Tropical Medicine and Infectious Disease最新文献

Systematic screening of household contacts (HHCs) of people with tuberculosis (TB) and starting them on either TB treatment or tuberculosis preventive treatment (TPT) reduces TB incidence. This project supported HHC management in six health facilities in Zimbabwe through the provision of CXR services, reimbursement of transport costs for HHCs, and provision of fuel and refreshments for healthcare workers involved in contact tracing. We describe TB and TPT cascades among the HHCs of index patients with all forms of TB. We enrolled 251 index patients who listed 794 HHCs: 551 (69%) HHCs of 158 index patients were traced and 520 (94%) screened for TB. Of the 502 who were referred to clinics, 362 (72%) reached the clinic. Among 520 HHCs, 324 (62%) underwent CXR screening and 18 (5%) had CXRs suggestive of TB. The yield of TB was 2.3% (12/520), with CXR detecting eight people who had not reported TB symptoms. Of the 311 who were assessed for TPT eligibility, 126 (41%) started TPT and 119 were assessed for TPT outcomes. Of these, 111 (93%) had successful TPT outcomes. The median times to starting TB treatment and TPT were 7 days and 11 days, respectively. The intervention facilitated timely access to healthcare services and a high yield of TB detection.

Apart from some information on dengue virus (DENV), there is limited data on the circulation of arboviruses in Burkina Faso. The aim of this study was to investigate antibody prevalence against six arboviruses in four regions of the country to document previous virus exposure. Serum samples collected between August 2018 and December 2022 from people infected with viral hepatitis B and C in Bobo-Dioulasso were used to detect IgG antibodies against DENV, Chikungunya virus (CHIKV), Zika virus (ZIKV), Yellow fever virus (YFV), Rift Valley fever virus (RVFV) and Crimean-Congo hemorrhagic fever virus (CCHFV) using commercial ELISA kits. A total of 1808 serum samples, accompanied by basic epidemiologic data (sex, age and residency) were included in this study. We observed an IgG antibodies seroprevalence of 75.4% for DENV, 30.8% for CHIKV, 2.9% for ZIKV, 1.2% for RVFV, 1.1% for CCHFV and 1.1% for YFV. Age, sex, and place of residence were significantly associated with seropositivity for DENV and age and sex with CHIKV seropositivity. The results suggested widespread circulation of DENV and CHIKV and possible circulation of CCHFV and RVFV in humans in Burkina Faso. The importance of strengthening arbovirus surveillance by including additional arboviruses in the diagnostic panel is emphasized.

Brucellosis is a bacterial zoonotic disease which poses a significant public health challenge globally. In Kenya, it is a priority zoonosis, causing morbidity and losses in humans and animals. Here, we used monthly surveillance data from 2014 to 2022 from the official human and animal health surveillance databases. We conducted spatiotemporal analysis, tested associations between human and animal brucellosis using Time Series Linear Models, and forecasted the incidence of human brucellosis for twelve months using Seasonal Autoregressive Integrated Moving Average (SARIMA) models. Our analysis revealed a significant disparity in brucellosis cases, with a much higher cumulative number of human cases (4,688,787) compared to animal cases (1214). Human incidence depicted a relatively stable trend, with occasional fluctuations. However, cattle and camel incidences displayed sporadic peaks and troughs. Only cattle brucellosis was significantly associated (estimate: 0.355; 95% CI: 0.004 to 0.707) with human brucellosis. SARIMA models demonstrated reasonable predictive accuracy for human incidence, but incorporating animal data did not significantly improve model performance. Our study highlights the weaknesses in the existing surveillance systems and the need for comprehensive evaluation of the systems and implementation of integrated surveillance to address gaps in surveillance, improve the accuracy of predictive analysis, and enhance early detection for zoonotic diseases.

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.