The WHO recommended the use of intermittent preventive treatment (IPT) regimens for malaria in HIV-positive pregnant women living in endemic areas to prevent malaria-related perinatal complications. However, the high drug resistance rates make the effectiveness of the various available options questionable.
Methods
This systematic review and meta-analysis was conducted according to the PRISMA guidelines and registered in Prospero (ID: CRD42024579942). PubMed, Scopus, and Cochrane libraries were searched in June 2024 for relevant studies. Randomized clinical trials reporting the use of ITP for malaria in HIV-infected pregnant women were included. The incidence of peripheral malaria diagnosis was our primary extracted outcome. RevMan 5.3 was used for meta-analysis.
Results
Thirteen clinical trials with 5226 HIV-positive pregnant patients were included. ITP showed 55 % lower odds of malaria during pregnancy or at delivery (OR = 0.45, 95 % CI: 0.36, 0.56, P ≤ 0.001), with IPTp-DP (Dihydroartemisinin-Piperaquine) being the most effective regimen. However, despite reducing the odds of placental malaria by 48 % (OR = 0.52, 95 % CI: 0.39, 0.70, P ≤ 0.001), ITP showed no significant effect on low birth weight, fetal loss, stillbirth, or preterm labor. Furthermore, IPT reduces the odds of maternal anemia by 18 % (OR = 0.82, 95 % CI: 0.69, 0.97, P = 0.03).
Conclusion
IPT was shown to be effective in reducing malaria-related maternal complications, including malaria during pregnancy, at delivery, or placental and maternal anemia. However, it showed no effective impact on adverse birth outcomes. Further research may be necessary to explore birth-related outcomes.
{"title":"Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women: Systematic review and meta-analysis of clinical trials","authors":"Ammar Elgadi , Tibyan Noorallah , Egbal Abdelazim , Sara Altraifi , Hajir Altraifi , Ammar Elhaj , Walaa Elnaiem , Lina Hemmeda","doi":"10.1016/j.tmaid.2025.102908","DOIUrl":"10.1016/j.tmaid.2025.102908","url":null,"abstract":"<div><h3>Background</h3><div>The WHO recommended the use of intermittent preventive treatment (IPT) regimens for malaria in HIV-positive pregnant women living in endemic areas to prevent malaria-related perinatal complications. However, the high drug resistance rates make the effectiveness of the various available options questionable.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted according to the PRISMA guidelines and registered in Prospero (ID: CRD42024579942). PubMed, Scopus, and Cochrane libraries were searched in June 2024 for relevant studies. Randomized clinical trials reporting the use of ITP for malaria in HIV-infected pregnant women were included. The incidence of peripheral malaria diagnosis was our primary extracted outcome. RevMan 5.3 was used for meta-analysis.</div></div><div><h3>Results</h3><div>Thirteen clinical trials with 5226 HIV-positive pregnant patients were included. ITP showed 55 % lower odds of malaria during pregnancy or at delivery (OR = 0.45, 95 % CI: 0.36, 0.56, P ≤ 0.001), with IPTp-DP (Dihydroartemisinin-Piperaquine) being the most effective regimen. However, despite reducing the odds of placental malaria by 48 % (OR = 0.52, 95 % CI: 0.39, 0.70, P ≤ 0.001), ITP showed no significant effect on low birth weight, fetal loss, stillbirth, or preterm labor. Furthermore, IPT reduces the odds of maternal anemia by 18 % (OR = 0.82, 95 % CI: 0.69, 0.97, P = 0.03).</div></div><div><h3>Conclusion</h3><div>IPT was shown to be effective in reducing malaria-related maternal complications, including malaria during pregnancy, at delivery, or placental and maternal anemia. However, it showed no effective impact on adverse birth outcomes. Further research may be necessary to explore birth-related outcomes.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102908"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092562","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 : 2025-11-01Epub Date: 2025-10-13DOI: 10.1016/j.tmaid.2025.102918
Diego Gayoso Cantero , Pablo Fernández-González , Sandra Chamorro-Tojeiro , Carmen Quereda , Marta Tato , Emilio Berna-Rico , Jorge Naharro-Rodríguez , Jose A. Perez-Molina
Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae (or M. lepromatosis) that targets macrophages and Schwann cells. The resulting neuropathy and skin lesions can lead to lifelong deformities and disabilities. Despite being poorly transmissible and readily treatable, leprosy remains a neglected disease. Management is hampered by delayed diagnosis, multidrug resistance, recalcitrant leprosy reactions, and entrenched social stigma. We report a case of imported multidrug-resistant borderline lepromatous leprosy that progressed with recurrent, steroid-dependent erythema nodosum leprosum (ENL). The patient experienced multiple toxicities secondary to the medications used for treating leprosy and managing ENL. Disease was controlled through a clofazimine–clarithromycin–minocycline regimen combined with the phosphodiesterase-4 inhibitor apremilast, enabling complete withdrawal of corticosteroids and thalidomide while maintaining sustained clinical and microbiological remission. We examine the key clinical challenges in managing this patient and summarise current evidence, including a literature review on apremilast as treatment for refractory leprosy reactions.
{"title":"Clinical, therapeutic, and stigma-related challenges in leprosy and the emerging role of apremilast in managing leprosy reactions","authors":"Diego Gayoso Cantero , Pablo Fernández-González , Sandra Chamorro-Tojeiro , Carmen Quereda , Marta Tato , Emilio Berna-Rico , Jorge Naharro-Rodríguez , Jose A. Perez-Molina","doi":"10.1016/j.tmaid.2025.102918","DOIUrl":"10.1016/j.tmaid.2025.102918","url":null,"abstract":"<div><div>Leprosy is a chronic granulomatous infection caused by <em>Mycobacterium leprae</em> (or <em>M. lepromatosis</em>) that targets macrophages and Schwann cells. The resulting neuropathy and skin lesions can lead to lifelong deformities and disabilities. Despite being poorly transmissible and readily treatable, leprosy remains a neglected disease. Management is hampered by delayed diagnosis, multidrug resistance, recalcitrant leprosy reactions, and entrenched social stigma. We report a case of imported multidrug-resistant borderline lepromatous leprosy that progressed with recurrent, steroid-dependent erythema nodosum leprosum (ENL). The patient experienced multiple toxicities secondary to the medications used for treating leprosy and managing ENL. Disease was controlled through a clofazimine–clarithromycin–minocycline regimen combined with the phosphodiesterase-4 inhibitor apremilast, enabling complete withdrawal of corticosteroids and thalidomide while maintaining sustained clinical and microbiological remission. We examine the key clinical challenges in managing this patient and summarise current evidence, including a literature review on apremilast as treatment for refractory leprosy reactions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102918"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303714","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 : 2025-11-01Epub Date: 2025-10-28DOI: 10.1016/j.tmaid.2025.102927
Silvia Otero-Rodriguez , Martin Casapia-Morales , Lilia-Lorena Pinedo-Ramirez , Esperanza Merino , Eva H. Clark , José-Manuel Ramos-Rincón
Introduction
Chagas disease (CD) - Trypanosoma cruzi infection - in people living with HIV (PWH), particularly those with advanced CD4 T cell depletion, can lead to severe syndromes affecting the central nervous system and the heart.
Methods
We performed a cross-sectional study to screen for CD among PWH in Iquitos, Peru, between October 2023 and May 2024, with the objective of understanding the frequency of infection in this population. Adults with confirmed HIV attending outpatient services at two regional hospitals were enrolled. Two ELISA tests (lysate and recombinant) were used, and discordant results were adjudicated by indirect chemiluminescence immunoassay (CLIA).
Result
Of 534 PWH, the median age was 41 years (IQR 32–49), 66.1 % were male, the median current CD4+ count was 443/μL, and 75.8 % had an undetectable viral load. Two discordant serologic results were resolved with a negative CLIA, resulting in no confirmed CD cases.
Conclusion
The prevalence of T. cruzi infection is likely very low in urban and peri-urban areas of Iquitos. Continued epidemiological surveillance is essential to monitor potential changes over time.
{"title":"Screening for Trypanosoma cruzi in patients living with the human immunodeficiency virus (PWH) in the Peruvian Amazon","authors":"Silvia Otero-Rodriguez , Martin Casapia-Morales , Lilia-Lorena Pinedo-Ramirez , Esperanza Merino , Eva H. Clark , José-Manuel Ramos-Rincón","doi":"10.1016/j.tmaid.2025.102927","DOIUrl":"10.1016/j.tmaid.2025.102927","url":null,"abstract":"<div><h3>Introduction</h3><div>Chagas disease (CD) - <em>Trypanosoma cruzi</em> infection - in people living with HIV (PWH), particularly those with advanced CD4 T cell depletion, can lead to severe syndromes affecting the central nervous system and the heart.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study to screen for CD among PWH in Iquitos, Peru, between October 2023 and May 2024, with the objective of understanding the frequency of infection in this population. Adults with confirmed HIV attending outpatient services at two regional hospitals were enrolled. Two ELISA tests (lysate and recombinant) were used, and discordant results were adjudicated by indirect chemiluminescence immunoassay (CLIA).</div></div><div><h3>Result</h3><div>Of 534 PWH, the median age was 41 years (IQR 32–49), 66.1 % were male, the median current CD4<sup>+</sup> count was 443/μL, and 75.8 % had an undetectable viral load. Two discordant serologic results were resolved with a negative CLIA, resulting in no confirmed CD cases.</div></div><div><h3>Conclusion</h3><div>The prevalence of <em>T. cruzi</em> infection is likely very low in urban and peri-urban areas of Iquitos. <em>Continued epidemiological surveillance is essential to monitor potential changes over time.</em></div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102927"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410147","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 : 2025-11-01Epub Date: 2025-10-19DOI: 10.1016/j.tmaid.2025.102926
Mikael Kajova , Tamim Khawaja , Katariina Kainulainen , Anu Kantele
Background
Carbapenemase-producing Enterobacterales (CPE) are increasing worldwide, with strains associated with difficult-to-treat infections. We previously reported that international travel is a major source of CPE acquisition in the Helsinki region, Finland. To clarify the extent of importation, we investigated the epidemiology and associated risk factors of foreign-acquired CPEs.
Methods
We revisited two earlier cohorts. Cohort A (n = 187 after a one-year extension) comprised patients from 2010 through 2024 presumed to have acquired CPE abroad; CPE types were categorized by travel region. Cohort B included 3029 patients screened for CPE from 2010 through 2019 within 12 months after hospitalization abroad. Multivariable analysis identified factors that predispose to colonization.
Results
Among patients hospitalized abroad (Cohort B), CPE rates were particularly high for South Asia (14.6 %) and North Africa (13.7 %). Across the 24 individual countries with data, the highest CPE colonization risks were observed for Egypt (20.8 %) and India (16.4 %). In addition to destination, independent risk factors included antibiotic use, travel type, short interval between discharge from a foreign hospital and screening (within one week or one month) and male sex. For South/Southeast Asia and sub-Saharan Africa, over 70 % of CPE carriers (Cohort A) had metallo-β-lactamase-producing Enterobacterales, predominantly NDM, whereas OXA-48–like enzymes predominated in North Africa and the Middle East.
Conclusions
Hospitalization in high-prevalence countries and antibiotic use emerged as key risk factors for CPE acquisition. Regional variation was evident: OXA-48–like enzymes dominated among CPEs linked to the Middle East and North Africa, whereas NDM was prevalent elsewhere in Eurasia and Africa.
{"title":"Travel-associated carbapenemase-producing Enterobacterales: Epidemiology and risk factors in a Finnish cohort","authors":"Mikael Kajova , Tamim Khawaja , Katariina Kainulainen , Anu Kantele","doi":"10.1016/j.tmaid.2025.102926","DOIUrl":"10.1016/j.tmaid.2025.102926","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacterales (CPE) are increasing worldwide, with strains associated with difficult-to-treat infections. We previously reported that international travel is a major source of CPE acquisition in the Helsinki region, Finland. To clarify the extent of importation, we investigated the epidemiology and associated risk factors of foreign-acquired CPEs.</div></div><div><h3>Methods</h3><div>We revisited two earlier cohorts. Cohort A (n = 187 after a one-year extension) comprised patients from 2010 through 2024 presumed to have acquired CPE abroad; CPE types were categorized by travel region. Cohort B included 3029 patients screened for CPE from 2010 through 2019 within 12 months after hospitalization abroad. Multivariable analysis identified factors that predispose to colonization.</div></div><div><h3>Results</h3><div>Among patients hospitalized abroad (Cohort B), CPE rates were particularly high for South Asia (14.6 %) and North Africa (13.7 %). Across the 24 individual countries with data, the highest CPE colonization risks were observed for Egypt (20.8 %) and India (16.4 %). In addition to destination, independent risk factors included antibiotic use, travel type, short interval between discharge from a foreign hospital and screening (within one week or one month) and male sex. For South/Southeast Asia and sub-Saharan Africa, over 70 % of CPE carriers (Cohort A) had metallo-β-lactamase-producing Enterobacterales, predominantly NDM, whereas OXA-48–like enzymes predominated in North Africa and the Middle East.</div></div><div><h3>Conclusions</h3><div>Hospitalization in high-prevalence countries and antibiotic use emerged as key risk factors for CPE acquisition. Regional variation was evident: OXA-48–like enzymes dominated among CPEs linked to the Middle East and North Africa, whereas NDM was prevalent elsewhere in Eurasia and Africa.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102926"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347506","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 : 2025-11-01Epub Date: 2025-11-06DOI: 10.1016/j.tmaid.2025.102934
Patricia Marques Moralejo Bermudi , Raquel Gardini Sanches Palasio , Monica Pirani , Lidia Maria Reis Santana , Gerson Laurindo Barbosa , Marta Blangiardo , Francisco Chiaravalloti-Neto
Background
Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.
Methods
This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.
Results
High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.
Conclusions
These findings provide a basis for generating hypotheses for future modeling studies on these associations.
{"title":"Dengue incidence, mortality, and case-fatality in Brazil: spatial patterns, socioeconomic contrasts, and serotype impact","authors":"Patricia Marques Moralejo Bermudi , Raquel Gardini Sanches Palasio , Monica Pirani , Lidia Maria Reis Santana , Gerson Laurindo Barbosa , Marta Blangiardo , Francisco Chiaravalloti-Neto","doi":"10.1016/j.tmaid.2025.102934","DOIUrl":"10.1016/j.tmaid.2025.102934","url":null,"abstract":"<div><h3>Background</h3><div>Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.</div></div><div><h3>Methods</h3><div>This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.</div></div><div><h3>Results</h3><div>High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.</div></div><div><h3>Conclusions</h3><div>These findings provide a basis for generating hypotheses for future modeling studies on these associations.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102934"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477010","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 : 2025-11-01Epub Date: 2025-11-10DOI: 10.1016/j.tmaid.2025.102931
Romain Gueneau , Lei Tanaka , Pierre Reimbold , Julien Harroche , Cécile Nabet , Stéphane Jauréguiberry
Conidiobolomycosis is a rare tropical mycosis that is often difficult to diagnose and treat.
Method
We describe here an imported case that highlights these issues.
Results
A 24-year-old HIV positive patient was diagnosed and treated for a conidiobolomycosis due to Conidiobolus coronatus. Imaging showed extensive facial invasion. Biopsy and fungal culture confirmed conidiobolomycosis, resistant to standard antifungals. Initial therapy with liposomal amphotericin B and itraconazole failed due to drug interactions. After adjusting treatment and performing surgery, the patient's condition improved. Despite high MICs, clinical response was favorable. He completed 14 months of itraconazole without recurrence four months post-treatment. Serial beta-D-glucan assays showed promise as a reliable biomarker for therapeutic monitoring.
Conclusion
This case highlights the complex medicosurgical management of a rare imported tropical mycosis, the diagnostic aspects of conidiobolomycosis, and the promising potential benefit of beta-D-glucan for the management and follow-up of this severe tropical deep-sited mycosis.
分生孢子菌病是一种罕见的热带真菌病，通常难以诊断和治疗。方法：我们在这里描述一个导入的案例，突出了这些问题。结果：1例24岁的HIV阳性患者因冠状孢子虫引起的分生孢子菌病被诊断并治疗。影像学显示广泛的面部侵犯。活检和真菌培养证实为分生孢子菌病，对标准抗真菌药有耐药性。由于药物相互作用，最初用两性霉素B脂质体和伊曲康唑治疗失败。经过调整治疗和手术治疗，患者病情好转。尽管mic较高，但临床反应良好。他完成了14个月的伊曲康唑治疗，治疗后4个月无复发。一系列β - d -葡聚糖测定显示出作为治疗监测可靠的生物标志物的前景。结论：本病例强调了一种罕见的输入性热带真菌病的复杂内科手术治疗，分生孢子菌病的诊断方面，以及β - d -葡聚糖对这种严重热带深部真菌病的治疗和随访的潜在益处。
{"title":"Rhino-orbital conidiobolomycosis in non-endemic Settings. A diagnostic and therapeutic challenge","authors":"Romain Gueneau , Lei Tanaka , Pierre Reimbold , Julien Harroche , Cécile Nabet , Stéphane Jauréguiberry","doi":"10.1016/j.tmaid.2025.102931","DOIUrl":"10.1016/j.tmaid.2025.102931","url":null,"abstract":"<div><div>Conidiobolomycosis is a rare tropical mycosis that is often difficult to diagnose and treat.</div></div><div><h3>Method</h3><div>We describe here an imported case that highlights these issues.</div></div><div><h3>Results</h3><div>A 24-year-old HIV positive patient was diagnosed and treated for a conidiobolomycosis due to <em>Conidiobolus coronatus.</em> Imaging showed extensive facial invasion. Biopsy and fungal culture confirmed conidiobolomycosis, resistant to standard antifungals. Initial therapy with liposomal amphotericin B and itraconazole failed due to drug interactions. After adjusting treatment and performing surgery, the patient's condition improved. Despite high MICs, clinical response was favorable. He completed 14 months of itraconazole without recurrence four months post-treatment. Serial beta-D-glucan assays showed promise as a reliable biomarker for therapeutic monitoring.</div></div><div><h3>Conclusion</h3><div>This case highlights the complex medicosurgical management of a rare imported tropical mycosis, the diagnostic aspects of conidiobolomycosis, and the promising potential benefit of beta-D-glucan for the management and follow-up of this severe tropical deep-sited mycosis.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102931"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507562","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 : 2025-11-01Epub Date: 2025-09-15DOI: 10.1016/j.tmaid.2025.102905
Carlos Arturo Alvarez-Moreno , Jorge Alberto Cortes , Carlos Humberto Saavedra , Álvaro A. Faccini-Martínez , Sonia Isabel Cuervo-Maldonado , Alfonso J. Rodriguez-Morales
{"title":"Renaming the tropical febrile syndrome: A clinical and semantic imperative in global health","authors":"Carlos Arturo Alvarez-Moreno , Jorge Alberto Cortes , Carlos Humberto Saavedra , Álvaro A. Faccini-Martínez , Sonia Isabel Cuervo-Maldonado , Alfonso J. Rodriguez-Morales","doi":"10.1016/j.tmaid.2025.102905","DOIUrl":"10.1016/j.tmaid.2025.102905","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102905"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081752","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 : 2025-11-01Epub Date: 2025-11-17DOI: 10.1016/j.tmaid.2025.102943
Nadja Hedrich , Thibault Lovey , Julian Bernhard , Martin P. Grobusch , Philippe Gautret , Patricia Schlagenhauf , ITIT Global Network
Background
International travel is growing exponentially. Monitoring infectious disease in travellers is increasingly important to identify infection trends and signals. The ITIT (illness Tracking in Travellers) app project aims to monitor travel-related illness in a prospective, real-time surveillance study (ClinicalTrials.gov NCT04672577) integrating geolocation and environmental data.
Methods
Adults (>18 years) traveling internationally (>2 days), provided e-consent and used the ITIT app to record daily illness symptoms, which were analysed together with geospatial and climate data. All data are encrypted. A pre-travel survey collected demographic and itinerary data and follow-up surveys assessed post-travel diagnoses and self-treatment.
Results
1355 participants enrolled until December 2024; 676 completed symptom surveys covering 703 trips. Symptoms were reported in 42 % of trips, with gastrointestinal, respiratory and general symptoms being the most common. Post-travel diagnoses were reported in 6 % of respondents, including malaria, COVID-19, and schistosomiasis. Self-treatment was reported by 20 % of travellers. Participants visited 95 countries and reported symptoms in 70. The most common destinations of travel with symptoms reported were Indonesia, Thailand and Pakistan. Duration of travel and the age of the traveller were the most important demographic factors for predicting symptom occurrence.
Conclusion
ITIT enables real-time global health surveillance in travellers and can augment traditional surveillance systems, particularly in regions with limited infrastructure.
{"title":"Real-time illness monitoring in travellers: an international, prospective, digital surveillance study","authors":"Nadja Hedrich , Thibault Lovey , Julian Bernhard , Martin P. Grobusch , Philippe Gautret , Patricia Schlagenhauf , ITIT Global Network","doi":"10.1016/j.tmaid.2025.102943","DOIUrl":"10.1016/j.tmaid.2025.102943","url":null,"abstract":"<div><h3>Background</h3><div>International travel is growing exponentially. Monitoring infectious disease in travellers is increasingly important to identify infection trends and signals. The ITIT (illness Tracking in Travellers) app project aims to monitor travel-related illness in a prospective, real-time surveillance study (ClinicalTrials.gov NCT04672577) integrating geolocation and environmental data.</div></div><div><h3>Methods</h3><div>Adults (>18 years) traveling internationally (>2 days), provided e-consent and used the ITIT app to record daily illness symptoms, which were analysed together with geospatial and climate data. All data are encrypted. A pre-travel survey collected demographic and itinerary data and follow-up surveys assessed post-travel diagnoses and self-treatment.</div></div><div><h3>Results</h3><div>1355 participants enrolled until December 2024; 676 completed symptom surveys covering 703 trips. Symptoms were reported in 42 % of trips, with gastrointestinal, respiratory and general symptoms being the most common. Post-travel diagnoses were reported in 6 % of respondents, including malaria, COVID-19, and schistosomiasis. Self-treatment was reported by 20 % of travellers. Participants visited 95 countries and reported symptoms in 70. The most common destinations of travel with symptoms reported were Indonesia, Thailand and Pakistan. Duration of travel and the age of the traveller were the most important demographic factors for predicting symptom occurrence.</div></div><div><h3>Conclusion</h3><div>ITIT enables real-time global health surveillance in travellers and can augment traditional surveillance systems, particularly in regions with limited infrastructure.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102943"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557881","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 : 2025-11-01Epub Date: 2025-11-13DOI: 10.1016/j.tmaid.2025.102942
Flora Delamaire , Pierre Kergoat , Jean-Marc Tadié , Nicolas Terzi
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