Tropical Medicine and Infectious Disease最新文献

One of the major obstacles to improving the management of snakebite envenoming is the lack of accurate identification of species responsible for clinical cases, which prevent the improvement of definitions of species-specific syndromes [...].

As Wüster et al [...].

Insecticide-based strategies have been central to vector control programs targeting diseases of human and veterinary importance for decades [...].

(1) Background: Human rabies continues to be a significant public health challenge and imposes a heavy disease burden. The epidemiological characteristics and post-exposure prophylaxis (PEP) of human rabies in Chongqing were analyzed to provide a scientific basis for its prevention and control in Chongqing. (2) Methods: Data and case investigation forms of the human rabies epidemic in Chongqing from 2016 to 2024 were collected and analyzed using descriptive epidemiological methods. (3) Results: From 2016 to 2024, 84 human rabies cases were reported in Chongqing, with an average annual incidence rate of 0.03 per 100,000 population. Among the cases, 72.6% were aged 45 and above. Farmers constituted the primary infected group (73.8%). Analysis of exposure patterns and PEP revealed that 92.4% of cases involved dog transmission, with domestic dogs responsible for 65.2% and stray dogs for 31.8%. After exposure, 51.5% received no treatment, while only 6 individuals were vaccinated against rabies. (4) Conclusions: Although rabies incidence in Chongqing is low, dogs remain the primary source, and post-exposure vaccination is often delayed. Strengthening health education and dog immunization is crucial for supporting the global "Zero by 30" target.

Neglected tropical diseases (NTDs) comprise a diverse group of infections that disproportionately affect impoverished populations in tropical and subtropical regions [...].

Following World Health Organization (WHO) validation of lymphatic filariasis (LF) elimination as a public health problem, countries are required to implement post-validation surveillance (PVS) to detect potential resurgence and ensure sustained elimination. WHO's guidelines released in 2025 recommend implementation of at least two of four PVS strategies-targeted surveys, integration into standardised surveys, health facility-based screening, and molecular xenomonitoring (MX) of mosquitoes. This review synthesised global evidence on PVS activities from 2007 to 2025 in the 23 countries and territories validated as having eliminated LF. Studies were identified through PubMed, Scopus, Embase, Web of Science, and the WHO Institutional Repository for Information Sharing (IRIS). Data on publication information, surveillance strategies, priority populations, and operational challenges and enablers were extracted. Narrative synthesis using deductive content analysis was applied. Thirty documents from 17 countries were included. Targeted surveillance and integration of PVS with other health programmes were the most common approaches noted (reported in ten and nine countries, respectively), followed by MX (seven countries) and health facility-based screening (four countries). Surveillance often focused on migrants and previous hotspots, with operational challenges linked to limited funding, workforce, and supply chains. Documents indicated that Sri Lanka, Thailand, China, and South Korea developed sustained PVS through national policies and domestic funding. Findings highlight the need for clear, contextualised guidance to operationalise sustainable PVS in different settings.

A new generation of insecticide-treated nets (ITNs) that incorporate the synergist piperonyl butoxide (PBO) has been shown to restore susceptibility to pyrethroids where P450 enzymes are the primary mechanism conferring the resistance. The present study evaluated the efficacy of YAHE 4.0, a PBO ITN, against wild free-flying Anopheles arabiensis in experimental huts in Lower Moshi, north-eastern Tanzania. It is the first evaluation of YAHE 4.0 in the country. Bio-efficacy evaluations, including susceptibility tests and cone bioassays, were conducted using the standard WHO guidelines. DuraNet Plus, a WHO-recommended PBO ITN, and Interceptor ITNs served as active and standard comparators, respectively. Unwashed and 20 times washed nets were subjected to experimental hut trials. Multiple logistic regression was employed to analyse experimental hut trial data. The results of the susceptibility testing showed that the An. arabiensis population of Lower Moshi was resistant to pyrethroids, but susceptible to organophosphates. Particularly, low mortality was recorded for cyhalothrin (2%) and alpha-cypermethrin (38%). Mortality rates to alpha-cypermethrin pirimiphos-methyl were 38% and 100%, respectively. The non-inferiority of YAHE 4.0 to DuraNet Plus ITN in terms of mortality and blood feeding was determined according to the WHO guidelines. The results for pooled unwashed and 20 times washed ITNs showed that YAHE 4.0 was superior to Interceptor ITN (adjusted odds ratio, AOR = 1.33; 95% CI = 1.04-1.69; non-inferiority margin, NIM = 0.68; p-value = 0.023) and non-inferior to DuraNet Plus (AOR = 1.02; 95% CI = 0.78-1.35; NIM = 0.72; p-value = 0.867) in terms of mortality. In terms of blood feeding inhibition for pooled unwashed and 20× washed ITNs, YAHE 4.0 was superior to both Interceptor ITN (AOR = 0.80; 95% CI = 0.64-1.00; NIM = 1.35; p-value = 0.049) and DuraNet Plus (AOR = 0.67; 95% CI = 0.52-0.86; NIM = 1.33; p-value = 0.002). Chemical analysis showed higher wash retention of active ingredients in YAHE 4.0 LLIN (88.9% for PBO and 94.9% for alpha-cypermethrin) compared to DuraNet Plus LLIN (89.2% for PBO and 90.5% for alphaypermethrin) before the hut trial. YAHE 4.0 LLIN demonstrated superior entomological efficacy and wash durability to DuraNet Plus and Interceptor LLINs, and fulfilled WHO non-inferiority criteria for mosquito mortality and blood-feeding inhibition. Therefore, YAHE 4.0 LLIN should be considered as an addition to the current list of pyrethroid-PBO nets used for control of pyrethroid-resistant vector populations with P450 enzymes as the main mechanism conferring resistance.

Eight Pacific Island Countries and Territories (PICTs) have been validated by the World Health Organization (WHO) as having eliminated lymphatic filariasis (LF) as a public health problem. WHO recommends that these countries implement post-validation surveillance (PVS) to ensure resurgence has not occurred. Some PICTs proactively conducted LF PVS even in the absence of specific recommendations or best-practice guidelines at the time of implementation. We aimed to explore the barriers and facilitators to implementing LF PVS in PICTs, with a view to informing context-specific strategies and regional guidelines. Key informant interviews were held between March and September 2024 with 15 participants involved in LF and/or neglected tropical disease surveillance. Transcripts were analysed thematically using a generalised deductive approach. A conceptual framework was developed to summarise themes with two main streams of barriers identified. Stream One Barriers included limited awareness of, and guidelines for, PVS requirements and competing national health priorities. Stream Two Barriers included cost, resource, and logistical barriers to conducting PVS. Participants called for clearer, contextually tailored guidelines, improved communication from WHO, and integration within existing systems. This study highlights the urgent need for operational guidance, policy advocacy, and capacity strengthening to ensure sustainable LF PVS in PICTs. Incorporating local context and leveraging existing health structures will be essential to prevent disease resurgence and maintain gains achieved through elimination programmes.

Schistosomiasis remains a major neglected tropical disease globally and presents particular challenges for countries transitioning from control to elimination. Saudi Arabia represents a unique epidemiological setting, having shifted from historical endemic transmission to very low reported incidence, yet long-term national analyses remain limited. A retrospective longitudinal analysis of national schistosomiasis surveillance data from 2002 to 2024 was conducted to evaluate temporal trends, clinical subtypes, regional distribution, and demographic characteristics. Joinpoint regression was used to identify significant changes in temporal trends, and autoregressive integrated moving average (ARIMA) models were applied to forecast national and regional trajectories. National incidence declined markedly from 5.5 per 100,000 in 2002 to 0.12 per 100,000 in 2024, with a notable change around 2010, followed by sustained low-level incidence. Intestinal schistosomiasis accounted for most cases, with increasing concentration among adult non-Saudi males and near-elimination among children. Regionally, cases were confined to a limited number of western and southwestern regions, particularly Ta'if, Al Baha, Jazan, and Madinah. Forecasting analyses indicated continued low-level detection without evidence of national resurgence. These findings demonstrate a transition to an elimination-maintenance phase and highlight the need for sustained surveillance in historically endemic regions and mobile populations.

As Nigeria advances toward the elimination of soil-transmitted helminthiasis (STH), updated endemicity maps are essential for guiding programmatic decisions. A cross-sectional study was conducted to update the STH endemicity maps in ten local government areas (LGAs) of Ondo State from July to August 2024. LGAs were stratified into three categories (C1-C3) based on the history of preventive chemotherapy (PC), with C1 being endemic LGAs with ≥5 effective rounds of PC, C2 being endemic LGAs with <5 effective rounds of PC, and C3 being low-endemicity (STH prevalence <20%; PC not required). A total of 4507 school-aged children (5-14 years) from 151 systematically selected communities (15 per LGA) provided fresh stool samples to assess the prevalence and intensity of STH. Stool samples were examined using the Kato-Katz technique. Prevalence of STH was aggregated at the LGA level and compared with World Health Organization thresholds. In the first category (C1), the baseline prevalence was reduced significantly by 60-96%, with specific prevalence in Akoko Southwest (from 28.2% to 0.4%, Risk Ratio (RR): 0.01), Akure North (from 39% to 1.5%, RR = 0.04), Ifedore (from 25% to 2.5%, RR = 0.10), and Ondo East (from 45.2% to 8.2%, RR = 0.18). In the second category (C2), the baseline was reduced significantly by 66-100%, with Akure South (from 29% to 1.2%, RR = 0.04), Ose (from 20% to 2.2%, RR = 0.11), Owo (~100% reduction), and Odigbo (38% to 12.8%, RR = 0.34). In the C3 LGAs, infection was significantly below the baseline threshold, with Akoko Northwest (5.2% to 0.9%, RR = 0.17) and Idanre (from 14.2% to 1.8%, RR = 0.13). Overall, significant reductions in STH prevalence were observed across the surveyed LGAs, with risk ratios ranging from 0.04 to 0.40. These findings updated the endemicity map for the ten LGAs in Ondo State, demonstrating significant progress toward STH elimination following PC implementation.