Journal of Tropical Medicine最新文献

[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.

Background: Q fever is a zoonotic bacterial infection with worldwide distribution. Based on seroepidemiology studies among the human population and also serological and molecular surveys of animals, Q fever is an endemic disease in Iran. However, the status of acute Q fever in many parts of Iran is still unknown. This study aimed to investigate acute Q fever among high-risk patients with fever and pneumonia symptoms in Western Iran. Methods: In this survey, 96 patients were included in the study in Kurdistan Province who had symptoms of suspected pneumonia or acute Q fever and epidemiological evidence for the risk of Q fever. From each individual, paired acute and convalescent serum samples were taken, and the elevation of the phase II IgG antibody titer against Coxiella burnetii was traced by ELISA. Also, molecular detection of C. burnetii was done in acute blood samples by real-time PCR. Results: Seven patients (7.3%) were diagnosed with acute Q fever who had seroconversion and a four-fold rise in the phase II IgG antibody titer against C. burnetii in their paired sera samples. Also, 22 of 89 (24.7%) individuals with a negative result for acute Q fever had a previous history of exposure to C. burnetii. There was a significant relationship between sheep husbandry and a previous history of exposure to C. burnetii (p=0.04). All molecular tests were negative. Conclusion: The results of this study showed that there are cases of acute Q fever in Western Iran, but it is not considered by the healthcare system or clinicians.

Background: Intestinal parasitic infections (IPIs) are a persistent public health challenge in low- and middle-income countries, particularly among school-aged children. Objective: This study aimed to compare IPI prevalence and risk factors before and after the COVID-19 pandemic in Eswatini, based on the hypothesis that pandemic-related disruptions may have influenced infection dynamics, despite no formal interventions being introduced. Methods: A prospective cohort of 128 schoolchildren from Manzini and Lubombo Provinces was followed from 2019 to 2022. Stool samples were analyzed using the merthiolate-iodine-formaldehyde (MIF) method. Structured interviews assessed hygiene behaviors and household factors. Logistic regression was used to identify associations with infection risk, reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: Overall, IPI prevalence remained consistent (43.0% in 2019 vs. 42.2% in 2022), with protozoan infections predominating and helminth infections remaining low (1.6% in 2019 and 2.4% in 2022, respectively). In 2022, children with only one employed parent had significantly higher odds of IPIs (aOR = 3.97; 95% CI: 1.48-10.64; p=0.006) and pathogenic protozoan infections (aOR = 4.33; 95% CI: 1.41-13.27; p=0.01). Handwashing before meals was protective in 2019 (aOR = 0.10; 95% CI: 0.02-0.58; p=0.01) but not significant in 2022. Notably, Giardia intestinalis infections declined, while Blastocystis hominis increased. Conclusion: The stable infection rates and changing species composition suggest that pandemic-associated shifts in behavior and public health disruptions may have influenced IPIs' epidemiology. Continued surveillance and targeted hygiene interventions are needed to mitigate the burden of IPIs in schoolchildren.

Current French guidelines on the diagnosis of dengue infection recommend both nucleic acid testing and serology as tools for laboratory confirmation. This study aimed to evaluate the performance of the fully automated Virclia IgM assay for the diagnosis of dengue infection. Samples from patients with a suspicion of dengue were prospectively tested using the Virclia Dengue IgM assay (Vircell) and subsequently underwent additional investigations (dengue RT-PCR and conventional dengue IgM EIA) at the French Reference Center for Arboviruses. A total of 104 patients were included with a median age of 34.3 years old and a median time since symptom (TSS) of 6 days. Dengue RT-PCR was positive in 57 patients (54.8%). The agreement was excellent (90.5%; κ = 0.81) between RT-PCR and Virclia Dengue IgM assay on samples collected from Day 5 postsymptom onset. On these samples, the sensitivity and specificity of the Virclia IgM assay were 95.7% (95% CI: 84.7%-96.9%) and 96.4% (95% CI: 80.8%-100%), respectively. In addition, the agreement was also excellent between the Virclia Dengue IgM assay and the Euroimmun plate-based Dengue IgM ELISA (92.7%; κ = 0.85). In conclusion, the Virclia Dengue IgM assay showed a good performance in the diagnosis of dengue infection and can be recommended in addition to nucleic acid testing to broaden the diagnostic window. The automation coupled with the monotest format is well-adapted for nonendemic areas.