Tropical Medicine and Infectious Disease最新文献

In South America, cutaneous leishmaniasis is caused by several species of the parasite of the genus Leishmania. Here, we describe an imported case of cutaneous leishmaniasis acquired in Peru by a Brazilian patient during her travel to Iquitos. Infection by Leishmania parasites was confirmed by histopathologic examination, and the patient was treated with pentavalent antimony (Pentostam), without clinical response. Molecular typing was performed by sequencing the ribosomal DNA internal transcribed spacer and heat-shock protein 70 gene, which identified the parasites as Leishmania guyanensis. The clinical isolate was similarly susceptible to amphotericin B, pentamidine, and miltefosine as the reference strain, while for pentavalent antimony, this clinical isolate was more susceptible than the reference strain, even though its susceptibility in vitro was still considered low. The patient was then treated with liposomal amphotericin B, with clinical improvement of the lesions.

Aedes albopictus and Aedes japonicus are invasive mosquito species that are causing great public concern. Aedes albopictus have successfully spread in Croatia, established in both the coastal and continental parts of the country, while Aedes japonicus is invading temperate climate areas. The invasive Aedes species are particularly attracted to the black plastic water containers and flower vases in cemeteries where they oviposit their eggs. Therefore, monitoring of this species was carried out in 12 cemeteries in Zagreb, using ovitraps with masonite strips as a substrate for oviposition. The monitoring was carried out from 2017 to 2020. The traps were inspected and the substrate was replaced every two weeks. This study showed that these two invasive species were present and very abundant in the cemeteries. In the case of Ae. albopictus, a higher population density and a greater number of occupied cemeteries were detected. This species was identified in all 12 cemeteries. Aedes albopictus was identified as the dominant species at all study sites. The spread of Ae. japonicus increased during 2018 in comparison to the previous year. Although this species was present in approximately 9% of the ovitraps, the observed population remained consistent throughout the course of the study. The findings indicate that cemeteries can be considered as significant public health hotspots, as the invasive Aedes mosquitoes tend to develop and reproduce in such environments. Consequently, the mosquito population of these two invasive species may only be reduced by applying integrated mosquito management measures, focused on the education of citizens.

Ethiopia is among the countries most heavily affected by tuberculosis, where it is the leading cause of morbidity, the third cause of hospital admission and the second cause of death. To improve tuberculosis management and control, the early detection of cases, effective treatment and the persistent evaluation of treatment outcomes are vital issues that should be taken into consideration. This study was designed to determine the treatment outcomes and associated risk factors among TB patients registered at Adare General Hospital in Southern Ethiopia. A five-year retrospective study was conducted by reviewing the files of the TB patients registered from September 2013 to August 2017. The data were coded, cleaned, entered and analyzed using SPSS version 20 statistical software. Bivariate and multivariable logistic regression with odds ratios (OR) along with a 95% confidence interval was computed and interpreted. A p-value < 0.05 was declared as statistically significant. Among the 1122 cases, 620 (55.3%) were male, 748 (66.7%) were from urban areas, 319 (28.4%) were smear positive, 352 (31.4%) were smear negative and 451 (40.2%) were extra-pulmonary patients. Among the treated patients, 284 were declared cured, 753 completed their treatment, 29 were defaulters, 3 failed to follow up, and 53 died. The overall treatment success rate was 92.4%. The TB patients from urban areas (AOR = 1.44, 95% CI: 0.28, 0.67), and the HIV-negative TB patients (AOR = 5.48, 95% CI; 3.474, 8.64) were significantly associated with successful treatment outcomes. The treatment success rates of tuberculosis at Adare General Hospital were comparable to the national health facility-level coverage, but they should be maintained and strengthened further to attain tuberculosis-related national and millennium goals.

The Mexican state of Chiapas is considered epidemiologically significant for Chagas disease due to the coexistence of infected reservoirs and vectors, including migratory populations from Central and South America. However, there is a lack of monitoring programs for the timely detection of this disease. The objective of this study was to elucidate the prevalence of Trypanosoma cruzi infection in pregnant women and the risk of vertical transmission in newborns at two hospitals located in the Metropolitan Region of Tuxtla Gutierrez, the capital of Chiapas State Mexico. A cross-sectional study was carried out with 193 pregnant women with gestational ages between 32 and 40 weeks, who underwent immunological testing to diagnose Chagas disease. Conventional PCR testing on cord blood revealed the presence of T. cruzi in newborns. The prevalence of T. cruzi infection in pregnant women was 32.12% (95% confidence interval (CI): 0.25, 0.38). The 62 pregnant women who tested positive for Chagas disease gave birth to 63 children, and in 5 newborns (8% (5/62), 95% confidence interval (CI): 0.02, 0.19), PCR tests on umbilical cord blood were positive for T. cruzi. In conclusion, the dataset showed a high prevalence of Chagas disease in the sample of pregnant women studied and a maternal-fetal transmission rate of 8%.

Anopheles species composition, abundance, and Plasmodium natural infection are important aspects to assess malaria transmission risk. In this study, these aspects were evaluated in a large number of localities in the most important malaria-endemic regions of Colombia. Mosquitoes were collected from 2012 to 2015 in 55 localities of northwestern and western Colombia. Anopheles species composition, abundance, and Plasmodium infection were estimated. A total of 13,218 Anopheles specimens were evaluated. The highest species richness was detected in the northwest, where the main vectors, An. albimanus (27.8%) and An. nuneztovari (26.7%), were the most abundant species. In the west, An. nuneztovari predominated (51.6%), followed by An. darlingi (29.2%). Six species were infected with Plasmodium, An. darlingi, An. nuneztovari, An. albimanus, An. calderoni, An. triannulatus, and An. braziliensis. Results showed that in these localities the main Colombian vectors are widely spread, which suggests a high malaria risk. Notably, this study is the first to report An. braziliensis from Colombia as being naturally infected with Plasmodium. Infection results for species that are suspected local vectors indicate the importance of conducting further studies to assess their epidemiological importance. This information provides the basis for the application of directed vector control strategies that are species-specific.

Leishmaniasis encompasses a group of neglected diseases caused by flagellated protozoa belonging to the Leishmania genus, associated with high morbidity and mortality. The search for compounds with anti-Leishmania activity that exhibit lower toxicity and can overcome the emergence of resistant strains remains a significant goal. In this context, the calpain inhibitor MDL28170 has previously demonstrated deleterious effects against promastigote forms of Leishmania amazonensis, which led us to investigate its role on axenic amastigote forms. The calpain inhibitor MDL28170 was able to decrease the viability of amastigotes in a typically dose-dependent manner. The treatment with the IC₅₀ dose (13.5 μM) for 72 h led to significant amastigote lysis and increased cell-to-cell aggregation. Ultrastructural analysis revealed several cellular alterations, including disruption of the trans-Golgi network and the formation of autophagosomes when treated with MDL28170 at ½ × IC₅₀ dose. Additionally, mitochondrial swelling and the formation of concentric membranous structures inside the mitochondrion were observed after incubation with the IC₅₀ dose. These results reinforce the potential application of the calpain inhibitor MDL28170 against L. amazonensis, highlighting its effectiveness and possible mechanism of action against the parasite.

(1) Background: HIV drug resistance (HIVDR) poses a significant challenge to the effectiveness of antiretroviral therapy and the overall management of HIVand AIDS. Understanding the predictors of HIVDR is critical for developing strategies to mitigate its impact. The objectives of this study were to identify the predictors of HIVDR among Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA 2020) study participants, a national population-based survey. (2) Methods: Data from people living with HIV who participated in the ZIMPHIA 2020 were used to determine the predictors of HIVDR. (3) Results: The prevalence of HIVDR was 44.9%. Acquired HIVDR was present in 76.1% of people with a virological failure and transmitted resistance is 22.6% in naïve individuals. Factors associated with HIVDR in adjusted analysis were the number of lifetime sexual partners (aOR = 1.03, 95% CI: 1.01-1.06, p = 0.017), each additional year since the first HIV positive result (aOR = 1.17, 95% CI: 1.09-1.25, p < 0.01), each additional year on ART (aOR = 1.14, 95% CI: 1.06-1.23, p = 0.001), initiating ART before 2014 (aOR = 3.08, 95% CI: 1.72-5.49, p = 0.020), ever had switched antiretrovirals (aOR = 2.47, 95% CI: 1.15-5.29, p = 0.020) or had ever had a viral load test (aOR = 2.54, 95% CI: 1.54-4.17, p < 0.001) and a CD4 count < 350 (aOR = 2.04, 95% CI: 1.48-2.83, p < 0.01), while age ≥ 50 (aOR = 0.56, 95% CI: 0.32-0.98, 32 p = 0.04), condom use at last encounter (OR: 0.49, 95%CI: 0.33-0.73, p < 0.001), and not being on ART (aOR = 0.09, 95% CI: 0.06-0.13, p < 0.01) were associated with reduced odds of HIVDR. Conclusions: HIVDR was high among the participants. There is a need to address HIVDR and enhance the mechanisms already in place. This study introduces more information that would help in developing targeted interventions to prevent HIVDR and improve patient outcomes.

Leishmaniasis is classified as a neglected tropical disease (NTD), caused by protozoan parasites of the genus Leishmania, which are transmitted to humans and other animals through the bite of infected female phlebotomine sandflies. There are three forms of the disease: cutaneous leishmaniasis (CL) manifested by ulcers and scars; systemic or visceral leishmaniasis (VL), which can lead to life-threatening complications if left untreated; and mucocutaneous leishmaniasis (MCL), which can destroy the mucous membranes of the nose, mouth and throat. Human leishmaniasis is endemic in many countries across Africa, Asia, Southern Europe, the Middle East, and Central and South America. The interconnection of environmental, animal and human health underlies the spread of the Leishmania parasite. Environmental disruptions, such as climate change, deforestation or urbanisation, but also globalisation and migration, significantly affect the distribution and abundance of sand fly vectors and reservoir hosts. Climate change alters the breeding patterns of sandflies and expands their geographic range; deforestation and misuse of large areas disrupt ecosystems, leading to increased human-vector contact; and urbanisation increases the potential for contact between parties, particularly in densely populated areas. Migration of humans and animals, either through natural migration or, for example, the pet trade and breeding, can facilitate the spread of Leishmania parasites. In addition, socio-economic factors, including poverty and lack of access to healthcare, increase the burden of leishmaniasis in vulnerable populations. Due to this multitude of reasons, the geographic distribution of sandflies has expanded to higher latitudes and altitudes in recent years, with a consequent increase in disease burden. Indeed, despite ongoing challenges in the surveillance systems, data from the last available year have shown an increase in many cases in both humans and dogs. This perspective explores the interconnected factors influencing the spread of leishmaniasis worldwide and the epidemiology of the disease. In addition, it illustrates the importance of integrated strategies in a One Health approach: surveillance, prevention and control of vectors, animals and humans.

Citizen science resources have had great relevance in community educational intervention, fostering interest in ecological research projects. This study investigated the influence of the application of multimedia didactic resources focused on citizen science and analysis of sociodemographic variables to improve the levels of ecological knowledge about mosquito-borne diseases. For this, a probabilistic sample of 172 participants from an urban sector in southwestern Colombia was selected. A multimedia didactic material was designed for the educational intervention and evaluated by means of pretest and posttest. To assess whether the educational intervention was statistically significant, the data were processed with statistical inference to determine the influence of various variables (gender, age, marital status, schooling, and occupation) on each person's ecological knowledge. The findings showed a significant increase in the knowledge levels of the participants. The marital status variable (married and cohabiting) significantly influenced ecological knowledge. These participants are more likely to obtain high knowledge, associated with the prevention of their family environment. This study demonstrated that multimedia didactic strategies are an important factor to take into account in the structuring of environmental education and citizen science projects. For future research, it is suggested to deepen the relationship between sociodemographic variables and ecological knowledge.

Community mobilisation is a vital process for raising awareness and increasing participation in healthcare interventions, research, and programmes that require human sample collection and mass management. In this report, we present the community mobilisation approach undertaken for the implementation of the operational mapping and assessment of granular schistosomiasis and soil-transmitted helminths in Ekiti State, Nigeria. The mobilisation was conducted in 177 communities/wards of the 16 local government areas. A total of 15,340 urine and stool samples were collected in 34 days. The efficacy and success of the strategy were evaluated through the following three performance metrics: community compliance rate, the participant response rate at the community level, and the overall compliance response rate of the four most sensitive LGAs. Community compliance was 93.7% as sample collection was denied in nine communities and two other communities demanded the return of the collected samples despite our mobilisation effort because of cultural bias and myths that connect the collection of stool and urine samples to ritual activities in the local context. The participant response rate at the community level was 86.7%. Three of the four sensitive LGAs (based on previous assessment programmes) demonstrated satisfactory compliance rates of 100%, while a response rate of 64.0% was computed for one of the LGAs. We believe our approach contributed to effective community mobilisation and awareness and that the developed model has the potential to improve participation rates in large healthcare assessments and intervention programmes.