and Infectious Disease

14 pages, 1670 KiB

Open AccessArticle

Desiccation Tolerance of Aedes aegypti and Aedes albopictus Eggs of Northeastern Argentina Origin

by Mía E. Martín, Elizabet L. Estallo, Luis G. Estrada, Carolina Matiz Enriquez and Marina Stein

Trop. Med. Infect. Dis. 2025, 10(4), 116; https://doi.org/10.3390/tropicalmed10040116 - 21 Apr 2025

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This study examines the desiccation tolerance of Aedes aegypti and Aedes albopictus eggs, two major arbovirus vectors, in a subtropical region of Argentina to understand their survival under varying relative humidity (RH) conditions (35%, 68%, and 82%). Laboratory experiments revealed that Ae. aegypti [...] Read more.

This study examines the desiccation tolerance of Aedes aegypti and Aedes albopictus eggs, two major arbovirus vectors, in a subtropical region of Argentina to understand their survival under varying relative humidity (RH) conditions (35%, 68%, and 82%). Laboratory experiments revealed that Ae. aegypti eggs exhibited significantly higher survival rates across all RH levels and exposure times compared to Ae. albopictus. After 1 month, Ae. aegypti eggs maintained 88% survival at 35% RH, while Ae. albopictus survival dropped to 38%. This disparity was more pronounced at low RH, where Ae. albopictus eggs experienced a rapid decline in survival over time. The results highlight the importance of RH as a key factor influencing the persistence of both species in the environment. The coexistence of Ae. aegypti and Ae. albopictus in Puerto Iguazú suggests that microhabitats with distinct humidity conditions may favor one species over the other. These findings provide crucial insights for predicting mosquito population dynamics under changing climate conditions and developing more effective vector control strategies to reduce arbovirus transmission in subtropical regions. Full article

(This article belongs to the Special Issue Mosquito-Borne Diseases: Intervention Strategies Used to Control Mosquito Populations and Reduce Disease Transmission)

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11 pages, 1329 KiB

Open AccessReview

The State of Antimicrobial Resistance of Gram-Negative Bacilli in Canada

by Jeremy Li, Andrew Walkty, Philippe Lagacé-Wiens, James Karlowsky and George Zhanel

Trop. Med. Infect. Dis. 2025, 10(4), 115; https://doi.org/10.3390/tropicalmed10040115 - 21 Apr 2025

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Abstract

In the last two decades, there has been an increase in resistance among Gram-negative bacteria in Canada. From 2007 to 2016, the proportion of ESBL-producing isolates among Escherichia coli and Klebsiella pneumoniae isolates increased from 3.5% to 11.1%. There has also been an [...] Read more.

In the last two decades, there has been an increase in resistance among Gram-negative bacteria in Canada. From 2007 to 2016, the proportion of ESBL-producing isolates among Escherichia coli and Klebsiella pneumoniae isolates increased from 3.5% to 11.1%. There has also been an increase in carbapenem use over this time period, which may be contributing to the increasing prevalence of carbapenemase-producing Enterobacterales (CPE) in Canada. CPE, which were historically associated with travel, are now mostly acquired domestically. The prevalence of multi-drug resistant (MDR) Pseudomonas aeruginosa has decreased slightly, possibly due to decreasing use of fluoroquinolones and aminoglycosides. Many of the most effective antimicrobials for the treatment of infections with resistant Gram-negative organisms, including many of the novel β-lactam/β-lactamase inhibitors (βL/βLIs), are not marketed in Canada. A coordinated focus on antimicrobial stewardship and infection control is necessary to slow the spread of resistance and to preserve the efficacy of our current antimicrobials for future generations. Full article

(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)

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15 pages, 1092 KiB

Open AccessArticle

Qualitative Study of Nutritional Support-Related Perceptions and Preferences Among Persons Affected by TB, Family Caregivers, and Healthcare Providers in India

by Balaji Ramraj, Karikalan Nagarajan, Debjani Ram Purakayastha, Major Madhukar, Makesh Kumar, Neha Raj, Sarath Kumar, Banappa S. Unger, Nithin Rajamani, Sampada Dipak Bangar, Murugesan Periyasamy, Hansraj Choudhary, Yasaswany Santhoshkumar, Ramesh Kumar, Seema Sahay, Nivedita Gupta and Chandrasekaran Padmapriyadarsini

Trop. Med. Infect. Dis. 2025, 10(4), 114; https://doi.org/10.3390/tropicalmed10040114 - 21 Apr 2025

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Abstract

Evidence on the implementation aspects of nutritional support interventions for persons with TB in India is limited. This qualitative study employed focus group discussions with persons with TB (n = 71), their family caregivers (n = 17), and healthcare providers (n = 18). [...] Read more.

Evidence on the implementation aspects of nutritional support interventions for persons with TB in India is limited. This qualitative study employed focus group discussions with persons with TB (n = 71), their family caregivers (n = 17), and healthcare providers (n = 18). The study was conducted from August 2023 to April 2024 in five states in India. Participants’ knowledge, perceptions, and practices about nutritional intake, experiences, and expectations when accessing nutritional support were explored. Four nutrition-related themes emerged: (a) the experiences and perceptions of persons with tuberculosis and their caregivers, explained by their understanding of the importance of adequate nutrition and TB cures; (b) changes in food practices, explained by protein food adoption, alongside food insecurity experienced by those in poverty; (c) Direct Benefit Transfer (DBT)-related issues, explained by insufficiency and access-related gaps; and (d) preferred choices for nutrition support delivery, explained by less preference towards the involvement of intermediaries and a public distribution system alongside preference for the provision of nutrition through treatment facilities. Our findings underscore the importance of the provision of protein-rich food and an increase in financial support based on needs assessments. Mitigating the linkage and access gaps in DBT is needed. The delivery of ready-to-consume food through tuberculosis treatment facilities could be prioritized. Full article

(This article belongs to the Special Issue Tuberculosis Control in Africa and Asia)

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19 pages, 9253 KiB

Open AccessSystematic Review

Prevalence of Trichomonas vaginalis Among Women in the Chinese Population: A Systematic Review and Meta-Analysis

by Shuang Li, Jiahui Xu, Sisi Ru, Changjun Hu, Chongyang Liu, Xingquan Sun, Heteng Guo and Xi Zhang

Trop. Med. Infect. Dis. 2025, 10(4), 113; https://doi.org/10.3390/tropicalmed10040113 - 19 Apr 2025

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Abstract

Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) among women worldwide. However, there is little information available regarding the burden of trichomoniasis infection among Chinese women. The aim of the present study is to assess the status of trichomoniasis [...] Read more.

Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) among women worldwide. However, there is little information available regarding the burden of trichomoniasis infection among Chinese women. The aim of the present study is to assess the status of trichomoniasis in China. To address this gap, we searched seven databases for relevant studies published from their inception to June 2024. The overall prevalence of T. vaginalis in China was determined to be 6.31% with a high level of heterogeneity (I² = 99.68%). Subgroup analysis also demonstrated a statistically significant association between the T. vaginalis prevalence in the type of population, age range, year, residential status, and province. Among these, sex workers are the most prominent with 12.16%. Meta-regression analysis indicated that the infection rate of T. vaginalis among Chinese women had not shown a significant decline over time (p = 0.2919). Therefore, it continues to be a public health issue that should not be overlooked. Sex workers and rural women have a relatively higher infection rate of trichomoniasis, and this is largely associated with sexual safety awareness and hygiene conditions. Our findings provide crucial information for healthcare authorities and can shed light on the prevention strategies for trichomoniasis in China. Full article

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14 pages, 1531 KiB

Open AccessArticle

Infectivity and Dissemination of Dengue Virus-1 in Different Aedes aegypti Populations Throughout Brazil

by Amanda Cupertino de Freitas, Ellen Santos, Lívia Baldon, Silvana de Mendonça, Fernanda Oliveira Rezende, Rafaela Moreira, Viviane Sousa, Mariana Lima, Emanuele Silva, Flávia Ferreira, João Paulo Pereira de Almeida, Siad Amadou, Bruno Marçal, Sara Comini, Marcele Rocha, Yaovi Todjro, Thiago Jiran Leite, Viviane Santos, Isaque João da Silva de Faria, Marta Giovanetti, Luiz Carlos Junior Alcantara, Luciano A. Moreira and Alvaro Ferreira Show full author list Hide full author list

Trop. Med. Infect. Dis. 2025, 10(4), 112; https://doi.org/10.3390/tropicalmed10040112 - 19 Apr 2025

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Abstract

Dengue virus, one of the most prevalent mosquito-borne flaviviruses affecting humans globally, is primarily transmitted by the Aedes aegypti mosquito, which thrives in densely populated urban environments. Dengue incidence has surged in recent decades, becoming a major public health concern in many regions, [...] Read more.

Dengue virus, one of the most prevalent mosquito-borne flaviviruses affecting humans globally, is primarily transmitted by the Aedes aegypti mosquito, which thrives in densely populated urban environments. Dengue incidence has surged in recent decades, becoming a major public health concern in many regions, particularly in Brazil, which has experienced recurrent outbreaks and reported over 6.6 million probable cases in the year of 2024. While the link between the mosquito vector and dengue transmission is well understood, the effects of different DENV types and their interactions with the vector capacity of natural mosquito populations are crucial for understanding disease dynamics. Here we report findings from experiments designed to analyze and compare the infectivity and dissemination of the DENV-1 strain among five Ae. aegypti populations collected from different regions of Brazil. When exposed to DENV-infected AG129 mice for blood feeding, these populations exhibited variations in infection rates and dissemination efficiency. Eight days post-infection, all populations demonstrated high infection rates, underscoring the substantial capacity of Brazilian Ae. aegypti populations to support the locally circulating DENV-1 strain. Our results demonstrate variation in Ae. aegypti vector competence across Brazil, revealing distinct patterns of DENV transmission efficiency. These findings highlight the necessity for geographically tailored control strategies, particularly in high-risk urban areas where outbreak potential is greatest. Full article

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16 pages, 2007 KiB

Open AccessArticle

The Incidence of Scabies in Far North Queensland, Tropical Australia: Implications for Local Clinical Practice and Public Health Strategies

by Mert Hamdi Korkusuz, Maria Eugenia Castellanos, Linton R. Harriss, Allison Hempenstall, Simon Smith and Josh Hanson

Trop. Med. Infect. Dis. 2025, 10(4), 111; https://doi.org/10.3390/tropicalmed10040111 - 18 Apr 2025

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Abstract

The recognition and treatment of scabies has been incorporated into Australian guidelines for the prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). The incidence of both diagnosed ARF and RHD is increasing in Far North Queensland (FNQ) in northeast tropical [...] Read more.

The recognition and treatment of scabies has been incorporated into Australian guidelines for the prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). The incidence of both diagnosed ARF and RHD is increasing in Far North Queensland (FNQ) in northeast tropical Australia, but the local burden of scabies is incompletely defined. We reviewed the results of every skin scraping collected in FNQ’s public health system between 2000 and 2023; 121/4345 (2.8%) scrapings were positive, including 19/1071 (1.8%) in the last 5 years of the study; the proportion of scrapings that were positive for scabies declined over the study period. Individuals who tested positive for scabies were no more likely to have had a prior diagnosis of ARF or RHD compared to the matched controls (1/101 (1%) versus 3/101 (3%), p = 1.0). During a median of 14.7 years of follow-up, individuals who tested positive for scabies were also no more likely to have a diagnosis of ARF or RHD than matched controls (2/100 (2%) versus 6/98 (6%); hazard ratio (95% confidence interval): 0.30 (0.06–1.50) p = 0.14). Microbiologically confirmed scabies is uncommon in FNQ and appears to make a limited contribution to the local incidence of ARF and RHD. Full article

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

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10 pages, 2343 KiB

Open AccessCase Report

Non-O1, Non-O139 Vibrio cholerae Bacteremic Skin Infection with Multiple Skin Necrosis: Case Report

by Amer Ibrahim Alomar, Nasreldin Elhadi, Lamya Zohair Yamani, Reema Allahham, Rana Alghamdi, Ibrahim Alhabib, Asim Diab, Nehal Mahmoud, Bashayer AlDossary, Mariam Almejhim, Nouf Al-Romihi, Faye Aldehalan and Reem Al Jindan

Trop. Med. Infect. Dis. 2025, 10(4), 110; https://doi.org/10.3390/tropicalmed10040110 - 17 Apr 2025

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Abstract

Non-O1, non-O139 Vibrio cholerae (NOVC) extraintestinal infections are rare, but recently, several clinical incidents have been reported worldwide. Toxigenic V. cholerae is a well-known etiological agent of cholera, responsible for acute dehydrating watery diarrhea. Outbreaks occur in an epidemic seasonal pattern, particularly in [...] Read more.

Non-O1, non-O139 Vibrio cholerae (NOVC) extraintestinal infections are rare, but recently, several clinical incidents have been reported worldwide. Toxigenic V. cholerae is a well-known etiological agent of cholera, responsible for acute dehydrating watery diarrhea. Outbreaks occur in an epidemic seasonal pattern, particularly in countries with poverty and poor sanitation. Strains of NOVC are usually not involved in causing the epidemic or pandemic outbreaks seen with potential strains of V. cholerae serogroup O1 and O139. However, they can still cause severe sporadic cases of intestinal as well as extraintestinal infections. In this study, we investigated a case of extraintestinal infections associated with the NOVC serogroup isolated from a deep closed wound abscess. The isolate was screened for the presence of three major virulence genes, toxR, ctxA, and tcpA. The strain tested positive for the toxR gene encoding the regulatory protein and cholera toxin (ctx) gene and tested negative for the toxin-coregulated pilus (TCP) gene, which is essential for the colonization of the human intestine, causing the severe diarrheal disease cholera. To the best of our knowledge, this is the first case of extraintestinal infection caused by toxigenic Vibrio cholerae non-O1/non-O139 in a hospitalized patient in Saudi Arabia. Full article

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18 pages, 3837 KiB

Open AccessArticle

Phylogeographic Patterns and Genetic Diversity of Anopheles stephensi: Implications for Global Malaria Transmission

by Jehangir Khan, Dongjing Zhang, Saber Gholizadeh, Yidong Deng, Abdul Aziz, Jianhuang Chen, Pir Tariq Shah, Zhiyue Lv and Tao Chen

Trop. Med. Infect. Dis. 2025, 10(4), 109; https://doi.org/10.3390/tropicalmed10040109 - 16 Apr 2025

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Abstract

Background: Anopheles stephensi, a primary malaria vector in South Asia, is expanding its geographic range, raising concerns about increased malaria transmission. However, critical aspects of its genetic diversity, population structure, and evolutionary dynamics remain poorly understood in Khyber Pakhtunkhwa (KP), Pakistan, [...] Read more.

Background: Anopheles stephensi, a primary malaria vector in South Asia, is expanding its geographic range, raising concerns about increased malaria transmission. However, critical aspects of its genetic diversity, population structure, and evolutionary dynamics remain poorly understood in Khyber Pakhtunkhwa (KP), Pakistan, an endemic malaria region where An. stephensi is adapting to urban settings, posing challenges for the development of targeted vector control strategies. This study addresses this gap by analyzing COI, COII (cytochrome oxidase subunit I and II), and ITS2 (internal transcribed spacer 2) sequences from An. stephensi populations in KP and comparing them with global isolates. Additionally, egg morphology analysis was conducted to identify the biological form. Methods: Mosquitoes were collected from malaria-endemic districts (Nowshera, Charsadda, and Peshawar) using ovitraps. Eggs were characterized morphologically, and DNA was extracted for PCR amplification of COI, COII, and ITS2 markers. Sequences from 17 Pakistani isolates, along with global sequences, were analyzed. Phylogenetic relationships, haplotype networks, genetic diversity, and neutrality tests (Tajima’s D and Fu’s Fs) were assessed. Results: Egg morphology confirmed the mysorensis form (13–15 ridges per egg) in KP. COI sequences clustered into two subclades (Punjab and KP), with >99% similarity to global isolates. COII and ITS2 sequences showed high similarity (99.46–100%) with populations from China, Iran, India, and Brazil, reflecting strong genetic connectivity rather than distinct regional clustering. Haplotype analysis identified six COI, ten COII, and ten ITS2 haplotypes, with Hap_2 (50.7%) and Hap_1 (43.3%) being the most prevalent in COI, Hap_7 (29.4%) in COII, and Hap_3 (80.8%) in ITS2. Population genetic analysis revealed higher COI diversity in Pakistan and India, with moderate diversity in COII. Neutrality tests suggested balancing selection in COI for both countries, while COII and ITS2 indicated population contraction in Iran. Conclusions: The findings reveal strong genetic connectivity within regions (e.g., Pakistan) and differentiation across global populations of An. stephensi, highlighting its potential for further expansion and adaptation. These insights are critical for informing global malaria control strategies, particularly in regions vulnerable to vector invasion. Full article

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11 pages, 237 KiB

Open AccessArticle

Current Antimicrobial Susceptibility Trends and Clinical Outcomes of Typhoidal Salmonella in a Large Health Authority in British Columbia, Canada

by Calvin Ka-Fung Lo, Merisa Mok, Cole Schonhofer, Kevin Afra and Shazia Masud

Trop. Med. Infect. Dis. 2025, 10(4), 108; https://doi.org/10.3390/tropicalmed10040108 - 15 Apr 2025

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Abstract

Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) Salmonella Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal Salmonella antimicrobial susceptibility trends (including multi-drug resistance phenotypes; MDR) within a large health authority in British Columbia, Canada. Methods: This retrospective study [...] Read more.

Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) Salmonella Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal Salmonella antimicrobial susceptibility trends (including multi-drug resistance phenotypes; MDR) within a large health authority in British Columbia, Canada. Methods: This retrospective study included patients with Salmonella Typhi or Paratyphi A, B or C bacteremia identified at Fraser Health regional microbiology laboratory from 2018 to 2024. The primary outcome was the proportion of cases with MDR and XDR typhoidal Salmonella. Secondary outcomes included annual antimicrobial susceptibility for ampicillin, ceftriaxone, ciprofloxacin, trimethoprim-sulfamethoxazole, ertapenem, meropenem and azithromycin. Clinical outcomes included hospitalization length, and 30-day mortality, clinical cure and infection relapse. Results: Among 271 patients, most were previously healthy and recently travelled. There were extended spectrum beta-lactamase (1.1%) and MDR (1.5%) typhoidal Salmonella, with no XDR cases observed. In 2024, ciprofloxacin resistance was 96% while susceptibility rates were high for other studied antimicrobials. Within 30 days, no deaths were reported; however, six patients (3%) had infection relapse. Conclusions: Currently, in British Columbia, MDR typhoidal Salmonella remains rare. Empiric ciprofloxacin should be avoided due to persistently high resistance rates. With ongoing travel patterns, it is beneficial for institutions to continue typhoidal Salmonella antimicrobial susceptibility surveillance, and travelers should seek pre-travel health assessments. Full article

(This article belongs to the Special Issue Emerging Trends of Infectious Diseases in Canada)

7 pages, 216 KiB

Open AccessCase Report

Osteomyelitis Caused by Moesziomyces aphidis in an Immunocompetent Adult: A Case Report and Literature Review

by Yi-Ying Chen, Ting-Kuang Yeh, Chi-Jung Wu and Po-Yu Liu

Trop. Med. Infect. Dis. 2025, 10(4), 107; https://doi.org/10.3390/tropicalmed10040107 - 14 Apr 2025

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Abstract

Osteomyelitis caused by Moesziomyces aphidis is exceedingly rare and, to our knowledge, has not been previously reported in immunocompetent individuals. This case represents the first documented instance. A 19-year-old woman developed osteomyelitis following an open right leg fracture sustained in a traffic accident. [...] Read more.

Osteomyelitis caused by Moesziomyces aphidis is exceedingly rare and, to our knowledge, has not been previously reported in immunocompetent individuals. This case represents the first documented instance. A 19-year-old woman developed osteomyelitis following an open right leg fracture sustained in a traffic accident. Initial cultures yielded an unidentified yeast, later identified as M. aphidis through internal transcribed spacer sequencing. The patient demonstrated clinical improvement with combination therapy of amphotericin B and following oral voriconazole. This case underscores the emerging pathogenic potential of Moesziomyces spp., particularly in the setting of trauma and open wounds, and highlights the importance of including this genus in the differential diagnosis of osteomyelitis. A literature review indicates that Moesziomyces infections are predominantly observed in immunocompromised patients, especially in Asia. However, our case underscores the need for greater awareness of this emerging pathogen in immunocompetent hosts as well. Full article

(This article belongs to the Special Issue Monitoring and Diagnosis of Invasive Fungal Infections)

11 pages, 844 KiB

Open AccessArticle

Treatment-Decision Algorithm of Child TB: Evaluation of WHO Algorithm and Development of Indonesia Algorithm

by Rina Triasih, Finny Fitry Yani, Diah Asri Wulandari, Betty Weri Yolanda Nababan, Muhammad Buston Ardiyamustaqim, Fransiska Meyanti, Sang Ayu Kompiyang Indriyani, Tiffany Tiara Pakasi and Ery Olivianto

Trop. Med. Infect. Dis. 2025, 10(4), 106; https://doi.org/10.3390/tropicalmed10040106 - 14 Apr 2025

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Abstract

Clinical algorithms for child tuberculosis (TB) are a valuable guide for healthcare workers to initiate treatment. We evaluated the agreement of pediatric TB diagnosis using the current Indonesia diagnostic algorithms with the 2022 WHO treatment decision algorithm and developed a new Indonesia algorithm [...] Read more.

Clinical algorithms for child tuberculosis (TB) are a valuable guide for healthcare workers to initiate treatment. We evaluated the agreement of pediatric TB diagnosis using the current Indonesia diagnostic algorithms with the 2022 WHO treatment decision algorithm and developed a new Indonesia algorithm for child TB based upon our findings and expert opinion. We conducted a retrospective study at 10 hospitals in Indonesia, involving children (0–10 years), who were evaluated for TB diagnosis in 2022. A panel of child TB experts used participants’ records to make a diagnosis using the 2022 WHO algorithm and the 2016 Indonesian algorithm. We assessed agreement between the diagnosis made by the attending doctor and those determined by the expert panel. A new Indonesia guideline was developed based on the findings and consensus of various stakeholders. Of 523 eligible children, 371 (70.9%) were diagnosed with TB by the attending doctors, 295 (56.4%) by the WHO algorithm, and 246 (47%) by the Indonesia algorithm. The Cohen’s Kappa of TB diagnosis was: attending doctor vs. WHO algorithm (0.27), attending doctor vs. Indonesia algorithm (0.45), and WHO algorithm vs. Indonesia algorithm (0.42). A review of both algorithms revealed challenges for implementation. An algorithmic approach for child TB diagnosis may not be universally applicable or implementable due to variable access to diagnostic tests and the wide variety of clinical presentations. Full article

(This article belongs to the Special Issue Implementing TB Elimination Approaches in Indonesia: Operational Research on Case Finding, Treatment and Prevention of TB in Yogyakarta and Timika)

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12 pages, 511 KiB

Open AccessReview

The Antimicrobial Resistance–Water–Corporate Interface: Exploring the Connections Between Antimicrobials, Water, and Pollution

by Jason P. Burnham

Trop. Med. Infect. Dis. 2025, 10(4), 105; https://doi.org/10.3390/tropicalmed10040105 - 12 Apr 2025

Viewed by 346

Abstract

Antibiotic resistance is a public health emergency, with ten million deaths estimated annually by the year 2050. Water systems are an important medium for the development and dissemination of antibiotic resistance from a variety of sources, explored in this perspective review. Hospital wastewater [...] Read more.

Antibiotic resistance is a public health emergency, with ten million deaths estimated annually by the year 2050. Water systems are an important medium for the development and dissemination of antibiotic resistance from a variety of sources, explored in this perspective review. Hospital wastewater and wastewater systems more broadly are breeding grounds for antibiotic resistance because of the nature of their waste and how it is processed. Corporations from various sectors contribute to antibiotic resistance in many direct and indirect ways. Pharmaceutical factory runoff, agricultural antibiotic use, agricultural use of nitrogen fertilizers, heavy metal pollution, air pollution (atmospheric deposition, burning of oil and/or fossil fuels), plastic/microplastic pollution, and oil/petroleum spills/pollution have all been demonstrated to contribute to antibiotic resistance. Mitigation strategies to reduce these pathways to antibiotic resistance are discussed and future directions hypothesized. Full article

(This article belongs to the Special Issue Pathogen-Host-Environment Interactions: One-Health Perspectives and Solutions in Antimicrobial Resistance and Disease)

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9 pages, 1057 KiB

Open AccessBrief Report

Detection of Trypanosoma cruzi in a Reactive Blood Bank Sample in Sonora, Mexico

by Idalia Paredes-Sotelo, Mónica Reséndiz-Sandoval, Adriana Garibay-Escobar, Edgar Alfonso Paredes-González, Aracely Angulo-Molina, Angel Ramos-Ligonio, Eric Dumonteil, Claudia Herrera and Olivia Valenzuela

Trop. Med. Infect. Dis. 2025, 10(4), 104; https://doi.org/10.3390/tropicalmed10040104 - 11 Apr 2025

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Abstract

Chagas disease is a neglected disease caused by the parasite Trypanosoma cruzi, a public health problem in both endemic and non-endemic countries. In Mexico, the southern region is considered endemic, and cases are frequently reported; however, in the northwestern region, only a [...] Read more.

Chagas disease is a neglected disease caused by the parasite Trypanosoma cruzi, a public health problem in both endemic and non-endemic countries. In Mexico, the southern region is considered endemic, and cases are frequently reported; however, in the northwestern region, only a few cases are confirmed annually. This study describes, for the first time, the Discrete Typing Unit (DTU) of Trypanosoma cruzi in a volunteer blood donor rejected for being reactive in the northwestern region of Mexico. Seroreactivity was confirmed using “in-house” ELISAs which employed three different antigens: total extract from Trypanosoma cruzi isolated from a vector (Triatoma rubida) from Sonora (strain T1), strain H1 and CL-Brener. The molecular characterization of Trypanosoma cruzi was conducted by amplifying satellite DNA by qPCR and posterior sequencing of the mini-exon gene, using Next Generation Sequencing (NGS) to enhance the accuracy of genetic characterization. The results show that the reactive status of this blood donor was confirmed using our in-house ELISAs, and the presence of Trypanosoma cruzi by detecting TcI DTU confirmed the infection status. Full article

(This article belongs to the Special Issue Emerging Vector-Borne Diseases and Public Health Challenges)

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15 pages, 247 KiB

Open AccessArticle

Using a Machine Learning Approach to Predict Snakebite Envenoming Outcomes Among Patients Attending the Snakebite Treatment and Research Hospital in Kaltungo, Northeastern Nigeria

by Nicholas Amani Hamman, Aashna Uppal, Nuhu Mohammed, Abubakar Saidu Ballah, Danimoh Mustapha Abdulsalam, Frank Mela Dangabar, Nuhu Barde, Bello Abdulkadir, Suraj Abdullahi Abdulkarim, Habu Dahiru, Idris Mohammed, Trudie Lang and Joshua Abubakar Difa

Trop. Med. Infect. Dis. 2025, 10(4), 103; https://doi.org/10.3390/tropicalmed10040103 - 11 Apr 2025

Viewed by 912

Abstract

The Snakebite Treatment and Research Hospital (SBTRH) is a leading centre for snakebite envenoming care and research in sub-Saharan Africa, treating over 2500 snakebite patients annually. Despite routine data collection, routine analyses are seldom conducted to identify trends or guide clinical practices. This [...] Read more.

The Snakebite Treatment and Research Hospital (SBTRH) is a leading centre for snakebite envenoming care and research in sub-Saharan Africa, treating over 2500 snakebite patients annually. Despite routine data collection, routine analyses are seldom conducted to identify trends or guide clinical practices. This study retrospectively analyzes 1022 snakebite cases at SBTRH from January to June 2024. Most patients were adults (62%) and were predominantly male (72%). Key factors such as age, sex, and time between bite and hospital presentation were associated with outcomes, including recovery, amputation, debridement, and death. Adult males who took more than four hours to arrive to hospital were identified as a high-risk group for poor outcomes. Using patient characteristics, an XGBoost model was developed and was compared to Random Forest and logistic regression models. In general, all models had high positive predictive value and low sensitivity, meaning that if they predicted a patient to experience amputation, debridement, or death, that patient almost always actually experienced amputation, debridement, or death; however, most models rarely made this prediction. The XGBoost model with all features was optimal, given that it had both a high positive predictive value and relatively high sensitivity. This may be of significance to resource-limited settings like SBTRH, where antivenoms can be scarce; however, more research is needed to build better predictive models. These findings underscore the need for targeted interventions for high-risk groups, and further research and integration of machine-learning-driven decision support tools in low-resource-limited clinical settings. Full article

(This article belongs to the Special Issue Snake Bite: Prevention, Diagnosis and Treatment)

15 pages, 835 KiB

Open AccessArticle

Community-Based Tuberculosis Preventive Treatment Among Child and Adolescent Household Contacts in Ethiopia

by Eshetu Abelti, Zewdu Dememew, Asfawesen Gebreyohannes, Yohannes Alemayehu, Tilay Terfassa, Taye Janfa, Degu Jerene, Pedro Suarez and Daniel Datiko

Trop. Med. Infect. Dis. 2025, 10(4), 102; https://doi.org/10.3390/tropicalmed10040102 - 9 Apr 2025

Viewed by 304

Abstract

There are limited studies on the community-based outcomes of tuberculosis (TB) preventive treatment (TPT) among children and adolescent contacts <15 years in Ethiopia. Our objective was to assess TPT uptake and completion rates among eligible under-15-year-old TB household contacts through an enhanced community-based [...] Read more.

There are limited studies on the community-based outcomes of tuberculosis (TB) preventive treatment (TPT) among children and adolescent contacts <15 years in Ethiopia. Our objective was to assess TPT uptake and completion rates among eligible under-15-year-old TB household contacts through an enhanced community-based model of interventions. The study was conducted between July 2021 and June 2022 in twenty primary health care units in the Sidama and Southern Nations, Nationalities, and Peoples’ Region (SNNPR) regions. A total of 4367 (99.2%) household contacts of 1069 bacteriologically confirmed PTB index cases were symptomatically screened for TB by trained health extension workers (HEWs) at the community level. A total of 696 (15.9%) symptomatic contacts were identified, of which 694 (99.7%) were evaluated for TB, resulting in 60 (8.6%) TB cases. A total of 1567 (95.3%) asymptomatic children and adolescent contacts <15 years of age were initiated on TPT (88.8%) at health posts in the community. After the interventions, there was a significant increase in contact screening coverage (95.6% vs. 99.2%, Odds Ratio (OR), 5.54; 95% Confidence interval (CI), 2.93–10.13) and TPT uptake (81.7% vs. 95.4%; OR, 4.67; 95% CI, 2.54–8.23). The TPT completion rate was also 98.1% (of 1567). The TPT completion rate at health posts in the community was higher than the rate at health centers (99.4% vs. 88.0%; OR, 20.95; 95% CI, 8.97–52.71). TPT uptake and completion in children and adolescent contacts could be improved remarkably with the implementation of an enhanced community-based model of intervention in high-TB-burden districts. Full article

(This article belongs to the Special Issue Tuberculosis Control in Africa and Asia)

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24 pages, 2183 KiB

Open AccessArticle

Breaking the Cycle of Echinococcosis: A Mathematical Modeling Approach

by Richard Lagos, Juan Pablo Gutiérrez-Jara, Beatriz Cancino-Faure, Leidy Yissedt Lara-Díaz, Ignacio Barradas and Andrei González-Galeano

Trop. Med. Infect. Dis. 2025, 10(4), 101; https://doi.org/10.3390/tropicalmed10040101 - 9 Apr 2025

Viewed by 189

Abstract

This study presents a mathematical model of the transmission and spread of the Echinococcus granulosus parasite. The model incorporates host mobility, laws governing the dynamics of Echinococcosis transmission between hosts, and control and prevention measures. The basic reproductive number of the proposed model [...] Read more.

This study presents a mathematical model of the transmission and spread of the Echinococcus granulosus parasite. The model incorporates host mobility, laws governing the dynamics of Echinococcosis transmission between hosts, and control and prevention measures. The basic reproductive number of the proposed model is calculated, and a sensitivity analysis is performed to identify the parameters that most influence the dynamics of transmission and spread of the disease among its hosts. The study evaluates two control strategies—dog deworming and sheep vaccination—based on their respective target reproductive numbers. The impact of these control and prevention measures is investigated through numerical simulations, which reveal that the dog deworming strategy consistently reduces infections in humans. In contrast, the sheep vaccination strategy demonstrates a more favorable scenario for disease eradication in both hosts. In addition, simulations show a close relationship between the early detection of the disease and the recovery of the patient. 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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12 pages, 693 KiB

Open AccessArticle

Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever

by Mürşit Hasbek, Yasemin Çakır Kıymaz, Seyit Ali Büyüktuna and Hayrettin Yavuz

Trop. Med. Infect. Dis. 2025, 10(4), 99; https://doi.org/10.3390/tropicalmed10040099 - 8 Apr 2025

Viewed by 284

Abstract

Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease, causing clinical presentations ranging from asymptomatic infection to fatal viral hemorrhagic fever. Throughout the course of CCHF, the levels of certain biomarkers, such as platelets (PLTs), white blood cells (WBCs), C-reactive protein (CRP), and [...] Read more.

Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease, causing clinical presentations ranging from asymptomatic infection to fatal viral hemorrhagic fever. Throughout the course of CCHF, the levels of certain biomarkers, such as platelets (PLTs), white blood cells (WBCs), C-reactive protein (CRP), and interleukin-6 (IL-6), may vary, decreasing below or rising above normal limits. This study aimed to investigate the role of parameters such as WBC/PLT, WBC/IL-6, WBC/CRP, and WBC/D-dimer ratios in predicting disease prognosis in patients diagnosed with CCHF. The study population consisted of 60 CCHF patients and 30 controls. Statistically significant differences were observed in hemoglobin (HGB), PLT, WBC, activated partial thromboplastin time (aPTT), international normalized ratio (INR), fibrinogen, and d-dimer values between the patients and controls. Statistically significant differences were observed in WBC/aPTT, WBC/fibrinogen, WBC/D-dimer, and WBC/IL-6 values between the patient and control groups. WBC/INR and WBC/fibrinogen values were lower in fatal cases compared to survivors. WBC/D-dimer and WBC/IL-6 values, on the other hand, were higher in fatal cases compared to survivors. In patients requiring intensive care unit (ICU), WBC/PLT, WBC/INR, WBC/aPTT, and WBC/fibrinogen values were higher compared to those who did not. However, WBC/D-dimer and WBC/IL-6 values were lower in patients requiring ICU compared to those who did not. Full article

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

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12 pages, 1351 KiB

Open AccessArticle

HPV Genotype Trends in Iran: Necessity for a Reevaluation of Prevention Strategies

by Maryam Shahi, Azam Shafaei, Mohamad Ghodsi, Reza Jafarzadeh Esfehani and Mahdi Moradi Marjaneh

Trop. Med. Infect. Dis. 2025, 10(4), 100; https://doi.org/10.3390/tropicalmed10040100 - 8 Apr 2025

Viewed by 429

Abstract

Introduction: Human papillomavirus (HPV) genotyping is critical for preventing and managing HPV-related health issues, including cancers. This study re-evaluates HPV genotype trends in Iran to inform prevention strategies. Materials and Methods: A cross-sectional analysis of HPV genotyping data from individuals tested at the [...] Read more.

Introduction: Human papillomavirus (HPV) genotyping is critical for preventing and managing HPV-related health issues, including cancers. This study re-evaluates HPV genotype trends in Iran to inform prevention strategies. Materials and Methods: A cross-sectional analysis of HPV genotyping data from individuals tested at the ACECR Khorasan Razavi molecular laboratory in Iran (2016–2022) was conducted, with a forecast of genotype trends through 2027. Results: Among 5009 female patients, 40.4% tested positive for HPV (mean age: 32 ± 8.77 years), with a significant upward trend in positivity over time (tau = 0.905, p = 0.0069). HPV 6, 11, 16, 31, 53, and 54 showed significant increases (p < 0.01), while HPV 66, 84, 67, and 35 exhibited notable trends (p < 0.05). HPV 18 and 33 had marginal trends (p = 0.065, p = 0.052), and HPV 68, 70, and 82 remained stable. Linear regression indicated a non-significant decline in low-risk HPV cases (R = 0.703, p = 0.078) and negligible change in high-risk cases (R = 0.052, p = 0.912). Forecasts predicted increases in HPV 84, 54, 43, 42, and 26, with HPV 6 projected to decrease significantly. HPV 44, 73, and 33 were expected to remain stable. Conclusion: While low-risk HPV cases may decline, the trend lacks statistical significance, and high-risk HPV cases show no change. These findings underscore the need for targeted prevention strategies in Iran, particularly for high-risk genotypes, to reduce the burden of HPV-related cancers. Further research is essential to validate these trends and refine public health interventions. Full article

(This article belongs to the Special Issue Molecular Epidemiology of Human Papillomavirus Infection)

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16 pages, 803 KiB

Open AccessArticle

Vitamin D Status and Incidence of SARS-CoV-2 Reinfections in the Borriana COVID-19 Cohort: A Population-Based Prospective Cohort Study

by Salvador Domènech-Montoliu, Laura López-Diago, Isabel Aleixandre-Gorriz, Óscar Pérez-Olaso, Diego Sala-Trull, Alba Del Rio-González, Maria Rosario Pac-Sa, Manuel Sánchez-Urbano, Paloma Satorres-Martinez, Juan Casanova-Suarez, Cristina Notari-Rodriguez, Raquel Ruiz-Puig, Gema Badenes-Marques, Laura Aparisi-Esteve, Carmen Domènech-León, Maria Angeles Romeu-Garcia and Alberto Arnedo-Pena

Trop. Med. Infect. Dis. 2025, 10(4), 98; https://doi.org/10.3390/tropicalmed10040098 - 6 Apr 2025

Viewed by 364

Abstract

A deficient vitamin D (VitD) status has been associated with SARS-CoV-2 infections, severity, and mortality. However, this status related to SARS-CoV-2 reinfections has been studied little. Our aim was to quantify the risk of reinfections considering VitD status before reinfection. Methods: We performed [...] Read more.

A deficient vitamin D (VitD) status has been associated with SARS-CoV-2 infections, severity, and mortality. However, this status related to SARS-CoV-2 reinfections has been studied little. Our aim was to quantify the risk of reinfections considering VitD status before reinfection. Methods: We performed a population-based prospective cohort study in Borriana (Valencia Community, Spain) during 2020–2023, measuring 25-hydroxyvitamin D [25(OH)D] levels by electrochemiluminescence. Cox proportional hazards models were employed. Results: Of a total of 644 SARS-CoV-2 cases with confirmed laboratory tests, 378 (58.9%) were included in our study, with an average age of 38.8 years; 241 were females (63.8%), and 127 reinfections occurred (33.6%). SARS-CoV-2 reinfection incidence rates per 1000 person-days by VitD status were 0.50 for a deficient status (<20 ng/mL), 0.50 for an insufficient status (20–29 ng/mL), and 0.37 for a sufficient status (≥30 ng/mL). Compared with a sufficient VitD status, adjusted hazard ratios were 1.79 (95% confidence interval [CI] 0.89–3.59) for a deficient status and 1.59 (95% CI 1.06–2.38) for an insufficient status with a significant inverse dose–response (p = 0.02). These results can help improve nutritional actions against SARS-CoV-2 reinfections. Conclusions: These results suggest that a VitD status lower than 30 ng/mL showed a higher risk of SARS-CoV-2 reinfection. Achieving and maintaining a sufficient VitD status is recommended to prevent reinfections. Full article

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

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11 pages, 813 KiB

Open AccessArticle

COVID-19 in Morocco: Nurses’ Knowledge of Anti-COVID-19 Vaccines and Their Involvement in Vaccine Vigilance

by Fatima Zahra Laamiri, Manar Aarrad, Abdelmounaim Manoussi, Youssef Baba Khouya, Fatine Hadrya, Mohamed Chahboune and Amina Barkat

Trop. Med. Infect. Dis. 2025, 10(4), 97; https://doi.org/10.3390/tropicalmed10040097 - 6 Apr 2025

Viewed by 216

Abstract

The COVID-19 pandemic has highlighted the crucial role of nurses in managing health crises, particularly in implementing vaccination campaigns launched in many countries worldwide. This descriptive study assesses nurses’ knowledge of COVID-19 vaccines and their involvement in vaccine vigilance. Conducted over four months [...] Read more.

The COVID-19 pandemic has highlighted the crucial role of nurses in managing health crises, particularly in implementing vaccination campaigns launched in many countries worldwide. This descriptive study assesses nurses’ knowledge of COVID-19 vaccines and their involvement in vaccine vigilance. Conducted over four months in 2022 among 200 primary healthcare nurses in the Fès-Meknès region, the data were collected using a questionnaire developed and validated by a multidisciplinary team. The results show that 60% of participants self-reported being unaware of the nature of COVID-19 vaccines, and 49.5% did not understand the concept of vaccine pharmacovigilance. Additionally, 76.5% had not received any pharmacovigilance training in this pandemic context, 80% had never been in contact with pharmacovigilance centers, and 48.5% expressed a need for training in this field. One-third of the participants were unaware of severe adverse effects. The most frequently reported adverse effects were fever (76.5%), malaise (73%), and anxiety (63%). These results highlight the importance of strengthening continuous training and improving the coordination among various healthcare sector stakeholders to reduce vaccine hesitancy, enhance healthcare expertise, and ensure the effectiveness of vaccination campaigns during current and future pandemics. Full article

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

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7 pages, 3387 KiB

Open AccessCase Report

Tuberculous Meningitis in a Child: A Rare Presentation of Cytotoxic Lesion of the Corpus Callosum

by Ny Thi Hong Tran, Nhung Thi Hong Nguyen, Uyen Phuong Vo and Julie Huynh

Trop. Med. Infect. Dis. 2025, 10(4), 96; https://doi.org/10.3390/tropicalmed10040096 - 4 Apr 2025

Viewed by 195

Abstract

Tuberculous meningitis (TBM) is the most severe form of tuberculosis, disproportionately affecting vulnerable populations such as young children and people living with human immunodeficiency virus (HIV). Major challenges to accurate and early diagnosis of TBM are the non-specific clinical features which overlap with [...] Read more.

Tuberculous meningitis (TBM) is the most severe form of tuberculosis, disproportionately affecting vulnerable populations such as young children and people living with human immunodeficiency virus (HIV). Major challenges to accurate and early diagnosis of TBM are the non-specific clinical features which overlap with other infectious syndromes and the lack of adequately sensitive tests to detect Mycobacterium tuberculosis in the cerebrospinal fluid (CSF). Diagnosis is, therefore, still dependent on clinical suspicion along with clinical features, cerebrospinal fluid (CSF) characteristics and, where facilities are available, neuroimaging. Typical neuroimaging features of TBM include hydrocephalus, infarcts, tuberculomas and basal exudates; however, less well described are very rare features such as cytotoxic lesion of the corpus callosum (CLOCC), otherwise known as transient splenic lesion. We describe the first case report of a child with confirmed TBM who had a very rare presentation of CLOCC with complete recovery and present a literature review on the pathophysiology and alternative aetiologies where CLOCC is more commonly seen. Full article

(This article belongs to the Special Issue Tuberculosis Control in Africa and Asia)

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19 pages, 2080 KiB

Open AccessArticle

One Health Lens on Rabies: Human–Bat Interactions and Genomic Insights of Rabies Virus in Rural Lilongwe, Malawi

by Nathan Singano, Henson Kainga, Elisha Chatanga, Joseph Nkhoma, Gilson Njunga, Julius Chulu, Rabecca Tembo, Hirofumi Sawa and Walter Muleya

Trop. Med. Infect. Dis. 2025, 10(4), 95; https://doi.org/10.3390/tropicalmed10040095 - 4 Apr 2025

Viewed by 407

Abstract

Rabies, a fatal zoonotic disease, affects humans, domestic animals, and wildlife predominantly in Africa, Asia, and Latin America. In Malawi, rabies virus (RABV) is primarily transmitted by infected dogs, impacting humans and cattle. Lyssavirus has also been documented in insectivorous bats. A community [...] Read more.

Rabies, a fatal zoonotic disease, affects humans, domestic animals, and wildlife predominantly in Africa, Asia, and Latin America. In Malawi, rabies virus (RABV) is primarily transmitted by infected dogs, impacting humans and cattle. Lyssavirus has also been documented in insectivorous bats. A community survey near bat roosts assessed knowledge, attitudes, and practices regarding bat-borne zoonoses. Bat samples were tested for lyssavirus using RT-PCR, and RABV genomes from humans and domestic animals were sequenced and analysed phylogenetically. The survey revealed that 50% of participants consumed bat meat, and 47% reported bats entering their homes. Reduced bat presence indoors significantly lowered contact risk (aOR: 0.075, p = 0.021). All 23 bat samples tested negative for lyssavirus. Malawian RABV genomes, 11,801 nucleotides long, belonged to the Africa 1b lineage, showing >95% similarity with GenBank sequences. Phylogenetic analysis indicated close clustering with strains from Tanzania, Zimbabwe, and South Africa. Human and cattle strains shared 99% and 92% amino acid similarity with dog strains, respectively, with conserved critical sites and unique substitutions across all five RABV genes. Frequent human–bat interactions pose zoonotic risks. While no lyssavirus was detected in bats, ongoing surveillance is crucial. This first comprehensive genome analysis of Malawian RABVs highlights their regional transmission and signifies the need for regional collaboration in rabies control, community education, and further study of genetic adaptations. Full article

(This article belongs to the Special Issue Rabies Epidemiology, Control and Prevention Studies)

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25 pages, 2604 KiB

Open AccessReview

Combating Malaria: Targeting the Ubiquitin-Proteasome System to Conquer Drug Resistance

by Bazgha Sanaullah, Nguyen Van Truong, Tuyet-Kha Nguyen and Eun-Taek Han

Trop. Med. Infect. Dis. 2025, 10(4), 94; https://doi.org/10.3390/tropicalmed10040094 - 3 Apr 2025

Viewed by 260

Abstract

Malaria primarily affects developing nations and is one of the most destructive and pervasive tropical parasite infections. Antimalarial drug resistance, characterized by a parasite’s ability to survive and reproduce despite recommended medication doses, poses a significant challenge. Along with resistance to antimalarial drugs, [...] Read more.

Malaria primarily affects developing nations and is one of the most destructive and pervasive tropical parasite infections. Antimalarial drug resistance, characterized by a parasite’s ability to survive and reproduce despite recommended medication doses, poses a significant challenge. Along with resistance to antimalarial drugs, the rate of mutation a parasite undergoes, overall parasite load, drug potency, adherence to treatment, dosing accuracy, drug bioavailability, and the presence of poor-quality counterfeit drugs are some of the contributing factors that elicit opposition to treatment. The ubiquitin-proteasome system (UPS) has become a promising drug target for malaria because of its central importance in the parasite’s life cycle and its contribution to artemisinin resistance. Polymorphisms in the Kelch13 gene of Plasmodium falciparum are the best-known markers for artemisinin resistance and are associated with a highly active UPS. Certain proteasome inhibitors, which are the other key players of the UPS, have demonstrated activity against malarial parasites and the ability to work with artemisinin. This work describes how, through targeting the UPS, the greater effectiveness of antimalarial drugs—especially where there is strong resistance—can be achieved, which contributes to overcoming the drug resistance phenomenon in malaria. Full article

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17 pages, 1840 KiB

Open AccessArticle

Leveraging Artificial Intelligence to Predict Potential TB Hotspots at the Community Level in Bangui, Republic of Central Africa

by Kobto G. Koura, Sumbul Hashmi, Sonia Menon, Hervé G. Gando, Aziz K. Yamodo, Anne-Laure Budts, Vincent Meurrens, Saint-Cyr S. Koyato Lapelou, Olivia B. Mbitikon, Matthys Potgieter and Caroline Van Cauwelaert

Trop. Med. Infect. Dis. 2025, 10(4), 93; https://doi.org/10.3390/tropicalmed10040093 - 3 Apr 2025

Viewed by 572

Abstract

Tuberculosis (TB) is a global health challenge, particularly in the Central African Republic (CAR), which is classified as a high TB burden country. In the CAR, factors like poverty, limited healthcare access, high HIV prevalence, malnutrition, inadequate sanitation, low measles vaccination coverage, and [...] Read more.

Tuberculosis (TB) is a global health challenge, particularly in the Central African Republic (CAR), which is classified as a high TB burden country. In the CAR, factors like poverty, limited healthcare access, high HIV prevalence, malnutrition, inadequate sanitation, low measles vaccination coverage, and conflict-driven crowded living conditions elevate TB risk. Improved AI-driven surveillance is hypothesized to address under-reporting and underdiagnosis. Therefore, we created an epidemiological digital representation of TB in Bangui by employing passive data collection, spatial analysis using a 100 × 100 m grid, and mapping TB treatment services. Our approach included estimating undiagnosed TB cases through the integration of TB incidence, notification rates, and diagnostic data. High-resolution predictions are achieved by subdividing the area into smaller units while considering influencing variables within the Bayesian model. By designating moderate and high-risk hotspots, the model highlighted the potential for precise resource allocation in TB control. The strength of our model lies in its adaptability to overcome challenges, although this may have been to the detriment of precision in some areas. Research is envisioned to evaluate the model’s accuracy, and future research should consider exploring the integration of multidrug-resistant TB within the model. Full article

(This article belongs to the Section Infectious Diseases)

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14 pages, 2687 KiB

Open AccessArticle

Baseline Seroprevalence of Arboviruses in Liberia Using a Multiplex IgG Immunoassay

by Albert To, Varney M. Kamara, Davidetta M. Tekah, Mohammed A. Jalloh, Salematu B. Kamara, Teri Ann S. Wong, Aquena H. Ball, Ludwig I. Mayerlen, Kyle M. Ishikawa, Hyeong Jun Ahn, Bode Shobayo, Julius Teahton, Brien K. Haun, Wei-Kung Wang, John M. Berestecky, Vivek R. Nerurkar, Peter S. Humphrey and Axel T. Lehrer

Trop. Med. Infect. Dis. 2025, 10(4), 92; https://doi.org/10.3390/tropicalmed10040092 - 3 Apr 2025

Viewed by 1250

Abstract

Insect-borne viruses may account for a significant proportion of non-malaria and non-bacterial febrile illnesses in Liberia. Although the presence of many arthropod vectors has been documented, the collective burden of arbovirus infections and baseline pre-existing immunity remains enigmatic. Our goal was to determine [...] Read more.

Insect-borne viruses may account for a significant proportion of non-malaria and non-bacterial febrile illnesses in Liberia. Although the presence of many arthropod vectors has been documented, the collective burden of arbovirus infections and baseline pre-existing immunity remains enigmatic. Our goal was to determine the seroprevalence of arbovirus exposure across the country using a resource-sparing, multiplex immunoassay to determine IgG responses to immunodominant antigens. 532 human serum samples, from healthy adults, collected from 10 counties across Liberia, were measured for IgG reactivity against antigens of eight common flavi-, alpha-, and orthobunya/nairoviruses suspected to be present in West Africa. Approximately 32.5% of our samples were reactive to alphavirus (CHIKV) E2, ~7% were reactive separately to West Nile (WNV) and Zika virus (ZIKV) NS1, while 4.3 and 3.2% were reactive to Rift Valley Fever virus (RVFV) N and Dengue virus-2 (DENV-2) NS1, respectively. Altogether, 21.6% of our samples were reactive to ≥1 flavivirus NS1s. Of the CHIKV E2 reactive samples, 8.5% were also reactive to at least one flavivirus NS1, and six samples were concurrently reactive to antigens of all three arbovirus groups, suggesting a high burden of multiple arbovirus infections for some participants. These insights suggest the presence of these four arbovirus families in Liberia with low and moderate rates of flavi- and alphavirus infections, respectively, in healthy adults. Further confirmational investigation, such as mosquito surveillance or other serological tests, is warranted and should be conducted before initiating additional flavivirus vaccination campaigns. The findings of these studies can help guide healthcare resource mobilization, vector control, and animal husbandry practices. Full article

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

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12 pages, 547 KiB

Open AccessArticle

Strongyloidiasis Treatment Outcomes: A Prospective Study Using Serological and Molecular Methods

by Ana Lucas Dato, Philip Wikman-Jorgensen, José María Saugar Cruz, Elisa García-Vázquez and Jara Llenas-García

Trop. Med. Infect. Dis. 2025, 10(4), 91; https://doi.org/10.3390/tropicalmed10040091 - 1 Apr 2025

Viewed by 265

Abstract

Strongyloidiasis, caused by the soil-transmitted helminth Strongyloides stercoralis, is estimated to infect around 600 million people worldwide. Ivermectin is the current first-line treatment. This prospective study evaluated long-term treatment response in patients with chronic strongyloidiasis. Conducted from 2019 to 2022 at Vega [...] Read more.

Strongyloidiasis, caused by the soil-transmitted helminth Strongyloides stercoralis, is estimated to infect around 600 million people worldwide. Ivermectin is the current first-line treatment. This prospective study evaluated long-term treatment response in patients with chronic strongyloidiasis. Conducted from 2019 to 2022 at Vega Baja Hospital in Alicante, Spain, this study enrolled 28 patients diagnosed with S. stercoralis infection. Patients received ivermectin at a dosage of 200 mcg/kg for one or two days and were followed for at least 12 months, with evaluations at 3, 6, 12, and 18 months post-treatment. Assessments included hemogram, IgE, Strongyloides serology, larvae culture and direct visualization and Strongyloides PCR in stool. Twenty-three patients completed at least 12 months of follow-up. Twenty-one patients (91.3%) achieved treatment response. Two patients (8.6%) experienced parasitological treatment failure, with detectable Strongyloides stercoralis DNA during follow-up. Ivermectin is highly effective in treating strongyloidiasis, with serology aiding in monitoring treatment efficacy. However, PCR detected an additional case of persistent infection, underscoring its complementary role. Full article

(This article belongs to the Special Issue Advances in Parasitic Neglected Tropical Diseases)

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16 pages, 4252 KiB

Open AccessPerspective

Building Pathogen Genomic Sequencing Capacity in Africa: Centre for Epidemic Response and Innovation Fellowship

by Eric Agboli, Molalegne Bitew, Christian N. Malaka, Tiangay M. P. S. Kallon, Alhaji M. S. Jalloh, Baron Yankonde, Doreen M. Shempela, Jay F. M. Sikalima, Mutale Joseph, Mpanga Kasonde, Feleke M. Demeke, Ayemfouo F. I. Valdese, Lele B. Grace, Godwe Célestin, Ana Papkiauri, Sado Y. F. Berlange, Janet Majanja, Vane K. Omwenga, Evalyne N. Wambugu, Samuel M. Kariuki, Alex A. Mwanyongo, Ubheeram Jaykissen, Caroline Abanto Alvarez, Seyni Ndiaye, Benjamin Moswane, Ester K. Adamson, Mariam Makange, Luka Sote, Ibrahimm Mugerwa, Julius Sseruyange, Patrick Semanda, Brian A. Kagurusi, Abdualmoniem O. Musa, Kourush Fassihi, Lavanya Singh and Monika Moir Show full author list Hide full author list

Trop. Med. Infect. Dis. 2025, 10(4), 90; https://doi.org/10.3390/tropicalmed10040090 - 31 Mar 2025

Viewed by 764

Abstract

The World Health Organization African region has the greatest infectious disease burden in the world. However, many African countries have limited capacity to rapidly detect, report, and respond to public health events. The Centre for Epidemic Response and Innovation (CERI), KwaZulu-Natal Research Innovation [...] Read more.

The World Health Organization African region has the greatest infectious disease burden in the world. However, many African countries have limited capacity to rapidly detect, report, and respond to public health events. The Centre for Epidemic Response and Innovation (CERI), KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) in South Africa, and global Climate Amplified Diseases and Epidemics (CLIMADE) consortium are investing in building the capacity of African scientists in pathogen genomics and bioinformatics. A two-week long (11–21 April 2023) intensive training in wet-laboratory genomic data production, bioinformatics, and phylogenetic analyses of viral and bacterial pathogens was held in Cape Town, South Africa. Training was provided to 36 fellows with diverse backgrounds from 16 countries, 14 of which were low- and middle-income African countries. In this report, we, the fellows, share our collective experiences and describe how the learnt skills have been integrated into the operations of our home institutions to advance genomic surveillance capabilities. We identified the in-person and hands-on learning format of the training, taught by genomics experts and field application specialists, as the most impactful elements of this training event. Adaptation and miniaturisation of protocols to detect other pathogens is a great enhancement over the traditional method of using a single protocol for a pathogen. We note the duration of the training as the largest limiting factor, particularly for the computationally intensive bioinformatics sessions. We recommend this programme continue to build pathogen genomics capacity in Africa. Full article

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11 pages, 431 KiB

Open AccessReview

A Narrative Review on the Prevalence of Plasmodium falciparum Resistance Mutations to Antimalarial Drugs in Rwanda

by Muharib Alruwaili, Abozer Elderdery, Emad Manni and Jeremy Mills

Trop. Med. Infect. Dis. 2025, 10(4), 89; https://doi.org/10.3390/tropicalmed10040089 - 29 Mar 2025

Viewed by 392

Abstract

Malaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disease [...] Read more.

Malaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disease complications. Cultural factors such as unawareness of and disinterest in using recommended preventive tools and combating the primary host (i.e., the female Anopheles mosquito) play a significant role. This host transmits the malaria-causing Plasmodium parasite by biting an infected individual and spreading it to humans. The current overview focuses on the molecular markers associated with antimalarial drug resistance in Plasmodium falciparum (P. falciparum) in Rwanda, considered an exemplar of sub-Saharan countries where malaria is prevalent and effective policies on the development of malaria treatment, approved recently by WHO in 2025, have been adopted. The prevalence of mutations in key resistance genes, including pfcrt, pfmdr1, and pfdhfr/pfdhps, are linked to resistance against common antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine (SP). In addition, the Plasmodium falciparum kelch13 (pfk13) gene is linked to resistance against artemisinin, as its mutations can cause delayed parasite clearance and treatment failure. Despite changes in therapeutic use policies owing to high prevalence of variant alleles, which reduce the drug’s efficacy resistance to SP, the gene persists in Rwanda. Malaria parasites are becoming more resistant to chloroquine, leading to diminished effectiveness and slower recovery or treatment failure. Surveillance data reported from several studies provide crucial insights into the evolving trends of resistance markers and are vital for guiding treatment protocols and informing therapeutic use policy decisions. It is important that we continue to maintain and develop the effectiveness of malaria prevention strategies and treatments, due to the multiple types of resistance found in the population. Full article

(This article belongs to the Special Issue The Global Burden of Malaria and Control Strategies)

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17 pages, 4425 KiB

Open AccessArticle

Epidemiological Scenario of American Trypanosomiasis and Its Socioeconomic and Environmental Relations, Pará, Eastern Brazilian Amazon

by Claudia do Socorro Carvalho Miranda, Bruna Costa de Souza, Tainara Carvalho Garcia Miranda Filgueiras, João Simão de Melo Neto, Amanda Sophia Carvalho Miranda da Silva, Hilton Pereira da Silva, Marcos Valério Santos da Silva, Frederico Itã Mateus Carvalho Oliveira Miranda, Edilene do Socorro Nascimento Falcão Sarges, Sérgio Luiz Althoff, Selma Kazumi da Trindade Noguchi and Nelson Veiga Gonçalves

Trop. Med. Infect. Dis. 2025, 10(4), 88; https://doi.org/10.3390/tropicalmed10040088 - 28 Mar 2025

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Abstract

Chagas disease is a serious public health problem worldwide. In Brazil, the state of Pará has the largest number of reported cases. This article analyzes the spatial distribution of this disease and its relationship with socioeconomic, environmental, and public policy health variables in [...] Read more.

Chagas disease is a serious public health problem worldwide. In Brazil, the state of Pará has the largest number of reported cases. This article analyzes the spatial distribution of this disease and its relationship with socioeconomic, environmental, and public policy health variables in three mesoregions in the Pará state from 2013 to 2022. This ecological study used secondary data obtained from official Brazilian agencies. Spatial analysis was carried out using the flow, kernel, and bivariate global Moran techniques expressed in thematic maps. A total of 3664 cases of the disease were confirmed, with the highest number of cases being reported in the northeast of Pará. A seasonal pattern of the disease, an epidemiological profile similar to other diseases in the Amazon region, and the spatial dependence between the disease prevalence and socioeconomic indicators were observed. The most intense movement of patients for treatment was to the Belém metropolitan mesoregion, which has the majority of the health services and professionals. The disease showed an inhomogeneous pattern of cases in terms of the spatial distribution, with a direct relationship between areas with a higher number of cases and those with human clusters. The socioenvironmental origins of the disease transcend mesoregion boundaries and stem from the historically unsustainable development model in the Amazon. Full article

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Open AccessSystematic Review

Assessing Insect Growth Regulator Resistance Using Bioassays: A Systematic Review and Meta-Analysis of Methoprene and Pyriproxyfen Inhibition of Emergence in Three Vector Mosquito Species

by Mark E. Clifton and Kristina Lopez

Trop. Med. Infect. Dis. 2025, 10(4), 87; https://doi.org/10.3390/tropicalmed10040087 - 28 Mar 2025

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Abstract

This systematic review and meta-analysis aims to: (1) characterize the distribution of published inhibition of emergence (IE₅₀, IE₉₀, and IE₉₅) reference values for pyriproxyfen and methoprene in Culex pipiens [L.], Aedes aegypti [L.], and Aedes albopictus [Skuse]; [...] Read more.

This systematic review and meta-analysis aims to: (1) characterize the distribution of published inhibition of emergence (IE₅₀, IE₉₀, and IE₉₅) reference values for pyriproxyfen and methoprene in Culex pipiens [L.], Aedes aegypti [L.], and Aedes albopictus [Skuse]; (2) generate combined-effect IE values using a DerSimonian and Laird (DL) random-effects model to establish benchmarks for future resistance assessments; and (3) compare these combined-effect IE values with previously published literature. A systematic search was conducted in PubMed, SciELO, J-STAGE, and Google Scholar up to 10 February 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were primary, peer-reviewed literature that aligned with World Health Organization (WHO) protocols for insect growth regulator (IGR) resistance testing, specifically those reporting susceptible reference IE values from continuous immersion dose-response bioassays analyzed using probit regression. A total of 72 unique studies that aligned with WHO protocols were assessed for publication bias using a funnel plot and Egger’s regression. Sensitivity and subgroup analyses were conducted to evaluate individual study contributions to the overall combined effect. Heterogeneity (I²) and combined effect values were estimated for 18 different species/active ingredient/IE concentration subgroup pairings. Heterogeneity (I²) ranged from 29.32 to 99.78% between the 18 subgroups, indicating inconsistency within the literature. The DL combined effect IE₅₀ varied from 0.048 ppb for Cx. pipiens exposed to pyriproxyfen to 1.818 ppb for Ae. albopictus exposed to methoprene. A certainty analysis indicated that 1 combined effect value exhibited high certainty, 8 out of 18 pairings were moderately certain, 6 exhibited low certainty and 3 exhibited very low certainty. The main causes of uncertainty (ranked) were inconsistency between studies, imprecision of the combined effect size, and possible publication bias. Our findings indicate that (1) robust DL combined effect IE₅₀ values could be established for all species/IGR pairings, providing essential benchmarks for future resistance assessments; (2) substantial heterogeneity among susceptible laboratory colonies complicates resistance detection in field-collected mosquitoes; and (3) a significant portion of the literature relies on reference mosquito strains that are likely not fully susceptible, further complicating resistance detection. This study was not registered and was supported by the North Shore Mosquito Abatement District. Full article

(This article belongs to the Special Issue Mosquito-Borne Diseases: Intervention Strategies Used to Control Mosquito Populations and Reduce Disease Transmission)

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Trop. Med. Infect. Dis., Volume 10, Issue 4 (April 2025) – 33 articles

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