Tropical Medicine and Infectious Disease

Leishmaniasis is an endemic zoonotic disease caused by the protozoan parasite Leishmania and transmitted by infected female phlebotomine sandflies. The World Health Organization (WHO) classifies it among the 20 neglected tropical diseases (NTDs), ranking eighth globally. The disease predominantly affects resource-limited populations in tropical regions. Kenya bears a significant global burden of leishmaniasis, with Baringo County identified as a major endemic area. A cross-sectional survey on knowledge, attitudes, and practices (KAP) was conducted from July 2025 to January 2026 among 135 residents of Baringo South Sub-County using a structured questionnaire. The study evaluated sociodemographic characteristics, disease awareness, perceptions, preventive practices, and treatment-seeking behaviors. Additionally, 12 healthcare professionals were interviewed regarding their diagnostic and treatment capacities. Associations between variables were analyzed using Chi-square tests and multivariate logistic regression. Overall awareness of leishmaniasis was high (94.8%), with KAP scores of 86.7%, 76%, and 77.7%, respectively. Despite this, critical knowledge gaps persisted regarding transmission dynamics, the role of dogs as reservoir hosts, and preventive measures. Significant associations were found for awareness of local cases, recognition of clinical signs, knowledge of vector activity, community control measures, and attitudes toward treatment preferences. Age and education level predicted KAP outcomes. Healthcare practitioners demonstrated technical capacity to diagnose and treat human Leishmania infections, whereas veterinarians lacked awareness of Leishmania infection in dogs, including its diagnosis and treatment. Integration of human, animal, and vector surveillance within a One Health framework is recommended to enhance disease monitoring and control in Baringo County. Full article

Background: Dermatophilus congolensis, a Gram-positive actinomycete, is a well-known animal pathogen but a rare cause of human skin infections. Human dermatophilosis is an infection associated with tropical environments and animal contact that remains frequently underdiagnosed. Case Presentation: We report a case of recurrent folliculitis in a 34-year-old male Muay Thai fighter returning from Thailand to Spain. The patient presented with pustular lesions on his lower limbs following frequent leg shaving and close physical contact during training. Microbiological culture from skin swabs yielded beta-hemolytic colonies, identified as D. congolensis by MALDI-TOF MS. Identification was confirmed through Whole-Genome Sequencing (WGS), which also revealed an absence of antimicrobial resistance genes. Despite the lack of established EUCAST breakpoints, the isolate showed low MICs for most tested antibiotics. The patient was treated with doxycycline, although clinical follow-up was not possible due to travel. Conclusions: This case highlights D. congolensis as an emerging differential diagnosis for persistent folliculitis in travelers and athletes. Our findings suggest a potential horizontal transmission route through contact sports and fomites (e.g., mats) in high-humidity settings. Full article

Background: Intestinal parasitic infections are common in tropical settings and may influence immune regulation, allergic responses, and respiratory health. In children with sickle cell disease (SCD), respiratory morbidity is multifactorial, and the contribution of intestinal parasites remains uncertain. This study assessed whether documented intestinal parasitic infections, particularly helminth infections, were associated with asthma-like respiratory phenotypes and clinical morbidity in children with SCD in French Guiana. Methods: We conducted a multicenter cross-sectional analysis of children and adolescents younger than 18 years with confirmed SCD who were being followed by the pediatric SCD centers of Saint-Laurent-du-Maroni, Cayenne, and Kourou between January 2022 and December 2025. Clinical, respiratory, and parasitological data were extracted from routine-care medical records. Intestinal parasitic infection was defined as at least one documented stool parasitology result identifying Strongyloides stercoralis, hookworm, or Entamoeba histolytica, according to the variables consistently available in the database. Respiratory outcomes included physician-diagnosed asthma, bronchial obstruction, bronchodilator reversibility, and an asthma-like respiratory phenotype. Results: Among 233 included children, 105 (45.1%) had at least one documented intestinal parasitic infection and 82 (35.2%) had a helminth infection. Hookworm was the most common parasite (75/233, 32.2%), followed by Entamoeba histolytica (33/233, 14.2%) and Strongyloides stercoralis (24/233, 10.3%). An asthma-like respiratory phenotype was observed in 32/105 infected children (30.5%) versus 44/128 non-infected children (34.4%). Bronchial obstruction and bronchodilator reversibility were also similar between groups. After adjustment for age, sex, genotype, hydroxyurea treatment, rural residence, site of follow-up, and environmental tobacco smoke exposure, intestinal parasitic infection was not associated with asthma-like respiratory phenotype (adjusted OR: 0.94, 95% CI: 0.51–1.72; p = 0.844), recurrent hospitalization, or history of acute chest syndrome. Conclusions: In this routine-care multicenter pediatric SCD cohort from French Guiana, intestinal parasitic infections were common but were not associated with respiratory phenotype or selected morbidity outcomes. Because testing and respiratory assessment were not systematic, these findings should be interpreted as showing that routine parasitological status alone could not identify children with respiratory morbidity. Prospective studies with standardized repeated parasitological, immunological, environmental, and respiratory assessments are needed. Full article

Background: Malaria remains a major public health challenge in Pakistan, where persistent transmission, heterogeneous risk patterns, and evolving treatment practices continue to impede control and elimination efforts. Methods: A community-based cross-sectional study was conducted among 9211 symptomatic individuals in District Dera Ismail Khan, northwestern Pakistan, from January 2024 to December 2025. Malaria was diagnosed using rapid immunochromatographic assays for Plasmodium vivax (P. vivax) and Plasmodium falciparum (P. falciparum), and associated risk factors were assessed using multivariable logistic regression. Results: Overall malaria prevalence was 36.27% (3341/9211). P. vivax predominated, accounting for 93.8% (3133/3341) of infections, while P. falciparum represented 5.8% (195/3341) and mixed infections 0.4% (13/3341). Infection risk was significantly associated based on multivariate analysis with male sex, younger age, pregnancy (AOR = 4.69), and absence of mosquito net use (AOR = 6.17), whereas indoor residual spraying (AOR = 0.08) showed a strong protective effect. Malaria transmission showed two peaks: October–December (AOR = 3.78–4.97) and February–March (AOR = 2.25–2.31) and declined significantly based on unadjusted analysis from 39.5% in 2024 to 32.8% in 2025 (OR = 0.74; p < 0.001). Blood groups B+ (AOR = 0.77), B− (AOR = 0.78), and AB− (AOR = 0.86) were significantly associated with reduced odds of malaria infection. A notable shift toward artemisinin-based combination therapy was observed, with artemether–lumefantrine largely replacing chloroquine for malaria treatment. Conclusions: The persistence of P. vivax-dominated transmission alongside ongoing P. falciparum circulation highlights the need for targeted vector control, enhanced surveillance, and evidence-based treatment strategies to accelerate malaria elimination in Pakistan. Full article

Tuberculosis (TB) remains a major infectious disease associated with substantial healthcare burdens. Although previous studies mainly focused on mortality and treatment outcomes, factors associated with TB-related hospitalization have not been sufficiently investigated. The aim of our study was to evaluate clinical factors associated with TB-related hospitalization in patients with TB. Patients diagnosed with TB at Kangwon National University Hospital between January 2024 and December 2025 were included in our study. The primary outcome was TB-related hospitalization during follow-up after TB diagnosis. Hospitalization-free probability was analyzed using Kaplan–Meier analysis, and Cox proportional hazards regression analysis was performed to identify factors associated with hospitalization risk. A total of 81 patients were included; 63 patients were in the outpatient group and 18 patients were in the hospitalization group. The median time to hospitalization was 36 days. The Charlson comorbidity index (CCI) was significantly higher in the hospitalization group (5.78 ± 2.88 vs. 4.16 ± 2.22, p = 0.038). Patients with CCI values ≥ 5 showed significantly lower hospitalization-free probability during the 180-day follow-up period (log-rank p = 0.013). In multivariable Cox hazards regression analysis, both serum creatinine (hazard ratio (HR), 1.599; 95% confidence interval (CI), 1.057–2.419; p = 0.026) and CCI (HR, 1.221; 95% CI, 1.018–1.466; p = 0.032) were significantly associated with TB-related hospitalization. A higher comorbidity burden may help identify patients at risk for TB-related hospitalization. Full article

The Philippines achieved World Health Organization (WHO) certification for the elimination of leprosy as a public health problem in 1998. Despite this milestone, new cases continue to be reported each year, highlighting the need for sustained surveillance and interventions to achieve zero transmission. This paper provides an update on the country’s progress toward interruption of leprosy transmission using national surveillance data and programmatic reports from 2020–2024. Quantitative data were obtained from the Department of Health (DOH) Field Health Services Information System (FHSIS), while policy and programmatic information were drawn from national reports, WHO guidance, and implementation reviews. Descriptive analyses were conducted to examine trends in prevalence, case detection rates (CDRs), and age-sex distribution patterns to identify high-risk groups. Leprosy prevalence declined from 0.41 per 10,000 population in 2020 to 0.11 in 2024, remaining below the WHO elimination threshold. The CDR increased from 0.45 in 2022 to 1.17 per 100,000 in 2024, indicating recovery of active surveillance after COVID-19-related disruptions. Most newly detected cases occurred among adults aged 20–59 years (72%), although continued detection among children aged 0–14 years (6–7%) suggests ongoing transmission in selected endemic areas. Key program strengths include policy integration and WHO-supported surveillance initiatives, while major barriers include stigma, uneven local implementation, and limited access to rehabilitation. The Philippines has maintained low national prevalence while strengthening efforts toward transmission interruption. Continued investment in surveillance, contact tracing, stigma reduction, and integrated neglected tropical disease (NTD) services will be essential to achieving zero transmission, zero disability, and zero discrimination by 2030. Full article

Human intestinal nematode infections (HINIs) remain a public health concern despite reduced prevalence following mass drug administration (MDA) in low- and middle-income countries. Children continue to bear a substantial burden of infection, and caregiver knowledge and practices may influence their risk of acquiring infection. Sustaining control during the transition of prevention programmes to surveillance-based strategies requires an understanding of behavioural determinants of transmission. Therefore, we assessed caregiver knowledge, attitudes, and practices (KAP) and their associations with sociodemographic characteristics and child infection status. A community-based cross-sectional study was conducted among 945 caregivers of primary school children in Anuradhapura, a low-prevalence setting where school-based MDA ceased in 2019, to assess caregiver KAP and child HINI status. An interviewer-administered questionnaire assessed KAP, sociodemographic, water, sanitation, hygiene (WASH), and behavioural factors. Participants were predominantly mothers (89.5%). Good knowledge was observed in 61.7%, positive attitudes in 95.6% and good practices in 99.2%. Knowledge gaps persisted regarding transmission and complications. Higher caregiver knowledge (OR = 0.52; 95% CI: 0.36–0.72) and regular deworming (OR = 0.58, 95% CI: 0.40–0.83) were associated with lower odds of infection, whereas attitudes and practices were not independently associated. Caregiver knowledge remains a key determinant of infection risk. Gaps in knowledge, misconceptions, and practices may sustain transmission even in low-prevalence settings. Strengthening health education, school-based hygiene promotion, and community engagement remains essential to reinforce preventive behaviours and support long-term control as countries transition from routine MDA to elimination-oriented strategies. Full article

Background: Malaria remains a major public health challenge in sub-Saharan Africa, where asymptomatic infections continue to hinder elimination efforts. Although the clinical and epidemiological consequences of microscopic infections are well documented, the health implications of submicroscopic Plasmodium falciparum infections remain poorly understood, particularly in Ghana. This study assessed the burden of submicroscopic P. falciparum infections and their association with antimalarial drug resistance markers among outpatients attending Korle Bu Teaching Hospital. Methods: A cross-sectional study involving 345 participants was conducted. Malaria infection was assessed using mRDT, blood smear microscopy, and LAMP-PCR for parasite detection and species identification. Antimalarial drug resistance markers were analyzed by multiplex PCR and Oxford Nanopore sequencing. Statistical analysis was performed using STATA version 14, applying Pearson’s chi-square test and logistic regression. Results: The overall prevalence of asymptomatic P. falciparum infection was 35.0% (117/334), with 18.9% microscopic and 16.1% submicroscopic infections. The wild-type pfcrt K76 allele, associated with chloroquine susceptibility, was highly prevalent (90.1%). Conclusions: Asymptomatic P. falciparum infections are common in this population, with a substantial proportion occurring at submicroscopic levels. The high prevalence of chloroquine-susceptible parasites and identified transmission hotspots underscore the need for sensitive diagnostics and targeted interventions to support malaria elimination efforts in Ghana. Full article

This study aimed to project the current and future suitable habitats of three primary malaria vectors in China—An. lesteri, An. minimus, and An. sinensis—using an ensemble modeling approach. We simulated their geographical distributions under current and future climates (SSP126, SSP245, SSP585) using the Biomod2 platform with 19 bioclimatic variables and elevation. The ensemble models achieved high predictive performance, as reflected by AUC and TSS values. Environmental drivers were species-specific: An. lesteri was primarily influenced by elevation, temperature seasonality (Bio4), and seasonal precipitation (Bio18, Bio19); An. minimus by the mean temperature of the coldest quarter (Bio11); and An. sinensis by annual precipitation (Bio12), mean temperature of the wettest quarter (Bio8), and elevation. Future projections revealed divergent responses: the habitat of An. lesteri is projected to contract and shift northeastward; An. sinensis is expected to expand northward, potentially extending climatically suitable areas into new regions; and although the overall range of An. minimus remains stable, its internal suitability shifts toward higher classes under warming. These findings demonstrate that climate change will critically reshape the distribution of major malaria vectors across China, underscoring the need to integrate climate-informed projections into adaptive surveillance and vector control strategies in the post-elimination era. Full article

Mother-to-child transmission (MTCT) of infectious diseases remains a public health challenge in socially vulnerable regions with limited healthcare access. This study assessed the epidemiological situation, spatial distribution, and socioeconomic context of MTCT infections—Chagas disease (ChD), syphilis, HIV, and hepatitis B (HB)—in the Gran Chaco region (Argentina–Paraguay), 2018–2024. Epidemiological data from 2877 patients enrolled in an MTCT Plus programme were analysed, alongside socioeconomic variables and spatio-temporal cluster analysis using SaTScan software. Maternal seroprevalence of ChD was 4.1%, the highest among the infections evaluated. Syphilis prevalence was 0.8%, while no HIV or HBV infections were detected among screened pregnant women. Two statistically significant spatiotemporal clusters of maternal Trypanosoma cruzi seropositivity were identified: a household-level cluster in 2018 and a regional cluster during 2019–2021. The highest prevalence of maternal ChD seropositivity was observed in census tracts with greater socioeconomic vulnerability, although this spatial overlap was assessed descriptively. These findings highlight the effectiveness of integrated maternal–child health services in ensuring coverage, timely diagnosis, and treatment in vulnerable populations. The identified spatial patterns provide evidence to support targeted surveillance and coordinated binational public health strategies in border regions affected by persistent social inequalities. Full article

Marine envenomations are common non-infectious hazards for travelers. Lionfish, venomous fish native to Indo-Pacific waters, have become an invasive species in the Atlantic Ocean and threat to native marine ecosystems. Various control measures have been implemented in response to rapidly expanding lionfish populations, including licensed culling by recreational divers. We herein review lionfish envenomation through framing with a case that occurred during a diving trip to Curacao for the purpose of lionfish spearfishing. Following initial management in Curacao with hot water immersion, wound care, and antibiotic prophylaxis, the patient continued to have persistent swelling, bruising, and pain to the puncture site and was referred to our outpatient clinic for further evaluation. In addition to reviewing clinical syndromes and approach to management for common marine envenomations that may be encountered in the post-travel setting, we situate this case within the broader ecological context of expanding invasive species ranges with climate change and rising sea temperatures. Pre-travel providers should counsel patients at high risk for marine envenomations on preventative measures, along with how and when to seek care following exposure. Post-travel providers should be familiar with the immediate and long-term sequelae of non-infectious envenomations and intoxications, including marine exposures. Larger national and multinational collaborations are required to mitigate the effects of climate change and international marine movement on invasive species, especially those that incur risk to marine and human health alike. Full article

Background: Pre-travel health consultations require individualised risk assessment across itinerary, destination, traveller characteristics, vaccine and medication history, comorbidities, pregnancy and immune status, activities, and access to care. Artificial intelligence (AI), particularly large language models (LLMs), may support pre-consultation education, structured history collection, guideline retrieval, multilingual communication and post-consultation reinforcement, but unsafe use may introduce hallucinated, outdated or insufficiently personalised recommendations. Objectives: This scoping review maps the current evidence on AI tools relevant to pre-travel health consultations, characterises implementation gaps, identifies patient-safety risks and proposes a supervised implementation model for travel medicine clinics. Original contribution: Unlike previous reviews of clinical AI, patient-education LLMs or chatbots in chronic illness, this is the first scoping review focused specifically on AI in pre-travel consultations. It uniquely combines a five-tier evidence hierarchy that separates direct travel-medicine AI evidence from indirect clinical-AI safety and equity evidence, and provides a travel-medicine-specific clinical safety risk taxonomy and a supervised implementation framework anchored to authoritative travel-medicine guidance and current AI regulatory regimes. Methods: A scoping review was conducted following PRISMA-ScR reporting, using a Population–Concept–Context eligibility framework and a targeted retrieval in May 2026 covering January 2017 to May 2026. Sources were screened and charted by a single reviewer using a structured eligibility checklist. Quality and applicability were appraised conceptually using MMAT, AMSTAR 2 and JBI text-and-opinion criteria, with GRADE-informed certainty. Results: Of 70 records identified, 11 were included: four direct pre-travel AI sources, one adjacent travel-related decision-support study, four guideline and context sources and two clinical LLM safety sources. The only patient-level implementation involved 26 travellers using a GPT-4 Travel Clinic Assistant in Singapore, where physicians and travellers reported acceptability and workflow benefit but objective effectiveness outcomes were not measured. Broader clinical LLM evidence indicates heterogeneous evaluation methods, vulnerability to hallucinated guidelines, and accuracy that varies widely across model versions and specialties. Conclusions: Current evidence supports supervised AI augmentation of pre-travel consultations but does not support autonomous AI-led vaccine selection, malaria prophylaxis, contraindication screening or individualised travel-risk clearance. Near-term deployment should be restricted to clinician-supervised education, structured intake, source-grounded guideline retrieval, after-visit reinforcement and escalation-triggered workflow support. Priority research includes travel-medicine-specific hallucination audits; equity testing in visiting-friends-and-relatives, migrant, older-adult, First Nations Australian, and Pacific Islander travellers; and prospective trials reported under CONSORT-AI, SPIRIT-AI and TRIPOD + AI. Full article

Background: Human brucellosis is a widespread zoonotic febrile illness in livestock-rearing endemic regions, including Türkiye (pooled human seroprevalence approximately 4.5%). Age-stratified item-level knowledge profiles paired with information-source patterns are rarely reported in adult populations. We aimed to describe age-stratified brucellosis knowledge and information-source ecosystems in a hospital-attending adult sample from an endemic Turkish province. Methods: A hospital-based cross-sectional survey enrolled 397 adults in Balıkesir, Türkiye. A 17-question instrument assessed demographics, prior awareness, a 26-item composite knowledge score among aware respondents, and information sources. Item-level recognition was compared across four age strata, with multivariable logistic regression identifying independent predictors. Results: Of 397 adults (mean age 36.1 years; 62.7% male), 233 (58.7%) reported prior awareness, increasing with age (51.8% in 18–29 vs. 74.5% in ≥60 years; p < 0.001). Among aware respondents, composite knowledge declined with age (mean 8.52 vs. 5.94; p < 0.001). Raw dairy transmission and treatment availability were uniformly recognized (>80% across all strata). Recognition of clinical symptoms (fever 68.9% vs. 34.3%; p = 0.005) and veterinary signs (decreased milk yield 36.9% vs. 8.6%; p = 0.001) was substantially lower in older respondents. Internet citation declined with age (41.7% to 17.1%), while older respondents relied more on interpersonal networks. Conclusions: Brucellosis knowledge was not uniformly distributed across the adult age spectrum. Dominant transmission and treatment messages were near-universally recognized, while clinical-symptom and veterinary-sign recognition showed substantial age-related deficits, accompanied by generational divergence in information-source ecosystems. These findings suggest that age-tailored, channel-specific reinforcement of less-recognized clinical and veterinary knowledge, delivered through trusted healthcare-worker channels, may strengthen brucellosis education in endemic Turkish settings. Community-based replication is required before broader policy translation. Full article

Plasmodium knowlesi infections can progress rapidly to life-threatening complications, such as acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI), which are driven by the ability of the zoonotic parasite to rapidly replicate towards high parasitemia and the cytoadherence properties of the infected erythrocytes (IRBCs). This study evaluated the anti-parasitic and vasoprotective potential of Annona muricata (soursop) leaf ethanol extract against P. knowlesi. In vitro assays using the P. knowlesi A1-H.1 reference strain revealed significant blood stage schizogony inhibition (IC₅₀: 9.65 µg/mL), specifically targeting the trophozoites. The anti-parasitic activity was concentrated in the <30 kDa subfraction of the extract. Washout assays confirmed that the effect was parasitostatic rather than parasiticidal, where the malaria parasites underwent developmental arrest but remained morphologically normal and resumed growth post-removal. Furthermore, priming human endothelial cell lines with the extract significantly reduced IRBC–endothelial binding. These results demonstrate that A. muricata extract exerts a dual-action effect by arresting P. knowlesi asexual replication and inhibiting IRBC–endothelial cytoadherence. While clinical translation would require exhaustive standardization and chemotypic profiling due to the natural variability of plant compositions, these findings provide a foundational academic framework for the potential of A. muricata leaf extract in mitigating severe knowlesi malaria complications. Full article

Background: Opportunistic infections remain a significant cause of morbidity among people living with HIV (PLHIV) in sub-Saharan Africa despite expanded access to antiretroviral therapy (ART). This study evaluated the association between immune status, viral load suppression, ART adherence, and the risk of opportunistic infections among HIV-positive patients receiving ART in the rural Eastern Cape, South Africa. Methods: A retrospective cross-sectional study was conducted using clinical records of HIV-positive patients attending an HIV clinic in Mthatha between January 2021 and December 2024. Demographic characteristics, CD4 counts, viral load results, ART regimens, adherence status, and documented opportunistic infections were extracted. Viral load suppression was defined according to WHO guidelines as <1000 copies/mL. CD4 counts were categorized as <200, 200–499, and ≥500 cells/mm³. Multivariable logistic regression analysis was performed to identify independent predictors of opportunistic infections. Results: A total of 155 patients (105 females, 50 males) were included. Females demonstrated significantly higher mean CD4 counts than males (p = 0.037) and better ART adherence (p < 0.001). Tuberculosis, hepatitis B virus, and herpes simplex virus infections were more prevalent among males, whereas candidiasis was significantly more common among females (p = 0.034). In multivariable analysis, CD4 count < 200 cells/mm³, unsuppressed viral load, and poor ART adherence were independently associated with increased odds of opportunistic infections. Conclusions: Immune suppression and suboptimal ART adherence significantly increase the risk of opportunistic infections among HIV-positive patients in rural South Africa. Strengthening adherence interventions and early immune monitoring may reduce infection burden in high-prevalence settings. Full article

Climate change is reshaping the epidemiology of vector-borne diseases in Europe by altering the ecological conditions that determine vector survival, seasonal activity and pathogen transmission. Rising temperatures, milder winters, prolonged warm seasons and changing precipitation patterns are increasing the suitability of parts of Europe for competent mosquito, tick and sandfly vectors. These changes, combined with human mobility and land-use change, increase the probability that imported pathogens encounter permissive conditions for local transmission. This Opinion article examines autochthonous vector-borne disease transmission in Europe, using dengue as a sentinel example of a wider climate-sensitive transition. We discuss how imported viraemic cases, established competent vectors, vector–host contact and delayed clinical recognition can converge to enable local outbreaks. Beyond dengue, we consider West Nile virus, chikungunya, tick-borne encephalitis, leishmaniasis and Crimean–Congo haemorrhagic fever as examples of a broader and increasingly heterogeneous European risk landscape. We argue that the public-health impact of this transition is shaped not only by vector expansion, but also by gaps in surveillance integration, diagnostic readiness, workforce preparedness and One Health coordination. Strengthening climate-informed surveillance, rapid laboratory capacity, frontline clinical awareness and cross-sectoral response systems will be essential to prevent repeated introductions from becoming sustained public-health challenges. Full article

Early detection of infectious disease outbreaks is critical in densely populated, resource-limited settings. This study aimed to describe the community-based surveillance (CBS) system and its application of the Data–Information–Knowledge–Wisdom (DIKW) framework in Bangladesh. CBS was implemented in 12 urban wards across Dhaka South, Rajshahi, and Sylhet, where trained community volunteers conducted routine household visits to identify five priority syndromes. Data were collected through a mobile application integrated with an automated pipeline for cleaning, geocoding, cluster detection, and alert generation. Between January and June 2025, 38,489 households were visited, enrolling 128,626 individuals. The system generated 10,191 alerts and 577 clusters, predominantly for suspected dengue (58.7%), followed by acute watery diarrhea (24.1%) and influenza-like illness (10.7%). Rajshahi contributed the majority of alerts and clusters. Spatiotemporal analysis identified ward-level outbreak signals, including localized dengue peaks across all three cities. Over 98% of records were synchronized within 24 h, and more than 99% of data entry errors were automatically corrected, ensuring timely and high-quality analytics. These findings demonstrate that digital CBS can effectively transform community-level data into actionable public health intelligence, supporting early outbreak detection and response. This translation enabled timely public health actions, including targeted outbreak investigations and localized vector control measures in identified hotspots. Integration with national surveillance platforms may further strengthen health system responsiveness and epidemic preparedness. Full article

Cystic echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus sensu lato, poses a persistent public health burden in agro-pastoral regions worldwide. This study provides a large-scale epidemiological assessment of CE, highlighting sustained zoonotic transmission driven by agro-pastoral practices and human–animal interactions, and supporting the urgent implementation of One Health strategies. This ten-year retrospective study (2015–2024) analyzed 326 surgically confirmed cases from five hospitals in Djelfa. The cumulative surgical incidence was 2.04 cases per 100,000 person-years, classifying the region as hypoendemic. Females predominated (61.96%), and individuals aged 31–60 years represented 47.24% of cases. Rural residence (73.62%) and dog contact (94.17%) were major risk factors, with hepatic localization dominating (88.96%). Correlation analysis showed moderate associations between rural habitat and dog contact (V = 0.46, p < 0.001) and between sex and habitat (V = 0.34, p < 0.001), as well as weaker but significant associations for age and cyst location (V = 0.28, p < 0.001) and dog contact and cyst location (V = 0.20, p < 0.05). No postoperative mortality was recorded. These findings confirm active transmission linked to agro-pastoral practices and emphasize the need for coordinated One Health control strategies. Full article

Rickettsia spp. are ubiquitous in nature and capable of causing diseases of varying severity. The most extensive group comprises the spotted fever group (SFG) Rickettsiae, the members of which are predominantly transmitted by ticks. The expansion of tick habitats observed in recent decades poses an increasing threat of dissemination of tick-borne infections into regions previously considered non-endemic. The aim of this study was to determine the prevalence of SFG Rickettsiae in ixodid ticks collected in Northwest Russia and to characterize the species diversity of these pathogens within the study area. Questing adult ixodid ticks (n = 4566) were collected from eight regions of Northwest Russia (Arkhangelsk, Kaliningrad, Leningrad, Novgorod, Pskov and Vologda Regions, as well as the Republic of Karelia and St. Petersburg) in 2023 to 2025 (from April to September). The species composition included Ixodes ricinus (n = 1683), Ixodes persulcatus (n = 2404), and Dermacentor reticulatus (n = 479). Genomic DNA was extracted from individual ticks and screened for SFG Rickettsiae using real-time PCR, followed by conventional PCR targeting the gltA, ompA, ompB, and sca4 (gene D) genes. Nucleotide sequences obtained for a subset of positive samples for the various genes were analyzed. The overall prevalence of SFG Rickettsiae was 12.6% (95% CI: 11.7–13.6). Circulation of the following species was detected: Rickettsia helvetica, Rickettsia conorii subsp. raoultii, Candidatus Rickettsia tarasevichiae, Rickettsia monacensis, and Rickettsia felis. The findings indicate considerable species diversity of SFG Rickettsiae in natural foci of Northwest Russia. Rickettsia monacensis was detected in ixodid ticks within the study area for the first time, and R. felis was identified in Russia for the first time. Full article