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Trop. Med. Infect. Dis., Volume 9, Issue 11 (November 2024) – 33 articles

Cover Story (view full-size image): Tick-borne diseases (TBDs) have emerged as a major global public health problem in recent decades, prompting the need for robust surveillance systems to track their prevalence, distribution and impact on public health. The impact of human infection extends to the diagnostic challenges that arise when the same symptomatology can be associated with any tick-borne pathogen, and therapeutic recommendations do not focus on an integrated approach to potential TBDs. Thus, both surveillance systems and holistic diagnosis of tick-borne pathogens are necessary tools to respond to the emergence of these diseases. This study focuses on the main TBDs in Spain to reflect the need to establish syndromic diagnoses in patients with a history of tick bites and symptomatology compatible with tick bites. View this paper
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11 pages, 1328 KiB  
Review
Genotyping and Characterizing Plasmodium falciparum to Reveal Genetic Diversity and Multiplicity of Infection by Merozoite Surface Proteins 1 and 2 (msp-1 and msp-2) and Glutamate-Rich Protein (glurp) Genes
by Muharib Alruwaili, Abozer Y. Elderdery, Hasan Ejaz, Aisha Farhana, Muhammad Atif, Hayfa Almutary and Jeremy Mills
Trop. Med. Infect. Dis. 2024, 9(11), 284; https://doi.org/10.3390/tropicalmed9110284 - 20 Nov 2024
Viewed by 716
Abstract
Resistance to current antimalarial drugs is steadily increasing, and new drugs are required. Drug efficacy trials remain the gold standard to assess the effectiveness of a given drug. The World Health Organization (WHO)’s recommendation for the optimal duration of follow-up for assessing antimalarial [...] Read more.
Resistance to current antimalarial drugs is steadily increasing, and new drugs are required. Drug efficacy trials remain the gold standard to assess the effectiveness of a given drug. The World Health Organization (WHO)’s recommendation for the optimal duration of follow-up for assessing antimalarial efficacy is a minimum of 28 days. However, assessing antimalarial drug efficacy in highly endemic regions can be challenging due to the potential risks of acquiring a new infection in the follow-up period, and thus, it may underestimate the efficacy of the given drugs. A new treatment should be introduced if treatment failure rates exceed 10%. Overestimation occurs as a result of retaining a drug with a clinical efficacy of less than 90% with increases in morbidity and mortality, while underestimation may occur due to a misclassification of new infections as treatment failures with tremendous clinical and economic implications. Therefore, molecular genotyping is necessary to distinguish true new infections from treatment failures to ensure accuracy in determining antimalarial efficacy. There are three genetic markers that are commonly used in antimalarial efficiency trials to discriminate between treatment failures and new infections. These include merozoite surface protein 1 (msp-1), merozoite surface protein 2 (msp-2), and glutamate-rich protein (glurp). The genotyping of P. falciparum by nested polymerase chain reaction (n-PCR) targeting these markers is discussed with the inherent limitations and uncertainties associated with the PCR technique and limitations enforced by the parasite’s biology itself. Full article
(This article belongs to the Special Issue The Global Burden of Malaria and Control Strategies)
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10 pages, 291 KiB  
Article
Evaluation of Serological Tests for Different Disease Stages of Leptospirosis Infection in Humans
by Virginia C. Rodríguez-Rodriguez, Ana María Castro, Ronald Soto-Florez, Luis Urango-Gallego, Alfonso Calderón-Rangel, Piedad Agudelo-Flórez and Fernando P. Monroy
Trop. Med. Infect. Dis. 2024, 9(11), 283; https://doi.org/10.3390/tropicalmed9110283 - 20 Nov 2024
Viewed by 647
Abstract
Background/Objectives: Leptospirosis is a zoonotic disease that is widely distributed around the world and presents symptoms similar to other febrile illnesses in tropical regions, which complicates clinical diagnosis. This study aimed to evaluate the performance and agreement between serological diagnostic tests for detecting [...] Read more.
Background/Objectives: Leptospirosis is a zoonotic disease that is widely distributed around the world and presents symptoms similar to other febrile illnesses in tropical regions, which complicates clinical diagnosis. This study aimed to evaluate the performance and agreement between serological diagnostic tests for detecting both acute and convalescent human leptospirosis, using the micro agglutination test (MAT) as a reference in an endemic region of the Colombian Caribbean. Methods: A prospective descriptive study was conducted on 275 participants with suspected leptospirosis. Paired serum samples were obtained, and an epidemiological survey was conducted. Using the MAT as the gold standard, we calculated positive and negative predictive values, sensitivity, specificity, and kappa index. A Bayesian latent class model was also used to compare the diagnostic tests. Results: In 223 paired serum samples, the sensitivity values for various stages of the disease ranged between 10.8% to 54.1% in the acute and 6.1% to 66.7% during the convalescent phase compared to the MAT. According to the Bayesian model, sensitivity was 9.5% to 75.3% in the acute phase and 5.7% to 85.3% in the convalescent phase. The Kappa value, an indicator of agreement, was moderate for the IgM ELISA in the acute phase (0.553) and substantial in the convalescent phase (0.692). Conclusions: The MAT was the best confirmatory test in both acute and convalescent phases of leptospirosis. Despite the high specificity of ELISA, 21.62% of participants identified as negative by IgM-ELISA in both phases were subsequently confirmed as positive by the MAT. It is necessary to re-evaluate diagnostic guidelines that do not employ the MAT for confirmation and to enhance the diagnostic and clinical identification of leptospirosis within healthcare institutions and public health laboratories while providing a rapid and reliable test for its implementation. Full article
(This article belongs to the Special Issue Advances in Molecular Diagnosis in Neglected Tropical Diseases)
16 pages, 2519 KiB  
Article
Surveillance of Emerging Rodent-Borne Pathogens in Wastewater in Taiwan: A One Health Approach
by Kun-Hsien Tsai, Tsai-Ying Yen, Hsin-Hsin Tung, Amy Ho, Yang-Ta Chien, Chung-Yu Wang, Shu-Wei Kang, Ning-Ning Juan and Fang-Ling Lin
Trop. Med. Infect. Dis. 2024, 9(11), 282; https://doi.org/10.3390/tropicalmed9110282 - 18 Nov 2024
Viewed by 740
Abstract
Leptospirosis and hantavirus syndrome are two major rodent-borne diseases in Taiwan. Rocahepevirus ratii (RHEV), a virus closely related to hepatitis E virus (HEV, Paslahepevirus balayani), is emerging and has been reported to cause hepatitis in humans. We employed wastewater-based epidemiology to actively [...] Read more.
Leptospirosis and hantavirus syndrome are two major rodent-borne diseases in Taiwan. Rocahepevirus ratii (RHEV), a virus closely related to hepatitis E virus (HEV, Paslahepevirus balayani), is emerging and has been reported to cause hepatitis in humans. We employed wastewater-based epidemiology to actively monitor rodent-borne pathogens, and the correlations with human cases were evaluated. Wastewater was collected using grab sampling at 11 sites along a sewer system including influents and effluents at a wastewater treatment plant in Tamsui, New Taipei City, Taiwan, monthly during June 2023 to May 2024. The presence of pathogens was examined by reverse transcription-polymerase chain reaction (RT-PCR). The result showed an overall positivity rate of 38.2% (50/131). Leptospira was detected most often (48/131, 36.6%), and RHEV and hantaviruses were found once each during the study period. Sequencing identified Leptospira interrogans close to isolates from rodents and human cases, while sequences of hantavirus and RHEV were most similar to isolates from rodents. No significant correlation was found with human cases or positive samples for rodent DNA. Here, we present an example of a One Health approach applying wastewater to environmental surveillance for the early detection and prevention of emerging diseases. Full article
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15 pages, 918 KiB  
Article
Community Knowledge, Attitudes and Practices About Malaria: Insights from a Northwestern Colombian Endemic Locality
by Paola Muñoz-Laiton, Juan C. Hernández-Valencia and Margarita M. Correa
Trop. Med. Infect. Dis. 2024, 9(11), 281; https://doi.org/10.3390/tropicalmed9110281 - 18 Nov 2024
Viewed by 695
Abstract
Malaria prevention and control programs are mainly oriented to vector control, timely diagnosis and adequate treatment. Malaria transmission is influenced by several factors, including biological and social aspects. Thus, it is relevant to consider community beliefs and practices to ensure sustainable prevention and [...] Read more.
Malaria prevention and control programs are mainly oriented to vector control, timely diagnosis and adequate treatment. Malaria transmission is influenced by several factors, including biological and social aspects. Thus, it is relevant to consider community beliefs and practices to ensure sustainable prevention and control strategies. This study aimed to determine knowledge, attitudes and practices (KAP) towards malaria in an endemic locality in northwestern Colombia. Preliminary data were collected through a focus group discussion. Subsequently, a KAP survey was administered to the community. KAP scores were associated with both sociodemographic characteristics and with previous malaria infection. Focus group data revealed knowledge gaps and the absence of or having worn-out nets. Survey results showed that participants recognized a mosquito bite as the transmission mode (72.09%), followed by dirty water (44.19%), high fever (86.05%) and headache (79.07%) as the main symptoms. Regarding attitudes, 44.19% of the people would go to the hospital in the case of having symptoms. The most recognized practices for disease prevention were the use of mosquito nets (65.12%) and fans (23.26%). The results showed that some people had misconceptions about the disease transmission mode. The analysis showed significant associations of either female gender and homemaker occupation with a good knowledge [OR = 3.74, (p = 0.04), OR = 3.55, (p = 0.04), respectively] or female with a positive attitude towards malaria control and prevention [OR = 4.80, (p = 0.04)]. These results showed that the identified gaps in KAP require increasing education among the community in addition to applying public health prevention efforts. The data may be useful in designing malaria control strategies that involve community participation. Full article
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28 pages, 625 KiB  
Review
A Risk Management Approach to Global Pandemics of Infectious Disease and Anti-Microbial Resistance
by Annie Sparrow, Meghan Smith-Torino, Samuel M. Shamamba, Bisimwa Chirakarhula, Maranatha A. Lwaboshi, Christine Stabell Benn and Konstantin Chumakov
Trop. Med. Infect. Dis. 2024, 9(11), 280; https://doi.org/10.3390/tropicalmed9110280 - 18 Nov 2024
Viewed by 1545
Abstract
Pandemics of infectious disease and growing anti-microbial resistance (AMR) pose major threats to global health, trade, and security. Conflict and climate change compound and accelerate these threats. The One Health approach recognizes the interconnectedness of human, animal, and environmental health, but is grounded [...] Read more.
Pandemics of infectious disease and growing anti-microbial resistance (AMR) pose major threats to global health, trade, and security. Conflict and climate change compound and accelerate these threats. The One Health approach recognizes the interconnectedness of human, animal, and environmental health, but is grounded in the biomedical model, which reduces health to the absence of disease. Biomedical responses are insufficient to meet the challenges. The COVID-19 pandemic is the most recent example of the failure of this biomedical model to address global threats, the limitations of laboratory-based surveillance, and the exclusive focus on vaccination for disease control. This paper examines the current paradigm through the lens of polio and the global campaign to eradicate it, as well as other infectious threats including mpox and drug-resistant tuberculosis, particularly in the context of armed conflict. Decades before vaccines became widely available, public health measures—ventilation, chlorination, nutrition and sanitation— led to longer, healthier, and even taller lives. Chlorine, our primary tool of public health, conquered cholera and transformed infection control in hospitals. The World Health Organization (WHO), part of the One Health alliance, focuses mainly on antibiotics and vaccines to reduce deaths due to superbugs and largely ignores the critical role of chlorine to control water-borne diseases (including polio) and other infections. Moreover, the One Health approach ignores armed conflict. Contemporary wars are characterized by indiscriminate bombing of civilians, attacks targeting healthcare, mass displacement and lack of humanitarian access, conditions which drive polio outbreaks and incubate superbugs. We discuss the growing trend of attacks on healthcare and differentiate between types: community-driven attacks targeting vaccinators in regions like Pakistan, and state-sponsored attacks by governments such as those of Syria and Russia that weaponize healthcare to deliberately harm whole populations. Both fuel outbreaks of disease. These distinct motivations necessitate tailored responses, yet the WHO aggregates these attacks in a manner that hampers effective intervention. While antimicrobial resistance is predictable, the escalating pandemic is the consequence of our reliance on antibiotics and commitment to a biomedical model that now borders on pathological. Our analysis reveals the international indenture to the biomedical model as the basis of disease control is the root driver of AMR and vaccine-derived polio. The unique power of vaccines is reduced by vaccination-only strategy, and in fact breeds vaccine-derived polio. The non-specific effects of vaccines must be leveraged, and universal vaccination must be supplemented by international investment in water chlorination. This will reduce health costs and strengthen global health security. While vaccines are an important weapon to combat pandemics and AMR, they must be accompanied by the entire arsenal of public health interventions. Full article
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10 pages, 784 KiB  
Article
Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens
by Chiadika Nwanze, Daniel Muller, Priscilla Suleman, Mrinmayee Takle, John R. Barber, Kyle J. Wilson, Nicholas A. V. Beare, Karl B. Seydel and Douglas G. Postels
Trop. Med. Infect. Dis. 2024, 9(11), 279; https://doi.org/10.3390/tropicalmed9110279 - 16 Nov 2024
Viewed by 570
Abstract
Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular [...] Read more.
Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular whitening, retinal hemorrhages, and vessel color changes) with the total, circulating, or sequestered parasite load in children with CM. Total parasite burden was estimated by measuring plasma levels of Plasmodium falciparum histidine-rich protein 2 (PfHRP2), while the sequestered load was calculated as the difference between the total burden and circulating parasitemia. Children with retinopathy-positive CM (n = 172) had higher total and sequestered parasite burdens compared to retinopathy-negative children (n = 42) (both p = 0.049). In a subgroup with detailed retinopathy grading (n = 52), more extensive vessel color changes correlated with higher total, sequestered, and circulating parasite loads (p = 0.0057, p = 0.0068, and p = 0.0433, respectively). Peripheral retinal whitening was also associated with increased total and sequestered loads (p = 0.0017 and p = 0.0012). No association was found between retinal hemorrhages and parasite burden, indicating that other factors may influence their pathogenesis. Full article
(This article belongs to the Special Issue Recent Progress in Mosquito-Borne Diseases)
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4 pages, 178 KiB  
Editorial
Renewing Our Focus on Vulnerable Populations Among People Living with HIV
by James Ayieko, Marguerite Thorp and Musie Ghebremichael
Trop. Med. Infect. Dis. 2024, 9(11), 278; https://doi.org/10.3390/tropicalmed9110278 - 14 Nov 2024
Viewed by 643
Abstract
The global HIV landscape has changed over the past few decades, with great milestones achieved in both HIV treatment and prevention [...] Full article
12 pages, 650 KiB  
Article
Standardization and Evaluation of the LAMP Technique for the Diagnosis of Canine Visceral Leishmaniasis in Conjunctival Swab Samples Using DNA Extracted by a Silica Column and Boiling
by Isabela C. S. Santos, Daniel M. Avelar, Luciana F. C. Miranda, Cintia X. de Mello, Lucas Keidel, Maria Inês F. Pimentel, Luanna S. Ventura, Aline Fagundes, Fernanda N. Santos, Liliane F. A. Oliveira, Shanna A. Santos, Sandro Antonio Pereira, Rodrigo C. Menezes and Andreza P. Marcelino
Trop. Med. Infect. Dis. 2024, 9(11), 277; https://doi.org/10.3390/tropicalmed9110277 - 14 Nov 2024
Viewed by 653
Abstract
The diagnosis of canine visceral leishmaniasis (CVL) presents a challenge due to a variety of non-specific clinical signs. The available tests have low sensitivity. This study aimed to standardize and evaluate the loop-mediated isothermal amplification technique with K26 target (K26-LAMP) for diagnosis of [...] Read more.
The diagnosis of canine visceral leishmaniasis (CVL) presents a challenge due to a variety of non-specific clinical signs. The available tests have low sensitivity. This study aimed to standardize and evaluate the loop-mediated isothermal amplification technique with K26 target (K26-LAMP) for diagnosis of CVL in conjunctival swab (CS) DNA samples extracted through a silica column commercial kit (SW-kit) and boiling (SW-DB) and to compare sensitivity with conventional PCR (kDNA-cPCR) and quantitative real-time PCR (18S-qPCR). Clinical samples of CSs were collected from 54 dogs after reactive serology tests. Positive parasitological and/or histological tests were used as inclusion criteria for a sensitivity analysis. A total of 79.2% (43/54) of dogs without clinical signs or with mild, moderate, or severe clinical signs were included in the study. The sensitivity results of K26-LAMP, kDNA-cPCR, and 18S-qPCR were 72.1%, 81.4%, and 80.5% with the SW-kit and 97.2%, 95.2%, and 57.1% with SW-DB, respectively. In all techniques, the proportion of positives was higher in the group with severe clinical disease, with statistically significant differences in the K26-LAMP and 18S-qPCR techniques being seen with the SW-kit. The results obtained with LAMP for CS samples are promising and its performance is similar to other techniques. Full article
(This article belongs to the Special Issue Molecular Surveillance and New Diagnostic Tests for Leishmaniasis)
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12 pages, 646 KiB  
Article
The Safety, Acceptability, and Feasibility of Single-Dose Rifampicin as Post-Exposure Chemoprophylaxis for Contacts of Leprosy Patients in Togo: A Mixed-Method Sequential Explanatory Study
by Akila Wimima Bakoubayi, Falapalaki Haliba, Wendpouiré Ida C. Zida-Compaore, P’tanam P’kontème Bando, Yao Rodion Konu, Abissouwèssim Egbare Tchade, Kodjo Akpadja, Kamevor Alaglo, Maweke Tchalim, P’niwè Patchali, Yaovi Djakpa, Komi Amekuse, Piham Gnossike, Denis A. Yawovi Gadah, Christa Kasang and Didier Koumavi Ekouevi
Trop. Med. Infect. Dis. 2024, 9(11), 276; https://doi.org/10.3390/tropicalmed9110276 - 14 Nov 2024
Viewed by 911
Abstract
The World Health Organization is encouraging countries to include contact screening and single-dose rifampicin administration as preventive chemotherapy for contacts of leprosy patients in their leprosy control activities. However, no study has been conducted to assess the safety of SDR-PEP and the acceptability [...] Read more.
The World Health Organization is encouraging countries to include contact screening and single-dose rifampicin administration as preventive chemotherapy for contacts of leprosy patients in their leprosy control activities. However, no study has been conducted to assess the safety of SDR-PEP and the acceptability and feasibility of this intervention in Togo. To assess the safety of SDR-PEP, we used a cohort design, and for acceptability and feasibility, we used a mixed method, combining a quantitative study to assess the safety of SDR-PEP in a cohort of contacts from recently diagnosed leprosy patients followed by a qualitative study to identify the social, cultural, or institutional factors that would influence the adoption of single-dose rifampicin as post-exposure prophylaxis for contacts of leprosy patients in Togo. For the quantitative study, all identified index patients agreed to the disclosure of their status to their contacts and provided a list of their contacts. All the contacts found agreed to take part in the study, and an appointment was made for screening. However, some contacts were absent on the screening day for no reason. All eligible contacts agreed to take SDR and were followed up after taking the drug. No severe adverse events were reported during the follow-up. For the qualitative study, 72 interviews (66 semi-structured interviews and 6 focus groups) were carried out, and it emerged that, overall, opinions were favorable on the acceptability and feasibility of implementing single-dose rifampicin as post-exposure prophylaxis for contacts of leprosy patients in Togo. However, a number of conditions need to be considered for more effective results. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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19 pages, 620 KiB  
Article
African Schistosomiasis: A Framework of Indicators Assessing the Transmission Risk and Intervention Effectiveness
by Hong-Mei Li, Nicholas Midzi, Masceline Jenipher Mutsaka-Makuvaza, Zhi-Qiang Qin, Shan Lv, Shang Xia, Ying-Jun Qian, Robert Berquist and Xiao-Nong Zhou
Trop. Med. Infect. Dis. 2024, 9(11), 275; https://doi.org/10.3390/tropicalmed9110275 - 13 Nov 2024
Viewed by 952
Abstract
Schistosomiasis, a parasitic disease with a complex transmission mechanism, requiring a snail intermediate host, is influenced by biology, the environment, human behavior and the prevailing socioeconomic situation. This study aimed to systematically investigate the importance and feasibility of indicators related to the factors [...] Read more.
Schistosomiasis, a parasitic disease with a complex transmission mechanism, requiring a snail intermediate host, is influenced by biology, the environment, human behavior and the prevailing socioeconomic situation. This study aimed to systematically investigate the importance and feasibility of indicators related to the factors influencing transmission and intervention measures for Schistosoma mansoni and S. haematobium. Based on a literature review and group discussions according to the Delphi method, a framework questionnaire was designed. A total of 33 experts on schistosomiasis were invited, and 27 were accepted, to rate the importance and feasibility of indicators for transmission with and the control of schistosomiasis, with a focus on intervention measures for S. mansoni and S. haematobium infections in Zimbabwe. After two rounds of Delphi consultations with these experts, calculated to have a high average authority coefficient (0.88), a consensus was reached on a framework that included 2 primary, 6 secondary and 39 tertiary indicators. The Delphi–entropy method was applied to assess the weight of each indicator. The key influencing factors included hazardous water exposure, accessibility to safe drinking water, sanitary facilities and the contamination of water bodies by outdoor defecation/urinary habits. The intervention measures involved improved diagnostics, health education, preventive chemotherapy, the presence of national control plans and the implementation of the strategy on water, sanitation and hygiene (WASH). While these factors are already well known, their detailed order of importance could help to improve the allocation of specific control efforts. Full article
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9 pages, 270 KiB  
Communication
Strengthening Tuberculosis Control Among Migrant Workers
by Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate, Prithvi Brahmanand Petkar, Harshal Gajanan Mendhe and Gulshan Ruprao Bandre
Trop. Med. Infect. Dis. 2024, 9(11), 274; https://doi.org/10.3390/tropicalmed9110274 - 12 Nov 2024
Viewed by 617
Abstract
Tuberculosis (TB) is a serious infectious disease accounting for a significant number of deaths due to the infectious nature of the disease on the global platform. Migrant workers need special attention as these population groups live in substandard and crowded environmental conditions with [...] Read more.
Tuberculosis (TB) is a serious infectious disease accounting for a significant number of deaths due to the infectious nature of the disease on the global platform. Migrant workers need special attention as these population groups live in substandard and crowded environmental conditions with poor ventilation, which play a crucial role in augmenting the risk of acquisition of infection. The global vision to ensure the delivery of effective TB control-related services for migrant workers has been influenced by a wide range of barriers. This issue is further complicated by the limited knowledge of migrant workers about tuberculosis, their rights, the kind of services available in healthcare facilities, and the ways to prevent the acquisition and transmission of infectious disease. By acknowledging the role of predisposing factors and the potential barriers that impact accessing timely healthcare services, it can be seen that the need of the hour is to plan and implement a comprehensive package of services for the benefit of migrant workers. Full article
(This article belongs to the Special Issue Contemporary Migrant Health, 2nd Edition)
12 pages, 270 KiB  
Article
Knowledge, Attitude, and Practice of Healthcare Providers Towards Preventive Chemotherapy Neglected Tropical Diseases in the Forécariah Health District, Guinea, 2022
by Fatoumata Diaraye Diallo, Tamba Mina Millimouno, Hawa Manet, Armand Saloum Kamano, Emmanuel Camara, Bienvenu Salim Camara and Alexandre Delamou
Trop. Med. Infect. Dis. 2024, 9(11), 273; https://doi.org/10.3390/tropicalmed9110273 - 11 Nov 2024
Viewed by 643
Abstract
Background: Neglected tropical diseases (NTDs) are a diverse group of twenty diseases that occur in tropical and subtropical regions that particularly affect vulnerable and often marginalised populations. Five of these are classified as “preventive chemotherapy” (PC) diseases such as trachoma, onchocerciasis, geo-helminthiasis, lymphatic [...] Read more.
Background: Neglected tropical diseases (NTDs) are a diverse group of twenty diseases that occur in tropical and subtropical regions that particularly affect vulnerable and often marginalised populations. Five of these are classified as “preventive chemotherapy” (PC) diseases such as trachoma, onchocerciasis, geo-helminthiasis, lymphatic filariasis, and schistosomiasis. This study aimed to describe the knowledge, attitudes, and practices of healthcare providers in the Forecariah health district with respect to PC-NTDs in Guinea in 2022. Methods: A descriptive cross-sectional study was conducted from 7 to 22 November 2022 among healthcare providers in the health district of Forécariah in Guinea. Data on participants’ socio-demographic characteristics and knowledge of and attitudes and practices regarding PC-NTDs were collected using an electronic (KoboToolbox) semi-structured questionnaire and analysed using descriptive statistics. Results: Among the 86 healthcare providers who participated in this study, nurses (44.2%) and young adults aged between 25 and 49 years (81.4%) were mostly represented. The majority of respondents declared having already heard about onchocerciasis (70.7%) and lymphatic filariasis (60.0%) but only the minority declared having already heard about geo-helminthiasis (30.7%), schistosomiasis (21.3%), and trachoma (9.3%). Only a few respondents knew how to prevent PC-NTDs (onchocerciasis 26.7%, lymphatic filariasis 26.7%, geo-helminthiasis 29.3%, and schistosomiasis 17.3%). Many healthcare providers reported they would refer cases of onchocerciasis (50.6%), lymphatic filariasis (58.7%), and schistosomiasis (46.7%) to a management centre. Conclusions: This study highlights the varying levels of knowledge, attitudes, and practices among healthcare providers in dealing with PC-NTDs, suggesting areas for improvement in training and resource allocation. Full article
(This article belongs to the Special Issue Insights on Neglected Tropical Diseases in West Africa)
17 pages, 1673 KiB  
Review
Why an Integrated Approach to Tick-Borne Pathogens (Bacterial, Viral, and Parasitic) Is Important in the Diagnosis of Clinical Cases
by Raúl Contreras-Ferro, Jorge Martín Trueba, Patricia Sánchez-Mora, Raquel Escudero, María Paz Sánchez-Seco, Estrella Montero, Anabel Negredo, Luis Miguel González, Alejandro Dashti, María Teresa Llorente, Judit Gil-Zamorano, Ana Vázquez, Isabel Jado and David González-Barrio
Trop. Med. Infect. Dis. 2024, 9(11), 272; https://doi.org/10.3390/tropicalmed9110272 - 11 Nov 2024
Viewed by 1091
Abstract
Tick-borne diseases have emerged as a major global public health problem in recent decades. The increasing incidence and geographical dissemination of these diseases requires the implementation of robust surveillance systems to monitor their prevalence, distribution, and public health impact. It is therefore not [...] Read more.
Tick-borne diseases have emerged as a major global public health problem in recent decades. The increasing incidence and geographical dissemination of these diseases requires the implementation of robust surveillance systems to monitor their prevalence, distribution, and public health impact. It is therefore not unexpected that tick-borne pathogens coexist in the same vectors, but the interactions of these agents between vectors and vertebrate hosts, including humans, remain poorly understood. The impact of infection in humans extends to the diagnostic challenges that arise when the same symptomatology can be associated with any tick-borne pathogen, and therapeutic recommendations only focus on the major or best-known tick-borne diseases, ignoring other lesser-known or less prevalent infections. Both surveillance systems and the holistic diagnosis of tick-borne pathogens are necessary tools to address the emergence of vector-borne diseases. In this study, we will focus on the main tick-borne viral, bacterial, and parasitic diseases in Spain to reflect the need to establish syndromic diagnostics in samples from patients with a history of tick bites and symptomatology compatible with them. On the other hand, and highlighting this need, innovations in molecular techniques, syndromic surveillance, and surveillance programs for ticks and tick-borne pathogens with public health implications are expected to be developed. Full article
(This article belongs to the Section Vector-Borne Diseases)
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11 pages, 919 KiB  
Article
Evaluation of the Intensive Acute Flaccid Paralysis Surveillance System in Ghana: Post the Switch from tOPV to bOPV
by Evangeline Obodai, Jessica Dufie Boakye, Nana Afia Asante Ntim, Gayheart Deladem Agbotse, Comfort Nuamah Antwi, Ewurabena Oduma Duker, Sharon Ansong Bimpong, Deborah Odame, Patience Lartekai Adams, Josephine Nayan, Jude Yayra Mensah, Angelina Evelyn Dickson, Keren Attiku, Isaac Baffoe-Nyarko, Dennis Laryea and John Kofi Odoom
Trop. Med. Infect. Dis. 2024, 9(11), 271; https://doi.org/10.3390/tropicalmed9110271 - 8 Nov 2024
Viewed by 767
Abstract
The Global Polio Eradication Initiative was adopted by Ghana in 1996, and through robust AFP surveillance was able to interrupt the circulation of wild poliovirus in 2008. However, the country suffered vaccine-derived poliovirus type 2 outbreaks in 2019 and 2022. We conducted a [...] Read more.
The Global Polio Eradication Initiative was adopted by Ghana in 1996, and through robust AFP surveillance was able to interrupt the circulation of wild poliovirus in 2008. However, the country suffered vaccine-derived poliovirus type 2 outbreaks in 2019 and 2022. We conducted a retrospective analysis of all AFP surveillance data received by the polio program in Ghana from 2018 to 2022. An analysis of the WHO performance indicators for evaluating a surveillance system was conducted using Epi Info 3.5.4 and Microsoft Excel. Of the 4832 cases investigated, 56.3% were males, 71.1% comprised children aged 5 years and below, and more than half (65.2%) had received a maximum of three doses of OPV. Over 77% (3028) had a fever at the onset of paralysis, and 67.8% had paralysis progression within 3 days. The non-polio AFP rate of ≥2 and the stool adequacy rate exceeded the target of ≥80% in nearly every study year. The proportion of non-polio enteroviruses isolated surpassed the target of ≥10% in all years except 2018. The AFP surveillance system in Ghana is sensitive and representative. Though the surveillance became more intensive and proactive during the outbreak, the system needs to focus on improving the completeness of the data as well as the timeliness of the arrival of stool specimens within 3 days of collection. Full article
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13 pages, 1838 KiB  
Article
Polymorphisms in the ACE I/D (rs4646994) and ACE2 G8790A (rs2285666) in Young Children Living in the Amazon Region and SARS-CoV-2 Infection
by Yan Cardoso Pimenta, Flávia Freitas de Oliveira Bonfim, Carlos Eduardo da Silva Figueiredo, Bruno Loreto de Aragão Pedroso, Mauro França Silva, Alberto Ignacio Olivares Olivares, Isabella Fernandes Delgado, José Paulo Gagliardi Leite and Marcia Terezinha Baroni de Moraes
Trop. Med. Infect. Dis. 2024, 9(11), 270; https://doi.org/10.3390/tropicalmed9110270 - 7 Nov 2024
Viewed by 735
Abstract
COVID-19 infection caused by SARS-CoV-2 continues to cause significant mortality and morbidity. ACE2 is a key regulator of the renin–angiotensin–aldosterone system (RAAS). Differences in COVID-19 severity are thought to be due to the imbalance of RAAS/ACE mutations. This retrospective study evaluated the detection [...] Read more.
COVID-19 infection caused by SARS-CoV-2 continues to cause significant mortality and morbidity. ACE2 is a key regulator of the renin–angiotensin–aldosterone system (RAAS). Differences in COVID-19 severity are thought to be due to the imbalance of RAAS/ACE mutations. This retrospective study evaluated the detection and genetic susceptibility to SARS-CoV-2 infection in 202 children ≤3 years of age living in the Amazon region in 2021. The angiotensin-converting enzyme ACE I/D (rs4646994) and ACE2 G8790A (rs2285666) polymorphisms were detected by SYBR GREEN real-time PCR and PCR-RFLP/Alul digestion, respectively. SARS-CoV-2 detection was performed by RT-qPCR in feces and saliva samples collected simultaneously from the same children presenting acute gastroenteritis (AGE) or acute respiratory infection (ARI). The frequency of SARS-CoV-2 detected by qRT-PCR in children was low (5.9%, 12/202), although higher in the group of children with AGE (8.9%, 9/101) than with ARI (2.9%, 3/101). Susceptibility to SARS-CoV-2 infection was not verified due to the low frequency. Homozygous II (rs4646994) children were the majority (87.1%, 176/202). Boys with genotype A (rs2285666) were more susceptible to ARI and pneumonia symptoms than AGE (OR = 3.8, 95% CI 1.4–10.3, p 0.007). Boys with genotype G (rs4646994) or the combination II + G were more susceptible to acquiring AGE. Surveillance, along with understanding their causes, is crucial to controlling ARI and COVID-19 in children living in low-income countries. Full article
(This article belongs to the Section Infectious Diseases)
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19 pages, 1503 KiB  
Article
Application of Monoclonal Anti-Mycolate Antibodies in Serological Diagnosis of Tuberculosis
by Alma Truyts, Ilse Du Preez, Eldas M. Maesela, Manfred R. Scriba, Les Baillie, Arwyn T. Jones, Kevin J. Land, Jan A. Verschoor and Yolandy Lemmer
Trop. Med. Infect. Dis. 2024, 9(11), 269; https://doi.org/10.3390/tropicalmed9110269 - 6 Nov 2024
Viewed by 841
Abstract
Patient loss to follow-up caused by centralised and expensive diagnostics that are reliant on sputum is a major obstacle in the fight to end tuberculosis. An affordable, non-sputum biomarker-based, point-of-care deployable test is needed to address this. Serum antibodies binding the mycobacterial cell [...] Read more.
Patient loss to follow-up caused by centralised and expensive diagnostics that are reliant on sputum is a major obstacle in the fight to end tuberculosis. An affordable, non-sputum biomarker-based, point-of-care deployable test is needed to address this. Serum antibodies binding the mycobacterial cell wall lipids, mycolic acids, have shown promise as biomarkers for active tuberculosis. However, anti-lipid antibodies are of low affinity, making them difficult to detect in a lateral flow immunoassay—a technology widely deployed at the point-of-care. Previously, recombinant monoclonal anti-mycolate antibodies were developed and applied to characterise the antigenicity of mycolic acid. We now demonstrate that these anti-mycolate antibodies specifically detect hexane extracts of mycobacteria. Secondary antibody-mediated detection was applied to detect the displacement of the monoclonal mycolate antibodies by the anti-mycolic acid antibodies present in tuberculosis-positive guinea pig and human serum samples. These data establish proof-of-concept for a novel lateral flow immunoassay for tuberculosis provisionally named MALIA—mycolate antibody lateral flow immunoassay. Full article
(This article belongs to the Section Infectious Diseases)
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11 pages, 610 KiB  
Article
Factors Associated with Complications of Snakebite Envenomation in Health Facilities in the Cascades Region of Burkina Faso from 2016 to 2021
by Rene Kinda, Sidikiba Sidibe, Dramane Zongo, Tieba Millogo, Alexandre Delamou and Seni Kouanda
Trop. Med. Infect. Dis. 2024, 9(11), 268; https://doi.org/10.3390/tropicalmed9110268 - 6 Nov 2024
Viewed by 623
Abstract
Snakebite envenomation remains a major cause of morbidity and mortality in rural populations. This study identified factors associated with the complications of snakebite envenomation reported in the Cascades region of Burkina Faso. This cross-sectional study used the routine data of patients admitted for [...] Read more.
Snakebite envenomation remains a major cause of morbidity and mortality in rural populations. This study identified factors associated with the complications of snakebite envenomation reported in the Cascades region of Burkina Faso. This cross-sectional study used the routine data of patients admitted for snakebite envenomation at five health facilities between 1 January 2016 and 31 December 2021. Data were collected on sociodemographic, clinical, and therapeutic characteristics of patients with signs of envenomation. Bivariate and multivariate analyses were conducted to identify factors associated with complications. Among the 846 patients with envenomation, 355 (42%) experienced complications. Local complications (23.2%, 196/846) included wounds and skin necrosis, whereas systemic complications (34.3%, 290/846) included hemorrhage, shock, and coma. Of all complicated cases, 7.6% (27/355) died. Factors associated with complications were rural residence (AOR: 4.80; 95% CI: 2.21–11.4), incision at the bite site (AOR: 4.31; 95% CI: 2.51–7.52), tourniquet application (AOR: 5.52; 95% CI: 1.42–30.8), bleeding (AOR: 14.2; 95% CI: 8.80–23.4), abnormal vital signs (AOR: 14.3; 95% CI: 9.22–22.7), and lack of antivenom administration (AOR: 2.92; 95% CI: 1.8–4.8). These findings highlight the importance of antivenom availability and public awareness for reducing the incidence of complications of snakebite envenomation. Full article
(This article belongs to the Special Issue Insights on Neglected Tropical Diseases in West Africa)
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13 pages, 273 KiB  
Article
Factors Associated with the Knowledge, Attitudes, and Practices of Primary Healthcare Workers Regarding Neglected Tropical Diseases with Skin Manifestations in the Dakar Region, Senegal, 2022
by Lahla Fall, Karifa Kourouma, Assane Diop, Abdoulaye Diouf, Mohamet Lamine Déthié Sarr, Abdoulaye Dethie Sarr, Hawa Manet, Ivlabèhirè Bertrand Meda, Ndeye Mbacké Kane, Alexandre Delamou and Seni Kouanda
Trop. Med. Infect. Dis. 2024, 9(11), 267; https://doi.org/10.3390/tropicalmed9110267 - 6 Nov 2024
Viewed by 734
Abstract
Neglected tropical diseases (NTDs) with skin manifestations present a significant health and societal problems challenge worldwide. This study aimed to analyzed factors associated with the knowledge, attitudes and practices (KAPs) of primary healthcare workers (HCW) concerning NTDs with skin manifestations in the Dakar [...] Read more.
Neglected tropical diseases (NTDs) with skin manifestations present a significant health and societal problems challenge worldwide. This study aimed to analyzed factors associated with the knowledge, attitudes and practices (KAPs) of primary healthcare workers (HCW) concerning NTDs with skin manifestations in the Dakar region of Senegal. We conducted a cross-sectional study utilizing a semi-structured questionnaire which was administered to eligible HCW (general practitioners, nurses and midwives) working at the 24 health centers located in the Dakar region. Data were collected using the ODK Collect application (version 2022.3.6). KAPs measures were constructed from questionnaire responses, and bivariate analysis was used to identify associated factors. Of the 187 HCW surveyed, 75.9% were female, with a mean age of 35.1 years (SD: 8.56). The majority of HCWs had a bachelor’s degree (40.6%), were nurses (49.2%) and had between 1- and 10-years of professional experience (52.4%). Regarding their knowledge of NTDs with skin manifestations, only 43.3% of HCW had received initial training on NTDs. The most commonly reported NTDs with skin manifestations were leprosy (53.5%), lymphatic filariasis (51.3%), scabies (49.7%), onchocerciasis (45.5%) and schistosomiasis (42.8%). Television was the main source of information about these NTDs (38.5%). In term of practices, only 47.6% of HCW reported being able to diagnose NTDs with skin. Factors associated with good knowledge regarding NTDs with skin manifestations included having received training on NTDs (p = 0.0015) and more years of professional experience (p = 0.004). In summary, there is a need to strengthen and raise awareness about NTDs with skin manifestations among HCWs and promote quality management of patients in Senegal. Full article
(This article belongs to the Special Issue Insights on Neglected Tropical Diseases in West Africa)
20 pages, 7746 KiB  
Article
Clinical Characteristics and Outcomes of Hospitalized COVID-19 Patients with Different Variants of SARS-CoV-2 in a Tertiary Care Hospital, Thailand
by Kitchawan Hengkrawit, Juthamas Thananon, Kritakarn Telapol and Chirawat Chiewchalermsri
Trop. Med. Infect. Dis. 2024, 9(11), 266; https://doi.org/10.3390/tropicalmed9110266 - 5 Nov 2024
Viewed by 907
Abstract
The different strains of SARS-CoV-2 were detected and labeled in 2021. Each strain differs in both clinical symptoms and severity. Previous studies found different clinical symptoms and treatment outcomes between outbreak waves; however, data in Southeast Asia were limited. This study collected data [...] Read more.
The different strains of SARS-CoV-2 were detected and labeled in 2021. Each strain differs in both clinical symptoms and severity. Previous studies found different clinical symptoms and treatment outcomes between outbreak waves; however, data in Southeast Asia were limited. This study collected data of hospitalized COVID-19 patients from a Tertiary hospital in Thailand between January 2020 and December 2023 and analyzed patients’ data in each outbreak wave using Pearson’s chi-square. A total of 1084 inpatients were included for analysis. The median age was 64 (IQR, 0.4–100) years. The patients were hospitalized in predominantly Alpha (22.78%), Delta (21.68%), and Omicron (5.07%) periods of the virus outbreak. The largest age group was elderly (over 65 years old) in all three variant of concern (VOC) periods; 82.65% of the patients had comorbidities, including 58.5% hypertension, 46.5% dyslipidemia, and 42.0% diabetes mellitus (DM). The study found pneumonia at 67.53%, septic shock at 4.61%, acute respiratory distress syndrome (ARDS) at 2.86%, and congestive heart failure at 0.83% in all age groups with no significant difference between outbreak periods. The overall mortality rate was 16.14%. A total of 75% of deaths occurred in patients over 65 years old. The mortality rates in each VOC period were 20.0% Delta, 19.83% Alpha, and 13.23% Omicron. In the elderly group, the mortality rates were Delta 15.32%, Alpha 11.75%, and Omicron 10.88%. The Omicron VOC was less severe than other variants, particularly in the elderly (≥65 years). There were no significant differences in the younger (<65 years) age group. The elderly still had more severe symptoms and the highest mortality rates in every wave of outbreak. Full article
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11 pages, 2908 KiB  
Article
Experience of Health System Personnel in the Implementation of Mass Distribution Campaigns for the Control of Lymphatic Filariasis in Rural Guinea in 2022
by Akoi Zoumanigui, Delphin Kolié, Lamine Lamah, Nouhou Konkouré Diallo, Aissata Tounkara, Hawa Manet, Mamadou Camara and Alexandre Delamou
Trop. Med. Infect. Dis. 2024, 9(11), 265; https://doi.org/10.3390/tropicalmed9110265 - 5 Nov 2024
Viewed by 592
Abstract
This study documents the experiences of health system personnel in the implementation of mass distribution campaigns for the control of lymphatic filariasis in rural Guinea. This was an exploratory qualitative study using data collected from implementing actors of mass distribution campaigns in the [...] Read more.
This study documents the experiences of health system personnel in the implementation of mass distribution campaigns for the control of lymphatic filariasis in rural Guinea. This was an exploratory qualitative study using data collected from implementing actors of mass distribution campaigns in the Boké health district. The results showed four main facilitators of mass distribution campaign rollout in the Boké health district: (i) support to the district teams in the organization of the campaigns; (ii) involvement of community-based associations in social mobilization; (iii) strong adherence of the communities to the different mass distribution campaigns, facilitated through the involvement of community relays, who are members of these communities, in the distribution of drugs; and (iv) transparency in the allocation of incentives to drug dispensers and supervisors. However, the frequent shortages of medicines, the difficulty of access to rural areas, and the lack of logistical means for the supervision of activities were the main obstacles to the success of the various mass distribution campaigns in Boké. The provision of buffer stocks for special areas such as Boké by national programme actors and partners, joint planning of campaign activities with local managers of health systems and services, and improvement of existing mechanisms for motivating health workers, including community health workers, during future campaigns should help to achieve national objectives in the fight against NTDs in Guinea. Full article
(This article belongs to the Special Issue Insights on Neglected Tropical Diseases in West Africa)
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7 pages, 1160 KiB  
Case Report
Imported Cutaneous Leishmaniasis from Peru Caused by Leishmania (Viannia) guyanensis in a Brazilian Patient: Case Report and In Vitro Drug Susceptibility Analysis
by Elizabeth M. Coser, Juliana I. Aoki, Cristiele Saborito, Stephane de la Roca, João Paulo T. Brufatto, Rodrigo Angerami, Rafael F. Stelini, Paulo Eduardo N. F. Velho and Adriano C. Coelho
Trop. Med. Infect. Dis. 2024, 9(11), 264; https://doi.org/10.3390/tropicalmed9110264 - 5 Nov 2024
Viewed by 774
Abstract
In South America, cutaneous leishmaniasis is caused by several species of the parasite of the genus Leishmania. Here, we describe an imported case of cutaneous leishmaniasis acquired in Peru by a Brazilian patient during her travel to Iquitos. Infection by Leishmania parasites [...] Read more.
In South America, cutaneous leishmaniasis is caused by several species of the parasite of the genus Leishmania. Here, we describe an imported case of cutaneous leishmaniasis acquired in Peru by a Brazilian patient during her travel to Iquitos. Infection by Leishmania parasites was confirmed by histopathologic examination, and the patient was treated with pentavalent antimony (Pentostam), without clinical response. Molecular typing was performed by sequencing the ribosomal DNA internal transcribed spacer and heat-shock protein 70 gene, which identified the parasites as Leishmania guyanensis. The clinical isolate was similarly susceptible to amphotericin B, pentamidine, and miltefosine as the reference strain, while for pentavalent antimony, this clinical isolate was more susceptible than the reference strain, even though its susceptibility in vitro was still considered low. The patient was then treated with liposomal amphotericin B, with clinical improvement of the lesions. Full article
(This article belongs to the Special Issue Chemotherapy of Leishmaniasis: Past, Present and Future)
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20 pages, 5482 KiB  
Article
Temporal Activity and Distribution of the Invasive Mosquitoes Aedes albopictus and Aedes japonicus in the Zagreb Area, Croatia
by Ana Klobučar, Mihaela Kavran, Sunčica Petrinić and Marcela Curman Posavec
Trop. Med. Infect. Dis. 2024, 9(11), 263; https://doi.org/10.3390/tropicalmed9110263 - 4 Nov 2024
Viewed by 826
Abstract
Aedes albopictus and Aedes japonicus are invasive mosquito species that are causing great public concern. Aedes albopictus have successfully spread in Croatia, established in both the coastal and continental parts of the country, while Aedes japonicus is invading temperate climate areas. The invasive [...] Read more.
Aedes albopictus and Aedes japonicus are invasive mosquito species that are causing great public concern. Aedes albopictus have successfully spread in Croatia, established in both the coastal and continental parts of the country, while Aedes japonicus is invading temperate climate areas. The invasive Aedes species are particularly attracted to the black plastic water containers and flower vases in cemeteries where they oviposit their eggs. Therefore, monitoring of this species was carried out in 12 cemeteries in Zagreb, using ovitraps with masonite strips as a substrate for oviposition. The monitoring was carried out from 2017 to 2020. The traps were inspected and the substrate was replaced every two weeks. This study showed that these two invasive species were present and very abundant in the cemeteries. In the case of Ae. albopictus, a higher population density and a greater number of occupied cemeteries were detected. This species was identified in all 12 cemeteries. Aedes albopictus was identified as the dominant species at all study sites. The spread of Ae. japonicus increased during 2018 in comparison to the previous year. Although this species was present in approximately 9% of the ovitraps, the observed population remained consistent throughout the course of the study. The findings indicate that cemeteries can be considered as significant public health hotspots, as the invasive Aedes mosquitoes tend to develop and reproduce in such environments. Consequently, the mosquito population of these two invasive species may only be reduced by applying integrated mosquito management measures, focused on the education of citizens. Full article
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10 pages, 701 KiB  
Article
The Treatment Outcomes of Tuberculosis Patients at Adare General Hospital, Southern Ethiopia (A Five-Year Retrospective Study)
by Bizunesh Tsegaye, Zufan Bedewi and Solomon Asnake
Trop. Med. Infect. Dis. 2024, 9(11), 262; https://doi.org/10.3390/tropicalmed9110262 - 2 Nov 2024
Viewed by 610
Abstract
Ethiopia is among the countries most heavily affected by tuberculosis, where it is the leading cause of morbidity, the third cause of hospital admission and the second cause of death. To improve tuberculosis management and control, the early detection of cases, effective treatment [...] Read more.
Ethiopia is among the countries most heavily affected by tuberculosis, where it is the leading cause of morbidity, the third cause of hospital admission and the second cause of death. To improve tuberculosis management and control, the early detection of cases, effective treatment and the persistent evaluation of treatment outcomes are vital issues that should be taken into consideration. This study was designed to determine the treatment outcomes and associated risk factors among TB patients registered at Adare General Hospital in Southern Ethiopia. A five-year retrospective study was conducted by reviewing the files of the TB patients registered from September 2013 to August 2017. The data were coded, cleaned, entered and analyzed using SPSS version 20 statistical software. Bivariate and multivariable logistic regression with odds ratios (OR) along with a 95% confidence interval was computed and interpreted. A p-value < 0.05 was declared as statistically significant. Among the 1122 cases, 620 (55.3%) were male, 748 (66.7%) were from urban areas, 319 (28.4%) were smear positive, 352 (31.4%) were smear negative and 451 (40.2%) were extra-pulmonary patients. Among the treated patients, 284 were declared cured, 753 completed their treatment, 29 were defaulters, 3 failed to follow up, and 53 died. The overall treatment success rate was 92.4%. The TB patients from urban areas (AOR = 1.44, 95% CI: 0.28, 0.67), and the HIV-negative TB patients (AOR = 5.48, 95% CI; 3.474, 8.64) were significantly associated with successful treatment outcomes. The treatment success rates of tuberculosis at Adare General Hospital were comparable to the national health facility-level coverage, but they should be maintained and strengthened further to attain tuberculosis-related national and millennium goals. Full article
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10 pages, 291 KiB  
Article
Prevalence of Trypanosoma cruzi Infection in Pregnant Women and Risk of Vertical Transmission in Newborns in Chiapas, Mexico
by Sury Antonio López Cancino, Leticia Eligio García, María del Pilar Crisóstomo Vázquez, Mariana Soria Guerrero, Enedina Jiménez Cardoso, Marcos Meneses Mayo and Sergio Agustín Islas Andrade
Trop. Med. Infect. Dis. 2024, 9(11), 261; https://doi.org/10.3390/tropicalmed9110261 - 1 Nov 2024
Viewed by 988
Abstract
The Mexican state of Chiapas is considered epidemiologically significant for Chagas disease due to the coexistence of infected reservoirs and vectors, including migratory populations from Central and South America. However, there is a lack of monitoring programs for the timely detection of this [...] Read more.
The Mexican state of Chiapas is considered epidemiologically significant for Chagas disease due to the coexistence of infected reservoirs and vectors, including migratory populations from Central and South America. However, there is a lack of monitoring programs for the timely detection of this disease. The objective of this study was to elucidate the prevalence of Trypanosoma cruzi infection in pregnant women and the risk of vertical transmission in newborns at two hospitals located in the Metropolitan Region of Tuxtla Gutierrez, the capital of Chiapas State Mexico. A cross-sectional study was carried out with 193 pregnant women with gestational ages between 32 and 40 weeks, who underwent immunological testing to diagnose Chagas disease. Conventional PCR testing on cord blood revealed the presence of T. cruzi in newborns. The prevalence of T. cruzi infection in pregnant women was 32.12% (95% confidence interval (CI): 0.25, 0.38). The 62 pregnant women who tested positive for Chagas disease gave birth to 63 children, and in 5 newborns (8% (5/62), 95% confidence interval (CI): 0.02, 0.19), PCR tests on umbilical cord blood were positive for T. cruzi. In conclusion, the dataset showed a high prevalence of Chagas disease in the sample of pregnant women studied and a maternal–fetal transmission rate of 8%. Full article
(This article belongs to the Section Neglected and Emerging Tropical Diseases)
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11 pages, 1594 KiB  
Article
Malaria Vectors and Plasmodium Transmission in Malaria-Endemic Localities of Colombia
by Stefani Piedrahita and Margarita M. Correa
Trop. Med. Infect. Dis. 2024, 9(11), 260; https://doi.org/10.3390/tropicalmed9110260 - 1 Nov 2024
Viewed by 758
Abstract
Anopheles species composition, abundance, and Plasmodium natural infection are important aspects to assess malaria transmission risk. In this study, these aspects were evaluated in a large number of localities in the most important malaria-endemic regions of Colombia. Mosquitoes were collected from 2012 to [...] Read more.
Anopheles species composition, abundance, and Plasmodium natural infection are important aspects to assess malaria transmission risk. In this study, these aspects were evaluated in a large number of localities in the most important malaria-endemic regions of Colombia. Mosquitoes were collected from 2012 to 2015 in 55 localities of northwestern and western Colombia. Anopheles species composition, abundance, and Plasmodium infection were estimated. A total of 13,218 Anopheles specimens were evaluated. The highest species richness was detected in the northwest, where the main vectors, An. albimanus (27.8%) and An. nuneztovari (26.7%), were the most abundant species. In the west, An. nuneztovari predominated (51.6%), followed by An. darlingi (29.2%). Six species were infected with Plasmodium, An. darlingi, An. nuneztovari, An. albimanus, An. calderoni, An. triannulatus, and An. braziliensis. Results showed that in these localities the main Colombian vectors are widely spread, which suggests a high malaria risk. Notably, this study is the first to report An. braziliensis from Colombia as being naturally infected with Plasmodium. Infection results for species that are suspected local vectors indicate the importance of conducting further studies to assess their epidemiological importance. This information provides the basis for the application of directed vector control strategies that are species-specific. Full article
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12 pages, 3305 KiB  
Article
Susceptibility of Leishmania amazonensis Axenic Amastigotes to the Calpain Inhibitor MDL28170
by Simone S. C. Oliveira, Fernanda A. Marinho, Leandro S. Sangenito, Sergio H. Seabra, Rubem F. Menna-Barreto, Claudia M. d’Avila, André L. S. Santos and Marta H. Branquinha
Trop. Med. Infect. Dis. 2024, 9(11), 259; https://doi.org/10.3390/tropicalmed9110259 - 31 Oct 2024
Viewed by 1186
Abstract
Leishmaniasis encompasses a group of neglected diseases caused by flagellated protozoa belonging to the Leishmania genus, associated with high morbidity and mortality. The search for compounds with anti-Leishmania activity that exhibit lower toxicity and can overcome the emergence of resistant strains remains [...] Read more.
Leishmaniasis encompasses a group of neglected diseases caused by flagellated protozoa belonging to the Leishmania genus, associated with high morbidity and mortality. The search for compounds with anti-Leishmania activity that exhibit lower toxicity and can overcome the emergence of resistant strains remains a significant goal. In this context, the calpain inhibitor MDL28170 has previously demonstrated deleterious effects against promastigote forms of Leishmania amazonensis, which led us to investigate its role on axenic amastigote forms. The calpain inhibitor MDL28170 was able to decrease the viability of amastigotes in a typically dose-dependent manner. The treatment with the IC50 dose (13.5 μM) for 72 h led to significant amastigote lysis and increased cell-to-cell aggregation. Ultrastructural analysis revealed several cellular alterations, including disruption of the trans-Golgi network and the formation of autophagosomes when treated with MDL28170 at ½ × IC50 dose. Additionally, mitochondrial swelling and the formation of concentric membranous structures inside the mitochondrion were observed after incubation with the IC50 dose. These results reinforce the potential application of the calpain inhibitor MDL28170 against L. amazonensis, highlighting its effectiveness and possible mechanism of action against the parasite. Full article
(This article belongs to the Special Issue Chemotherapy of Leishmaniasis: Past, Present and Future)
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18 pages, 1736 KiB  
Perspective
Leishmaniasis in Humans and Animals: A One Health Approach for Surveillance, Prevention and Control in a Changing World
by Claudia Cosma, Carla Maia, Nushrat Khan, Maria Infantino and Marco Del Riccio
Trop. Med. Infect. Dis. 2024, 9(11), 258; https://doi.org/10.3390/tropicalmed9110258 - 28 Oct 2024
Viewed by 2175
Abstract
Leishmaniasis is classified as a neglected tropical disease (NTD), caused by protozoan parasites of the genus Leishmania, which are transmitted to humans and other animals through the bite of infected female phlebotomine sandflies. There are three forms of the disease: cutaneous leishmaniasis [...] Read more.
Leishmaniasis is classified as a neglected tropical disease (NTD), caused by protozoan parasites of the genus Leishmania, which are transmitted to humans and other animals through the bite of infected female phlebotomine sandflies. There are three forms of the disease: cutaneous leishmaniasis (CL) manifested by ulcers and scars; systemic or visceral leishmaniasis (VL), which can lead to life-threatening complications if left untreated; and mucocutaneous leishmaniasis (MCL), which can destroy the mucous membranes of the nose, mouth and throat. Human leishmaniasis is endemic in many countries across Africa, Asia, Southern Europe, the Middle East, and Central and South America. The interconnection of environmental, animal and human health underlies the spread of the Leishmania parasite. Environmental disruptions, such as climate change, deforestation or urbanisation, but also globalisation and migration, significantly affect the distribution and abundance of sand fly vectors and reservoir hosts. Climate change alters the breeding patterns of sandflies and expands their geographic range; deforestation and misuse of large areas disrupt ecosystems, leading to increased human-vector contact; and urbanisation increases the potential for contact between parties, particularly in densely populated areas. Migration of humans and animals, either through natural migration or, for example, the pet trade and breeding, can facilitate the spread of Leishmania parasites. In addition, socio-economic factors, including poverty and lack of access to healthcare, increase the burden of leishmaniasis in vulnerable populations. Due to this multitude of reasons, the geographic distribution of sandflies has expanded to higher latitudes and altitudes in recent years, with a consequent increase in disease burden. Indeed, despite ongoing challenges in the surveillance systems, data from the last available year have shown an increase in many cases in both humans and dogs. This perspective explores the interconnected factors influencing the spread of leishmaniasis worldwide and the epidemiology of the disease. In addition, it illustrates the importance of integrated strategies in a One Health approach: surveillance, prevention and control of vectors, animals and humans. Full article
(This article belongs to the Special Issue Infectious Disease Prevention and Control: A One Health Approach)
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13 pages, 356 KiB  
Article
Prevalence and Risk Factors of HIV Drug Resistance in Zimbabwe: Evidence from Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2020 Survey
by Munyaradzi Mapingure, Solomon Mukwenha, Innocent Chingombe, Rutendo Birri Makota, Elliot Mbunge, Enos Moyo, Garikayi Chemhaka, John Batani, Brian Moyo and Godfrey Musuka
Trop. Med. Infect. Dis. 2024, 9(11), 257; https://doi.org/10.3390/tropicalmed9110257 - 28 Oct 2024
Viewed by 1305
Abstract
(1) Background: HIV drug resistance (HIVDR) poses a significant challenge to the effectiveness of antiretroviral therapy and the overall management of HIVand AIDS. Understanding the predictors of HIVDR is critical for developing strategies to mitigate its impact. The objectives of this study were [...] Read more.
(1) Background: HIV drug resistance (HIVDR) poses a significant challenge to the effectiveness of antiretroviral therapy and the overall management of HIVand AIDS. Understanding the predictors of HIVDR is critical for developing strategies to mitigate its impact. The objectives of this study were to identify the predictors of HIVDR among Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA 2020) study participants, a national population-based survey. (2) Methods: Data from people living with HIV who participated in the ZIMPHIA 2020 were used to determine the predictors of HIVDR. (3) Results: The prevalence of HIVDR was 44.9%. Acquired HIVDR was present in 76.1% of people with a virological failure and transmitted resistance is 22.6% in naïve individuals. Factors associated with HIVDR in adjusted analysis were the number of lifetime sexual partners (aOR = 1.03, 95% CI: 1.01–1.06, p = 0.017), each additional year since the first HIV positive result (aOR = 1.17, 95% CI: 1.09–1.25, p < 0.01), each additional year on ART (aOR = 1.14, 95% CI: 1.06–1.23, p = 0.001), initiating ART before 2014 (aOR = 3.08, 95% CI: 1.72–5.49, p = 0.020), ever had switched antiretrovirals (aOR = 2.47, 95% CI: 1.15–5.29, p = 0.020) or had ever had a viral load test (aOR = 2.54, 95% CI: 1.54–4.17, p < 0.001) and a CD4 count < 350 (aOR = 2.04, 95% CI: 1.48–2.83, p < 0.01), while age ≥ 50 (aOR = 0.56, 95% CI: 0.32–0.98, 32 p = 0.04), condom use at last encounter (OR: 0.49, 95%CI: 0.33–0.73, p < 0.001), and not being on ART (aOR = 0.09, 95% CI: 0.06–0.13, p < 0.01) were associated with reduced odds of HIVDR. Conclusions: HIVDR was high among the participants. There is a need to address HIVDR and enhance the mechanisms already in place. This study introduces more information that would help in developing targeted interventions to prevent HIVDR and improve patient outcomes. Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions)
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16 pages, 13395 KiB  
Article
Citizen Science and Multimedia Didactic Resources: Knowledge of Mosquito-Borne Diseases in an Urban Area of Southwestern Colombia
by Francisco Javier Bedoya-Rodríguez, Carlos Eduardo Guevara-Fletcher and Jonathan S. Pelegrin
Trop. Med. Infect. Dis. 2024, 9(11), 256; https://doi.org/10.3390/tropicalmed9110256 - 25 Oct 2024
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Abstract
Citizen science resources have had great relevance in community educational intervention, fostering interest in ecological research projects. This study investigated the influence of the application of multimedia didactic resources focused on citizen science and analysis of sociodemographic variables to improve the levels of [...] Read more.
Citizen science resources have had great relevance in community educational intervention, fostering interest in ecological research projects. This study investigated the influence of the application of multimedia didactic resources focused on citizen science and analysis of sociodemographic variables to improve the levels of ecological knowledge about mosquito-borne diseases. For this, a probabilistic sample of 172 participants from an urban sector in southwestern Colombia was selected. A multimedia didactic material was designed for the educational intervention and evaluated by means of pretest and posttest. To assess whether the educational intervention was statistically significant, the data were processed with statistical inference to determine the influence of various variables (gender, age, marital status, schooling, and occupation) on each person’s ecological knowledge. The findings showed a significant increase in the knowledge levels of the participants. The marital status variable (married and cohabiting) significantly influenced ecological knowledge. These participants are more likely to obtain high knowledge, associated with the prevention of their family environment. This study demonstrated that multimedia didactic strategies are an important factor to take into account in the structuring of environmental education and citizen science projects. For future research, it is suggested to deepen the relationship between sociodemographic variables and ecological knowledge. Full article
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Article
Community Mobilisation for Human Sample Collection in Sensitive Communities: Experiences from Granular Mapping of Schistosomiasis and Soil-Transmitted Helminths in Ekiti State, South West, Nigeria
by Temitope Agbana, Omolade Omotade, Moses Aderogba, David Bell, Jacob Solomon, Saheed Animashaun, Peace Alabi, Oladimeji Ajayi, Adebowale Akinwumi, Samuel Popoola, Alex Bunda, Jan-Carel Diehl, Gleb Vdovine and Louise Makau-Barasa
Trop. Med. Infect. Dis. 2024, 9(11), 255; https://doi.org/10.3390/tropicalmed9110255 - 25 Oct 2024
Viewed by 799
Abstract
Community mobilisation is a vital process for raising awareness and increasing participation in healthcare interventions, research, and programmes that require human sample collection and mass management. In this report, we present the community mobilisation approach undertaken for the implementation of the operational mapping [...] Read more.
Community mobilisation is a vital process for raising awareness and increasing participation in healthcare interventions, research, and programmes that require human sample collection and mass management. In this report, we present the community mobilisation approach undertaken for the implementation of the operational mapping and assessment of granular schistosomiasis and soil-transmitted helminths in Ekiti State, Nigeria. The mobilisation was conducted in 177 communities/wards of the 16 local government areas. A total of 15,340 urine and stool samples were collected in 34 days. The efficacy and success of the strategy were evaluated through the following three performance metrics: community compliance rate, the participant response rate at the community level, and the overall compliance response rate of the four most sensitive LGAs. Community compliance was 93.7% as sample collection was denied in nine communities and two other communities demanded the return of the collected samples despite our mobilisation effort because of cultural bias and myths that connect the collection of stool and urine samples to ritual activities in the local context. The participant response rate at the community level was 86.7%. Three of the four sensitive LGAs (based on previous assessment programmes) demonstrated satisfactory compliance rates of 100%, while a response rate of 64.0% was computed for one of the LGAs. We believe our approach contributed to effective community mobilisation and awareness and that the developed model has the potential to improve participation rates in large healthcare assessments and intervention programmes. Full article
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