Journal of Tropical Medicine最新文献

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.

Background: Febrile illnesses can have devastating effects on the health, wellbeing and productivity of infected individuals. Fever is one of the most frequent reasons for seeking medical care globally. In Uganda, malaria is a major cause of fever and other nonmalarial causes such as typhoid and brucellosis. The aim of this study was to improve our understanding of the spatial and temporal distribution of malaria, typhoid fever and brucellosis in Uganda in order to inform the management and control of these diseases.

Methods: A retrospective analysis of data was conducted on human brucellosis, typhoid fever and malaria cases reported through the national disease surveillance system from 2016 to 2023. The data were downloaded from the health management information system into Microsoft Excel. The total number of malaria cases, typhoid fever cases and brucellosis cases over this period were 110,134,705, 1,572,162 and 361,563, respectively. Descriptive analyses were conducted using Epi Info, spatial distribution using Quantum Geographic Information System (QGIS) software. Choropleth maps were created showing cases per 100,000.

Results: Nationally, from 2016 to 2023, the prevalence for malaria, typhoid fever and brucellosis varied from 43,316 to 29,271; 538 to 445 and 151 to 89 cases/100,000 population, respectively. From 2016 to 2023, there was an overall 4% decrease in the malaria prevalence/100,000, 2% decrease in the typhoid fever prevalence/100,000 and 8% decrease in the brucellosis prevalence/100,000. The burden of malaria and the nonmalarial febrile illnesses, typhoid fever and brucellosis varied across regions throughout the eight years. Overall, the northern region had the highest prevalence/100,000 for malaria and brucellosis, while the central region had the lowest prevalence for both diseases. The central region had the highest prevalence for typhoid fever.

Conclusions: The study revealed the disproportionate burden of malaria and nonmalarial febrile illnesses, typhoid fever and brucellosis. The findings suggest a need to review the existing national malaria control program, to strengthen measures to mitigate the risk of typhoid fever infection and multisectoral prevention and control of brucellosis in the most affected regions and districts.

Introduction: One important measure of community and personal hygiene is the prevalence of lice. Healthcare providers and strategists must analyze this illness across several groups if they are to create sensible plans and services for its decrease. The objective of this study was to find the prevalence of head lice in Iranian endemic regions.

Methods: In this retrospective cross-sectional study, all patients referred to healthcare centers affiliated with Shiraz University of Medical Sciences from 2016 to 2021 who were diagnosed with head lice were included. Those confirmed with head lice were isolated and examined by a physician of the healthcare center. Patient information, including city, diagnosis date, type of disease, age, sex, nationality, and urban or rural status, was recorded. Data analysis was performed using descriptive methods in SPSS Version 24 and STATA 14.2.

Results: The results showed a total of 153,550 cases of lice infection (average annual prevalence 0.52% [95% CI: 0.52% to 0.53%]), with a declining trend from 20,951 infections to 5912 during the study period. The highest infection rate (49.3%) was observed in the 6-12 age range; most infected patients, 93.2%, were female. Furthermore, Qirokarzin, Zarrin Dasht, Mohr, and Rostam displayed the highest infestation levels, accounting for 55.4% of infections among the urban population.

Conclusion: Overall, the present study revealed a low prevalence of head lice in Fars Province, southern Iran; most of the individuals with head lice were elementary school-aged girls. Therefore, it is important to focus on interventions and policy-making with the aim of preventing infestation and the spread of disease among this population. Moreover, the general drop in yearly infestation shows how well Shiraz University of Medical Sciences' policies regulate the disease.

Bovine mastitis, a widespread disease in dairy cattle characterized by udder inflammation triggered primarily by pathogenic micro-organisms, poses a considerable challenge to the dairy industry. Staphylococcus epidermidis (S. epidermidis) stands out as a significant etiological factor in the incidence of bovine subclinical mastitis (SCM), further exacerbated by the diminishing efficacy of antibiotics due to the increase in antibiotic-resistant strains. This study sets out to comprehensively investigate the landscape of S. epidermidis in dairy cattle afflicted with SCM. We examined the prevalence of S. epidermidis, assessed its antibiotic resistance patterns, and probed for the presence of antibiotic-resistant genes (mecA, tetK, and ermC) within S. epidermidis strains isolated from 305 milk samples across four distinct dairy cattle breeds: Holstein Friesian, Red Sindhi, Sahiwal, and Cholistani. Among the sampled cows, 56.39% (172 out of 305) were found to have SCM. Within this group, S. epidermidis was identified in 27.90% (48 out of 172) of the cases. Our breed-specific analysis revealed significant disparities, with Red Sindhi cows displaying the highest prevalence at 75%, followed by Holstein Friesian at 45.45%, and significantly lower levels in Sahiwal (5.19%) and Cholistani (3.44%) breeds. To assess the efficacy of antibiotics, we conducted sensitivity testing using nine commonly prescribed antibiotics. Alarmingly, 18 out of the 48 isolates (37.5%) exhibited multidrug resistance (MDR). Our antibiogram results underscored a high resistance of S. epidermidis isolates, particularly against cefoxitin (56.25%) and penicillin (43.75%), while demonstrating remarkable susceptibility to amikacin (2.08%), clindamycin (0%), ciprofloxacin (0%), and chloramphenicol (0%). Furthermore, we employed PCR to ascertain the presence of resistant genes in all S. epidermidis isolates. mecA was detected in 38 isolates (79.16%), while tetK was identified in 33 isolates (68.75%). Notably, the study did not detect the presence of the ermC gene. Our investigation highlights the efficacy of chloramphenicol, clindamycin, and ciprofloxacin against S. epidermidis. However, the prevalence of multidrug-resistant strains calls for careful antibiotic use in veterinary practices. Further research is needed to examine geographic and farm-specific factors affecting S. epidermidis prevalence, and genetic techniques like multilocus sequence typing should be employed to study clonal spread and horizontal gene transfer. Routine antimicrobial sensitivity assessments and continuous monitoring of medication use are essential to develop sustainable strategies against antibiotic resistance in the dairy industry.

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil's major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil.

Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5-90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection.

Results: Among the 183 individuals from 40 participating families, an 8% positivity rate was observed, with variation by age and sex. In 30% of families, at least one member tested positive, indicating continued viral presence within the community. Spatial analysis using Global and Local Moran's I statistics showed a random distribution of positive samples, consistent with multiple introductions from nearby urban centers and intermittent local persistence.

Conclusion: These findings highlight the ongoing detection and persistence of SARS-CoV-2 in a remote Amazonian community, underscoring the need for continued surveillance in geographically isolated populations.

Background and aims: Antirabies vaccine postexposure prophylaxis (PEP) is effective in preventing rabies when administered promptly and in full. This study assessed factors associated with antirabies PEP full-dose completion among patients attending Nyagatare District Hospital.

Methods: A facility-based cross-sectional study was conducted using data from patients who sought antirabies PEP at the hospital's emergency department in 2022. Patient files and registers were reviewed, and data were analyzed in STATA. Logistic regression was performed to identify factors associated with vaccine completion.

Results: Of the 472 participants, 50.0% were under 16 years, 58.9% were male, and 63.6% lived in rural areas. Most (90.9%) had health insurance, 51.7% received PEP during the dry season, 11.0% received the antitetanus vaccine, and 82.2% had WHO wound Category II. Only 26.5% completed the full vaccination schedule, 16.1% missed appointments, and 57.4% dropped out before completion. Health insurance significantly increased the odds of completing PEP (AOR = 2.19, p = 0.032). Age, sex, and wound characteristics were not significantly associated with ARV full-dose completion.

Conclusion: Compliance with the full antirabies vaccine course was low, with only a quarter of patients completing all five doses. Improving completion requires targeted interventions such as reminder systems, community education, provider counseling, and financial support.

Background: Common identification techniques do not differentiate among members of the Acinetobacter calcoaceticus-baumannii (ACB) complex, and the presence of non-baumannii Acinetobacter is often misinterpreted. The bla _OXA-51 gene is located within the chromosome of Acinetobacter baumannii. Despite its plasmid dissemination to other members of the genus, it may be considered in initial species screening. Thus, this study aimed to determine the presence of bla _OXA-51-negative Acinetobacter spp. as a cause of infection in Peru.

Methods: Two hundred ninety-eight ACB complex isolates from different regions of Peru were isolated between January 2018 and March 2024. Of these, 272 and 25 were confirmed as hospital-acquired and community infections, respectively. The presence of bla _OXA-51 was determined by polymerase chain reaction, and the susceptibility levels to 12 antimicrobial agents were determined.

Results: The results showed that 38 (12.7%) isolates were bla _OXA-51-negative. These isolates were frequent among community infections (13/25, p < 0.0001), often causing urine infections. They showed significantly lower levels of resistance to almost all antimicrobial agents tested, and most of them were recovered from regions outside metropolitan Lima.

Conclusion: A relevant number of infections by non-baumannii Acinetobacter species in Peru is suggested, highlighting the need for systematic identification of these species in the country.

Podoconiosis is a neglected tropical disease (NTD) that primarily affects poor communities in tropical regions, particularly in sub-Saharan African countries. The disease results from prolonged contact with red clay soils, leading to chronic lymphedema of the lower limbs. However, the pathogenesis is not yet fully clarified, which continues to hinder the development of targeted interventions and definitive diagnostic tools. This review synthesizes recent advancements in understanding the genetic, immunological, and tissue-level factors driving podoconiosis to help bridge this knowledge gap. It also addresses the clinical features, epidemiology, and public health impact of podoconiosis, focusing on the challenges of misdiagnosis and the lack of standardized diagnostic tests. The identification of biomarkers for early detection and the development of targeted interventions are critical steps toward mitigating the economic and social burden of podoconiosis. Comprehensive research into the genetic and immunopathological basis of podoconiosis is essential for advancing diagnostic and therapeutic approaches and supporting global eradication efforts.

The battle against antibiotic resistance demands innovative solutions for efficient and accurate antibiotic susceptibility testing (AST). Traditional methods, though reliable, are often time-consuming and labor-intensive, limiting their ability to provide timely results in clinical settings. In response, automated systems have emerged as a revolutionary tool, offering rapid, precise, and comprehensive AST processes. The purpose of this review article was to provide a comprehensive guide on automated methods for AST, exploring their principles, advantages over traditional techniques, and implications for clinical practice. By examining recent advancements in this field, we highlight how these innovative approaches can revolutionize our ability to detect antibiotic resistance swiftly and accurately, ultimately improving patient outcomes and combating the growing threat of antimicrobial resistance. The findings from the collected studies indicate that employing various automated techniques for assessing antibiotic resistance facilitates the identification of resistance and allows for precise detection of different pathogens from infectious samples. These automated methods have the potential to decrease hospital stay duration and future treatment costs. Moreover, by accurately detecting resistance more quickly, they can lead to more targeted treatments, ultimately reducing patient mortality rates.

Background: In Ethiopia, parasitic infections pose a major health concern, particularly affecting children. Understanding the occurrence of parasitic infections within a hospital setting provides insights into the overall health status of the broader community.

Aim: The aim of this study was to evaluate the occurrence of parasitic infections among pediatric patients treated at a tertiary hospital in South Ethiopia over a 5-year period.

Method: A retrospective data collection was conducted from February 1, 2023, to April 1, 2023, using the parasitology laboratory stool test results logbook at Wolaita Sodo University Comprehensive Specialized Hospital, a tertiary hospital. The data covered the period from January 1, 2018, to December 30, 2022. Microsoft Excel was used to enter data from logbooks, and the descriptive results were summarized using tables and graphs.

Result: Out of 6542 pediatric patients examined, 6482 were included in the evaluation after excluding incomplete records. Among these patients, 51.6% tested positive for at least one parasite. Of the positive cases, 68% were due to protozoan infections and 32% were due to helminth infections. The most identified parasite was Entamoeba histolytica/dispar, accounting for 43.7% of positive cases. Ascaris lumbricoides was the predominant helminth, representing 17.2% of positive cases. The age group under 5 years had the highest parasitic infections among others.

Conclusion: The occurrence of parasitic infections among pediatric patients treated at this hospital was alarmingly high. Therefore, it is recommended to promote personal hygiene, enhance environmental sanitation, and implement regular screening for intestinal parasites.