Journal Description
Tropical Medicine and Infectious Disease
Tropical Medicine and Infectious Disease
(TropicalMed) is an international, scientific, peer-reviewed, open access journal of tropical medicine and infectious disease published monthly online by MDPI. It is the official journal of the Australasian College of Tropical Medicine (ACTM) and its Joint Faculties of Travel Medicine and Expedition and Wilderness Medicine. Their members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Informit, and other databases.
- Journal Rank: JCR - Q1 (Tropical Medicine) / CiteScore - Q2 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.6 days after submission; acceptance to publication is undertaken in 3.1 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.6 (2024);
5-Year Impact Factor:
2.8 (2024)
Latest Articles
Impact of El Nino Southern Oscillation and Climate Change on Infectious Diseases with Ophthalmic Manifestations
Trop. Med. Infect. Dis. 2025, 10(10), 297; https://doi.org/10.3390/tropicalmed10100297 (registering DOI) - 18 Oct 2025
Abstract
Climate change and the El Niño Southern Oscillation (ENSO) events have been increasingly linked to infectious disease outbreaks. While growing evidence has connected climate variability with systemic illnesses, the ocular implications remain underexplored. This study aimed to assess the relationships between ENSO-driven climate
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Climate change and the El Niño Southern Oscillation (ENSO) events have been increasingly linked to infectious disease outbreaks. While growing evidence has connected climate variability with systemic illnesses, the ocular implications remain underexplored. This study aimed to assess the relationships between ENSO-driven climate events and infectious diseases with ophthalmic consequences. A narrative review of 255 articles was conducted, focusing on infectious diseases influenced by ENSO and their associated ocular findings. 39 articles met criteria for full review, covering diseases such as dengue, zika, chikungunya, malaria, leishmaniasis, leptospirosis, and Rift Valley fever. Warmer temperatures, increased rainfall, and humidity associated with ENSO events were found to enhance vector activity and disease transmission. Ocular complications included uveitis, retinopathy, and optic neuropathy, but the specific disease findings varied by infectious disease syndrome. The climactic variable changes in response to ENSO events differed across diseases and regions and were influenced by geography, local infrastructure, and socioeconomic factors. ENSO event-related climate shifts significantly impact the spread of infectious diseases with ocular symptoms. These findings highlight the need for region-specific surveillance and predictive models that may provide insight related to the risk of ophthalmic disease during ENSO events. Further research is needed to clarify long-term ENSO effects and develop integrated strategies for systemic and eye disease detection, prevention, and management.
Full article
(This article belongs to the Special Issue Infectious Diseases, Health and Climate Change)
Open AccessArticle
Evaluation of Tuberculosis Preventive Treatment Uptake Among People Living with HIV in PEPFAR-Supported Facilities in Zimbabwe
by
Collins Timire, Tawanda Mapuranga, Ronald T. Ncube, Talent Maphosa, Sithabiso Dube, Nqobile Mlilo, Cynthia Chiteve, Selma Dar Berger, Owen Mugurungi, Fungai Kavenga, Tsitsi Mutasa-Apollo, Manners Ncube, Clorata Gwanzura, Macarthur Charles, Riitta A. Dlodlo and Julia Ershova
Trop. Med. Infect. Dis. 2025, 10(10), 296; https://doi.org/10.3390/tropicalmed10100296 (registering DOI) - 18 Oct 2025
Abstract
Tuberculosis preventive treatment (TPT) reduces the incidence of tuberculosis (TB) among people living with HIV (PLHIV), but its coverage remains suboptimal in most settings. We conducted a cross-sectional study to describe TPT uptake among PLHIV and factors influencing TPT initiation. Healthcare workers (HCWs)
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Tuberculosis preventive treatment (TPT) reduces the incidence of tuberculosis (TB) among people living with HIV (PLHIV), but its coverage remains suboptimal in most settings. We conducted a cross-sectional study to describe TPT uptake among PLHIV and factors influencing TPT initiation. Healthcare workers (HCWs) in selected facilities were trained and supported to strengthen TPT management among PLHIV, including children living with HIV (CLHIV). Of 1309 enrolled PLHIV, 1268 (97%) were eligible for TPT; 1078 (85%) initiated TPT, including 663/776 (86%) among those currently on ART and 415/492 (84%) among clients newly on ART. The major reasons for not starting TPT included stock-outs of TPT medicines, TB disease, and refusal of TPT, mostly by CLHIV and adults currently on ART. Optimal and sustained uptake of TPT can be achieved through ensuring uninterrupted stocks of TPT medicines, including shorter regimens and pediatric formulations, addressing knowledge deficits among HCWs, and improving demand for TPT by educating PLHIV and caregivers of CLHIV about the benefits and risks of TPT formulations.
Full article
(This article belongs to the Special Issue New Perspectives in Tuberculosis Prevention and Control)
Open AccessSystematic Review
From Pediatric to Adult HIV Care: What Works to Keep Adolescents Engaged—A Systematic Review of Transition Strategies
by
Po-Pin Hung and Hsi-Hsien Wei
Trop. Med. Infect. Dis. 2025, 10(10), 295; https://doi.org/10.3390/tropicalmed10100295 - 16 Oct 2025
Abstract
Adolescents living with HIV face unique challenges when transitioning from pediatric to adult care—including stigma, disclosure concerns, and loss of support—that undermine continuity. We systematically searched PubMed, Embase, and Web of Science through August 2025 in accordance with PRISMA 2020. Two reviewers independently
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Adolescents living with HIV face unique challenges when transitioning from pediatric to adult care—including stigma, disclosure concerns, and loss of support—that undermine continuity. We systematically searched PubMed, Embase, and Web of Science through August 2025 in accordance with PRISMA 2020. Two reviewers independently screened records and appraised risk of bias using Joanna Briggs Institute (JBI) tools by study design; appraisals informed interpretation but did not determine inclusion. Thirty-two studies met criteria; given heterogeneity, findings were narratively synthesized. Post-transition outcomes were suboptimal: retention often declined to ~70% by two years and viral suppression to roughly two-thirds, below global targets. Older transfer age and minimal gaps between pediatric discharge and adult enrollment were associated with better retention. Structured programs combining early preparation, coordinated handoffs, psychosocial/peer support, and youth-friendly adult services consistently improved engagement (often >90% 12-month retention), though improvements in viral suppression were less uniform. JBI appraisal indicated mostly moderate methodological quality with common risks from confounding and incomplete follow-up, tempering certainty. Purposeful, well-supported transition models are essential to sustain treatment success into adulthood; future work should evaluate scalable delivery and long-term outcomes across diverse settings.
Full article
(This article belongs to the Special Issue Adolescent HIV Care and Transition Strategies: Challenges, Outcomes, and Interventions)
Open AccessArticle
Serology-Based Screening and Prevalence of Schistosomiasis, Strongyloidiasis, and Chagas Disease in Migrants Living with HIV: Results from a 10-Year Retrospective Cohort in an Italian Tertiary Healthcare Center
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Anna Barbiero, Riccardo Paggi, Sasha Trevisan, Giuseppe Gasparro, Michele Spinicci, Costanza Malcontenti, Marco Pozzi, Paola Corsi, Gian Maria Rossolini, Maria Grazia Colao, Alessandro Bartoloni, Lorenzo Zammarchi and Filippo Lagi
Trop. Med. Infect. Dis. 2025, 10(10), 294; https://doi.org/10.3390/tropicalmed10100294 - 16 Oct 2025
Abstract
Background: Migration phenomena from low- to high-income countries have been constantly increasing in the past years, and migrants living with HIV (MLHIVs) currently represent a non-negligible proportion of the population living with HIV in the European setting. When taken into care, MLHIVs should
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Background: Migration phenomena from low- to high-income countries have been constantly increasing in the past years, and migrants living with HIV (MLHIVs) currently represent a non-negligible proportion of the population living with HIV in the European setting. When taken into care, MLHIVs should be screened for tropical diseases capable of asymptomatically persisting for years and leading to severe and/or chronic complications, especially in immunocompromised populations. Methods: We conducted a retrospective study aimed at analyzing the screening ratios and seroprevalences of strongyloidiasis, schistosomiasis, and Chagas disease among MLHIVs who attended a tertiary care hospital outpatient clinic in Florence, Italy. Results: Between 2014 and 2023, 251 MLHIVs were enrolled, of which 85 (33.9%), 137 (54.6%), and 219 (87.3%) were at risk for schistosomiasis, Chagas disease, and strongyloidiasis, respectively. Among individuals at risk for each of these parasitic diseases, 43.4% were screened for strongyloidiasis, 25.9% for schistosomiasis, and 65.0% for Chagas disease, with a seroprevalence of 5.3%, 13.6%, and 0%, respectively. Conclusions: While confirming the relevant burden of neglected parasitic diseases in the MLHIV population, our results suggest the need to improve awareness of these diseases even in the specialist context in order to reduce underdiagnoses and the risk of severe complications, especially in particularly vulnerable groups of the population.
Full article
(This article belongs to the Special Issue Emerging and Re-emerging Infectious Diseases: Global and Local Burden, Surveillance, and Response Strategies)
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Open AccessArticle
Clinical Characteristics and Risk Factors of Tuberculosis in Children and Adolescents in Xinjiang, China: A Retrospective Analysis
by
Tao Xin, Gaofeng Sun, Jiangbutaer Entemake, Beiming Zhang, Weiwei Jiao and Qifeng Li
Trop. Med. Infect. Dis. 2025, 10(10), 293; https://doi.org/10.3390/tropicalmed10100293 - 16 Oct 2025
Abstract
Background: Tuberculosis (TB) remains a major public health challenge among children and adolescents in high-burden countries. Xinjiang, the region with the highest TB incidence in China, has limited data on the clinical and epidemiological characteristics of pediatric TB. Methods: We conducted a retrospective
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Background: Tuberculosis (TB) remains a major public health challenge among children and adolescents in high-burden countries. Xinjiang, the region with the highest TB incidence in China, has limited data on the clinical and epidemiological characteristics of pediatric TB. Methods: We conducted a retrospective cross-sectional study of children and adolescents (≤17 years) hospitalized with TB at a regional referral hospital in Xinjiang between 1 January 2020 and 31 December 2022. Demographic, clinical, and laboratory data were analyzed, and risk factors for extrapulmonary TB (EPTB) and severe TB were assessed. Results: A total of 253 patients were included, of whom 54.9% (139/253) had pulmonary TB (PTB) and 45.1% (114/253) had EPTB. EPTB was more common among children <5 years (78.9%, 15/19). The predominant clinical symptoms were fever (55.7%, 141/253), cough (66.8%, 169/253), fatigue (60.9%, 154/253), and night sweats (51.8%, 131/253). Tuberculous meningitis (TBM) was the most frequent EPTB manifestation (40.4%, 46/114). Younger age, rural residence, and absence of BCG vaccination were associated with a higher risk of EPTB. Laboratory findings showed high positivity rates for tuberculin skin test (96.1%, 99/103) and interferon-γ release assay (84.5%, 196/232), but low yields for smear microscopy and Xpert MTB/RIF, especially in EPTB cases. Conclusions: Pediatric TB in Xinjiang is characterized by a high burden of EPTB, particularly TBM in young children. Strengthening early diagnosis and improving access to effective diagnostic tools are essential to reduce morbidity and improve outcomes in this vulnerable population.
Full article
(This article belongs to the Section Infectious Diseases)
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Open AccessArticle
Molecular Characterization of Plasmodium Species to Strengthen Malaria Surveillance in Migrant Populations in Honduras
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Ashley Godoy, Kevin Euceda, Alejandra Pinto, Hugo O. Valdivia, Lesly Chaver, Gloria Ardon and Gustavo Fontecha
Trop. Med. Infect. Dis. 2025, 10(10), 292; https://doi.org/10.3390/tropicalmed10100292 - 15 Oct 2025
Abstract
As Honduras approaches malaria elimination, imported infections pose a growing challenge to disease surveillance and control. In this study, we analyzed 14 molecular markers—six from Plasmodium falciparum and eight from P. vivax—in samples from local and migrant subjects to assess their utility
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As Honduras approaches malaria elimination, imported infections pose a growing challenge to disease surveillance and control. In this study, we analyzed 14 molecular markers—six from Plasmodium falciparum and eight from P. vivax—in samples from local and migrant subjects to assess their utility in differentiating local versus imported infections. All P. falciparum isolates carried the wild-type pfcrt haplotype associated with chloroquine susceptibility. However, polymorphisms in pfmdr1, pfama1, pfglurp, and pfs47 revealed distinct genotypes in migrant versus local samples, suggesting external origins. For P. vivax, three novel pvcsp VK210 haplotypes and the first detection of a VK247 variant in Honduras were identified in migrants. Additional novel haplotypes were found in pvmsp1, pvmsp3α, pvmsp3β, pvs47, and pvs48/45. Several of these markers—particularly pfmdr1, pfs47, pvs47, and pvs48/45—proved informative for inferring geographic origin. This study demonstrates the value of molecular surveillance in low-transmission settings, supporting public health efforts by identifying potentially imported cases.
Full article
(This article belongs to the Special Issue Challenges and Prevention Strategies for Travel-Related Infectious Diseases)
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Open AccessArticle
Antibiotic-Resistant Bacteria in Drinking Water Across Twelve Regions of Ghana: Strengthening Evidence for National Surveillance
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Karyn Ewurama Quansah, Hawa Ahmed, Pruthu Thekkur, George Kwesi Hedidor, Lady Asantewah Boamah Adomako, Regina Ama Banu, Mark Osa Akrong, Selorm Borbor, Nawal Moro Buri, Mohammed Bello, Ebenezer Worlanyo Wallace-Dickson, Gerard Quarcoo, Emmanuel Martin Obeng Bekoe and Maria Zolfo
Trop. Med. Infect. Dis. 2025, 10(10), 291; https://doi.org/10.3390/tropicalmed10100291 - 14 Oct 2025
Abstract
Antimicrobial resistance (AMR) surveillance plays a critical role in tracking emerging trends and informing evidence-based policies. This study assessed bacterial contamination and resistance profiles of Escherichia coli and Pseudomonas aeruginosa in 1886 drinking water samples from 12 regions of Ghana between April 2024
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Antimicrobial resistance (AMR) surveillance plays a critical role in tracking emerging trends and informing evidence-based policies. This study assessed bacterial contamination and resistance profiles of Escherichia coli and Pseudomonas aeruginosa in 1886 drinking water samples from 12 regions of Ghana between April 2024 and April 2025. Findings were compared to a baseline study from the Greater Accra region (2022). Water samples analysed included sachet, bottled, tap, borehole, well, and surface water. Isolates were tested for antibiotic susceptibility using the Kirby–Bauer disk diffusion method. The majority of treated and packaged water samples were free from bacterial contamination. E. coli was frequently detected in untreated surface water (68%) and well water (63%). E. coli isolates from untreated water samples exhibited high resistance to cefuroxime (74%) and amoxicillin-clavulanate (50%); resistance to gentamicin increased from 3% in 2022 to 35% in 2025, while ertapenem resistance rose from 6% to 18%. Multidrug-resistant (MDR) E. coli isolates were found in samples from eight regions, and MDR P. aeruginosa in three, mostly from borehole water. These findings highlight the urgency to integrate AMR surveillance into national water quality initiatives, along with coordinated public health interventions, to educate communities on household water treatment practices and the health risks posed by AMR.
Full article
(This article belongs to the Special Issue Field Impact of the SORT IT Initiative on Combating Antimicrobial Resistance Through a One Health Approach in Ghana)
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Open AccessArticle
Endemicity, Clinical Features, Risk Factors, and the Potential for Severe Infection in Leptospira wolffii-Associated Leptospirosis in North-Central Bangladesh
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Sheikh Anika Tasnim, Nazia Haque, Shyamal Kumar Paul, Meiji Soe Aung, Md. Rafiul Hasan, Sheikh Nayeem Niaz, Arup Islam, Syeda Anjuman Nasreen, Mosammat Rezaun Nahar, Sultana Jahan Tuly, Parsa Irin Disha, Abdullah Al Mamun, Md. Shafiqul Islam, Santana Rani Sarkar and Nobumichi Kobayashi
Trop. Med. Infect. Dis. 2025, 10(10), 290; https://doi.org/10.3390/tropicalmed10100290 - 13 Oct 2025
Abstract
Leptospirosis is a zoonotic disease caused by pathogenic Leptospira, prevalent in tropical/sub-tropical regions. This study aimed to clarify the prevailing leptospiral species, clinical features, and risk factors of leptospirosis in north-central Bangladesh in 2024. Venous blood and urine samples were collected from
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Leptospirosis is a zoonotic disease caused by pathogenic Leptospira, prevalent in tropical/sub-tropical regions. This study aimed to clarify the prevailing leptospiral species, clinical features, and risk factors of leptospirosis in north-central Bangladesh in 2024. Venous blood and urine samples were collected from 117 patients with clinically suspected leptospirosis. Among these cases, 75 (64%) tested positive for Leptospira infection by IgM ELISA test and/or PCR. By phylogenetic analysis of the 16S rRNA gene, all the samples tested were classified into L. wolffii (pathogenic group P2), showing high sequence identity to those of the type strain Khorat-H2 (97–99%) and L. wolffii reported in Bangladesh previously. Confirmed leptospirosis patients were mostly male (93%), aged 15–60 years (93%), living in rural areas in low socioeconomic conditions. Variable symptoms were presented by patients, with jaundice (84%), nausea/vomiting (84%), and myalgia (67%) being common. Some patients showed severe symptoms involving the nervous system (disorientation and neck stiffness) and the respiratory tract (cough, shortness of breath, and hemoptysis). Major risk factors for leptospirosis were exposures to mud/wet soil, sanding water, heavy rain, working in a paddy field, and cattle. In conclusion, L. wolffii was revealed to be circulating endemically in north-central Bangladesh, since its first detection in 2018, associated with variable and severe clinical symptoms in humans.
Full article
(This article belongs to the Special Issue Leptospirosis and One Health)
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Open AccessArticle
Comparison of Clinical, Epidemiological, Haematological, and Biochemical Characteristics in Serologically Confirmed and Suspected Cases of Tularemia
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Nurten Nur Aydın, Murat Aydın and Ömer Karaşahin
Trop. Med. Infect. Dis. 2025, 10(10), 289; https://doi.org/10.3390/tropicalmed10100289 - 10 Oct 2025
Abstract
Background: Tularemia is a zoonotic infection caused by Francisella tularensis, transmitted to humans through direct contact with infected animals, arthropod bites, or by ingesting contaminated water. It commonly presents with fever, lymphadenopathy, and oropharyngeal symptoms. In Turkey, where waterborne outbreaks are frequent,
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Background: Tularemia is a zoonotic infection caused by Francisella tularensis, transmitted to humans through direct contact with infected animals, arthropod bites, or by ingesting contaminated water. It commonly presents with fever, lymphadenopathy, and oropharyngeal symptoms. In Turkey, where waterborne outbreaks are frequent, tularemia remains a significant public health concern. This study aimed to compare the clinical, epidemiological, and laboratory characteristics of patients diagnosed with tularemia and those with similar clinical features but seronegative results, with the goal of identifying parameters that may assist in differential diagnosis. Methods: This retrospective study included adults (≥18 years) who presented to the Infectious Diseases Outpatient Clinic between 2016 and 2024 with suspected tularemia and were tested using a microagglutination test (MAT). Patients with a positive MAT (≥1:160) or a fourfold titre increase were classified as tularemia cases, while seronegative patients were defined as tularemia-like cases. Demographic data, clinical symptoms, epidemiological risk factors, and laboratory findings were compared between the two groups. Results: A total of 105 patients were included, 54 (51.4%) of whom were diagnosed with tularemia. The duration from symptom onset to healthcare presentation was significantly longer in tularemia cases (20.3 ± 5.7 vs. 15.7 ± 6.2 days; p < 0.001). Sore throat (66.7% vs. 43.1%; p = 0.026) and tonsillitis/pharyngitis (55.6% vs. 21.6%; p = 0.001) were significantly more prevalent in the tularemia group. Epidemiological risk factors, including rural residence (92.6%), animal husbandry (74.1%), agricultural activity (72.2%), and contact with lake or stream water, were significantly more prevalent among tularemia cases (all p < 0.001). Alanine aminotransaminase (p = 0.019) and C-reactive protein levels (p = 0.027) were significantly lower in the tularemia group. Conclusions: Tularemia cases are associated with particular epidemiological risk factors and oropharyngeal symptoms. A thorough epidemiological evaluation is crucial for diagnosis, and enhancing awareness among healthcare providers and the public may facilitate earlier recognition and management.
Full article
(This article belongs to the Section Vector-Borne Diseases)
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Open AccessArticle
A 15-Minute Exposure to Locally Available Disinfectants Eliminates Escherichia coli from Farm-Grown Lettuce While Preserving Quality in Ghana
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Emmanuel Martin Obeng Bekoe, Gerard Quarcoo, Olga Gonocharova, Divya Nair, Obed Kwabena Offe Amponsah, Karyn Ewurama Quansah, Ebenezer Worlanyo Wallace-Dickson, Emmanuel Tetteh-Doku Mensah, Regina Ama Banu, Mark Osa Akrong and Rony Zachariah
Trop. Med. Infect. Dis. 2025, 10(10), 288; https://doi.org/10.3390/tropicalmed10100288 - 10 Oct 2025
Abstract
We evaluated the effectiveness of three locally available disinfectants in reducing Escherichia coli (E. coli) contamination of wastewater-irrigated lettuce while preserving structural integrity. We conducted a quasi-experimental study using lettuce from two farms (Accra and Tamale) in Ghana. Disinfectants tested included
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We evaluated the effectiveness of three locally available disinfectants in reducing Escherichia coli (E. coli) contamination of wastewater-irrigated lettuce while preserving structural integrity. We conducted a quasi-experimental study using lettuce from two farms (Accra and Tamale) in Ghana. Disinfectants tested included (i) salt combined with vinegar, (ii) sequential salt and potassium permanganate, and (iii) sequential vinegar and potassium permanganate. Structural integrity (stem crispness and leaf mushiness) was assessed at 5, 10, and 15 min. E. coli counts and antibiotic resistance were determined pre- and post-disinfection. All three disinfectants preserved structural integrity of lettuce at 5 and 10 min. At 15 min, sequential disinfectants preserved 100% structural integrity, while the salt–vinegar mix caused mushiness in 16%. Pre-disinfection E. coli counts were 9720 cfu/g for Accra (Inter Quartile range, IQR: 3915–14,175) and 72 cfu/g (IQR: 36–189) for Tamale. All disinfectants eliminated E. coli after 15 min. Multi-drug-resistant isolates were common (45% in Accra and 30% in Tamale), particularly against “Watch, restricted use” antibiotics. A 15 min exposure of lettuce to locally available disinfectants, particularly when used sequentially, can eliminate E. coli contamination while preserving structural quality. This practical, low-cost intervention can empower households, vendors, and farmers to limit lettuce-borne diarrheal diseases and antimicrobial resistance transmission.
Full article
(This article belongs to the Special Issue Field Impact of the SORT IT Initiative on Combating Antimicrobial Resistance Through a One Health Approach in Ghana)
Open AccessArticle
Prognostic Significance of CRP/Albumin, D-Dimer/Albumin, D-Dimer/Fibrinogen Ratios and Triglyceride-Glucose Index in Crimean–Congo Hemorrhagic Fever: A Prospective Observational Study
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Nurten Nur Aydın and Murat Aydın
Trop. Med. Infect. Dis. 2025, 10(10), 287; https://doi.org/10.3390/tropicalmed10100287 - 9 Oct 2025
Abstract
Background: Crimean–Congo hemorrhagic fever (CCHF) is a severe zoonotic viral infection with high mortality rates. This study aimed to examine the prognostic value of new-generation inflammatory markers—CRP/albumin ratio (CAR), D-dimer/albumin ratio (DAR), D-dimer/fibrinogen ratio (DFR), and triglyceride-glucose index (TGI)—in predicting mortality among patients
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Background: Crimean–Congo hemorrhagic fever (CCHF) is a severe zoonotic viral infection with high mortality rates. This study aimed to examine the prognostic value of new-generation inflammatory markers—CRP/albumin ratio (CAR), D-dimer/albumin ratio (DAR), D-dimer/fibrinogen ratio (DFR), and triglyceride-glucose index (TGI)—in predicting mortality among patients diagnosed with CCHF. Methods: This prospective study involved 76 patients with a positive polymerase chain reaction test for CCHF and 38 age- and sex-matched healthy controls between 15 April 2023 and 15 October 2024. Participants’ demographic, clinical, and laboratory data at presentation were recorded. Results: CAR, DAR, DFR, and TGI levels were significantly higher in the patient group compared to the control group (all p < 0.001). Furthermore, when mortal cases were compared with survivors, all of these markers were found to be significantly higher in the mortal group (p = 0.005, p = 0.004, p = 0.001, and p = 0.003, respectively). In Kaplan–Meier analysis, survival time was significantly shorter in patients with higher levels of these parameters (p < 0.001 for all). In the Receiver Operating Characteristic analysis conducted to differentiate mortal cases from survivors, DFR and TGI were identified as the markers with the highest predictive power (area under the curve: 0.938 and 0.899, respectively). Conclusions: Inflammatory markers CAR, DAR, DFR and TGI may serve as significant prognostic tools to predict mortality in CCHF.
Full article
(This article belongs to the Special Issue Emerging Vector-Borne Diseases and Public Health Challenges)
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Open AccessReview
Gender-Associated Factors on the Occurrence and Prevalence of Zero-Dose Children in Sub-Saharan Africa: A Critical Literature Review
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Godfrey Musuka, Enos Moyo, Patrick Gad Iradukunda, Pierre Gashema, Roda Madziva, Helena Herrera, Tapiwa Dhliwayo, Constantine Mutata, Noah Mataruse, Oscar Mano, Elliot Mbunge and Tafadzwa Dzinamarira
Trop. Med. Infect. Dis. 2025, 10(10), 286; https://doi.org/10.3390/tropicalmed10100286 - 6 Oct 2025
Abstract
Background: Immunisation remains one of the most effective and cost-efficient public health interventions for preventing infectious diseases in children. Despite global progress, Sub-Saharan Africa (SSA) continues to face challenges in achieving equitable immunisation coverage. Gender-related disparities, rooted in sociocultural and structural inequalities, significantly
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Background: Immunisation remains one of the most effective and cost-efficient public health interventions for preventing infectious diseases in children. Despite global progress, Sub-Saharan Africa (SSA) continues to face challenges in achieving equitable immunisation coverage. Gender-related disparities, rooted in sociocultural and structural inequalities, significantly influence the prevalence of zero-dose and under-immunised children in the region. This review critically examines the gender-associated barriers to routine childhood immunisation in SSA to inform more inclusive and equitable health interventions. Methods: A critical literature review was conducted generally following some steps of the PRISMA-P and CRD guidelines. Using the Population–Concept–Context (PCC) framework, studies were selected that examined gender-related barriers to routine immunisation for children under five in Sub-Saharan Africa. Comprehensive searches were performed across PubMed, Google Scholar, and relevant organisational websites, targeting articles published between 2015 and 2025. A total of 3683 articles were retrieved, with 24 studies ultimately meeting the inclusion criteria. Thematic analysis was used to synthesise the findings. Results: Four major themes emerged: (1) women’s empowerment and autonomy, including limited decision-making power, financial control, and the impact of gender-based violence; (2) male involvement and prevailing gender norms, where patriarchal structures and low male engagement negatively influenced vaccine uptake; (3) socioeconomic and structural barriers, such as poverty, geographic inaccessibility, maternal workload, and service availability; and (4) education, awareness, and health system responsiveness. Conclusions: Gender dynamics have a significant impact on childhood immunisation outcomes in Sub-Saharan Africa. Future policies must integrate these insights to improve immunisation equity and reduce preventable child morbidity and mortality across the region.
Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Strategies for Their Prevention and Control)
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Open AccessArticle
Epidemiology and Risks Survey of Onchocerca volvulus Infection in Igbo-Eze North Local Government Area, Enugu State, Nigeria
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Ifeoma Esther Aniaku, Grace Chinenye Onyishi, Chigozie Godwin Nwosu, Godwin Ikechukwu Ngwu, Chioma Janefrances Okeke, Uche Boniface Oraneli, Chidiebere Agha Otuu, Nicholas Arome Akobe, Augustine Uchechukwu Nnama and Kyrian Ikenna Onah
Trop. Med. Infect. Dis. 2025, 10(10), 285; https://doi.org/10.3390/tropicalmed10100285 - 6 Oct 2025
Abstract
Background: An epidemiological survey of Onchocerca volvulus infection and onchocerciasis in Igbo-Eze North Local Government Area, Enugu State, Nigeria, was undertaken to assess its distribution and risks among individuals in the area. Methods: A total of 201 residents who have lived in the
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Background: An epidemiological survey of Onchocerca volvulus infection and onchocerciasis in Igbo-Eze North Local Government Area, Enugu State, Nigeria, was undertaken to assess its distribution and risks among individuals in the area. Methods: A total of 201 residents who have lived in the study area for at least one year were recruited. At recruitment, they were examined using a rapid assessment method. Their demographic information and risk factors were obtained using a structured questionnaire. Results: The overall prevalence for onchocerciasis was 3.5% (7/201). The prevalence of onchocerciasis was observed to be non-significantly (p = 0.689) different among the studied communities. The sex and age-related prevalence differences were non-significant (p > 0.05); however, onchocerciasis was more prevalent among males and those between 30 and 39 years of age. The prevalence of onchocerciasis was higher (p = 0.001) among farmers/fishermen. The significant risk associated with onchocerciasis is the proximity of the water body to houses (p = 0.034). Conclusions: The onchocerciasis prevalence was low and not dependent on sex or age but rather occupation. Risks to onchocerciasis are environmental and occupational, with chances of scaled up prevalence and burden overtime if unchecked. There is a need for awareness campaigning to enable proper education of the people about onchocerciasis in the area and neighboring communities.
Full article
(This article belongs to the Special Issue Neglected Zoonotic Diseases in Sub-Saharan Africa)
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Open AccessArticle
In Vitro Larvicidal Efficacy of a Fipronil-Based Nanoixodicide Against Rhipicephalus microplus
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José Pablo Villarreal-Villarreal, José Noel García-Pérez, Jesús Jaime Hernández Escareño, Sergio Arturo Galindo Rodríguez, Michel Stéphane Heya, Gustavo Hernández Vidal and Romario García-Ponce
Trop. Med. Infect. Dis. 2025, 10(10), 284; https://doi.org/10.3390/tropicalmed10100284 - 6 Oct 2025
Abstract
Controlling Rhipicephalus microplus is currently one of the main challenges in livestock farming due to the significant economic losses it causes. Traditionally, managing this parasite has been based on the use of synthetic ixodicides, among which fipronil has proven to be highly effective.
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Controlling Rhipicephalus microplus is currently one of the main challenges in livestock farming due to the significant economic losses it causes. Traditionally, managing this parasite has been based on the use of synthetic ixodicides, among which fipronil has proven to be highly effective. However, its low water solubility and the limitations of commercially available formulations can affect the bioavailability of this compound, favoring the emergence of resistance in tick populations. In this context, fipronil-loaded nanoparticles were developed using the Eudragit® E PO polymer (NP_F) (Helm, Naucalpan, Mexico, Mexico), which were physicochemically characterized and evaluated against fipronil-susceptible R. microplus larvae. NP_F had an average size of 143.43 ± 1.88 nm, a polydispersity index (PDI) of 0.162 ± 0.01, a ζ (P ζ) of 21.16 ± 0.54, an encapsulation percentage (%E) of 7.36 ± 0.30, and an encapsulation efficiency percentage (%EE) of 66.28 ± 3.5%. Free fipronil showed an LC50 of 0.582 µg/mL and an LC90 of 2.503 µg/mL against R. microplus. The NP_F formulation showed an LC50 of 0.427 µg/mL and an LC90 of 2.092 µg/mL. These results suggest that incorporating fipronil into nanoparticles improves its ixodicide efficacy, positioning it as an innovative and promising alternative for the development of effective tick control formulations.
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(This article belongs to the Special Issue Insecticide Resistance and Vector Control)
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Understanding Patient Experiences: A Mixed-Methods Study on Barriers and Facilitators to TB Care-Seeking in South Africa
by
Farzana Sathar, Claire du Toit, Violet Chihota, Salome Charalambous, Denise Evans and Candice Chetty-Makkan
Trop. Med. Infect. Dis. 2025, 10(10), 283; https://doi.org/10.3390/tropicalmed10100283 - 3 Oct 2025
Abstract
Introduction: Tuberculosis (TB) remains a public health concern, and people at risk for TB are hesitant to seek care. The first South African National TB prevalence survey, conducted in 2017–2019, found that most participants with TB symptoms did not seek care for TB.
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Introduction: Tuberculosis (TB) remains a public health concern, and people at risk for TB are hesitant to seek care. The first South African National TB prevalence survey, conducted in 2017–2019, found that most participants with TB symptoms did not seek care for TB. In 2022, an estimated 23% of people with TB in South Africa were undiagnosed, contributing to the country’s burden of “missing” TB cases. This study explores health-seeking behaviour among people with TB (PwTB) in South Africa, focussing on barriers and facilitators to care-seeking and the quantification of TB-related stigma from a patient and community perspective. Methods: We conducted a mixed-method study in the City of Johannesburg (COJ) Metropolitan Municipality from February to March 2022. PwTB aged 18 and older initiating TB treatment for microbiologically confirmed pulmonary TB were recruited from three primary healthcare facilities in the COJ. After providing written informed consent, they participated in a one-time, in-depth, face-to-face interview. The interviews were digitally recorded and conducted by trained facilitators. We used thematic analysis with deductive approaches to develop themes. We used the Van Rie TB stigma assessment scale to quantify perceived stigma. Results: We interviewed 23 PwTB with an overall median age of 39 years and 14 (61%) males. Patient-level barriers to accessing TB care included visiting traditional healers and pharmacists before their TB diagnosis; wrong or missed diagnosis by private doctors; work commitments; scarcity of resources to attend the clinic or walk long distances; perceived and experienced stigma; and a lack of TB knowledge. Facility-level barriers included long clinic queues and uncertainty about where to receive TB care in the clinic. Facilitators for TB care-seeking included being in contact with someone who had TB, receiving encouragement from family, or having knowledge about TB transmission and early diagnosis. The overall median total stigma score among 21 PwTB was 53 (IQR: 46–63), with median community and patient stigma scores of 25 (IQR: 22–30) and 31 (IQR: 21–36), respectively. Conclusions: We found important considerations for the TB programme to improve the uptake of services. Since PwTB consult elsewhere before visiting a facility for TB care, TB programmes could establish private–public partnerships. TB programmes could also increase TB awareness in the community, especially among males, and mobile clinics could be considered to assist with TB case detection and treatment provision. Applying behavioural design techniques and co-designing interventions with patients and providers could improve TB health-seeking behaviours.
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(This article belongs to the Special Issue New Perspectives in Tuberculosis Prevention and Control)
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Improvements in Prescribing Indicators and Antibiotic Utilization Patterns Following Antimicrobial Stewardship Intervention at a District Hospital in Ghana
by
Nana Akua Abruquah, Obed Kwabena Offe Amponsah, Divya Nair, Douglas Aninng Opoku, Emmanuel Konadu, Kannamkottapilly Chandrasekharan Prajitha, Annabella Bensusan Osafo, Kwame Ohene Buabeng and Nana Kwame Ayisi-Boateng
Trop. Med. Infect. Dis. 2025, 10(10), 282; https://doi.org/10.3390/tropicalmed10100282 - 1 Oct 2025
Abstract
Rational use of medicines, particularly antimicrobials, is critical for reducing antimicrobial resistance. In 2021, a study conducted at the outpatient department (OPD) of a district hospital in Ghana, identified high antibiotic prescribing and suboptimal adherence to World Health Organization (WHO) prescribing indicators. Based
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Rational use of medicines, particularly antimicrobials, is critical for reducing antimicrobial resistance. In 2021, a study conducted at the outpatient department (OPD) of a district hospital in Ghana, identified high antibiotic prescribing and suboptimal adherence to World Health Organization (WHO) prescribing indicators. Based on those findings, antimicrobial stewardship (AMS) intervention was extended to the OPD. This before-and-after study was used to compare WHO prescribing indicators and patterns of antibiotic use, using WHO AWaRe (Access, Watch and Reserve) categorization of the years 2021 and 2023. A total of 65,157 patients visited the OPD in 2023 with 171,517 patient encounters and 247,313 prescriptions. Encounters resulting in antibiotic prescriptions halved from 36% to 18%. The average number of medicines prescribed per encounter reduced from three to two. Prescriptions using generic names increased from 76% to 80% and injection use reduced from 7% to 6%. However, prescriptions from the Ghana essential medicines list reduced from 90% to 79%. Access antibiotics use remained unchanged while Watch and Reserve categories increased by 5% and 2%, respectively. The AMS interventions potentially improved three of five WHO indicators. Continued efforts are needed to achieve complete compliance with all indicators and increase access antibiotic use to above 70%.
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(This article belongs to the Special Issue Field Impact of the SORT IT Initiative on Combating Antimicrobial Resistance Through a One Health Approach in Ghana)
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Open AccessArticle
Risk Factors for Foodborne Zoonoses Among Populations With and Without a Migration Background in Berlin, Germany
by
Idesbald Boone, Sabrina Janßen, Tanguy Marcotty, Verena Moos, Kristina Allers, Anika Geelhaar-Karsch, Thomas Schneider and Sascha Al Dahouk
Trop. Med. Infect. Dis. 2025, 10(10), 281; https://doi.org/10.3390/tropicalmed10100281 - 30 Sep 2025
Abstract
Knowledge gaps exist regarding foodborne zoonotic diseases in migrant populations. We assessed the seroprevalence of Campylobacter, Salmonella, Yersinia, Brucella, hepatitis E virus (HEV), and Trichinella, and identified potential exposure risks in populations with and without migration backgrounds. In
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Knowledge gaps exist regarding foodborne zoonotic diseases in migrant populations. We assessed the seroprevalence of Campylobacter, Salmonella, Yersinia, Brucella, hepatitis E virus (HEV), and Trichinella, and identified potential exposure risks in populations with and without migration backgrounds. In a cross-sectional study (2014–2016), adults with Turkish, Russian, Vietnamese, or German backgrounds residing in Berlin, Germany, were recruited via convenience sampling. Sera were screened for anti-IgG antibodies, and risk factors were assessed via a structured questionnaire. Logistic regression was used for analysis. We included 1180 participants: 497 Germans and 215, 273, and 195 individuals with Russian, Turkish, and Vietnamese backgrounds, respectively. Salmonella seroprevalence was highest among Vietnamese (47–50%) and lowest among Turks (18–20%). Campylobacter seroprevalence ranged from 17% to 23%. Yersinia seroprevalence was highest among Germans (64–70%) and associated with raw pork consumption. HEV seropositivity was highest among Vietnamese (27–28%) and lowest among Russians (5%). No samples were positive for Brucella; two were positive for Trichinella. High seroprevalence of Campylobacter, Salmonella, Yersinia, and HEV suggests substantial exposure and frequent asymptomatic or mild infections. While Yersinia seropositivity was associated with raw pork consumption, high seroprevalence in Turks—who rarely consume pork—suggests other food sources or transmission routes.
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(This article belongs to the Special Issue The Epidemiology, Diagnosis and Treatment of Foodborne and Waterborne Diseases)
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AmpC β-Lactamase-Producing Microorganisms in South American Hospitals: A Meta-Regression Analysis, Meta-Analysis, and Review of Prevalence
by
Valmir Nascimento Rastely-Junior, Hosanea Santos Nascimento Rocha and Mitermayer Galvão Reis
Trop. Med. Infect. Dis. 2025, 10(10), 280; https://doi.org/10.3390/tropicalmed10100280 - 29 Sep 2025
Abstract
AmpC β-lactamases are class C enzymes that hydrolyze penicillins, cephalosporins, and monobactams. The WHO recently classified third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales as critical pathogens. We conducted a systematic review and meta-analysis to evaluate AmpC prevalence in hospital isolates across South America. We searched
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AmpC β-lactamases are class C enzymes that hydrolyze penicillins, cephalosporins, and monobactams. The WHO recently classified third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales as critical pathogens. We conducted a systematic review and meta-analysis to evaluate AmpC prevalence in hospital isolates across South America. We searched PubMed/MEDLINE, SciELO, and Google Scholar. We included 69 observational studies that phenotypically or genotypically identified AmpC producers. A random-effects generalized linear mixed model with logit transformation estimated pooled prevalence; heterogeneity and moderators were explored through subgroup analyses and meta-regression. Seventy studies, including 48,801 isolates, were eligible. AmpC β-lactamases were detected in 11.7% of isolates (95% CI 11.4–12.0), with extreme heterogeneity (I2 ≈ 97%). Enterobacter species showed the highest prevalence (~46%), whereas Escherichia spp. had the lowest (~4.5%) prevalence of AmpC positivity within each genus. Meta-regression indicated that studies focusing on a single genus reported higher prevalence and that including pediatric patients was associated with a lower prevalence of AmpC-positive microorganisms among isolates. Quality of evidence was rated low due to inconsistency, moderate risk of bias, and indirectness of data. AmpC producers are entrenched in South American hospitals, and species-aware surveillance and harmonized detection are critical to guide empiric therapy and antimicrobial stewardship.
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(This article belongs to the Special Issue Emerging and Re-emerging Infectious Diseases: Global and Local Burden, Surveillance, and Response Strategies)
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A Simple, Highly Sensitive, and Highly Specific Dot-Blot-Based Immunoassay for Serodiagnosis of HTLV-1 in Resource-Limited Settings
by
Haohan Zhuang, Shanhai Ou, Lixing Wang and Hongzhi Gao
Trop. Med. Infect. Dis. 2025, 10(10), 279; https://doi.org/10.3390/tropicalmed10100279 - 26 Sep 2025
Abstract
Human T-cell leukemia virus type 1 (HTLV-1), the first identified human retrovirus, is associated with adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The lack of effective antiviral therapies or vaccines highlights the critical importance of early diagnosis in managing HTLV-1-associated
[...] Read more.
Human T-cell leukemia virus type 1 (HTLV-1), the first identified human retrovirus, is associated with adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The lack of effective antiviral therapies or vaccines highlights the critical importance of early diagnosis in managing HTLV-1-associated diseases. However, current commercial immunoassays, including enzyme immunoassays, line immunoassays, particle agglutination tests, and Western blots, are often limited by the need for specialized equipment and high costs, which restrict their accessibility in resource-poor regions. To address these challenges, we developed a novel dot-blot immunoassay using HTLV-1 P19 and GP46 synthetic peptides in combination with a precipitating tetramethylbenzidine (TMB) substrate. This innovative approach enables instrument-free visual detection through the formation of distinct blue-brown precipitates. Validation of this immunoassay with 179 clinical serum samples demonstrated 100% specificity and 91% sensitivity. Our assay offers a simple, cost-effective, and field-applicable diagnostic solution for HTLV-1 screening in resource-limited settings, potentially enhancing global surveillance of this neglected pathogen.
Full article
(This article belongs to the Special Issue Innovative Approaches to Combat Infectious Diseases in Low and Middle Income Countries (LMICs): Epidemiology, Diagnosis, and Interventions)
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The Construction and Characterization of an Infectious Clone of the Asian Genotype Chikungunya Virus from Yunnan, China
by
Xinhang Ning, Binghui Xia, Zimeng Cheng, Liuyi Zhang, Fengfeng Mo, Hao Ren and Hailin Tang
Trop. Med. Infect. Dis. 2025, 10(10), 278; https://doi.org/10.3390/tropicalmed10100278 - 26 Sep 2025
Abstract
Chikungunya fever (CHIKF), which is caused by the Chikungunya virus (CHIKV), has rapidly spread across the globe in recent years, leading to its listing as a public health concern by the World Health Organization. In 2019, the first local outbreak of Asian-type CHIKF
[...] Read more.
Chikungunya fever (CHIKF), which is caused by the Chikungunya virus (CHIKV), has rapidly spread across the globe in recent years, leading to its listing as a public health concern by the World Health Organization. In 2019, the first local outbreak of Asian-type CHIKF was reported in Xishuangbanna, Yunnan Province, China, with 88 CHIKV nucleic acid-positive cases detected from clinical specimens. To further investigate the biological characteristics of the virus strain responsible for this outbreak, we reconstructed the 625D6h strain using reverse genetics and tested its growth kinetics in different cell lines. The results showed a strong replication capacity in the Aedes albopictus C6/36 insect cell line but a weaker one in mammalian cell lines. The virus’s high replication capacity in mosquito cells is an interesting phenotype that warrants further study to determine if it influences vector adaptation and transmission dynamics in endemic settings. The study also found that two DHODH inhibitors, ML390 and vidofludimus, could effectively inhibit CHIKV replication in vitro. The infectious clone created in this study provides a useful tool for studying the recently prevalent Asian-type strain in China, supporting the subsequent development of prevention and treatment methods.
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(This article belongs to the Special Issue Emerging and Re-emerging Infectious Diseases: Global and Local Burden, Surveillance, and Response Strategies)
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