Journal of Tropical Medicine最新文献

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.

Background: Schistosomiasis and intestinal helminthiases are significant public health issues that severely impact the development of children and adolescents in impoverished regions, such as the rural village of Soavinarivo in central Madagascar. These issues are often associated with deficient hygienic and sanitary conditions.

Methods: A prospective cross-sectional study was conducted in October 2017 on children aged 3-15 years. A total of 114 stool samples were collected and analysed using microscopy and molecular techniques to identify schistosomiasis and intestinal helminthiases. Descriptive statistics assessed prevalence, and binary logistic regression identified risk factors for helminth infections.

Results: Helminth prevalence was 88.6%, with Schistosoma mansoni being the most common (76.3%), followed by Hymenolepis (= Rodentolepis) nana (31.6%). Soil-transmitted helminths, including Trichuris trichiura and Ascaris lumbricoides, each affected 14% of participants. It should be noted that 5.3% of participants tested positive for Taenia solium. Undernutrition affected 66.7% of participants, with 58.8% suffering from stunting and 22.8% from wasting. Stunting was more likely in participants with A. lumbricoides. Risk factors for S. mansoni included being over 9 years old and working in rice fields. Not washing fruits and vegetables before eating and contact with pigs were related to A. lumbricoides infections. Clinical symptoms, such as abdominal distension and pain, were associated with S. mansoni infection.

Conclusions: The prevalence rates of schistosomiasis and soil-transmitted helminthiases, highlighting S. mansoni, and its coexistence with undernutrition in the same population, are alarming. These findings underscore the urgent need to intensify current control strategies, which include deworming, provision of clean water, implementation of sewage systems and education on sanitation and hygiene.

Objective: This study aimed to investigate the clinical features of patients with autoimmune liver disease (AILD) following coronavirus disease 2019 (COVID-19).

Methods: For the AILD group, 19 inpatients who were first diagnosed with AILD were enrolled from Wuxi Fifth People's Hospital between January 2021 and December 2021. The post-COVID-19 AILD group comprised seven patients recruited after December 2022 who were initially diagnosed with COVID-19 and later diagnosed with AILD. Routine blood indices, biochemical parameters, serum-related antibodies, and serum immunoglobulin levels were assessed in the two groups. Ultrasound-guided liver biopsy was performed to observe the pathological characteristics of the liver in the two groups. The expression of immune indices in the two groups was observed by immunohistochemistry.

Results: The age and calcium levels of the post-COVID-19 AILD patients were significantly lower than those of the AILD patients (p < 0.05). The IgM levels were significantly higher in the post-COVID-19 AILD group than in the AILD group (p < 0.05). No significant differences in the other routine blood and blood biochemical indices were present between the two groups. The antinuclear antibody (ANA) and SM antibody levels were compared, revealing a significantly higher percentage of ANA positivity among post-COVID-19 AILD patients than AILD patients (p < 0.05).

Conclusion: AILD following COVID-19 has typical AILD characteristics, including acute onset, but has other characteristics that allow it to be distinguished from other AILDs.

Linarin, a flavonoid glycoside found in the Asteraceae, Lamiaceae, and Scrophulariaceae families, shows diverse therapeutic benefits in laboratory studies. This study aims to evaluate the pharmacological effects of linarin through clinical and preclinical experiments, investigating its mechanisms against different diseases. To achieve this, data collection and search operations were carried out (current as of April 09, 2024) in several reliable online databases, such as PubMed/Medline, Scopus, Springer Link, ScienceDirect, Wiley Online, Web of Science, and Google Scholar, as part of this research. Studies revealed that linarin provides benefits against inflammation and various diseases, including osteoporosis, osteoarthritis, liver injuries, diabetes, hypertension, and neurodegenerative conditions, such as Alzheimer's, ischemia-reperfusion, convulsions, and depression. Our results further reveal that linarin displays remarkable anticancer potentials through multiple molecular pathways, including apoptotic cell death, oxidative stress induction, cytotoxic effect, antiproliferative effect, genotoxic effect, and mitigation of cancer cell migration and invasion and migration against a range of malignancies, including lung, brain, prostate, and glioma cell cancers. Database reports and the current literature-based study suggest that linarin might be a prospective lead chemical for treating a range of illnesses and ailments. For linarin to be proven as a medicine, further clinical and preclinical trials are required.

Bovine tuberculosis (bTB) has significant economic losses on the livestock productivity and poses serious public health risks worldwide. In Ethiopia, bTB is endemic and distributed across all parts of the country. Therefore, the systematic review aims to provide comprehensive investigations of the trends, risk factors, and zoonotic impacts of bTB in Ethiopia. Only English language publications from 2009 to 2022 were included. Databases searched included PubMed, PubMed Central, Medline, Scopus, Web of Science, Google Scholar, and ResearchGate. From a total of 129 articles retrieved, only 44 studies fulfilled the eligibility criteria. The overall pooled prevalence of bTB over 15 years was 11.04%. Female cattle had a significantly higher prevalence (19.85%) compared to male cattle (4.07%) (p=0.002). Emaciated animals were more affected than those in good body condition (p=0.04). Prevalence differed significantly among intensive (22.60%), semi-intensive (17.08%), and extensive (13.70%) production systems (p=0.01). The prevalence of bTB showed statistical significance (p=0.001) in three different breeds. Exotic breeds had the highest prevalence (28.46%), followed by crossed (12.61%) and local breeds (9.56%). Large herds showed a higher prevalence (42.69%) compared to medium (12.13%) and small herds (11.26%) (p=0.001). Poor management systems had a higher positivity rate (31.27%) compared to medium (15.23%) and good (9.89%) management systems (p=0.01). Studies with sample sizes less than 400 reported higher prevalence (20.70%) compared to those with 400-800 samples (11.70%) and more than 800 samples (5.83%) (p=0.001). Significant variations were observed among different diagnosis techniques (p=0.004). Only 40.82% and 35.51% of cattle owners had knowledge of bTB and awareness of its zoonotic impacts, respectively. Overall, the trends of bTB remain a significant impact in Ethiopia, affecting both livestock productivity and public health. Understanding these trends is essential for the development of evidence-based control strategies. The integration of epidemiological modeling with public health impact assessments can further strengthen policy formulation and guide resource prioritization more effectively. Therefore, effective control and prevention measures, along with continuous public education, are essential to mitigate economic losses and reduce the zoonotic impacts of bTB in the country. Using improved diagnostic techniques should be recommended to estimate the actual prevalence of the disease.

Dengue fever is highly prevalent in tropical and subtropical regions, where it is caused by dengue virus (DENV) and transmitted by arthropods. While DENV infection manifests with a spectrum of clinical symptoms, severe cases can lead to hemorrhagic fever and shock syndrome. Increasing evidence over the past decade has highlighted the neurological complications associated with DENV; however, the underlying mechanisms remain poorly understood. Despite this knowledge gap, various central nervous system (CNS)-targeted drugs have shown promise in mitigating DENV-induced neurological impairment. In this review, we provide an overview of the neurotropic features of DENV and summarize current evidence on the antiviral effects of selected nervous system-acting compounds. We also explore the potential mechanisms by which these agents may reduce DENV infection. Given the urgent need for effective dengue therapeutics, repurposing CNS-targeting drugs represents a promising strategy. Finally, we examine the potential and underlying mechanisms for employing neuropharmaceutical agents as one of the antiviral therapies for DENV infection.