Pathogens

Research

17 pages, 2824 KB

Open AccessArticle

Persistent and Circulating Plasmodium falciparum dhfr and dhps Mutations in Busia County, Western Kenya

by Loise Ndung’u, Kelvin Thiong’o, Lewis Karani, Stephen Gitahi, Francis Kimani, Mathew Piero Ngugi and Daniel Kiboi

Pathogens 2026, 15(2), 233; https://doi.org/10.3390/pathogens15020233 - 20 Feb 2026

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Abstract

Malaria in pregnancy remains a major driver of poor maternal and neonatal health outcomes in sub-Saharan Africa. For decades, intermittent preventive treatment in pregnancy (IPTp), with sulphadoxine-pyrimethamine (SP), has mitigated malaria-associated health risks, but concerns have been raised regarding accumulated Plasmodium falciparum dihydrofolate [...] Read more.

Malaria in pregnancy remains a major driver of poor maternal and neonatal health outcomes in sub-Saharan Africa. For decades, intermittent preventive treatment in pregnancy (IPTp), with sulphadoxine-pyrimethamine (SP), has mitigated malaria-associated health risks, but concerns have been raised regarding accumulated Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations on the efficacy of SP. Western Kenya, including Busia County, is a high malaria transmission setting where molecular surveillance of dhfr and dhps mutations remains limited. This study assessed the prevalence and haplotype structure of dhfr and dhps mutations in P. falciparum isolates from Busia County, Kenya. A total of 66 samples of P. falciparum isolates collected from patients attending Matayos Sub-County Hospital between November 2024 and January 2025 were analysed. PCR amplification and Sanger sequencing targeted dhfr codons C50R, N51I, C59R, S108N/T, I164L, and dhps codons I431V, S436A/F, A437G, K540E, A581G, and A613S/T to determine mutation frequencies, haplotypes, and combined dhps and dhfr haplotype profiles. High frequencies of dhfr and dhps mutations were observed across the parasite isolates. The most common dhfr substitutions included N51I (85.2%) and C59R (75.4%), while S108N (32.8%) and S108T (19.7%) were detected at lower frequencies. Dhfr haplotypes identified included N51I + C59R, N51I + C59R + S108N, and a N51I + C59R + S108T + I164L variant. The I164L mutation was detected at a frequency of 18.0% and was observed exclusively on a non-canonical S108T background (19.7%). Dhps haplotypes were dominated by A437G (92.3%), K540E (40%) alone, and the A437G + K540E double mutant. Combined dhfr and dhps haplotype analyses revealed circulation of classical dhfr triple-mutant (N51I + C59R + S108N) backgrounds with dhps A437G. Quintuple haplotypes (dhfr N51I + C59R + S108T + I164L with dhps A437G) and rare complex haplotypes incorporating both I164L and K540E or I164L and S436F were also detected. These findings indicate the persistence and circulation of both canonical and non-canonical dhfr and dhps haplotypes in P. falciparum isolates from Busia County. This study highlights the need for continuous molecular and phenotypic surveillance to clarify the functional and epidemiological significance of parasites carrying S108T and I164L mutations, and to inform IPT policy. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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16 pages, 1120 KB

Open AccessArticle

Clinical Progression of Cardiac Chronic Trypanosoma cruzi Infection in a Long-Term Prospective Cohort from Rural Colombia

by Mario J. Olivera, Julián F. Porras-Villamil, Christian Toquica-Gahona and Màrius V. Fuentes

Pathogens 2025, 14(12), 1198; https://doi.org/10.3390/pathogens14121198 - 24 Nov 2025

Cited by 1 | Viewed by 980

Abstract

Chronic Trypanosoma cruzi infection remains a major cause of preventable cardiomyopathy in Latin America, yet prospective data from endemic rural populations after the interruption of domestic transmission are limited. This study characterizes the long-term clinical evolution, treatment response, and cardiovascular outcomes of 80 [...] Read more.

Chronic Trypanosoma cruzi infection remains a major cause of preventable cardiomyopathy in Latin America, yet prospective data from endemic rural populations after the interruption of domestic transmission are limited. This study characterizes the long-term clinical evolution, treatment response, and cardiovascular outcomes of 80 adults with confirmed chronic infection from Mogotes, Santander, Colombia. Participants were followed from 2015 to 2023 by means of standardized clinical, electrocardiographic, echocardiographic, serological, and qPCR evaluations. The primary outcome was progression from the indeterminate to the cardiac form; secondary outcomes included worsening to advanced cardiomyopathy and cardiovascular events. During 422 person-years of follow-up (median 61.5 months), 14 participants (17.5%) experienced clinical progression (3.3 per 100 person-years) and seven (9%) died (1.7 per 100 person-years). Benznidazole treatment was initiated in 42 participants and completed by 34 (81%); only 4 of 34 (12%) remained qPCR-positive after one year, compared with 21% among untreated individuals. Progression from the indeterminate form occurred in one participant (0.7 per 100 person-years), whereas deterioration clustered among those with baseline cardiomyopathy. Despite low mortality, stage-dependent progression persisted, highlighting the need for early diagnosis, treatment adherence, and sustained molecular and cardiac monitoring in post-certification settings. These findings provide rare longitudinal evidence on chronic T. cruzi infection under real-world endemic conditions. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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10 pages, 671 KB

Open AccessArticle

Temporal Parasitemia Trends Predict Risk and Timing of Experimental Cerebral Malaria in Mice Infected by Plasmodium berghei ANKA

by Peyton J. Murin, Cláudio Tadeu Daniel-Ribeiro, Leonardo José Moura Carvalho and Yuri Chaves Martins

Pathogens 2025, 14(7), 676; https://doi.org/10.3390/pathogens14070676 - 9 Jul 2025

Cited by 1 | Viewed by 1822

Abstract

Background: Experimental models using Plasmodium berghei ANKA (PbA)-infected mice have been essential for uncovering cerebral malaria (CM) pathogenesis. However, variability in experimental CM (ECM) incidence, onset, and mortality introduce challenges when analyses rely solely on infection day, which may reflect different disease stages [...] Read more.

Background: Experimental models using Plasmodium berghei ANKA (PbA)-infected mice have been essential for uncovering cerebral malaria (CM) pathogenesis. However, variability in experimental CM (ECM) incidence, onset, and mortality introduce challenges when analyses rely solely on infection day, which may reflect different disease stages among animals. Methods: We applied machine learning to predict ECM risk and onset in a cohort of 153 C57BL/6, 164 CBA, and 53 Swiss Webster mice. First, we fitted a logistic regression model to estimate the risk of ECM at any day using parasitemia data from day 1 to day 4. Next, we developed and trained a Random Forest Regressor model to predict the exact day of symptom onset. Results: A total of 64.5% of the cohort developed ECM, with onset ranging between 5 and 11 days. Early increases in parasitemia were strong predictors for the development of ECM, with an increase in parasitemia equal to or greater than 0.05 between day 1 and day 3 predicting the development of ECM with 97% sensitivity. The Random Forest model predicted the day of ECM onset with high precision (mean absolute error: 0.43, R²: 0.64). Conclusion: Parasitemia dynamics can effectively identify mice at high risk of ECM, enabling more accurate modeling of early pathological processes and improving the consistency of experimental analyses. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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17 pages, 1986 KB

Open AccessArticle

Occurrence of Ticks and Tick-Borne Pathogens During Warm Winter—A Snapshot from Central Europe

by Weronika Buczek, Alicja Buczek, Marek Asman, Agnieszka Borzęcka-Sapko, Ewelina Minciel, Jadwiga Grzeszczak and Katarzyna Bartosik

Pathogens 2025, 14(4), 326; https://doi.org/10.3390/pathogens14040326 - 28 Mar 2025

Cited by 2 | Viewed by 2109

Abstract

Background: Climate warming and anthropogenic environmental changes impact the spread of ticks and tick-borne pathogens (TBPs). This study investigated the occurrence of ticks and the risk of TBPs infection in urban and rural recreational areas in Eastern Poland at record-high temperatures in winter. [...] Read more.

Background: Climate warming and anthropogenic environmental changes impact the spread of ticks and tick-borne pathogens (TBPs). This study investigated the occurrence of ticks and the risk of TBPs infection in urban and rural recreational areas in Eastern Poland at record-high temperatures in winter. Methods: Ticks were collected from vegetation using the flagging method. Various types of polymerase chain reactions were applied to detect Borrelia burgdorferi s.l., Anaplasma phagocytophilum, Rickettsia spp., and Babesia spp. in the studied ticks. Results: 268 ticks were sampled in the four urban/suburban and one rural sites, including 78 Ixodes ricinus specimens and 190 Dermacentor reticulatus ticks. Of the ticks, 49.19% were infected by at least one TBP, including 41.03% of I. ricinus and 63.04% of D. reticulatus specimens. Co-infections with TBPs that involved only I. ricinus were recorded in 6.41% of these ticks. Conclusions: The study indicates that hosts are exposed to tick attacks and TBPs infection in Central Europe at high temperatures in winter. The high activity of ticks may increase the incidence of tick-borne diseases in humans and companion animals. The record’s importance indicates that practical preventive measures against TBPs should be taken due to weather conditions rather than the season. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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14 pages, 1869 KB

Open AccessArticle

Molecular Evidence of Raccoon Dog (Nyctereutes procyonoides) as a Natural Definitive Host for Several Sarcocystis Species

by Petras Prakas, Tamara Kalashnikova, Naglis Gudiškis, Donatas Šneideris, Evelina Juozaitytė-Ngugu and Dalius Butkauskas

Pathogens 2025, 14(3), 288; https://doi.org/10.3390/pathogens14030288 - 15 Mar 2025

Cited by 4 | Viewed by 2284

Abstract

Sarcocystis parasites infect a wide range of animals, including reptiles, birds, and mammals, and have complex two-host prey–predator life cycle. Sarcocysts are mainly found in the muscles of intermediate hosts, and oocysts sporulate in the intestines of the definitive host. The raccoon dog [...] Read more.

Sarcocystis parasites infect a wide range of animals, including reptiles, birds, and mammals, and have complex two-host prey–predator life cycle. Sarcocysts are mainly found in the muscles of intermediate hosts, and oocysts sporulate in the intestines of the definitive host. The raccoon dog (Nyctereutes procyonoides), native to Asia and invasive in Europe, is a known disease carrier. However, studies on raccoon dogs in the transmission of Sarcocystis are scarce. Between 2019 and 2024, a total of 26 raccoon dog carcasses were collected in Lithuania. The results of a light microscopy examination indicated that 50% of the samples were positive for Sarcocystis spp. sporocysts and sporulated oocysts. Based on nested PCR and sequencing of cox1, 88.5% of the samples were positive for these parasites. Molecular analysis revealed the presence of 11 different Sarcocystis species. Eight species, including S. alces, S. capracanis, S. hjorti, S. iberica, S. linearis, S. morae, S. tenella, and S. venatoria were reported for the first time in raccoon dogs as definitive hosts. The identified Sarcocystis species were linked to intermediate hosts, such as cervids, wild boars, pigs, goats, and sheep. These findings suggest that raccoon dogs play a key role in the spread of Sarcocystis, particularly species infecting cervids. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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19 pages, 3267 KB

Open AccessArticle

Human Retinal Organoid Model of Ocular Toxoplasmosis

by Liam M. Ashander, Grace E. Lidgerwood, Amanda L. Lumsden, João M. Furtado, Alice Pébay and Justine R. Smith

Pathogens 2025, 14(3), 286; https://doi.org/10.3390/pathogens14030286 - 14 Mar 2025

Cited by 4 | Viewed by 2042

Abstract

The health burden of ocular toxoplasmosis is substantial, and there is an unmet need for safe and curative anti-microbial drugs. One major barrier to research on new therapeutics is the lack of in vitro human-based models beyond two-dimensional cultured cells and tissue explants. [...] Read more.

The health burden of ocular toxoplasmosis is substantial, and there is an unmet need for safe and curative anti-microbial drugs. One major barrier to research on new therapeutics is the lack of in vitro human-based models beyond two-dimensional cultured cells and tissue explants. We aimed to address this research gap by establishing a human retinal organoid model of ocular toxoplasmosis. Retinal organoids, generated from human induced pluripotent stem cells and grown to two stages of organization, were incubated with a suspension of live or heat-killed GT-1 strain T. gondii tachyzoites, or medium without tachyzoites. Both developing (1 month post-isolation) and matured (6 months post-isolation) organoids were susceptible to infection. Spread of live parasites from the margin to the entire organoid over 1 week was indicated by immunolabelling for T. gondii surface antigen 1. This progression was accompanied by changes in the levels of selected tachyzoite transcripts—SAG1, GRA6, and ROP16—and human cytokine transcripts—CCL2, CXCL8, CXCL10, and IL6—in infected versus control conditions. Our human retinal organoid model of ocular toxoplasmosis offers the opportunity for many future lines of study, including tachyzoite interactions with retinal cell populations and leukocyte subsets, parasite stage progression, and disease processes of different T. gondii strains, as well as drug testing. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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16 pages, 3907 KB

Open AccessArticle

Repurposing COVID-19 Compounds (via MMV COVID Box): Almitrine and Bortezomib Induce Programmed Cell Death in Trypanosoma cruzi

by Carlos J. Bethencourt-Estrella, Atteneri López-Arencibia, Jacob Lorenzo-Morales and José E. Piñero

Pathogens 2025, 14(2), 127; https://doi.org/10.3390/pathogens14020127 - 1 Feb 2025

Cited by 3 | Viewed by 1468

Abstract

Chagas disease, caused by the protozoan Trypanosoma cruzi, affects millions globally, with limited treatment options available. Current therapies, such as benznidazole and nifurtimox, present challenges, including their toxicity, side effects, and inefficacy in the chronic phase. This study explores the potential of [...] Read more.

Chagas disease, caused by the protozoan Trypanosoma cruzi, affects millions globally, with limited treatment options available. Current therapies, such as benznidazole and nifurtimox, present challenges, including their toxicity, side effects, and inefficacy in the chronic phase. This study explores the potential of drug repurposing as a strategy to identify new treatments for T. cruzi, focusing on compounds from the Medicines for Malaria Venture (MMV) COVID Box. An initial screening of 160 compounds identified eight with trypanocidal activity, with almitrine and bortezomib showing the highest efficacy. Both compounds demonstrated significant activity against the epimastigote and amastigote stages of the parasite and showed no cytotoxicity in murine macrophage cells. Key features of programmed cell death (PCD), such as chromatin condensation, mitochondrial membrane potential disruption, and reactive oxygen species accumulation, were observed in T. cruzi treated with these compounds. The potential to induce controlled cell death of these two compounds in T. cruzi suggests they are promising candidates for further research. This study reinforces drug repurposing as a viable approach to discovering novel treatments for neglected tropical diseases like Chagas disease. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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13 pages, 999 KB

Open AccessArticle

Intestinal Parasites and Hematological Parameters in Children Living in Ambatoboeny District, Madagascar

by Wanesa Richert, Daria Kołodziej, Danuta Zarudzka, Daniel Kasprowicz, Dariusz Świetlik and Krzysztof Korzeniewski

Pathogens 2024, 13(11), 930; https://doi.org/10.3390/pathogens13110930 - 25 Oct 2024

Cited by 4 | Viewed by 3628

Abstract

Madagascar is one of the poorest countries in the world. The country’s extreme weather conditions, poor sanitation, and weak economy facilitate the spread of parasitic diseases. Infections with intestinal parasites are particularly dangerous for children because they can cause malnutrition and anemia, which, [...] Read more.

Madagascar is one of the poorest countries in the world. The country’s extreme weather conditions, poor sanitation, and weak economy facilitate the spread of parasitic diseases. Infections with intestinal parasites are particularly dangerous for children because they can cause malnutrition and anemia, which, in turn, have a negative effect on children’s cognitive functions and physical development. The aim of the present study was to analyze the prevalence of intestinal parasites and to assess hematological parameters in a group of children living in northern Madagascar. The screening was conducted in May 2024 in the Clinique Medicale Beyzym in Manerinerina, the Ambatoboeny district. It involved a sample of 208 children aged 0–17 years. Single stool samples were collected from all study participants. The samples were fixed in SAF fixative and then transported from Africa to Europe for further diagnostics at the Department of Epidemiology and Tropical Medicine, the Military Institute of Medicine–the National Research Institute in Poland. First, the samples were analyzed by light microscopy methods using three different diagnostic techniques (direct smear, decantation with distilled water, and the Fülleborn method). Next, they were tested by molecular biology methods (real-time PCR). Blood samples for the assessment of hematological parameters were collected at the healthcare center in Madagascar. The prevalence of intestinal parasites in the study sample was 61.5%. Helminths were found in 15.2% of the investigated children, and Giardia intestinalis (20.5%) was found to be the most prevalent parasite in the study population. Most infections were caused by potentially pathogenic stramenopila Blastocystis spp. (32.0%). Mean Hb, HCT, MCV, MCH, and MCHC levels in the study participants were below normal values. However, no correlation was found between the presence of a parasitic infection and low hematological parameters, which are a clinical sign of anemia. High rates of infections with intestinal parasites in children living in northern Madagascar support the necessity to introduce long-term preventive measures, which would limit the spread of parasitic diseases in the Malagasy population. Low hematological parameters in non-infected children may be indicative of persistent malnutrition or infection with other parasites, e.g., malaria or schistosomiasis. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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Review

Jump to: Research, Other

18 pages, 312 KB

Open AccessReview

Enterocytozoon bieneusi in European Domestic Ungulates and Pets: Occurrence, Genetic Diversity, and Public Health Perspectives from a Narrative Review

by Mirela Imre, Marius-Stelian Ilie, Tiana Florea, Corina Badea, Alexandra Pocinoc and Kálmán Imre

Pathogens 2025, 14(11), 1158; https://doi.org/10.3390/pathogens14111158 - 13 Nov 2025

Cited by 2 | Viewed by 694

Abstract

Enterocytozoon bieneusi is the most frequently diagnosed microsporidian parasite in humans and a recognized cause of diarrheal disease, particularly in immunocompromised individuals. Its broad host range, which includes livestock, companion animals, and wildlife, highlights its zoonotic potential and warrants careful epidemiological assessment. This [...] Read more.

Enterocytozoon bieneusi is the most frequently diagnosed microsporidian parasite in humans and a recognized cause of diarrheal disease, particularly in immunocompromised individuals. Its broad host range, which includes livestock, companion animals, and wildlife, highlights its zoonotic potential and warrants careful epidemiological assessment. This narrative review synthesizes available data on the occurrence and genetic diversity of E. bieneusi in European domestic ungulates (cattle, pigs, sheep, goats, horses, and water buffaloes) and pets (dogs and cats), aiming to provide an integrated perspective on animal reservoirs and their relevance for public health. Publications retrieved from the Web of Science Core Collection database were systematically screened, and country-specific results were extracted, emphasizing prevalence rates, genotype distributions, and zoonotic implications. Across Europe, cattle and pigs emerged as the most studied hosts, frequently harboring zoonotic group 1 genotypes such as I, J, BEB4, BEB6, and EbpA, while small ruminants, horses, and buffaloes remain comparatively undocumented. In pets, the dog-adapted genotype PtEb IX was predominant, but several zoonotic genotypes were also identified. Overall, the current evidence confirms the wide host range of E. bieneusi in Europe but also reveals significant data gaps compared to regions such as China, underlining the need for broader surveillance and harmonized molecular approaches within a One Health framework. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

17 pages, 306 KB

Open AccessReview

Toxocara Seroprevalence in Europe and Considerations for Future Research

by Roxana Gabriela Cobzaru, Carmen Valerica Ripa, Ramona Gabriela Ursu, Miruna Raluca Ripa, Costin Damian and Luminita Smaranda Iancu

Pathogens 2025, 14(11), 1117; https://doi.org/10.3390/pathogens14111117 - 3 Nov 2025

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Abstract

Toxocarosis is one of the most widespread zoonotic parasitic diseases, caused by Toxocara canis and Toxocara cati. Studying the epidemiological situation is a real challenge for specialists in the field worldwide. The aim of this study was to highlight the epidemiological aspects [...] Read more.

Toxocarosis is one of the most widespread zoonotic parasitic diseases, caused by Toxocara canis and Toxocara cati. Studying the epidemiological situation is a real challenge for specialists in the field worldwide. The aim of this study was to highlight the epidemiological aspects of the prevalence rate in Europe, and we found that the distribution of Toxocara infection is uneven, depending on geographical, climatic and socio-economic factors. Currently, there is a continuous spread of this parasite in many regions, including economically developed countries, but the exact prevalence is not known because there are no regular reports and statistical evidence regarding toxocarosis. The presence of nonspecific symptoms and subclinical disease may delay diagnosis and treatment, with long-term implications for the patient, and because of this, we discussed the possible Toxocara detection methods, with several novel and interesting approaches. Toxocarosis is included among the neglected parasitic diseases, requiring seroprevalence studies to be carried out to develop programs to reduce the frequency of this parasitosis. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

Other

Jump to: Research, Review

13 pages, 1425 KB

Open AccessSystematic Review

The Global Landscape of Plasmodium falciparum Drug Resistance Markers, 2005–2025: A Systematic Review and Meta-Analysis

by Felix Habarugira, Jeanne Batamuriza, Raphael Ndahimana, Jules Ndoli Minega, Mame Massar Dieng, Masceline Jenipher Mutsaka-Makuvaza, Tolessa Muleta Daba, Youssef Idaghdour and Leon Mutesa

Pathogens 2026, 15(2), 179; https://doi.org/10.3390/pathogens15020179 - 6 Feb 2026

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Abstract

Malaria remains a global health threat, with Plasmodium falciparum causing most deaths, especially in sub-Saharan Africa. Although artemisinin-based therapies reduce the burden, drug-resistant parasites threaten control efforts. Mapping the distribution and evolution of molecular resistance markers is vital for evidence-based strategies. This systematic [...] Read more.

Malaria remains a global health threat, with Plasmodium falciparum causing most deaths, especially in sub-Saharan Africa. Although artemisinin-based therapies reduce the burden, drug-resistant parasites threaten control efforts. Mapping the distribution and evolution of molecular resistance markers is vital for evidence-based strategies. This systematic review mapped the global distribution, pooled prevalence, and temporal trends of key P. falciparum antimalarial resistance markers. Following the PRISMA methodology (PROSPERO: CRD4202511098991), databases (PubMed, Web of Science, Scopus, and Google Scholar) and gray sources were searched (July 2005–July 2025). Data were extracted in Rayyan, assessed via the JBI prevalence tool, and analyzed using Python v3.13 for WHO regional distribution, temporal trends, and treatment outcome trends. Of the 1972 records, 261 studies from 64 countries qualified for inclusion in this review. The pooled prevalence was highest for pfdhfr (85.7%), followed by pfcrt (78.0%), pfdhps (73.7%), pfmdr1 (60.5%), and pfk13 (45.0%). High heterogeneity (I² > 95%) and rising pfk13 since 2012 highlight emerging artemisinin resistance, while persistent pfdhfr/pfdhps mutations show that ongoing sulfadoxine–pyrimethamine (SP) pressure on P. falciparum drug resistance, decreased parasite clearance, and treatment failure remain widespread and evolving in Africa. Integrating molecular surveillance into national malaria programs is essential to guide treatment modalities and support progress toward malaria elimination. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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27 pages, 3634 KB

Open AccessSystematic Review

Global Landscape of Molecular and Immunological Diagnostic Tests for Human Leishmaniasis: A Systematic Review and Meta-Analysis

by Mayron Antonio Candia-Puma, Brychs Milagros Roque-Pumahuanca, Laura Yesenia Machaca-Luque, Leydi Pola-Romero, Alexsandro Sobreira Galdino, Ricardo Andrez Machado-de-Ávila, Rodolfo Cordeiro Giunchetti, Eduardo Antonio Ferraz Coelho, Vanessa Adaui and Miguel Angel Chávez-Fumagalli

Pathogens 2025, 14(11), 1123; https://doi.org/10.3390/pathogens14111123 - 4 Nov 2025

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Abstract

Background: Leishmaniasis is a serious global public health challenge. Its accurate diagnosis is essential for guiding treatment but remains complex, often requiring a combination of tests. Methods: We conducted a systematic review and meta-analysis to evaluate the applicability and diagnostic accuracy of molecular [...] Read more.

Background: Leishmaniasis is a serious global public health challenge. Its accurate diagnosis is essential for guiding treatment but remains complex, often requiring a combination of tests. Methods: We conducted a systematic review and meta-analysis to evaluate the applicability and diagnostic accuracy of molecular and immunological tests for human tegumentary (TL) and visceral leishmaniasis (VL), searching PubMed for studies published between 1990–2021. Results: Among 165 included studies, PCR-based tests showed high accuracy, with area under the curve values (AUC_FPR) of 0.919 for TL and 0.965 for VL. For TL, serological tests exhibited median sensitivities of 83.3–88.1% and specificities of 82.0–92.4%. For VL, the direct agglutination test (DAT) and ELISA demonstrated higher sensitivity (93.0–93.8%) than rapid tests (89.1%) or immunofluorescence (82.0%), all with high specificity (95.5–96.9%). DAT performance (AUC_FPR = 0.966) was comparable to molecular tests. Conclusions: Molecular tests are highly accurate for diagnosing leishmaniasis. However, their routine implementation in endemic areas is limited by the need for specialized expertise and infrastructure. We advocate for developing diagnostic procedures tailored to each endemic setting, where molecular methods could facilitate early and accurate diagnosis. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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12 pages, 2573 KB

Open AccessCase Report

An Unusual Case of Anterior Mediastinal Cystic Echinococcosis Successfully Resolved with Multidisciplinary Approach

by Katarzyna Rodak, Magdalena Mnichowska-Polanowska, Arkadiusz Waloryszak, Konrad Ptaszyński, Janusz Wójcik and Małgorzata Edyta Wojtyś

Pathogens 2025, 14(10), 1016; https://doi.org/10.3390/pathogens14101016 - 7 Oct 2025

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Abstract

Human echinococcosis is a zoonotic disease caused by accidental ingestion of tapeworm eggs of the genus Echinococcus, shed in the feces of animal definitive host. In the human duodenum, these eggs release oncospheres, which penetrate the intestinal wall and via the bloodstream [...] Read more.

Human echinococcosis is a zoonotic disease caused by accidental ingestion of tapeworm eggs of the genus Echinococcus, shed in the feces of animal definitive host. In the human duodenum, these eggs release oncospheres, which penetrate the intestinal wall and via the bloodstream reach the liver—the most common site for development of cysts. However, it is important to remember that any other organ can be affected via the bloodstream, due to larvae size. In Europe, the most diagnostically relevant species are Echinococcus granulosus, with a median incidence of 0.6 cases per 100,000 inhabitants, and Echinococcus multilocularis, with 0.1 cases per 100,000 inhabitants. This article aims to describe an exceptionally unusual location of human cystic echinococcosis in the anterior mediastinum. We describe the role of multidisciplinary diagnostics in establishing the definitive diagnosis. The pathomorphological examination, radiological imaging and serological testing for diagnosing cystic echinococcosis are hereby described. It is particularly important to avoid reporting unspecified Echinococcus (NOS) if possible, as the management and treatment of patients with echinococcosis varies depending on the species. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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12 pages, 1784 KB

Open AccessCase Report

Profile of Cytokines TNFα, IL-1β, IL-6, IL-4, and IL-10 in Relation to Disease Progression in a Patient with Advanced Liver Alveolar Echinococcosis and Non-Optimal Antiparasitic Treatment: Four-Year Follow-Up

by Katarzyna Zorena, Małgorzata Sulima, Beata Szostakowska, Barbara Siewert and Katarzyna Sikorska

Pathogens 2025, 14(10), 957; https://doi.org/10.3390/pathogens14100957 - 23 Sep 2025

Cited by 2 | Viewed by 1496

Abstract

Alveolar echinococcosis (AE) is a zoonotic disease caused by the larval form of the tapeworm Echinococcus multilocularis, which is considered one of the most dangerous parasites for humans. E. multilocularis infections are most frequently observed in forestry workers, farmers, hunters, berry harvesters, [...] Read more.

Alveolar echinococcosis (AE) is a zoonotic disease caused by the larval form of the tapeworm Echinococcus multilocularis, which is considered one of the most dangerous parasites for humans. E. multilocularis infections are most frequently observed in forestry workers, farmers, hunters, berry harvesters, and workers employed in animal shelters. The subject of this study was a four-year follow-up profile of cytokines, including tumor necrosis factor alpha (TNFα), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-4 (IL-4), and interleukin-10 (IL-10), in a patient with advanced liver alveolar echinococcosis and non-optimal antiparasitic treatment. Ultrasound, computed tomography (CT) of the abdomen, X-ray, CT of the chest, and magnetic resonance imaging (MRI) of the head were performed during the observation and treatment of the AE patient. After antiparasitic treatment was initiated, decreased activity of the gamma-glutamyl transpeptidase (GGTP), decreased serum concentrations of immunoglobulin E, C-reactive protein (CRP), and the pro-inflammatory cytokines TNFα, IL-1, and IL-6 were observed, as well as slightly increased levels of the anti-inflammatory cytokines (IL-4 and IL-10). Conclusions. During a four-year follow-up in a patient with advanced hepatic alveolar echinococcosis and non-optimal antiparasitic treatment, a decrease in proinflammatory cytokines (TNFα, IL-1β, IL-6) and a slight increase in anti-inflammatory cytokines (IL-4, IL-10) were detected. A better understanding of cytokine regulation in infectious diseases may be important to the development of new therapeutic strategies aimed at antiparasitic treatment. We suggest that broad initiatives (preferably at the local community level) should be implemented to raise awareness of the threat of alveolar echinococcosis and methods for avoiding E. multilocularis infection. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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8 pages, 217 KB

Open AccessBrief Report

Infections with Soil-Transmitted Helminths in BaAka Pygmies Inhabiting the Rain Forests in the Central African Republic

by Wanesa Wilczyńska and Krzysztof Korzeniewski

Pathogens 2024, 13(11), 995; https://doi.org/10.3390/pathogens13110995 - 14 Nov 2024

Cited by 3 | Viewed by 1841

Abstract

Poor sanitation, improper food handling, limited access to safe drinking water sources, and limited access to healthcare services contribute to a high prevalence of infections caused by soil-transmitted helminths (STHs) among the BaAka Pygmies, an indigenous community living in Central Africa. The aim [...] Read more.

Poor sanitation, improper food handling, limited access to safe drinking water sources, and limited access to healthcare services contribute to a high prevalence of infections caused by soil-transmitted helminths (STHs) among the BaAka Pygmies, an indigenous community living in Central Africa. The aim of this study was to determine the rates of STH infections in the BaAka people inhabiting the rain forests of the south-western parts of the Central African Republic (CAR) as well as to examine the validity of biannual deworming with a single dose of albendazole 400 mg in high-risk communities exposed to extreme environmental conditions. The study was conducted in August 2021 and involved a sample of 49 BaAka Pygmies inhabiting the rain forest of the Sangha-Mbaéré Prefecture, CAR. The study consisted of collecting single stool samples from each participant and examining the samples for intestinal parasites by light microscopy methods. The collected samples were fixed in SAF fixative and next transported from Africa to Europe, where they were analyzed by light microscopy using three different diagnostic methods (direct smear in Lugol’s solution, the Fülleborn’s flotation, the Kato–Katz thick smear) at the Department of Epidemiology and Tropical Medicine in Gdynia, Poland. Microscopic examination found that 61.2% of the study group were infected with at least one helminthic species. The parasitological screening found invasions with four different species of nematodes, of which hookworm invasions were the most prevalent. The study results demonstrated that although the WHO-recommended mass deworming, which is provided to the BaAka Pygmies in healthcare centers set up on the premises of catholic missions, can effectively reduce the number of infections with soil-transmitted helminths, the prevalence of STH infections remains high in the region. The study findings suggest that in order to contain the spread of STHs in the local community, it will be necessary to implement additional preventive measures, apart from only conducting mass deworming programs. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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Open AccessCase Report

Acute Kidney Injury and Post-Artesunate Delayed Haemolysis in the Course of Plasmodium falciparum Malaria

by Alicja Kubanek, Małgorzata Sulima, Aleksandra Szydłowska, Katarzyna Sikorska and Marcin Renke

Pathogens 2024, 13(10), 851; https://doi.org/10.3390/pathogens13100851 - 30 Sep 2024

Cited by 2 | Viewed by 3286

Abstract

Malaria is a major international public health problem. The risk of acquiring malaria varies depending on the intensity of transmission and adherence to mosquito precautions and prophylaxis recommendations. Severe malaria can cause significant multiorgan dysfunction, including acute kidney injury (AKI). Intravenous artesunate is [...] Read more.

Malaria is a major international public health problem. The risk of acquiring malaria varies depending on the intensity of transmission and adherence to mosquito precautions and prophylaxis recommendations. Severe malaria can cause significant multiorgan dysfunction, including acute kidney injury (AKI). Intravenous artesunate is the treatment of choice for severe malaria in non-endemic areas. One of the possible events connected with the lifesaving effects of artemisins is post-artesunate haemolysis (PADH), which may be potentially dangerous and under-recognised. We present a case of a seafarer with severe Plasmodium falciparum malaria complicated with AKI and PADH, with a good response to steroid treatment. This case highlights the need for malaria prophylaxis in business travellers, e.g., seafarers to malara-endemic regions, and close supervision of patients with malaria even after the completion of antimalarial treatment due to the possibility of late complications. Full article

(This article belongs to the Special Issue Parasitic Diseases in the Contemporary World)

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