Tropical Medicine and Infectious Disease最新文献

Tuberculosis remains the deadliest infectious disease worldwide. Among extrapulmonary forms, peritoneal tuberculosis stands out as a rare and challenging diagnosis, often mistaken for intra-abdominal neoplasms or peritoneal carcinomatosis. The clinical, paraclinical, and imaging findings are similar and sometimes indistinguishable between the two entities, making the diagnosis a challenge for the treating physician. Here, we present the case of a young woman with chronic constitutional symptoms who presented to the emergency department with abdominal pain and ascites. An initial differential diagnosis of peritoneal carcinomatosis was considered based on findings in the peritoneal fluid and abdominal CT scan, leading to diagnostic laparoscopy. Histopathological examination of the samples revealed non-caseating granulomas involving the peritoneum, with no findings suggestive of malignancy. Subsequently, molecular testing for Mycobacterium tuberculosis was positive in the biopsies and peritoneal fluid, establishing the diagnosis of peritoneal tuberculosis. This case highlights the importance of awareness of peritoneal tuberculosis as a differential diagnosis of ascites and its significant potential to mimic other pathologies.

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Recent outbreaks of yellow fever in Brazil, with hundreds of cases despite available vaccination, have drawn attention to the pressing need for effective therapeutic interventions, with a special focus on the critically ill [...].

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Human filariasis caused by Wuchereria bancrofti and Brugia malayi continues to circulate within Northern and Central Thailand and Southern Thailand, respectively. Major clinical presentations comprise lymphedema of extremities, hydrocele, funiculitis, orchitis, and tropical pulmonary eosinophilia. Microfilaria in other organs is rare. We report an unusual case of a 48-year-old woman from Southern Thailand with parotid filariasis presenting with chronic parotid gland enlargement. Wuchereria bancrofti microfilaria was observed within cytologic smear samples from the swollen left parotid gland and subsequently confirmed via a positive filaria immunoblot. The patient's condition was successfully resolved through administration of a triple regimen consisting of three antiparasitic medications.

Mycobacterium tuberculosis (TB) antigen-based skin tests, known as TB-specific skin tests (TBSTs), have been recommended by the World Health Organization (WHO) to test for TB infection (TBI). In light of these new recommendations, we conducted a situational analysis and market assessment to evaluate the utility of testing for TBI in general and of the new TBSTs in South Africa. We found the following barriers to acceptability of testing for TBI overall, regardless of the test: the perceived high prevalence of TBI; prior experiences of poor TB preventive treatment (TPT) uptake, which has led to the removal of TBI tests from the current TPT guidelines; and a poor sensitivity of previous TBI tests in people living with HIV (PLHIV). In addition, further barriers to the new TBSTs in particular were as follows: patient level barriers linked to repeat visits; the need for cold chains; and the need for a strong laboratory system, which reduces the need for point-of-care options. TBI testing was thought to be potentially useful to determine the eligibility for TPT in these use cases: healthcare workers, pregnant women living with HIV and prisoners. One other use case was in the TB diagnoses of children, where it was thought that a positive immunological test (TST/IgRA/TBST) could indicate a TB contact and serve as a 'rule in' test to strengthen the evidence for TB disease as a cause.

Background: Rabies is a fatal yet preventable zoonosis. In Saudi Arabia, uneven surveillance and limited public awareness may delay post-exposure prophylaxis (PEP). In Makkah, where residents regularly encounter free-roaming dogs, knowledge gaps could elevate exposure risks. Objectives: This study aims to assess public knowledge, attitudes, and post-bite practices regarding rabies, including wound washing and access to PEP among adult residents of the Makkah Region, and to examine associations with pet dog ownership. Methods: A cross-sectional survey was conducted in the Makkah Region (March-June 2025). An online validated bilingual questionnaire targeted residents ≥ 18 years via social media. Descriptive statistics, chi-square tests, 95% confidence intervals, and binomial logistic regression were applied in IBM SPSS v26; p < 0.05 was significant. Results: Of 523 respondents, 91.8% lived in Makkah city, 52.8% were female, and the age distribution was 18-24 years (44.2%), 25-34 years (35.6%), 35-44 years (12.0%), and ≥45 years (8.2%). Pet dog ownership was rare (1.9%), yet 39.4% reported stray dogs in their communities. Overall, 60.6% knew what rabies is and 63.7% knew it is vaccine-preventable, but 52.2% wrongly believed that transmission occurs only via dog bites. Hospitals (79.7%) and health centers (79.2%) were the most cited vaccination sites; social media was the dominant information source (74.6%). No significant association was found between pet ownership and rabies awareness (all p > 0.05). In multivariable regression (n = 509), adequate rabies knowledge increased the odds of an appropriate intended response (AOR 1.85, 95% CI: 1.27-2.68). Participants aged 30-40 years and those >50 years had significantly lower odds (AOR 0.45, 95% CI: 0.24-0.85 and AOR 0.23, 95% CI: 0.09-0.56, respectively). Conclusions: Despite moderate awareness, critical misconceptions and inconsistent first aid intentions persist. Priority actions include clear, locally adapted education on immediate wound washing and prompt PEP, standardized bite management pathways across facilities, reliable access to vaccines and immunoglobulin, and targeted social media micro-campaigns. By identifying public misconceptions, knowledge gaps, and preferred communication channels, this study provides baseline evidence to guide community awareness programs, intersectoral collaboration, and One Health-based surveillance essential for Saudi Arabia's progress toward the global "Zero rabies by 2030" goal.

Since the emergence of COVID-19, the epidemiological and seasonal patterns of respiratory pathogens have shifted, highlighting the need for ongoing surveillance. This study investigated the epidemiology, seasonal trends, and age-specific detection of respiratory viruses among patients with acute respiratory infections (ARIs) in Thailand from January to December 2024. Eight respiratory viruses were detected using multiplex real-time RT-PCR. Of 7853 samples, 60.8% (4777) tested positive. The most frequently detected pathogens were influenza virus (IFV, 24.8%), SARS-CoV-2 (21.5%), and human rhinovirus (HRV, 20.8%). IFV showed biannual peaks during the cold and rainy seasons, SARS-CoV-2 peaked in the warm months, and HRV circulated year-round. Respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) were primarily detected during the rainy season (July-November), reflecting a return toward pre-COVID-19 seasonal patterns. Age-specific differences were notable: HRV was most prevalent in children < 5 years, IFV predominated among those aged 6-18 years, and adults ≥ 19 years were mainly positive for IFV and SARS-CoV-2. Co-infections were most frequent in children aged 3-5 years, often involving HRV. These findings provide updated insights into post-COVID-19 viral epidemiology, emphasize the importance of age- and season-specific surveillance, and support the development of effective public health strategies for ARI control.

In Brazil, public health programs have relied predominantly on chemical insecticides to control Aedes aegypti, Anopheles spp., Culex quinquefasciatus, triatomines, and phlebotomines. Rising vector-borne disease incidence and insecticide resistance (IR) call for a critical appraisal of historical and current control practices. This literature review compiles secondary data produced from 1901 to 2024 obtained from Medline/PubMed, Google Scholar, and governmental notes and reports. Brazil's vector control progressed from organochlorines (e.g., DDT) to organophosphates, carbamates, pyrethroids, insect growth regulators, microbial larvicides (Bti and Lsp), spinosad, and recently formulations with dual active-ingredient. Ae. aegypti showed widespread resistance to temephos and pyrethroids, decreased susceptibility to pyriproxyfen, and no documented Bti resistance. Anopheles spp. exhibited low to moderate resistance to pyrethroids. Cx. quinquefasciatus resistance is likely influenced by collateral exposure from Aedes control and domestic use. Regarding triatomines and phlebotomines, there was a predominant reliance on pyrethroids; most studies indicate their susceptibility to these compounds. In short, Brazil's century-long, insecticide-centric strategy has delivered episodic gains but fostered Aedes aegypti resistance. For other species, for which there is no dedicated program for a long period, data on resistance are scarce or nonexistent. Sustainable progress requires strengthened, nationwide IR surveillance and entomological mapping to coordinate cross-program actions.

Data on HIV prevalence in remote, rural communities of Cameroon are scarce despite the country's high HIV-1 group M diversity. This study assessed HIV seroprevalence and socio-demographic determinants in four regions of the equatorial rainforest location of the country. A cross-sectional survey was conducted among 5631 individuals in rural communities of the Centre, East, Littoral, and South regions. HIV testing was performed, and socio-demographic data were collected. Prevalence ratios (PRs) and adjusted prevalence ratios (aPRs) were estimated using bivariate and multivariate analyses (negative log-binomial model with generalised estimating equations, GEEs). Overall, HIV prevalence was 3.4% (95% CI: 2.9-3.9%) in individuals aged 15-49 years and 4.9% in those aged ≥50 years. Women had higher prevalence than men (4.5% vs. 3.0%, aPR = 1.53, 95% CI: [1.12-2.08], p = 0.007) and also higher HIV prevalence among individuals aged 50-54 years compared to those aged 15-19 years (5.5% vs. 1.8%, aPR = 2.76, 95% CI: [1.24-6.15], p = 0.013). The South region recorded the highest prevalence (5.2%, aPR = 1.82, 95% CI: [1.04-3.18], p = 0.035) compared to the Centre region with the lowest (2.3%). Divorced/separated/widowed individuals (10.2%) had increased risk (aPR = 1.70, 95% CI: [0.80-3.58], p = 0.165) compared to single individuals (3.2%). HIV remains a significant public health concern in remote, rural Cameroon, with a disproportionate impact on older adults and women. Surveillance should extend beyond the traditional 15-49-year age range, and targeted prevention is needed for high-prevalence regions and older populations to curb ongoing transmission.