Tropical Medicine and Infectious Disease

16 pages, 1596 KiB

Open AccessArticle

Acute Immunological Biomarkers for Predicting Chronic Rheumatologic Disease After Chikungunya Virus Infection

by Anyela Lozano-Parra, Víctor Herrera, Luis Ángel Villar, Silvio Urcuqui-Inchima, Juan Felipe Valdés-López and Elsa Marina Rojas Garrido

Trop. Med. Infect. Dis. 2025, 10(7), 195; https://doi.org/10.3390/tropicalmed10070195 - 11 Jul 2025

Abstract

Early biomarkers are needed to predict the long-term persistence of rheumatical symptoms in patients infected with Chikungunya virus (CHIKV). This nested case-control study aimed to assess immunological factors during the early phases of CHIKV infection to predict the risk of post-CHIK chronic rheumatism [...] Read more.

Early biomarkers are needed to predict the long-term persistence of rheumatical symptoms in patients infected with Chikungunya virus (CHIKV). This nested case-control study aimed to assess immunological factors during the early phases of CHIKV infection to predict the risk of post-CHIK chronic rheumatism (pCHIK-CR) in adult patients of two prospective cohorts. We evaluated 46 febrile patients (median age: 33.5 years; IQR: 19 years; women: 50.0%) with CHIKV infection confirmed during the 2014–2015 outbreak in Santander, Colombia. The participants were classified by a rheumatologist as either cases (pCHIK-CR) or controls (WoRM, without rheumatical manifestations). We quantified serum levels of IL-4, IL-6, IL-8/CXCL-8, IL-27, CCL-2, CXCL-9, CXCL-10, and IgG using Luminex and ELISA assays during the acute and subacute phases of infection. Then, we evaluated the association of these immune factors with the case-control status using piecewise logistic regression adjusted for age and sex. There were non-linear associations between IL-8/CXCL-8, CXCL-9, and CXCL-10 with pCHIK-CR. Increases in the levels of IL-8/CXCL-8 (<35.7 pg/mL), CXCL-9 (≥6000 pg/mL), and CXCL-10 (≥36,800 pg/mL) were significantly associated with a reduced risk of pCHIK-CR (adjusted ORs: 0.85, 0.96, and 0.94, respectively). These results suggest that increases in IL-8/CXCL-8, CXCL-9, and CXCL-10 levels, measured in the early stages of CHIKV infection, may predict a chronic disease risk. This suggests the possibility that an early and strong immune response could contribute to enhancing CHIKV control and potentially reduce the risk of persistent joint symptoms. Given their expression patterns and timing, these three immune factors may be considered promising biomarker candidates for assessing the risk of chronic rheumatologic disease. These findings should be considered as exploratory and validated in additional cohort studies. Full article

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16 pages, 268 KiB

Open AccessArticle

Series 2: Development of a Multiplex Amplicon Next Generation Sequencing Assay for Rapid Assessment of Resistance-Associated Mutations in M. tuberculosis Clinical Cases

by Adriana Cabrera, Tracy Lee, Kathleen Kolehmainen, Trevor Hird, Danielle Jorgensen, Calvin Ka-Fung Lo, Hasan Hamze, Alan O’Dwyer, Dan Fornika, Rupinder Kaur KhunKhun, Mabel Rodrigues, Natalie Prystajecky, John Tyson, James E. A. Zlosnik and Inna Sekirov

Trop. Med. Infect. Dis. 2025, 10(7), 194; https://doi.org/10.3390/tropicalmed10070194 - 10 Jul 2025

Abstract

Treatment of Mycobacterium tuberculosis requires multi-drug regimens, and resistance to any individual antibiotic can compromise outcomes. For slow-growing organisms like M. tuberculosis, rapid detection of resistance-conferring mutations enables timely initiation of effective therapy. Conversely, confirming wild-type status in resistance-associated genes supports confidence [...] Read more.

Treatment of Mycobacterium tuberculosis requires multi-drug regimens, and resistance to any individual antibiotic can compromise outcomes. For slow-growing organisms like M. tuberculosis, rapid detection of resistance-conferring mutations enables timely initiation of effective therapy. Conversely, confirming wild-type status in resistance-associated genes supports confidence in standard regimens. We developed an amplicon-based next generation sequencing (amplicon tNGS) assay on the Illumina platform targeting eight genes linked to resistance to isoniazid, rifampin, ethambutol, pyrazinamide, and fluoroquinolones. Sequencing results were analyzed using a custom bioinformatics pipeline. Forty-seven samples were used for assay development, and 37 additional samples underwent post-implementation clinical validation. Compared to whole genome sequencing (WGS), amplicon tNGS demonstrated 97.7% sensitivity, 98.9% specificity, and 98.7% overall accuracy for variant detection in targeted regions. Resistance prediction showed 79.3% concordance with WGS; discrepancies were primarily due to mutations outside of target regions. Among post-implementation samples, 27/37 passed quality metrics for all targets, with 95.7% concordance between amplicon tNGS results and final susceptibility results. This assay is now in use in our laboratory and offers significantly faster turnaround than both WGS and phenotypic methods on cultured isolates, enabling more rapid, informed treatment decisions for tuberculosis patients. Full article

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

15 pages, 626 KiB

Open AccessReview

Prediction of Mortality by Clinical Laboratory Parameters in Severe Fever with Thrombocytopenia Syndrome: A Meta-Analysis

by Shicui Yan, Xuebin Ding, Qiao Gao, Lili Zhao, Cong Li, Zhenlu Sun and Xuejun Ma

Trop. Med. Infect. Dis. 2025, 10(7), 193; https://doi.org/10.3390/tropicalmed10070193 - 9 Jul 2025

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Abstract

Background: This study intended to fully assess the predictive efficiency of different clinical laboratory parameters for the mortality risk in severe fever with thrombocytopenia syndrome (SFTS). Methods: We systematically searched the Web of Science, PubMed, Cochrane Library, and Embase up to 13 December [...] Read more.

Background: This study intended to fully assess the predictive efficiency of different clinical laboratory parameters for the mortality risk in severe fever with thrombocytopenia syndrome (SFTS). Methods: We systematically searched the Web of Science, PubMed, Cochrane Library, and Embase up to 13 December 2024 for studies on the association of laboratory parameters with SFTS mortality. Two investigators were independently responsible for the study screening and data extraction, and they assessed the study quality using the Newcastle–Ottawa Scale (NOS). Stata17.0 was adopted for the meta-analyses. Results: We finally included 33 observational studies involving 9502 participants (1799 deaths and 7703 survivors). The results showed that increases in the viral load (odds ratio (OR) 1.93, 95% confidence interval (CI) 1.56–2.38), neutrophil-to-lymphocyte ratio (hazard ratio (HR) 1.31, 95% CI 1.13–1.51), neutrophil percentage (HR 1.02, 95% CI 1.01–1.03), white blood cells (HR 1.06, 95% CI 1.01–1.11), activated partial thromboplastin time (OR 1.07, 95% CI 1.04–1.09), prothrombin time (OR 1.31, 95% CI 1.03–1.65), creatine kinase-myocardial band (OR 1.01, 95% CI 1.01–1.02), and procalcitonin (HR 1.27, 95% CI 1.10–1.47) greatly increased the SFTS mortality, while decreases in the lymphocyte percentage (HR 0.96, 95% CI 0.94–0.98), platelets (HR 0.98, 95% CI 0.97–0.99), and albumin (HR 0.91, 95% CI 0.86–0.96) also greatly increased the SFTS mortality; the results were all statistically significant (p < 0.05). Conclusion: Abnormalities of laboratory parameters (e.g., viral load, blood routine, coagulation, multi-organ dysfunction, and inflammation indicators) are good predictors of SFTS mortality, which can provide valuable references in clinical practice. Full article

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18 pages, 1386 KiB

Open AccessArticle

Series 1: The Use of hsp65- and erm(41)-Targeted Amplicon Sequencing in the Diagnostic Workflow for Non-Tuberculous Mycobacteria

by Tracy Lee, Adriana Cabrera, Kathleen Kolehmainen, Trevor Hird, Danielle Jorgensen, Alan O’Dwyer, Dan Fornika, Rupinder Kaur KhunKhun, Mabel Rodrigues, Natalie Prystajecky, John Tyson, Inna Sekirov and James E. A. Zlosnik

Trop. Med. Infect. Dis. 2025, 10(7), 192; https://doi.org/10.3390/tropicalmed10070192 - 9 Jul 2025

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Abstract

Evolving technologies available to clinical laboratories and laboratory-related updates to clinical guidelines both drive the need for clinical laboratories to keep their test menu updated and in line with current technological and clinical developments. Our laboratory has developed a targeted Illumina-based amplicon next-generation [...] Read more.

Evolving technologies available to clinical laboratories and laboratory-related updates to clinical guidelines both drive the need for clinical laboratories to keep their test menu updated and in line with current technological and clinical developments. Our laboratory has developed a targeted Illumina-based amplicon next-generation sequencing (NGS) assay to interrogate the hsp65 and erm(41) genes of Mycobacterium spp. for the purposes of providing species-level ± subspecies-level identification of Mycobacterium spp. organisms in clinical samples and genotypic predictions for inducible macrolide resistance (in the case of M. abscessus complex members). The developed assay demonstrated 100% sensitivity and specificity for M. tuberculosis and M. abscessus complex cultured organisms, 98% ID overall concordance relative to the available reference identification, and a nearly 60% “rescue” rate for primary samples that could not be identified using our previous method. There was 94.6% concordance between genotypic and phenotypic results for inducible macrolide resistance. The developed assay was successfully implemented in our clinical laboratory and has been accredited for clinical use. Full article

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

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13 pages, 1871 KiB

Open AccessArticle

Impact of Health Education on Infectious Disease Knowledge in Indigenous Communities in Northwestern Malaysia

by Barathan Muttiah, Wathiqah Wahid and Alfizah Hanafiah

Trop. Med. Infect. Dis. 2025, 10(7), 191; https://doi.org/10.3390/tropicalmed10070191 - 9 Jul 2025

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Abstract

Indigenous people possess unique health literacy issues and challenges with preventing infectious diseases. This research assessed the baseline knowledge and misinformation in the Semai indigenous subgroup in Perak state, Malaysia, and the impact of a culturally adapted health education intervention. A single-group pre-test/post-test [...] Read more.

Indigenous people possess unique health literacy issues and challenges with preventing infectious diseases. This research assessed the baseline knowledge and misinformation in the Semai indigenous subgroup in Perak state, Malaysia, and the impact of a culturally adapted health education intervention. A single-group pre-test/post-test design was used with 156 participants ranging from 7 to 69 years old, predominantly children. The survey addressed key issues of head lice, intestinal parasites, tuberculosis (TB), handwashing, and germ transmission. An interactive, multi-station health education session in the local language produced a significant increase in overall knowledge (mean score increased from 3.17 to 3.83 out of 5, p < 0.0001), with the largest increase among the adult group aged 31–50 years. This was most notable for handwashing knowledge, which had the greatest increase, and misconceptions about intestinal worms and head lice remained. Differences in outcome by age suggest the need for targeted educational strategies, particularly for teenagers and elderly individuals who achieved less gain. The results support the effectiveness of culturally tailored, community-based health education in promoting the awareness of disease among indigenous communities. The drawbacks are convenience sampling, the child dominance of the sample, and the short-term follow-up. Future emphasis should be placed on long-term, community-based intervention using culturally tailored content and digital media. Full article

(This article belongs to the Section Infectious Diseases)

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12 pages, 251 KiB

Open AccessArticle

Risk of Latent Tuberculosis Infection Reactivation in Patients Treated with Tumor Necrosis Factor Antagonists: A Five-Year Retrospective Study

by Işıl Deniz Alıravcı, Pınar Mutlu, Sibel Oymak, Ufuk Ilter Guney and Oguzhan Keskin

Trop. Med. Infect. Dis. 2025, 10(7), 190; https://doi.org/10.3390/tropicalmed10070190 - 7 Jul 2025

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Abstract

Background: This study aims to reveal the demographic and clinical data of patients receiving TNF-α blockers, to compare the characteristics of those who received latent tuberculosis infection (LTBI) treatment and those who did not, and to evaluate and determine potential risk factors for [...] Read more.

Background: This study aims to reveal the demographic and clinical data of patients receiving TNF-α blockers, to compare the characteristics of those who received latent tuberculosis infection (LTBI) treatment and those who did not, and to evaluate and determine potential risk factors for developing active TB disease. Methods: A systematic retrospective study was conducted in a tertiary university hospital examining all patients receiving at least one TNF-α blocker between January 2019 and October 2024. The incidence of tuberculosis (TB) was analyzed across various TNF-α blocker medications in patients, both with and without LTBI treatment. Results: A total of 519 patients had TNF-α blockers: 452 (87.09%) underwent TST, 193 (37.1%) underwent booster TST, and 33 (6.3%) underwent IGRA/TST; 362 (69.7%) were treated for LTBI, and 7 (1.3%) developed TB. Comparing all TNF-α blockers, adalimumab showed a higher risk of TB. Patients with and without LTBI treatment did not significantly differ in TB incidence after biologic therapy. Conclusions: The incidence of TB in people taking TNF-α blockers was higher compared to the incidence in the general population. LTBI screening, including both TST and IGRA, should be performed with TST and IGRA tests, and LTBI-positive individuals should be started on preventive treatment. However, it should not be forgotten that active TB disease may also develop in LTBI-negative individuals. Full article

(This article belongs to the Special Issue Tuberculosis in Special Populations: Epidemiology and Evidence-Based Interventions)

12 pages, 574 KiB

Open AccessReview

An Overview of Dengue Knowledge, Attitudes, and Practices (KAPs) Among the General Public in Sri Lanka: A Review and Meta-Analysis of Questionnaire-Based Surveys from 2000–2023

by Nilmini Chandrasena, Dileepa Ediriweera, Deshaka Jayakody, Nayana Gunathilaka and Ranjan Premaratna

Trop. Med. Infect. Dis. 2025, 10(7), 189; https://doi.org/10.3390/tropicalmed10070189 - 6 Jul 2025

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Abstract

The objective was to conduct a review and meta-analysis of questionnaire-based surveys of dengue knowledge, attitudes, perceptions, and practices (KAP)s among the general public in Sri Lanka as no prior island-wide survey existed. The electronic database PubMed and other bibliography were searched for [...] Read more.

The objective was to conduct a review and meta-analysis of questionnaire-based surveys of dengue knowledge, attitudes, perceptions, and practices (KAP)s among the general public in Sri Lanka as no prior island-wide survey existed. The electronic database PubMed and other bibliography were searched for literature on dengue questionnaire-based KAP surveys in Sri Lanka from 2000–2023. Data pertaining to the three domains were extracted from sixteen eligible articles, pooled, and analyzed separately using random effect models. Meta-analyses of the three domains were performed using R version 3.6.3. The population surveyed (8955) was <0.045% of the total Sri Lankan population. The publication frequency increased over time and surveys were distributed in Colombo and suburbs 43.7% (7/16), Kandy 25% (4/16,) Gampaha 12.5% (2/16), and 6.3% (1/16) one each in Kurunegala, Matara, Batticaloa, and Jaffna. Knowledge on dengue transmission, vector breeding, and fever as a symptom was >80%, while on vector species, preferred feeding times, recurrence of dengue it was > 55% and on warning signs of severity it was 25%. Attitudes towards community participation in dengue prevention activities and knowledge of dengue risk factors (avoidance of aspirin and dark colored drinks) were poor, while practice of control measures (removal of water collecting receptacles, roof-gutter management) lacked regularity. Full article

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

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12 pages, 1648 KiB

Open AccessArticle

Spatiotemporal Distribution of Hand, Foot, and Mouth Disease and the Influence of Air Pollutants and Socioeconomic Factors on Incidence in Fujian, China

by Meirong Zhan, Shaojian Cai, Zhonghang Xie, Senshuang Zheng, Zhengqiang Huang, Jianming Ou and Shenggen Wu

Trop. Med. Infect. Dis. 2025, 10(7), 188; https://doi.org/10.3390/tropicalmed10070188 - 3 Jul 2025

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Abstract

Background: Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence. Methods: Daily reported HFMD [...] Read more.

Background: Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence. Methods: Daily reported HFMD case data, daily air pollutant data, and socioeconomic data in Fujian Province from 2014 to 2023 were collected for analysis. A descriptive analysis was used to describe the epidemiological trends of HFMD. Spatial autocorrelation analysis was applied to explore the spatiotemporal clustering characteristics. The associations between risk factors and HFMD incidence were evaluated using the generalized additive model (GAM). Results: HFMD incidence in Fujian has decreased since 2019, and the peak in each year occurred between May and June. Distinct high–high and low–low clustering areas were identified. The cumulative exposure–response curves for SO₂, NO₂, and CO showed a monotonically increasing trend, with relative risks (RRs) < 1 at concentrations lower than the median levels (SO₂ ≈ 4 μg/m³, NO₂ ≈ 16 μg/m³, CO ≈ 1 mg/m³). In contrast, the curves for O₃ and PM_2.5 showed a decreasing trend, with RR < 1 at concentrations above the median levels (O₃ ≈ 55 μg/m³, PM_2.5 ≈ 20 μg/m³). Among socioeconomic factors, only the proportion of the population under 15 years old was found to be associated with HFMD incidence. Conclusions: HFMD incidence in Fujian exhibited distinct spatiotemporal clustering. The incidence was associated with the concentrations of air pollutants. Targeted interventions should be implemented in high-risk areas to mitigate HFMD transmission, with particular attention given to the environmental and demographic factors. Full article

(This article belongs to the Special Issue Climate Change and Environmental Epidemiology of Infectious Diseases)

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5 pages, 161 KiB

Open AccessEditorial

An Update on Syndemics: Editorial Comments

by Nicola Bulled and Merrill Singer

Trop. Med. Infect. Dis. 2025, 10(7), 187; https://doi.org/10.3390/tropicalmed10070187 - 2 Jul 2025

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Abstract

The theory of syndemics hypothesizes that observed clusters of diseases in specific temporal and geographical contexts are the result of harmful socio-environmental conditions resulting in mutually enhancing deleterious consequences [...] Full article

(This article belongs to the Special Issue An Update on Syndemics)

15 pages, 1715 KiB

Open AccessArticle

High Levels of Community Support for Mansonellosis Interventions in an Endemic Area of the Brazilian Amazon

by Uziel Ferreira Suwa, Carla Letícia Gomes Simão, Ulysses Carvalho Barbosa, Patrícia Moura Sousa, Cláudia Patrícia Mendes de Araújo, Marilaine Martins and James Lee Crainey

Trop. Med. Infect. Dis. 2025, 10(7), 186; https://doi.org/10.3390/tropicalmed10070186 - 2 Jul 2025

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Abstract

Mansonellosis is a chronic infectious tropical disease that affects hundreds of millions of people worldwide but is not currently targeted for control. In this study, we interviewed 320 residents from Sao Gabriel do Cachoeira (SGC) about their support for soil transmitted helminth (STH) [...] Read more.

Mansonellosis is a chronic infectious tropical disease that affects hundreds of millions of people worldwide but is not currently targeted for control. In this study, we interviewed 320 residents from Sao Gabriel do Cachoeira (SGC) about their support for soil transmitted helminth (STH) and mansonellosis interventions. Our survey found no significant difference between community support for mansonellosis and STH disease treatment when comparing any equivalent treatment regimen or program, although support for STH treatments was always higher than for mansonellosis treatments. No significant differences were detected when comparing community members’ willingness to participate in treatment programs and their willingness to allow family members to participate in an equivalent program. Our survey did, however, almost always find that significantly more community members were willing to participate in a proposed treatment program if the treatment regimen of that program was shorter than an otherwise equivalent regimen. Although significantly fewer people said they would participate in a curative four-week treatment course for mansonellosis than in a mansonellosis mass drug administration (MDA) program, significantly more community members said they would take a curative mansonellosis treatment course that lasted seven days or less than they would participate in any type of anthelminthic MDA proposed to them. The number of community members who said they would participate in any helminthic treatment program if they knew there was a ≥50% chance that they were infected was significantly higher than the number who said that they would without knowing the regional prevalence rate. Full article

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23 pages, 4669 KiB

Open AccessArticle

The Factors Influencing the Incidence, Persistence, and Severity of Symptoms After SARS-CoV-2 Infection in Chinese Adults: A Case–Control Study

by Weixiao Wang, Runjie Qi, Siyue Jia, Zhihang Peng, Hongxing Pan, Ming Xu, Yuanbao Liu, Xiaoqiang Liu, Qing Wang, Li Zhang, Jihai Tang, Hao Yang, Pengfei Jin, Simin Li and Jingxin Li

Trop. Med. Infect. Dis. 2025, 10(7), 185; https://doi.org/10.3390/tropicalmed10070185 - 30 Jun 2025

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Abstract

Following the emergence of COVID-19, breakthrough SARS-CoV-2 infections have demonstrated substantial heterogeneity in both occurrence and clinical severity. This case–control study aimed to elucidate the factors associated with the incidence, duration, and severity of SARS-CoV-2 symptoms among Chinese adults during the Omicron wave. [...] Read more.

Following the emergence of COVID-19, breakthrough SARS-CoV-2 infections have demonstrated substantial heterogeneity in both occurrence and clinical severity. This case–control study aimed to elucidate the factors associated with the incidence, duration, and severity of SARS-CoV-2 symptoms among Chinese adults during the Omicron wave. The analysis was based on data from a national COVID-19 surveillance program encompassing six provinces—Jiangsu, Chongqing, Shandong, Hunan, Anhui, and Yunnan—and included both laboratory-confirmed and clinically diagnosed cases. Data were systematically collected between February and April 2023. For each confirmed case, a matched control was selected through simple random sampling, matched on sex, age (±5 years), and province of residence. Multivariate logistic regression analyses were employed to assess a range of potential determinants, including demographic characteristics, lifestyle behaviors, and pre-existing medical conditions, in relation to the risk of infection, as well as the persistence and severity of symptoms following SARS-CoV-2 breakthrough infection. A total of 10,426 cases and 10,426 matched controls were included in the final analysis. Among the infected individuals, 963 (9.24%) reported persistent symptoms, while 773 (7.41%) experienced moderate-to-severe clinical manifestations. Occasional alcohol consumption, presence of comorbidities, tea and coffee intake, overweight status, and a longer interval since the last vaccination dose were all significantly associated with increased odds of infection (OR > 1, FDR < 0.05). Conversely, weekly alcohol consumption and smoking were associated with a decreased risk (OR < 1, FDR < 0.05). Female sex was significantly associated with both persistent and moderate-to-severe symptoms. Additional risk factors for prolonged or severe symptoms included older age, being underweight or overweight, a history of immunotherapy, coffee consumption, and the presence of comorbidities. These findings underscore the multifactorial nature of SARS-CoV-2 infection outcomes and highlight the interplay between host characteristics and behavioral factors. The results support the development of personalized prevention strategies aimed at reducing the clinical burden and long-term impact of COVID-19. 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, 2744 KiB

Open AccessCase Report

Dirofilaria repens in the Spermatic Cord of a 5-Year-Old Boy: A Rare Pediatric Case in Italy

by Alessandro Franzò, Andrea Marino, Benedetto Maurizio Celesia, Roberto Bruno, Pieralba Catalano, Sebastiano Cacciaguerra, Stefano Reale, Bruno Santi Cacopardo and Giuseppe Nunnari

Trop. Med. Infect. Dis. 2025, 10(7), 184; https://doi.org/10.3390/tropicalmed10070184 - 29 Jun 2025

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Abstract

We report the case of a 5-year-old boy from a Sri Lankan migrant family in Catania, Italy, diagnosed with a Dirofilaria repens infection in the spermatic cord. The child presented with pain and swelling in the left inguinal area. Initial evaluation suggested orchiepididymitis, [...] Read more.

We report the case of a 5-year-old boy from a Sri Lankan migrant family in Catania, Italy, diagnosed with a Dirofilaria repens infection in the spermatic cord. The child presented with pain and swelling in the left inguinal area. Initial evaluation suggested orchiepididymitis, which was treated unsuccessfully with amoxicillin/clavulanate and NSAIDs. As symptoms worsened, torsion of the Morgagni hydatid was considered. An exploratory surgery revealed a firm mass in the left spermatic cord. Histopathological examination of the excised lesion showed fragments of a helminth within a granulomatous inflammatory reaction. Subsequent PCR analysis detected D. repens DNA. The patient fully recovered after surgical excision of the mass. Given the increasing incidence of human dirofilariasis, D. repens should be considered in the differential diagnosis of unexplained subcutaneous or inguinal nodules, especially in patients with a relevant travel history. This case highlights the importance of accurate diagnosis to avoid unnecessary invasive procedures or prolonged antimicrobial therapies. It represents one of the youngest pediatric cases with genital involvement reported in Italy, a country that accounts for half of the cases in Europe. Full article

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

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12 pages, 896 KiB

Open AccessReview

Impact of Human Granulocytic Anaplasmosis in Spain from 1997 to 2022

by Hugo Almeida, Montserrat Alonso-Sardón, Beatriz Rodríguez-Alonso, Amparo López-Bernus, Ángela Romero-Alegría, Virginia Velasco-Tirado, Antonio Muro and Moncef Belhassen-García

Trop. Med. Infect. Dis. 2025, 10(7), 183; https://doi.org/10.3390/tropicalmed10070183 - 29 Jun 2025

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Abstract

Human granulocytic anaplasmosis (HGA) is an emerging zoonosis in Europe, with limited data available from Spain. This study aimed to quantify HGA cases in the Spanish National Health System over the last 26 years, assess its evolution, and evaluate the impact in terms [...] Read more.

Human granulocytic anaplasmosis (HGA) is an emerging zoonosis in Europe, with limited data available from Spain. This study aimed to quantify HGA cases in the Spanish National Health System over the last 26 years, assess its evolution, and evaluate the impact in terms of hospital stay and cost. A retrospective observational case series was conducted using the Minimal Basic Data Set (MBDS, CMBD in Spanish). Hospitalized patients with ICD-9-CM and ICD-10 codes for anaplasmosis from 1997 to 2022 were included. Ten HGA cases were reported. The incidence remained stable at one case per year [IR = 0.021 cases/million person-years], except in 2018 [IR = 0.048]. Six patients (60%) were men, with a mean age of 49 years (±20.9). Hospital stays ranged from 3 to 13 days. The total cost was EUR 45,540.57, with an average cost of EUR 4554.06 (±1032.16) per case. All patients had favorable outcomes. HGA has a low incidence in Spain, with moderate associated costs. Despite its emergence, its economic and health impact remains manageable, underscoring the effectiveness of Spain’s healthcare system. Continued surveillance and prevention are essential to address evolving vector-borne diseases. Full article

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

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17 pages, 1618 KiB

Open AccessArticle

First Report of the L925I kdr Mutation Associated with Pyrethroid Resistance in Genetically Distinct Triatoma dimidiata, Vector of Chagas Disease in Mexico

by Mario C. Saucedo-Montalvo, Jesus A. Davila-Barboza, Selene M. Gutierrez-Rodriguez, Beatriz Lopez-Monroy, Susana Favela-Lara, Iram P. Rodriguez-Sanchez, Guadalupe del C. Reyes-Solis, Cristina Bobadilla-Utrera and Adriana E. Flores

Trop. Med. Infect. Dis. 2025, 10(7), 182; https://doi.org/10.3390/tropicalmed10070182 - 27 Jun 2025

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Abstract

Triatoma dimidiata is a widely distributed vector of Trypanosoma cruzi in Mexico and Central America, found across a range of habitats from sylvatic to domestic. Vector control has relied heavily on indoor residual spraying with pyrethroids; however, reinfestation and emerging resistance have limited [...] Read more.

Triatoma dimidiata is a widely distributed vector of Trypanosoma cruzi in Mexico and Central America, found across a range of habitats from sylvatic to domestic. Vector control has relied heavily on indoor residual spraying with pyrethroids; however, reinfestation and emerging resistance have limited its long-term effectiveness. In this study, we analyzed the genetic diversity and population structure of T. dimidiata from Veracruz, Oaxaca, and Yucatan using mitochondrial markers (cyt b and ND4) and screened for knockdown resistance (kdr)-type mutations in the voltage-gated sodium channel (VGSC) gene. High haplotype diversity and regional differentiation were observed, with most genetic variation occurring between populations. The ND4 marker provided greater resolution than cyt b, revealing ten haplotypes and supporting evidence of recent population expansion. Haplotype networks showed clear geographic segregation, particularly between populations east and west of the Isthmus of Tehuantepec. The L925I mutation, highly associated with pyrethroid resistance, was detected for the first time in Mexican populations of T. dimidiata, albeit at low frequencies. These findings highlight the importance of integrating population genetic data and resistance surveillance into regionally adapted vector control strategies for Chagas disease. Full article

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

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11 pages, 1397 KiB

Open AccessArticle

Differential Emodepside Efficacy in Drug-Resistant and Drug-Susceptible Ancylostoma caninum Highlights Variability in Potassium Channel Activity

by Catherine A. Jackson, Elise L. McKean and John M. Hawdon

Trop. Med. Infect. Dis. 2025, 10(7), 181; https://doi.org/10.3390/tropicalmed10070181 - 27 Jun 2025

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Abstract

Multi-anthelmintic resistance in hookworms poses a significant challenge to both human and veterinary health, underscoring the need for novel treatment strategies. In this study, we evaluated the in vitro efficacy of three anthelmintics—pyrantel, ivermectin, and emodepside—against L3 larvae of drug-susceptible (WMD) and triple-anthelmintic-resistant [...] Read more.

Multi-anthelmintic resistance in hookworms poses a significant challenge to both human and veterinary health, underscoring the need for novel treatment strategies. In this study, we evaluated the in vitro efficacy of three anthelmintics—pyrantel, ivermectin, and emodepside—against L3 larvae of drug-susceptible (WMD) and triple-anthelmintic-resistant (BCR) isolates of Ancylostoma caninum. While pyrantel was largely ineffective and ivermectin induced high mortality in both isolates, emodepside displayed a surprising trend: the drug-resistant BCR isolate was more susceptible than the drug-susceptible WMD isolate. To explore the underlying mechanism, we performed survival assays in the presence of penitrem A, a BK channel (SLO-1) inhibitor. The addition of penitrem A reversed the enhanced emodepside sensitivity in BCR, implicating elevated basal expression of SLO-1 channels as a potential factor. These findings suggest that emodepside, via its action on SLO-1, may offer a promising therapeutic avenue to combat multidrug-resistant hookworm infections. Full article

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

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15 pages, 6168 KiB

Open AccessArticle

Global Trends and Attributable Risk Factors in the Disease Burden of Lower Respiratory Infections

by E Yu and Chunhui Li

Trop. Med. Infect. Dis. 2025, 10(7), 180; https://doi.org/10.3390/tropicalmed10070180 - 26 Jun 2025

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Abstract

Background: Lower respiratory infections (LRIs) are the leading cause of the global disease burden, accounting for millions of deaths each year. Methods: Data on LRIs, including deaths, disability-adjusted life years (DALYs), and incidence, were obtained from the Global Burden of Disease Study 2021. [...] Read more.

Background: Lower respiratory infections (LRIs) are the leading cause of the global disease burden, accounting for millions of deaths each year. Methods: Data on LRIs, including deaths, disability-adjusted life years (DALYs), and incidence, were obtained from the Global Burden of Disease Study 2021. Joinpoint regression was employed to assess temporal trends in the LRIs’ burden, while the age–period–cohort model was used to evaluate age, period, and cohort effects. Pearson’s correlation coefficients were calculated to examine the relationship between DALYs attributable to risk factors and the socio-demographic index (SDI). Results: Over recent decades, the average annual percentage change in age-standardized mortality rate, age-standardized DALYs rate, and age-standardized incidence rate of LRIs globally were −2.4%, −3.5%, and −1.3%, respectively. Notably, the LRIs’ burden dropped considerably from 2019 to 2021. The disease burden was higher among children under five and individuals over 60 compared to other age groups. In terms of gender, males had a higher burden. The age-standardized DALYs rate of LRIs was strongly and negatively correlated with SDI (r = −0.84; p < 0.05). Streptococcus pneumoniae remained the leading pathogen, followed by Staphylococcus aureus, and Klebsiella pneumoniae. Conclusions: In recent years, the global burden of LRIs has declined, but regional, gender, and age disparities persist. Targeted measures are needed to address high-risk populations and major risk factors. Full article

(This article belongs to the Special Issue Respiratory Infectious Disease Epidemiology and Control)

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15 pages, 516 KiB

Open AccessArticle

Occupational Syndemics in Farmworkers in the Cape Winelands, South Africa

by Nicola Bulled

Trop. Med. Infect. Dis. 2025, 10(7), 179; https://doi.org/10.3390/tropicalmed10070179 - 24 Jun 2025

Cited by 1 | Viewed by 242

Abstract

Occupational exposures in the agricultural industry globally have been associated with heightened risk for several diseases. Reports written in South Africa in the last decade have raised awareness of the harsh occupational conditions and human rights abuses suffered by farmworker communities in the [...] Read more.

Occupational exposures in the agricultural industry globally have been associated with heightened risk for several diseases. Reports written in South Africa in the last decade have raised awareness of the harsh occupational conditions and human rights abuses suffered by farmworker communities in the wine industry. Despite receiving “fair trade” labels upon reentry into the global market in the 1990s, the working conditions on wine farms in South Africa have remained unchanged and exploitative for centuries. Farmworkers remain dependent on substandard farm housing, have insecure land tenure rights, are exposed to toxic pesticides, are denied access to benefits and unionization, and endure long working hours in harsh environmental conditions with low pay. These occupational conditions are linked to interacting disease clusters: metabolic syndrome, problematic drinking, and communicable diseases including tuberculosis, HIV, and COVID-19. This milieu of interacting diseases with deleterious outcomes is an under-considered occupational syndemic that will likely worsen given both the lasting impacts of COVID-19 and more recent shifts in global public health funding. Full article

(This article belongs to the Special Issue An Update on Syndemics)

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1 pages, 146 KiB

Open AccessRetraction

RETRACTED: Jang, S.; Sohn, A. Awareness, Intention to Use Pre-Exposure Prophylaxis, and Factors Associated with Awareness among Men Who Have Sex with Men in the Republic of Korea. Trop. Med. Infect. Dis. 2024, 9, 170

by Sarang Jang and Aeree Sohn

Trop. Med. Infect. Dis. 2025, 10(7), 178; https://doi.org/10.3390/tropicalmed10070178 - 23 Jun 2025

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Abstract

The Journal retracts and removes the article, “Awareness, Intention to Use Pre-Exposure Prophylaxis, and Factors Associated with Awareness among Men Who Have Sex with Men in the Republic of Korea” [...] Full article

13 pages, 8195 KiB

Open AccessReview

Lagochilascariasis: A Neglected Zoonosis in the Brazilian Amazon Biome and the Role of Wildlife in Its Epidemiological Chain Amidst Anthropization

by Felipe Masiero Salvarani, Karoline Petrini Pinheiro da Cruz, Flavio Roberto Chaves da Silva and Cíntia Daudt

Trop. Med. Infect. Dis. 2025, 10(7), 177; https://doi.org/10.3390/tropicalmed10070177 - 21 Jun 2025

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Abstract

Lagochilascariasis is a neglected zoonotic helminthiasis, caused by Lagochilascaris minor, characterized by a complex and not well understood transmission cycle. This parasitic disease is endemic to Latin America, particularly Brazil, and is associated with rural and forested areas, where humans may serve [...] Read more.

Lagochilascariasis is a neglected zoonotic helminthiasis, caused by Lagochilascaris minor, characterized by a complex and not well understood transmission cycle. This parasitic disease is endemic to Latin America, particularly Brazil, and is associated with rural and forested areas, where humans may serve as accidental hosts. The southeastern region of Pará state reports the highest number of cases, highlighting its epidemiological significance. Wildlife species, especially carnivores and rodents, play crucial roles as definitive and intermediate hosts, respectively. Although lagochilascariasis can lead to severe clinical manifestations, including chronic soft tissue infections and potential central nervous system involvement, it is likely underdiagnosed due to its similarity to fungal and bacterial diseases. The anthropization of the Amazon Biome, through deforestation and habitat fragmentation, coupled with increased human–wildlife interactions, may be influencing the epidemiology of this parasitosis. This review aims to summarize current knowledge of L. minor transmission routes, the role of wildlife in maintaining its cycle, and the impact of environmental changes on disease patterns. Such insights are vital for One Health strategies, which integrate human, animal, and environmental health approaches to mitigate the disease burden. Full article

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

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11 pages, 243 KiB

Open AccessArticle

Evaluation of Social and Clinical Factors Associated with Adverse Drug Reactions Among Children with Drug-Resistant Tuberculosis in Pakistan

by Muhammad Soaib Said, Razia Fatima, Rabbiya Ahmad, Mahmood Basil A. Al Rawi, Faheem Jan, Sobia Faisal, Irfanullah Khan and Amer Hayat Khan

Trop. Med. Infect. Dis. 2025, 10(7), 176; https://doi.org/10.3390/tropicalmed10070176 - 20 Jun 2025

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Abstract

(1) Background: The occurrence, intensity, and characteristics of adverse drug reactions (ADRs) caused by anti-tuberculosis (TB) drugs have consistently been a subject of worry. There is a lack of published research from Pakistan regarding the negative effects of anti-TB treatment on children, specifically [...] Read more.

(1) Background: The occurrence, intensity, and characteristics of adverse drug reactions (ADRs) caused by anti-tuberculosis (TB) drugs have consistently been a subject of worry. There is a lack of published research from Pakistan regarding the negative effects of anti-TB treatment on children, specifically about ADRs. In this study, we aimed to investigate the ADR associated with anti-DR-TB treatment in children. (2) Methods: A prospective longitudinal study was conducted in the multicenter setting of Khyber Pakhtunkhwa, Pakistan. A total of 450 TB children in multicenter hospitals under ATT were assessed for ADRs. Naranjo Causality Assessment and Hartwig’s Severity Assessment Scale were used to evaluate the causality and severity. (3) Results: A total of 300 (66.66%) ADRs were reported in 450 people with DRTB. Anemia was the most frequently observed ADR (37.6%) followed by nausea and vomiting (18.6%). On multivariate analysis, the independent variables that had a statistically significant positive association with ADRs were participants aged, 5–14 years (AOR, 0.3 (0.1–0.5), p ≤ 0.001), normal weight (1.1 (2.0–1.9), p < 0.001), and children having comorbidities (AOR, 0.5 (0.1–0.8), p ≤ 0.001). (4) Conclusions: Our findings advocate for personalized treatment approaches, incorporating nutritional support, comprehensive comorbidity management, and vigilant monitoring to mitigate ADRs and improve treatment outcomes. Full article

(This article belongs to the Special Issue Tuberculosis in Special Populations: Epidemiology and Evidence-Based Interventions)

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Trop. Med. Infect. Dis., Volume 10, Issue 7 (July 2025) – 20 articles

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