Tropical Medicine and Infectious Disease

21 pages, 4659 KB

Open AccessArticle

In Vitro Assessment of the Combined Activity of Amphotericin B and Cu²⁺-1,10-Phenanthroline-5,6-dione Coordination Compound Against Leishmania amazonensis Promastigotes

by Simone Santiago Carvalho de Oliveira, Débora Duarte Batista, Michael Devereux, Malachy McCann, Christiane Fernandes, André Luis Souza dos Santos and Marta Helena Branquinha

Trop. Med. Infect. Dis. 2026, 11(1), 4; https://doi.org/10.3390/tropicalmed11010004 - 24 Dec 2025

Abstract

Leishmaniasis is a severe parasitic disease transmitted by sandflies that affects both humans and animals, with clinical manifestations ranging from cutaneous lesions to life-threatening visceral involvement. Current treatments are limited by toxicity, high cost, and the emergence of drug-resistant strains, underscoring the need [...] Read more.

Leishmaniasis is a severe parasitic disease transmitted by sandflies that affects both humans and animals, with clinical manifestations ranging from cutaneous lesions to life-threatening visceral involvement. Current treatments are limited by toxicity, high cost, and the emergence of drug-resistant strains, underscoring the need for safer and more effective therapeutic strategies. In this study, we investigated the antiparasitic potential of combining Amphotericin B, a drug commonly used for leishmaniasis treatment, with 1,10-phenanthroline-5,6-dione (phendione) coordinated to copper (Cu²⁺-phendione), an experimental coordination compound, against Leishmania amazonensis promastigotes. The combination markedly impaired parasite proliferation, disrupted ultrastructural integrity, and interfered with metabolic activity. Mechanistic analyses revealed the presence of autophagosomes and pronounced mitochondrial alterations in treated parasites, suggesting the induction of cellular stress and the disruption of essential survival pathways. In addition, the treatment reduced the association index with THP-1 cells, indicating a decrease in parasite infectivity. Collectively, these findings demonstrate that the combination of Cu²⁺-phendione and Amphotericin B exerts potent antiparasitic effects through multiple mechanisms. Our results also showed that Cu²⁺-phendione combined with AmB displayed an additive effect, although the isobologram suggested that certain ratios approached synergy. The results support the potential of this combination as a novel chemotherapeutic approach against leishmaniasis and provide a basis for future in vivo studies to evaluate safety, efficacy, and optimal dosing strategies. Full article

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

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20 pages, 1101 KB

Open AccessReview

Clinical Protocols for the Initial Evaluation and Follow-Up of Patients with Chronic Chagas Disease: A Proposal for Referral Centers

by Alejandro Marcel Hasslocher-Moreno, Ana Cristina Ribeiro Rohem, Andrea Rodrigues da Costa, Andréa Silvestre de Sousa, Fernanda de Souza Nogueira Sardinha Mendes, Fernanda Martins Carneiro, Flavia Mazzoli-Rocha, Gilberto Marcelo Sperandio da Silva, Henrique Horta Veloso, Luciana Fernandes Portela, Luiz Henrique Conde Sangenis, Marcelo Teixeira de Holanda, Paula Simplicio da Silva, Roberto Magalhães Saraiva, Sergio Salles Xavier and Mauro Felippe Felix Mediano

Trop. Med. Infect. Dis. 2026, 11(1), 3; https://doi.org/10.3390/tropicalmed11010003 - 20 Dec 2025

Abstract

Chagas disease (CD) remains a major global health challenge and requires standardized, multidisciplinary, and evidence-based clinical approaches. This article aims to present and systematize the model of clinical routines developed at the Clinical Research Laboratory on Chagas Disease (Lapclin-Chagas), INI/Fiocruz, for the initial [...] Read more.

Chagas disease (CD) remains a major global health challenge and requires standardized, multidisciplinary, and evidence-based clinical approaches. This article aims to present and systematize the model of clinical routines developed at the Clinical Research Laboratory on Chagas Disease (Lapclin-Chagas), INI/Fiocruz, for the initial evaluation and longitudinal follow-up of patients with chronic CD. The proposal is intended to serve as a replicable and adaptable framework for referral centers in both endemic and non-endemic settings. Using a descriptive qualitative design, institutional protocols, national and international guidelines, and expert consultations were analyzed to construct a comprehensive care model. The resulting protocol integrates diagnostic pathways (including dual serological confirmation and clinical staging), criteria for etiological treatment, and coordinated multidisciplinary follow-up involving cardiology, gastroenterology, pharmaceutical care, nutrition, psychology, and social support. Specific pathways are also presented for Trypanosoma cruzi (T. cruzi)/HIV coinfection, laboratory accidents, and monitoring of adverse reactions to benznidazole. By consolidating more than three decades of institutional experience into operational workflows, this proposal offers an innovative contribution to the organization of CD care and provides actionable guidance for health systems seeking to improve diagnostic accuracy, therapeutic adherence, patient safety, and long-term outcomes. Full article

(This article belongs to the Special Issue Global Perspectives on Neglected Tropical Diseases: Burden, Science, and Policy Interventions)

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28 pages, 1758 KB

Open AccessReview

The Role of Immunogenetics in the Host–Parasite Interaction of Chagas Disease: Implications for Personalized Medicine

by Muhammad Hassnain, Syeda Mahnoor Bukhari, Tahira Bibi, Syeda Fakhra Waheed, Monica C. Botelho and Waqas Ahmad

Trop. Med. Infect. Dis. 2026, 11(1), 2; https://doi.org/10.3390/tropicalmed11010002 - 19 Dec 2025

Abstract

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, continues to be a significant global health issue, especially in Latin America, with increasing international prevalence due to migration. Despite advancements in diagnosis and treatment, it remains a neglected tropical disease characterized by [...] Read more.

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, continues to be a significant global health issue, especially in Latin America, with increasing international prevalence due to migration. Despite advancements in diagnosis and treatment, it remains a neglected tropical disease characterized by significant morbidity and mortality, mainly influenced by the complex interaction between parasite diversity and host immune responses. Importantly, the remarkable genetic diversity of T. cruzi lineages also contributes to clinical heterogeneity, influencing immune evasion, therapeutic responses, and vaccine feasibility. This review analyzes the impact of immunogenetics on host–parasite interactions in Chagas disease and explores its implications for personalized therapy approaches. Recent research, particularly over the last decade, has indicated that processes including antigenic variation, extracellular vesicle-mediated regulation, and disruption of host signaling pathways facilitate parasite persistence. Host genetic variables significantly influence susceptibility, disease development, and treatment outcomes, including changes in Human Leukocyte Antigen (HLA) genes, cytokine gene polymorphisms, and immunogenetic determinants of cardiac pathology. These findings underscore the potential of immunogenetic markers as tools for prognosis and as targets for personalized therapies. However, there are still considerable research deficiencies. Inadequate comprehension of gene–environment interactions, lack of representation of varied populations, and inconsistencies in study design limit the use of immunogenetic findings in therapeutic settings. At present, the concept of personalized medicine in Chagas disease remains largely aspirational, better understood as a framework for precision public health or stratified interventions guided by host immunogenetic and parasite lineage data. Addressing these issues necessitates comprehensive genomic research, mechanistic investigations of host–parasite interactions, and clinical validation of genetic markers. This study emphasizes the necessity of incorporating immunogenetics into personalized patient management strategies based on existing evidence. This integration has the potential to improve diagnosis, enhance treatment efficacy, and inform preventive interventions, thereby advancing personalized therapy for Chagas disease. Full article

(This article belongs to the Special Issue Advances in Parasitic Neglected Tropical Diseases)

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Graphical abstract

16 pages, 1778 KB

Open AccessArticle

Spatial Distribution and Biodiversity of Anopheles Mosquito Species Across Climatic Zones in Burkina Faso: Implications for Malaria Vector Control

by Odette N. Zongo, Emmanuel Kiendrebeogo, Bazoumana B. D. Sow, Mahamadi Kientega, Inoussa Toé, Roger Sanou, Saberé O. G. Yemien, Grégoire Sawadogo, Honorine Kaboré, Achaz Agolinou, Nouhoun Traore, Patric Stephane Epopa, Abdoul Azize Millogo, Abdoulaye Niang, Moussa Namountougou, Hamidou Maiga and Abdoulaye Diabaté

Trop. Med. Infect. Dis. 2026, 11(1), 1; https://doi.org/10.3390/tropicalmed11010001 - 19 Dec 2025

Abstract

Malaria transmission in sub-Saharan Africa is dominated by the An. gambiae complex and An. funestus group, whose distribution varies across ecological settings. Secondary species occur at lower densities, but their role in transmission may differ from one locality to another depending on local [...] Read more.

Malaria transmission in sub-Saharan Africa is dominated by the An. gambiae complex and An. funestus group, whose distribution varies across ecological settings. Secondary species occur at lower densities, but their role in transmission may differ from one locality to another depending on local conditions. Assessing Anopheles biodiversity using ecological indices is therefore essential to characterise their diversity and relative abundance. This study investigated the biodiversity and spatial distribution of Anopheles species across the three climatic zones of Burkina Faso to guide effective vector control strategies. Indoor resting mosquitoes were collected from 67 health districts across the 13 regions of Burkina Faso between September and December 2022 using pyrethroid spray catches. A total of 30,521 Anopheles mosquitoes were identified, with An. gambiae s.l. dominating (94.4%). The Sudano-Sahelian zone recorded the highest abundance, followed by the Soudanian and Sahelian zones. Biodiversity decreased from humid southern to arid northern areas, with the Soudanian zone showing the highest diversity. Molecular analysis of 2026 An. gambiae s.l. specimens revealed marked heterogeneity: An. coluzzii predominated in Sahelian (74.9%) and Sudano-Sahelian (71.2%) zones, while An. gambiae s.s. was most frequent in the Soudanian zone (53.8%). These results highlight spatial and ecological differences in Anopheles composition across Burkina Faso and emphasize the need for locally adapted malaria vector control strategies. Full article

(This article belongs to the Special Issue Vector-Borne Diseases in a Changing Climate: Transmission Dynamics and Epidemiological Shifts)

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15 pages, 673 KB

Open AccessArticle

Multi-Target Molecular Detection of Sexually Transmitted Infections in Women Living with HIV in Northeastern Brazil

by Melina Vieira Alves, Letícia Alves dos Santos Silva, Maria Luísa Rodrigues Nolasco, Anny Beatriz de Oliveira Gama, Márcia Guimarães da Silva and Marcus Vinicius de Aragão Batista

Trop. Med. Infect. Dis. 2025, 10(12), 354; https://doi.org/10.3390/tropicalmed10120354 - 18 Dec 2025

Abstract

Co-infection by human papillomavirus (HPV) and human immunodeficiency virus (HIV) facilitates cervical carcinogenesis, and additional cofactors such as other sexually transmitted infections (STI) further aggravate this scenario. This study aimed to validate a molecular detection strategy for Chlamydia trachomatis, Trichomonas vaginalis and [...] Read more.

Co-infection by human papillomavirus (HPV) and human immunodeficiency virus (HIV) facilitates cervical carcinogenesis, and additional cofactors such as other sexually transmitted infections (STI) further aggravate this scenario. This study aimed to validate a molecular detection strategy for Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae and to assess the association of these infections with cervical lesions in HPV-positive women living with HIV in Northeastern Brazil. In total, 155 samples were collected from CRIST/AIDS. After microorganism detection by conventional PCR, a multiplex PCR was standardized and validated. A prevalence of 9.03% was observed for C. trachomatis and 6.45% for T. vaginalis, with 0.64% co-infection. In addition, infection with both STIs showed a prevalence of 0.64%. Among HPV-positive women, high-risk genotypes accounted for 70.9% of cases, with HPV-16 being the most prevalent (35.5%). Overall, 18.2% of women presented cervical lesions, and 13.2% of those with co-detection of C. trachomatis and T. vaginalis were associated with high-grade squamous intraepithelial lesions (HSIL). These findings highlight the clinical relevance of screening for multiple STIs in HPV-positive women living with HIV and support the incorporation of multiplex molecular testing into public health strategies to improve early detection and targeted management. Full article

(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)

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15 pages, 1417 KB

Open AccessArticle

Respiratory Illness and Diarrheal Disease Surveillance in U.S. Military Personnel Deployed to Southeast Asia for Military Exercises from 2023–2025

by Sidhartha Chaudhury, Paphavee Lertsethtakarn, Piyawan Chinnawirotpisan, Nattaya Ruamsap, Worachet Kuntawunginn, Chadin Thongpiam, Kingkan Pidtana, Kittijarankon Phontham, Saowaluk Wongarunkochakorn, Montri Arsanok, Kamonporn Poramathikul, Parat Boonyarangka, Paksathorn Kietsiri, Wilawan Oransathit, Siriphan Gonwong, Patcharawalai Wassanarungroj, Panida Nobthai, Nuanpan Khemnu, Thipwipha Phonpakobsin, Wudtichai Manasatienkij, Joonlasak Khajohn, Chonthicha Klungthong, Nillawan Buathong, Sabaithip Sriwichai, Siriporn Sornsakrin, Umaporn Suksawad, Susie Leonardia-Santiago, Maria Theresa Valderama, John Mark Velasco, Paula Corazon Diones, Matthew Pascual, Chris Mahabir, Kathryn A. McGuckin and Daniel M. Boudreaux Show full author list Hide full author list

Trop. Med. Infect. Dis. 2025, 10(12), 353; https://doi.org/10.3390/tropicalmed10120353 - 17 Dec 2025

Abstract

The Indo-Pacific region hosts several annual military exercises that involve the deployment of thousands of U.S. and partner-nation military personnel. Respiratory and diarrheal diseases pose a significant health risk to exercise participants and represent a substantial portion of medical encounters and lost duty [...] Read more.

The Indo-Pacific region hosts several annual military exercises that involve the deployment of thousands of U.S. and partner-nation military personnel. Respiratory and diarrheal diseases pose a significant health risk to exercise participants and represent a substantial portion of medical encounters and lost duty days. We conducted surveillance for respiratory and diarrheal illness at the Cobra Gold and Balikatan military exercises in Thailand and the Philippines from 2023–2025. Through coordination with health providers in the field, military personnel that reported acute symptoms were asked to provide a nasopharyngeal swab or stool sample. These samples were transported to a field lab and tested by PCR for common respiratory and diarrheal pathogens. Follow-up analyses included bacterial culture, antimicrobial susceptibility testing, and viral whole-genome sequencing. From 84 respiratory and 61 diarrheal samples analyzed, we found that respiratory illness was primarily attributed to rhinoviruses/enteroviruses (23%), common coronaviruses (21%), and SARS-CoV-2 (11%) while diarrheal disease was attributed to a high rate of diarrheagenic E. coli (73%) and norovirus (20%), followed by Salmonella spp. (18%) and Campylobacter spp. (13%). Our findings highlight the distinct etiologies of respiratory and diarrheal disease in military field settings and demonstrate the feasibility of conducting real-time infectious disease surveillance in operational environments. Full article

(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)

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12 pages, 464 KB

Open AccessArticle

The Tolerability of the Dengue Vaccine TAK-003 (Qdenga^®) in German Travelers: The Results of a Prospective Survey

by Tomas Jelinek, Juliane Kramm, Maik Wagner and Claudia Jelinek

Trop. Med. Infect. Dis. 2025, 10(12), 352; https://doi.org/10.3390/tropicalmed10120352 - 16 Dec 2025

Abstract

Background: The global incidence of dengue has markedly increased over the last decades. Consequently, the risk of infection has increased significantly, resulting in record numbers of imported cases in various European countries and elsewhere in 2024. Methods: In early 2023, TAK-003, a novel, [...] Read more.

Background: The global incidence of dengue has markedly increased over the last decades. Consequently, the risk of infection has increased significantly, resulting in record numbers of imported cases in various European countries and elsewhere in 2024. Methods: In early 2023, TAK-003, a novel, live attenuated vaccine against dengue, became available in Germany. At the Berlin Centre for Travel & Tropical Medicine, we delivered 56,459 doses during the first 24 months of its availability, from February 2023 to February 2025. To obtain data on the tolerability of the vaccine in travelers, an active follow-up survey was initiated. Results: In total, 30,306 (53.7%) vaccinees agreed to being contacted. Of these, 11,827 (39.0%) completed an anonymous questionnaire ≥ 4 weeks after the vaccination. Overall, 6856 (58.0%) were female, and 565 (4.8%) reported having had a prior dengue infection. The average age was 38.3 years (range 4–86 years). An endemic area had been visited by 6309 subjects before answering the questionnaire, and among these, 46 (0.7%) reported a dengue infection while abroad. All cases were mild, and no complications were reported. TAK-003 was applied with other vaccines in 7363 (62.3%) travelers. Local adverse reactions, mostly local pain, were reported by 5263 (47.5%) subjects. Systemic reactions were reported by 4891 subjects (41.4%) and were most frequently fatigue, myalgia, and flu-like symptoms. The majority of adverse events manifested in the second week after vaccination (median 8 days) and were mostly limited to a duration of 1–3 days. A macular exanthema was described by 1844 subjects (15.6%), typically during the second week after the vaccination. Conclusions: Side effects were frequently reported but generally well tolerated. Age groups above 50 years showed a decline in reactogenicity. Co-vaccination was frequent and led to an increase in systemic adverse events. Denominator data of the study population suggest a strong reporting bias towards adverse events. This survey adds evidence of the chronology and characteristics of adverse events associated with TAK-003 and may support decision making when vaccinating dengue-naïve travelers. Full article

(This article belongs to the Section Travel Medicine)

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12 pages, 932 KB

Open AccessArticle

Spatial Analysis of Drug-Resistant Tuberculosis in Colombia (2020–2023): Departmental Rates, Clusters, and Associated Factors

by Brayan Patiño-Palma, Sandra Chacon-Bambague, Farlhyn Bermudez-Moreno, Carmencita Peña-Briceño, Juan Bustos-Carvajal and Florencio Arias-Coronel

Trop. Med. Infect. Dis. 2025, 10(12), 351; https://doi.org/10.3390/tropicalmed10120351 - 15 Dec 2025

Abstract

Background: Drug-resistant tuberculosis (DR-TB) constitutes a serious threat to global public health due to the increase in strains resistant to multiple drugs, especially isoniazid and rifampicin. This resistance increases mortality, estimated at 25.6% globally, and complicates treatments due to its high toxicity and [...] Read more.

Background: Drug-resistant tuberculosis (DR-TB) constitutes a serious threat to global public health due to the increase in strains resistant to multiple drugs, especially isoniazid and rifampicin. This resistance increases mortality, estimated at 25.6% globally, and complicates treatments due to its high toxicity and cost. Materials and Methods: A quantitative ecological study was carried out with data on drug-resistant tuberculosis reported in Sivigila in the years (2020–2023) SIVIGILA database. 1694 cases were analyzed, considering sociodemographic variables such as age, sex, nationality and prioritized population groups. Departmental rates per 100,000 inhabitants were calculated with DANE projection, from these choropleth maps were developed. Applying a Kulldorff spatial scan under a Poisson model using the SMERC package of R (version 4.5.1), with windows centered on each department and Monte Carlo simulation contrast to identify high-risk clusters (RR > 1). Results: (DR-TB) Predominantly in men aged 30–44 years, with a progressive increase until 2023 (IRR = 2.11). Three high-risk clusters were detected in the southwest and center of the country. Discussion: Drug-resistant tuberculosis in Colombia showed a sustained increase in the years of study, with a cumulative increase of 110% compared to 2020, associated with economically active people more exposed due to occupational and social factors. The greatest burden was observed in the general population. Cases also increased in groups with social and health vulnerability conditions. Conclusions: The departments of Risaralda, Meta, and Valle del Cauca presented the highest drug resistance rates in Colombia. Full article

(This article belongs to the Special Issue Surveillance, Modelling, and Risk Mapping of Tropical Infectious Diseases)

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2 pages, 158 KB

Open AccessCorrection

Correction: Majeed et al. Mapping Evidence on the Regulations Affecting the Accessibility, Availability, and Management of Snake Antivenom Globally: A Scoping Review. Trop. Med. Infect. Dis. 2025, 10, 228

by Ramsha Majeed, Janette Bester, Kabelo Kgarosi and Morné Strydom

Trop. Med. Infect. Dis. 2025, 10(12), 350; https://doi.org/10.3390/tropicalmed10120350 - 15 Dec 2025

Abstract

Error in Table [...] Full article

(This article belongs to the Special Issue Recent Advances in Snakebite Envenoming Research)

17 pages, 972 KB

Open AccessArticle

Concurrent Assessment of Synthetic and Natural Compounds on the Proliferation of Toxoplasma gondii in In Vitro Models

by Alejandro Zamora-Vélez, Derly Lorena Vanegas, María Camila Fernández, Gerardo Ramos, Edwar Cortés, Ailan Farid Arenas, Néstor Cardona, Jessica Palacio-Rodriguez, Juan David Valencia-Hernandez, Luz Angela Veloza, Juan Carlos Sepúlveda-Arias and Jorge Enrique Gómez-Marín

Trop. Med. Infect. Dis. 2025, 10(12), 349; https://doi.org/10.3390/tropicalmed10120349 - 13 Dec 2025

Abstract

Concurrent evaluation of the antiparasitic efficacy of synthetic and natural compounds can provide novel insights into the development of anti-Toxoplasma drugs. We assessed 16 synthetic compounds and two fractions derived from the leaves of Tabebuia rosea and Tabebuia chrysantha tree species for [...] Read more.

Concurrent evaluation of the antiparasitic efficacy of synthetic and natural compounds can provide novel insights into the development of anti-Toxoplasma drugs. We assessed 16 synthetic compounds and two fractions derived from the leaves of Tabebuia rosea and Tabebuia chrysantha tree species for their in vitro activity against live parasites, employing strains that express green fluorescent protein and specific identification of bradyzoites using an anti-BAG1 monoclonal antibody. This study successfully identified several promising synthetic compounds with potent anti-Toxoplasma activity and favorable in vitro selectivity profiles, notably pyrazoline 2 and thiazolidinone 9. One thiazolidinone compound exhibited significant activity against extracellular tachyzoites, whereas one tree fraction demonstrated excellent activity against both tachyzoites and bradyzoites. Additionally, their in silico ADMET properties suggest their potential for good in vivo performance and CNS penetration. Although the natural extracts showed less potency in their crude form, they provide a basis for future purification efforts. The simultaneous evaluation of compounds sourced from diverse discovery pipelines can offer valuable insights into the development of drugs that target various biological pathways. Full article

(This article belongs to the Special Issue Advances in Toxoplasma gondii Infection Research)

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7 pages, 622 KB

Open AccessCommentary

Ending the TB Crisis in Low- and Middle-Income Countries of the Eastern Mediterranean Region—Overcoming Inaction Through Strategical Leaps

by Santosha Kelamane, Ghada Muhjazi, Nevin Wilson and Martin van den Boom

Trop. Med. Infect. Dis. 2025, 10(12), 348; https://doi.org/10.3390/tropicalmed10120348 - 12 Dec 2025

Abstract

Tuberculosis (TB) remains a public health threat in low- and middle-income countries (LMICs) of the World Health Organization (WHO) Eastern Mediterranean Region (EMR), driven by a combination of social determinants including undernutrition, fragile health systems, conflict-related disruptions, human mobility and displacement, sub-optimal programmatic [...] Read more.

Tuberculosis (TB) remains a public health threat in low- and middle-income countries (LMICs) of the World Health Organization (WHO) Eastern Mediterranean Region (EMR), driven by a combination of social determinants including undernutrition, fragile health systems, conflict-related disruptions, human mobility and displacement, sub-optimal programmatic implementation, and insufficient domestic investment. These programmatic and governance constraints operate within a broader geopolitical context marked by conflict, sanctions, protracted crises, and large-scale displacement, which further limit countries’ ability to deliver uninterrupted TB services. In 2023, the region’s TB incidence was estimated at 116 per 100,000 population, with Pakistan alone accounting for about 73% of the regional burden. Despite a multitude of efforts, progress in reducing the TB burden in the EMR remains slow, with high case detection and treatment coverage gaps, low uptake of TB preventive treatment (TPT), underutilization of WHO-recommended rapid diagnostics, and only 25% of drug-resistant TB (DR-TB) cases initiated on treatment. Vulnerable populations, including internally displaced persons, migrants, refugees, prisoners, and returnees, continue to face major access barriers, and cross-border TB collaboration remains limited. This commentary reasons that the slow pace of TB burden reduction in the region is not only a biomedical or resource issue but also a reflection of structural and governance shortcomings. It proposes a ten-point strategic vision focused on building a sustainable ecosystem, enhancing primary healthcare systems, adopting people-centered and rights-based approaches, leveraging artificial intelligence, and gradually reducing dependency on external donors where feasible. However, in highly fragile settings such as Yemen or Somalia, domestic financing remains limited, and sustained external support will continue to be indispensable. The commentary calls for stronger national leadership, inclusive stakeholder engagement, and increased domestic financing to deliver integrated and resilient TB services. Ending TB in the EMR is within reach, but it requires boldly committed, coordinated, and country-led action. Full article

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

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17 pages, 741 KB

Open AccessArticle

Optimization of Case Finding and Preventive Treatment Among Household Contacts of People with Tuberculosis in Zimbabwe

by Tawanda Mapuranga, Collins Timire, Ronald T. Ncube, Sithabiso Dube, Nqobile Mlilo, Cynthia Chiteve, Owen Mugurungi, Fungai Kavenga, Manners Ncube, Nicholas Siziba, Selma Dar Berger, Talent Maphosa, Macarthur Charles, Julia Ershova and Riitta A. Dlodlo

Trop. Med. Infect. Dis. 2025, 10(12), 347; https://doi.org/10.3390/tropicalmed10120347 - 10 Dec 2025

Abstract

Systematic screening of household contacts (HHCs) of people with tuberculosis (TB) and starting them on either TB treatment or tuberculosis preventive treatment (TPT) reduces TB incidence. This project supported HHC management in six health facilities in Zimbabwe through the provision of CXR services, [...] Read more.

Systematic screening of household contacts (HHCs) of people with tuberculosis (TB) and starting them on either TB treatment or tuberculosis preventive treatment (TPT) reduces TB incidence. This project supported HHC management in six health facilities in Zimbabwe through the provision of CXR services, reimbursement of transport costs for HHCs, and provision of fuel and refreshments for healthcare workers involved in contact tracing. We describe TB and TPT cascades among the HHCs of index patients with all forms of TB. We enrolled 251 index patients who listed 794 HHCs: 551 (69%) HHCs of 158 index patients were traced and 520 (94%) screened for TB. Of the 502 who were referred to clinics, 362 (72%) reached the clinic. Among 520 HHCs, 324 (62%) underwent CXR screening and 18 (5%) had CXRs suggestive of TB. The yield of TB was 2.3% (12/520), with CXR detecting eight people who had not reported TB symptoms. Of the 311 who were assessed for TPT eligibility, 126 (41%) started TPT and 119 were assessed for TPT outcomes. Of these, 111 (93%) had successful TPT outcomes. The median times to starting TB treatment and TPT were 7 days and 11 days, respectively. The intervention facilitated timely access to healthcare services and a high yield of TB detection. Full article

(This article belongs to the Special Issue New Perspectives in Tuberculosis Prevention and Control)

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7 pages, 4885 KB

Open AccessCase Report

Hidden in Plain Sight: Peritoneal Tuberculosis Mimicking Ovarian Neoplasm—A Case Report

by Dolfus Santiago Romero-Rojas, Andrés Rojas-Torres, Brenda Amell-Barón, David Serna, Luis Vasquez-Pinto, Luis Eduardo Barrera-Herrera and Javier Iván Lasso-Apraez

Trop. Med. Infect. Dis. 2025, 10(12), 346; https://doi.org/10.3390/tropicalmed10120346 - 9 Dec 2025

Abstract

Tuberculosis remains the deadliest infectious disease worldwide. Among extrapulmonary forms, peritoneal tuberculosis stands out as a rare and challenging diagnosis, often mistaken for intra-abdominal neoplasms or peritoneal carcinomatosis. The clinical, paraclinical, and imaging findings are similar and sometimes indistinguishable between the two entities, [...] Read more.

Tuberculosis remains the deadliest infectious disease worldwide. Among extrapulmonary forms, peritoneal tuberculosis stands out as a rare and challenging diagnosis, often mistaken for intra-abdominal neoplasms or peritoneal carcinomatosis. The clinical, paraclinical, and imaging findings are similar and sometimes indistinguishable between the two entities, making the diagnosis a challenge for the treating physician. Here, we present the case of a young woman with chronic constitutional symptoms who presented to the emergency department with abdominal pain and ascites. An initial differential diagnosis of peritoneal carcinomatosis was considered based on findings in the peritoneal fluid and abdominal CT scan, leading to diagnostic laparoscopy. Histopathological examination of the samples revealed non-caseating granulomas involving the peritoneum, with no findings suggestive of malignancy. Subsequently, molecular testing for Mycobacterium tuberculosis was positive in the biopsies and peritoneal fluid, establishing the diagnosis of peritoneal tuberculosis. This case highlights the importance of awareness of peritoneal tuberculosis as a differential diagnosis of ascites and its significant potential to mimic other pathologies. Full article

(This article belongs to the Special Issue Biomarkers, Diagnostic, and Therapeutic Approaches for Mycobacterial Diseases)

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14 pages, 1069 KB

Open AccessArticle

Serologic Evidence of Circulation of Six Arboviruses (Dengue Virus, Chikungunya Virus, Zika Virus, Rift Valley Virus, Yellow Fever Virus, Crimean-Congo Hemorrhagic Fever Virus) in Four Regions of Burkina Faso, West Africa

by Armel Moumouni Sanou, Achille Sindimbasba Nikiéma, Aurélie Sausy, Jeoffray Diendéré, Mathuola Nina Genéviève Ouattara, Arielle Bettina Sandra Badiel, Isidore Bonkoungou, Henri Gautier Ouédraogo and Judith M. Hübschen

Trop. Med. Infect. Dis. 2025, 10(12), 345; https://doi.org/10.3390/tropicalmed10120345 - 9 Dec 2025

Abstract

Apart from some information on dengue virus (DENV), there is limited data on the circulation of arboviruses in Burkina Faso. The aim of this study was to investigate antibody prevalence against six arboviruses in four regions of the country to document previous virus [...] Read more.

Apart from some information on dengue virus (DENV), there is limited data on the circulation of arboviruses in Burkina Faso. The aim of this study was to investigate antibody prevalence against six arboviruses in four regions of the country to document previous virus exposure. Serum samples collected between August 2018 and December 2022 from people infected with viral hepatitis B and C in Bobo-Dioulasso were used to detect IgG antibodies against DENV, Chikungunya virus (CHIKV), Zika virus (ZIKV), Yellow fever virus (YFV), Rift Valley fever virus (RVFV) and Crimean-Congo hemorrhagic fever virus (CCHFV) using commercial ELISA kits. A total of 1808 serum samples, accompanied by basic epidemiologic data (sex, age and residency) were included in this study. We observed an IgG antibodies seroprevalence of 75.4% for DENV, 30.8% for CHIKV, 2.9% for ZIKV, 1.2% for RVFV, 1.1% for CCHFV and 1.1% for YFV. Age, sex, and place of residence were significantly associated with seropositivity for DENV and age and sex with CHIKV seropositivity. The results suggested widespread circulation of DENV and CHIKV and possible circulation of CCHFV and RVFV in humans in Burkina Faso. The importance of strengthening arbovirus surveillance by including additional arboviruses in the diagnostic panel is emphasized. Full article

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

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19 pages, 3361 KB

Open AccessArticle

Integrated Surveillance for Human and Animal Brucellosis in Kenya: A Predictive Analysis

by Samuel Kahariri, Lian F. Thomas, Bernard Bett, Marianne W. Mureithi, Anita Makori, Brian Njuguna, Samuel Kadivane, Dennis N. Makau, Nyamai Mutono and S. M. Thumbi

Trop. Med. Infect. Dis. 2025, 10(12), 344; https://doi.org/10.3390/tropicalmed10120344 - 9 Dec 2025

Abstract

Brucellosis is a bacterial zoonotic disease which poses a significant public health challenge globally. In Kenya, it is a priority zoonosis, causing morbidity and losses in humans and animals. Here, we used monthly surveillance data from 2014 to 2022 from the official human [...] Read more.

Brucellosis is a bacterial zoonotic disease which poses a significant public health challenge globally. In Kenya, it is a priority zoonosis, causing morbidity and losses in humans and animals. Here, we used monthly surveillance data from 2014 to 2022 from the official human and animal health surveillance databases. We conducted spatiotemporal analysis, tested associations between human and animal brucellosis using Time Series Linear Models, and forecasted the incidence of human brucellosis for twelve months using Seasonal Autoregressive Integrated Moving Average (SARIMA) models. Our analysis revealed a significant disparity in brucellosis cases, with a much higher cumulative number of human cases (4,688,787) compared to animal cases (1214). Human incidence depicted a relatively stable trend, with occasional fluctuations. However, cattle and camel incidences displayed sporadic peaks and troughs. Only cattle brucellosis was significantly associated (estimate: 0.355; 95% CI: 0.004 to 0.707) with human brucellosis. SARIMA models demonstrated reasonable predictive accuracy for human incidence, but incorporating animal data did not significantly improve model performance. Our study highlights the weaknesses in the existing surveillance systems and the need for comprehensive evaluation of the systems and implementation of integrated surveillance to address gaps in surveillance, improve the accuracy of predictive analysis, and enhance early detection for zoonotic diseases. Full article

(This article belongs to the Topic Surveillance Systems and Predictive Analytics for Epidemics)

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2 pages, 197 KB

Open AccessReply

Reply to Omansen, T.F.; Ramharter, M. Intensive Therapeutic Plasma Exchange for Severe Yellow Fever: What Is the Evidence? Comment on “Ho et al. Intensive Therapeutic Plasma Exchange—New Approach to Treat and Rescue Patients with Severe Form of Yellow Fever. Trop. Med. Infect. Dis. 2025, 10, 39”

by Yeh-Li Ho, Youko Nukui, Paula Ribeiro Villaça, Erica Okazaki, Nelson Hidekazu Tatsui, Lucas Chaves Netto, Daniel Joelsons, Tania Rubia Flores da Rocha, Fernanda de Mello Malta, João Renato Rebello Pinho, Aluisio Augusto Cotrim Segurado and Vanderson Rocha

Trop. Med. Infect. Dis. 2025, 10(12), 343; https://doi.org/10.3390/tropicalmed10120343 - 8 Dec 2025

Abstract

Dear Drs [...] Full article

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

2 pages, 161 KB

Open AccessComment

Intensive Therapeutic Plasma Exchange for Severe Yellow Fever: What Is the Evidence? Comment on Ho et al. Intensive Therapeutic Plasma Exchange—New Approach to Treat and Rescue Patients with Severe Form of Yellow Fever. Trop. Med. Infect. Dis. 2025, 10, 39

by Till F. Omansen and Michael Ramharter

Trop. Med. Infect. Dis. 2025, 10(12), 342; https://doi.org/10.3390/tropicalmed10120342 - 8 Dec 2025

Abstract

Recent outbreaks of yellow fever in Brazil, with hundreds of cases despite available vaccination, have drawn attention to the pressing need for effective therapeutic interventions, with a special focus on the critically ill [...] Full article

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

1 pages, 146 KB

Open AccessCorrection

Correction: Sirijatuphat et al. Distinguishing SARS-CoV-2 Infection and Non-SARS-CoV-2 Viral Infections in Adult Patients through Clinical Score Tools. Trop. Med. Infect. Dis. 2023, 8, 61

by Rujipas Sirijatuphat, Kulprasut Sirianan, Navin Horthongkham, Chulaluk Komoltri and Nasikarn Angkasekwinai

Trop. Med. Infect. Dis. 2025, 10(12), 341; https://doi.org/10.3390/tropicalmed10120341 - 5 Dec 2025

Abstract

There was an error in the original publication [...] Full article

(This article belongs to the Special Issue COVID-19 Variants, Vaccines and New Waves)

6 pages, 522 KB

Open AccessCase Report

An Unusual Presentation of Human Parotid Filariasis

by Tanaya Siripoon, Suppachok Kirdlarp, Polrat Wilairatana, Viravarn Luvira, Prakaykaew Charunwatthana, Parnpen Viriyavejakul and Paron Dekumyoy

Trop. Med. Infect. Dis. 2025, 10(12), 340; https://doi.org/10.3390/tropicalmed10120340 - 1 Dec 2025

Abstract

Human filariasis caused by Wuchereria bancrofti and Brugia malayi continues to circulate within Northern and Central Thailand and Southern Thailand, respectively. Major clinical presentations comprise lymphedema of extremities, hydrocele, funiculitis, orchitis, and tropical pulmonary eosinophilia. Microfilaria in other organs is rare. We report [...] Read more.

Human filariasis caused by Wuchereria bancrofti and Brugia malayi continues to circulate within Northern and Central Thailand and Southern Thailand, respectively. Major clinical presentations comprise lymphedema of extremities, hydrocele, funiculitis, orchitis, and tropical pulmonary eosinophilia. Microfilaria in other organs is rare. We report an unusual case of a 48-year-old woman from Southern Thailand with parotid filariasis presenting with chronic parotid gland enlargement. Wuchereria bancrofti microfilaria was observed within cytologic smear samples from the swollen left parotid gland and subsequently confirmed via a positive filaria immunoblot. The patient’s condition was successfully resolved through administration of a triple regimen consisting of three antiparasitic medications. Full article

(This article belongs to the Special Issue Filarial Infections in Humans: Advances in Epidemiology and Immunological Insights)

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