Journal of Tropical Medicine最新文献

Molecular docking and molecular dynamics simulations were conducted to assess propolis compounds of sulabiroin-A, sulabiroin-B, and broussoflavonol F as tuberculosis (TB) inhibitors with rifampicin as the control ligand. TB remains a significant world health concern, requiring the development of new drug candidates to address more drug-resistant variants. The target protein chosen was 3PTY. The molecular docking simulation showed that sulabiroin-A, sulabiroin-B, and broussoflavonol F docking scores are comparable to rifampicin, with the order of docking score from least favorable to more favorable is sulabiroin-B< sulabiroin-A< rifampicin< broussoflavonol F (-3.397, -3.449, -5.256, -5.961). Molecular dynamics simulations also demonstrated that sulabiroin-B exhibited stable interactions with the target protein, comparable to rifampicin, while sulabiroin-A and broussoflavonol F demonstrated increased fluctuation, suggesting possible instability. Absorption, distribution, metabolism, excretion, and toxicity (ADMET) study verified that all three drugs possess advantageous pharmacokinetic characteristics, with broussoflavonol F exhibiting the most favorable safety and tolerability profile. According to these findings, sulabiroin-B is recognized as the most promising candidate for TB treatment owing to its enhanced stability in molecular dynamics simulations, although broussoflavonol F and sulabiroin-A exhibit intermediate promise. Additional experimental validation is advised to verify their therapeutic efficacy.

Objective: To investigate the infection status, species composition, and genetic diversity of Bartonella in local rodent populations in coastal mudflat wetland habitats in eastern Jiangsu Province of China. Methods: From March to June 2023, rodents were captured in mudflat wetlands of Dongtai and Tinghu Counties, Eastern China. Rodent species were identified, and nucleic acids were extracted from liver and spleen tissues. The mitochondrial cytochrome b (mt-cytb) gene was amplified by PCR, while Bartonella-specific citrate synthase (gltA) and 16S rRNA genes were amplified by semi-nested PCR. Phylogenetic and homology analyses were conducted to identify rodent and Bartonella species. Results: Among 29 captured rodents, 26 were Apodemus agrarius and 3 were Mus musculus. Phylogenetic analysis of the mt-cytb gene divided A. agrarius into 7 lineages, each linked to geographically diverse Bartonella populations. Six A. agrarius rodents tested positive for Bartonella, with a positivity rate of 20.69%. Phylogenetic analyses revealed three Bartonella species: B. fuyuanensis, B. taylorii, and one undetermined species. The infected Bartonella strains clustered into three evolutionary branches based on gltA and 16S rRNA genes. Conclusions: This study provides the first evidence of Bartonella infection among rodent populations in wetland habitats along China's eastern coast. The region harbors diverse rodent species, with a high Bartonella infection rate, and at least three species were identified, including a potential novel species.

Currently, carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains, particularly those producing New Delhi metallo-beta-lactamase (NDM), are increasingly recognized as a significant threat to global health. The present study aimed to conduct a genomic analysis of an NDM-1-producing CR-KP strain isolated from patients with coronavirus disease of 2019 (COVID-19) admitted to the intensive care unit (ICU). The K. pneumoniae isolate was obtained from the bronchoalveolar lavage fluid of a 68 year-old male patient hospitalized in the ICU with COVID-19 at Besat Hospital in Sanandaj, Iran. The minimum inhibitory concentrations (MICs) for 15 antibiotics were determined using the VITEK 2 system. Genomic analysis of the isolate was performed using whole genome sequencing. The CRKP-51 strain was identified as an extensively drug-resistant (XDR) strain, exhibiting resistance to all tested antibiotics except tigecycline (MIC = 2 μg/mL). The highest resistance values were recorded against sulfamethoxazole-trimethoprim (SXT), nitrofurantoin (NIT), and piperacillin-tazobactam (TZP), with MICs of ≥ 320, 256 μg/mL, and ≥ 128 μg/mL, respectively. Multilocus sequence typing revealed that CRKP-51 belonged to sequence type 15 (ST15). The IncHI1B replicon type associated with this strain harbored several resistance genes, including bla _NDM-1 , armA, msrE, mphE, BRP (MBL), bla _OXA-1, aadA2, dfrA12, qnrB1, bla _CTX-M-15, and cat1. High-risk K. pneumoniae clones, such as ST15, are increasingly associated with antimicrobial resistance and the emergence of XDR strains in ICUs. Additionally, the global dissemination of the NDM enzyme occurs through various plasmid replicon types. Therefore, monitoring local epidemiology is essential for the effectiveness of antimicrobial stewardship programs.

Background: Malaria is one of the deadliest mosquito-borne diseases. Despite the demonstrated benefits of insecticide-treated nets (ITNs) usage in children under 5 years of age, nonuse is linked to higher mortality and morbidity rates. This study examined how child-, maternal-, household-, and community-level determinants influence ITN utilization among children under 5 in The Gambia for malaria prevention. It further elucidates how household environment, infrastructure, and drinking water sources mediate under-5 ITN utilization in The Gambia. Method: Secondary data analysis of The Gambia Demographic Health Survey (2019-2020) was conducted in this study. We used Chi-square test, linear model ANOVA, multivariable regression model, and mediation analysis to analyze the influence of child-, maternal-, household-, and community-level factors on under-5 ITN utilization in The Gambia. We computed crude and adjusted odds ratios (cOR and aOR, respectively) for potential confounders across groups, with statistical significance set at p < 0.05, and 95% confidence interval (CI). Results: The prevalence of ITN utilization among under-5 children was 63.4% (95% CI: 61.0%, 65.8%). This study identified several significant factors influencing under-5 ITN utilization in The Gambia, such as children's anemia status (aOR = 0.53, 95% CI [0.27, 0.97], p = 0.050), mother's literacy (aOR = 0.77, 95% CI [0.61, 0.96], p = 0.021), female household heads (aOR = 0.67, 95% CI [0.56, 0.81], p < 0.001), household wealth index (aOR = 0.55, 95% CI [0.42, 0.72], p < 0.001), and residence (aOR = 1.30, 95% CI [1.04, 1.62], p = 0.022). Ethnicity and region also influenced ITN utilization, with variations across different ethnic groups and regions (including Kerewan aOR = 2.29, 95% CI [1.54, 3.39], p < 0.001). Mediation analysis highlighted both the direct and indirect effects of household infrastructure and drinking water sources on ITN utilization, emphasizing the multifaceted nature of the factors influencing ITN use in this context. Conclusion: This study elucidates the complex factors influencing ITN utilization among children under 5 years of age in The Gambia. The nuanced understanding of individual-, household-, and community-level factors offers a robust foundation for targeted strategies for malaria prevention, with far-reaching implications for public health policy and practice.

Background: In the last two decades, Human immune deficiency virus has been a major health concern in sub-Saharan Africa particularly in Ethiopia. The objective of this study was to identify determinants associated with CD4 cell count and disclosure status among first-line antiretroviral therapy patients treated at Felege Hiwot Comprehensive Specialized Hospital, Ethiopia. Methods: This retrospective study was conducted at Felege Hiwot Comprehensive Specialized Hospital. Data analysis was conducted using Statistical System Analysis (SAS) software Version 9.4. In this study, quasi-Poisson mixed-effects model for CD4 cell count, a binary logistic regression model for disclosure status, and joint modeling were used. Result: Out of 300 adult participants, around 76% of the patients were discloses their disease status to their family members. The correlation between CD4 cell count and disclosure was positive (0.4607). The current study indicates that among the predictor variables, noneducators (β = -0.6185, p-value < 0.01), primary educators (β = -0.3687, p-value < 0.01), employed patients (β = 0.3888, p-value < 0.01), adherent patients (β = 0.2274, p-value < 0.01), and patients who did not had social support (β = -0.1148, p-value = 0.030) have a significant effect for CD4 cell count. Similarly, noneducators (AOR = 0.000145, p-value < 0.01), primary educators (AOR = 0.004413, p-value < 0.01), employed patients (AOR = 3.4562, p-value = 0.021), adherent patients (AOR = 1.564, p-value < 0.01), and patients who did not had social support (AOR = 0.075, p-value = 0.0078) had a significant effect for disclosure status. Conclusion: This study concluded that patients who had disclosed their disease status to near relatives or families have a positive correlation with CD4 cell count through time. This study also concluded that significant determinants affected both the variables of interest were educational level, occupation, adherence, and social support. Health professionals should give more attention to these important determinants to create good status of patients. In addition, health staff should conduct health-related studies for individuals to understand better ART follow-up. Patients should be adhere to their prescribed HIV medication properly on time and disclose their disease status without fearing stigma and discrimination to the community; this may help to increase their CD4 cell count. The family members should give social support to the infected patients, and the government should work on education; this may help to improve their CD4 cell count and increase the prevalence of disclosure of the disease status. The authors also recommended that further studies of this nature include other important variables that are not included in this study such as income of the patients and many other covariates.

Vitamin D is an important modulator of host immune response during immunity development in context to several diseases in children. This study included 280 pediatric dengue cases, which were further stratified as dengue fever (DF), dengue with warning signs (DWS), and severe dengue (SD), wherein naturally circulating vitamin D metabolite, 25(OH)D was assessed, followed by statistical analysis for elucidating the role of serum 25(OH)D in dengue severity. qRT-PCR based serotyping showed that dengue virus (DENV)-2 was the major circulating DENV serotype in the patients. Among DENV cases, 92 (32.86%), 108 (38.57%), and 80 (28.57%) were diagnosed with DF, DWS, and SD, respectively. Among SD patients, serum 25(OH)D deficiency and insufficiency were observed in 37 (46.25%) and 43 (53.75%) patients, respectively, and found to be significantly associated with SD (p < 0.05) in comparison to DF and DWS. Serum 25(OH)D sufficiency had a protective effect against dengue severity and could be a determinant for DENV outcome in children.

Hepatitis B virus (HBV) infection remains a critical global health issue, particularly in high-burden regions with substantial global morbidity and mortality. Despite the efficacy of the hepatitis B vaccine in inducing immunity, a subset of vaccinated individuals fails to achieve adequate immunity. This study investigated the factors influencing immunological response to the hepatitis B vaccine among Nigerian adults. A cohort study was conducted at Usmanu Danfodiyo University Teaching Hospital, Sokoto, involving 307 participants aged 19-60 who had not previously received the hepatitis B vaccine. Data were collected using structured questionnaires assessing demographic characteristics, medical history, and lifestyle factors. Participants received GeneVac-B, a recombinant hepatitis B vaccine, and 0-, 1-, and 2-month schedule anti-HB levels were measured post-vaccination using a commercial enzyme-linked immunosorbent assay (ELISA) kit (AccuDiag ELISA, Diagnostic Automation/Cortez Diagnostics, Inc., USA) to classify vaccine response. The association between demographic and lifestyle factors and vaccine response was analyzed using IBM SPSS Statistics (Version 25). Of the 307 participants, 209 received the first vaccine dose, and 192 completed all three doses. Anti-HB quantification revealed that 94.3% of the participants achieved protective immunity (≥ 10 IU/L), while 5.7% were classified as nonresponders (< 10 IU/L). Statistical analysis indicated significant differences in the immune response based on gender (p = 0.031), with females exhibiting higher mean anti-HB levels than males. Negative correlations were observed between age and vaccine response (ρ = -0.296, p < 0.01) and between body mass index (BMI) and response, although the latter was not statistically significant (ρ = -0.131, p = 0.071). Prior tuberculosis, malaria, measles, smoking, and alcohol use showed no significant impact on the immune response, although recurrent malaria, measles, and smoking were associated with slightly lower mean antibody levels. The study indicates gender and age significantly influence hepatitis B vaccine response, with females and younger individuals demonstrating stronger immunity.

Introduction: A. baumannii and P. aeruginosa belong to the multidrug-resistant Gram-negative bacteria group, posing significant challenges in treatment. Colistin is considered the last-line antibiotic for treating this bacterium. It is essential to determine the minimum inhibitory concentration (MIC) to adjust the appropriate dosage. Method: A cross-sectional descriptive study using data from January 2020 to December 2024 was conducted. Results: The infections caused by A. baumannii and P. aeruginosa showed an increasing trend over the years, accounting for 17.4% and 9.6% of common multidrug-resistant Gram-negative bacteria, respectively. A. baumannii exhibited higher resistance rates than P. aeruginosa with multiple tested antibiotics. Although no Colistin-resistant strains were observed for either bacterium of interest during the observation period, both bacteria of interest showed a statistically significant change during the survey period (p < 0.05). In addition, the MIC value of ≤ 0.75 μg/mL was the most prevalent over 80% from 2020 to 2021, but its percentage declined strongly by 60%-65% in the next 3 years (p < 0.0001). Meanwhile, the MIC value of 1.0 μg/mL became the most common over 70% with a statistically significant difference (p < 0.0001). Regarding the MIC value based on infection types, the MIC value for P. aeruginosa causing septicemia was considerably concentrated at 1.0 μg/mL at 84.6%, while its percentage was lower in A. baumannii at 37.9% (p < 0.0001). Looking into MIC values based on carbapenem-resistant proportions, the MIC values from 1.0 to 2.0 μg/mL were higher in imipenem-resistant strains of both bacteria of interest compared with nonresistant strains (p < 0.0001). This difference was also observed in meropenem-resistant A. baumannii but was not demonstrated in P. aeruginosa. Conclusions: Although no colistin-resistant strains were observed, A. baumannii and P. aeruginosa showed statistically significant changes in the most prevalent colistin MIC values, which have been approaching the resistance threshold over the years. It is essential to implement control measures of colistin usage before bacteria become completely resistant.

Objectives: Neglected tropical diseases (NTDs), such as leprosy, significantly impact mental health and overall well-being. This study aims to evaluate the effectiveness and acceptability of a mental health intervention targeting individuals affected by leprosy in Ethiopia. The intervention utilizes the Traumatic Stress Relief (TSR) program to target symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, and to improve overall mental health. Methods: This exploratory randomized controlled trial (RCT) will recruit participants with lived experiences of leprosy. Participants will receive four group sessions of a low-intensity TSR intervention. The intervention will be administered by a pair of trained facilitators, including one mental health practitioner and one community member with lived experience of leprosy. Data will be collected through self-report questionnaires to assess changes in PTSD symptoms, anxiety, and depression. In addition, interviews will provide further insights into participants' experiences and the acceptability of the intervention. Discussion: This exploratory trial will provide insights into the feasibility of mental health interventions for individuals affected by leprosy. The findings will inform the design of future trials to evaluate the effectiveness of such programs on a larger scale and in more diverse contexts. Trial Registration: The UK's Clinical Study Registry: ISRCTN868254411.

Introduction: Herpes zoster is a viral dermatosis that occurs after reactivation of the varicella-zoster virus (VZV). The aim of this study is to illustrate the epidemiological and clinical aspects, as well as the complications, of herpes zoster in children. Materials and Methods: This is a descriptive, prospective study of a series of 25 children followed for herpes zoster over a 3 year period in the dermatology department of CHU Ibn Rochd in Casablanca. Results: There were 16 boys and 9 girls, with a mean age of 8.05 years. None of the patients had been vaccinated against varicella. Nine patients were immunocompromised. All patients were treated with antivirals, analgesics, antiseptics, and antibiotics (for seven infected patients). All patients had a favorable outcome with no sequelae. Discussion: VZV belongs to the Herpesviridae family, an enveloped virus with a DNA genome. It has a particular affinity for the skin, nervous system, and lungs. Shingles is a rare disease in children, which typically follows a favorable course without sequelae. In children with shingles, if the history and physical examination are normal, laboratory testing for occult immunodeficiency or malignancy is not necessary. The diagnosis is primarily clinical. Except for ophthalmic forms, complicated cases, and immunocompromised patients, no specific treatment is required. In immunocompromised children, the infection is usually severe and disseminated, leading to high morbidity and mortality, and requires specific intravenous antiviral treatment. Conclusion: Herpes zoster is a rare condition in children, typically evolving without sequelae.