Search Results (9,836)

Introduction: Catheter-associated urinary tract infections (CAUTIs) caused by multidrug-resistant (MDR) uropathogens pose a management challenge due to bacterial biofilm formation and crystalline encrustation, especially those associated with Proteus mirabilis, which result in persistent infections and catheter obstructions. Current catheter surface coatings against CAUTIs target either the initial stages or later phases of such pathologies separately. Aim: We report the design and characterization of a novel polyfunctional coating comprised of polydopamine (PDA), genipin-crosslinked chitosan (GCS), and ZnO nanoparticles capable of blocking bacterial attachment, biofilm formation, and mineral encrustation. Methods: PDA-coated silicon surfaces were functionalized with genipin-crosslinked GCS/ZnO nanocomposites and studied by means of TEM, XRD, FTIR, SEM, AFM, water contact angle measurements, and zinc ion release tests. Antibacterial, antibiofilm, anti-encrustation, and hemocompatibility activities were then assessed. Results: ZnO nanoparticles were spherical, with an average particle size of 34.6 ± 8.2 nm and a highly crystalline hexagonal wurtzite structure. Coatings containing ZnO nanoparticles retained hydrophilic surface properties and released Zn²⁺ ions steadily. The G5 coating (containing 0.2% ZnO) demonstrated an ability to decrease bacterial adherence by >4 log₁₀ CFU, lower biofilm biomass by 80–90% (p < 0.001), prevent mineral deposition by 67–70% caused by Proteus mirabilis, and keep catheter patency for 14 days. Hemolysis was within the ISO 10993-4 acceptance criteria. Conclusions: A rationally designed combination of PDA, genipin-crosslinked GCS, and ZnO nanoparticles provided a multifunctional coating with potent antibacterial, antibiofilm, anti-encrustation, and initial hemocompatibility activity, serving as a proof-of-concept platform for further cytotoxicity assessment, mechanical durability studies, and preclinical evaluations prior to clinical implementation. Full article

Neonatal infections remain a major global health challenge because of antimicrobial resistance, biofilm-associated persistence, and limited antiviral therapies. This study evaluated the antimicrobial, antibiofilm, in vivo efficacy, and antiviral activities of Brazilian red propolis (BRP) and Brazilian green propolis from the “Caatinga” biome (BGP-C) against pathogens associated with neonatal infections. Antimicrobial activity was determined by broth microdilution, whereas antibiofilm activity was assessed through biofilm biomass and metabolic activity inhibition and structural alterations were evaluated by fluorescence microscopy, and scanning electron microscopy. In vivo efficacy was assessed in a Caenorhabditis elegans infection model, and antiviral activity was investigated against Zika virus (ZIKV, PE243 strain). Both extracts exhibited antibacterial activity, mainly against Gram-positive bacteria, with minimum inhibitory concentrations of 6.25–400 µg/mL and minimum bactericidal concentrations of 25 to >400 µg/mL. MBIC₅₀ and IC₅₀ values ranged from 1.56–400 µg/mL and 0.64–163 µg/mL, respectively. Microscopy findings suggested reduced cell viability and compromised membrane integrity, together with biofilm disorganization. BRP consistently increased nematode survival across the infection models in which it was tested, whereas BGP-C showed no consistent protective effect. Under non-cytotoxic conditions, BRP and BGP-C reduced ZIKV infectivity by approximately 34% and 40%, respectively. These findings support the antimicrobial and antiviral potential of both extracts, while BRP demonstrated more consistent in vivo efficacy. Full article

(1) Background: The available literature on sexually transmitted infections in patients with genital molluscum contagiosum is limited. In this study, we aimed to evaluate the serological test results and screening rate for sexually transmitted infections, including human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis, among patients with genital molluscum contagiosum. (2) Methods: In this retrospective cross-sectional study, we reviewed the medical records of patients aged ≥18 years diagnosed with genital molluscum contagiosum at our dermatology outpatient clinic between October 2016 and December 2025. Age, sex, and serological test results for anti-human immunodeficiency virus, hepatitis B surface antigen, anti-hepatitis C virus, and Venereal Disease Research Laboratory/Rapid Plasma Reagin were recorded. (3) Results: Serological screening was performed in 202 of 528 patients (38.3%), and 11 (5.45%) had positive test results for at least one sexually transmitted infection. (4) Conclusions: Our findings support routine screening for sexually transmitted infections in patients with genital molluscum contagiosum, given that a substantial proportion of these patients do not undergo serological screening. Full article

Prion diseases are invariably fatal neurodegenerative disorders characterized by the conformational conversion of the host-encoded prion protein (PrP^C) into its misfolded, pathogenic isoform (PrP^Sc). Unlike conventional infectious agents such as viruses, prions lack nucleic acids, leading to the long-held assumption that they escape immune surveillance. Accumulating evidence, however, challenges this view and implicates the innate immune system in shaping prion pathogenesis. Yet, the underlying molecular mechanisms remain incompletely defined. Among innate immune pathways, our studies have implicated type I interferons (I-IFN), traditionally recognized as antiviral mediators, in the regulation of prion propagation and disease progression. We demonstrated that IRF3, a central transcriptional activator of I-IFN, restricts prion propagation and delays the onset of disease. Moreover, I-IFN itself enhances cellular resistance to prion infection in both in vitro and in vivo systems. Our recent work identified 2′-5′-oligoadenylate synthetase 1A (Oas1a), a downstream effector induced by I-IFN, as a mediator of noncanonical anti-prion activity. Genetic deletion of Oas1a increases susceptibility to prion infection, whereas recombinant Oas1a or enforced expression of Oas1a restores resistance. Oas1a blocks prion propagation by directly binding to PrP^C and interfering with its conversion into PrP^Sc. This protective activity depends on Oas1a oligomerization, but not on its canonical 2′-5′-oligoadenylate synthetase activity. Collectively, these findings support a model in which the IRF3–I-IFN–Oas1a axis contributes to host defense against prion infection, at least in the experimental systems examined to date. In this review, we highlight current evidence for the involvement of this axis in innate immune responses to prion infection and discuss its mechanistic and potential therapeutic implications. Full article

Mycoplasma pneumoniae pneumonia (MPP) is driven by excessive host immune responses and metabolic dysregulation, yet its systemic pathogenesis remains poorly understood. Here, we established a murine MPP via MP (1 × 10⁸ CCU/mL), which faithfully recapitulates clinical features, including interstitial pneumonia, elevated pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), and increased alveolar macrophage abundance. Integrating lung transcriptomics and metabolomics, we found that MP infection activates pro-inflammatory cytokines (e.g., cytokine–cytokine receptor interaction, Th17 differentiation, NF-κB signaling) while disrupting fatty acid metabolism. Correlative analyses revealed that downregulated 3′-AMP and CMP-Neu5Ac correlated with elevated pro-inflammatory IL-18/IL-33, whereas upregulated 4-imidazoleacrylic acid correlated with reduced anti-inflammatory IL-12A base on transcriptomic data, suggesting that metabolic reprogramming may exacerbate pulmonary inflammation. Furthermore, 16S rRNA sequencing and fecal metabolomics revealed marked microbiota dysbiosis, enrichment of Marvinbryantia, and depletion of beneficial taxa, alongside altered fecal metabolites, with correlations linking gut microbial shifts and metabolite changes to lung transcript-level inflammatory cytokines, supporting a gut–lung axis involvement in MPP. Collectively, our multi-omics dissection provides a systems-level view of immune–metabolic crosstalk in MP infection, offering mechanistic insights and potential biomarkers for improved diagnosis and therapeutic targeting. Full article

Background/Objectives: RELA encodes the p65 subunit of NF-κB and plays a critical role in immune regulation, epithelial protection, and anti-apoptotic signaling. Pathogenic RELA variants cause monogenic immune dysregulation with heterogeneous clinical manifestations. However, genotype–phenotype relationships and optimal treatment strategies remain incompletely defined. Methods: We conducted a comprehensive literature-based analysis of reported individuals with RELA variants and additionally described a family carrying a RELA c.706C>T (p.R236*) variant, including a clinically affected proband and his variant-positive father with isolated vitiligo. Clinical, immunological, genetic, endoscopic, and therapeutic data were extracted and summarized using a module-based phenotypic framework. Exploratory analyses were performed to examine potential genotype–phenotype patterns and reported treatment responses. Results: A total of 72 individuals with RELA variants, including the proband and his variant-positive father from the present family, were analyzed. RELA-associated disease exhibited marked clinical heterogeneity, encompassing mucocutaneous, systemic inflammatory, autoimmune, gastrointestinal, hematologic, allergic/eosinophilic, and infection-related manifestations. Exploratory analyses suggested that truncating or splice-site variants were more frequently observed among individuals with mucocutaneous lesions, whereas missense variants appeared to be more common among those with autoimmune manifestations. Tumor necrosis factor (TNF) inhibitors were among the therapies associated with favorable reported responses. In the present family, the proband presented with early-onset Behçet-like intestinal inflammation and achieved clinical and endoscopic remission after thalidomide and dose-escalated infliximab treatment. Conclusions: This study expands the clinical spectrum of RELA-associated disease and highlights preliminary variant-related clinical patterns that require confirmation in larger independent cohorts. The available treatment experience suggests that TNF blockade may be considered as a therapeutic option in selected patients, although comparative efficacy cannot be established from the available data. Full article

Background and Objectives: Anti-hepatitis B core antibody (anti-HBc) is generally regarded as a lifelong serological marker of previous hepatitis B virus (HBV) infection. However, anti-HBc seroclearance has been increasingly reported in patients receiving anti-CD20 therapy, while its incidence, longitudinal serological dynamics, and clinical significance remain insufficiently characterized. In this study, we aimed to evaluate the incidence, timing, and predictors of anti-HBc seroclearance and investigate longitudinal changes in HBV serology in HBsAg-negative/anti-HBc-positive patients undergoing anti-CD20 therapy. Materials and Methods: This retrospective single-center cohort study included 230 HBsAg-negative/anti-HBc-positive adults who received anti-CD20 therapy between 2011 and 2025. Anti-HBc seroclearance was evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Longitudinal changes in anti-HBc and anti-HBs titers were assessed using linear mixed-effects models. Results: Confirmed anti-HBc seroclearance occurred in 38 of 230 patients (16.5%). Younger age (adjusted hazard ratio (aHR) 0.96, 95% confidence interval (CI) 0.93–0.98; p = 0.001), fewer anti-CD20 treatment cycles (aHR 0.90, 95% CI 0.83–0.99; p = 0.025), and mycophenolate mofetil therapy (aHR 2.52, 95% CI 1.14–5.56; p = 0.022) were independently associated with anti-HBc seroclearance. Anti-HBc titers progressively declined during follow-up, with a significantly steeper decline among patients receiving mycophenolate mofetil. HBV reactivation occurred in five of 230 patients (2.2%), including two who had developed anti-HBc seroclearance. HBsAg seroreversion occurred in all five patients. Conclusions: Anti-HBc seroclearance is a relatively frequent serological finding in HBsAg-negative/anti-HBc-positive patients receiving anti-CD20 therapy and is accompanied by progressive declines in anti-HBc titers. Despite seroclearance, HBV reactivation may still occur, indicating that anti-HBc loss should not be considered evidence of elimination of HBV-related immunological risk. These findings improve our understanding of HBV serological dynamics during anti-CD20 therapy and support maintaining current antiviral prophylaxis and virological monitoring strategies regardless of anti-HBc seroclearance. Full article

Topical non-steroidal anti-inflammatory drugs (NSAIDs) such as flurbiprofen and benzydamine may be used for the symptomatic relief of pharyngitis, triggered by infections. The onset and spectrum of anti-inflammatory activity of both drugs were compared in human tonsil (HTEpiC) and bronchial epithelial (BEAS-2B) cells stimulated with poly I:C against key inflammatory mediators. Cells were stimulated with poly I:C for 24 h and treated with flurbiprofen or benzydamine for 20 s, 2 min and 5 min. Production of prostaglandin E2 (PGE₂), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1 beta (IL-1β), interleukin-8 (IL-8), interleukin-18 (IL-18), monocyte chemotactic protein-3 (MCP-3) and C-X-C motif chemokine ligand 10 (CXCL10), as well as cyclooxygenase-2 (COX-2) protein expression, was evaluated. Flurbiprofen significantly (p < 0.05) reduced PGE₂ production and COX-2 expression in both cell types within 20 s of treatment and maintained these effects at 2 and 5 min. However, benzydamine produced delayed, inconsistent inhibition. Although both drugs reduced poly I:C induced IL-6, IL-1β, IL-8 and IL-18 production, the magnitude and onset were greater with flurbiprofen. Flurbiprofen also reduced MCP-3 and CXCL10 in both cell types, alongside significant inhibition of caspase-1 activity. Benzydamine showed limited or no effect and less inhibition of caspase-1. With rapid suppression of the COX-2/PGE₂ pathway, rapid onset and a broad inhibition spectrum, flurbiprofen more comprehensively modulates inflammatory processes in epithelial respiratory models. Full article

Background: Topical semi-solid dosage forms are crucial for treating inflammatory skin disorders, wounds, burns, and superficial infections. Despite their widespread clinical use, comprehensive pharmaceutical market analyses of registered topical medicines remain limited in Central Asia. The aim of this study was to characterize the pharmaceutical market of topical semi-solid dosage forms registered in the Republic of Kazakhstan, including their dosage-form distribution, pharmacotherapeutic composition, manufacturer structure, and structural diversity of active pharmaceutical ingredients (APIs), with particular attention to heterocyclic compounds. Methods: A cross-sectional descriptive analysis was conducted using the State Register of Medicinal Products of the Republic of Kazakhstan. Registration records of topical semi-solid dosage forms were identified according to predefined inclusion criteria and classified by dosage form, pharmacotherapeutic category, manufacturer, country of origin, and API chemical structure. Descriptive statistical analysis, market concentration indices, and structural classification of heterocyclic compounds were applied. Therapeutic recommendations for dermatitis management from selected CIS countries were reviewed to provide a contextual interpretation of the observed market structure. Results: A total of 1046 registered topical semi-solid dosage forms met the inclusion criteria. Ointments (39.5%), gels (28.9%), and creams (25.4%) accounted for 93.8% of all registered products, indicating a highly concentrated dosage-form structure. Anti-inflammatory agents represented the largest pharmacotherapeutic group, whereas wound-healing and combination products accounted for smaller proportions of the market. Structural classification demonstrated broad representation of established heterocyclic chemical classes, while no registered medicinal products containing dihydropyrimidine-2(1H)-thione (DHPM-thione) derivatives were identified in the registry. Comparison with regional clinical recommendations indicated differences between recommended therapeutic approaches and the distribution of registered pharmacotherapeutic categories. Conclusions: This study provides the first comprehensive descriptive assessment of the registered market of topical semi-solid dosage forms in Kazakhstan. The results establish a reference dataset describing the current pharmaceutical landscape, including dosage forms, therapeutic categories, manufacturers, and API chemical classes. The absence of registered DHPM-thione-containing medicinal products indicates that this chemical class is currently not represented in the national medicines registry. Together with previously published preclinical evidence, this observation supports consideration of DHPM-thione derivatives as a subject for future pharmaceutical research, although the present study does not permit conclusions regarding their clinical effectiveness, market demand, or future commercialization. Full article

Phage therapy has been revisited as a biologically based strategy to tackle the escalating global crisis of multidrug-resistant (MDR) bacterial infections. Distinct from conventional antibiotics, bacteriophages target specific bacterial strains precisely, replicate locally at infection sites, penetrate bacterial biofilms, and exert synergistic effects with multiple antimicrobial agents. These inherent mechanistic advantages minimize collateral damage to the host’s commensal microbiota. However, existing regulatory frameworks—originally established for chemically synthesized, mass-produced drugs—fail to accommodate personalized, living biological phage products, leading to uncertain approval pathways and inconsistent manufacturing supervision. Clinical experience of phage therapy is predominantly derived from compassionate-use cases via multiple administration routes, including intravenous, inhaled, and topical delivery. This review systematically analyzes major challenges restricting clinical application, such as standardized production, quality control, pharmacokinetic characterization, rapid pathogen identification, and regulatory adaptation, as well as the limited performance of fixed phage cocktails against genetically heterogeneous bacterial populations. Current clinical practice demonstrates that phage therapy exhibits acceptable safety profiles across intravenous, inhaled, and topical administration routes, with promising therapeutic outcomes in otherwise untreatable MDR infections. Nevertheless, stable and reproducible clinical outcomes are hindered by multiple scientific and operational obstacles: the absence of unified standards for phage production and quality control, insufficient understanding of route-dependent pharmacokinetics, the imperative demand for rapid pathogen identification to enable precise phage matching, and the limited efficacy of fixed-cocktail regimens against genetically diverse clinical isolates. The successful integration of phage therapy into routine clinical practice relies on coordinated progress in diagnostic infrastructure construction, GMP-compliant phage repository establishment, international regulatory harmonization, and high-quality evidence generation through well-designed clinical trials. Rather than serving as a universal substitute for antibiotics, phage therapy is best implemented as a precision complementary component within comprehensive antimicrobial stewardship strategies. Full article

Background/Objectives: Pseudomonas aeruginosa is a notorious multidrug-resistant pathogen that causes serious acute and chronic infections by employing quorum sensing (QS)-regulated virulence, biofilm formation, and host-damaging inflammation. To overcome the yield limitation of two previously identified marine secondary metabolites with dual QS inhibitory and PPAR-γ agonistic activities, we further screened marine-derived natural products for more abundant candidates with similar anti-virulence and anti-inflammatory properties. Methods: In this study, isoflavones were evaluated for anti-QS and PPAR-γ transactivation activities using reporter gene assays, and for antibacterial, anti-virulence, and anti-inflammatory effects via broth microdilution, biofilm, G. mellonella infection, and ELISA cytokine assays. Results: Daidzein and genistein were selected for their optimal anti-QS and PPAR-γ activation activities. They inhibited a key QS regulator and suppressed pyocyanin production and biofilm formation in P. aeruginosa without affecting bacterial growth, indicating minimal selective pressure for resistance. In addition, daidzein and genistein were found to synergistically sensitize the wild-type P. aeruginosa strain to gentamicin, carbenicillin, tobramycin, ampicillin, and polymyxin B, and synergistically or partially synergistically sensitize a multidrug-resistant strain to gentamicin, tobramycin, and ampicillin. Moreover, a Galleria mellonella infection model confirmed that daidzein and genistein significantly enhance the efficacy of gentamicin against P. aeruginosa infection in vivo. Furthermore, in host macrophages, daidzein and genistein significantly inhibited LPS-induced production of NO, IL-6, and IL-1β when combined with an RXR agonist, implying a protective effect on host tissues through PPAR-γ activation. Conclusions: These findings demonstrate that daidzein and genistein serve as effective adjuncts to conventional antibiotics, exerting multifaceted actions against P. aeruginosa infection. Full article

Purpose: Cryptosporidiosis is a parasitic inflammatory disease that causes the death of around 1.6 million people annually worldwide and is associated with Cryptosporidium parvum (C. parvum) infection. This study aimed to evaluate the therapeutic efficacy of carvacrol (CV) loaded into mesoporous silicate nanoparticles (MSNs) against C. parvum using in vitro, in vivo, histopathological, immunohistochemical, biochemical, and computational approaches. Methods: In vitro assays were conducted to evaluate the oocysticidal activity of CV-loaded MSNs (CV-MSNs) for 96 h. In silico assays were carried out to investigate target inflammatory proteins involved in cryptosporidiosis. In vivo tests were performed on male Swiss albino mice (22 ± 5 g, 4–6 weeks) to assess the anti-inflammatory and antioxidant effects of CV after loading onto MSNs. Results: CV showed its highest oocysticidal efficacy after loading onto spherical 72 nm MSNs (MSN2), exhibiting a 0.07 mg/mL LC₅₀. At the in vivo level, CV-MSN2 markedly restored ileal, pulmonary, and hepatic histoarchitecture and normalized biochemical indices in infected mice. CV-MSN2 also showed the strongest inhibitory action against computationally selected target proteins, TLR-4, NF-κb-P65, STAT-3, NOS2, and JAK-1, with accompanying downregulation of IL-6, IL-1β, and TNF-α. Similarly, antioxidant markers were significantly decreased following CV-MSN2 treatment compared to the positive controls. Conclusions: This study shows that MSNs enhanced CV efficacy against ileal inflammation induced by C. parvum, preserving CV’s molecular targets. Full article

Malaria pathogenesis results from a complex interplay among parasite burden, inflammation, and oxidative stress, all of which contribute to disease severity. This study evaluated the antimalarial, immunomodulatory, and antioxidant effects of a suspension of powdered aerial parts of Artemisia mexicana (A. mexicana) suspended in 0.5% carboxymethylcellulose (CMC), using a murine model of cerebral malaria. Male CBA/Ca mice were infected with Plasmodium berghei ANKA and treated with A. mexicana. Disease progression was evaluated through parasitemia, haemoglobin levels, body weight and temperature. Immunomodulatory effects were assessed by analysing splenic immune cell populations and pro- and anti-inflammatory cytokines, while antioxidant activity was determined in brain and spleen tissues. Treatment reduced parasitemia in a dose-dependent manner, with the highest efficacy observed at 1600 mg/kg, and also prevented haemoglobin loss and body weight decline. A. mexicana preserved CD4⁺ (T-helper) and CD8⁺ (T-cytotoxic) T-cell populations and modulated cytokine responses, increasing IFN-γ, IL-17, and IL-10 levels. Additionally, treatment increased glutathione peroxidase activity in the brain and spleen without affecting lipid peroxidation. These findings demonstrate that A. mexicana exerts antimalarial and immunomodulatory effects and modulates antioxidant responses, suggesting that the regulation of inflammation and redox balance contributes to improved outcomes during malaria infection. Full article

Strongyloidiasis is a neglected, potentially lifelong disease caused by Strongyloides stercoralis that can lead to a high mortality rate in immunocompromised hosts; therefore, it is necessary to increase the accuracy of infection diagnosis. In the current study, we used Wistar rats experimentally infected with different burdens of Strongyloides venezuelensis to characterize circulating leukocytes and IgM, IgG, IgG1, IgG2a, and IgA reactivity before and after anthelmintic treatment or immunosuppression. Infection, especially with 500 L3, induced an increase in circulating leukocytes, particularly during the acute phase. Animals treated with ivermectin showed complete elimination of the parasite and an early reduction in circulating eosinophils. The production of IgM, IgG, and IgG1 anti-L3 (infective larvae) and anti-Sv (adult worm) antigens was significantly elevated in all infected groups but did not allow differentiation between cured and infected animals. Treatment with dexamethasone delayed worm elimination and temporarily reduced cellular response and parasite-specific IgG production but did not alter IgM reactivity. IgG2a anti-L3 and anti-Sv reactivity showed a progressive reduction, returning to baseline levels in ivermectin-treated rats. IgA anti-ES/L3 (excretory and secretory larval antigens) reactivity significantly decreased in intestinal wash after parasitological cure. These data would help the development of more efficient immunodiagnostic alternatives for human strongyloidiasis based on antibody isotype reactivity. Full article

Background. Stool microscopy and anti-Ascaris IgG serology assess different, but related biological domains. Joint interpretation can identify immunological exposure and intestinal egg shedding without assuming one or both markers are a measure of current infection independently. Objective. To develop a four-pattern paired-marker framework for anti-A. lumbricoides IgG and copromicroscopy results from adults in Kazakhstan and to assess the qualitative analytical concordance of two IgG enzyme-linked immunosorbent assays (ELISAs). Methods. The cross-sectional field study involved 1000 adult volunteers from Almaty and the region providing matched serum and stool samples. Sera were tested by MVA Group indirect anti-Ascaris IgG ELISA, and stool samples were examined by the Kato–Katz and Fülleborn methods. The binary outcome was classified into four pair patterns. All sera were further tested with a commercial ELISA (DRG), and qualitative concordance was calculated. Results. Anti-Ascaris IgG was found in 331 of the 1000 subjects (33.1%; 95% CI, 30.3–36.1%), while A. lumbricoides eggs were detected in 240 subjects (24.0%; 95% CI, 21.5–26.7%). The paired patterns were IgG-positive/egg-positive in 185 participants (18.5%), IgG-positive/egg-negative in 146 (14.6%), IgG-negative/egg-positive in 55 (5.5%), and IgG-negative/egg-negative in 614 (61.4%). IgG positivity was detected in 77.1% of subjects with detected eggs and 19.2% of subjects without detected eggs (odds ratio, 14.15; 95% CI, 9.96–20.09; p < 0.001). The MVA Group and DRG ELISAs agreed for 990 of 1000 specimens (99.0%; 95% CI, 98.2–99.5%), with positive and negative agreements of 98.2% and 99.4%, respectively (κ = 0.98). Conclusions. Serology and copromicroscopy showed a high association, but they are not interchangeable. The paired-marker paradigm clarified concordant and discordant patterns while retaining IgG as a marker of past or ongoing immune exposure and stool eggs as markers of shedding at the time of sampling. High inter-assay agreement suggests analytical consistency within this serum panel, but does not imply diagnostic accuracy for active ascariasis. Full article