Journal of Tropical Medicine最新文献

Background: Neglected tropical diseases (NTDs) disproportionately affect impoverished populations in tropical regions. Despite their significant health burden, data on NTD prevalence and distribution are limited in many areas, including Khartoum State, Sudan.

Objective: This study aimed to assess the prevalence and geographical distribution of NTDs in Khartoum State, Sudan, to inform targeted control interventions and elimination strategies.

Methods: A cross-sectional study was conducted using annual statistical reports from Khartoum State Ministry of Health for 2020 and 2021. Data on the prevalence of NTDs were extracted, focusing on prevalent NTDs in the state. Descriptive statistics summarized NTD prevalence. Time-series analysis identified trends. Spatial data analysis pinpointed hotspots and clustering of NTD cases. Data consistency and accuracy were ensured.

Results: Nine NTDs were prevalent: soil-transmitted helminthiases (STHs), schistosomiasis, scabies, trachoma, snakebite envenoming, leishmaniasis, taeniasis, mycetoma, and leprosy. STH had the highest prevalence (32.7% in 2020 and 32.9% in 2021), primarily affecting children under 15. Schistosomiasis was the second most prevalent (23.0% in 2020 and 20.9% in 2021), predominantly affecting males aged 5-25. Trachoma prevalence varied across localities. Leprosy showed an increasing detection rate.

Conclusion: NTDs pose a significant public health burden in Khartoum State, particularly STH and schistosomiasis. Localized control strategies, improved sanitation, hygiene, access to clean water, and integrated NTD programs are crucial to reduce the NTD burden and improve population health. Continuous surveillance is warranted, especially for leprosy.

Chagas disease, caused by Trypanosoma cruzi, is a neglected tropical disease (NTD) that can lead to severe cardiac complications, including chronic Chagas cardiomyopathy. While NTDs are caused by a variety of pathogens-such as protozoa, bacteria, viruses, and helminths, Chagas disease remains underexplored, particularly regarding host immune responses. In this context, purinergic signaling has gained attention as a relevant pathway in the regulation of both infection and inflammation. Extracellular adenosine triphosphate (ATP), commonly elevated during inflammatory conditions, acts through P2 receptors, with P2X7 standing out for its ability to induce cell death and modulate cytokine release. This study investigates the involvement of the P2X7 receptor in NTDs, with a particular focus on Chagas disease, due to its established association with cardiovascular inflammation and its potential role in T. cruzi infection. Although other NTDs were initially considered, some NTDs were not investigated in detail because of insufficient data linking P2X7 receptor activity to their pathogenesis. Consequently, the analysis concentrated on Chagas disease, where current evidence indicates that P2X7 receptor activation increases proinflammatory cytokine levels and may contribute to disease progression, especially in its cardiac form. Thus, P2X7R emerges as a promising molecular target for therapeutic strategies and may serve as a potential biomarker for identifying early or indeterminate forms of Chagas disease.

Objective: To assess the awareness, perceptions, and practices of telemedicine among Togolese doctors.

Material and methods: Descriptive cross-sectional study was conducted from January to March 2021 on Togolese doctors residing and practicing in Togo. A structured questionnaire which included 32 questions (closed-ended and multiple-choice items) was developed. Data were collected electronically using a Google Form sent by e-mail and WhatsApp to the doctors.

Results: Of the 136 doctors surveyed, 83.8% were specialists and 33.8% were university hospital doctors. The internet connection at their place of practice was considered to be mediocre by 44.1% and acceptable by 40.4%. Awareness of teleconsultation (92.7%), tele-expertise (61%), and medical teleassistance (52.9%) was reported. A minority were aware of telemonitoring (43.4%) and medical regulation (14%). Around two-thirds of doctors were aware of the need for patient consent prior to telemedicine (65.4%). Telemedicine was perceived as a necessity in 67.7% of cases. Telemedicine was practiced by 68.4% and this was teleconsultation in 57.4% and tele-expertise in 21.3%. Majority (90%) used WhatsApp to consult and prescribe a prescription remotely. Around 7% and 4% used Facebook for teleconsultation and tele-expertise, respectively. It was opined that medical imaging (74.3%), general medicine (63.2%), and dermatology (56.6%) were the areas in which telemedicine should be further developed.

Conclusion: The level of awareness of telemedicine among Togolese doctors was suboptimal. Good practices were not always adopted and perceptions were relatively encouraging. Ongoing training and awareness raising on telemedicine good practices could be necessary for its efficient and safe use in Togo.

Background and aims: Malaria is a deadly disease spread through the bite of an infected female Anopheles mosquito and remains the leading cause of mortality globally. Screening donated blood for malaria parasites is essential to prevent its transmission; however, conventional methods have limitations in accuracy and sensitivity. The National Library of Medicine (NLM) mobile application that uses machine learning algorithms to detect malaria parasites in blood smears could reduce some of these limitations. Hence, its performance in different settings needs to be evaluated. This study aimed to evaluate the performance of the NLM screener in screening malaria parasites against microscopy, rapid diagnostic tests (RDTs), and polymerase chain reaction (PCR) among blood donors at the Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana.

Methods: We conducted a cross-sectional study of 300 blood donors at the KBTH in Ghana. Each donor sample was tested with PCR (reference standard), microscopy, RDT, and the NLM screener app. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's κ were calculated with 95% confidence intervals (CIs). Agreement and paired outcomes were assessed with McNemar's exact test.

Results: PCR identified Plasmodium falciparum in 18/300 donors (6.0%). The NLM screener app showed sensitivity of 38.9% (7/18; 95% CI: 20.3-61.4), specificity of 60.6% (171/282; 95% CI: 54.8-66.2), PPV of 5.9% (7/118; 95% CI: 2.9-11.7), and NPV of 94.0% (171/182; 95% CI: 89.5-96.6), with negligible agreement (κ = -0.001). RDT and microscopy had lower sensitivities (44.4% and 27.8%, respectively) but perfect specificity (100%).

Conclusion: The NLM screener app demonstrated low diagnostic performance in this setting. Applied to our donor pool, it would have led to 111 unnecessary discards (false positives) and 11 missed infections (false negatives). While promising, the app requires substantial improvement and validation before consideration for clinical use in transfusion safety programs.

Background: In urban areas of developing countries, cockroaches pose a significant public health threat by spreading diseases and contaminating food sources. This study aimed to assess the infestation levels of indoor cockroach species across various household settings and to evaluate community management practices.

Methods: The study was conducted from April to June 2022, utilizing sticky traps placed within 2 × 2 m distance transects. Morphological identification of cockroach species was performed using standard taxonomic keys. Data on community management practices were gathered through a well-structured questionnaire. A factorial ANOVA was conducted using SAS statistical software to determine significant differences in cockroach abundance based on the various factors such as sampling months, habitats, species, and sexes. Descriptive statistics were applied to analyze questionnaire data.

Results: A total of 2670 cockroach individuals were collected. The overall ANOVA indicated a statistically significant difference in cockroach abundance among the measured variables and factors (F = 11.7, DF = 59, 540, p < 0.0001). A significant interaction was also observed between month, habitat, and cockroach sexes (excluding species) (F = 3.1, DF = 8, p < 0.0022). The interaction between cockroach species and habitats was significant (F = 4, DF = 33.44, p < 0.0001), while interactions between species and months (F = 2, DF = 1.88, p = 0.15) and species and sexes were not significant (F = 1, DF = 0.87, p = 0.35).

Conclusion: Grain mills with Periplaneta americana and residential areas with Blattella germanica exhibited higher infestation levels compared to other habitats. Households primarily relied on chemical and physical methods for cockroach control. Further studies should be conducted on a broader scale to enhance understanding and management of cockroach infestations.

Ocimum basilicum is an important alternative source to explore diverse anti-infective compounds. In the present study, aqueous seed extract of O. basilicum was used to identify bioactive compounds with antihemolytic, thrombolytic, antivancomycin-resistant Staphylococcus aureus and antivancomycin-resistant S. epidermidis activity. Anti-VRSA and anti-VRSE activity of O. basilicum seed aqueous extract was evaluated by the well diffusion assay. Hemolytic and thrombolytic activities were performed using a 96-well plate. Phytochemical identification was done by GC-MS. ADMET and docking analyses with VanA ligase of VRSA and VRSE were also performed. The aqueous extract showed antibacterial activity against VRSA (12 ± 0.35 mm) and VRSE (13 ± 0.11 mm) isolates. The O. basilicum showed significantly less hemolysis (3.7 ± 0.24%, p < 0.00001) of red blood cells, reflecting low cytotoxicity as compared to the control (98 ± 0.44%). The O. basilicum seed extract exhibited significant thrombolytic activity (4.33 ± 0.2%, p < 0.000429) as compared to the negative control (2 ± 0.34%). Among 23 identified compounds on GC-MS, eight were reported for the first time in O. basilicum aqueous seed extract and processed for molecular docking. After favorable water solubility, pharmacokinetics, medicinal chemistry, and drug likeness, only two compounds, d-glucopyranoside, 2,3,4,6-di-O-(ethylboranediyl)-1-O-methyl and 4(3,4-dihydroxy-2-oxo-butylamino) benzonitrile, were processed for molecular docking. The first one formed three hydrogen bonds with Leu-259, Ser-127, and His-49 residues of the VanA ligase. The second one formed two hydrogen bonds with Ser-161 and Val-160 residues of the VanA ligase. d-Glucopyranoside, 2,3,4,6-di-O-(ethylboranediyl)-1-O-methyl and 4(3,4-dihydroxy-2-oxo-butylamino) benzonitrile. The O. basilicum seed extract has potential bioactivity, and the identified compounds are novel putative VanA ligase inhibitors. Further characterization of the bioactive compounds would help to explore therapeutic targets against VRSA and VRSE.

Introduction: Infection-associated hemophagocytic syndrome (IAHS) is a rare complication in dengue infection that leads to multiple organ dysfunction (MOD) and increased mortality rates. The early use of hemoperfusion with hemoadsorption and standard treatment may reduce inflammation and prevent mortality. This study investigates the therapeutic effectiveness of a combination of hemoperfusion with hemoadsorption and multimodal therapy, including intravenous immunoglobulin (IVIG), corticosteroids, therapeutic plasma exchange (TPE), and/or extracorporeal organ support in pediatric patients with MOD and IAHS resulting from dengue shock syndrome (DSS).

Methods: This retrospective observational research includes MOD and IAHS resulting from DSS. All children had 4 h of hemoperfusion with hemoadsorption for a duration of 1-3 consecutive days, accompanied by multimodal therapy. Inflammatory markers and mortality rates were assessed.

Results: Five patients were included. All patients received hemoperfusion with hemoadsorption combined with CRRT, while four out of five patients received IVIG, dexamethasone, and plasmapheresis. The median PELOD-2 and vasoactive-inotropic score (VIS) decreased postintervention (8.0 vs. 6.0 and 20.0 vs. 10.0). The median log₁₀ serum ferritin (5.000 vs. 4.724 ng/mL, p value < 0.05) and log₁₀ serum IL-6 (3.193 vs. 2.018 pg/mL, p value < 0.05) levels of the biomarker were significantly decreased. No additional adverse effects were noted.

Conclusion: The combination of hemoperfusion with hemoadsorption and multimodal therapy effectively reduced inflammatory biomarkers and enhanced hemodynamic stability. Nevertheless, mortality outcomes should be assessed across larger populations.

Dengue virus (DENV) infection can potentially lead to severe dengue disease due to the risk of antibody-dependent enhancement. This study reports a comparative analysis of the host cytokine/chemokine response triggered by primary and secondary DENV infections using an artificial ex vivo whole-blood coculture model to simulate viremia during the acute febrile phase of infection. Using ex vivo primary and secondary DENV infection modes, a dengue-specific customized multiplex cytokine/chemokine assay was employed. Secondary infection did not exacerbate DENV-induced hematological and cytopathological changes, such as alterations in complete blood count, intracellular vacuolization, and thrombophagocytosis. However, cytokine/chemokine assay revealed a significant increase in the production of MIP-1α, MIP-1β, IL-6, TNF-α, and RANTES. Notably, a substantial decrease in NS1 levels indicated the neutralization effect in individuals with prior DENV exposure or secondary infection group, especially in some cases of secondary infection. This was accompanied by pre-existing anti-E antibodies, highly associated with IL-6 overproduction. These findings support the potential strategy of assessing DENV susceptibility using NS1 and IL-6 using an ex vivo method.

Introduction: Human T-lymphotropic virus 1 (HTLV-1) is related to several clinical diseases, including adult T-cell leukemia/lymphoma and HTLV-1-associated myelopathy. Intrafamilial transmission of HTLV-1 is rarely reported in Brazil and worldwide.

Objective: To identify HTLV-1 family transmissions in Belem, Para, the Amazon region of Brazil.

Methods: Nested PCR of the pX gene, followed by restrict fragment length polymorphism (RFLP) to identify HTLV-1. Nested PCR of the 5'LTR region was used for nucleotide sequencing. Nucleotide sequences were analyzed using GENEIOUS 4.8.5 and MAFFT V.7.

Results: The study investigated 72 individuals (14 index cases and 58 relatives) from 14 families, identifying HTLV-1 infection in 47% (27/58) of the relatives. Vertical transmission occurred in 14 (39%) of the 36 mother/child relationships investigated, and sexual transmission was observed in 14 (74%) of the 19 marital relationships (p = 0.0299). Both transmission routes were identified only in families with the highest average number of relatives investigated. Nucleotide analysis demonstrated HTLV-1 stability in intrafamilial transmission.

Conclusion: High rate of HTLV-1 intrafamilial transmission was identified in this study. Sexual and vertical transmission are important to familiar dissemination and perpetuation of the virus in this endemic area of the Brazilian Amazon.

Objective: Bloodborne pathogens including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and Treponema pallidum pose a significant menace to transfusion medicine and the public health system. Conducted during the unprecedented global COVID-19 pandemic, this retrospective analysis (2020-2024) evaluated blood donors from Shiyan, China, aiming to ensure blood safety amidst the challenges posed by the pandemic.

Methods: Cases of transfusion-transmitted infections (TTIs) were analyzed by using ELISA. Infection rates were quantified as stratified percentages based on sociodemographic characteristics of the study population. Chi-square trend tests were performed to examine the variation in trends. The chi-square test was performed to evaluate associations between sociodemographic characteristics (age, gender, and occupation) and the risk of pathogen infection (HBV, HCV, HIV, and T. pallidum).

Results: Analysis of 231,733 blood samples from 114,593 donors revealed an overall 0.51% seropositivity for TTIs, with prevalence rates of HBV (0.23%), HCV (0.03%), HIV (0.03%), and syphilis (0.22%). During the COVID-19 pandemic, a declining trend was observed for all infections. The chi-square test disclosed that HBV and T. pallidum infection were higher in the other occupation group of women aged 35-60 years, HCV positivity was more pronounced in men in the same group, and HIV infection was mainly concentrated in the group of men aged 25-44 years.

Conclusions: Continuous monitoring of the prevalence of TTIs among blood donors offers valuable information for ensuring blood safety and new directions in the development of blood transfusion systems.