Tropical Medicine and Infectious Disease最新文献

Background/Objectives: This study aimed to evaluate the prevalence of viral agents identified by Multiplex PCR in acute respiratory viral infection (ARVI) patients at Edirne Sultan 1, Murat State Hospital, from April 2023 to April 2024, and to investigate the relationship between monthly average humidity and viral positivity rates. Methods: The study included 764 adult patients (aged 18 and older) diagnosed with influenza symptoms. Respiratory viral samples were collected and analyzed for COVID-19, influenza A and B, and RSV using Multiplex PCR, with results evaluated retrospectively. Continuous variables in the study were compared using a t-test, and categorical variables were compared with a chi-square test. A logistic regression analysis was performed for the analysis of COVID-19. In this analysis, PCR positivity was the dependent variable, while age, gender, and humidity level served as independent variables. Results: COVID-19 PCR positivity was detected in 142 patients (18.6%), with INF-A (influenza A) in 13 (3.7%), INF-B (influenza B) in 15 (4.2%), and RSV in 2 (0.6%). Higher humidity (over 60%) was associated with reduced viral PCR positivity rates for COVID-19 and influenza B, while low (up to 40%)/normal (40-60%) humidity correlated with positivity rate (p < 0.05 for both). Logistic regression analysis indicated that high humidity levels offer protection against COVID-19 (OR: 0.356; 95% CI: 0.245-0.518). Conclusions: Our study provides essential epidemiological data by summarizing monthly virus distribution in Edirne.

Background and Objective: Air pollution poses significant risks to global public health and has well-established links to respiratory diseases. This study investigates the associations between air pollution markers-Air Quality Index (AQI), ambient ozone, and nitrogen dioxide (NO₂)-and the incidence of chronic obstructive pulmonary disease (COPD), asthma, and tuberculosis. It also examines how socioeconomic factors such as gross domestic product (GDP) per capita, tobacco prevalence, and healthcare expenditure influence these relationships. This study includes data from 27 countries, thereby offering a global perspective to inform public health interventions and policy reforms. Methods: Data on average air pollution levels, respiratory disease incidence, and socioeconomic factors were collected from publicly available sources spanning four years. The 27 countries included in the study were selected to represent a broad range of pollution levels, income brackets, and geographical regions. Statistical analyses were performed using Python 3.12.0 to explore the relationships between these variables. Key Findings: AQI and NO₂ levels were significantly associated with increased incidences of COPD and tuberculosis, with rates rising especially during periods of heightened pollution. Conversely, ambient ozone exhibited inconsistent relationships with respiratory diseases, heavily influenced by socioeconomic factors. Higher GDP per capita and healthcare expenditure were linked to improved management of infectious diseases like tuberculosis, though they also corresponded with higher reporting of chronic conditions such as COPD. Tobacco smoking emerged as a critical risk factor for COPD across all regions. Conclusions: This study underscores the strong associations between air pollutants and respiratory diseases, particularly tuberculosis and COPD, with socioeconomic factors significantly influencing these relationships. Reducing air pollution and improving healthcare systems, particularly in low-income regions, are essential to mitigating the global burden of respiratory diseases.

This study tested the efficacy of xenomonitoring using contaminated flies and cockroaches at ports in Shenzhen by analysing sample data from imported flies and cockroaches from October 2023 to April 2024 to identify the pathogens they carried. Among all the samples of flies and cockroaches collected, Musca domestica vicina and Blattella germanica accounted for the highest proportion, 27.59% and 66.47%, respectively. Their positive rates for carrying Staphylococcus aureus were also the most significant, reaching 4.35% and 6.47%, respectively. The imported flies and cockroaches mainly came from Asia, with the highest proportion coming from Hong Kong, at 97.71% and 92.11%, respectively. Metagenomic sequencing indicated that the pathogens carried by the flies and cockroaches from different regions of Asia were generally similar but showed some differences. Flies from Southeast Asia, East Asia, South Asia, and West Asia and cockroaches from Southeast Asia, East Asia, and West Asia harboured unique opportunistic pathogens capable of causing gastrointestinal and respiratory infections in humans. Specifically, flies carried pathogens such as Campylobacter jejuni, Bacillus anthracis, Bacteroides fragilis, and Bordetella bronchiseptica, while cockroaches carried B. fragilis, Clostridium tetani, and Bacillus cereus. Our findings provide data support for future risk assessments of pathogens carried by imported vectors.

Depression among adolescents and young adults with HIV affects both their wellbeing and clinical care outcomes. Integrated care models are needed. We hypothesized that the SEARCH-Youth intervention, a life-stage-based care model that improved viral suppression, would reduce depressive symptoms as compared to the standard of care. We conducted a mixed-methods study of youth with HIV aged 15-24 years in SEARCH-Youth, a cluster-randomized trial in rural Uganda and Kenya (NCT03848728). Depression was assessed cross-sectionally with the PHQ-9 screening tool and compared by arm using targeted minimum loss-based estimation. In-depth semi-structured interviews with young participants, family members, and providers were analyzed using a modified framework of select codes pertaining to depression. We surveyed 1,234 participants (median age 21 years, 80% female). Having any depressive symptoms was less common in the intervention arm (53%) compared to the control (73%), representing a 28% risk reduction (risk ratio: 0.72; CI: 0.59-0.89). Predictors of at least mild depression included pressure to have sex, physical threats, and recent major life events. Longitudinal qualitative research among 113 participants found that supportive counseling from providers helped patients build confidence and coping skills. Integrated models of care that address social threats, adverse life events, and social support can be used to reduce depression among adolescents and young adults with HIV.

Chikungunya fever (CHIKF) is a re-emerging infectious disease caused by the chikungunya virus (CHIKV), transmitted primarily by Aedes mosquitoes. A significant number progress to chronic chikungunya arthritis, which shares similarities with rheumatoid arthritis (RA). Despite evidence of a link between CHIKV infection and subsequent RA development, a comprehensive analysis of the relationship between these two diseases is lacking. This study systematically analyzes the incidence of RA after CHIKV infection and its immunological mechanisms, following PRISMA guidelines with literature searches across multiple databases up to 3 September 2024. Eligible studies included retrospective and prospective designs reporting RA diagnoses after CHIKV infection. Data extraction was performed independently, and the risk of bias was assessed using appropriate tools. Sixteen studies involving 2879 patients were included, with 449 individuals diagnosed with RA following CHIKV infection, resulting in a combined incidence of 13.7% (95% CI: 6.12% to 27.87%). High heterogeneity between studies was observed (I² = 96%), indicating variability related to diagnostic criteria and population characteristics. This review highlights the significant RA incidence after CHIKV infection, emphasizing the need for research on autoimmune mechanisms, long-term rheumatological follow-up, early diagnostic biomarkers, and CHIKV's long-term health impacts.

The HIV epidemic remains a major public health issue globally and in Vietnam. This study assesses changes in HIV/AIDS-related mortality rates over time in Lang Son Province, Vietnam, from 2005-2018. We performed a descriptive epidemiological study using a population-based mortality registration system to examine HIV/AIDS-related mortality. HIV/AIDS-related mortality was converted to a crude and adjusted rate per 100,000 person-years using the World Health Organization's standard population for 2000-2025. The mortality rate ratio and 95% confidence interval were estimated to examine the province's time trend from 2005 to 2018. The adjusted mortality rate for HIV/AIDS in Lang Son Province was 12.3 and 2.4 per 100,000 for men and women, respectively, with a male-to-female ratio of 5.1. The province experienced a 94% reduction in HIV/AIDS-related deaths between 2005 and 2018. The mortality rate ratio for 2018 compared to 2005 was lower for men (0.056, 95% CI: 0.029, 0.110) than for women (0.080, 95% CI: 0.019, 0.338). The findings show a gradual decline in HIV/AIDS-related mortality rates in Lang Son Province, Vietnam. However, significant gender disparities in mortality remain a major concern, and HIV remains a significant burden. This highlights the urgency for major efforts to prevent HIV transmission and address these disparities to effectively end the HIV epidemic in Lang Son and throughout Vietnam.

Despite the high prevalence of latent Kaposi's sarcoma-associated herpesvirus (KSHV) infections in patients from endemic areas with a high human immunodeficiency virus (HIV) prevalence, KSHV lytic reactivation in the context of other co-infections is not well understood. Lytic KSHV infections can contribute to severe inflammatory symptoms and KSHV-associated pathogenesis. We have previously reported on KSHV reactivation upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in a non-hospitalised cohort of people living with HIV (PLWH). From this cohort, we identified a 34-year-old male who presented for routine HIV care in May 2021 with an unusually high KSHV viral load (VL) of 189,946.3 copies/10⁶ cells, before SARS-CoV-2 infection. The patient was invited into a 2-year follow-up study where his peripheral blood was analysed for selected virological, clinical, and inflammatory parameters every 6 months. He remained highly viremic for KSHV throughout the 2-year study period, during which he was infected with SARS-CoV-2 and developed disseminated tuberculosis, with steadily increasing levels of the inflammatory markers C-reactive protein (CRP), and interleukin-6 (IL-6). His HIV VL remained controlled (<1000 copies/mL) and his CD4 count bordered immunosuppression (±200 cells/µL), suggesting some responsiveness to antiretroviral treatment (ART). However, the patient's uncontrolled lytic KSHV infection may increase his risk for developing a KSHV-associated pathology manifesting with inflammation which should be closely monitored beyond the study period.

Background: The fatality rate of hemorrhagic fever with renal syndrome (HFRS), due to hantavirus transmitted by rodents, ranges from 1% to 12%. This study aims to delineate the clinical and laboratory characteristics of HFRS, identify factors associated with disease severity, and construct and validate a nomogram for prognosis prediction of HFRS in the central part of China.

Methods: Out of 598 HFRS patients diagnosed via serology tests from four hospitals in Hubei Province, 551 were included. Clinical data were gathered and analyzed, followed by logistic univariate and multivariate analyses to identify independent prognostic factors. A nomogram was developed and validated to forecast the patient's prognosis.

Results: Vaccination led to a notable drop in HFRS incidence from 2018 to 2019, and seasonal trends exhibited bimodal changes with peaks from May to July and November to January. The 30-day mortality rate was 4.17% (23/551). Red blood cell count (RBC), age, two-stage overlap, qSOFA ≥ 2, aspartate aminotransferase (AST), and three-stage overlap were identified as independent prognostic factors. A predictive risk classification system using a nomogram chart was developed, and Kaplan-Meier curves indicated that the new system accurately distinguished 30-day mortality among the three risk groups.

Conclusions: The risk score (EASTAR) system demonstrated good predictive performance for prognostic prediction, and it can be applied to quickly screen patients who require ICU admission.

Effective tools to prevent mosquito bites are essential for malaria control. The Lehmann Funnel Entry Trap (LFET), a window screen proven effective in reducing mosquito density, was tested for its large-scale impact on malaria vector control and community acceptance. A total of 1313 traps were deployed in Vallée du Kou 3 (VK3), with 12 traps randomly selected for detailed evaluation against untrapped houses in Vallée du Kou 5 (VK5). Traps were placed in windows with doors blocked by curtains. From July to October, mosquitoes were collected for nine days per month from VK3 traps and VK5 control houses. Morphological identification, density analysis, resistance gene screening, and female age structure determination were conducted. The trap's impact was assessed via pyrethrum spray catch (PSC) and for nine days per month, while trap fabric integrity and community perceptions were also evaluated. Traps reduced mosquito entry density by more than 90% in VK3 houses. VK3 had 33% higher house mosquito density pre-intervention and 47% lower house mosquito density post-intervention than VK5. Old female mosquito numbers rose in VK5 but not VK3. Pyrethroid resistance was high (kdr mutation frequency > 0.9) in both control and intervention sites. VK3 residents appreciated the traps for reducing bites and improving sleep. The LFET effectively controls malaria vectors and is well-suited for widespread use in malaria elimination efforts.

Chagas disease, caused by Trypanosoma cruzi, remains a neglected tropical disease with limited and often suboptimal chemotherapeutic treatment options. The WHO recommends nifurtimox (NFX) for treating Chagas disease, which, although it is effective in the early stages of infection, has variable efficacy in the chronic phase and induces adverse effects that frequently compromise the continuity of the treatment. This study focused on the development and characterization of innovative lipid-based self-emulsifying drug delivery systems (SEDDSs) and poly(ε-caprolactone) implants containing NFX. The SEDDS formulations modified the NFX release extent and rate. The implant characterization included thermal analysis, X-ray diffraction, thermo-optical analysis, and scanning electron microscopy, confirming the low interaction between NFX and the polymer. In vitro assays demonstrated the enhanced anti-T. cruzi activity of the NFX-SEDDS, with minimal cytotoxicity in mammalian cells. In vivo studies using T. cruzi-infected mice revealed that both formulations effectively suppressed parasitemia, achieving cure rates comparable to those of the standard oral NFX treatment. Additionally, the implants showed improved tolerability and sustained efficacy, delivering a prolonged effect equivalent to 40 oral doses. These findings highlight the potential of these innovative NFX formulations as promising alternatives for treating Chagas disease, particularly in the chronic phase, offering improved adherence and comparable efficacy to the existing therapies.