Pub Date : 2026-01-27DOI: 10.1016/j.tmaid.2026.102955
Yu Yan, Yan Li, Meng Zhang, Xiaohua Tan, Yunxia Mao, Ximing Huang, Jianqian Chen, Guopeng He, Wei Ma
Background: Although numerous studies have investigated the link between tropical cyclones and dengue transmission, this body of research is predominantly ecological. How individual-level factors modify vulnerability to this risk remains understudied. We investigated how socioeconomic status, knowledge, attitudes, practices (KAP), and risk perception modulate post-cyclone vulnerability to inform targeted interventions.
Methods: We conducted a 1:1 matched case-control study in Guangzhou, Zhongshan, and Foshan cities between September 14 and October 1, 2024, following the Super Typhoon Yagi on September 7, 2024. Cases were confirmed using the local surveillance system and matched to controls recruited via community sampling by age and sex. Structural equation modeling (SEM) was used to identify the mediating pathways between SES and vulnerability, while multivariable conditional logistic regression was used to identify independent direct predictors of dengue infection.
Results: Structural equation modeling identified a significant pathway in which a higher socioeconomic status predicted greater knowledge (β = 0.34, p < 0.01), which in turn was associated with stronger preventive practices. In the final multivariable logistic regression, higher scores for practice (aOR = 0.62, 95 % CI: 0.43, 0.88), environment risk perception (aOR = 0.73, 95 % CI: 0.59, 0.91), and knowledge (aOR = 0.57, 95 % CI: 0.42, 0.77) were significant protective factors against dengue. Conversely, frequent mosquito exposure emerged as the strongest risk factor. Compared to individuals bitten weekly or less often, those experiencing daily bites had more than double the odds of infection (aOR = 2.38, 95 % CI: 1.43, 3.97).
Conclusion: Individual-level determinants, particularly adaptive practices and environmental risk perception, are critical mediators of post-cyclone dengue risk. Public health interventions should be tailored to bolster these protective behaviors, mitigating outbreak threats in vulnerable populations.
{"title":"Socioeconomic status and post-cyclone dengue Vulnerability: The mediating roles of knowledge and risk perception in Southern China.","authors":"Yu Yan, Yan Li, Meng Zhang, Xiaohua Tan, Yunxia Mao, Ximing Huang, Jianqian Chen, Guopeng He, Wei Ma","doi":"10.1016/j.tmaid.2026.102955","DOIUrl":"10.1016/j.tmaid.2026.102955","url":null,"abstract":"<p><strong>Background: </strong>Although numerous studies have investigated the link between tropical cyclones and dengue transmission, this body of research is predominantly ecological. How individual-level factors modify vulnerability to this risk remains understudied. We investigated how socioeconomic status, knowledge, attitudes, practices (KAP), and risk perception modulate post-cyclone vulnerability to inform targeted interventions.</p><p><strong>Methods: </strong>We conducted a 1:1 matched case-control study in Guangzhou, Zhongshan, and Foshan cities between September 14 and October 1, 2024, following the Super Typhoon Yagi on September 7, 2024. Cases were confirmed using the local surveillance system and matched to controls recruited via community sampling by age and sex. Structural equation modeling (SEM) was used to identify the mediating pathways between SES and vulnerability, while multivariable conditional logistic regression was used to identify independent direct predictors of dengue infection.</p><p><strong>Results: </strong>Structural equation modeling identified a significant pathway in which a higher socioeconomic status predicted greater knowledge (β = 0.34, p < 0.01), which in turn was associated with stronger preventive practices. In the final multivariable logistic regression, higher scores for practice (aOR = 0.62, 95 % CI: 0.43, 0.88), environment risk perception (aOR = 0.73, 95 % CI: 0.59, 0.91), and knowledge (aOR = 0.57, 95 % CI: 0.42, 0.77) were significant protective factors against dengue. Conversely, frequent mosquito exposure emerged as the strongest risk factor. Compared to individuals bitten weekly or less often, those experiencing daily bites had more than double the odds of infection (aOR = 2.38, 95 % CI: 1.43, 3.97).</p><p><strong>Conclusion: </strong>Individual-level determinants, particularly adaptive practices and environmental risk perception, are critical mediators of post-cyclone dengue risk. Public health interventions should be tailored to bolster these protective behaviors, mitigating outbreak threats in vulnerable populations.</p>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":" ","pages":"102955"},"PeriodicalIF":4.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-27DOI: 10.1016/j.tmaid.2026.102958
Francisco Javier Membrillo, Juan-Carlos Navarro, Diana Marcela Pava-Garzón, Jill Weatherhead, José A Suárez, Alfonso J Rodriguez-Morales
{"title":"From local burden to global threat: Neglected tropical diseases in an era of climate change and human mobility.","authors":"Francisco Javier Membrillo, Juan-Carlos Navarro, Diana Marcela Pava-Garzón, Jill Weatherhead, José A Suárez, Alfonso J Rodriguez-Morales","doi":"10.1016/j.tmaid.2026.102958","DOIUrl":"10.1016/j.tmaid.2026.102958","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":" ","pages":"102958"},"PeriodicalIF":4.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-23DOI: 10.1016/j.tmaid.2026.102957
Deniz Güllü , Yeşim Beşli , Önder Ergönül
{"title":"Food-borne infections originating from Turkey but detected abroad: A historical review and recommendations","authors":"Deniz Güllü , Yeşim Beşli , Önder Ergönül","doi":"10.1016/j.tmaid.2026.102957","DOIUrl":"10.1016/j.tmaid.2026.102957","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102957"},"PeriodicalIF":4.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.tmaid.2026.102956
Szu-Hsuan Huang , Yung-Ching Lin , Yi-Li Shih , Jiun-Shian Kuo , Li-Li Ho
Background
The COVID-19 pandemic profoundly disrupted international travel and travel medicine services worldwide. Few studies have examined nationwide trends. We analyzed travel clinic visits and travel medicine services in Taiwan across the pandemic to assess its impact and inform future policy and preparedness planning.
Methods
This population-based longitudinal study utilized nationwide data from Travel Medicine Contract Hospitals from 2019 to 2022. The number of travel clinic visits, travel vaccinations, and International Certificate of Vaccination or Prophylaxis (ICVP) issuance were compared between 2019 and subsequent years using paired sample t-tests.
Results
During 2019–2022, 218,700 travel clinic visits, 92,218 travel vaccine doses, and 162,653 ICVPs were recorded. Clinic visits decreased by 52 % in 2020 but increased by 80 % in 2021 and 143 % in 2022, exceeding pre-pandemic levels. Travel vaccinations decreased by 70 % in 2020, increased by 229 % in 2021, and then decreased slightly by 22 % in 2022. ICVP issuance dropped by 74 % in 2020 but rose more than fivefold by 2022. The surge in travel vaccinations and ICVP issuance in 2021–2022 was mainly attributed to COVID-19 vaccinations and free yellow fever and meningococcal conjugate vaccination campaigns. The most documented vaccine in ICVPs shifted from yellow fever vaccines to COVID-19 vaccines during 2021–2022.
Conclusions
The pandemic reshaped Taiwan's travel medicine landscape. Coordinated government-hospital efforts enabled timely vaccine allocation, minimized wastage, and maintained service capacity. These results underscore the need for flexible vaccination strategies and the transition toward digital health documentation for future preparedness.
{"title":"Impact of the COVID-19 pandemic on travel medicine services in Taiwan, 2019–2022","authors":"Szu-Hsuan Huang , Yung-Ching Lin , Yi-Li Shih , Jiun-Shian Kuo , Li-Li Ho","doi":"10.1016/j.tmaid.2026.102956","DOIUrl":"10.1016/j.tmaid.2026.102956","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic profoundly disrupted international travel and travel medicine services worldwide. Few studies have examined nationwide trends. We analyzed travel clinic visits and travel medicine services in Taiwan across the pandemic to assess its impact and inform future policy and preparedness planning.</div></div><div><h3>Methods</h3><div>This population-based longitudinal study utilized nationwide data from Travel Medicine Contract Hospitals from 2019 to 2022. The number of travel clinic visits, travel vaccinations, and International Certificate of Vaccination or Prophylaxis (ICVP) issuance were compared between 2019 and subsequent years using paired sample t-tests.</div></div><div><h3>Results</h3><div>During 2019–2022, 218,700 travel clinic visits, 92,218 travel vaccine doses, and 162,653 ICVPs were recorded. Clinic visits decreased by 52 % in 2020 but increased by 80 % in 2021 and 143 % in 2022, exceeding pre-pandemic levels. Travel vaccinations decreased by 70 % in 2020, increased by 229 % in 2021, and then decreased slightly by 22 % in 2022. ICVP issuance dropped by 74 % in 2020 but rose more than fivefold by 2022. The surge in travel vaccinations and ICVP issuance in 2021–2022 was mainly attributed to COVID-19 vaccinations and free yellow fever and meningococcal conjugate vaccination campaigns. The most documented vaccine in ICVPs shifted from yellow fever vaccines to COVID-19 vaccines during 2021–2022.</div></div><div><h3>Conclusions</h3><div>The pandemic reshaped Taiwan's travel medicine landscape. Coordinated government-hospital efforts enabled timely vaccine allocation, minimized wastage, and maintained service capacity. These results underscore the need for flexible vaccination strategies and the transition toward digital health documentation for future preparedness.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102956"},"PeriodicalIF":4.7,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One of the most severe and least understood forms of cutaneous leishmaniasis (CL) is leishmaniasis recidivans (LR), a chronic variant in which lesions reappear months or years after apparent healing. This review aimed to consolidate fragmented information to clarify LR's epidemiological scope, diagnostic methods, and treatment strategies.
Methods
A comprehensive literature search according to PRISMA guidelines was conducted across multiple databases, with the final search completed on November 15, 2025. Risk of bias was assessed using JBI checklists. A study protocol for this review was registered with OSF (10.17605/OSF.IO/6NFT3). Data were synthesized narratively as meta-analysis was not feasible.
Results
Forty-three papers were included, thirty-two from the Old World and eleven from the New, representing seventeen countries. LR primarily affected children, and factors such as trauma, immunosuppression, or irregular treatment were stated as triggers. Cases tended to be geographically restricted, with L. tropica most frequently reported. Both the lesion morphology and the latency period varied widely. Microscopy and histology gave poor accuracy, limited by low parasite loads and overlapping diagnoses. Isoenzyme analysis identified distinct LR strains. Pentavalent antimonials (PA) were the main treatment, and combination regimens showed promise in overcoming LR persistence.
Conclusion
LR remains modestly recognized, with considerable overlap with classical CL. The evidence points to species-level differences in recurrence, compounded by the role of host factors and parasite diversity. Consistent adherence to therapy is a decisive element in managing LR. Without broader, more systematically coordinated data, both clinical guidance and effective public health strategies will not be possible.
{"title":"Systematic review on the epidemiology, diagnostics and management of leishmaniasis recidivans","authors":"Niels Vanden Bossche , Matthew Willis , Fabian Schlumberger , Mourad Mokni , Anil Fastenau","doi":"10.1016/j.tmaid.2026.102954","DOIUrl":"10.1016/j.tmaid.2026.102954","url":null,"abstract":"<div><h3>Background</h3><div>One of the most severe and least understood forms of cutaneous leishmaniasis (CL) is leishmaniasis recidivans (LR), a chronic variant in which lesions reappear months or years after apparent healing. This review aimed to consolidate fragmented information to clarify LR's epidemiological scope, diagnostic methods, and treatment strategies.</div></div><div><h3>Methods</h3><div>A comprehensive literature search according to PRISMA guidelines was conducted across multiple databases, with the final search completed on November 15, 2025. Risk of bias was assessed using JBI checklists. A study protocol for this review was registered with OSF (10.17605/OSF.IO/6NFT3). Data were synthesized narratively as meta-analysis was not feasible.</div></div><div><h3>Results</h3><div>Forty-three papers were included, thirty-two from the Old World and eleven from the New, representing seventeen countries. LR primarily affected children, and factors such as trauma, immunosuppression, or irregular treatment were stated as triggers. Cases tended to be geographically restricted, with <em>L. tropica</em> most frequently reported. Both the lesion morphology and the latency period varied widely. Microscopy and histology gave poor accuracy, limited by low parasite loads and overlapping diagnoses. Isoenzyme analysis identified distinct LR strains. Pentavalent antimonials (PA) were the main treatment, and combination regimens showed promise in overcoming LR persistence.</div></div><div><h3>Conclusion</h3><div>LR remains modestly recognized, with considerable overlap with classical CL. The evidence points to species-level differences in recurrence, compounded by the role of host factors and parasite diversity. Consistent adherence to therapy is a decisive element in managing LR. Without broader, more systematically coordinated data, both clinical guidance and effective public health strategies will not be possible.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102954"},"PeriodicalIF":4.7,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1016/j.tmaid.2026.102953
Anna Bogacka , Ravi Kant , Maciej Grzybek
Introduction
Mosquito-borne diseases continue to pose a significant global health challenge, driven by environmental, climatic, and socio-demographic factors. This study investigates the epidemiological trends of malaria, dengue fever, chikungunya, and West Nile virus (WNV) in Poland and Europe, from 2018 to 2024, with a focus on regional differences, local transmission, and temporal dynamics.
Material and methods
Data were obtained from national and international surveillance systems. Annual case counts for each disease, including autochthonous cases, were analyzed using Poisson regression models, with calendar year as a continuous predictor. Trends were assessed for Poland (2018–2024) and Europe (2018–2023).
Results
In Poland, 521 cases were reported across the study period, with a significantly increasing trend in total case counts for malaria, dengue, and chikungunya. WNV showed a non-significant increase. In Europe, a significant reduction in total cases was observed from 2018 to 2023, including declines in malaria, chikungunya, and WNV, while dengue cases showed a modest but significant increase. Analysis of autochthonous cases revealed a significant overall decrease in malaria and WNV, but a significant increase in dengue cases.
Conclusions
The results highlight contrasting regional and transmission-specific trends, with increasing incidence in Poland, declining total and local transmission in Europe, and a rise in autochthonous dengue cases. These findings underscore the importance of strengthening surveillance and response strategies tailored to the dynamic patterns of vector-borne diseases.
{"title":"Surveillance-based insights into mosquito-borne disease trends: Implications for public health in Poland and Europe (2018–2024)","authors":"Anna Bogacka , Ravi Kant , Maciej Grzybek","doi":"10.1016/j.tmaid.2026.102953","DOIUrl":"10.1016/j.tmaid.2026.102953","url":null,"abstract":"<div><h3>Introduction</h3><div>Mosquito-borne diseases continue to pose a significant global health challenge, driven by environmental, climatic, and socio-demographic factors. This study investigates the epidemiological trends of malaria, dengue fever, chikungunya, and West Nile virus (WNV) in Poland and Europe, from 2018 to 2024, with a focus on regional differences, local transmission, and temporal dynamics.</div></div><div><h3>Material and methods</h3><div>Data were obtained from national and international surveillance systems. Annual case counts for each disease, including autochthonous cases, were analyzed using Poisson regression models, with calendar year as a continuous predictor. Trends were assessed for Poland (2018–2024) and Europe (2018–2023).</div></div><div><h3>Results</h3><div>In Poland, 521 cases were reported across the study period, with a significantly increasing trend in total case counts for malaria, dengue, and chikungunya. WNV showed a non-significant increase. In Europe, a significant reduction in total cases was observed from 2018 to 2023, including declines in malaria, chikungunya, and WNV, while dengue cases showed a modest but significant increase. Analysis of autochthonous cases revealed a significant overall decrease in malaria and WNV, but a significant increase in dengue cases.</div></div><div><h3>Conclusions</h3><div>The results highlight contrasting regional and transmission-specific trends, with increasing incidence in Poland, declining total and local transmission in Europe, and a rise in autochthonous dengue cases. These findings underscore the importance of strengthening surveillance and response strategies tailored to the dynamic patterns of vector-borne diseases.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102953"},"PeriodicalIF":4.7,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1016/j.tmaid.2026.102952
Antonio Seigerschmidt , Maria Cristina Moreno-del Castillo , Gabriela Equihua Martinez , Paul Pitzinger , Janina Hammer , Susanne Georgi , Michael Nürnberg , Julian Bernhard , Franziska Olgemöller , Beate Kampmann , Frank P. Mockenhaupt , Thomas Weitzel , Andreas K. Lindner
Background
Strongyloides stercoralis is a widespread helminth in tropical and subtropical regions, which can persist in humans for life through autoinfection. The clinical picture varies from asymptomatic to life-threatening hyperinfection syndrome. There is concern about increasing prevalence in Europe due to the number of cases imported by migrants and travelers.
Methods
This is a retrospective chart review of patients evaluated at the Charité Tropical Medicine outpatient clinic in Berlin, Germany. Cases were identified based on either a positive serologic test for Strongyloides (i.e., probable cases) or the detection of Strongyloides larvae in stool samples (i.e., confirmed cases).
Results
From April 2018 to November 2023, 162 patients with Strongyloides infection were identified. Diagnosis was confirmed in 49 patients (30.2 %) and probable in 113 patients (69.8 %). About half of the patients (48.8 %) were classified as migrants, who were diagnosed through screening in 48.1 %. Eosinophilia was present in 27.6 % of all patients, with no significant differences between migrants and non-migrants, or between probable or confirmed infections. In patients with a positive stool microscopy, only 8/37 (21.6 %) had a positive serology.
Conclusion
Nearly half of the migrant cases were detected through serology as part of screening. Most patients had no eosinophilia, and the positivity of serological tests was very low in patients with positive stool microscopy. These findings highlight the usefulness of targeted screening strategies in risk populations and suggest implementing sensitive stool tests detecting larvae combined with serology, to improve case detection.
{"title":"Imported Strongyloides stercoralis infections in Germany: descriptive study of cases over 5 years in a referral center in Berlin","authors":"Antonio Seigerschmidt , Maria Cristina Moreno-del Castillo , Gabriela Equihua Martinez , Paul Pitzinger , Janina Hammer , Susanne Georgi , Michael Nürnberg , Julian Bernhard , Franziska Olgemöller , Beate Kampmann , Frank P. Mockenhaupt , Thomas Weitzel , Andreas K. Lindner","doi":"10.1016/j.tmaid.2026.102952","DOIUrl":"10.1016/j.tmaid.2026.102952","url":null,"abstract":"<div><h3>Background</h3><div><em>Strongyloides stercoralis</em> is a widespread helminth in tropical and subtropical regions, which can persist in humans for life through autoinfection. The clinical picture varies from asymptomatic to life-threatening hyperinfection syndrome. There is concern about increasing prevalence in Europe due to the number of cases imported by migrants and travelers.</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of patients evaluated at the Charité Tropical Medicine outpatient clinic in Berlin, Germany. Cases were identified based on either a positive serologic test for <em>Strongyloides</em> (i.e., probable cases) or the detection of <em>Strongyloides</em> larvae in stool samples (i.e., confirmed cases).</div></div><div><h3>Results</h3><div>From April 2018 to November 2023, 162 patients with <em>Strongyloides</em> infection were identified. Diagnosis was confirmed in 49 patients (30.2 %) and probable in 113 patients (69.8 %). About half of the patients (48.8 %) were classified as migrants, who were diagnosed through screening in 48.1 %. Eosinophilia was present in 27.6 % of all patients, with no significant differences between migrants and non-migrants, or between probable or confirmed infections. In patients with a positive stool microscopy, only 8/37 (21.6 %) had a positive serology.</div></div><div><h3>Conclusion</h3><div>Nearly half of the migrant cases were detected through serology as part of screening. Most patients had no eosinophilia, and the positivity of serological tests was very low in patients with positive stool microscopy. These findings highlight the usefulness of targeted screening strategies in risk populations and suggest implementing sensitive stool tests detecting larvae combined with serology, to improve case detection.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"70 ","pages":"Article 102952"},"PeriodicalIF":4.7,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmaid.2025.102947
Xinjie Zhang , Rui Wang , Wenling Zhu , Jie Tao , Fen He , Bao Liu , Zhong Chen
Background
Current prediction tools for acute mountain sickness (AMS) are mainly limited by single-altitude designs. This study aimed to evaluate the cross-altitude predictive value of pre-ascent echocardiography and investigate altitude-specific cardiac mechanisms.
Methods
This prospective study assigned 238 healthy young males to 3800 m (n = 106), 4300 m (n = 60), or 4500 m (n = 72) groups. Baseline echocardiography was performed at 200 m before ascent. AMS was assessed (days 1–7) using the Lake Louise Questionnaire. Candidate predictors were selected via a multi-stage process (univariate screening followed by LASSO regression) for subsequent multivariate logistic regression.
Results
AMS incidence was altitude-dependent (11.3 % at 3800 m, 16.7 % at 4300 m, 55.6 % at 4500 m; P < 0.001). Pulmonary artery diameter (PAD) was a robust, consistent predictor across all altitudes (aOR = 1.53, 95 % CI 1.21–1.93, P < 0.001). Altitude-stratified analysis identified distinct predictors: right ventricular pressure load (RVOT-PGmax, aOR = 0.21, 95 % CI 0.07–0.62, P = 0.004) and structural remodeling (RV ESAi, aOR = 1.52, 95 % CI 1.13–2.05, P = 0.006) were dominant at 3800 m, whereas right ventricular systolic function (TAPSE, aOR = 2.55, 95 % CI 1.76–3.69, P < 0.001) was the primary predictor at 4500 m. The altitude-interaction model (AUC = 0.85) outperformed the global model (AUC = 0.80; P = 0.020).
Conclusions
Pre-ascent echocardiography predicts AMS risk across altitudes, with PAD emerging as a robust, cross-altitude predictor.
背景：目前急性高山病（AMS）的预测工具主要受单一海拔设计的限制。本研究旨在评估上升前超声心动图的跨海拔预测价值，并探讨海拔特异性心脏机制。方法：本前瞻性研究将238名健康年轻男性分为3800米（106）、4300米（60）和4500米（72）组。在上升前200米进行基线超声心动图检查。采用路易斯湖问卷对AMS进行评估（第1-7天）。候选预测因子通过多阶段过程（单变量筛选，然后是LASSO回归）选择，用于随后的多变量逻辑回归。结果：AMS发病率与海拔高度相关（海拔3800 m 11.3%，海拔4300 m 16.7%，海拔4500 m 55.6%, P < 0.001）。肺动脉直径（PAD）是所有海拔高度的可靠、一致的预测因子（aOR = 1.53, 95% CI 1.21-1.93, P < 0.001）。海拔分层分析发现了不同的预测因子：右室压力负荷（RVOT-PGmax, aOR = 0.21, 95% CI 0.07-0.62, P = 0.004）和结构重构（RV ESAi, aOR = 1.52, 95% CI 1.13-2.05, P = 0.006）是3800 m时的主要预测因子，而右室收缩功能（TAPSE, aOR = 2.55, 95% CI 1.76-3.69, P < 0.001）是4500 m时的主要预测因子。高度-相互作用模型（AUC = 0.85）优于全局模型（AUC = 0.80; P = 0.020）。结论：上升前超声心动图可预测不同海拔高度的AMS风险，PAD是一个可靠的跨海拔预测指标。
{"title":"Echocardiographic biomarkers for cross-altitude prediction of acute mountain sickness: A prospective cohort study in young males","authors":"Xinjie Zhang , Rui Wang , Wenling Zhu , Jie Tao , Fen He , Bao Liu , Zhong Chen","doi":"10.1016/j.tmaid.2025.102947","DOIUrl":"10.1016/j.tmaid.2025.102947","url":null,"abstract":"<div><h3>Background</h3><div>Current prediction tools for acute mountain sickness (AMS) are mainly limited by single-altitude designs. This study aimed to evaluate the cross-altitude predictive value of pre-ascent echocardiography and investigate altitude-specific cardiac mechanisms.</div></div><div><h3>Methods</h3><div>This prospective study assigned 238 healthy young males to 3800 m (n = 106), 4300 m (n = 60), or 4500 m (n = 72) groups. Baseline echocardiography was performed at 200 m before ascent. AMS was assessed (days 1–7) using the Lake Louise Questionnaire. Candidate predictors were selected via a multi-stage process (univariate screening followed by LASSO regression) for subsequent multivariate logistic regression.</div></div><div><h3>Results</h3><div>AMS incidence was altitude-dependent (11.3 % at 3800 m, 16.7 % at 4300 m, 55.6 % at 4500 m; P < 0.001). Pulmonary artery diameter (PAD) was a robust, consistent predictor across all altitudes (aOR = 1.53, 95 % CI 1.21–1.93, P < 0.001). Altitude-stratified analysis identified distinct predictors: right ventricular pressure load (RVOT-PGmax, aOR = 0.21, 95 % CI 0.07–0.62, P = 0.004) and structural remodeling (RV ESAi, aOR = 1.52, 95 % CI 1.13–2.05, P = 0.006) were dominant at 3800 m, whereas right ventricular systolic function (TAPSE, aOR = 2.55, 95 % CI 1.76–3.69, P < 0.001) was the primary predictor at 4500 m. The altitude-interaction model (AUC = 0.85) outperformed the global model (AUC = 0.80; P = 0.020).</div></div><div><h3>Conclusions</h3><div>Pre-ascent echocardiography predicts AMS risk across altitudes, with PAD emerging as a robust, cross-altitude predictor.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"69 ","pages":"Article 102947"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.tmaid.2025.102950
Mariangela L'Episcopia , Andrea Poloni , Mario Corbellino , Daniela Boccolini , Anna Gigantiello , Alice Covizzi , Davide Bernasconi , Valeria Colombo , Carlo Severini , Spinello Antinori
Background
Artemisinin-based combination therapy for Plasmodium falciparum malaria is threatened by the emergence of partial resistance.
Methods
Molecular characterization of antimalarial resistance-associated genes Pfk13, Pfcrt, Pfmdr1, Pfdhfr, Pfdhps and PfCytB was performed on blood samples collected from two patients with recurrent episodes of P. falciparum malaria.
Results
Two severe P. falciparum malaria in Italian travelers from sub-Saharan Africa showed recrudescence after standard treatment with intravenous artesunate and oral dihydroartemisinin-piperaquine. In one case, the validated marker R561H of artemisinin partial resistance was identified. In the second patient, no Pfkelch13 mutations were detected, and the recrudescent episode was probably the consequence of low blood drug concentration administered by nasogastric tube, although the possible role of Pfkelch13-independent pathways or reduced artemisinin susceptibility cannot be ruled out.
Conclusion
The first imported case of artemisinin-resistant P. falciparum in Italy from sub-Saharan Africa underscores the need for continuous surveillance and eventually adapting treatment protocols.
{"title":"Recrudescence of Plasmodium falciparum malaria imported from Sub-Saharan Africa: a report of two cases and the first detection of artemisinin resistance in Italy","authors":"Mariangela L'Episcopia , Andrea Poloni , Mario Corbellino , Daniela Boccolini , Anna Gigantiello , Alice Covizzi , Davide Bernasconi , Valeria Colombo , Carlo Severini , Spinello Antinori","doi":"10.1016/j.tmaid.2025.102950","DOIUrl":"10.1016/j.tmaid.2025.102950","url":null,"abstract":"<div><h3>Background</h3><div>Artemisinin-based combination therapy for <em>Plasmodium falciparum</em> malaria is threatened by the emergence of partial resistance.</div></div><div><h3>Methods</h3><div>Molecular characterization of antimalarial resistance-associated genes <em>Pfk13, Pfcrt, Pfmdr1, Pfdhfr, Pfdhps</em> and <em>PfCytB</em> was performed on blood samples collected from two patients with recurrent episodes of <em>P. falciparum</em> malaria.</div></div><div><h3>Results</h3><div>Two severe <em>P. falciparum</em> malaria in Italian travelers from sub-Saharan Africa showed recrudescence after standard treatment with intravenous artesunate and oral dihydroartemisinin-piperaquine. In one case, the validated marker R561H of artemisinin partial resistance was identified. In the second patient, no <em>Pfkelch13</em> mutations were detected, and the recrudescent episode was probably the consequence of low blood drug concentration administered by nasogastric tube, although the possible role of <em>Pfkelch13</em>-independent pathways or reduced artemisinin susceptibility cannot be ruled out.</div></div><div><h3>Conclusion</h3><div>The first imported case of artemisinin-resistant <em>P. falciparum</em> in Italy from sub-Saharan Africa underscores the need for continuous surveillance and eventually adapting treatment protocols.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"69 ","pages":"Article 102950"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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