Journal of Tropical Medicine最新文献

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.

The increasing burden of schistosomiasis, compounded by the restriction imposed by monotherapeutic regimens, highlights the pressing need for new molecules that target specific molecular pathways. Schistosoma mansoni histone deacetylase 8 (SmHDAC8), a zinc-dependent epigenetic regulator, has emerged as a nonredundant and druggable enzyme, critical for parasite survival, fertility, and chromatin homeostasis. In this study, we outline multiple-mode computational analysis involving structure-based virtual screening against a chemically diverse ligand library, frontier molecular orbital analysis through DFT, large-scale molecular dynamics (MD) simulations (500 ns), and molecular mechanics/gas-phase/Generalized Born (MM/GBSA) energy component analysis, complemented with machine learning-guided pIC₅₀ model building and prediction. Our screening cascade comprising docking, MM, and MD identified the lead candidate, 24374890, with the best docking score (-9.5 kcal/mol) and desirable electronic configuration (HOMO-LUMO gap: 4.143 eV) for its optimal reactivity-stability balance. MD simulations confirmed its stability in the short term, as well as its conformational preservation in the SmHDAC8 catalytic pocket, as evidenced through low RMSD values, stable free energy basins, and sustained intermolecular interactions. Hydrogen bond analysis proved that compounds 24374890 and 24280440 kept 1-4 stable hydrogen bonds for the entire 500 ns simulation, supporting their strong and stable binding in SmHDAC8's active site. Thermodynamic calculations through MM/GBSA indicated 24374890 has the best energetics for binding (ΔG_total = -65.11 kcal/mol), comprising largely van der Waals and nonpolar solvation energies. Finally, the pIC₅₀ value for 24374890 was predicted, through supervised machine learning, as 8.1, better than the reference molecule. These convergent findings from quantum mechanical, molecular mechanical, and AI-based computations validate 24374890 as an SmHDAC8 inhibitor that is structurally and dynamically sound. These calculations need to be supported with in vitro enzyme inhibition experiments against recombinant SmHDAC8 and cytotoxicity profiling in schistosome cultures. Moreover, X-ray crystallography or cryo-EM analysis of the SmHDAC8-24374890 complex would reveal detailed binding conformations.

Background: Previous studies reported increasing herbal medicine (HM) use among patients with cardiovascular diseases, including hypertension. Although HMs are widely used for their therapeutic benefits, repeated use has raised concerns due to reported adverse effects and potential interactions with conventional treatments. This study assessed the prevalence, forms (preparation), and factors associated with HM use among hypertension patients in an urban setting in Uganda.

Methods: An analytical cross-sectional study was conducted in March 2021 among 121 patients with hypertension at Naguru Regional Referral Hospital using standardized questionnaires. Descriptive and multivariate analyses identified factors independently associated with HM use, with p  <  0.05 as the significance threshold.

Results: All 121 (100%) participants had ever used HM for hypertension; 86 (71.1%) reported consistent use in the past 12 months. Daily use was reported at 53 (43.8%), while 74 (61.2%) reported concurrent use with conventional medicine. The majority used HM in the liquid form [74 (61.2%)], but most HMs were ingested orally [101 (83.5%)]. 53 participants (43.8%) chose HMs themselves, and 46 (39.3%) procured from herbalists. The main HM knowledge source was family [53 (25.6%)]. High odds of HM use were observed among participants from the Central Region (AOR = 9.4; 95% CI = 1.7-51.0), those with easy access to herbalists and doctors (AOR = 1.6; 95% CI = 0.4-76.8), those who did not inform health workers about HM use (AOR = 5.3; 95% CI = 0.5-54.0), and those who perceived concurrent HM use as safe and beneficial (AOR = 2.2; 95% CI = 0.6-7.3) or free of side effects (AOR = 6.8; 95% CI = 1.6-28.9). Region (p = 0.009), accessibility (p = 0.049), and perception of no side effects (p = 0.009) were significantly associated with HM use.

Conclusion: HM is widely used by urban-dwelling patients with hypertension and is influenced by perceived benefits, safety, and ease of access. Health workers need to proactively inquire about HM use to effectively advise hypertension patients, tailor interventions appropriately, and monitor treatment outcomes. More research is needed to systematically measure and track outcomes in patients who use HM remedies to treat hypertension.

Dengue fever presents a growing public health challenge in tropical and subtropical regions, where early detection is crucial for effective intervention. This study conducts a comprehensive comparative analysis of 13 machine learning and deep learning models for nonclinical, symptom-based dengue prediction, focusing on the Bangladeshi population. Using a dataset of 500 patient records with 22 symptom-based features, we evaluated a wide spectrum of classifier algorithms, including tree-based (e.g., random forest, extra trees, bagging), linear (logistic regression, SGDClassifier), and an instance-based classifier. Our comparative evaluation revealed that a custom-built, hyperparameter-tuned artificial neural network (ANN) achieved the highest accuracy of 97.5%, significantly outperforming all other models. While tree-based models like random forest also demonstrated strong performance (93.2%), other classifiers showed considerably lower efficacy. To ensure transparency in our top-performing model, SHapley Additive exPlanations (SHAP) was employed, identifying critical predictors such as retro-ocular pain, swollen eyelids, and age. This study not only establishes the superiority of a well-tuned ANN for this task but also demonstrates the value of broad model comparison and explainability in building reliable diagnostic tools for public health.

Background: Despite being preventable and treatable, malaria continues to have a devastating impact on people's health and livelihoods around the world. In Ethiopia, it is one of the three leading causes of hospital admission and mortality. Therefore, the aim of this study was to assess the trend, burden, seasonal variations, and interventional assessment of malaria in Western Tigray, Ethiopia, from 2011 to 2019.

Methods: A hospital-based retrospective cross-sectional study was carried out to determine trend, burden, seasonal variations, and interventional assessment of malaria in Kahsay Abera General Hospital, Western Tigray, North Ethiopia, from 2011 to 2019. All recorded microscopically confirmed malaria cases in the Health Management Information System of the hospital were carefully taken and analyzed. Also, malaria intervention activities applied in the area were assessed using a checklist, personal communication with hospital administrators, and observations. All data of malaria cases were entered and analyzed using Microsoft Office Excel and presented in tables and figures.

Results: A total of 36,438 malaria cases with 50 (0.14%) hospital mortality and 2016 (5.5%) hospital admissions were recorded from 2011 to 2019. Plasmodium falciparum, with 22,621 cases (62.1%), was the predominant malaria species identified. The highest hospital malaria death was observed in the age group ≥ 15 years, with 38 cases (0.10%), and the highest hospital deaths occurred during October-December, with 21 cases (0.06%) of the total confirmed malaria cases. Although the fluctuating trend of malaria cases, with no shift in species, was statistically significant (p = 0.001) over the study period, the trend in hospital mortality due to malaria was not statistically significant (p = 0.62).

Conclusions: Despite Ethiopia's notable progress in malaria control, the disease remains a major health problem with fluctuating annual trends.