Tropical Medicine and Infectious Disease

14 pages, 263 KiB

Open AccessReview

Antimicrobial Resistance and Its Impact on Food Safety Determinants Along the Beef Value Chain in Sub-Saharan Africa—A Scoping Review

by Godfrey Musuka, Jairus Machakwa, Oscar Mano, Patrick Gad Iradukunda, Pierre Gashema, Enos Moyo, Amon Nsengimana, Shepherd Manhokwe, Tapiwa Dhliwayo and Tafadzwa Dzinamarira

Trop. Med. Infect. Dis. 2025, 10(3), 82; https://doi.org/10.3390/tropicalmed10030082 - 20 Mar 2025

Abstract

Antimicrobial resistance (AMR) poses a significant threat to human, animal, and public health, particularly in Sub-Saharan Africa (SSA), where the beef sector is vital to food security and livelihoods. We conducted a scoping review to explore the determinants and impacts of AMR within [...] Read more.

Antimicrobial resistance (AMR) poses a significant threat to human, animal, and public health, particularly in Sub-Saharan Africa (SSA), where the beef sector is vital to food security and livelihoods. We conducted a scoping review to explore the determinants and impacts of AMR within the beef value chain in SSA, highlighting the challenges and progress in mitigating AMR risks in livestock production. This review identifies key factors contributing to AMR, including the overuse and misuse of antimicrobials, inadequate veterinary oversight, and weak regulatory frameworks. These practices are prevalent across various stages of the beef value chain, from farm to slaughterhouse, and are exacerbated by informal markets and insufficient infrastructure. Our findings also highlight the role of environmental factors, such as contamination of feed, water, and manure, in the spread of resistant pathogens. Additionally, gaps in AMR surveillance, education, and enforcement limit effective control measures in the region. While efforts to combat AMR have gained momentum in some countries, including the development of national action plans and surveillance systems, substantial challenges remain. These include poor adherence to antimicrobial guidelines, insufficient veterinary training, and the lack of integration between sectors. There is a need for targeted research to better understand antimicrobial misuse, socio-economic drivers, and the environmental pathways of AMR, as well as the need for stronger regulatory frameworks and cross-border cooperation. Addressing these challenges will be essential to safeguarding food safety, public health, and the sustainability of the beef industry in SSA. Full article

(This article belongs to the Section One Health)

21 pages, 541 KiB

Open AccessReview

Alterations and Dynamics of Major Meningitis Etiological Agents During and Post-COVID-19 Pandemic: A Systematic Review

by Luís Arthur Brasil Gadelha Farias, Larissa Santos Weyne, Lenifer Siqueira Landim, Pablo Eliack Linhares de Holanda, Aliniana da Silva Santos, Luciano Pamplona de Góes Cavalcanti, Lourrany Borges Costa, Antonio Gutierry Neves Dantas de Melo, Melissa Soares Medeiros, Evelyne Santana Girão, Tânia Mara Silva Coelho and Lauro Vieira Perdigão Neto

Trop. Med. Infect. Dis. 2025, 10(3), 81; https://doi.org/10.3390/tropicalmed10030081 - 18 Mar 2025

Abstract

The transmission dynamics of many pathogens were altered during the coronavirus disease 2019 (COVID-19) pandemic. Several factors, including control measures and social distancing, have influenced the circulation and epidemiology of major etiological agents of meningitis during this period. This review examined trends in [...] Read more.

The transmission dynamics of many pathogens were altered during the coronavirus disease 2019 (COVID-19) pandemic. Several factors, including control measures and social distancing, have influenced the circulation and epidemiology of major etiological agents of meningitis during this period. This review examined trends in the primary etiologic agents of meningitis during and after the COVID-19 pandemic. A comprehensive literature search was conducted using the MEDLINE, Embase, LILACS, and SciELO databases for studies published between 2020 and 2024. The data were summarized descriptively and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-eight studies are included in this review. Bacterial and viral meningitis pathogens exhibited significant epidemiological shifts during the pandemic. A marked decline in infections caused by the enteroviruses, Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae was observed from 2020 to 2021 in the northern and southern hemispheres during the pandemic. Post-pandemic, meningitis cases increased, with a resurgence in various countries. Despite the heterogeneity of the studies, the evidence indicates that the COVID-19 pandemic significantly affected the epidemiology of meningitis-causing microorganisms during and after the pandemic. Understanding these epidemiological shifts and dynamics is crucial for defining the control measures, vaccination strategies, and public health policies in the post-COVID-19 era. Full article

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

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5 pages, 189 KiB

Open AccessEditorial

Microbial Infections and Antimicrobial Use in Neonates and Infants

by Chryssoula Tzialla

Trop. Med. Infect. Dis. 2025, 10(3), 80; https://doi.org/10.3390/tropicalmed10030080 - 18 Mar 2025

Abstract

Infectious diseases in infants are a major cause of morbidity and mortality during the first 28 days of life, accounting for approximately 33% of neonatal deaths and 50% of deaths in children under the age of five [...] Full article

(This article belongs to the Special Issue Microbial Infections and Antimicrobial Use in Neonates and Infants)

11 pages, 1111 KiB

Open AccessArticle

A High Burden of Infectious Tuberculosis Cases Among Older Children and Young Adolescents of the Female Gender in Ethiopia

by Zewdu Dememew, Atakilt Deribew, Amtatachew Zegeye, Taye Janfa, Teshager Kegne, Yohannes Alemayehu, Asfawosen Gebreyohannes, Sidhartha Deka, Pedro Suarez, Daniel Datiko and Dan Schwarz

Trop. Med. Infect. Dis. 2025, 10(3), 79; https://doi.org/10.3390/tropicalmed10030079 - 17 Mar 2025

Abstract

The study was conducted in all regions of Ethiopia, except Tigray. It describes types of Tuberculosis (TB) based on gender, age, region, HIV status, and geographic setting in Ethiopia. It is a cross-sectional study that utilized the Ministry of Health’s District Health Information [...] Read more.

The study was conducted in all regions of Ethiopia, except Tigray. It describes types of Tuberculosis (TB) based on gender, age, region, HIV status, and geographic setting in Ethiopia. It is a cross-sectional study that utilized the Ministry of Health’s District Health Information System-based reporting to analyze all types of TB from July 2022 to March 2024. In total, 290,450 TB cases were detected: 42.6% (123,871) were female, 9.4% (27,160) were children (under 15 years of age), and 14.5% (42,228) were adolescents (10–19 years of age). About 48% (20,185) of adolescent TB cases were bacteriologically confirmed, of which 47.5% were females. Compared to children <5 years, the male-to-female ratio is 26% higher among older children (5–9 years of age) (Adjusted Odds Ratio (AOR): 1.26, 95% Confidence Interval (CI): 0.51–2.01)) and 53% higher among adolescents (AOR: 1.53, 95% CI 0.87–2.18). In short, about half of TB cases are infectious among older children and young adolescents of the female gender in Ethiopia. TB among these age categories may be addressed through the integration of TB services with reproductive health services and youth-friendly and pediatric clinics. Full article

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

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16 pages, 505 KiB

Open AccessReview

Treatment Adherence and Outcomes in Patients with Tuberculosis Treated with Telemedicine: A Scoping Review

by Kikelomo Sabainah Olowoyo, Deborah Tolulope Esan, Paul Olowoyo, Babatunji Emmanuel Oyinloye, Israel Opeyemi Fawole, Segun Aderibigbe, Mary Opeyemi Adigun, David Bamidele Olawade, Theophilus Olaide Esan and Benedict Tolulope Adeyanju

Trop. Med. Infect. Dis. 2025, 10(3), 78; https://doi.org/10.3390/tropicalmed10030078 - 17 Mar 2025

Abstract

Patient non-adherence to drug usage is a major barrier to treating tuberculosis (TB). Telemedicine has shown promise in treatment monitoring and evaluation. This paper aims to explore scientific evidence of telemedicine application in TB treatment to promote widespread adoption in areas that are [...] Read more.

Patient non-adherence to drug usage is a major barrier to treating tuberculosis (TB). Telemedicine has shown promise in treatment monitoring and evaluation. This paper aims to explore scientific evidence of telemedicine application in TB treatment to promote widespread adoption in areas that are remote or have poor road networks from health facilities. Articles published from 2010 to 2023 on the adherence and outcomes in pulmonary tuberculosis with the use of telemedicine were reviewed. A scoping review of the studies was conducted by two authors independently, following the PRISMA guidelines to identify relevant articles. Telemedicine interventions have shown improvements in medication adherence, treatment completion, cure rates, and smear conversion among TB patients. The available evidence supports the beneficial effect of telemedicine in improving treatment adherence and outcomes in patients with pulmonary tuberculosis. However, the effect and outcomes varied across studies, indicating the need for further research and standardization of telemedicine interventions. Full article

(This article belongs to the Section Infectious Diseases)

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13 pages, 1021 KiB

Open AccessEditorial

Neglected Tropical Diseases Remain a Considerable Public Health Challenge in West Africa

by Andrew Ramsay and Edward Mberu Kamau

Trop. Med. Infect. Dis. 2025, 10(3), 77; https://doi.org/10.3390/tropicalmed10030077 - 14 Mar 2025

Abstract

Neglected tropical diseases (NTDs) form a category of diverse, mainly infectious, diseases that are prevalent in tropical and subtropical countries [...] Full article

(This article belongs to the Special Issue Insights on Neglected Tropical Diseases in West Africa)

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13 pages, 905 KiB

Open AccessArticle

Dog-Mediated Rabies Surveillance in Nigeria (2014–2023): Investigating Seasonality and Spatial Clustering

by Rebecca D. Williams, Mahbod Entezami, Ruth Alafiatayo, Olaniran Alabi, Daniel L. Horton, Emma Taylor, Rachel Tidman, Columba T. Vakuru, Taiwo Olasoju, Abel B. Ekiri and Joaquin M. Prada

Trop. Med. Infect. Dis. 2025, 10(3), 76; https://doi.org/10.3390/tropicalmed10030076 - 12 Mar 2025

Abstract

Rabies is an important zoonotic disease responsible for 59,000 human deaths worldwide each year. More than a third of these deaths occur in Africa. The first step in controlling rabies is establishing the burden of disease through data analysis and investigating regional risk [...] Read more.

Rabies is an important zoonotic disease responsible for 59,000 human deaths worldwide each year. More than a third of these deaths occur in Africa. The first step in controlling rabies is establishing the burden of disease through data analysis and investigating regional risk to help prioritise resources. Here, we evaluated the surveillance data collected over the last decade in Nigeria (2014–2023). A spatio-temporal model was developed using the NIMBLE (1.2.1) package in R to assess outbreak risk. Our analysis found a high risk of canine rabies outbreaks in Plateau state and its surrounding states, as well as increased trends of outbreaks from July to September. The high number of reported canine rabies outbreaks in the North Central region could be due to cross-border transmission or improved reporting in the area. However, this could be confounded by potential reporting bias, with 8 out of 37 states (21.6%) never reporting a single outbreak in the period studied. Improving surveillance efforts will highlight states and regions in need of prioritisation for vaccinations and post-exposure prophylaxis. Using a One Health approach will likely help improve reporting, such as through integrated bite-case management, creating a more sustainable solution for the epidemiology of rabies in Nigeria in the future. Full article

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

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11 pages, 776 KiB

Open AccessReview

Generalized Treatment as Prevention Plus Focused Pre-Exposure Prophylaxis Is the Key to Controlling HIV/AIDS

by Julio S. G. Montaner, Viviane D. Lima, Kate A. Salters, Junine Toy, Jeffrey B. Joy, Silvia Guillemi and Rolando Barrios

Trop. Med. Infect. Dis. 2025, 10(3), 75; https://doi.org/10.3390/tropicalmed10030075 - 12 Mar 2025

Abstract

Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and [...] Read more.

Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) are both widely recognized as essential biomedical tools to control HIV/AIDS. TasP calls for the immediate initiation of fully subsidized and supported antiretroviral therapy (ART) following HIV diagnosis. TasP effectively prevents progression to AIDS, and premature AIDS-related deaths among people living with HIV (PLWH), and simultaneously renders HIV non-transmissible, thus preventing onward HIV transmission. In addition, PrEP has proven effective against HIV transmission among high-risk individuals who are adherent to the regimen. PrEP traditionally consists of two antiretrovirals given orally as one pill daily: originally, tenofovir-DF plus emtricitabine (TDF-FTC), and later, tenofovir-AF (TAF) plus FTC (more recently, other options have become available, including long-acting parenteral formulations; however, these are still of limited availability). Over the last two decades, the province of British Columbia has rolled out TasP among all PLWH, and starting in 2018, PrEP was added as a strategy to reach individuals most at risk of acquiring HIV to further accelerate progress in addressing HIV/AIDS as a public health threat. Our “generalized TasP + focused PrEP” program proved to be synergistic (or multiplicative) as it relates to reducing the HIV effective reproduction number (

R_{e}

). TasP lowers HIV incidence by reducing the pool of individuals able to transmit HIV, which is dependent on the extent of community plasma viral load (pVL) suppression. Meanwhile, PrEP reduces the number of potential new infections among those most susceptible to acquiring HIV in the community, independent of viral load suppression among PLWH. Our results strongly support widespread implementation of the combination of “generalized TasP + focused PrEP” strategy and underscore the importance of long-term monitoring of

R_{e}

at a programmatic level to identify opportunities for optimizing TasP and PrEP programs. This approach aligns with the United Nations goal of “Ending HIV/AIDS as a pandemic by 2030”, both in Canada and globally. Full article

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

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2 pages, 285 KiB

Open AccessCorrection

Correction: Cosma et al. Leishmaniasis in Humans and Animals: A One Health Approach for Surveillance, Prevention and Control in a Changing World. Trop. Med. Infect. Dis. 2024, 9, 258

by Claudia Cosma, Carla Maia, Nushrat Khan, Maria Infantino and Marco Del Riccio

Trop. Med. Infect. Dis. 2025, 10(3), 74; https://doi.org/10.3390/tropicalmed10030074 - 12 Mar 2025

Abstract

Error in Figure [...] Full article

(This article belongs to the Special Issue Infectious Disease Prevention and Control: A One Health Approach)

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36 pages, 388 KiB

Open AccessReview

Do Statins Affect Viral Infections Encountered by International Travelers?

by Chinmay T. Jani, Christian Mouchati, Nour Abdallah, Ruchi Jani, Loukas Kakoullis and Lin H. Chen

Trop. Med. Infect. Dis. 2025, 10(3), 73; https://doi.org/10.3390/tropicalmed10030073 - 11 Mar 2025

Abstract

Statins are among the most frequently prescribed medications. In addition to their well-established effectiveness in lowering total cholesterol, LDL, and triglycerides, statins have been described to have immunomodulatory and anti-inflammatory properties and have been associated with improved endothelial functions. Given the common use [...] Read more.

Statins are among the most frequently prescribed medications. In addition to their well-established effectiveness in lowering total cholesterol, LDL, and triglycerides, statins have been described to have immunomodulatory and anti-inflammatory properties and have been associated with improved endothelial functions. Given the common use of statins, we sought to evaluate the effect of statins on some viral infections encountered by residents in tropical areas or by international travelers. A literature search was performed in PubMED/MEDLINE focusing on keywords that included statins and the viruses of interest, including SARS-CoV-2, influenza, yellow fever, dengue, Zika, tick-borne encephalitis, hemorrhagic fever viruses, hepatitis A, norovirus, hepatitis B, hepatitis C, measles, and herpesviruses; findings were synthesized for each virus into a summary. The effects of statins on viral infections vary depending on the specific virus. While some studies indicate potential benefits in chronic HBV and HCV infections, evidence regarding SARS-CoV-2 and influenza remains inconclusive due to mixed findings from observational studies and randomized controlled trials. The role of statins in other viral infections is largely unexplored, with preclinical data available for only a few viruses. Given the conflicting evidence, further prospective studies and randomized controlled trials are warranted to elucidate statins’ role in viral infections, particularly in modulating inflammation, endothelial dysfunction, and immune responses. Future research should aim to define the optimal patient populations, target viruses, statin types, and treatment durations that may confer benefits in specific viral infections. Full article

(This article belongs to the Special Issue Travel Medicine and Migrant Health)

6 pages, 648 KiB

Open AccessBrief Report

Streamlining Preparedness: A Practical Pathway to Special Pathogens Management

by Sarah Irene Brown, Priya Dhagat, Aishani V. Aatresh, Saoirse Bodnar and Syra Madad

Trop. Med. Infect. Dis. 2025, 10(3), 72; https://doi.org/10.3390/tropicalmed10030072 - 11 Mar 2025

Abstract

Managing special pathogens cases, also known as high consequence infectious diseases, presents unique challenges for healthcare systems. It requires thorough planning and comprehensive operational protocols, as well as an appreciation of how human and organizational factors influence readiness. Based on the outcomes from [...] Read more.

Managing special pathogens cases, also known as high consequence infectious diseases, presents unique challenges for healthcare systems. It requires thorough planning and comprehensive operational protocols, as well as an appreciation of how human and organizational factors influence readiness. Based on the outcomes from a full-scale Ebola Virus Disease exercise at New York City Health and Hospitals (NYC Health + Hospitals), this paper presents a checklist of considerations to promote healthcare facility preparedness for special pathogens and to minimize gaps between protocol design and real-world implementation. This approach not only strengthens compliance with the new Joint Commission requirements but also provides a replicable framework for enhancing special pathogens preparedness within other healthcare systems. Full article

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

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16 pages, 925 KiB

Open AccessSystematic Review

The Utility of Infectious Disease Prevalence Studies to Inform Public Health Decision-Making in the Samoan Islands: A Systematic Review

by Beatris Mario Martin, Alison Brown, Filipina Amosa-Lei Sam, Aifili Tufa, Luis Furuya-Kanamori and Colleen L. Lau

Trop. Med. Infect. Dis. 2025, 10(3), 71; https://doi.org/10.3390/tropicalmed10030071 - 10 Mar 2025

Abstract

We conducted a systematic review of infectious disease (ID) prevalence studies in the Samoan Islands from 2000 to 2024 and aimed to synthesise the prevalence of IDs, the purpose of the studies, and the potential utility of survey results for informing public health [...] Read more.

We conducted a systematic review of infectious disease (ID) prevalence studies in the Samoan Islands from 2000 to 2024 and aimed to synthesise the prevalence of IDs, the purpose of the studies, and the potential utility of survey results for informing public health decision-making. We searched five academic databases, the Western Pacific Region Index Medicus, and grey literature up until April 2024. English language publications of ID surveys in American Samoa and Samoa were included. Each study’s aim, design, and prevalence results were extracted and categorised by disease and data sources. We identified 46 publications reporting the prevalence of 15 different IDs; 42 publications (91%) reported data from 31 original surveys, of which three (9%) investigated the prevalence of multiple IDs. Twenty-eight (62%) publications primarily aimed to report prevalence to inform public health interventions. Samples from one survey, initially conducted for leptospirosis, were subsequently tested to confirm transmission, describe prevalence, and investigate risk factors for seven other diseases. We emphasise the valuable contribution of prevalence studies in supporting evidence-based public health interventions. The extensive prevalence studies in the Samoan Islands illustrate the need for adopting integrated multipathogen approaches to surveillance to reduce costs, document burden, and generate actionable insights to support evidence-based decisions to prevent, control, and eliminate infectious diseases. Full article

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16 pages, 502 KiB

Open AccessSystematic Review

Sensitivity of Immunodiagnostic Tests in Localized Versus Disseminated Tuberculosis—A Systematic Review of Individual Patient Data

by Michael Eisenhut, Shagun Shah, Ozge Kaba, Manolya Kara, Murat Sütçü, Kyoung-Ho Song, Hong Bin Kim and Maoshui Wang

Trop. Med. Infect. Dis. 2025, 10(3), 70; https://doi.org/10.3390/tropicalmed10030070 - 7 Mar 2025

Abstract

Our objective was to perform a systematic review of individual patient data comparing immunodiagnostic test sensitivity in patients with localized versus disseminated tuberculosis who are from high- and less-than-high-income countries. In a systematic review of individual patient data, we compared IGRA results and [...] Read more.

Our objective was to perform a systematic review of individual patient data comparing immunodiagnostic test sensitivity in patients with localized versus disseminated tuberculosis who are from high- and less-than-high-income countries. In a systematic review of individual patient data, we compared IGRA results and characteristics of patients with disseminated tuberculosis with IGRA results and characteristics of patients with localized tuberculosis. Data were extracted from Pubmed, EMBASE and the Cochrane Library, analyzed and presented following the PRISMA-IPD and STROBE statements. We identified 52 patients with localized and 105 with disseminated tuberculosis. Immunodiagnostic tests in localized tuberculosis from high-income countries were positive in 88.8% and in 67.3% of patients with disseminated tuberculosis (p = 0.034). In patients from less-than-high-income countries, the sensitivity of immunodiagnostic tests was not significantly lower with disseminated tuberculosis. Patients with disseminated tuberculosis were significantly younger and had a higher rate of microbiological confirmation. Multivariate logistic regression analysis revealed that rate of microbiological confirmation was associated with a negative IGRA. Disseminated tuberculosis may be associated with a reduced sensitivity of IGRA in high-income countries and this may be related to a higher bacterial load with a negative IGRA. Full article

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9 pages, 1293 KiB

Open AccessArticle

18-Fluorine-Fluorodeoxyglucose Positron Emission Computer Tomography Imaging in Melioidosis: Valuable but Not Essential

by Joshua Bramwell, Natalia Kovaleva, Joshua J. Morigi and Bart J. Currie

Trop. Med. Infect. Dis. 2025, 10(3), 69; https://doi.org/10.3390/tropicalmed10030069 - 6 Mar 2025

Abstract

Melioidosis is an endemic tropical disease caused by Burkholderia pseudomallei. It typically causes pulmonary disease and bacteraemia but can disseminate to cause multi-organ disease. 18-F FDG PET/CT has an evolving role in diagnosing other infectious diseases, especially where the pathogen or extent [...] Read more.

Melioidosis is an endemic tropical disease caused by Burkholderia pseudomallei. It typically causes pulmonary disease and bacteraemia but can disseminate to cause multi-organ disease. 18-F FDG PET/CT has an evolving role in diagnosing other infectious diseases, especially where the pathogen or extent of infection is challenging to elucidate clinically and with conventional imaging (CT, US and MRI). We present a case series of patients diagnosed with melioidosis who also underwent 18-F FDG PET/CT from December 18th 2018 to September 30th 2022. Indications for imaging were categorised and analysed as to whether 18-F FDG PET/CT changed management over conventional imaging. Twenty-one 18-F FDG PET/CT scans were performed for sixteen patients. Two scans (9.5%) performed for pyrexia of unknown origin changed management in both cases. Twelve scans (57.1%) performed to ascertain the extent of dissemination of melioidosis changed management in only three (25%) cases. Five scans (23.8%) performed to monitor the response to treatment of known foci changed management in all five cases. Five scans (23.8%) performed for suspected or known malignancy changed management in three (60%) cases. 18-F FDG PET/CT is an emerging tool which improves diagnosis and changes the management of melioidosis when applied judiciously and for well-selected indications. Full article

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16 pages, 372 KiB

Open AccessArticle

Process Evaluation of Pragmatic Cluster-Randomized Trials of Digital Adherence Technologies for Tuberculosis Treatment Support: A Mixed-Method Study in Five Countries

by Norma Madden, Amare W. Tadesse, Chung Lam Leung, Bianca Gonçalves Tasca, Jason Alacapa, Natasha Deyanova, Nontobeko Ndlovu, Nontobeko Mokone, Baraka Onjare, Andrew Mganga, Kristian van Kalmthout, Degu Jerene and Katherine Fielding

Trop. Med. Infect. Dis. 2025, 10(3), 68; https://doi.org/10.3390/tropicalmed10030068 - 6 Mar 2025

Abstract

Digital adherence technologies (DATs) could improve the person-centeredness of tuberculosis (TB) treatment. DATs are found to be acceptable, though evidence of their effectiveness is varied. Our objective was to understand the fidelity of DAT interventions within five cluster-randomized trials. Two DATs (smart pillbox, [...] Read more.

Digital adherence technologies (DATs) could improve the person-centeredness of tuberculosis (TB) treatment. DATs are found to be acceptable, though evidence of their effectiveness is varied. Our objective was to understand the fidelity of DAT interventions within five cluster-randomized trials. Two DATs (smart pillbox, medication labels) were assessed, with real-time adherence data available to healthcare providers (HCPs) on a digital platform in Ethiopia, the Philippines, South Africa, Tanzania, and Ukraine. A framework assessed four components of implementation: inputs (training, support, mobile access), processes (SMS, home visits, platform usage), outputs (DAT engagement, manual dosing), and outcomes (people with TB (PwTB)–HCP relationship). Fidelity was evaluated by quantitative indicators, and content analysis of qualitative sub-studies supplemented some indicators. Engagement with DATs was high among PwTB. Pillbox users showed high levels of sustained engagement (box opening), with digitally recorded doses ranging from 82% to 91%. Differences were observed in login frequency by HCPs to the adherence platform. In Ethiopia, Tanzania, and Ukraine, there was at least one login to the platform on 71% of weekdays per facility compared with the Philippines and South Africa at 42% and 52%, respectively. Intervention fidelity varied among countries, suggesting a need for future work on optimizing implementation. Full article

(This article belongs to the Special Issue Transforming TB Prevention and Care: The Era of Technology and AI)

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14 pages, 1298 KiB

Open AccessArticle

Syndemic Factors Associated with Zika Virus Infection Prevalence and Risk Factors in a Cohort of Women Living in Endemic Areas for Arboviruses in Northeast Brazil

by Ligia Kerr, Carlos Sanhueza-Sanzana, Marto Leal, Italo Aguiar, Kasim Allel, Moisés H. Sandoval, Cristiane Cunha Frota, Marco Túlio Aguiar, Adriano Ferreira Martins, Livia Dias, Rosa Livia Freitas de Almeida, Francisco Herlânio Costa Carvalho, Francisco Gustavo Silveira Correia, Roberto da Justa Pires Neto, Fernanda Montenegro Araújo, Shirlene Telmos Silva de Lima, Leda Maria Simões Mello, Lucas de Lima Nogueira, Terezinha do Menino Jesus Silva Leitão, Maria da Glória Teixeira, Jeni Stolow, Guilherme Loureiro Werneck, Ivo Castelo Branco Coelho, Ronald Blanton, Ana Zaira da Silva, George W. Rutherford and Carl Kendall Show full author list Hide full author list

Trop. Med. Infect. Dis. 2025, 10(3), 67; https://doi.org/10.3390/tropicalmed10030067 - 1 Mar 2025

Abstract

Background: We sought to explain the seroprevalence of Zika Virus (ZIKV) as a syndemic of socioeconomic, environmental, and health factors in a cohort of women living in Brazil. Methods: This is a cohort study comprising 1498 women between 15 and 39 years of [...] Read more.

Background: We sought to explain the seroprevalence of Zika Virus (ZIKV) as a syndemic of socioeconomic, environmental, and health factors in a cohort of women living in Brazil. Methods: This is a cohort study comprising 1498 women between 15 and 39 years of age followed up in two waves between February 2018 and August 2019. Two questionnaires addressed the arbovirus’s socioeconomic, demographic, and behavioral aspects and participants’ arbovirus infection history. Blood samples were collected to detect IgM and IgG for ZIKV, chikungunya virus (CHIKV), and dengue virus (DENV), and RT-PCR for ZIKV. Results: The baseline prevalence for ZIKV was 43% (95%CI: 40.5, 45.6), increasing to 44.7% in the following period (95%CI: 42, 47.1). We found a prevalence of 44.1% among women having one syndemic factor, 49.9% for those having two, and 58% for women having three or more factors. Women reporting a single syndemic factor resulted in higher odds of acquiring ZIKV (OR = 1.6, 95%CI: 1.2–2.4). There were increased adjusted odds among women having two or three or more factors (OR = 2.1, 95%CI: 1.6–3.1; OR = 2.9, 95%CI: 2.0–4.3, respectively). Conclusions: Tailored interventions targeting syndemic conditions, such as the co-circulation of urban arboviruses and poor living conditions, are crucial to improving the burden produced by ZIKV. Full article

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

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14 pages, 759 KiB

Open AccessArticle

Estimating Dengue Outbreak Thresholds in West Africa: A Comprehensive Analysis of Climatic Influences in Burkina Faso, 2018–2024

by John Otokoye Otshudiema, Watton R. Diao, Sonia Marie Wend-Kuuni Ouedraogo, Alain Ngoy Kapete, Laurent Moyenga, Emmanuel Chanda, Tieble Traore, Otim Patrick Ramadan and Alimuddin Zumla

Trop. Med. Infect. Dis. 2025, 10(3), 66; https://doi.org/10.3390/tropicalmed10030066 - 28 Feb 2025

Abstract

Background: Dengue, transmitted by Aedes spp. mosquitoes, poses significant public health challenges in Burkina Faso. This study investigated outbreak thresholds, utilizing historical data since 2018 to explore the climatic impacts on dengue transmission and address knowledge gaps. Methodology: This retrospective ecological study utilized [...] Read more.

Background: Dengue, transmitted by Aedes spp. mosquitoes, poses significant public health challenges in Burkina Faso. This study investigated outbreak thresholds, utilizing historical data since 2018 to explore the climatic impacts on dengue transmission and address knowledge gaps. Methodology: This retrospective ecological study utilized historical and contemporary data from Burkina Faso’s Public Health Ministry (2018–2024) to model dengue outbreak thresholds. A combination of epidemic channel analysis, joinpoint regression, climate–disease relationship analysis, and negative binomial regression was employed to provide comprehensive insights into the factors driving dengue outbreaks. Principal Findings: The incidence of probable dengue cases remained stable, mostly below 5 cases per 100,000 people, except for a sharp surge in week 40 of 2023, peaking at 38 cases per 100,000. This surge was brief, normalizing by week 47, but coincided with a marked increase in mortality, reaching 90 deaths in week 45. Joinpoint regression identified key thresholds, an alert at 2.1 cases per 100,000 by week 41 and an intervention threshold at 19.1 cases by week 44, providing a framework for timely public health responses. Climatic factors significantly influenced dengue transmission, with higher temperatures (RR = 2.764) linked to increased incidence, while higher precipitation (RR = 0.551) was associated with lower case numbers, likely due to disrupted mosquito breeding conditions. Additionally, intermediate precipitation levels showed a complex relationship with higher incidence rates. Conclusions: This study established evidence-based epidemiological thresholds for dengue outbreak detection in Burkina Faso (2018–2024), demonstrating temperature as a primary transmission driver while precipitation showed inverse relationships. Analysis of the 2023 outbreak identified a critical five-week intervention window (weeks 40–45), providing a framework for climate-sensitive early warning systems. These findings advance the understanding of dengue dynamics in West Africa, though future research should integrate geographical and socioeconomic variables to enhance predictive modeling and outbreak preparedness. Full article

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

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11 pages, 1015 KiB

Open AccessArticle

The Association Between Syphilis Infection and HIV Acquisition and HIV Disease Progression in Sub-Saharan Africa

by Sindhuri Gandla, Raja Nakka, Ruhul Ali Khan, Fatemeh Salboukh and Musie Ghebremichael

Trop. Med. Infect. Dis. 2025, 10(3), 65; https://doi.org/10.3390/tropicalmed10030065 - 28 Feb 2025

Abstract

Syphilis and other sexually transmitted infections (STIs) are highly prevalent in most regions experiencing severe human immunodeficiency virus (HIV) epidemics. In sub-Saharan Africa, the region most heavily affected by HIV, the prevalence of syphilis among people living with HIV (PLWH) is notably high. [...] Read more.

Syphilis and other sexually transmitted infections (STIs) are highly prevalent in most regions experiencing severe human immunodeficiency virus (HIV) epidemics. In sub-Saharan Africa, the region most heavily affected by HIV, the prevalence of syphilis among people living with HIV (PLWH) is notably high. This region accounts for 40% of global STIs and 70% of HIV cases. Despite the high prevalence of syphilis and other STIs among PLWH in the region, there are limited studies on the interplay between the two infections from the region. Most studies on the association between syphilis and HIV transmission/progression from the region are limited to specific groups of people, such as female sex workers or pregnant women. In this manuscript, we evaluated the association between the two infections using population-based surveys conducted in the region. Statistical methods (such as logistic regression models and propensity score matching) were employed to assess the interplay between the two infections. Our findings indicated that syphilis infection was associated with higher odds of HIV acquisition. Moreover, co-infection with syphilis was associated with higher odds of HIV disease progression among antiretroviral therapy (ART)-treated PLWH, though the association did not reach statistical significance. Our findings suggest that the recognition and treatment of syphilis to reduce the risk of HIV acquisition/progression should be a public health priority in sub-Saharan Africa, where ART may not be readily available. Full article

(This article belongs to the Section Infectious Diseases)

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11 pages, 689 KiB

Open AccessArticle

The Etiology and Antimicrobial Susceptibility of Community-Onset Urinary Tract Infections in a Low-Resource/High-Resistance Area of Latin America

by Maria Micieli, Selene Rebecca Boncompagni, Tiziana Di Maggio, Yenny Bertha Mamani Ramos, Antonia Mantella, Ana Liz Villagrán, Carmen Angélica Revollo Yelma, Evelin Esther Fortún Fernández, Michele Spinicci, Marianne Strohmeyer, Lucia Pallecchi, Gian Maria Rossolini and Alessandro Bartoloni

Trop. Med. Infect. Dis. 2025, 10(3), 64; https://doi.org/10.3390/tropicalmed10030064 - 27 Feb 2025

Abstract

Urinary tract infections (UTIs) are common and are typically treated empirically, based on local antimicrobial resistance (AMR) data, which are often scarce in low- and middle-income countries. This study examines the AMR patterns of pathogens causing community-onset (CO) UTIs in the Bolivian Chaco. [...] Read more.

Urinary tract infections (UTIs) are common and are typically treated empirically, based on local antimicrobial resistance (AMR) data, which are often scarce in low- and middle-income countries. This study examines the AMR patterns of pathogens causing community-onset (CO) UTIs in the Bolivian Chaco. Urine samples were collected from subjects with suspected CO-UTIs and analyzed by culture techniques. Significant isolates were tested for their antimicrobial susceptibility. Additionally, bla_CTX-M and mcr genes were searched for using real-time PCR. A total of 361 CO-UTI episodes were diagnosed among 731 subjects from February 2020 to November 2021. The cases included uncomplicated and complicated UTIs (58.2% and 41.8%, respectively), with females accounting for the majority (85.3%) of cases. Escherichia coli was the most prevalent pathogen (86.6%), followed by Klebsiella pneumoniae (5.4%) and Proteus spp. (2.2%). Very high resistance rates (>50%) were observed for ampicillin, trimethoprim–sulfamethoxazole and fluoroquinolones, high resistance rates (>20%) for amoxicillin–clavulanate, third-generation cephalosporins and gentamicin, while lower resistance rates (<10%) were observed for nitrofurantoin and fosfomycin. The prevalence of bla_CTX-M among E. coli was high (26.7%). Colistin resistance was detected in 3.4% of E. coli, mostly associated with mcr genes. CO-UTIs from this area were characterized by high resistance rates to commonly used antibiotics (trimethoprim–sulfamethoxazole, amoxicillin–clavulanic acid and ciprofloxacin), highlighting the importance of knowledge of the local epidemiology to inform the selection of appropriate empirical antibiotic regimens. Full article

(This article belongs to the Section Infectious Diseases)

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