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
Improved Utilisation and Quality of Blood Culture Services Following Operational Research in a Tertiary Hospital in Ghana
Trop. Med. Infect. Dis. 2025, 10(9), 270; https://doi.org/10.3390/tropicalmed10090270 - 18 Sep 2025
Abstract
Operational research (OR) published in 2023 revealed low utilisation and suboptimal quality of blood culture services at a tertiary hospital in Ghana. To address these, several interventions were implemented, including sensitisation of physicians, training of laboratory staff, use of automated incubation systems, and
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Operational research (OR) published in 2023 revealed low utilisation and suboptimal quality of blood culture services at a tertiary hospital in Ghana. To address these, several interventions were implemented, including sensitisation of physicians, training of laboratory staff, use of automated incubation systems, and improved availability of laboratory consumables. To assess the impact of these interventions, we conducted a follow-up study in a cross-section of inpatients (n = 1080) with suspected bloodstream infections (BSI) admitted in 2024. There were three key changes. First, there was a five-fold increase in requests for blood culture from 8% pre-OR to 40% post-OR. Culture requests were more frequent from child health department (63%) and intensive care units (53%) compared to surgery department (15%). Second, there was a reduction in delays: time from hospital admission to culture request was reduced from 2 days to 1 day, and the laboratory turn-around time was reduced from 7 days to 5 days. Third, there was a marginal improvement (p = 0.692) in the quality of blood cultures: diagnostic yield improved from 7% to 10%, and the contamination rate was reduced from 16% to 14%. Achieving universal culture utilisation among eligible patients and lowering contamination rates will require a detailed gap analysis and targeted interventions.
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 AccessCommunication
Agreement Document for the Study of Leishmaniasis from a One Health Approach in Spain
by
Joaquina Martín-Sánchez, Jose M. Requena, Montserrat Gállego, Maribel Jiménez, Ricardo Molina, Paul Nguewa, Francisco Morillas-Márquez, José M. Pérez-Victoria, Begoña Monge-Maillo, Manuel Morales-Yuste and Clotilde Marín
Trop. Med. Infect. Dis. 2025, 10(9), 269; https://doi.org/10.3390/tropicalmed10090269 - 18 Sep 2025
Abstract
Background: Leishmaniasis, a vector-borne disease caused by the parasite Leishmania, is a public health concern in Europe. Although Spain is an endemic country, it lacks a national surveillance network. To address this, the creation of a research and surveillance network is
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Background: Leishmaniasis, a vector-borne disease caused by the parasite Leishmania, is a public health concern in Europe. Although Spain is an endemic country, it lacks a national surveillance network. To address this, the creation of a research and surveillance network is proposed, which would integrate data from various fields and enhance control and public health strategies. Objectives: The first objective is to gather epidemiological data on vectors, reservoirs, and transmission rates in Spain, with a particular focus on the role of dogs and wildlife as primary reservoirs. The plan includes establishing forums, databases, and specialised training programmes. The second objective is to improve case surveillance and reporting by establishing a comprehensive national registry. Implementing molecular diagnostics and bioinformatics tools will aid analysis of retrospective data and tracking of disease evolution. The third objective is to develop a standardised method for the molecular characterisation of Leishmania, using techniques such as PCR and genomic sequencing to detect virulence and resistance patterns. Key actions include collecting isolates, sharing analytical tools and providing genomic training. The fourth objective is to identify new therapeutic targets in response to toxicity and resistance to current treatments by studying specific enzymes (FeSOD, HDAC), metabolic pathways, and natural products. Ultimately, establishing the Leishmaniasis Surveillance Network will support a “One Health” approach and promote interdisciplinary collaboration towards a national control plan. Methods: We created the Working Group on Leishmaniasis funded by the Spanish Society of Tropical Medicine and International Health as a leishmaniasis forum for meetings and discussions on weaknesses and gaps we find in the knowledge and management of the infection based on the background of each academic and healthcare research group. Expected Impact: This study will promote the articulation of a Leishmaniasis Surveillance Network aiming to bring together the main stakeholders in the research and management of leishmaniasis in Spain.
Full article
(This article belongs to the Special Issue Leishmaniasis in Europe and the Mediterranean Region)
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Open AccessArticle
Seasonal Distribution of Viral Pneumonia After COVID-19 and the Role of Hematological Markers in Assessing Pneumonia Severity: A Case–Control Study
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Şaban Melih Şimşek and Ayşe Elif Bayar
Trop. Med. Infect. Dis. 2025, 10(9), 268; https://doi.org/10.3390/tropicalmed10090268 - 17 Sep 2025
Abstract
Background: Various studies have shown that viral pneumonia pathogens display distinct inflammatory profiles, and hematological indices, such as the Neutrophil/Lymphocyte Ratio (NLR), Lymphocyte/Monocyte Ratio (LMR), and Platelet/Lymphocyte Ratio (PLR), can serve as accessible markers of disease severity. Moreover, the seasonal distribution of respiratory
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Background: Various studies have shown that viral pneumonia pathogens display distinct inflammatory profiles, and hematological indices, such as the Neutrophil/Lymphocyte Ratio (NLR), Lymphocyte/Monocyte Ratio (LMR), and Platelet/Lymphocyte Ratio (PLR), can serve as accessible markers of disease severity. Moreover, the seasonal distribution of respiratory viruses appears to have shifted during the COVID-19 pandemic. Methods: This retrospective case–control study was conducted on patients diagnosed with PCR-confirmed viral pneumonia in the emergency department of a tertiary care center between 1 January and 31 December 2024. The control group comprised age- and sex-matched individuals without viral pneumonia. Subjects with comorbidities or ongoing treatments potentially affecting hematological indices were excluded. Seasonal distribution of viral pathogens was recorded. Hematological and inflammatory parameters at admission—including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)—were evaluated. The associations between these biomarkers, Pneumonia Severity Index (PSI) scores, and hospitalization status were statistically analyzed. Results: In this study, it was determined that Influenza A/B was more common in winter (67.3%) and SARS-CoV-2 in summer (70.7%). The relationship between the Pneumonia Severity Index and hemogram parameters was examined in determining the severity of pneumonia. In SARS-CoV-2, leukocyte and neutrophil counts were positively correlated (R: 0.392, p: 0.003; R: 0.466, p: <0.001), while in Influenza A/B, lymphocyte, platelet, and monocyte counts showed a negative correlation (R: −0.402, p: 0.005; R: −0.331, p: 0.021; R: −0.327, p: 0.023). Correlations were found between inflammation parameters and the Pneumonia Severity Index, except for the Lymphocyte/Monocyte Ratio, between SARS-CoV-2 and Influenza A/B (p < 0.05). Conclusions: The seasonal distribution of viral pneumonia pathogens has been revealed following the COVID-19 pandemic. Due to differences in inflammation patterns in viral infections, different leukocyte subgroups have been suggested as biomarkers.
Full article
(This article belongs to the Special Issue Respiratory Infectious Disease Epidemiology and Control)
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Open AccessArticle
High Rate of Human T-Cell Lymphotropic Virus-2 in Patients with HIV in the Peruvian Amazon
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Silvia Otero-Rodriguez, Martin Casapia-Morales, Carmen de Mendoza, Viviana Pinedo-Cancino, Seyer Mego-Campos, Vicente Soriano, Esperanza Merino and José-Manuel Ramos-Rincón
Trop. Med. Infect. Dis. 2025, 10(9), 267; https://doi.org/10.3390/tropicalmed10090267 - 17 Sep 2025
Abstract
HTLV-1/2 in people with HIV (PWH) has been little studied in the Peruvian Amazon, an endemic area for both viruses. We aimed to estimate its prevalence and describe the main clinical and epidemiological features of individuals with HTLV-HIV co-existence. We conducted a cross-sectional
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HTLV-1/2 in people with HIV (PWH) has been little studied in the Peruvian Amazon, an endemic area for both viruses. We aimed to estimate its prevalence and describe the main clinical and epidemiological features of individuals with HTLV-HIV co-existence. We conducted a cross-sectional study (October–December 2023) at the Division of Infectious Diseases and Tropical Medicine at the Regional Hospital of Loreto in Iquitos. We performed a screening test (recombinant HTLV I+II ELISA) and confirmed the results with INNO-LIA. Among 293 PWH analyzed, 14 (4.8%) were HTLV-positive: 1/293 was HTLV-1-positive (0.3%; 95% CI 0.06–0.9), 11/293 were HTLV-2-positive (3.8%; 95% CI 2.1–6.8), and 2/293 were non-typeable (0.7%; 95% CI 0.1–2.7). Compared with HIV-monoinfected individuals, superinfected patients were older (55 vs. 39 years; p = 0.001). Low education was more frequent in the univariate analysis (35.7% vs. 15.4%; p = 0.05) but was not retained in the multivariable model. In conclusion, HIV–HTLV-2 co-existence is relatively common (~4%) in the Peruvian Amazon, particularly among older individuals, highlighting the need for targeted screening and prevention strategies. Integrating HTLV testing into routine HIV clinic workflows, along with brief and focused counseling for superinfected patients, may help optimize follow-up and care.
Full article
(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions, 2nd Edition)
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Open AccessArticle
Prevalence of Antimicrobial and Colistin Resistance in Enterobacterales in Healthy Pigs in Ghana Before and After Farmer Education
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Elvis Fiam Amegayibor, Rita Ohene Larbi, Matilda Ayim-Akonor, Ebenezer D. O. Ansa, Pruthu Thekkur, Helena Owusu, Robert Fraser Terry, Anthony D. Harries, Benjamin Kissi Sasu, George Kwesi Hedidor and Richael Odarkor Mills
Trop. Med. Infect. Dis. 2025, 10(9), 266; https://doi.org/10.3390/tropicalmed10090266 - 17 Sep 2025
Abstract
High levels of antimicrobial resistance (AMR) were found in healthy pigs in the Greater Accra region of Ghana in 2022; this led to awareness creation and education of pig farmers about how to improve antimicrobial practices and biosecurity. To assess changes in AMR
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High levels of antimicrobial resistance (AMR) were found in healthy pigs in the Greater Accra region of Ghana in 2022; this led to awareness creation and education of pig farmers about how to improve antimicrobial practices and biosecurity. To assess changes in AMR after the intervention, we compared AMR, multi-drug resistance (MDR), and determined colistin resistance levels in healthy pigs in the region before (2022) and after (2024) the education of farmers. Rectal swabs (n = 140) from pigs in 14 farms were cultured for isolation of Enterobacterales (Escherichia coli and Enterobacter spp.) and subjected to antimicrobial susceptibility testing. A selective culture method was employed to isolate colistin-resistant Enterobacterales, which were further screened for the mcr-1 gene. AMR and MDR findings were compared with those from 140 pigs from the same farms in 2022. Enterobacterales were found in 137 (2022) and 138 (2024) rectal swabs, with Escherichia coli predominating. There was a marked increase in AMR prevalence for eight of the nine tested antibiotics in 2024. Notable increases in resistance were for tetracycline (58–82%), ampicillin (33–49%), and ciprofloxacin (3–33%). MDR prevalence was highest in Escherichia coli, increasing from 20% to 44%. Phenotypic colistin resistance was found in 44% of Escherichia coli isolates in 2024 (in 2022, using different methodology, phenotypic colistin resistance was 8%)—in 2024, the mcr-1 gene was found in 51% of these isolates. There were no relevant associations between farm and pig characteristics and prevalence of MDR and phenotypic colistin resistance. Although education is an important aspect of AMR control, the findings highlight that education alone cannot curb the rise of AMR. Further interventions including continuous surveillance, stronger regulatory policy on antimicrobial use, and behavioral interventions will be needed to mitigate the situation.
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
Campylobacter Colonisation of Poultry Slaughtered at Nigerian Slaughterhouses: Prevalence, Antimicrobial Resistance, and Risk of Zoonotic Transmission
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Emmanuel O. Njoga, Philip P. Mshelbwala, Akwoba J. Ogugua, Excel C. Enemuo-Edo, Onyinye S. Onwumere-Idolor, Temitope M. Ogunniran, Sunday N. Bernard, Joel C. Ugwunwarua, Ebube C. Anidobe, Chinwe E. Okoli, Enid Godwin, Simon I. Enem and James W. Oguttu
Trop. Med. Infect. Dis. 2025, 10(9), 265; https://doi.org/10.3390/tropicalmed10090265 - 17 Sep 2025
Abstract
Zoonotic Campylobacter species (ZCS), particularly C. jejuni and C. coli, cause major foodborne gastroenteritis and poultry as principal reservoirs. However, there is limited data on Campylobacter transmission risk practices and antimicrobial resistance (AMR) in Nigeria. Therefore, this study determined the prevalence, AMR,
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Zoonotic Campylobacter species (ZCS), particularly C. jejuni and C. coli, cause major foodborne gastroenteritis and poultry as principal reservoirs. However, there is limited data on Campylobacter transmission risk practices and antimicrobial resistance (AMR) in Nigeria. Therefore, this study determined the prevalence, AMR, and risk practices aiding Campylobacter transmission in two major slaughterhouses processing poultry carcasses in Enugu State, Nigeria. Four hundred poultry faecal samples were analysed for zoonotic Campylobacter organisms using standard protocols. Antimicrobial resistance was profiled via Kirby–Bauer disk diffusion technique, against eight antimicrobial agents. Risk practices were assessed through slaughterhouse observations and interviews with 56 workers. The overall prevalence of Campylobacter infections was 14.5% (58/400), while the species-specific prevalence were 13% (52/400) and 1.5% (6/400) for C. coli and C. jejuni, respectively. Campylobacter colonisation was significantly higher (p < 0.05) in broilers, and during the wet season. The AMR profile of the isolates against the eight antibiotics tested was: Amoxicillin/clauvlanic acid (100%), vancomycin (100%), tetracycline (96.6%), ciprofloxacin (55.2%), chloramphenicol (44.8%), ceftazidime (10.3%), azithromycin (3.4%) and streptomycin (3.4%). All the 58 Campylobacter isolates were multidrug-resistant. The multiple antibiotic resistance indices ranged from 0.4 to 0.9, with a mean of 0.7. Major risk practice associated with ZCS transmission include non-use of personal protective equipment (100%), slaughtering on unsanitary surfaces (100%), using visibly unclean water for meat processing (100%), improper manual evisceration (75%), eating or drinking during processing (64.4%), slaughtering sick animals (37.5%), inadequate cleaning of surfaces and equipment after use (21.4%) and consuming raw meat during carcass processing (19.6%). The findings reflect critical gaps in food safety, occupational health, prudent antimicrobial use in poultry farming and zoonotic disease control, emphasizing the need for antibiotic regulation, training on hygienic meat processing, public education, infrastructural development of slaughterhouse facilities, and inter-sectorial collaboration to curb Campylobacter contamination and spread of antimicrobial resistance.
Full article
(This article belongs to the Special Issue One-Health Perspectives and Solutions in Antimicrobial Resistance and Infectious Disease)
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Open AccessArticle
Wastewater-Based Surveillance of SARS-CoV-2 and Modeling of COVID-19 Infection Trends
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Wenli Wang, Ruoyu Li, Shilin Chen, Liangping Chen, Yu Jiang, Jianjun Xiang, Jing Wu, Jing Li, Zhiwei Chen and Chuancheng Wu
Trop. Med. Infect. Dis. 2025, 10(9), 264; https://doi.org/10.3390/tropicalmed10090264 - 16 Sep 2025
Abstract
Background: This study was performed to evaluate the early warning value of wastewater-based epidemiology (WBE) in monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its correlation with population-level coronavirus disease 2019 (COVID-19) infection trends. Methods: Wastewater samples from Fuzhou’s Sewage Treatment Plant
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Background: This study was performed to evaluate the early warning value of wastewater-based epidemiology (WBE) in monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its correlation with population-level coronavirus disease 2019 (COVID-19) infection trends. Methods: Wastewater samples from Fuzhou’s Sewage Treatment Plant A were concentrated via membrane filtration and quantified using reverse transcription quantitative polymerase chain reaction (RT-qPCR). Viral load data were integrated with sentinel hospital positivity rates and respiratory outpatient visits from 11 city hospitals. Stratified cross-correlation lag analysis was performed by gender, age, and hospital type. Results: Using the lowest single-day genome concentration as a proxy for daily SARS-CoV-2 levels was advantageous. Wastewater viral concentrations correlated positively with clinical cases, with peaks preceding reports by 0 to 17 days. Stratified analysis further indicated that women, older adults, and individuals from general hospitals were more sensitive to changes in wastewater viral loads, showing stronger correlations between infection trends and wastewater signals. Conclusions: Wastewater surveillance of SARS-CoV-2 can effectively predict COVID-19 infection trends and offers a scientific basis for stratified and targeted interventions. The findings underscore the value of WBE as an early warning tool in public health surveillance.
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(This article belongs to the Section Infectious Diseases)
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Open AccessArticle
Asymptomatic Pneumococcal Carriage, Antimicrobial Resistance, and Associated Risk Factors Among Paediatric Healthcare Workers in Benin
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Chakir Ishola Bello, Cyriaque Comlan Degbey, Yves Eric Denon, Adolphe Adjanonhoun and Lamine Baba-Moussa
Trop. Med. Infect. Dis. 2025, 10(9), 263; https://doi.org/10.3390/tropicalmed10090263 - 15 Sep 2025
Abstract
Healthcare professionals (HCPs) working in paediatric settings are routinely exposed to respiratory pathogens, increasing their risk of asymptomatic colonisation by meningitis-associated bacteria. This study is the first to assess oropharyngeal and nasopharyngeal carriage of major bacterial meningitis pathogens among paediatric HCPs in Benin,
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Healthcare professionals (HCPs) working in paediatric settings are routinely exposed to respiratory pathogens, increasing their risk of asymptomatic colonisation by meningitis-associated bacteria. This study is the first to assess oropharyngeal and nasopharyngeal carriage of major bacterial meningitis pathogens among paediatric HCPs in Benin, and to identify associated risk factors. A cross-sectional analytical study was conducted in nine hospitals between 1 September 2023 and 30 September 2024. Data collection involved a structured questionnaire and paired oropharyngeal and nasopharyngeal swabs. Culture-based identification and antimicrobial susceptibility testing were performed according to CA-SFM guidelines. By culture method, Streptococcus pneumoniae was the most frequently isolated pathogen, mainly from oropharyngeal samples (47.5%). Most of these strains exhibited multidrug resistance. In nasopharyngeal samples analysed by real-time PCR, detection rates for S. pneumoniae were markedly higher (24.4%) compared to culture (5.0%), highlighting the limited sensitivity of conventional methods in detecting asymptomatic carriage. Pneumococcal colonisation was significantly associated with recent respiratory tract infections, and residence in high-risk areas (p < 0.05). These findings underscore the need for enhanced molecular surveillance, along with strengthened infection control measures and targeted vaccination strategies, to mitigate the risk of horizontal transmission in paediatric wards.
Full article
(This article belongs to the Special Issue One-Health Perspectives and Solutions in Antimicrobial Resistance and Infectious Disease)
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Open AccessBrief Report
Praziquantel Pretreatment Reduces Schistosoma japonicum Infection in Mice by Targeting Immature Worm Stages
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Xiang Gui, Rongxue Lv, Haoran Zhong, Hao Li, Ke Lu, Zhiqiang Fu, Yamei Jin and Jinming Liu
Trop. Med. Infect. Dis. 2025, 10(9), 262; https://doi.org/10.3390/tropicalmed10090262 - 12 Sep 2025
Abstract
Schistosomiasis remains a significant public health concern, with Schistosoma japonicum infection endemic in certain regions of Asia. Praziquantel (PZQ), primarily known as an effective therapeutic agent, has recently shown potential as a prophylactic measure against delayed S. japonicum infections. This study investigated the
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Schistosomiasis remains a significant public health concern, with Schistosoma japonicum infection endemic in certain regions of Asia. Praziquantel (PZQ), primarily known as an effective therapeutic agent, has recently shown potential as a prophylactic measure against delayed S. japonicum infections. This study investigated the preventive efficacy of PZQ pretreatment at varying cercarial infection intensities and determined the parasite developmental stages targeted by the pretreatment in a mouse model. Results demonstrated that PZQ pretreatment significantly reduced both worm burdens and liver egg counts at low (10 and 20 cercariae) and high (100 cercariae) infection intensities, with reductions in worm burdens ranging from approximately 48% to 60% and liver egg counts by 47% to 73% compared to control groups (p < 0.05). Further analysis revealed that the mortality of parasites in PZQ-pretreated mice predominantly occurred during the juvenile schistosomula stages, particularly in worms younger than 15 days post-infection. These findings provide critical evidence supporting the application of PZQ pretreatment as a practical prophylactic measure to prevent S. japonicum infections, particularly in populations and animals frequently exposed to contaminated water in endemic areas.
Full article
(This article belongs to the Special Issue Research Advances and New Perspectives on Helminthic Diseases)
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Open AccessCase Report
Recurrent Malaria with Plasmodium vivax: A Case Report and Brief Review of the Literature
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Ákos Vince Andrejkovits, Adrian Vlad Pop, Magdolna Fejér, Elena Cristina Gîrbovan, Răzvan Lucian Coșeriu, Camelia Vintilă and Anca Meda Văsieșiu
Trop. Med. Infect. Dis. 2025, 10(9), 261; https://doi.org/10.3390/tropicalmed10090261 - 12 Sep 2025
Abstract
Background: Recurrent malaria refers to repeated episodes of the disease in the same individual. Plasmodium vivax is known for its ability to relapse due to dormant liver-stage hypnozoites and poses a particular risk to travelers returning from endemic areas. Prompt diagnosis and treatment
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Background: Recurrent malaria refers to repeated episodes of the disease in the same individual. Plasmodium vivax is known for its ability to relapse due to dormant liver-stage hypnozoites and poses a particular risk to travelers returning from endemic areas. Prompt diagnosis and treatment are crucial to prevent recurrences. Case Presentation: We present the case of a 41-year-old man from Romania who developed Plasmodium vivax malaria after traveling through Southeast Asia without chemoprophylaxis. He presented with fever, chills, myalgia, headache, vomiting, and abdominal pain. Clinical findings included mild jaundice and slight neurological signs. Laboratory tests showed severe thrombocytopenia, elevated bilirubin, inflammatory markers, and borderline creatinine levels. Malaria was confirmed by a rapid diagnostic test and blood smear microscopy. The patient was treated with doxycycline and atovaquone–proguanil. He improved and was discharged, but experienced two relapses, both confirmed as Plasmodium vivax by RT-PCR. Despite receiving primaquine as radical cure after the first Plasmodium vivax malaria relapse, a second relapse occurred. Each episode was managed with blood-stage antimalarial therapy, leading to full clinical and biological recovery. Conclusions: Malaria rarely occurs in non-endemic areas; it should be considered in patients with compatible travel history and symptoms. Given the high relapse potential of Plasmodium vivax, accurate species identification is critical to guide appropriate long-term management.
Full article
(This article belongs to the Topic Vector-Borne Disease Spatial Epidemiology, Disease Ecology, and Zoonoses)
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Open AccessArticle
Evaluation of an Online Survey for Pertussis Case Investigations in Regional Queensland: Impacts on Workload and Disease Trends
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Ho Yeung Lam, Arifuzzaman Khan, Matthew O’Bryan, Michelle Jones and Josette Chor
Trop. Med. Infect. Dis. 2025, 10(9), 260; https://doi.org/10.3390/tropicalmed10090260 - 12 Sep 2025
Abstract
In 2024, a significant pertussis surge in Queensland, Australia, strained public health resources. To improve investigation efficiency, the Wide Bay Public Health Unit introduced an online survey for pertussis cases on 1 August 2024, which collected data and provided automated health advice. This
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In 2024, a significant pertussis surge in Queensland, Australia, strained public health resources. To improve investigation efficiency, the Wide Bay Public Health Unit introduced an online survey for pertussis cases on 1 August 2024, which collected data and provided automated health advice. This retrospective evaluation assessed survey acceptance and staff workload. A controlled interrupted time series (ITS) analysis compared pertussis incidence in the intervention region against a control group of four other de-identified regional hospital and health services in Queensland where the survey was not implemented. Of the 298 eligible cases, 140 responded (47.0%); a total of 67.9% of these required no further staff follow-up, a subgroup for whom time savings were statistically significant (p < 0.01). The ITS analysis for the total population revealed a significant 4.9% weekly reduction in the notification trend compared to the control group (Rate Ratio: 0.95, p = 0.001), with a non-significant immediate level change. The online survey is a practical and effective tool for pertussis investigation in a regional setting. It is associated with significant workload efficiencies and a favourable, statistically significant impact on community disease transmission trends.
Full article
(This article belongs to the Special Issue Respiratory Infectious Disease Epidemiology and Control)
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Open AccessArticle
Operational Research Improves Compliance with Treatment Guidelines for Empirical Management of Urinary Tract Infection: A Before-and-After Study from a Primary Health Facility in Ghana
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Elizabeth Boateng, Helena Owusu, Pruthu Thekkur, George Kwesi Hedidor, Oksana Corquaye, Mercy N. A. Opare-Addo, Florence Amah Nkansah, Priscilla Vandyck-Sey, Daniel Ankrah and Charles Nii Kwadee Ofei-Palm
Trop. Med. Infect. Dis. 2025, 10(9), 259; https://doi.org/10.3390/tropicalmed10090259 - 11 Sep 2025
Abstract
Compliance with standard treatment guidelines (STGs) for the empirical management of uncomplicated urinary tract infections (UTIs) ensures the rational use of antibiotics and mitigates antimicrobial resistance. Operational research (OR) at Korle Bu Polyclinic in Ghana (2022) showed suboptimal STG compliance (prescription of recommended
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Compliance with standard treatment guidelines (STGs) for the empirical management of uncomplicated urinary tract infections (UTIs) ensures the rational use of antibiotics and mitigates antimicrobial resistance. Operational research (OR) at Korle Bu Polyclinic in Ghana (2022) showed suboptimal STG compliance (prescription of recommended antibiotics in the correct dose, route, frequency, and duration). Some of the recommendations from the OR, including training of medical residents, implementation of an antimicrobial stewardship team, and an audit–feedback system, were implemented. This before-and-after study compared the changes in empirical prescribing practices for patients diagnosed with uncomplicated UTIs before (October 2019–October 2021) and after (January 2023–December 2024) the OR. Of the 3717 and 3457 UTI patients in the before and after cohorts, 83% and 86% received empirical antibiotics, respectively. Among those who received empirical antibiotics, STG compliance increased from 60% to 66% (p-value < 0.001). However, STG compliance remained significantly lower among males (18%) compared to females (85%) in the after cohort, as 80% of males were prescribed antibiotics for a shorter period than the recommended 10–14 days. Moving forward, the training and audit–feedback system should emphasize longer antibiotic durations for males with UTI. Given its positive impact, the OR’s approach warrants replication for other disease conditions.
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
Prevalence and Screening Rates of Hepatitis B and Hepatitis C Infections in Adult Patients with Solitary Organ Tumors
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Seyhmus Abakay, Hüseyin Döngelli, Nilay Danış, Halil İbrahim Ellez, Göksel Bengi, Tuğba Yavuzşen and Hüseyin Salih Semiz
Trop. Med. Infect. Dis. 2025, 10(9), 258; https://doi.org/10.3390/tropicalmed10090258 - 10 Sep 2025
Abstract
Background and Aims: Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) remain significant global public health issues despite advances in their diagnosis and treatment. Our country is in a medium endemic region for HBV. Reactivation can occur during
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Background and Aims: Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) remain significant global public health issues despite advances in their diagnosis and treatment. Our country is in a medium endemic region for HBV. Reactivation can occur during or after immunosuppressive therapy. Therefore, screening patients before treatment is crucial to prevent reactivation. However, pretreatment screening is often insufficiently emphasized in studies. This study aimed to assess the incidence of HBV and pretreatment screening rates in patients with solid organ tumors at our center. Methods: We included patients aged over 18 years who were treated for solid organ tumors at our center between January 2016 and January 2022. Data on age, sex, histopathological diagnosis, and serological parameters were retrospectively collected. Appropriate HBV screening was defined as the assessment of HBsAg, anti-HBs, and anti-HBc IgG levels prior to the initiation of immunosuppressive therapy. Results: In our study, HBsAg testing was requested for 13.3% of the patients, and anti-HCV testing was requested for 13.3%. Among the patients screened for HBV and HCV, the prevalence rates of HBV and HCV infection were 3.3% and 1%, respectively. Conclusions: Our findings reveal inadequate screening rates for HBV and HCV among patients receiving immunosuppressive therapy. Increasing awareness about screening and implementing regular educational programs are crucial to protect patients from reactivation.
Full article
(This article belongs to the Special Issue Viral Hepatitis and Other Microbial Threats in Tropical Medicine)
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Open AccessCase Report
Nasal Myiasis Mimicking Allergic Rhinitis in Immunocompetent Adults: Case Series of 14 Adults
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Sameh Mezri, Mohamed Anas Ammar, Latifa Mtibaa, Sleheddine Mnasria, Chiraz Halwani and Khemaies Akkari
Trop. Med. Infect. Dis. 2025, 10(9), 257; https://doi.org/10.3390/tropicalmed10090257 - 9 Sep 2025
Abstract
Background: Human nasal myiasis is a rare zoonotic infection caused by Oestrus ovis with a non-specific clinical presentation that can mimic more common conditions such as allergic rhinitis. Objective: To report a series of nasal myiasis cases in immunocompetent individuals, emphasizing the clinical
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Background: Human nasal myiasis is a rare zoonotic infection caused by Oestrus ovis with a non-specific clinical presentation that can mimic more common conditions such as allergic rhinitis. Objective: To report a series of nasal myiasis cases in immunocompetent individuals, emphasizing the clinical presentation and complementary investigations (endoscopic findings, parasitological identification, skin prick tests, and imaging studies) that facilitate differential diagnosis from allergic rhinitis and enable early treatment. Methods: We conducted a retrospective study including cases of nasal myasis diagnosed and managed at the ENT department of the Military Hospital of Tunis over an 18-year period (2007–2025). Demographic, clinical, diagnostic, and therapeutic data were analyzed. Results: The mean age was 43 years, with a female predominance. Most patients presented with acute rhinological symptoms initially suggestive of allergic rhinitis. Nasal endoscopy revealed larvae in 79% of cases with parasitological confirmation of Oestrus ovis. Facial CT scans performed in five cases (36%) were unremarkable. Management consisted of multiple daily nasal saline irrigations and albendazole, in association with oral corticosteroids and antihistamines, resulting in symptom resolution within an average of 4 days. Conclusions: Nasal myiasis should be considered in atypical or treatment-resistant rhinitis. Nasal endoscopy is essential for diagnosis.
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(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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Open AccessBrief Report
Backyard Livestock Guinea Pigs Are Reservoirs for Leptospira Shedding in Rural Households from Ecuador
by
Mauricio Xavier Salas-Rueda, Fabricio Dugllay-Montaleza, Darwin Paredes-Núñez, Katherine Natalia Chávez Toledo, Angel Sebastián Rodríguez-Pazmiño, Elsy Carvajal, Maria Belen Paredes-Espinosa, Patricia Peralta-Ortiz, Jairo Guama-Tipas, Juan Pablo Garzon, Alexandra Narvaez, Solon Alberto Orlando and Miguel Angel Garcia-Bereguiain
Trop. Med. Infect. Dis. 2025, 10(9), 256; https://doi.org/10.3390/tropicalmed10090256 - 8 Sep 2025
Abstract
Guinea pigs (Cavia porcellus) are bred as livestock in South American countries from the Andean region, including Ecuador. Despite their importance for the local rural economy, no public health management guidelines have ever been implemented for guinea pig farming. Moreover, several
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Guinea pigs (Cavia porcellus) are bred as livestock in South American countries from the Andean region, including Ecuador. Despite their importance for the local rural economy, no public health management guidelines have ever been implemented for guinea pig farming. Moreover, several reports have shown the carriage of diverse zoonotic pathogens in livestock guinea pigs, including respiratory and enteric pathogens, or Toxoplasma gondii. Leptospirosis, a zoonotic disease caused by bacteria from Leptospira genus, is endemic in Ecuador and has multiple animal reservoirs, with rodents considered to be the main vector for transmission to humans. However, the role of livestock guinea pigs in the epidemiology of leptospirosis is poorly understood. In this study, the prevalence of antibodies against Leptospira in guinea pigs from Ecuador was analyzed with the Microaglutiantion Test (MAT). Moreover, the shedding of Leptospira by backyard livestock guinea pigs was also addressed, analyzing fecal and urine samples by qPCR for lipL32, secY and rrs genes. From the 118 guinea pigs analyzed by MAT, 61.9% were positive for 19 different pathogenic serovars, with Icterohaemorrhagiae, Pomona, Castellonis and Bataviae being the most prevalent ones. From the 231 urine samples and 225 fecal samples collected, 27.7% and 78.7% were positive for Leptospira by qPCR, respectively. Our results highlight the role of livestock guinea pigs as a reservoir for leptospirosis. Moreover, this study underscores the zoonotic threat associated with the shedding of Leptospira within households in rural communities where guinea pigs are bred as livestock. Animal and public health guidelines from a One Health perspective must be implemented to prevent leptospirosis transmission from guinea pigs in Ecuador and other countries in the Andean Region where the breeding of backyard livestock guinea pigs is common.
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(This article belongs to the Special Issue Leptospirosis and One Health Approach: Current Status and Future Prospects, 2nd Edition)
Open AccessArticle
Genetic Diversity of Plasmodium falciparum in Korhogo Health District, Northern Côte d’Ivoire
by
Edjronké M. A. Benié, Carla Beuret, Annina Schnoz, Sara L. Cantoreggi, Xavier C. Ding, Kigbafori D. Silué and Christian Nsanzabana
Trop. Med. Infect. Dis. 2025, 10(9), 255; https://doi.org/10.3390/tropicalmed10090255 - 7 Sep 2025
Abstract
Understanding Plasmodium falciparum population genetic diversity is crucial to assess the impact of malaria control interventions. This study investigated P. falciparum genetic diversity using merozoite surface protein 1 (msp1), msp2 and glutamate-rich protein (glurp) in Korhogo district, Northern Côte
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Understanding Plasmodium falciparum population genetic diversity is crucial to assess the impact of malaria control interventions. This study investigated P. falciparum genetic diversity using merozoite surface protein 1 (msp1), msp2 and glutamate-rich protein (glurp) in Korhogo district, Northern Côte d’Ivoire. DNA was extracted from dried blood spots (DBSs) collected in the health district of Korhogo between 2019 and 2020. The msp1, msp2, and glurp genes were amplified by polymerase chain reaction (PCR), and amplicon sizes were determined by capillary electrophoresis. Out of 179 samples randomly selected and genotyped, 82% were successfully amplified for msp1, 85% for msp2, and 75% for glurp. For msp1, the K1 allelic family had 20 genotypes, MAD20 had 23, and RO33 had only one genotype. For msp2, there were 59 and 33 genotypes for 3D7 and FC27, respectively, and for glurp, 45 genotypes were detected. The parasite population was highly diverse with an expected heterozygosity (HE) of ≥0.9 for all 3 markers. Our study showed high genetic diversity of msp1, msp2, and glurp in P. falciparum isolates from Korhogo district, Northern Côte d’Ivoire. These data could provide baseline information on P. falciparum genetic diversity for further epidemiological studies, needed to assess interventions implemented in this area.
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(This article belongs to the Section Vector-Borne Diseases)
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Open AccessArticle
Morbidity and Mortality Profile of Leishmaniasis in an Andean Region of Ecuador in the Context of Climate Change
by
Enma Veronica Páez-Espinosa, Delia Maria Sosa-Guzmán, Luis René Buitrón-Andrade, Nicole Dávila-Jumbo, Martín Israel Cáceres-Ruiz, Vinicio Francisco Robalino-Flores and Eugènia Mato-Matute
Trop. Med. Infect. Dis. 2025, 10(9), 254; https://doi.org/10.3390/tropicalmed10090254 - 3 Sep 2025
Abstract
Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are
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Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are associated with humid, low-altitude rural areas, our study uncovered an unexpected trend: confirmed cases occurring in traditionally cold Andean regions. To investigate this issue, we conducted a cross-sectional ecological study using official morbidity and mortality records from the Ecuadorian Health Care Registration Platform, focusing on the cantons of Alausí and Chunchi in Chimborazo Province from 2013 to 2022. Chimborazo Province, in the Andes, is characterized by higher altitudes (2740 m above sea level) and a cold climate (averaging 13 °C throughout the year). Among a population of 44,089 residents in Alausí, we reported a total of 40 confirmed cases, with 97.5% classified as cutaneous and 2.5% as mucocutaneous, predominantly affecting children and males. No mortality cases were recorded during the study period. To further explore environmental influences, we examined the Alausí region, where climate change has led to rising average temperatures, deforestation, and changes in humidity levels. Leishmaniasis cases in Alausí showed seasonal peaks, particularly in 2018 and 2019, correlating with warmer and more humid conditions. Environmental factors such as temperature and humidity were strongly associated with the prevalence of the disease, suggesting that climate change may be increasing transmission risks. These findings point to the value of incorporating environmental monitoring into public health strategies for vector-borne diseases that affect vulnerable populations in the Andes.
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(This article belongs to the Topic Vector-Borne Disease Spatial Epidemiology, Disease Ecology, and Zoonoses)
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Open AccessCommunication
Seropositivity for Pathogenic Leptospira in Dogs, Cats, and Horses at a Teaching Veterinary Hospital in Southern Chile
by
Lucía Azócar-Aedo, Gloria Meniconi, Carolina Pino-Olguín and María Gallardo
Trop. Med. Infect. Dis. 2025, 10(9), 253; https://doi.org/10.3390/tropicalmed10090253 - 3 Sep 2025
Abstract
At a veterinary hospital in southern Chile, we conducted an epidemiological study involving domestic dogs, cats, and horses to determine the seropositivity for pathogenic Leptospira spp., identify the infecting serogroups, measure antibody titers, and characterize seropositive animals by sex and age. None of
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At a veterinary hospital in southern Chile, we conducted an epidemiological study involving domestic dogs, cats, and horses to determine the seropositivity for pathogenic Leptospira spp., identify the infecting serogroups, measure antibody titers, and characterize seropositive animals by sex and age. None of the sampled animals showed clinical signs of leptospirosis. The microscopic agglutination test, using a panel of eight serogroups, was used for diagnosis. The seropositivity was 36.5% (95% confidence interval [CI] = 24.5–48.4) in dogs, 12.9% (95% CI = 2.6–23.1) in cats, and 45.2% (95% CI = 30.1–60.2) in horses. Serological reactions were detected for the Tarassovi and Canicola serogroups in dogs, Sejroe, Canicola, Icterohaemorrhagiae, and Grippotyphosa in horses, and Tarassovi in cats. The most frequent antibody titers were 1:200 and 1:400 in dogs, 1:400 in cats, and 1:800 in horses. The distribution of seropositivity varied by sex and age across different animal species. The seropositivity for pathogenic Leptospira in dogs, cats, and horses attending a veterinary hospital underscores the role of domestic animals as sentinels for zoonotic diseases. This finding has implications for epidemiological surveillance systems in increasing awareness of seropositivity and establishing specific prevention measures to mitigate the risk of leptospirosis transmission.
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(This article belongs to the Special Issue Leptospirosis and One Health)
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Open AccessArticle
Genotype Analysis on Orientia tsutsugamushi Causing Scrub Typhus in Malaysia: A Re-Emerging Disease
by
Shirley Yi Fen Hii, Maswani Nabilah Mohd Zaidi, Wan Norazanin Kassim, Rohaidah Hashim and Siti Roszilawati Ramli
Trop. Med. Infect. Dis. 2025, 10(9), 252; https://doi.org/10.3390/tropicalmed10090252 - 2 Sep 2025
Abstract
Introduction: Scrub typhus is caused by Gram-negative bacteria, Orientia tsutsugamushi. Humans are the dead-end host of scrub typhus. Currently, there is no vaccine available. The disease can be fatal without appropriate treatment. Here, we present the circulating OT genotypes in Malaysia and
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Introduction: Scrub typhus is caused by Gram-negative bacteria, Orientia tsutsugamushi. Humans are the dead-end host of scrub typhus. Currently, there is no vaccine available. The disease can be fatal without appropriate treatment. Here, we present the circulating OT genotypes in Malaysia and a tsa56-based single PCR to detect and determine OT genotypes, which is an approach to replace the time-consuming traditional nested PCR. Methods: The patients’ blood or tissue samples (n = 1200), received from all hospitals in Malaysia from December 2022 to November 2024, were screened for rickettsial infections. Both htrA qPCR and nested PCR were performed to detect the presence of OT DNA. Simultaneously, a selection of DNA was evaluated for the new single PCR protocol and confirmed with Sanger sequencing. Results: We report that Pahang state of Peninsular Malaysia presents the highest number of acute scrub typhus infections in Malaysia within the 24 months period. There are four genotypes circulating in the Malaysian population. OT genotype Gilliam (n = 31, 29.2%) and Karp (n = 31, 29.2%) are the predominant OT genotypes in Malaysia, followed by TA763 (n = 22, 20.8%) and Kato (n = 22, 20.8%). The single-run PCR presents longer sequence size and similar results with the nested PCR. Conclusions: Acute scrub typhus infection is not rare in Malaysia and should be considered for undifferentiated febrile illness. The single-run PCR protocol is time-saving and a promising approach for OT detection and genotype analysis in a single run to complement a clinical diagnostic setting and surveillance.
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(This article belongs to the Section Vector-Borne Diseases)
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Open AccessArticle
Vector-Borne Disease Control and Management in Irrigation Areas: A Neglected Critical Phenomenon in Malawi
by
Levi Kalitsilo, Rose Oronje and Nyanyiwe Masingi Mbeye
Trop. Med. Infect. Dis. 2025, 10(9), 251; https://doi.org/10.3390/tropicalmed10090251 - 2 Sep 2025
Abstract
Vector-borne diseases (VBDs) account for more than 17% of all infectious diseases, causing over 700,000 deaths annually, particularly among the poorest populations in tropical and subtropical areas. Climate change, particularly global warming, and certain human activities, including irrigation farming, exacerbate the situation by
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Vector-borne diseases (VBDs) account for more than 17% of all infectious diseases, causing over 700,000 deaths annually, particularly among the poorest populations in tropical and subtropical areas. Climate change, particularly global warming, and certain human activities, including irrigation farming, exacerbate the situation by creating conducive environments that facilitate the breeding of vectors such as mosquitoes and snails. This qualitative study aimed to understand the VBD control and management policy landscape in irrigation areas by gathering perceptions from key stakeholders in the irrigation farming sector in Malawi. Respondents indicated that there are no specific VBD control and management policies targeting irrigation areas in Malawi and that stakeholders essentially work in silos. Notwithstanding this, the Malawi government is committed to expanding irrigation areas to address food security. We, therefore, call for the integration of VBD control and management in irrigation farming, utilising the One Health approach—a promising strategy that could bring significant benefits. Further, we recommend the provision of VBD control and management resources in irrigation investments and the involvement of VBD researchers in the formulation of irrigation policies.
Full article
(This article belongs to the Special Issue One Health Approach to Mosquito-Borne Diseases: Epidemiology, Prevention and Treatment Strategies)
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