Transactions of The Royal Society of Tropical Medicine and Hygiene最新文献

Butterflies and moths have been admired for their beauty since ancient times, but even these graceful insects can pose a danger to humans, albeit rarely, mainly because of the stinging toxic hairs on the larval stage of some species. In addition to this, since the 16th century, occasional findings of caterpillars still alive after being expelled by people through vomit or faeces led prominent scientists to consider the possibility that the larvae of some species of butterflies and moths, if accidentally ingested, could survive in the human gastrointestinal tract and cause a true infestation. More recently, in the 20th century, there have been reports of caterpillars of certain moths penetrating pre-existing skin wounds under particular circumstances. The human infestation (true or alleged) with caterpillars is known as scoleciasis. The objective of this study is to provide a comprehensive review of all documented cases of human scoleciasis in the literature to date and to assess whether or not this phenomenon should be considered a true parasitosis.

Background: Social inequalities play a crucial role in the incidence of TB, making it plausible that they act as effect modifiers on the impact of active case-finding (ACF) strategies in the detection of the disease. We estimated the association between ACF strategies and TB detection rates and evaluated their effect modification due to social inequalities in Brazilian municipalities.

Methods: We included 5033 municipalities that reported at least one new TB case. We defined the TB detection rate as the outcome variable. Our exposure variables were the proportion of primary care team (PCT) reporting community-based ACF for TB and household contact investigation (HCI) of new TB cases. We also assessed the Municipal Human Development Index (MHDI) and the Social Vulnerability Index (SVI) as potential effect modifier variables.

Results: The TB detection rate was positively associated with both the proportion of PCTs conducting community-based ACF and the proportion conducting HCI. These associations weakened as MHDI increased (interaction incident rate ratio [IRR] 0.95, 95% CI 0.90 to 0.98 for ACF; IRR 0.93, 95% CI 0.89 to 0.96 for HCI) and strengthened with higher SVI values (IRR 1.11, 95% CI 1.02 to 1.22 and IRR 1.17, 95% CI 1.08 to 1.27, respectively).

Conclusion: Social inequalities in Brazilian municipalities modify the effect of ACF strategies on TB detection rates.

Background: Visceral leishmaniasis (VL) is considered a neglected tropical disease with high lethality. This study aimed to analyze the spatio-temporal dynamics of VL in the Central-West region of Brazil, from 2010 to 2019.

Methods: Using data obtained from the Sistema de Informação de Agravos de Notificações (SINAN) from Brazil and spatio-temporal analysis tools, an ecological study of VL cases was carried out considering each federated unit in the Central-West region from 2010 to 2019.

Results: It was observed that state of Mato Grosso do Sul had the majority of municipalities with high incidence in all temporal series analyzed. A heterogeneous distribution of VL with spatial clustering in the state of Mato Grosso do Sul was observed. Furthermore, Goiás and Mato Grosso also presented high-risk municipalities, with clusters of higher relative risk (RR) observed from 2013 to 2017 in Goiás and from 2010 to 2013 in Mato Grosso.

Conclusions: Therefore, it is observed that the states of Goiás, Mato Grosso and Mato Grosso do Sul need greater attention to support the adoption of effective measures to control VL in the Brazilian Central-West region.

Background: Mycoplasma pneumoniae infections declined globally during the COVID-19 pandemic but resurged in 2023, with no data from Latin America.

Methods: We conducted a time-series analysis of patients tested with a multiplex PCR panel at a tertiary hospital in Brazil (April 2022-December 2024).

Results: No cases were identified in 2022, two occurred in 2023 and 132 in 2024. Overall, 85% occurred in children; 68.2% were hospitalized; 18.9% required intensive care; and one patient died.

Conclusions: This is the first report of a postpandemic M. pneumoniae outbreak in a Latin American country, underscoring the need for improved surveillance.

Background: Mycetoma is a chronic, granulomatous, neglected tropical disease characterised by painless swellings, draining sinuses and the presence of grains. This study aims to delineate the clinical presentation, treatment modalities and outcomes for patients with mycetoma attending a dermatology centre in Ethiopia.

Methods: This retrospective longitudinal study was conducted at Boru Meda Hospital, Ethiopia. All the medical records of patients with mycetoma who sought treatment from June 2022 to May 2024 were carefully reviewed.

Results: Seventeen patients were included in the study. After 2 y of treatment, 52.94% of patients experienced treatment failure, 29.41% showed partial improvement and only 17.65% achieved a complete cure.

Conclusion: This study highlights that mycetoma continues to pose a significant public health challenge in Ethiopia, with most cases showing unsatisfactory responses to current treatment strategies.

We commend the study by Larkins et al. on the diagnostic sensitivity of formalin-fixed faecal microscopy for soil-transmitted helminths, particularly their introduction of the McMaster2 method. This innovation demonstrates superior sensitivity while preserving practicality for field use. We highlight key implications for national control programs in endemic settings, especially those constrained by limited infrastructure and cold-chain logistics. This commentary expands on potential regional adaptations, cost-effectiveness and integration into the World Health Organization guidelines and operational frameworks. Further evaluation of this method's utility in diverse epidemiological and health system contexts is warranted.

Background: Monitoring the impact of schistosomiasis mass drug administration (MDA) relies mainly on human sampling, which is resource intensive and raises ethical and logistical challenges. Xenomonitoring of intermediate host snails offers a non-invasive alternative; however, its utility for program evaluation in Ghana remains unexplored.

Methods: We conducted longitudinal snail sampling at 31 human-water contact points along Weija Lake, Ghana, 1 month before and at five time points up to 18 months after two rounds of community-wide praziquantel MDA. Snails were identified morphologically, examined for cercarial shedding and assessed by species-specific cyclooxygenase 1 polymerase chain reaction for Schistosoma mansoni, Schistosoma haematobium and Schistosoma bovis. Prevalence changes were analysed using χ2 tests, pairwise comparisons with Bonferroni correction and logistic regression. Human stools and urine were collected at the same time points for parasitological analysis.

Results: Of 2201 snails collected, 74.7% were Bulinus spp. and 25.3% were Biomphalaria spp. Human-specific Schistosoma infections decreased from 2.8% at baseline to 0.6% 2 months after the first MDA and 0.4% 6 months after the second MDA (p<0.05). Logistic regression analysis indicated significantly lower odds of infection at these time points compared with baseline. However, prevalence rebounded at intervening time points and mixed S. haematobium-S. bovis infections were common. The prevalence pattern in humans mirrored that of snails.

Conclusions: This first Ghanaian study demonstrates the potential of snail xenomonitoring to detect temporal changes in transmission following community-wide MDA. While findings support its value as a complementary monitoring tool, methodological refinements and parallel human-snail surveys are needed before program adoption.

Background: In 2023, Mayotte, a French department in the Mozambique channel, experienced a long drought that led to potable water restrictions. Although the French vaccination schedule makes polio vaccination compulsory for children, the large proportion of migrants on the island coupled with the water crisis raised concerns about the establishment of poliovirus transmission chains. Therefore, a surveillance was implemented to detect polioviruses in sewage sampled in the two main wastewater treatment plants.

Methods: Samples collected from September 2023 through January 2024 were processed following the Global Polio Laboratory Network's algorithm.

Results: Only two polioviruses were detected, both featuring a low number of nucleotide differences compared with vaccine strains, which suggested excretion by recently vaccinated people rather than circulation. The surveillance revealed viruses of the species Cardiovirus rueckerti in almost one-half of the samples. Furthermore, 305 non-polio enteroviruses were detected, belonging to various virus types of species Enterovirus betacoxsackie (53%), Enterovirus coxsackiepol (44%), and Enterovirus alphacoxsackie (3%).

Conclusions: The poliovirus surveillance did not detect any wild or highly mutated poliovirus strains and did not highlight poliovirus circulation. This provided an opportunity to obtain the first overview of the non-polio enteroviruses circulating in Mayotte.

Accession numbers: GenBank accession numbers PQ009012-PQ009102, PQ566710-PQ566937 and PQ868249-PQ868262.

Leprosy is a rare and easily misdiagnosed infectious disease in China. Leprosy reactions (LRs) are the greatest challenge in the treatment of leprosy. If LRs cannot be identified early and treated in a timely manner, patients are at risk of developing disabilities. Type I reactions often occur in borderline leprosy, whereas type II reactions are more prevalent in lepromatous leprosy. Clinically, lepromatous leprosy with type I and II mixed LRs is less common. This report details a case of lepromatous leprosy with mixed LRs, where the patient sequentially developed type II and then type I reactions. Through 1 y of multidrug therapy and our timely identification and intervention for LRs during treatment, the patient achieved a successful cure without any sequelae.

Background: Traditional surveillance systems for neglected tropical diseases (NTDs) often suffer from underreporting, delays and limited reach, hindering effective disease control. This study describes the integration process of crowdsourced image-based morbidity hotspot surveillance for NTDs (CIMS-NTDs) into the government-led NTD program and assesses its operational performance and stakeholder experience.

Methods: A mixed methods study embedded in an implementation research framework was conducted in Ondo State, Nigeria. A quasi-experimental design was used to compare CIMS-NTDs with the existing surveillance approach, while key informant interviews were used to explore stakeholder perceptions. Quantitative data were analysed using descriptive statistics and the Mann-Whitney U test, and qualitative data underwent reflexive thematic analysis.

Results: The training session had in attendance of 30 NTD personnel from the state, local government areas and wards. Results showed a >400% improvement in CIMS-NTDs knowledge following the training session. CIMS-NTDs outperformed traditional surveillance, with 62 confirmed case reports versus only 3 under the conventional system (p=0.023). Onchocerciasis was the most frequently reported NTD (62.9%). Key informants highlighted improved community engagement, data accuracy and reporting efficiency but noted challenges such as digital accessibility and funding constraints.

Conclusions: Integrating digital surveillance into national NTD programs enhances case detection, reporting and intervention strategies. Sustainable adoption requires government funding, capacity building and expanded digital infrastructure to improve accessibility and impact.