Tropical Medicine and Infectious Disease

15 pages, 506 KB

Open AccessArticle

Operational Research Improves Compliance with Treatment Guidelines for Empirical Management of Urinary Tract Infection: A Before-and-After Study from a Primary Health Facility in Ghana

by Elizabeth Boateng, Helena Owusu, Pruthu Thekkur, George Kwesi Hedidor, Oksana Corquaye, Mercy N. A. Opare-Addo, Florence Amah Nkansah, Priscilla Vandyck-Sey, Daniel Ankrah and Charles Nii Kwadee Ofei-Palm

Trop. Med. Infect. Dis. 2025, 10(9), 259; https://doi.org/10.3390/tropicalmed10090259 - 11 Sep 2025

Abstract

Compliance with standard treatment guidelines (STGs) for the empirical management of uncomplicated urinary tract infections (UTIs) ensures the rational use of antibiotics and mitigates antimicrobial resistance. Operational research (OR) at Korle Bu Polyclinic in Ghana (2022) showed suboptimal STG compliance (prescription of recommended [...] Read more.

Compliance with standard treatment guidelines (STGs) for the empirical management of uncomplicated urinary tract infections (UTIs) ensures the rational use of antibiotics and mitigates antimicrobial resistance. Operational research (OR) at Korle Bu Polyclinic in Ghana (2022) showed suboptimal STG compliance (prescription of recommended antibiotics in the correct dose, route, frequency, and duration). Some of the recommendations from the OR, including training of medical residents, implementation of an antimicrobial stewardship team, and an audit–feedback system, were implemented. This before-and-after study compared the changes in empirical prescribing practices for patients diagnosed with uncomplicated UTIs before (October 2019–October 2021) and after (January 2023–December 2024) the OR. Of the 3717 and 3457 UTI patients in the before and after cohorts, 83% and 86% received empirical antibiotics, respectively. Among those who received empirical antibiotics, STG compliance increased from 60% to 66% (p-value < 0.001). However, STG compliance remained significantly lower among males (18%) compared to females (85%) in the after cohort, as 80% of males were prescribed antibiotics for a shorter period than the recommended 10–14 days. Moving forward, the training and audit–feedback system should emphasize longer antibiotic durations for males with UTI. Given its positive impact, the OR’s approach warrants replication for other disease conditions. Full article

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

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10 pages, 354 KB

Open AccessArticle

Prevalence and Screening Rates of Hepatitis B and Hepatitis C Infections in Adult Patients with Solitary Organ Tumors

by Seyhmus Abakay, Hüseyin Döngelli, Nilay Danış, Halil İbrahim Ellez, Göksel Bengi, Tuğba Yavuzşen and Hüseyin Salih Semiz

Trop. Med. Infect. Dis. 2025, 10(9), 258; https://doi.org/10.3390/tropicalmed10090258 - 10 Sep 2025

Abstract

Background and Aims: Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) remain significant global public health issues despite advances in their diagnosis and treatment. Our country is in a medium endemic region for HBV. Reactivation can occur during [...] Read more.

Background and Aims: Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) remain significant global public health issues despite advances in their diagnosis and treatment. Our country is in a medium endemic region for HBV. Reactivation can occur during or after immunosuppressive therapy. Therefore, screening patients before treatment is crucial to prevent reactivation. However, pretreatment screening is often insufficiently emphasized in studies. This study aimed to assess the incidence of HBV and pretreatment screening rates in patients with solid organ tumors at our center. Methods: We included patients aged over 18 years who were treated for solid organ tumors at our center between January 2016 and January 2022. Data on age, sex, histopathological diagnosis, and serological parameters were retrospectively collected. Appropriate HBV screening was defined as the assessment of HBsAg, anti-HBs, and anti-HBc IgG levels prior to the initiation of immunosuppressive therapy. Results: In our study, HBsAg testing was requested for 13.3% of the patients, and anti-HCV testing was requested for 13.3%. Among the patients screened for HBV and HCV, the prevalence rates of HBV and HCV infection were 3.3% and 1%, respectively. Conclusions: Our findings reveal inadequate screening rates for HBV and HCV among patients receiving immunosuppressive therapy. Increasing awareness about screening and implementing regular educational programs are crucial to protect patients from reactivation. Full article

(This article belongs to the Special Issue Viral Hepatitis and Other Microbial Threats in Tropical Medicine)

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7 pages, 774 KB

Open AccessCase Report

Nasal Myiasis Mimicking Allergic Rhinitis in Immunocompetent Adults: Case Series of 14 Adults

by Sameh Mezri, Mohamed Anas Ammar, Latifa Mtibaa, Sleheddine Mnasria, Chiraz Halwani and Khemaies Akkari

Trop. Med. Infect. Dis. 2025, 10(9), 257; https://doi.org/10.3390/tropicalmed10090257 - 9 Sep 2025

Abstract

Background: Human nasal myiasis is a rare zoonotic infection caused by Oestrus ovis with a non-specific clinical presentation that can mimic more common conditions such as allergic rhinitis. Objective: To report a series of nasal myiasis cases in immunocompetent individuals, emphasizing the clinical [...] Read more.

Background: Human nasal myiasis is a rare zoonotic infection caused by Oestrus ovis with a non-specific clinical presentation that can mimic more common conditions such as allergic rhinitis. Objective: To report a series of nasal myiasis cases in immunocompetent individuals, emphasizing the clinical presentation and complementary investigations (endoscopic findings, parasitological identification, skin prick tests, and imaging studies) that facilitate differential diagnosis from allergic rhinitis and enable early treatment. Methods: We conducted a retrospective study including cases of nasal myasis diagnosed and managed at the ENT department of the Military Hospital of Tunis over an 18-year period (2007–2025). Demographic, clinical, diagnostic, and therapeutic data were analyzed. Results: The mean age was 43 years, with a female predominance. Most patients presented with acute rhinological symptoms initially suggestive of allergic rhinitis. Nasal endoscopy revealed larvae in 79% of cases with parasitological confirmation of Oestrus ovis. Facial CT scans performed in five cases (36%) were unremarkable. Management consisted of multiple daily nasal saline irrigations and albendazole, in association with oral corticosteroids and antihistamines, resulting in symptom resolution within an average of 4 days. Conclusions: Nasal myiasis should be considered in atypical or treatment-resistant rhinitis. Nasal endoscopy is essential for diagnosis. Full article

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

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10 pages, 252 KB

Open AccessBrief Report

Backyard Livestock Guinea Pigs Are Reservoirs for Leptospira Shedding in Rural Households from Ecuador

by Mauricio Xavier Salas-Rueda, Fabricio Dugllay-Montaleza, Darwin Paredes-Núñez, Katherine Natalia Chávez Toledo, Angel Sebastián Rodríguez-Pazmiño, Elsy Carvajal, Maria Belen Paredes-Espinosa, Patricia Peralta-Ortiz, Jairo Guama-Tipas, Juan Pablo Garzon, Alexandra Narvaez, Solon Alberto Orlando and Miguel Angel Garcia-Bereguiain

Trop. Med. Infect. Dis. 2025, 10(9), 256; https://doi.org/10.3390/tropicalmed10090256 - 8 Sep 2025

Abstract

Guinea pigs (Cavia porcellus) are bred as livestock in South American countries from the Andean region, including Ecuador. Despite their importance for the local rural economy, no public health management guidelines have ever been implemented for guinea pig farming. Moreover, several [...] Read more.

Guinea pigs (Cavia porcellus) are bred as livestock in South American countries from the Andean region, including Ecuador. Despite their importance for the local rural economy, no public health management guidelines have ever been implemented for guinea pig farming. Moreover, several reports have shown the carriage of diverse zoonotic pathogens in livestock guinea pigs, including respiratory and enteric pathogens, or Toxoplasma gondii. Leptospirosis, a zoonotic disease caused by bacteria from Leptospira genus, is endemic in Ecuador and has multiple animal reservoirs, with rodents considered to be the main vector for transmission to humans. However, the role of livestock guinea pigs in the epidemiology of leptospirosis is poorly understood. In this study, the prevalence of antibodies against Leptospira in guinea pigs from Ecuador was analyzed with the Microaglutiantion Test (MAT). Moreover, the shedding of Leptospira by backyard livestock guinea pigs was also addressed, analyzing fecal and urine samples by qPCR for lipL32, secY and rrs genes. From the 118 guinea pigs analyzed by MAT, 61.9% were positive for 19 different pathogenic serovars, with Icterohaemorrhagiae, Pomona, Castellonis and Bataviae being the most prevalent ones. From the 231 urine samples and 225 fecal samples collected, 27.7% and 78.7% were positive for Leptospira by qPCR, respectively. Our results highlight the role of livestock guinea pigs as a reservoir for leptospirosis. Moreover, this study underscores the zoonotic threat associated with the shedding of Leptospira within households in rural communities where guinea pigs are bred as livestock. Animal and public health guidelines from a One Health perspective must be implemented to prevent leptospirosis transmission from guinea pigs in Ecuador and other countries in the Andean Region where the breeding of backyard livestock guinea pigs is common. Full article

(This article belongs to the Special Issue Leptospirosis and One Health Approach: Current Status and Future Prospects, 2nd Edition)

12 pages, 675 KB

Open AccessArticle

Genetic Diversity of Plasmodium falciparum in Korhogo Health District, Northern Côte d’Ivoire

by Edjronké M. A. Benié, Carla Beuret, Annina Schnoz, Sara L. Cantoreggi, Xavier C. Ding, Kigbafori D. Silué and Christian Nsanzabana

Trop. Med. Infect. Dis. 2025, 10(9), 255; https://doi.org/10.3390/tropicalmed10090255 - 7 Sep 2025

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Abstract

Understanding Plasmodium falciparum population genetic diversity is crucial to assess the impact of malaria control interventions. This study investigated P. falciparum genetic diversity using merozoite surface protein 1 (msp1), msp2 and glutamate-rich protein (glurp) in Korhogo district, Northern Côte [...] Read more.

Understanding Plasmodium falciparum population genetic diversity is crucial to assess the impact of malaria control interventions. This study investigated P. falciparum genetic diversity using merozoite surface protein 1 (msp1), msp2 and glutamate-rich protein (glurp) in Korhogo district, Northern Côte d’Ivoire. DNA was extracted from dried blood spots (DBSs) collected in the health district of Korhogo between 2019 and 2020. The msp1, msp2, and glurp genes were amplified by polymerase chain reaction (PCR), and amplicon sizes were determined by capillary electrophoresis. Out of 179 samples randomly selected and genotyped, 82% were successfully amplified for msp1, 85% for msp2, and 75% for glurp. For msp1, the K1 allelic family had 20 genotypes, MAD20 had 23, and RO33 had only one genotype. For msp2, there were 59 and 33 genotypes for 3D7 and FC27, respectively, and for glurp, 45 genotypes were detected. The parasite population was highly diverse with an expected heterozygosity (H_E) of ≥0.9 for all 3 markers. Our study showed high genetic diversity of msp1, msp2, and glurp in P. falciparum isolates from Korhogo district, Northern Côte d’Ivoire. These data could provide baseline information on P. falciparum genetic diversity for further epidemiological studies, needed to assess interventions implemented in this area. Full article

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

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18 pages, 2450 KB

Open AccessArticle

Morbidity and Mortality Profile of Leishmaniasis in an Andean Region of Ecuador in the Context of Climate Change

by Enma Veronica Páez-Espinosa, Delia Maria Sosa-Guzmán, Luis René Buitrón-Andrade, Nicole Dávila-Jumbo, Martín Israel Cáceres-Ruiz, Vinicio Francisco Robalino-Flores and Eugènia Mato-Matute

Trop. Med. Infect. Dis. 2025, 10(9), 254; https://doi.org/10.3390/tropicalmed10090254 - 3 Sep 2025

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Abstract

Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are [...] Read more.

Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are associated with humid, low-altitude rural areas, our study uncovered an unexpected trend: confirmed cases occurring in traditionally cold Andean regions. To investigate this issue, we conducted a cross-sectional ecological study using official morbidity and mortality records from the Ecuadorian Health Care Registration Platform, focusing on the cantons of Alausí and Chunchi in Chimborazo Province from 2013 to 2022. Chimborazo Province, in the Andes, is characterized by higher altitudes (2740 m above sea level) and a cold climate (averaging 13 °C throughout the year). Among a population of 44,089 residents in Alausí, we reported a total of 40 confirmed cases, with 97.5% classified as cutaneous and 2.5% as mucocutaneous, predominantly affecting children and males. No mortality cases were recorded during the study period. To further explore environmental influences, we examined the Alausí region, where climate change has led to rising average temperatures, deforestation, and changes in humidity levels. Leishmaniasis cases in Alausí showed seasonal peaks, particularly in 2018 and 2019, correlating with warmer and more humid conditions. Environmental factors such as temperature and humidity were strongly associated with the prevalence of the disease, suggesting that climate change may be increasing transmission risks. These findings point to the value of incorporating environmental monitoring into public health strategies for vector-borne diseases that affect vulnerable populations in the Andes. Full article

(This article belongs to the Topic Vector-Borne Disease Spatial Epidemiology, Disease Ecology, and Zoonoses)

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14 pages, 816 KB

Open AccessCommunication

Seropositivity for Pathogenic Leptospira in Dogs, Cats, and Horses at a Teaching Veterinary Hospital in Southern Chile

by Lucía Azócar-Aedo, Gloria Meniconi, Carolina Pino-Olguín and María Gallardo

Trop. Med. Infect. Dis. 2025, 10(9), 253; https://doi.org/10.3390/tropicalmed10090253 - 3 Sep 2025

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Abstract

At a veterinary hospital in southern Chile, we conducted an epidemiological study involving domestic dogs, cats, and horses to determine the seropositivity for pathogenic Leptospira spp., identify the infecting serogroups, measure antibody titers, and characterize seropositive animals by sex and age. None of [...] Read more.

At a veterinary hospital in southern Chile, we conducted an epidemiological study involving domestic dogs, cats, and horses to determine the seropositivity for pathogenic Leptospira spp., identify the infecting serogroups, measure antibody titers, and characterize seropositive animals by sex and age. None of the sampled animals showed clinical signs of leptospirosis. The microscopic agglutination test, using a panel of eight serogroups, was used for diagnosis. The seropositivity was 36.5% (95% confidence interval [CI] = 24.5–48.4) in dogs, 12.9% (95% CI = 2.6–23.1) in cats, and 45.2% (95% CI = 30.1–60.2) in horses. Serological reactions were detected for the Tarassovi and Canicola serogroups in dogs, Sejroe, Canicola, Icterohaemorrhagiae, and Grippotyphosa in horses, and Tarassovi in cats. The most frequent antibody titers were 1:200 and 1:400 in dogs, 1:400 in cats, and 1:800 in horses. The distribution of seropositivity varied by sex and age across different animal species. The seropositivity for pathogenic Leptospira in dogs, cats, and horses attending a veterinary hospital underscores the role of domestic animals as sentinels for zoonotic diseases. This finding has implications for epidemiological surveillance systems in increasing awareness of seropositivity and establishing specific prevention measures to mitigate the risk of leptospirosis transmission. Full article

(This article belongs to the Special Issue Leptospirosis and One Health)

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11 pages, 1245 KB

Open AccessArticle

Genotype Analysis on Orientia tsutsugamushi Causing Scrub Typhus in Malaysia: A Re-Emerging Disease

by Shirley Yi Fen Hii, Maswani Nabilah Mohd Zaidi, Wan Norazanin Kassim, Rohaidah Hashim and Siti Roszilawati Ramli

Trop. Med. Infect. Dis. 2025, 10(9), 252; https://doi.org/10.3390/tropicalmed10090252 - 2 Sep 2025

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Abstract

Introduction: Scrub typhus is caused by Gram-negative bacteria, Orientia tsutsugamushi. Humans are the dead-end host of scrub typhus. Currently, there is no vaccine available. The disease can be fatal without appropriate treatment. Here, we present the circulating OT genotypes in Malaysia and [...] Read more.

Introduction: Scrub typhus is caused by Gram-negative bacteria, Orientia tsutsugamushi. Humans are the dead-end host of scrub typhus. Currently, there is no vaccine available. The disease can be fatal without appropriate treatment. Here, we present the circulating OT genotypes in Malaysia and a tsa56-based single PCR to detect and determine OT genotypes, which is an approach to replace the time-consuming traditional nested PCR. Methods: The patients’ blood or tissue samples (n = 1200), received from all hospitals in Malaysia from December 2022 to November 2024, were screened for rickettsial infections. Both htrA qPCR and nested PCR were performed to detect the presence of OT DNA. Simultaneously, a selection of DNA was evaluated for the new single PCR protocol and confirmed with Sanger sequencing. Results: We report that Pahang state of Peninsular Malaysia presents the highest number of acute scrub typhus infections in Malaysia within the 24 months period. There are four genotypes circulating in the Malaysian population. OT genotype Gilliam (n = 31, 29.2%) and Karp (n = 31, 29.2%) are the predominant OT genotypes in Malaysia, followed by TA763 (n = 22, 20.8%) and Kato (n = 22, 20.8%). The single-run PCR presents longer sequence size and similar results with the nested PCR. Conclusions: Acute scrub typhus infection is not rare in Malaysia and should be considered for undifferentiated febrile illness. The single-run PCR protocol is time-saving and a promising approach for OT detection and genotype analysis in a single run to complement a clinical diagnostic setting and surveillance. Full article

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

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17 pages, 1604 KB

Open AccessArticle

Vector-Borne Disease Control and Management in Irrigation Areas: A Neglected Critical Phenomenon in Malawi

by Levi Kalitsilo, Rose Oronje and Nyanyiwe Masingi Mbeye

Trop. Med. Infect. Dis. 2025, 10(9), 251; https://doi.org/10.3390/tropicalmed10090251 - 2 Sep 2025

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Abstract

Vector-borne diseases (VBDs) account for more than 17% of all infectious diseases, causing over 700,000 deaths annually, particularly among the poorest populations in tropical and subtropical areas. Climate change, particularly global warming, and certain human activities, including irrigation farming, exacerbate the situation by [...] Read more.

Vector-borne diseases (VBDs) account for more than 17% of all infectious diseases, causing over 700,000 deaths annually, particularly among the poorest populations in tropical and subtropical areas. Climate change, particularly global warming, and certain human activities, including irrigation farming, exacerbate the situation by creating conducive environments that facilitate the breeding of vectors such as mosquitoes and snails. This qualitative study aimed to understand the VBD control and management policy landscape in irrigation areas by gathering perceptions from key stakeholders in the irrigation farming sector in Malawi. Respondents indicated that there are no specific VBD control and management policies targeting irrigation areas in Malawi and that stakeholders essentially work in silos. Notwithstanding this, the Malawi government is committed to expanding irrigation areas to address food security. We, therefore, call for the integration of VBD control and management in irrigation farming, utilising the One Health approach—a promising strategy that could bring significant benefits. Further, we recommend the provision of VBD control and management resources in irrigation investments and the involvement of VBD researchers in the formulation of irrigation policies. Full article

(This article belongs to the Special Issue One Health Approach to Mosquito-Borne Diseases: Epidemiology, Prevention and Treatment Strategies)

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15 pages, 519 KB

Open AccessArticle

Interleukin-8 Predicts Fatal Kala-Azar: A Case–Control Study

by Simone Soares Lima, Débora Cavalcante Braz, Vladimir Costa Silva, Teresinha de Jesus Cardoso Farias Pereira, Líndia Kalliana da Costa Araújo Alves Carvalho, Dorcas Lamounier Costa and Carlos Henrique Nery Costa

Trop. Med. Infect. Dis. 2025, 10(9), 250; https://doi.org/10.3390/tropicalmed10090250 - 1 Sep 2025

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Abstract

Kala-azar is associated with case-fatality rates as high as 10% in certain regions. Early identification of mortality biomarkers can significantly reduce this risk. This study, strengthened by a relatively high number of kala-azar-related deaths, aimed to identify serum cytokines as predictive biomarkers of [...] Read more.

Kala-azar is associated with case-fatality rates as high as 10% in certain regions. Early identification of mortality biomarkers can significantly reduce this risk. This study, strengthened by a relatively high number of kala-azar-related deaths, aimed to identify serum cytokines as predictive biomarkers of fatal kala-azar. We compared 48 deceased patients with kala-azar to 42 survivors. The concentrations of IL-1β, IL-6, IL-8, IL-10, IL-12, and tumor necrosis factor-α (TNF-α) were measured by flow cytometry. Cytokine levels were compared between groups using the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis, coupled with Youden’s index, defined the optimal diagnostic threshold. Upon admission, IL-8 concentrations were substantially higher in deceased kala-azar patients (median 76.5 pg/mL [IQR 35.2–242.4 pg/mL]) than in survivors (median 26.4 pg/mL [IQR 15.1–47.7 pg/mL]; p < 0.0001). ROC analysis identified 49.3 pg/mL as the optimal cutoff. When rounded to the clinically convenient value of 50 pg/mL, IL-8 predicted a fatal outcome with an area under the curve of 0.75, sensitivity of 70.8%, and specificity of 76.2%. In contrast, IL-1β, IL-6, IL-10, IL-12, and TNF-α showed no significant prognostic utility. Our findings suggest that IL-8 levels equal to or greater than 50 pg/mL are a reliable predictor of fatal kala-azar. Full article

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

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9 pages, 1067 KB

Open AccessCommunication

Compatibility of Serratia ureylitica Su_YN1, Malaria Transmission-Blocking Bacterium, with the Anopheles aquasalis Vector

by Marília Andreza da Silva Ferreira, Elen Sabrina dos Reis Martins, Ricardo de Melo Katak, Keillen Monick Martins Campos, Elerson Matos Rocha, Rosemary Aparecida Roque, Pritesh Jaychand Lalwani, Luciete Almeida Silva, Edson Júnior do Carmo, Paulo Paes de Andrade, Sibao Wang, Luciano Andrade Moreira, Marcelo Jacobs-Lorena and Claudia María Ríos-Velásquez

Trop. Med. Infect. Dis. 2025, 10(9), 249; https://doi.org/10.3390/tropicalmed10090249 - 31 Aug 2025

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Abstract

Malaria continues to affect millions of people around the world. Current control strategies have not been sufficient, and additional tools are required for malaria elimination. A promising approach is the use of bacteria from the mosquito microbiota, such as the Su_YN1 Serratia ureilytica [...] Read more.

Malaria continues to affect millions of people around the world. Current control strategies have not been sufficient, and additional tools are required for malaria elimination. A promising approach is the use of bacteria from the mosquito microbiota, such as the Su_YN1 Serratia ureilytica bacterium, which is shown to strongly impair the development of P. falciparum and P. berghei in Anopheles mosquitoes. To evaluate the potential of using S. ureilytica Su_YN1 to block the Plasmodium parasite in South American vectors, we investigated its effects on mosquito fitness and survival. We found that this bacterium does not affect the longevity, blood feeding, fecundity and fertility of Anopheles aquasalis, an important South American vector. Overall, our results provide baseline support for the potential implementation of Su_YN1 for the control of malaria transmission in South America. Full article

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

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16 pages, 383 KB

Open AccessArticle

Alcohol Consumption of Male Tuberculosis Index Cases and Tuberculosis Transmission Among Social Contacts in Puducherry, India: A Cross-Sectional Analytical Study

by Charutha Retnakumar, Palanivel Chinnakali, Balaji Bharadwaj, Karikalan Nagarajan and Sonali Sarkar

Trop. Med. Infect. Dis. 2025, 10(9), 248; https://doi.org/10.3390/tropicalmed10090248 - 30 Aug 2025

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Abstract

We aimed to compare the proportion of tuberculosis infection among social contacts of male tuberculosis Index case with and without alcohol use in the Puducherry district. A cross-sectional study using ego-centric approach was conducted between November 2023 and May 2024. A total of [...] Read more.

We aimed to compare the proportion of tuberculosis infection among social contacts of male tuberculosis Index case with and without alcohol use in the Puducherry district. A cross-sectional study using ego-centric approach was conducted between November 2023 and May 2024. A total of 713 social contacts of 106 male pulmonary tuberculosis index cases were enrolled, stratified by alcohol-use (AUDIT ≥ 8): 358 contacts from 45 alcohol-using cases and 355 from 61 non-alcohol-use cases. Social contacts were defined based on the frequency and duration of shared indoor exposure with index cases within the past three months. Tuberculosis infection was screened with Cy-Tb skin test (≥5 mm induration) at the third month of index case treatment. Univariate and multivariable analysis were conducted to identify factors associated with tuberculosis transmission. Among the 358 social contacts of alcohol-use index cases, 33.8% (n = 121; 95% CI, 29.1–38.8%) tested positive for tuberculosis infection, significantly higher than 21.7% (n = 77; 95% CI, 17.7–26.3%) among 355 contacts of non-alcohol-use cases. Regression analysis revealed that contacts of alcohol-using index cases (aOR = 1.6, p < 0.05), were significantly associated with tuberculosis infection. Alcohol-use among tuberculosis patients significantly increases the risk of tuberculosis infection in their social networks. Full article

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

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15 pages, 2423 KB

Open AccessArticle

Impaired Lung Function and Quality of Life Outcomes in Patients with Tuberculosis: A Cross-Sectional Study

by Varshini Jagadeesh, Prashanth Chikkahonnaiah, Muskan Dubey, Shashidhar H. Byrappa, Hari Balaji Sridhar, Raghavendra G. Amachawadi and Ravindra P. Veeranna

Trop. Med. Infect. Dis. 2025, 10(9), 247; https://doi.org/10.3390/tropicalmed10090247 - 29 Aug 2025

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Abstract

Tuberculosis (TB) continues to be the world’s deadliest infectious disease, with an estimated 10.8 million new cases reported in 2023, of which India alone accounted for 28% of the global burden. This study aims to evaluate the impact of tuberculosis on pulmonary function [...] Read more.

Tuberculosis (TB) continues to be the world’s deadliest infectious disease, with an estimated 10.8 million new cases reported in 2023, of which India alone accounted for 28% of the global burden. This study aims to evaluate the impact of tuberculosis on pulmonary function and exercise tolerance, and to examine how these impairments affect health-related quality of life (HRQoL). In a cross-sectional design, 96 bacteriologically confirmed TB patients and 96 age- and sex-matched community controls underwent spirometry, six-minute-walk test (6 MWT), and HRQoL evaluation. DR-TB was detected in 27 patients (28.1%): Isoniazid monoresistance 59.3%, rifampicin monoresistance 11.1%, and XDR-TB 29.6%. Dyspnoea (70.8%) and cough (37.5%) were the most commonly reported symptoms among TB patients. Mean values of FEV₁, FVC, and FEV₁/FVC were significantly lower in TB patients compared to controls (62.8%, 65.97%, and 70.08% vs. 82.55%, 80.09%, and 78.08%, respectively; p < 0.001). Recurrent or DR-TB was associated with reduced spirometric indices and 6 MWT distances (241 m vs. 358 m in drug-sensitive TB). St. George’s respiratory questionnaire (SGRQ) scores indicated significantly poorer health-related quality of life (HRQoL) in patients compared to controls across all domains—symptoms (23.7 vs. 10.7), activity (33.3 vs. 14.2), and impact (20.6 vs. 9.4; p < 0.05). SGRQ scores were inversely correlated with lung function parameters (r = −0.42 to −0.56). These findings underscore the persistent health burden TB poses post-therapy, highlighting the need for routine post-TB functional screening and robust DR-TB control to achieve End-TB goals. Full article

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17 pages, 702 KB

Open AccessArticle

Diagnostic Accuracy of Antigen ELISA and Western Blot IgG for Neurocysticercosis in People Living with HIV/AIDS in Tanzania

by Yakobo Lema, Ulrich Fabien Prodjinotho, Charles Makasi, Marrywinnie A. Nanyaro, Frank Asenga, Andrew Kilale, Sayoki Mfinanga, Charlotte Rüther, Andrea Sylvia Winkler, Eligius F. Lyamuya, Bernard J. Ngowi, Mkunde Chachage and Clarissa Prazeres da Costa

Trop. Med. Infect. Dis. 2025, 10(9), 246; https://doi.org/10.3390/tropicalmed10090246 - 29 Aug 2025

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Abstract

Background: Neurocysticercosis (NCC) and HIV co-infection frequently occur in sub-Saharan Africa, yet the accuracy of available serological tests for NCC in immunosuppressed patients is uncertain. Methodology: We performed a cross-sectional diagnostic study on 101 people living with HIV from two endemic districts in [...] Read more.

Background: Neurocysticercosis (NCC) and HIV co-infection frequently occur in sub-Saharan Africa, yet the accuracy of available serological tests for NCC in immunosuppressed patients is uncertain. Methodology: We performed a cross-sectional diagnostic study on 101 people living with HIV from two endemic districts in Tanzania. Participants provided serum for cysticercosis antigen ELISA and Western Blot IgG; any positive result prompted neuroimaging investigation with cerebral computed tomography. NCC was diagnosed according to the 2017 revised Del Brutto criteria based on cCT according to Del Brutto criteria modified to exclude serology. Sensitivity, specificity, and area under the receiver–operating–characteristic curve (AUC) were calculated and adjusted for CD4 count and HIV stage. Two algorithms were compared: parallel testing (“either-test-positive”) and sequential screening (Ag ELISA screen, western blot IgG confirm). Results: NCC prevalence was 23%. Western Blot IgG outperformed Ag ELISA (sensitivity 57% vs. 30%; specificity 87% vs. 86%; AUC 0.73 vs. 0.57). Western blot IgG sensitivity declined to 54% when CD4 < 500 cells µL⁻¹, while Ag ELISA remained low. Western blot IgG positivity independently predicted NCC (adjusted odds ratio 4.1, 95% CI 1.4–11.9); Ag ELISA did not. When we counted a positive if either test was positive (parallel rule), sensitivity rose to 78% and NPV to 87%. When we ran Ag ELISA only if IgG was negative (sequential rule), we saved 70% of IgG strips, kept specificity at 95%, and PPV at 69%, but sensitivity fell to 39%. Conclusions: Western blot IgG is the most reliable single serological test for NCC in PLHIV. Parallel testing increased sensitivity and NPV and may suit better primary-level facilities without routine imaging. Sequential testing achieved high specificity, PPV, and conserved test kits, making it ideal for centers with limited reagents or scanner access. Tiered use of these assays can streamline NCC diagnosis in T. solium endemic, resource-limited settings. Full article

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13 pages, 638 KB

Open AccessReview

Structural Drivers of Cutaneous Leishmaniasis: Examining How the Converging Effects of Displacement, Environmental Disruption, and Political Instability Reshape Epidemiology Beyond Endemic Regions

by Janice Kim, Tarek Zieneldien, Sophia Ma and Bernard A. Cohen

Trop. Med. Infect. Dis. 2025, 10(9), 245; https://doi.org/10.3390/tropicalmed10090245 - 28 Aug 2025

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Abstract

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the Leishmania genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of [...] Read more.

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by protozoa of the Leishmania genus. Once confined to endemic regions such as the Middle East, Americas, North Africa, and Central Asia, CL is increasingly emerging in non-endemic areas due to a multitude of drivers, including population displacement, environmental disruption, and political instability. These overlapping drivers contribute to expanding sand fly habitats, degrading living conditions, and weakening health systems, increasing transmission. Rising global temperatures further facilitate vector expansion into new regions, where clinical unfamiliarity often leads to misdiagnosis, delayed treatment, increased morbidity, and greater financial burden. Despite its rising incidence and global spread, CL remains a neglected tropical disease since it is seldom fatal, with scant interest by public health authorities and financial donors, limiting activities that further research and prevent spread of the disease. This review synthesizes current evidence on how geopolitical instability, forced migration, and climate-driven ecological changes collectively reshape CL epidemiology and complicate diagnosis, treatment, and surveillance. As CL extends beyond traditional geographic boundaries, it requires integrated strategies that address its multifaceted drivers through strengthened cross-border surveillance, provider education, and international coordination—focusing on prevention, diagnosis, and equitable access to diagnostics and therapeutics, especially among displaced and underserved populations. Full article

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

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14 pages, 1646 KB

Open AccessArticle

Feasibility of Oral Rabies Vaccination of Dogs in Mexico

by Verónica Gutiérrez Cedillo, Luis Antonio Montoya Mondragón, Jose Ramón Fernández Colín, Katharina Bobe, Ad Vos, Luis Armando Lecuona Olivares and Ruy López Ridaura

Trop. Med. Infect. Dis. 2025, 10(9), 244; https://doi.org/10.3390/tropicalmed10090244 - 28 Aug 2025

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Abstract

Mexico has not only successfully eliminated dog-mediated human rabies in recent years, but also the last rabies case in a dog infected with the canine variant of the rabies virus was reported in 2016. Mass dog vaccination campaigns were the cornerstone of these [...] Read more.

Mexico has not only successfully eliminated dog-mediated human rabies in recent years, but also the last rabies case in a dog infected with the canine variant of the rabies virus was reported in 2016. Mass dog vaccination campaigns were the cornerstone of these achievements. Unfortunately, the rabies virus still circulates in wildlife and, thus, spill-over infections in humans, livestock, and pets, including dogs, still occurs. Especially dogs that cohabit at interfaces shared with wildlife, like shepherd dogs, are at risk. These dogs are often free-roaming and difficult to restrain for vaccination purposes. Oral rabies vaccination (ORV) as an alternative vaccination strategy was tested in several rural villages in Querétaro State, Mexico. Bait acceptance and immunogenicity studies were conducted to test a licensed vaccine bait in terms of attractiveness and if the oral rabies vaccine strain, SPBN GASGAS, was able to induce an adequate immune response in local dogs, respectively. Although the egg(-flavored) bait was less well accepted (68.4%) by the dogs than the two other bait types included in the study, a bait made from boiled intestine segments (71.2%) and a bait with fish meal as an attractant (72.3%), dogs offered the egg bait were more often considered successfully vaccinated. 83.3% of the dogs offered an egg bait seroconverted during the immunogenicity study. Hence, ORV can be a suitable alternative by increasing the overall vaccination coverage of dogs that cannot be easily restrained and handled for vaccination. Full article

(This article belongs to the Special Issue Tackling Emerging Zoonotic Diseases with a One Health Approach)

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10 pages, 392 KB

Open AccessArticle

Increase of Dengue in Pediatric Travelers in Madrid: A Multicentric Retrospective Experience

by Isabel Mellado-Sola, Sonia Milkova Ivanova, Milagros García López Hortelano, Paula Rodríguez-Molino, Cinta Moraleda, Sara Otero Alambillaga, Rut Fernández Martín, Francisco José Collado Díaz, Aida Sánchez García, Inés Ojeda Velázquez, Begoña Santiago-García and Talía Sainz

Trop. Med. Infect. Dis. 2025, 10(9), 243; https://doi.org/10.3390/tropicalmed10090243 - 28 Aug 2025

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Abstract

Dengue fever has significantly increased globally, extending into non-endemic regions. This study aims to describe the epidemiological and clinical characteristics of pediatric dengue cases diagnosed in Madrid, Spain, over ten years. We conducted a retrospective observational study across four tertiary hospitals, including all [...] Read more.

Dengue fever has significantly increased globally, extending into non-endemic regions. This study aims to describe the epidemiological and clinical characteristics of pediatric dengue cases diagnosed in Madrid, Spain, over ten years. We conducted a retrospective observational study across four tertiary hospitals, including all confirmed dengue cases in children under 16 between 2015 and 2024. Epidemiological data, clinical presentation, laboratory findings, and outcomes were collected, with severity assessed according to the 2009 WHO criteria. Forty-six cases were identified, with 72% diagnosed in the last three years and a peak incidence in 2024. Children visiting friends and relatives (VFR) constituted the majority of cases (56%). The most frequent clinical features were fever (100%) and gastrointestinal symptoms (78%), while laboratory findings included leukopenia (72%), thrombocytopenia (70%), and hypertransaminasemia (74%). Five cases (10%) met the criteria for severe dengue, one being fatal in a patient with pre-existing oncological disease. We identified no autochthonous cases. These results highlight the growing impact of imported pediatric dengue in non-endemic regions, the particular vulnerability of VFR travelers, and the need for clinical awareness, improved diagnostic availability and prevention strategies, especially in climate-influenced vector expansion. Full article

(This article belongs to the Section Travel Medicine)

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9 pages, 234 KB

Open AccessBrief Report

Epidemiological and Clinical Characteristics of Stenotrophomonas maltophilia Isolates from Hospitalized Medical Patients; An Emerging Pathogen in the Non-Critically Ill

by Dimitrios Kouroupis, Charalampos Zarras, Maria Zarfeiadou, Christos Sanos, Elias Iosifidis, Chrysi Michailidou, Konstantina Mpani, Panagiotis Pateinakis, Theocharis Koufakis, Michail Doumas, Ioannis Goulis, Dimitrios Vlachakis and Athina Pyrpasopoulou

Trop. Med. Infect. Dis. 2025, 10(9), 242; https://doi.org/10.3390/tropicalmed10090242 - 28 Aug 2025

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Abstract

Until recently, Stenotrophomonas maltophilia was considered a low-virulence pathogen, usually found as an environmental commensal and colonizer of moist abiotic surfaces. Lately, it has increasingly been implicated in invasive infections with high associated morbidity and mortality. Most epidemiological studies involving patients with S. [...] Read more.

Until recently, Stenotrophomonas maltophilia was considered a low-virulence pathogen, usually found as an environmental commensal and colonizer of moist abiotic surfaces. Lately, it has increasingly been implicated in invasive infections with high associated morbidity and mortality. Most epidemiological studies involving patients with S. maltophilia infections have recorded risk factors and their associations with outcomes in critically ill patients. The aim of this study was to investigate its epidemiology as a pathogen in patients hospitalized in medical wards and potential factors associated with mortality. For this purpose, S. maltophilia-positive cultures from patients admitted to medical wards from 1 January 2023 to 30 June 2025 were collected, demographics and patient characteristics were recorded and analyzed and associated with clinical outcome. Twenty-nine patients and their first positive S. maltophilia positive culture were included in the study with a direct attributable mortality of 27.6%. Patients with cardiovascular and chronic obstructive pulmonary disease more commonly developed respiratory tract infections. Among the recorded comorbidities, only diabetes was associated with worse outcome. Most of the strains retained sensitivity to co-trimoxazole and levofloxacin and treatment outcome was not affected by the choice of regimen. This study highlights the rise of S. maltophilia to a true pathogen affecting immunocompetent patients; in combination with its antimicrobial resistance, this justifies its recognition as an emerging pathogen of public health concern. Full article

(This article belongs to the Special Issue Emerging Infectious Diseases and Strategies for Their Prevention and Control)

18 pages, 3997 KB

Open AccessArticle

Identification of Statewide Hotspots for Respiratory Disease Targets Using Wastewater Monitoring Data

by Dustin Servello, Purnima Chalasani, Erica Leasure, Krysta Danielle LeMaster, Justin Kellar, Jill Stiverson, Michelle White and Zuzana Bohrerova

Trop. Med. Infect. Dis. 2025, 10(9), 241; https://doi.org/10.3390/tropicalmed10090241 - 28 Aug 2025

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Abstract

As wastewater monitoring networks continue to expand the monitoring of various targets, it is important to ensure these networks remain both representative of their monitored populations and flexible enough to accurately predict shifts in an expanding list of targets. In this study, we [...] Read more.

As wastewater monitoring networks continue to expand the monitoring of various targets, it is important to ensure these networks remain both representative of their monitored populations and flexible enough to accurately predict shifts in an expanding list of targets. In this study, we analyzed the levels of SARS-CoV-2, influenza A (InfA), and influenza B (InfB) detected in untreated wastewater during the 2023–2024 respiratory season at 70 locations participating in the Ohio Wastewater Monitoring Network. Locations with the first detection that are seasonal hotspots and sites reaching peak concentration for each target were compared and analyzed for dependence on healthcare access and population characteristics, such as population size and density, county traffic, and demographic and socioeconomic factors. The trends in these three respiratory viruses were found to closely mirror trends in clinical indicators including the number of cases and positive tests with wastewater levels providing a two-week lead for SARS-CoV-2 and no lead for influenza on these clinical indicators. InfA was first detected in more affluent sewersheds that were less racially and ethnically diverse and had higher traffic counts, while none of the parameters tested had an effect on InfB first detects. The seasonal hotspots varied for all three respiratory viruses, where InfA hotspots were exclusively in the northeast, InfB was in the southeast and east border areas, and SARS-CoV-2 wastewater hotspots concentrated around central and northwestern Ohio. While wastewater monitoring networks may not offer full coverage of all populous areas, we have shown that a spatially distributed and highly diverse network is needed for early detection of various respiratory targets. Full article

(This article belongs to the Special Issue Emerging and Re-emerging Infectious Diseases: Global and Local Burden, Surveillance, and Response Strategies)

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22 pages, 2811 KB

Open AccessArticle

Profiling HIV Risk and Determined, Resilient, Empowered AIDS-Free, Mentored, and Safe (DREAMS) Program Reach Among Adolescent Girls and Young Women (AGYW) in Namibia: Secondary Analysis of Population and Program Data

by Enos Moyo, Endalkachew Melese, Hadrian Mangwana, Simon Takawira, Rosalia Indongo, Bernadette Harases, Perseverance Moyo, Ntombizodwa Makurira Nyoni, Kopano Robert and Tafadzwa Dzinamarira

Trop. Med. Infect. Dis. 2025, 10(9), 240; https://doi.org/10.3390/tropicalmed10090240 - 27 Aug 2025

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Abstract

Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE [...] Read more.

Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE Namibia (PHN)-led consortium implemented the PEPFAR/USAID-funded DREAMS project in Khomas, Oshikoto, and Zambezi regions from 2018 to 2023. This study estimated the AGYW population most in need of HIV prevention and assessed geographic and age-specific gaps to improve program effectiveness and efficiency. Methods: This secondary data analysis utilized the Namibia Population-Based HIV Impact Assessment (NamPHIA) 2017, the Namibia census, and service data from the DREAMS project, which includes entry points for recruitment, screening, and enrolment. We used Python to conduct unadjusted and adjusted Poisson regression and UpSet plots for data visualization. Results: Analysis of NamPHIA data revealed low HIV prevalence in 10–14-year-olds, with only Oshikoto showing a detectable rate of 2.76%, mostly attributed to perinatal HIV transmission. Of the 12 DREAMS eligibility criteria, three could be mapped to 10–14-year-olds, while all except sexually transmitted infections could be mapped for 15–19 and 20–24-year-olds. Nationally, 17.3% of 10–14-year-old AGYW, 48.0% of 15–19-year-olds, and 50% of 20–24-year-olds met at least one DREAMS eligibility criterion. Among 15–19-year-olds, a history of pregnancy, no/irregular condom use, and out-of-school status were positively associated with HIV status. For 20–24-year-olds, transactional sex was positively associated with HIV status. Overall, 62% of screened individuals were eligible, and 62% of eligible individuals enrolled. PHN screened 134% of the estimated 37,965 10–14-year-olds, 95% of the estimated 35,585 15–19-year-olds, and 57% of the 24,011 20–24-year-olds residing in the five districts where DREAMS was implemented. Conclusions: We recommend the refinement of the DREAMS eligibility criteria, particularly for AGYW 10–14, to better identify and engage those at risk of HIV acquisition through sexual transmission. For 15–19-year-olds, PHN efforts should interrogate geographic variability in entry points for recruitment and screening practices. PHN should enhance the recruitment and engagement of AGYW 20–24, with a particular focus on those engaged in transactional sex. Full article

(This article belongs to the Special Issue Leaving No One Behind: The Prevention and Treatment of HIV Among Key and Vulnerable Populations)

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15 pages, 455 KB

Open AccessArticle

Enterobacterales and Antimicrobial Resistance in Feed, Water, and Slurry in Pig Production Farms in the Greater Accra Region of Ghana, 2024

by Elvis Fiam Amegayibor, Rita Ohene Larbi, Matilda Ayim-Akonor, Richael Odarkor Mills, Helena Owusu, Benjamin Kissi Sasu, Robert Fraser Terry, Anthony D. Harries and Florence S. Kuukyi

Trop. Med. Infect. Dis. 2025, 10(9), 239; https://doi.org/10.3390/tropicalmed10090239 - 27 Aug 2025

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Abstract

Increasing antimicrobial resistance (AMR) levels in Enterobacterales from pigs in Ghana prompted us to investigate farm feed, pig slurry, and farm water for Enterobacterales isolates, their antimicrobial resistance patterns, and antimicrobial residues. Between August and November 2024, we collected one sample each of [...] Read more.

Increasing antimicrobial resistance (AMR) levels in Enterobacterales from pigs in Ghana prompted us to investigate farm feed, pig slurry, and farm water for Enterobacterales isolates, their antimicrobial resistance patterns, and antimicrobial residues. Between August and November 2024, we collected one sample each of feed, slurry, and water from 14 pig farms for microbiological analysis. Out of 42 samples, Enterobacterales (E. coli and Enterobacter spp.) were isolated from 30 (71.4%) samples, with the highest prevalence found in feed (85.7%), followed by slurry (78.6%) and water (50.0%). The prevalence of AMR to tetracyclines, trimethoprim-sulfamethoxazole, and ampicillin was high, with over 50% of isolates from slurry and water and 40% from feed exhibiting tetracycline resistance. Multi-drug resistance (MDR) was identified in nine (27.3%) isolates of Enterobacterales, with the highest prevalence found in feed (38.5%), then slurry (23.1%), and water (14.3%). Among 42 farm samples screened for colistin-resistant Enterobacterales, 10 (23.8%) exhibited phenotypic colistin resistance. No antimicrobial residues were detected. Risk factors associated with MDR included large farms with high pig turnover (p < 0.05) and the channelling of slurry into both covered and uncovered pits on the farm (p < 0.05). These high resistance levels underscore the urgent need for improved hygiene in feed, water, and slurry management, stricter antibiotic stewardship with veterinary oversight, and better enforcement of existing antibiotic use regulations on pig farms. Full article

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

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15 pages, 1540 KB

Open AccessArticle

Evaluation of Hospitalizations for Tick-Borne Diseases in the United States from 2002 to 2021

by Sidhvi Nekkanti, Kirsten Hickok, Mahesh Shrestha, Eric Edewaard and Thomas A. Melgar

Trop. Med. Infect. Dis. 2025, 10(9), 238; https://doi.org/10.3390/tropicalmed10090238 - 27 Aug 2025

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Abstract

Tick-borne diseases (TBDs) are a growing public health concern in the United States. This study analyzed 261,630 weighted hospitalizations from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database between 2002 and 2021 to evaluate trends, coinfections, demographic disparities, and [...] Read more.

Tick-borne diseases (TBDs) are a growing public health concern in the United States. This study analyzed 261,630 weighted hospitalizations from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database between 2002 and 2021 to evaluate trends, coinfections, demographic disparities, and financial impacts. Lyme disease was the most common cause, accounting for 65% of hospitalizations (171,328 admissions), followed by ehrlichiosis/anaplasmosis (46,446), babesiosis (18,057), rickettsial diseases (16,412), tularemia (2428), and other TBDs (19,435). Hospitalizations increased 2.5-fold over the study period, with the Northeast region bearing 52.9% of the burden and peaking in July. Males (53.9%), Caucasians (81.4%), and residents of higher-income zip codes were predominant, though rickettsial diseases showed elevated Hispanic representation (18.4%). Coinfections were common, with 35.8% of babesiosis and 15.6% of ehrlichiosis/anaplasmosis cases involving another TBD, suggesting that routine testing may be warranted. Median hospital charges rose from USD 9433 in 2002 to USD 35,161 in 2021, totaling USD 1.265 billion in 2021. In-hospital mortality was 1.1%, with the highest cause of mortality being babesiosis (2.06%). Future areas for research include characterizing the burden of disease in an outpatient setting, understanding the causes of racial disparities in hospitalizations, and testing strategies to identify coinfection. Full article

(This article belongs to the Special Issue The Distribution and Diversity of Tick-Borne Zoonotic Pathogens)

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16 pages, 2215 KB

Open AccessArticle

Long-Term Durability and Public Health Impact of City-Wide wMel Wolbachia Mosquito Releases in Niterói, Brazil, During a Dengue Epidemic Surge

by Katherine L. Anders, Gabriel Sylvestre Ribeiro, Renato da Silva Lopes, Pilar Amadeu, Thiago Rodrigues da Costa, Thais Irene Souza Riback, Karlos Diogo de Melo Chalegre, Wesley Pimentel de Oliveira, Cátia Cabral da Silva, Marcos Vinicius Ferreira Mendes Blanco, Ana Lucia Fontes Eppinghaus, Fabio Villas Boas, Tibor Frossard, Benjamin R. Green, Scott L. O’Neill, Peter A. Ryan, Cameron P. Simmons and Luciano A. Moreira

Trop. Med. Infect. Dis. 2025, 10(9), 237; https://doi.org/10.3390/tropicalmed10090237 - 25 Aug 2025

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Abstract

In 2024, the Americas experienced the largest dengue outbreak on record and Brazil was among the worst affected countries, reporting 6.6 million cases and 6200 deaths. We report the long-term entomological and epidemiological effectiveness of city-wide deployment of wMel-strain Wolbachia-infected Aedes [...] Read more.

In 2024, the Americas experienced the largest dengue outbreak on record and Brazil was among the worst affected countries, reporting 6.6 million cases and 6200 deaths. We report the long-term entomological and epidemiological effectiveness of city-wide deployment of wMel-strain Wolbachia-infected Aedes aegypti in Niterói, a city of half a million people in Rio de Janeiro state, where Wolbachia releases across three-quarters of the urban population in 2017–2019 were expanded to remaining populated areas in 2023. wMel was durably established at ≥95% prevalence in Ae. aegypti populations throughout Niterói four years post-release, and up to seven years in the earliest release sites. Notified dengue case incidence in Niterói was 89% lower following Wolbachia releases, compared to the 10-year pre-intervention period of 2007–2016. Dengue incidence in Niterói in 2024, during a period of record high incidence in Brazil and the region, was 374 per 100,000 population, substantially lower than overall in Rio de Janeiro state (1884 per 100,000) and nationwide in Brazil (3157 per 100,000). Our findings show that city-wide Wolbachia coverage in Niterói provided sustained population-level reduction in dengue incidence throughout the five years post-intervention, including during the 2024 epidemic surge, averting an estimated three-quarters of the dengue case burden that may otherwise have been expected in Niterói in 2024. Full article

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

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Trop. Med. Infect. Dis., Volume 10, Issue 9 (September 2025) – 23 articles

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