Pub Date : 2026-01-08DOI: 10.1016/S1876-0341(26)00010-9
{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1016/S1876-0341(26)00010-9","DOIUrl":"10.1016/S1876-0341(26)00010-9","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103138"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the COVID-19 pandemic, several divergent mutants including the Omicron (B.1.1.529) BA.1 variant emerged, having a distinct mechanism of emergence compared with pre-existing variants of concern. Apart from playing a major role in causing recurrent epidemic waves, the highly divergent mutants also contributed to changing the fate of the pandemic by exhibiting large differences in phenotypic characteristics among even closely related variants. Given that several different variants emerged during the pandemic, the present study aimed to quantitatively evaluate the risk of emergence of divergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants and understand the mechanism of such emergence.
Methods
Upon identifying the emergence of phylogenetically distinct variants in “Omicron-like events” that have been recognized to date, a time-to-event analysis was carried out to estimate the monthly hazard rate of emergence. Four statistical models were established and compared using the Akaike Information Criterion.
Results
The model using the number of hospitalized cases was determined to be the best fit. The risk of Omicron-like events is not independent of time; instead, the monthly risk of emergence is likely to increase over time due to an increasing number of infection events.
Conclusions
Ongoing virus genomic surveillance is vital, and possible prevention among immunosuppressed individuals should be considered.
{"title":"Modeling the emergence of divergent mutants of SARS-CoV-2, “Omicron-like events”: A time-to-event analysis","authors":"Haruka Hayashi, Yuta Okada, Taishi Kayano, Katsuma Hayashi, Tetsuro Kobayashi, Hiroshi Nishiura","doi":"10.1016/j.jiph.2026.103140","DOIUrl":"10.1016/j.jiph.2026.103140","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, several divergent mutants including the Omicron (B.1.1.529) BA.1 variant emerged, having a distinct mechanism of emergence compared with pre-existing variants of concern. Apart from playing a major role in causing recurrent epidemic waves, the highly divergent mutants also contributed to changing the fate of the pandemic by exhibiting large differences in phenotypic characteristics among even closely related variants. Given that several different variants emerged during the pandemic, the present study aimed to quantitatively evaluate the risk of emergence of divergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants and understand the mechanism of such emergence.</div></div><div><h3>Methods</h3><div>Upon identifying the emergence of phylogenetically distinct variants in “Omicron-like events” that have been recognized to date, a time-to-event analysis was carried out to estimate the monthly hazard rate of emergence. Four statistical models were established and compared using the Akaike Information Criterion.</div></div><div><h3>Results</h3><div>The model using the number of hospitalized cases was determined to be the best fit. The risk of Omicron-like events is not independent of time; instead, the monthly risk of emergence is likely to increase over time due to an increasing number of infection events.</div></div><div><h3>Conclusions</h3><div>Ongoing virus genomic surveillance is vital, and possible prevention among immunosuppressed individuals should be considered.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103140"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.jiph.2026.103130
Chao-Chin Chang , Tzu-Chi Chang , Chia-Lin Chang
Background
Containment policies, also known as non-pharmaceutical interventions (NPIs), are crucial in managing emerging infectious diseases; however, their broader economic, social, and health impacts remain insufficiently understood. Previous studies have largely relied on aggregate indices, masking policy-specific effects and limiting their usefulness for preparedness and adaptive governance.
Methods
This study investigates how disaggregated containment measures affected international trade and the continuity of essential goods as a component of public health resilience. Using data from 182 countries during 2020–2021, we analyzed nine NPIs from the Oxford COVID-19 Government Response Tracker and international trade statistics across four product categories. Two indices, a conventional arithmetic mean and a novel entropy-weighted index, were constructed to capture policy intensity and cross-country heterogeneity. Panel regression models with fixed- and random-effects specifications were used to assess policy impacts.
Findings
Containment policies had heterogeneous effects on trade. Workplace closures were associated with trade resilience through digital adaptation, whereas stay-at-home orders and transport suspensions disrupted food and agricultural trade, revealing vulnerabilities in supply chains critical to health security. International travel restrictions correlated positively with goods trade, reflecting substitution from service- to goods-based activities. The entropy-weighted index outperformed the arithmetic mean by capturing policy variability, especially during 2020 early crisis phase.
Interpretation
Disaggregating NPIs reveals that policy design, timing, and institutional context shape both trade performance and health resilience. Integrating information-sensitive metrics such as entropy weighting can improve surveillance and preparedness frameworks. Policymakers should balance epidemiological effectiveness with the protection of essential trade flows to ensure equitable and adaptive pandemic governance.
{"title":"Trade and containment policies during COVID-19: Disaggregated evidence for adaptive public health governance","authors":"Chao-Chin Chang , Tzu-Chi Chang , Chia-Lin Chang","doi":"10.1016/j.jiph.2026.103130","DOIUrl":"10.1016/j.jiph.2026.103130","url":null,"abstract":"<div><h3>Background</h3><div>Containment policies, also known as non-pharmaceutical interventions (NPIs), are crucial in managing emerging infectious diseases; however, their broader economic, social, and health impacts remain insufficiently understood. Previous studies have largely relied on aggregate indices, masking policy-specific effects and limiting their usefulness for preparedness and adaptive governance.</div></div><div><h3>Methods</h3><div>This study investigates how disaggregated containment measures affected international trade and the continuity of essential goods as a component of public health resilience. Using data from 182 countries during 2020–2021, we analyzed nine NPIs from the Oxford COVID-19 Government Response Tracker and international trade statistics across four product categories. Two indices, a conventional arithmetic mean and a novel entropy-weighted index, were constructed to capture policy intensity and cross-country heterogeneity. Panel regression models with fixed- and random-effects specifications were used to assess policy impacts.</div></div><div><h3>Findings</h3><div>Containment policies had heterogeneous effects on trade. Workplace closures were associated with trade resilience through digital adaptation, whereas stay-at-home orders and transport suspensions disrupted food and agricultural trade, revealing vulnerabilities in supply chains critical to health security. International travel restrictions correlated positively with goods trade, reflecting substitution from service- to goods-based activities. The entropy-weighted index outperformed the arithmetic mean by capturing policy variability, especially during 2020 early crisis phase.</div></div><div><h3>Interpretation</h3><div>Disaggregating NPIs reveals that policy design, timing, and institutional context shape both trade performance and health resilience. Integrating information-sensitive metrics such as entropy weighting can improve surveillance and preparedness frameworks. Policymakers should balance epidemiological effectiveness with the protection of essential trade flows to ensure equitable and adaptive pandemic governance.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103130"},"PeriodicalIF":4.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Staphylococcal pneumonia is a serious cause of morbidity and mortality in children worldwide, particularly in resource-limited settings. This study aimed to investigate the national epidemiology, clinical outcomes, and mortality-associated factors of pediatric staphylococcal pneumonia in Thailand.
Materials and methods
A nationwide retrospective study was conducted using the National Health Security Office (NHSO) database. All hospital admissions of children aged 1 month to < 18 years diagnosed with staphylococcal pneumonia (ICD-10-TM code J15.2) between 2015 and 2023 were included. Demographics, comorbidities, complications, interventions, and outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with mortality.
Results
A total of 1718 admissions were analyzed. Annual admissions peaked at 249 in 2016 and were lowest at 129 in 2022. Most admissions were male (61.5 %) and infants under 1 year (34.2 %). Intubation was required in 60.9 % of cases, and 10.5 % underwent surgical interventions. The hospital mortality rate was 10.6 %. Factors associated with higher mortality included congenital heart disease (adjusted odds ratio [AOR] 3.57; 95 % CI 2.27–5.61), malignancy (AOR 4.13; 95 % CI 1.87–9.10), malnutrition (AOR 3.13; 95 % CI 1.45–6.75), acute respiratory distress syndrome (ARDS) (AOR 4.26; 95 % CI 2.23–8.14), septic shock (AOR 3.85; 95 % CI 2.52–5.90), acute renal failure (AOR 4.46; 95 % CI 2.72–7.30), disseminated intravascular coagulation (DIC) (AOR 2.13; 95 % CI 1.18–3.83), and need for endotracheal intubation (AOR 9.98; 95 % CI 4.50–22.15).
Conclusion
Pediatric staphylococcal pneumonia remains a significant clinical burden in Thailand, with high complication and mortality rates. Targeted interventions, particularly in high-risk populations, are essential to improve outcomes.
背景和目的葡萄球菌性肺炎是全世界儿童发病和死亡的一个严重原因，特别是在资源有限的地区。本研究旨在调查泰国儿童葡萄球菌性肺炎的全国流行病学、临床结果和死亡相关因素。材料与方法利用国家卫生安全办公室（NHSO）数据库进行了一项全国性的回顾性研究。纳入2015年至2023年期间所有住院诊断为葡萄球菌肺炎（ICD-10-TM代码J15.2）的1个月至 18岁儿童。分析了人口统计学、合并症、并发症、干预措施和结果。使用多变量逻辑回归来确定与死亡率独立相关的因素。结果共分析入院人数1718人。2016年全年入学人数达到249人的峰值，2022年最低，为129人。入院患者以男性（61.5% %）和1岁以下婴儿（34.2% %）居多。60.9% %的病例需要插管，10.5% %的病例需要手术干预。住院死亡率为10.6% %。与高死亡率相关的因素包括先天性心脏病（调整优势比[AOR] 3.57; 95 % CI 2.27-5.61）、恶性肿瘤（AOR 4.13; 95 % CI 1.87-9.10）、营养不良（AOR 3.13; 95 % CI 1.45-6.75）、急性呼吸窘迫综合征（ARDS） （AOR 4.26; 95 % CI 2.23-8.14）、感染性休克（AOR 3.85; 95 % CI 2.52-5.90）、急性肾功能衰竭（AOR 4.46; 95 % CI 2.72-7.30）、弥散性血管内凝血(AOR 2.13；95 % CI 1.18-3.83)，需要气管插管（AOR 9.98; 95 % CI 4.50-22.15）。结论在泰国，儿童葡萄球菌肺炎仍然是一个重要的临床负担，其并发症和死亡率都很高。有针对性的干预措施，特别是针对高危人群的干预措施，对于改善结果至关重要。
{"title":"Epidemiology, clinical outcomes and mortality-associated factors of staphylococcal pneumonia in hospitalized Thai children: A nationwide retrospective analysis 2015–2023","authors":"Sirapoom Niamsanit , Phanthila Sitthikarnkha , Leelawadee Techasatian , Suchaorn Saengnipanthkul , Pope Kosalaraksa , Kaewjai Thepsuthammarat , Rattapon Uppala","doi":"10.1016/j.jiph.2025.103127","DOIUrl":"10.1016/j.jiph.2025.103127","url":null,"abstract":"<div><h3>Background and aims</h3><div>Staphylococcal pneumonia is a serious cause of morbidity and mortality in children worldwide, particularly in resource-limited settings. This study aimed to investigate the national epidemiology, clinical outcomes, and mortality-associated factors of pediatric staphylococcal pneumonia in Thailand.</div></div><div><h3>Materials and methods</h3><div>A nationwide retrospective study was conducted using the National Health Security Office (NHSO) database. All hospital admissions of children aged 1 month to < 18 years diagnosed with staphylococcal pneumonia (ICD-10-TM code J15.2) between 2015 and 2023 were included. Demographics, comorbidities, complications, interventions, and outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with mortality.</div></div><div><h3>Results</h3><div>A total of 1718 admissions were analyzed. Annual admissions peaked at 249 in 2016 and were lowest at 129 in 2022. Most admissions were male (61.5 %) and infants under 1 year (34.2 %). Intubation was required in 60.9 % of cases, and 10.5 % underwent surgical interventions. The hospital mortality rate was 10.6 %. Factors associated with higher mortality included congenital heart disease (adjusted odds ratio [AOR] 3.57; 95 % CI 2.27–5.61), malignancy (AOR 4.13; 95 % CI 1.87–9.10), malnutrition (AOR 3.13; 95 % CI 1.45–6.75), acute respiratory distress syndrome (ARDS) (AOR 4.26; 95 % CI 2.23–8.14), septic shock (AOR 3.85; 95 % CI 2.52–5.90), acute renal failure (AOR 4.46; 95 % CI 2.72–7.30), disseminated intravascular coagulation (DIC) (AOR 2.13; 95 % CI 1.18–3.83), and need for endotracheal intubation (AOR 9.98; 95 % CI 4.50–22.15).</div></div><div><h3>Conclusion</h3><div>Pediatric staphylococcal pneumonia remains a significant clinical burden in Thailand, with high complication and mortality rates. Targeted interventions, particularly in high-risk populations, are essential to improve outcomes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103127"},"PeriodicalIF":4.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.jiph.2025.103128
Fanwei Liu , Siqi Sun , Yonghu Zhang , Fang Wang , Xiou Yang , Bingli Zhang , Sitong Fan , Hongyu Jia
Tuberculous meningitis (TBM) typically presents with neurological symptoms. Voiding dysfunction in TBM is usually attributed to spinal cord involvement. We report a rare case of possible TBM co-existing with possible prostatic tuberculosis, presenting primarily with urinary symptoms in the absence of spinal pathology. A 69-year-old male presented with a two-year history of progressive urinary retention, urgency, and frequency. Initial management for benign prostatic hyperplasia was ineffective. He subsequently developed fever, headache, and dizziness. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis and elevated protein. Despite extensive testing, including CSF culture, Xpert MTB/RIF, and metagenomic next-generation sequencing (mNGS), no pathogen was identified. However, a history of untreated testicular tuberculosis, pulmonary nodules on CT, and a prostatic nodule on MRI raised suspicion of disseminated tuberculosis. A clinical diagnosis of possible TBM was made based on a Marais score of 11. An intensive anti-tuberculosis regimen including moxifloxacin and linezolid led to complete resolution of neurological and urinary symptoms. This case suggests that voiding dysfunction in TBM patients may stem from concurrent genitourinary tuberculosis rather than spinal cord involvement. It highlights the importance of considering hematogenous dissemination from latent genitourinary foci in elderly patients and the utility of the Marais criteria for the diagnosis of TBM when microbiological evidence is elusive.
{"title":"Possible tuberculous meningitis presenting with predominant voiding dysfunction in an elderly patient: A case report","authors":"Fanwei Liu , Siqi Sun , Yonghu Zhang , Fang Wang , Xiou Yang , Bingli Zhang , Sitong Fan , Hongyu Jia","doi":"10.1016/j.jiph.2025.103128","DOIUrl":"10.1016/j.jiph.2025.103128","url":null,"abstract":"<div><div>Tuberculous meningitis (TBM) typically presents with neurological symptoms. Voiding dysfunction in TBM is usually attributed to spinal cord involvement. We report a rare case of possible TBM co-existing with possible prostatic tuberculosis, presenting primarily with urinary symptoms in the absence of spinal pathology. A 69-year-old male presented with a two-year history of progressive urinary retention, urgency, and frequency. Initial management for benign prostatic hyperplasia was ineffective. He subsequently developed fever, headache, and dizziness. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis and elevated protein. Despite extensive testing, including CSF culture, Xpert MTB/RIF, and metagenomic next-generation sequencing (mNGS), no pathogen was identified. However, a history of untreated testicular tuberculosis, pulmonary nodules on CT, and a prostatic nodule on MRI raised suspicion of disseminated tuberculosis. A clinical diagnosis of <strong>possible TBM</strong> was made based on a Marais score of 11. An intensive anti-tuberculosis regimen including moxifloxacin and linezolid led to complete resolution of neurological and urinary symptoms. This case suggests that voiding dysfunction in TBM patients may stem from concurrent genitourinary tuberculosis rather than spinal cord involvement. It highlights the importance of considering hematogenous dissemination from latent genitourinary foci in elderly patients and the utility of the Marais criteria for the diagnosis of TBM when microbiological evidence is elusive.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103128"},"PeriodicalIF":4.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.jiph.2025.103126
Lulu Xing , Jialu Li , Yifan Guo , Ying Liu , Jiang Xiao , Hongxin Zhao
Background
Recent findings on the outbreak of mpox indicate that immunosuppressed people are at significantly higher risk of death. The aims of the research were to provide a summary of the clinical features of mpox fatal cases, explore the effects of immunosuppression, monkeypox virus (MPXV)/human immunodeficiency virus (HIV) co-infection, and delayed antiretroviral therapy (ART) on prognosis, and offer evidence-based recommendations to inform clinical practices.
Methods
Demographic information, detailed HIV disease characteristics, ART history, mpox clinical features, laboratory results, and radiological evaluations were retrospectively extracted from electronic medical records.
Results
Six fatal cases were men who have sex with men (MSM), with a median age of 35 years (range: 23–37 years). Their median CD4+ count was 51 cells/μL (range: 2–116 cells/μL). Of these cases, two were simultaneously diagnosed with MPXV/HIV infection, one was diagnosed with HIV infection and never initiated ART, and the other three had interrupted ART prior to mpox diagnosis. All patients started or restarted ART, with a medium time from initiation of ART to death being 52 days (range: 20–148 days). Besides such symptoms like skin lesions and lymphadenopathy, all of them developed severe complications, including bacterial co-infections (n = 5), pneumonia (n = 5), intestinal obstruction (n = 2), and ocular involvement (n = 3). The median intervals between symptom onset and hospitalization or death were 30 days (range: 6–36 days) and 59 days (range: 32–110 days), respectively, with all death being due to sepsis or related multiple organ failure.
Conclusion
The combination of MPXV with advanced HIV infection carries an excessive risk of death, generated by severe immunodeficiency that facilitates serious secondary infections and MPXV dissemination. Even if ART is initiated as soon as possible, immune function cannot be restored quickly enough to clear MPXV.
{"title":"Clinical characteristics of six fatal cases with advanced HIV and monkeypox virus co-infection in Beijing: A retrospective analysis","authors":"Lulu Xing , Jialu Li , Yifan Guo , Ying Liu , Jiang Xiao , Hongxin Zhao","doi":"10.1016/j.jiph.2025.103126","DOIUrl":"10.1016/j.jiph.2025.103126","url":null,"abstract":"<div><h3>Background</h3><div>Recent findings on the outbreak of mpox indicate that immunosuppressed people are at significantly higher risk of death. The aims of the research were to provide a summary of the clinical features of mpox fatal cases, explore the effects of immunosuppression, monkeypox virus (MPXV)/human immunodeficiency virus (HIV) co-infection, and delayed antiretroviral therapy (ART) on prognosis, and offer evidence-based recommendations to inform clinical practices.</div></div><div><h3>Methods</h3><div>Demographic information, detailed HIV disease characteristics, ART history, mpox clinical features, laboratory results, and radiological evaluations were retrospectively extracted from electronic medical records.</div></div><div><h3>Results</h3><div>Six fatal cases were men who have sex with men (MSM), with a median age of 35 years (range: 23–37 years). Their median CD4<sup>+</sup> count was 51 cells/μL (range: 2–116 cells/μL). Of these cases, two were simultaneously diagnosed with MPXV/HIV infection, one was diagnosed with HIV infection and never initiated ART, and the other three had interrupted ART prior to mpox diagnosis. All patients started or restarted ART, with a medium time from initiation of ART to death being 52 days (range: 20–148 days). Besides such symptoms like skin lesions and lymphadenopathy, all of them developed severe complications, including bacterial co-infections (n = 5), pneumonia (n = 5), intestinal obstruction (n = 2), and ocular involvement (n = 3). The median intervals between symptom onset and hospitalization or death were 30 days (range: 6–36 days) and 59 days (range: 32–110 days), respectively, with all death being due to sepsis or related multiple organ failure.</div></div><div><h3>Conclusion</h3><div>The combination of MPXV with advanced HIV infection carries an excessive risk of death, generated by severe immunodeficiency that facilitates serious secondary infections and MPXV dissemination. Even if ART is initiated as soon as possible, immune function cannot be restored quickly enough to clear MPXV.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103126"},"PeriodicalIF":4.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Escherichia coli (E. coli), a common gut commensal, includes pathogenic strains responsible for gastrointestinal infections and hemolytic uremic syndrome (HUS). It spreads mainly through contaminated water and food, as well as direct human contact, with the risk being particularly high in densely populated regions. The growing emergence of antimicrobial-resistant (AMR) strains, particularly in Asia, poses serious public health challenges.
Methods
This study employed a multi-tiered computational framework comprising systematic review, quantitative evidence synthesis (meta-analysis), the Markov cluster algorithm with random walks on pan-genomics, and positive selection through evolutionary analysis, shedding light on the prevalence, geographical distribution, genomic diversity, and evolutionary dynamics of E. coli across Asia.
Results
Quantitative evidence synthesis (meta-analysis) technique included 66 articles (total sample n = 1,20,207) and revealed an E. coli prevalence of 18 % (95 % CI:14 %-21 %, I2=100, τ 2=0.0, P = 0) in Asia. The E. coli incidences identified the Indian strain Ec40 collected in 2013 showed the highest genetic diversity, and the sequences collected between 2012 and 2019 displayed the most variation. The emrY gene, recurrently identified within the E. coli genomes, was subjected to evolutionary analysis. Codon-based selection models indicated adaptive evolution, with five codon sites under pervasive selection and twelve under episode selection (ω > 1), suggesting antimicrobial pressure as the main driver of regional adaptation.
Conclusion
These findings underscore the urgent need for integrated prevention and control strategies, including robust surveillance systems to monitor infection trends, targeted interventions to curb transmission, and strengthened biosecurity measures aimed at reducing environmental contamination. Furthermore, the emergence of AMR variants calls for alternative treatment, e.g., bacteriophage therapy, to reduce the clinical and socioeconomic burden of E. coli infections in humans and animal populations.
{"title":"Integrated computational analysis for Escherichia coli prevalence, genetic evolution, and antimicrobial resistance evolution: Implications for public health and environmental sustainability in Asia","authors":"Ashwini Mallappa , Kuralayanapalya Puttahonnappa Suresh , Sharanagouda S. Patil , Shivasharanappa Nayakvadi , Baldev Raj Gulati , Raghavendra G. Amachawadi , Sudarshan Peramachanahalli Venkatesh , Yamini Sri Sekar , Archana Veeranagouda Patil","doi":"10.1016/j.jiph.2025.103117","DOIUrl":"10.1016/j.jiph.2025.103117","url":null,"abstract":"<div><h3>Background</h3><div><em>Escherichia coli</em> (<em>E. coli</em>), a common gut commensal, includes pathogenic strains responsible for gastrointestinal infections and hemolytic uremic syndrome (HUS). It spreads mainly through contaminated water and food, as well as direct human contact, with the risk being particularly high in densely populated regions. The growing emergence of antimicrobial-resistant (AMR) strains, particularly in Asia, poses serious public health challenges.</div></div><div><h3>Methods</h3><div>This study employed a multi-tiered computational framework comprising systematic review, quantitative evidence synthesis (meta-analysis), the Markov cluster algorithm with random walks on pan-genomics, and positive selection through evolutionary analysis, shedding light on the prevalence, geographical distribution, genomic diversity, and evolutionary dynamics of <em>E. coli</em> across Asia.</div></div><div><h3>Results</h3><div>Quantitative evidence synthesis (meta-analysis) technique included 66 articles (total sample n = 1,20,207) and revealed an <em>E. coli</em> prevalence of 18 % (95 % CI:14 %-21 %, I<sup>2</sup>=100, τ <sup>2</sup>=0.0, P = 0) in Asia. The <em>E</em>. <em>coli</em> incidences identified the Indian strain Ec40 collected in 2013 showed the highest genetic diversity, and the sequences collected between 2012 and 2019 displayed the most variation. The <em>emrY</em> gene, recurrently identified within the <em>E. coli</em> genomes, was subjected to evolutionary analysis. Codon-based selection models indicated adaptive evolution, with five codon sites under pervasive selection and twelve under episode selection (ω > 1), suggesting antimicrobial pressure as the main driver of regional adaptation.</div></div><div><h3>Conclusion</h3><div>These findings underscore the urgent need for integrated prevention and control strategies, including robust surveillance systems to monitor infection trends, targeted interventions to curb transmission, and strengthened biosecurity measures aimed at reducing environmental contamination. Furthermore, the emergence of AMR variants calls for alternative treatment, e.g., bacteriophage therapy, to reduce the clinical and socioeconomic burden of <em>E. coli</em> infections in humans and animal populations.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103117"},"PeriodicalIF":4.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eliminating Plasmodium vivax malaria in India’s tribal regions is challenging, mainly due to poor adherence to primaquine, the only hypnozoiticidal drug for radical cure under national policy. Incomplete adherence to the 14-day primaquine regimen leads to relapse, treatment failure, ongoing transmission, and may contribute to antimalarial resistance. This study quantified primaquine adherence, and explored behavioral factors influencing non-adherence in high-burden tribal districts of Odisha.
Methods
This prospective cohort study conducted from January to December 2024 in two high-burden tribal districts (Malkangiri, Koraput) enrolled 269 laboratory-confirmed P. vivax patients aged over one year. Structured questionnaires collected demographic, clinical, and treatment data. Adherence to the 14-day primaquine regimen was assessed on days 7 and 14 via self-report, pill counts, and blister pack inspection. Uni- and multivariable analyses identified predictors of non-adherence.
Results
Adherence to chloroquine (3 days) and artesunate–SP (mixed infections) exceeded 93 %, while only 58.7 % (95 % CI: 52.6–64.9) completed the 14-day primaquine course. Healthcare workers dispensed drugs according to guidelines. Treatment discontinuation was mainly due to symptom resolution (61.9 %) and forgetfulness (21.4 %); only one patient discontinued primaquine due to an adverse event. Older age and household malaria history were associated with better adherence.
Conclusion
Suboptimal primaquine adherence delays P. vivax elimination despite adequate drug supply and correct dosing. Addressing behavioral drivers of early treatment cessation is critical to interrupt relapse transmission. Programmatic focus should include intensified social behavior change communication, targeted directly observed therapy, and evaluation of shorter primaquine or single-dose tafenoquine treatments with G6PD testing to enhance radical cure and accelerate India’s 2030 malaria elimination goal.
{"title":"Suboptimal primaquine adherence in Plasmodium vivax malaria: Evidence from high-burden tribal districts in Odisha","authors":"Anju Viswan K , Kannan Thiruvengadam , Rohit Sharma, Nandhini Perumalsamy, Renuka Devi Arumugam, Srikanth Srirama, Arya Rahul , Manju Rahi","doi":"10.1016/j.jiph.2025.103123","DOIUrl":"10.1016/j.jiph.2025.103123","url":null,"abstract":"<div><h3>Background</h3><div>Eliminating <em>Plasmodium vivax</em> malaria in India’s tribal regions is challenging, mainly due to poor adherence to primaquine, the only hypnozoiticidal drug for radical cure under national policy. Incomplete adherence to the 14-day primaquine regimen leads to relapse, treatment failure, ongoing transmission, and may contribute to antimalarial resistance. This study quantified primaquine adherence, and explored behavioral factors influencing non-adherence in high-burden tribal districts of Odisha.</div></div><div><h3>Methods</h3><div>This prospective cohort study conducted from January to December 2024 in two high-burden tribal districts (Malkangiri, Koraput) enrolled 269 laboratory-confirmed <em>P. vivax</em> patients aged over one year. Structured questionnaires collected demographic, clinical, and treatment data. Adherence to the 14-day primaquine regimen was assessed on days 7 and 14 via self-report, pill counts, and blister pack inspection. Uni- and multivariable analyses identified predictors of non-adherence.</div></div><div><h3>Results</h3><div>Adherence to chloroquine (3 days) and artesunate–SP (mixed infections) exceeded 93 %, while only 58.7 % (95 % CI: 52.6–64.9) completed the 14-day primaquine course. Healthcare workers dispensed drugs according to guidelines. Treatment discontinuation was mainly due to symptom resolution (61.9 %) and forgetfulness (21.4 %); only one patient discontinued primaquine due to an adverse event. Older age and household malaria history were associated with better adherence.</div></div><div><h3>Conclusion</h3><div>Suboptimal primaquine adherence delays <em>P. vivax</em> elimination despite adequate drug supply and correct dosing. Addressing behavioral drivers of early treatment cessation is critical to interrupt relapse transmission. Programmatic focus should include intensified social behavior change communication, targeted directly observed therapy, and evaluation of shorter primaquine or single-dose tafenoquine treatments with G6PD testing to enhance radical cure and accelerate India’s 2030 malaria elimination goal.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103123"},"PeriodicalIF":4.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.jiph.2025.103120
Anyue Xia , Jie Luo , Xiaohui Yu , Sijuan Ding , Dongfang Feng , Bin Zhu , Maoshi Li , Shangshi Li , Li Shi , Huan Xu
Objective
This study aimed to characterize the genetic diversity of drug resistance in Mycobacterium tuberculosis (MTB) isolates from the Tibetan Plateau, elucidate the molecular epidemiological profile of tuberculosis (TB) in this high-altitude region, and offer a molecular basis to guide improved diagnostic, therapeutic, and preventive strategies.
Methods
A total of 169 clinical MTB isolates were collected from the General Hospital of Xizang Military Command between January 2024 and April 2025. Drug resistance-associated mutations were identified via targeted gene sequencing.
Results
Among the 169 isolates, the overall rate of genotypic resistance was 20.71 %, comprising mono-resistance (14.79 %), poly-resistance (1.78 %), and multidrug-resistance (MDR, 4.14 %). Retreated patients exhibited a higher resistance rate than newly treated cases (26.09 % vs. 14.29 %), with MDR exclusively identified in the retreatment group. Resistance to streptomycin was most prevalent (8.28 %), followed by isoniazid (7.69 %) and rifampicin (7.10 %). The predominant mutations observed were rpsL K43R and katG S315T. No mutations conferring resistance to second-line drugs were detected.
Conclusion
The substantial burden of drug-resistant TB on the Tibetan Plateau—particularly streptomycin resistance—underscores the critical need for implementing precision diagnostics and optimizing therapeutic regimens.
{"title":"The genetic diversity of drug resistance in Mycobacterium tuberculosis strains from the Tibetan Plateau","authors":"Anyue Xia , Jie Luo , Xiaohui Yu , Sijuan Ding , Dongfang Feng , Bin Zhu , Maoshi Li , Shangshi Li , Li Shi , Huan Xu","doi":"10.1016/j.jiph.2025.103120","DOIUrl":"10.1016/j.jiph.2025.103120","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to characterize the genetic diversity of drug resistance in <em>Mycobacterium tuberculosis</em> (MTB) isolates from the Tibetan Plateau, elucidate the molecular epidemiological profile of tuberculosis (TB) in this high-altitude region, and offer a molecular basis to guide improved diagnostic, therapeutic, and preventive strategies.</div></div><div><h3>Methods</h3><div>A total of 169 clinical MTB isolates were collected from the General Hospital of Xizang Military Command between January 2024 and April 2025. Drug resistance-associated mutations were identified via targeted gene sequencing.</div></div><div><h3>Results</h3><div>Among the 169 isolates, the overall rate of genotypic resistance was 20.71 %, comprising mono-resistance (14.79 %), poly-resistance (1.78 %), and multidrug-resistance (MDR, 4.14 %). Retreated patients exhibited a higher resistance rate than newly treated cases (26.09 % vs. 14.29 %), with MDR exclusively identified in the retreatment group. Resistance to streptomycin was most prevalent (8.28 %), followed by isoniazid (7.69 %) and rifampicin (7.10 %). The predominant mutations observed were <em>rpsL</em> K43R and <em>katG</em> S315T. No mutations conferring resistance to second-line drugs were detected.</div></div><div><h3>Conclusion</h3><div>The substantial burden of drug-resistant TB on the Tibetan Plateau—particularly streptomycin resistance—underscores the critical need for implementing precision diagnostics and optimizing therapeutic regimens.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103120"},"PeriodicalIF":4.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.jiph.2025.103125
{"title":"Best Paper Award “Journal of Infection and Public Health” – 2025 Edition","authors":"","doi":"10.1016/j.jiph.2025.103125","DOIUrl":"10.1016/j.jiph.2025.103125","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103125"},"PeriodicalIF":4.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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