Tropical Medicine and Infectious Disease

9 pages, 482 KB

Open AccessBrief Report

The Effect of Increased Temperature on Dengue Virus in the Vector Aedes aegypti from New Caledonia

by Méryl Delrieu, Olivia O’Connor, Nicolas Pocquet, Kenny Teraiharoa, Anne-Fleur Griffon, Christophe Menkes, Morgan Mangeas, Elvina Viennet, Valérie Burtet-Sarramegna, Myrielle Dupont-Rouzeyrol and Francesca D. Frentiu

Trop. Med. Infect. Dis. 2026, 11(2), 53; https://doi.org/10.3390/tropicalmed11020053 - 14 Feb 2026

Abstract

Dengue virus (DENV) is a major public health concern in tropical and subtropical regions, including the Pacific. Temperature is recognised as a major driver of transmission under climate change. Understanding how higher temperatures may alter DENV transmission is essential to anticipate future dengue [...] Read more.

Dengue virus (DENV) is a major public health concern in tropical and subtropical regions, including the Pacific. Temperature is recognised as a major driver of transmission under climate change. Understanding how higher temperatures may alter DENV transmission is essential to anticipate future dengue risk. Therefore, we assessed the effect of temperature on DENV-1 in Aedes aegypti from New Caledonia. Mosquitoes were orally infected and maintained for 14 days at 26.6 °C (average temperatures during recent outbreaks) or 31.1 °C (SSP5-8.5 scenario projected temperatures). Mosquito bodies, heads, and saliva were analysed separately to determine infection, dissemination, and transmission rates as well as transmission efficiencies. Infectious virus was detected by using a fluorescent focus assay, and viral titres were quantified via TCID₅₀ assays. No significant differences were observed in infection, dissemination, and transmission rates or transmission efficiencies between the two temperatures. However, DENV titres in mosquito bodies and heads were significantly higher at 31.1 °C than 26.6 °C. Our results indicate that elevated temperature increases viral loads within the insect but not the proportion of infectious mosquitoes, highlighting the importance of considering temperature as a key parameter in assessing dengue risk under climate change. Further studies are needed to investigate the effects of temperature on virus–mosquito interactions. Full article

(This article belongs to the Special Issue Surveillance of Eliminated and Near-Eliminated Infectious Disease in the Western Pacific Region)

► Show Figures

Graphical abstract

13 pages, 1118 KB

Open AccessArticle

Optimizing Quality of Care for Elderly Tuberculosis Patients in Shanghai, China: Insights from Patient Cascade of Care and Patient Pathway Analysis

by Yutong Han, Lixin Rao, Yu Huang, Qi Zhao, Xin Shen and Biao Xu

Trop. Med. Infect. Dis. 2026, 11(2), 52; https://doi.org/10.3390/tropicalmed11020052 - 12 Feb 2026

Abstract

With population aging, the burden of tuberculosis (TB) among the elderly is rising. Older adults are at high risk of TB but susceptible to poor TB care. In this study, we enrolled TB patients aged over 60 years registered in Shanghai during 2019–2021. [...] Read more.

With population aging, the burden of tuberculosis (TB) among the elderly is rising. Older adults are at high risk of TB but susceptible to poor TB care. In this study, we enrolled TB patients aged over 60 years registered in Shanghai during 2019–2021. A seven-step care cascade from estimated TB burden in the community to treatment outcomes was constructed to quantify retention and attrition at each step of TB health service. Patient pathway analysis was carried out in two districts of Shanghai to describe patients’ care-seeking behaviors, service coverage, and diagnosis delays. Across the care cascade, the largest gaps occurred from symptom onset to care seeking (11.3%) and from treatment initiation to completion (10.7%). Male sex, older age, and mycobacterium tuberculosis positivity were associated with treatment discontinuation and unfavorable outcomes. The patient pathway analysis revealed that first contact at lower-level or non-TB-designated hospitals was associated with more complex pathways and may contribute to diagnostic delays. These findings highlight the need to promote proactive care seeking upon symptoms, strengthen targeted adherence support for older people, and improve diagnostic capacity and referral efficiency at lower-level health facilities. Full article

(This article belongs to the Special Issue Burden of Tuberculosis in Different Countries, 2nd Edition)

► Show Figures

Figure 1

15 pages, 1281 KB

Open AccessArticle

Immunoendocrine Profiles in Neurocysticercosis Patients: A Case-Control Study in Honduras

by Nicholas Zugno-Gadea, Lázaro Molina, Mariangela Hernandez-González, María Mercedes Rueda, Francis Bejarano, Nelson Alexander Betancourt and Ana Sanchez

Trop. Med. Infect. Dis. 2026, 11(2), 51; https://doi.org/10.3390/tropicalmed11020051 - 12 Feb 2026

Abstract

Emerging evidence suggests that certain cestodes, including Taenia solium, may actively modulate the host’s hormonal and immune environment to facilitate their survival. This study aimed to determine whether patients diagnosed with neurocysticercosis (NCC) exhibit immunoendocrine alterations associated with infection. A clinical study [...] Read more.

Emerging evidence suggests that certain cestodes, including Taenia solium, may actively modulate the host’s hormonal and immune environment to facilitate their survival. This study aimed to determine whether patients diagnosed with neurocysticercosis (NCC) exhibit immunoendocrine alterations associated with infection. A clinical study was conducted in Honduras, enrolling 11 adult NCC patients (9 female, 2 male) and 11 age- and sex-matched healthy controls. Serum concentrations of seven hormones and two cytokines were evaluated. Compared to controls, NCC patients showed significantly elevated levels of 17β-Estradiol (E2), Progesterone (P4), Androstenedione (A4), Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), Interleukin-6 (IL-6), and Interleukin-10 (IL-10). Conversely, Free testosterone (FT) and Dihydrotestosterone (DHT) levels were significantly reduced. These findings support the hypothesis that T. solium may manipulate host immunoendocrine pathways to promote its establishment and persistence within the central nervous system. Full article

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

► Show Figures

Figure 1

15 pages, 293 KB

Open AccessArticle

Factors Associated with the Prevalence of Dengue–Leptospirosis Coinfection in Patients Hospitalized for Febrile Syndrome

by Dina I. Bance-Anicama, María M. Diaz-Orihuela, Luz M. Diaz-Orihuela and Wilter C. Morales-García

Trop. Med. Infect. Dis. 2026, 11(2), 50; https://doi.org/10.3390/tropicalmed11020050 - 12 Feb 2026

Abstract

Background: In tropical regions, dengue and leptospirosis coexist and share a nonspecific clinical onset that hinders timely diagnosis. Coinfection may worsen the clinical course and increase mortality. Objective: To estimate the prevalence of dengue, leptospirosis, and coinfection among patients with febrile syndrome in [...] Read more.

Background: In tropical regions, dengue and leptospirosis coexist and share a nonspecific clinical onset that hinders timely diagnosis. Coinfection may worsen the clinical course and increase mortality. Objective: To estimate the prevalence of dengue, leptospirosis, and coinfection among patients with febrile syndrome in Madre de Dios (Peru) and to identify associated clinical factors. Methods: Observational, analytical, cross-sectional, retrospective study conducted at a primary-level health facility. Clinical and laboratory records of patients with febrile syndrome seen in 2024 were analyzed. Categorical variables were summarized as frequencies (%) and numeric variables as mean ± SD or median [IQR]. Comparisons used chi-square or Fisher’s exact test, Student’s t test, or the Mann–Whitney U test, as appropriate. Associations were estimated using Poisson regression models with robust variance, adjusted for sex, reporting prevalence ratios (PRs) and 95% CIs. Analyses were performed in R 4.0.2. Results: A total of 226 patients were included. Positivity was 19.0% for dengue (43/226), 66.8% for leptospirosis (151/226), and 5.8% for coinfection (13/226). In the bivariate analysis, dengue was associated with higher temperature (p < 0.001), lower mean arterial pressure (p = 0.007), mucosal bleeding/ecchymosis (p = 0.049), and lower fluid intake (p = 0.021); temperature was also higher in coinfection (p = 0.021). In Poisson models, dengue was associated with tachycardia (PR = 5.69; 95% CI: 1.95–13.07; p < 0.001), temperature (PR = 1.61 per °C; 1.23–2.12; p = 0.001), bilateral polyarthralgia (PR = 2.55; 1.14–5.04; p = 0.012), and mucosal bleeding/ecchymosis (PR = 3.31; 0.94–8.37; p = 0.027). Leptospirosis was associated with male sex (PR = 0.78 vs. female; 0.65–0.94; p = 0.010) and fever (PR = 2.38; 1.17–6.03; p = 0.035). Leptospira–dengue coinfection was related to higher temperature (PR = 1.75 per °C; 1.05–3.01; p = 0.036). Conclusions: Simple clinical signs such as fever/elevated temperature, tachycardia, bilateral polyarthralgia, and mucosal bleeding can help prioritize suspicion of dengue, leptospirosis, or coinfection; guide requests for dual testing (dengue–Leptospira), early hydration in dengue, and timely initiation of antibiotic therapy in leptospirosis. These findings support the development of integrated triage algorithms and strengthening access to molecular diagnostics in high-burden febrile syndrome settings. Full article

(This article belongs to the Section Infectious Diseases)

11 pages, 230 KB

Open AccessArticle

Prognostic Value of Charlson Comorbidity Index in Patients with COVID-19

by Iliyan Todorov, Margarita Gospodinova and Kalina Stoyanova

Trop. Med. Infect. Dis. 2026, 11(2), 49; https://doi.org/10.3390/tropicalmed11020049 - 10 Feb 2026

Abstract

COVID-19, caused by SARS-CoV-2, is a highly contagious disease with variable clinical presentation. Severe forms are more common in patients with pre-existing chronic conditions. The objective of this study is to evaluate the prognostic value of the Charlson Comorbidity Index (CCI) in relation [...] Read more.

COVID-19, caused by SARS-CoV-2, is a highly contagious disease with variable clinical presentation. Severe forms are more common in patients with pre-existing chronic conditions. The objective of this study is to evaluate the prognostic value of the Charlson Comorbidity Index (CCI) in relation to disease severity and outcome in hospitalized COVID-19 patients with comorbidities. A retrospective analysis was conducted on 558 patients, hospitalized at the Infectious Diseases Clinic of “St. Marina” University Hospital, Varna, Bulgaria, between March 2020 and March 2021. CCI score was calculated to estimate 10-year survival probabilities. Prevalent comorbidities were arterial hypertension (78.55%), type 2 diabetes (16.09%), and ischemic heart disease (5.82%). A higher number of comorbidities was associated with increased rates of bilateral pulmonary consolidation (χ² = 6.63, p = 0.010), oxygen therapy needs (χ² = 5.41, p = 0.020), and mortality (χ² = 7.88, p = 0.005). Patients with higher CCI scores had worse outcomes. A CCI score above 5 was common among non-survivors and those with pulmonary consolidation and respiratory failure. The findings confirm that advanced age and multiple comorbidities are strong predictors of poor COVID-19 prognosis. Early CCI calculation at hospital admission would help identify high-risk patients and support timely, targeted medical interventions. Full article

(This article belongs to the Special Issue Post-Pandemic Challenges: Endemic COVID-19, Vaccine Hesitancy, and Viral Resurgence)

14 pages, 1545 KB

Open AccessArticle

Hospitalization Free-Survival, Adverse Drug Reactions, and Retention in Care Outcomes of an Outpatient Treatment Model for Cryptococcal Meningitis in PLWH in Maputo, Mozambique

by Maria Ruano Camps, Aleny Couto, Irénio Gaspar, Eudoxia Filipe, Idilia Nhamtumbo, Luis Armando, Gil Muvale, Ana Gabriela Gutierrez Zamudio, Rosa Bene, Jeff Lane, Florindo Mudender and Edy Nacarapa

Trop. Med. Infect. Dis. 2026, 11(2), 48; https://doi.org/10.3390/tropicalmed11020048 - 10 Feb 2026

Abstract

Background: Cryptococcal meningitis (CM) remains a leading cause of mortality among people with advanced HIV disease (AHD) in sub-Saharan Africa. Current guidelines recommend induction therapy with amphotericin B and flucytosine, typically administered in an inpatient setting due to concerns over severe clinical presentation [...] Read more.

Background: Cryptococcal meningitis (CM) remains a leading cause of mortality among people with advanced HIV disease (AHD) in sub-Saharan Africa. Current guidelines recommend induction therapy with amphotericin B and flucytosine, typically administered in an inpatient setting due to concerns over severe clinical presentation and drug-related toxicities. This requirement poses a significant burden on resource-limited health systems. We evaluated the real-world outcomes of a fully outpatient model for CM therapy in Maputo, Mozambique. Methods: A longitudinal retrospective cohort study was conducted at the Centro de Referência de Alto-Maé (CRAM), a specialized AHD outpatient clinic. We included 83 PLWH with laboratory-confirmed CM treated between October 2020 and December 2024. The primary outcome was hospitalization-free survival (HFS) within the first 10 weeks of treatment. Secondary outcomes included the frequency and severity of adverse drug reactions (ADRs), analysed by tracking haemoglobin (Hgb), potassium (K+), and creatinine (Creat) levels on days 1, 3, and 7 of induction therapy, and retention in care (RIC) at 6, 12, and 24 months. Statistical analyses included Kaplan–Meier survival estimates and paired t-tests. Results: The median age was 37 years (IQR: 27–42), 63.9% were male, and the median CD4 count was 62 cells/µL (IQR: 27–105). Most patients (95.2%) were symptomatic at presentation, and 56.6% had concurrent tuberculosis. For the 52 patients who completed the full induction protocol at CRAM, the HFS rate at 10 weeks was 84.6% (44/52), with an overall survival of 90.4% (47/52). ADR analysis (n = 52) showed a predictable pattern of mild, manageable toxicity: a significant decline in Hgb (11.2 ± 1.8 to 10.6 ± 2.0 g/dL, p < 0.001) and K+ (4.27 ± 0.66 to 3.86 ± 0.78 mmol/L, p = 0.008), and a transient increase in Creat (0.83 ± 0.42 to 1.13 ± 0.64 mg/dL, p = 0.001) from day 1 to day 3, with stabilization or a trend toward recovery by day 7. No significant differences in ADRs were found between single-dose (47%) and multiple-dose (53%) L-AmB regimens. RIC for the entire cohort (n = 83) was high at 81.9% at 6 months, declining to 74.0% at 12 months and 70.4% at 24 months. Conclusions: An ambulatory model for CM therapy is feasible and effective in a resource-limited setting, demonstrating high hospitalization-free survival, manageable and reversible adverse drug reactions, and excellent medium-term retention in care. These findings suggest potential benefits and provide support for re-evaluating the standard of inpatient care. They indicate that integrating outpatient CM management into advanced HIV disease (AHD) care packages could help alleviate health system burdens and may contribute to improved patient outcomes. Full article

(This article belongs to the Special Issue Innovative Approaches to Combat Infectious Diseases in Low and Middle Income Countries (LMICs): Epidemiology, Diagnosis, and Interventions)

► Show Figures

Figure 1

17 pages, 788 KB

Open AccessArticle

A Randomised, Parallel-Group Study to Compare the Efficacy of 3% Phenothrin-Containing Jigger Lotion Versus Potassium Permanganate for Treatment of Tungiasis in Vihiga County, Kenya

by Kana Suzuki, Asiko Ongaya, Evans Amukoye and Yasuhiko Kamiya

Trop. Med. Infect. Dis. 2026, 11(2), 47; https://doi.org/10.3390/tropicalmed11020047 - 9 Feb 2026

Abstract

Tungiasis, caused by the sand flea Tunga penetrans, results in itching and pain. Effective treatments, such as dimeticones, are often unaffordable. A 3% phenothrin lotion has shown safety and efficacy in Kenyan trials. This study compared the cure rate and safety of [...] Read more.

Tungiasis, caused by the sand flea Tunga penetrans, results in itching and pain. Effective treatments, such as dimeticones, are often unaffordable. A 3% phenothrin lotion has shown safety and efficacy in Kenyan trials. This study compared the cure rate and safety of 3% phenothrin lotion (as the intervention) and 0.05% potassium permanganate (KMnO₄; as the standard-care comparator) over 14 days. This parallel-group, three-arm, non-blinded, randomised comparative trial was conducted in Vihiga County, Kenya. Participants aged ≥2 years with ≥1 viable flea on each foot were allocated (2:1:1) to KMnO₄, single-dose 3% phenothrin, or two-dose 3% phenothrin groups. Overall, 415 fleas from 79 participants were followed up to day 14 (KMnO₄, 213; single-dose, 129; two-dose, 73). On days 4 and 7, the single-dose phenothrin showed significantly higher cure rates (11.6% and 21.7%) than KMnO₄ (0.9% and 11.7%) (p < 0.001 and p = 0.013). The differences diminished by days 10 and 14 because of spontaneous flea death. The cure rate of the two-dose group on day-7 (8.2%) was lower than that of the single-dose group. Single-dose 3% phenothrin improved early cure rates compared to KMnO₄, but not by days 10–14; two-dose phenothrin showed no benefit compared with single dose from day 7 onwards. Full article

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

► Show Figures

Figure 1

8 pages, 217 KB

Open AccessArticle

There Is No Association Between Loiasis and Malaria: Findings from a Secondary Analysis of a Cross-Sectional Survey in Rural Gabon

by Jacob Werner, Rella Zoleko-Manego, Ghyslain Mombo-Ngoma, Michael Ramharter and Johannes Mischlinger

Trop. Med. Infect. Dis. 2026, 11(2), 46; https://doi.org/10.3390/tropicalmed11020046 - 7 Feb 2026

Abstract

Loiasis exists in regions where malaria is highly endemic, yet few studies have investigated their association as concomitant infectious diseases. Secondary data analysis from a cross-sectional survey conducted in Gabon (2015–2016) was performed to assess the association between malaria and loiasis. A total [...] Read more.

Loiasis exists in regions where malaria is highly endemic, yet few studies have investigated their association as concomitant infectious diseases. Secondary data analysis from a cross-sectional survey conducted in Gabon (2015–2016) was performed to assess the association between malaria and loiasis. A total of 947 participants of all ages were enrolled in the original study. In crude analyses, malaria showed a seemingly protective association with loiasis, manifesting in an odds ratio (OR) of 0.67 (95% CI: 0.45 to 1.01; p = 0.0521). This borderline association disappeared completely after adjustment for confounders (adjusted OR: 1.31; 95% CI: 0.81 to 2.11; p = 0.276), particularly age. The apparent crude protective association is therefore likely explained by the different epidemiological distribution of both diseases according to age rather than a true biological interaction. Malaria predominantly occurred in children and loiasis mainly in older individuals. Findings of this study do not support an association between malaria and loiasis in this setting. Full article

(This article belongs to the Special Issue Innovative Approaches to Combat Infectious Diseases in Low and Middle Income Countries (LMICs): Epidemiology, Diagnosis, and Interventions)

14 pages, 7437 KB

Open AccessArticle

Spatial Dynamics and Sterilization Range of Incompatible Aedes albopictus Males: Advancing Toward an Optimized IIT Approach

by Elena Lampazzi, Chiara Virgillito, Beniamino Caputo, Giulia Lombardi, Greta Santarelli, Riccardo Moretti and Maurizio Calvitti

Trop. Med. Infect. Dis. 2026, 11(2), 45; https://doi.org/10.3390/tropicalmed11020045 - 6 Feb 2026

Abstract

The Incompatible Insect Technique (IIT) is a species-specific, eco-friendly mosquito control method that relies on releasing Wolbachia-infected males, which induce cytoplasmic incompatibility (CI), rendering eggs inviable when mating with wild females. Aiming at optimizing IIT protocols in terms of cost-effectiveness, data on [...] Read more.

The Incompatible Insect Technique (IIT) is a species-specific, eco-friendly mosquito control method that relies on releasing Wolbachia-infected males, which induce cytoplasmic incompatibility (CI), rendering eggs inviable when mating with wild females. Aiming at optimizing IIT protocols in terms of cost-effectiveness, data on incompatible male dispersal and survival and the distance- and time-related impact of induced sterility are fundamental. This study plans to fill this gap and reports findings from a two-year field trial (2022–2023) at the ENEA-Casaccia Research Center, based on single-spot releases of incompatible Aedes albopictus males (ARwP strain). Male releases were carried out in late September 2022 (~15,000 released males) and the early Ae. albopictus season (at the end of June 2023; ~24,000 released males). Fifty-eight ovitraps were located at a 20–900 m distance from the ARwP release spot and were monitored weekly from May to November to assess egg hatching rates and measure CI effects in relation to both distance and time. Following the 2023 release, samples of adults were collected at increasing distances from the release site and at multiple post-release time points to assess, individually, wild female fertility and ARwP male dispersal and survival using Wolbachia as a genetic marker. Statistical analyses revealed that: (a) the highest reduction in the egg hatching was found within 100 m from the release spot (46.5% and 19.9%, respectively, in 2022 and 2023) but remained significant even at greater distances (29.9% and 7.7% at 300 m, respectively, in 2022 and 2023); (b) accordingly, the highest reduction in the wild female fertility occurred within 100 m from the release spot (47.3%), but similar effects were recognizable up to 600 m; (c) the overflooding ratio of the ARwP males did not significantly differ between 3 and 11 days after the release, with ARwP males remaining active up to 18 days and dispersing as far as 400 m. These results demonstrate the potential of localized, non-inundative IIT trials to furnish clues for the setup of spatially optimized release strategies, especially in scaled-up applications. The study also emphasizes the need for standardized assessment tools and further research regarding environmental and behavioral factors influencing long-term suppression outcomes. Full article

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

► Show Figures

Figure 1

18 pages, 5321 KB

Open AccessArticle

Comparative Analysis of Next- and Third-Generation Sequencing Platforms for Chikungunya Virus Whole-Genome Sequencing Using a Lineage-Inclusive Primer Set During the 2025 Foshan Outbreak

by Penghui Jia, Xiao Cong, Chang Zhang, Zhe Liu, Xiaofang Peng, Juan Su, Qiqi Tan, Shen Huang, Changyun Sun, Xin Zhang and Baisheng Li

Trop. Med. Infect. Dis. 2026, 11(2), 44; https://doi.org/10.3390/tropicalmed11020044 - 5 Feb 2026

Abstract

Chikungunya virus (CHIKV) poses an increasing global public health threat, as evidenced by the significant 2025 Foshan outbreak in China. Rapid, whole-genome sequencing (WGS) is critical for outbreak response but is challenged by primer mismatches across diverse lineages and a lack of direct [...] Read more.

Chikungunya virus (CHIKV) poses an increasing global public health threat, as evidenced by the significant 2025 Foshan outbreak in China. Rapid, whole-genome sequencing (WGS) is critical for outbreak response but is challenged by primer mismatches across diverse lineages and a lack of direct sequencing platform comparisons. To address this, we developed a novel lineage-inclusive primer set and performed parallel WGS on 24 clinical samples from the outbreak using both Illumina (NGS) and Oxford Nanopore Technologies (TGS) platforms. Our lineage-inclusive primer set successfully amplified full-length CHIKV genomes across all samples. Comparisons revealed that Illumina NGS provided higher raw read accuracy, while Nanopore TGS achieved more complete coverage of terminal UTRs with a faster turnaround time. Crucially, after polishing, variant calls between the two platforms were 100% concordant. Phylogenetic analysis was consistent with a single introduction event, with all outbreak isolates forming a monophyletic clade within the ECSA lineage most closely related to contemporaneous strains from Réunion Island. This study validates a lineage-inclusive amplicon-based sequencing strategy and demonstrates that NGS and TGS offer complementary advantages. When integrated, they provide a robust framework for real-time genomic surveillance, enhancing preparedness and guiding public health interventions against CHIKV. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

16 pages, 2763 KB

Open AccessArticle

Global, Regional, and National Burden of Tuberculosis Among Children: A Population-Based Study

by Leiwen Fu, Ke Liu, Yuxian Sun, Wei Shu, Yujia Ning, Yang Liu, Jian Du and Liang Li

Trop. Med. Infect. Dis. 2026, 11(2), 43; https://doi.org/10.3390/tropicalmed11020043 - 5 Feb 2026

Abstract

Background: Tuberculosis remains a major global public health challenge, particularly among children. This study aims to provide a comprehensive assessment of the global, regional, and national burden of tuberculosis among children (0–14 years) using data from the Global Burden of Disease (GBD) 2021 [...] Read more.

Background: Tuberculosis remains a major global public health challenge, particularly among children. This study aims to provide a comprehensive assessment of the global, regional, and national burden of tuberculosis among children (0–14 years) using data from the Global Burden of Disease (GBD) 2021 study. Methods: Data on the incidence of tuberculosis (drug-susceptible, MDR-TB, and XDR-TB), as well as disability-adjusted life years (DALYs), among children aged 0–14 years in 204 countries and territories from 1990 to 2021 were obtained from the GBD 2021 study. Estimated annual percentage changes (EAPCs) in age-standardised incidence rates (ASIRs) and DALY rate were calculated overall and stratified by age, sex, and sociodemographic index (SDI) to quantify temporal trends. Spearman correlation analyses were performed to assess associations between tuberculosis burden and SDI. Results: In 2021, there were an estimated 759,300 new tuberculosis cases (ASIR: 37.7 per 100,000 population) among children globally, including 32,515 cases of MDR-TB (ASIR: 1.6) and 1193 cases of XDR-TB (ASIR: 0.1). Both global ASIR and DALY rate exhibited a declining trend from 1990 to 2021, with EAPC of −2.61% (95%CI: −2.74 to −2.47) and −4.38% (−4.61 to −4.14), respectively. From 1990 to 2021, High-income North America was the only GBD region with an increasing ASIR for tuberculosis (EAPC = 1.12, 95% CI: 0.61 to 1.64). From 1990 to 2021, there was no significant change in ASIR of MDR-TB (EAPC = 1.18, 95% CI: −0.16 to 2.54). However, eight of the 21 GBD regions exhibited increasing trends in the ASIR of MDR-TB, with the largest increase observed in Oceania (11.99, 10.49 to 13.52), followed by Central Asia (9.76, 6.48 to 13.13) and South Asia (5.71, 3.10 to 8.38). A strong negative correlation was observed between tuberculosis burden and SDI, with the highest disease burden concentrated in low-SDI regions. Conclusions: Achieving elimination targets will require stronger diagnostics and treatment for childhood tuberculosis, alongside reduced transmission, improved infection detection, and preventive therapy for exposed children, especially those under 5 years. Full article

(This article belongs to the Special Issue Tuberculosis in Special Populations: Epidemiology and Evidence-Based Interventions)

► Show Figures

Figure 1

11 pages, 5584 KB

Open AccessArticle

Physicochemical Properties of Anopheles Mosquito Larval Habitats in Nouakchott, Mauritania

by Mohamed Haidy Massa, Osman Abdillahi Guedi, Nicolas Gomez, Ali Ould Mohamed Salem Boukhary, Sébastien Briolant and Mohamed Aly Ould Lemrabott

Trop. Med. Infect. Dis. 2026, 11(2), 42; https://doi.org/10.3390/tropicalmed11020042 - 3 Feb 2026

Abstract

Malaria remains one of the main public health problems in Mauritania, and it is essential to identify the factors that determine the distribution and productivity of Anopheles breeding sites in order to develop more effective control strategies. A longitudinal survey with repeated measurements [...] Read more.

Malaria remains one of the main public health problems in Mauritania, and it is essential to identify the factors that determine the distribution and productivity of Anopheles breeding sites in order to develop more effective control strategies. A longitudinal survey with repeated measurements was conducted in Nouakchott between May 2023 and April 2024, in order to examine the factors influencing the distribution and productivity of Anopheles larval habitats. The larvae were collected by immersion in 60 water points, once a month during the dry season and twice a month during the rainy season, for a total of 294 observations. The physical and chemical characteristics of the sites were also measured. Logistic regression analyses with random effects showed that the presence of Culex and Aedes larvae, pH, and temperature were statistically significantly associated with positive water collection for Anopheles larvae (aOR = 3.03, 95%CI [1.14–8.07], p-value = 0.026; aOR = 0.18, 95%CI [0.05–0.60], p-value = 0.006; aOR = 3.17, 95%CI [1.32–7.61], p-value = 0.010 and aOR = 5.95, 95%CI [2.09–16.92], p-value < 0.001, respectively). Only Anopheles multicolor and An. arabiensis were present in Nouakchott. Our results could help health authorities by guiding the destruction of breeding sites with biological larvicides or physical elimination of peridomestic habitats. Full article

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

► Show Figures

Figure 1

16 pages, 1782 KB

Open AccessArticle

In Vitro Antiviral Activity of Red Algae Extracts from Chondracanthus teedei var. lusitanicus and Osmundea pinnatifida Against Coxsackievirus A12 and a Lentiviral Vector

by Nanci Santos-Ferreira, Clévio Nóbrega, Marta Mota, Luís Pereira de Almeida, Leonel Pereira, Teresa Gonçalves and Célia Nogueira

Trop. Med. Infect. Dis. 2026, 11(2), 41; https://doi.org/10.3390/tropicalmed11020041 - 31 Jan 2026

Abstract

Infectious diseases remain a major global health challenge, underscoring the need for safe and accessible antiviral therapies. Natural products, particularly marine macroalgae, are promising sources of bioactive compounds with antiviral properties. This study evaluated the antiviral activity of extracts from two red algae [...] Read more.

Infectious diseases remain a major global health challenge, underscoring the need for safe and accessible antiviral therapies. Natural products, particularly marine macroalgae, are promising sources of bioactive compounds with antiviral properties. This study evaluated the antiviral activity of extracts from two red algae collected along the Portuguese coast: two life stages (tetrasporophyte and female gametophyte) of Chondracanthus teedei var. lusitanicus and the algae Osmundea pinnatifida. Antiviral effects were assessed against Coxsackievirus A12 (CVA12) and a lentivirus (LV) vector model. Extracts from both algae inhibited viral replication in vitro at non-cytotoxic concentrations. The tetrasporophyte extract of C. teedei exhibited virucidal activity against CVA12, and the results are consistent with interference with multiple stages of the viral life cycle, while also inducing an antiviral state in HEK-293T cells against LV infection. The female gametophyte extract affected early stages of CVA12 and LV infection and showed potential virucidal activity. O. pinnatifida demonstrated the strongest antiviral effects against both viruses. These findings highlight the antiviral potential of these red algal extracts and warrant further in vivo evaluation. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

14 pages, 1011 KB

Open AccessArticle

AI-Assisted Differentiation of Dengue and Chikungunya Using Big, Imbalanced Epidemiological Data

by Thanh Huy Nguyen and Nguyen Quoc Khanh Le

Trop. Med. Infect. Dis. 2026, 11(2), 40; https://doi.org/10.3390/tropicalmed11020040 - 30 Jan 2026

Abstract

Dengue and chikungunya are endemic arboviral diseases in many low- and middle-income countries, often co-circulating and presenting with overlapping symptoms that hinder early diagnosis. Timely differentiation is critical, especially in resource-limited settings where laboratory testing is unavailable. We developed and evaluated machine-learning (ML)- [...] Read more.

Dengue and chikungunya are endemic arboviral diseases in many low- and middle-income countries, often co-circulating and presenting with overlapping symptoms that hinder early diagnosis. Timely differentiation is critical, especially in resource-limited settings where laboratory testing is unavailable. We developed and evaluated machine-learning (ML)- and deep-learning (DL) models to classify dengue, chikungunya, and discarded cases using a large-scale, real-world dataset of over 6.7 million entries from Brazil (2013–2020). After applying the Synthetic Minority Oversampling Technique (SMOTE) to address class imbalance, we trained six ML models and one artificial neural network (ANN) using only demographic, clinical, and comorbidity features. The Random Forest model achieved strong multi-class classification performance (Recall: 0.9288, the Area Under the Curve (AUC): 0.9865). The ANN model excelled in identifying chikungunya cases (Recall: 0.9986, AUC: 0.9283), suggesting its suitability for rapid screening. External validation confirmed the generalizability of our models, particularly for distinguishing discarded cases. Our models demonstrate high-accuracy in differentiating dengue and chikungunya using routinely collected clinical and epidemiological data. This work supports the development of Artificial Intelligence-powered decision-support tools to assist frontline healthcare workers in under-resourced settings and aligns with the One Health approach to improving surveillance and diagnosis of neglected tropical diseases. Full article

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

► Show Figures

Figure 1

14 pages, 3636 KB

Open AccessArticle

Seasonal Dynamics Versus Vertical Stratification of Mosquitoes (Diptera: Culicidae) in an Atlantic Forest Remnant, Brazil: A Focus on the Mansoniini Tribe

by Cecília Ferreira de Mello, Wellington Thadeu de Alcantara Azevedo, Shayenne Olsson Freitas Silva, Samara Campos Alves and Jeronimo Alencar

Trop. Med. Infect. Dis. 2026, 11(2), 39; https://doi.org/10.3390/tropicalmed11020039 - 30 Jan 2026

Abstract

Mosquitoes (Diptera: Culicidae) exhibit vertical stratification patterns in forest environments, a fundamental ecological aspect for understanding niche occupation patterns, host-seeking behavior, and consequently arbovirus transmission mechanisms. Despite the relevance of this topic, available studies mostly focus on genera such as Aedes, Haemagogus [...] Read more.

Mosquitoes (Diptera: Culicidae) exhibit vertical stratification patterns in forest environments, a fundamental ecological aspect for understanding niche occupation patterns, host-seeking behavior, and consequently arbovirus transmission mechanisms. Despite the relevance of this topic, available studies mostly focus on genera such as Aedes, Haemagogus, and Sabethes which are traditionally associated with arbovirus transmission. There are still important gaps regarding stratification and seasonality in the Mansoniini tribe, whose biology and epidemiological role remain underexplored, especially in highly biodiverse ecosystems such as the Atlantic Forest. This study evaluated the influence of seasonality and vertical stratification on the mosquito community, with a detailed focus on the Mansoniini tribe, in an Atlantic Forest fragment in Brazil, between May 2023 and December 2024. Captures were performed monthly using CDC light traps positioned at 1.5 m and 10 m heights, and specimens were morphologically identified. A total of 880 mosquitoes from nine genera and 24 species were captured, of which 91 (10.3%) belonged to the Mansoniini tribe. The most abundant species were Coquillettidia fasciolata and Mansonia titillans, recorded in both strata. Our results indicate no marked vertical segregation for the studied mosquito community in this specific location, but a strong influence of seasonality, particularly for the Mansoniini tribe, reinforcing the role of meteorological data on the population structure of these species. These site-specific findings offer a foundational ecological portrait and a robust methodological template for a neglected taxon. They generate critical, testable hypotheses about niche partitioning in fragmented forests and underscore the necessity for broader spatial replication to disentangle the relative influence of seasonal versus vertical drivers in similar ecosystems. Full article

(This article belongs to the Special Issue Emerging Vector-Borne Diseases and Public Health Challenges)

► Show Figures

Figure 1

14 pages, 509 KB

Open AccessArticle

Low Bone Mineral Density in Men Living with HIV on Tenofovir Antiretroviral Therapy: A Cross-Sectional Exploratory Study from a Malaysian Tertiary Hospital

by Muhamad Riduan Daud, Petrick Periyasamy, Kok-Yong Chin, Najma Kori, Ummu Afeera Zainulabid, Sheng Qian Yew, Nur Ezzaty Mohammad Kazmin and Xiong Khee Cheong

Trop. Med. Infect. Dis. 2026, 11(2), 38; https://doi.org/10.3390/tropicalmed11020038 - 29 Jan 2026

Abstract

Background and objectives: Low bone mineral density (BMD) is a recognized complication in people living with HIV (PLHIV) that remains under-addressed, particularly in Malaysia. Known contributing factors for low BMD include advanced age, HIV infection itself, and prolonged use of anti-retroviral therapy (ART), [...] Read more.

Background and objectives: Low bone mineral density (BMD) is a recognized complication in people living with HIV (PLHIV) that remains under-addressed, particularly in Malaysia. Known contributing factors for low BMD include advanced age, HIV infection itself, and prolonged use of anti-retroviral therapy (ART), particularly tenofovir-based regimens. There are limited data on the burden of low BMD in the HIV population in Malaysia. This study aimed to determine the prevalence of low BMD among men living with HIV on tenofovir disoproxil fumarate (TDF) and to identify the possible associated factors compared to a group of healthy individuals matched for age and ethnicity. Methods: This is single-center cross-sectional study involved 112 men (56 HIV-positive individuals and 56 uninfected individuals matched for age and ethnicity) who underwent dual-energy X-ray absorptiometry (DXA) scans of the femoral neck and lumbar spine. Sociodemographic, clinical lifestyle, and laboratory data, including FRAX scores for those aged more than 40 years old, were collected. Results: The prevalence of low BMD at the femoral neck in HIV-infected men on tenofovir disoproxil fumarate was significantly higher compared to healthy individuals (32.1% vs. 16.1%; p < 0.05). Low BMD prevalence at the lumbar spine was higher in the HIV group (8.9% vs. 3.6%; p = 0.463) but was not statistically significant. Older age and low body mass index (BMI) were found to be significantly associated with reduced BMD in HIV patients. Chronic kidney disease stage 2 and 3a was linked with low femoral neck BMD. HIV-related factors (duration of illness, duration of ART exposure, and CD4+ counts) showed no significant associations to low BMD. The 10-year risk of major osteoporotic and hip fractures estimated by the FRAX tool was low in both groups, and no participant exceeded the recommended intervention threshold. Conclusions: Men with HIV on tenofovir disoproxil fumarate have a higher prevalence of low BMD, particularly at the femoral neck. Traditional risk factors were more closely associated with low BMD compared to HIV-related factors and specific markers, supporting the need for routine bone health screening and preventive strategies in this population. Full article

(This article belongs to the Special Issue HIV Testing and Antiretroviral Therapy)

► Show Figures

Figure 1

12 pages, 732 KB

Open AccessPerspective

Reframing TB Care: A Perspective on Multimorbidity-Centered Care for People with TB

by Alexa Tabackman, Sadie Cowan, Claire Calderwood and Pranay Sinha

Trop. Med. Infect. Dis. 2026, 11(2), 37; https://doi.org/10.3390/tropicalmed11020037 - 29 Jan 2026

Abstract

Tuberculosis (TB) rarely occurs in isolation; most people with TB experience multiple coexisting conditions, including HIV, diabetes, undernutrition, depression, and substance use disorders, which worsen disease severity and compromise treatment outcomes. Although the World Health Organization has issued disease-specific guidance for managing key [...] Read more.

Tuberculosis (TB) rarely occurs in isolation; most people with TB experience multiple coexisting conditions, including HIV, diabetes, undernutrition, depression, and substance use disorders, which worsen disease severity and compromise treatment outcomes. Although the World Health Organization has issued disease-specific guidance for managing key comorbidities, TB care remains largely siloed and poorly equipped to address the growing burden of multimorbidity, particularly in African health systems. In this perspective article, we propose a phased framework for multimorbidity-centered TB care. The first phase emphasizes systematic screening for common comorbidities and establishment of basic referral pathways. The second phase focuses on strengthening coordination between TB programs and existing health and social services, including task sharing and longitudinal follow-up. The third phase advances toward fully integrated, co-located, multidisciplinary models of care that embed TB services within broader multimorbidity platforms. Together, this framework offers a pragmatic roadmap for TB programs to deliver more person-centered, equitable, and efficient care, strengthen primary care systems, and accelerate progress toward ending TB as a public health threat in Africa. Full article

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

► Show Figures

Figure 1

13 pages, 1058 KB

Open AccessArticle

AI-Driven Tuberculosis Hotspot Mapping to Optimize Active Case-Finding: Implementing the Epi-Control Platform in Uganda

by Geofrey Amanya, Sumbul Hashmi, Jessica Sarah Stow, Philip Tumwesigye, Bernadette Nkhata, Kelvin Roland Mubiru, Anne-Laure Budts, Matthys Gerhardus Potgieter, Seyoum Dejene Balcha, Muzamiru Bamuloba, Andiswa Zitho, Luzze Henry, Mary G. Nabukenya-Mudiope and Caroline Van Cauwelaert

Trop. Med. Infect. Dis. 2026, 11(2), 36; https://doi.org/10.3390/tropicalmed11020036 - 28 Jan 2026

Abstract

Tuberculosis remains a major public health concern in Uganda, one among the thirty high TB burden countries globally. Despite national progress, gaps persist due to asymptomatic disease, diagnostic limitations, and uneven access to healthcare within the country. This study implemented the Epi-control platform, [...] Read more.

Tuberculosis remains a major public health concern in Uganda, one among the thirty high TB burden countries globally. Despite national progress, gaps persist due to asymptomatic disease, diagnostic limitations, and uneven access to healthcare within the country. This study implemented the Epi-control platform, an AI-driven predictive modelling tool, to predict community-level hotspots and support data-driven active case-finding (ACF). Using retrospective chest X-ray screening data, we integrated demographic, environmental, and human development indicators from open-source databases to model TB risk at sub-parish level. A proprietary Bayesian modelling framework was deployed and validated by comparing TB yields between predicted hotspots and non-hotspot locations. Across Uganda, the model identified significantly higher TB yields in hotspot areas (risk ratio = 1.69, 95% CI 1.41–2.02; p < 0.001). The Central and Western regions showed the highest concentrations of hotspots, consistent with their population density and urbanization patterns. The results show that the model prioritized areas with higher observed ACF yield in this retrospective dataset, supporting its potential operational use for screening prioritization under similar implementation conditions. The results demonstrate that AI-based predictive modelling can enhance the efficiency of ACF by targeting high-risk areas for screening. Integrating such predictive tools within national TB programmes may support screening planning and resource prioritization; prospective evaluation and external validation are needed to assess generalisability and incremental impact. Full article

(This article belongs to the Special Issue Integrating Data-Driven Insights into Mathematical Modeling of Infectious Diseases)

► Show Figures

Figure 1

12 pages, 598 KB

Open AccessArticle

Laboratory-Based Surveillance and Genetic Diversity of Enteric Adenovirus Among Children in Argentina, 2022–2024

by Juan Ignacio Degiuseppe, Paula Mabel Moron, Christian Barrios Mathieur and Argentinean Surveillance Network for Viral Gastroenteritis

Trop. Med. Infect. Dis. 2026, 11(2), 35; https://doi.org/10.3390/tropicalmed11020035 - 25 Jan 2026

Abstract

Enteric adenoviruses are recognized causes of pediatric acute gastroenteritis, yet national-level data on their epidemiology and genetic diversity in Argentina remain limited. This study aimed to describe the laboratory-based surveillance of enteric adenoviruses and to characterize the circulating genotypes among children during the [...] Read more.

Enteric adenoviruses are recognized causes of pediatric acute gastroenteritis, yet national-level data on their epidemiology and genetic diversity in Argentina remain limited. This study aimed to describe the laboratory-based surveillance of enteric adenoviruses and to characterize the circulating genotypes among children during the 2022–2024 period. Data were obtained from the Argentine National Health Surveillance System, including weekly aggregated reports of adenovirus testing results from clinical laboratories nationwide. Detection frequencies were analyzed by year, age group, clinical setting, geographic region, and epidemiological week. Molecular characterization was performed using partial hexon gene sequencing. A total of 22,826 stool samples were tested, of which 1530 (6.7%) were positive for adenovirus, with no significant differences in positivity across years. Detection rates were highest among children under 1 year of age and were consistently greater in outpatient and emergency department settings compared with hospitalized patients. No clear seasonal pattern was observed. Genotyping revealed a predominance of HAdV-F41, with sporadic detection of non-enteric adenovirus types. These findings provide the first nationwide overview of enteric adenovirus circulation and genetic diversity in Argentina, highlighting stable transmission patterns and supporting the value of sustained laboratory surveillance to better characterize viral gastroenteritis etiology in the post-rotavirus vaccination era. Full article

(This article belongs to the Special Issue Viral Enteropathogens in Pediatric Populations)

► Show Figures

Figure 1

Journal Description

Tropical Medicine and Infectious Disease

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI