Journal of Tropical Medicine最新文献

Background: Nigeria has the highest burden of hepatitis B virus (HBV) infection in sub-Saharan Africa. However, the lack of a robust surveillance system and program data has limited the understanding of the burden and the distribution of HBV across different populations. This narrative review aimed to summarize available data on the epidemiology of HBV in Nigeria and identify research gaps in the existing literature. Methods: We searched PubMed, Scopus, and Google Scholar for relevant articles published between January 2000 and June 2025. Primary studies, reviews, and reports that contained data of interest, including prevalence, incidence, mode of transmission, mortality, and genotypes, were included in this review. Where available, we restricted our results to findings from representative surveys (conducted across the six geopolitical zones) or systematic reviews. Prevalence rates < 2%, 2%-7%, and ≥ 8% were described as low, intermediate, and high, respectively. Results: Studies on the prevalence of hepatitis B surface antigen (HBsAg) have reported intermediate to high rates in the general population (5.4%-13.6%), with evidence suggesting declining trend. The most recent estimates showed a prevalence of 5.4% in 2022, corresponding to approximately 14.4 million people living with HBV. Available data indicate sociodemographic disparities in HBV prevalence, with higher rates among men, adults (> 18 years), and rural dwellers. Reported prevalence rates among specific subpopulations include blood donors (13.2%-14.0%), pregnant women (5.5%-14.1%), prison inmates (4%-42.2%), people who inject drugs (7%-7.8%), healthcare workers (1.1%-25.7%), female sex workers (0%-17.1%), men who have sex with men (8.4%-11.7%), and transgender women (15.6%). The prevalence of hepatitis B e-antigen (HBeAg) in the general population ranged from 6.0% to 23.6%. The prevalence of occult HBV infection (OBI) ranged from 0.9% to 17.0%. Genotype E was consistently reported as the predominant HBV genotype. Most studies reported low, intermediate, and high prevalence rates for HBV-hepatitis C virus (HCV), HBV-hepatitis D virus (HDV), and HBV-HIV coinfections, respectively. In 2022, approximately 46,000 deaths were attributed to HBV, translating to a mortality rate of 21 per 100,000 population. Conclusions: A wide range of HBV prevalence rates has been observed across various population groups in Nigeria. Key research gaps in HBV epidemiology that must be addressed include modes of transmission, incidence rate, prevalence among key populations, prevalence of OBI in the general population, and spatial distribution of the burden.

Due to the increasing resistance to synthetic insecticides and the proliferation of resistant strains of malaria vectors, plant-derived essential oils (EOs) are gaining prominence as an alternative for controlling Anopheles gambiae s.l. larvae. This study evaluated the larvicidal efficacy of EOs from Azadirachta indica and Schinus molle, both individually and in combination, against early 4^th-instar Anopheles gambiae s.l. larvae under laboratory and semifield conditions. The EOs were extracted using ethanol in a Soxhlet apparatus. Twenty-five treatments were arranged in a completely randomized design for experimentation. Temephos (Abate) and distilled water served as positive and negative controls, respectively. Each treatment contained 20 larvae, which were acclimatized for 2 h prior to exposure to EOs. Treatment cups were covered with muslin cloth to prevent debris contamination. Larval mortality was assessed at 24, 48, and 72 h postexposure at concentrations of 25, 50, and 75 ppm. In the laboratory, A. indica oil exhibited the highest larvicidal activity among plant treatments, with 71.66% mortality at 75 ppm after 72 h, while S. molle and the combined treatment produced moderate effects. LC₅₀ and LC₉₀ values confirmed A. indica's superior potency, with significantly lower lethal concentrations across all exposure times (p < 0.05). In simulated field trials, A. indica oil also demonstrated time- and dose-dependent larvicidal activity, achieving 68.33% mortality at 75 ppm after 72 h. Synthetic larvicide Temephos (Abate) consistently caused 100% mortality within 24 h at all concentrations in both settings. These findings suggest that A. indica EO, particularly at higher concentrations and longer exposures, may serve as an effective botanical alternative for larval control in integrated vector management programs.

[This corrects the article DOI: 10.1155/jotm/5040196.].

[This corrects the article DOI: 10.1155/jotm/1307578.].

Iran is a significant center for cutaneous leishmaniasis, making it crucial to identify transmission modes and control measures to improve public health. Due to the frequent cases of leishmaniasis at health centers in Neyshabur and Firuzeh, this study aimed to create a comprehensive profile of the demographic and environmental factors influencing the prevalence of this condition. This retrospective study utilized secondary data involving 807 patients with suspected cutaneous leishmaniasis, referred to various health facilities, including clinics, outpatient centers, and hospitals in Neyshabur and Firuzeh Counties between 2013 and 2019. Of the total patients, 47.6% were male and 52.4% were female. The highest disease incidence was observed in middle-aged individuals, with 68% of cases occurring in urban areas and the remainder in rural settings. Of those infected, roughly 55% had no recent travel history, while approximately 45% reported recent travel. Among the subjects studied, 58.73% had one wound, 17.22% had two, and 7.08% had five or more. The hand was the most affected area, representing 20.69% of cases, followed by the face at 19.21%. A statistical correlation was found between patients' place of residence and occupational group with the type of cutaneous leishmaniasis. The incidence of the disease declined in 2018, but Neyshabur's central districts showed a higher average annual incidence rate than other studied areas, indicating increased risk for residents contracting cutaneous leishmaniasis. This highlights the need for targeted education for at-risk populations to reduce incidence rates and prevent disease spread.

Background: Anopheles arabiensis, the primary malaria vector in Ethiopia, exhibits diverse feeding behaviors influenced by geography, climate, and control strategies. Understanding its blood-feeding preference is crucial for devising effective interventions. This study aimed to conduct a systematic review and meta-analysis of existing evidence on An. arabiensis human blood index (HBI) in Ethiopia. Methods: A comprehensive search of multiple electronic databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using criteria adopted from the Joanna Briggs Institute (JBI) appraisal checklist. Data were analyzed using Stata Version 17, employing a random-effects model to estimate the pooled HBI at 95% confidence interval (CI). Subgroup analysis and meta-regression were performed based on regions and mosquito collection methods. Heterogeneity was assessed using the I ² test. Results: A total of 19 studies published from 1997 to 2023 were included, encompassing 12,794 blood-fed An. arabiensis. The meta-analysis revealed a pooled HBI of 37.18% (95% CI: 21.26-44.28). Subgroup analysis showed regional variation, with the highest HBI reported in Mixed Region 3 (covering Afar, Oromia, and the Amhara Regional States) at 64.02% (95% CI: 61.78-66.25), and the lowest in the Amhara Regional State at 7.53% (95% CI: -1.58-16.65). Temporal analysis indicated fluctuations over time, with the highest HBI reported in 2014 (70.62%, 95% CI: 68.72-72.46) and the lowest in 2021 (0%, 95% CI: 0.00-1.30). Conclusion: The present study found that An. arabiensis in Ethiopia exhibits a moderate preference for human blood, with a pooled HBI of 37.18%. However, significant variation exists across regions and over time. Continuous surveillance and further research are needed to explore the underlying factors influencing HBI and to guide evidence-based malaria prevention and control strategies.

Background: Rapid digital responses to pandemics highlight advancements in healthcare, data sharing, and artificial intelligence (AI). While AI has driven progress in precision medicine, drug discovery, and vaccine development, its application to emerging and reemerging infectious diseases (ERIDs) remains underexplored, presenting critical challenges in addressing future health threats. Objectives: The study evaluated knowledge of ERIDs, AI, and Digital One Health (DOH) technologies, examined preparedness for their adoption in home healthcare, and identified factors influencing readiness to utilize these technologies in selected health districts of Cameroon. Methods: A cross-sectional study assessed the preparedness of communities in Buea, Limbe, Bonassama, and New-Bell Health Districts to adopt AI and DOH technologies from April to May 2024. Systematic random sampling included 33 communities, with data collected using face-to-face structured questionnaires. Analysis using SPSS Version 26 involved descriptive statistics and logistic regression, with statistical significance set at p < 0.05 and a 95% confidence interval to identify key associations. Results: Among 1625 participants, only 280 (17.2%) had good knowledge of ERIDs, with COVID-19 (68.8%) and cholera (94.5%) being the most recognized examples. Knowledge of AI and DOH technologies was poor, with only 166 (10.2%) demonstrating accurate understanding. Early disease detection emerged as a critical application of AI for ERID control. Preparedness to adopt AI and DOH technologies was reported by 941 (57.9%), with 64.5% comfortable with AI-generated interpretations and willing to use digital health tools during ERID outbreaks. Factors independently associated with preparedness included being a student (AOR = 2.678; 95% CI: 1.744-4.113; p < 0.001), good knowledge of AI and DOH (AOR = 7.141; 95% CI: 4.192-12.162; p < 0.001), and prior training on AI and digital health (AOR = 3.081; 95% CI: 2.272-4.179; p < 0.001). Conclusion: The study revealed insufficient knowledge of ERIDs, AI, and DOH but high preparedness to adopt these technologies for home care. Enhanced educational campaigns are recommended to improve community understanding and effective utilization of AI and DOH for controlling ERIDs.

Introduction: Leptospirosis is endemic to Puerto Rico, affecting people through seasonal increases and outbreaks. This report describes the diagnostic approach and clinical characteristics of leptospirosis cases identified through active undifferentiated acute febrile illness (UAFI) surveillance in Puerto Rico. Materials and Methods: From 2019 to 2021, active surveillance was conducted in four emergency departments (EDs), with standardized recruitment of patients aged ≥ 5 years, presenting with fever or a history of fever of unknown origin within the past two weeks. Additional cases were recruited from referrals of patients with positive leptospirosis diagnostic tests routinely ordered by clinicians. All enrolled patients were subject to a standardized diagnostic algorithm using PCR and serology to identify probable and confirmed leptospirosis cases. Patient data were collected from electronic medical records and interviews. Results: Leptospirosis was diagnosed in 4% of 406 ED-enrolled UAFI patients, eight confirmed and eight probable cases. Referrals resulted in the identification of 12 routinely detected cases (five confirmed and seven probable). Of the 28 cases, 71% were ≤ 7 days post onset, 71% were male, average age was 43 years old, and the most common presentations included lower back pain (82%), headache (75%), fatigue (71%), vomiting (71%), myalgia (71%), and calf pain (64%). Common clinical laboratory findings were elevated AST (78%), hyperglycemia (74%), thrombocytopenia (48%), proteinuria (62%), and hematuria (62%). Classification of four isolates identified L. interrogans serovar Icterohaemorrhagiae/Copenhageni (n = 2), L. borgpetersenii serovar Ballum/Guangdong, and L. kirschneri (no serovar match). All but one of the leptospirosis cases met the current Council of State and Territorial Epidemiologists' definition for clinical compatibility with leptospirosis. Hemorrhagic symptoms and acute kidney injury with jaundice were associated with being a leptospirosis case. Conclusions: These findings underscore the role of leptospirosis among febrile illnesses in Puerto Rico, the need for increased awareness to optimize diagnosis and treatment, and further research to improve prevention and intervention strategies.

Malaria disease is a major health issue in Ethiopia, affecting three-fourths of the country's land area and more than two-thirds of the population living below 2000 m altitude. Over 42 Anopheles species have been identified in the country, but Anopheles arabiensis was the only major malaria vector, accounting for the majority of illness and mortality. However, there is a new invasive malaria vector, Anopheles stephensi, which is strikingly similar to the primary vector. This species transmits both Plasmodium falciparum and Plasmodium vivax and has gained resistance to all four types of insecticides, such as A. arabiensis. Plasmodium falciparum and Plasmodium vivax accounted for the majority of malaria cases in the country. However, these species have evolved resistance to several antimalarial medications throughout the country, adding to the burden. Furthermore, the country has just had a long civil war, which has resulted in an alarming spike in malaria cases throughout the country. Even in a few regions, such as Amhara and Oromo, the disease is spreading rapidly and beyond the control of regional health bureaus. All of these issues constitute major impediments to the country's malaria elimination aim. This article provides a comprehensive summary of the status of new and invading species, the status of insecticide-resistant malaria vectors, the ranges of drug-resistant Plasmodium species, the impacts of neglected Plasmodium vivax, and the impacts of civil war on Ethiopia's malaria elimination aim.

Background: Understanding the immune pathogenesis mechanisms of leishmaniasis is crucial for developing effective therapeutic interventions. In this study, we investigated the effect of ivermectin (IVE) on the expression of transcription factors GATA-binding protein 3 (GATA-3), T-bet, and ROR-γt as well as wound healing Leishmania infection. Methods: Leishmania promastigotes were subcutaneously inoculated into the tail base of BALB/c mice (n = 10 per group) who later received phosphate-buffered saline (PBS), IVE, Glucantime, or a combination of IVE and Glucantime as soon as wounds developed, approximately three weeks' postinfection. The treatment continued daily for 2 weeks. The diameter of the wound was measured weekly over 6 weeks. In addition, in the sixth week, the mRNA expression of T-bet, GATA-3, and ROR-γt in splenic T cells was assessed through real-time PCR analysis. Results: The findings of this research indicated a significant reduction in the lesion size among the treated groups compared with the control group (p < 0.05). IVE had a similar effect to Glucantime in reducing wound diameter (p > 0.05). Furthermore, the combined use of Glucantime and IVE led to the most reduction in the lesion size among all groups. The treated groups exhibited higher expression levels of T-bet and ROR-γt and lower levels of GATA-3 compared with the control group (p < 0.05). Conclusion: IVE has shown significant efficacy in accelerating the healing process of wounds related to leishmaniasis. In addition, the administration of this medication has triggered a strong immune response, marked by activation of T helper 1 (Th1) and Th17 cells while also modulating Th2 responses.