Background: Lymphatic filariasis is a major public health problem known for its disfiguring and debilitating effects. Alappuzha district in Kerala has been a hotspot for Brugian and Bancroftian filariasis. The efforts to combat Brugian filariasis in this region about two decades earlier led to notable decline in vector density and interruption of disease transmission. Materials and Method: A cross-sectional survey was carried out in Alappuzha district and 12 wards were selected using multistage random sampling method. An entomological survey was conducted in the selected wards. Result: Fourteen out of 69 Ma. annulifera were positive for filarial parasites. The average infection and infectivity rate was 20% and 0%. Molecular characterization of positive samples confirmed the parasites as Brugia malayi. Phylogenetic analysis of the isolates revealed that they belong to the same clade. Conclusion: This study highlights the importance of continued vector surveillance and timely intervention by appropriate vector control measures to prevent transmission of the disease.
{"title":"Xenomonitoring and Molecular Characterization of <i>Brugia malayi</i> from <i>Mansonia annulifera</i> in Alappuzha, Kerala, India.","authors":"Kiruthiga Tamilselvan, Aiswarya R Suresh, Sivalaxmi Balakrishnan, Harish Kumar Shah, Bhairavi Balasubramanian, Jessu Mathew, Hisham Moosan","doi":"10.1089/vbz.2025.0015","DOIUrl":"10.1089/vbz.2025.0015","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphatic filariasis is a major public health problem known for its disfiguring and debilitating effects. Alappuzha district in Kerala has been a hotspot for Brugian and Bancroftian filariasis. The efforts to combat Brugian filariasis in this region about two decades earlier led to notable decline in vector density and interruption of disease transmission. <b><i>Materials and Method:</i></b> A cross-sectional survey was carried out in Alappuzha district and 12 wards were selected using multistage random sampling method. An entomological survey was conducted in the selected wards. <b><i>Result:</i></b> Fourteen out of 69 Ma. annulifera were positive for filarial parasites. The average infection and infectivity rate was 20% and 0%. Molecular characterization of positive samples confirmed the parasites as Brugia malayi. Phylogenetic analysis of the isolates revealed that they belong to the same clade. <b><i>Conclusion:</i></b> This study highlights the importance of continued vector surveillance and timely intervention by appropriate vector control measures to prevent transmission of the disease.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"476-479"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-04-26DOI: 10.1089/vbz.2025.0023
Kristin Michel, Nicole M Ioerger, Ashlie M Ake, Susan M Hettenbach, Cassandra Olds, Dustin L Pendell, James Stack, Stephen Higgs, Dana L Vanlandingham
Background: The state of Kansas (KS) has been called the "agricultural heartland" of the United States. Vector-borne and parasitic diseases (VBPD) have a major impact on the production of livestock, such as cattle, swine, goats and sheep, as well as crops, such as wheat, corn, and sorghum. The purpose of this review is to educate agricultural professionals in the state of KS about VBPD of current or potential concern and to inform the public about the challenges faced by the agricultural community. Methods: This review describes and discusses the endemic VBPD that currently impact agricultural production in KS and foreign VBPD of concern. In addition, we outline the major arthropod vectors of VBPD in KS, including ticks, mites, and various insects. In the context of this review, parasites are strictly limited to arthropod ectoparasites that negatively impact livestock production. Modern agricultural data for the state of KS were mostly sourced from the USDA National Agricultural Statistics Service, and current KS VBPD data were mostly sourced from the KS State Veterinary Diagnostic Laboratory. Conclusion: These VBPD have a large economic impact on the state and country, and we have concluded there is a need for updated estimates regarding the economic burden of VBPD in KS and throughout the United States to make better animal and crop health investment decisions.
{"title":"Understanding the Burden of Agriculturally Significant Vector-Borne and Parasitic Diseases in Kansas.","authors":"Kristin Michel, Nicole M Ioerger, Ashlie M Ake, Susan M Hettenbach, Cassandra Olds, Dustin L Pendell, James Stack, Stephen Higgs, Dana L Vanlandingham","doi":"10.1089/vbz.2025.0023","DOIUrl":"10.1089/vbz.2025.0023","url":null,"abstract":"<p><p><b><i>Background:</i></b> The state of Kansas (KS) has been called the \"agricultural heartland\" of the United States. Vector-borne and parasitic diseases (VBPD) have a major impact on the production of livestock, such as cattle, swine, goats and sheep, as well as crops, such as wheat, corn, and sorghum. The purpose of this review is to educate agricultural professionals in the state of KS about VBPD of current or potential concern and to inform the public about the challenges faced by the agricultural community. <b><i>Methods:</i></b> This review describes and discusses the endemic VBPD that currently impact agricultural production in KS and foreign VBPD of concern. In addition, we outline the major arthropod vectors of VBPD in KS, including ticks, mites, and various insects. In the context of this review, parasites are strictly limited to arthropod ectoparasites that negatively impact livestock production. Modern agricultural data for the state of KS were mostly sourced from the USDA National Agricultural Statistics Service, and current KS VBPD data were mostly sourced from the KS State Veterinary Diagnostic Laboratory. <b><i>Conclusion:</i></b> These VBPD have a large economic impact on the state and country, and we have concluded there is a need for updated estimates regarding the economic burden of VBPD in KS and throughout the United States to make better animal and crop health investment decisions.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"429-443"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-20DOI: 10.1089/vbz.2025.0009
Wei Wang, Chun-Liang Yan, Qi-Shan Xue
Objective: This study aimed to analyze the clinical characteristics of five cases of Chlamydia psittaci pneumonia diagnosed using metagenomics next-generation sequencing (mNGS) and to provide help for its diagnosis and treatment. Methods: Five patients who were admitted to the department of Respiratory and Critical Care Medicine of Beijing Aerospace General Hospital between June 2020 and December 2021 and diagnosed with C. psittaci pneumonia using mNGS were selected, including one case with severe pneumonia. We analyzed the clinical characteristics, epidemiology, laboratory results, treatment, and prognosis of the five participating patients. Results: The main clinical manifestations were high fever, dry cough, chest tightness, shortness of breath, and myalgia. All five patients had a history of contact with poultry. The white blood cell count was normal or slightly increased, the lymphocyte count was significantly decreased, and the percentage of neutrophil granulocyte, C-reactive protein (CRP), erythrocyte sedimentation rate, and procalcitonin were significantly increased. Chest computed tomography showed inflammatory infiltration and consolidation of one or more lung lobes, possibly accompanied by pleural effusion and liver function impairment. Bronchoscopy mainly showed congestion and edema of airway mucosa with less sputum in the airway. In all patients, we detected the nucleic acid sequences of C. psittaci in alveolar lavage fluid or sputum using mNGS and confirmed the diagnosis of C. psittaci pneumonia based on clinical manifestations and exposure history. After adjusting antibiotics to a moxifloxacin-based treatment regimen, the disease improved. The application of the mNGS assay enables us to make faster diagnoses of diseases so that timely medication can be administered, thus shortening the duration of a patient's illness. Conclusion:C. psittaci pneumonia has an acute onset, and fever and cough are common symptoms. A history of contact between the patient and birds is an important diagnostic clue; however, clinical symptoms and laboratory and imaging examinations lack specificity. The detection using mNGS of bronchoalveolar lavage fluid can quickly confirm the diagnosis and reduce missed diagnoses and misdiagnoses. Moxifloxacin-based therapy is effective, and patients require combination therapy if they have other bacterial infections.
{"title":"Clinical Characteristics of Five Cases of <i>Chlamydia psittaci</i> Pneumonia Diagnosed Using Metagenomics Next-Generation Sequencing.","authors":"Wei Wang, Chun-Liang Yan, Qi-Shan Xue","doi":"10.1089/vbz.2025.0009","DOIUrl":"10.1089/vbz.2025.0009","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aimed to analyze the clinical characteristics of five cases of <i>Chlamydia psittaci</i> pneumonia diagnosed using metagenomics next-generation sequencing (mNGS) and to provide help for its diagnosis and treatment. <b><i>Methods:</i></b> Five patients who were admitted to the department of Respiratory and Critical Care Medicine of Beijing Aerospace General Hospital between June 2020 and December 2021 and diagnosed with <i>C. psittaci</i> pneumonia using mNGS were selected, including one case with severe pneumonia. We analyzed the clinical characteristics, epidemiology, laboratory results, treatment, and prognosis of the five participating patients. <b><i>Results:</i></b> The main clinical manifestations were high fever, dry cough, chest tightness, shortness of breath, and myalgia. All five patients had a history of contact with poultry. The white blood cell count was normal or slightly increased, the lymphocyte count was significantly decreased, and the percentage of neutrophil granulocyte, C-reactive protein (CRP), erythrocyte sedimentation rate, and procalcitonin were significantly increased. Chest computed tomography showed inflammatory infiltration and consolidation of one or more lung lobes, possibly accompanied by pleural effusion and liver function impairment. Bronchoscopy mainly showed congestion and edema of airway mucosa with less sputum in the airway. In all patients, we detected the nucleic acid sequences of <i>C. psittaci</i> in alveolar lavage fluid or sputum using mNGS and confirmed the diagnosis of <i>C. psittaci</i> pneumonia based on clinical manifestations and exposure history. After adjusting antibiotics to a moxifloxacin-based treatment regimen, the disease improved. The application of the mNGS assay enables us to make faster diagnoses of diseases so that timely medication can be administered, thus shortening the duration of a patient's illness. <b><i>Conclusion:</i></b> <i>C. psittaci</i> pneumonia has an acute onset, and fever and cough are common symptoms. A history of contact between the patient and birds is an important diagnostic clue; however, clinical symptoms and laboratory and imaging examinations lack specificity. The detection using mNGS of bronchoalveolar lavage fluid can quickly confirm the diagnosis and reduce missed diagnoses and misdiagnoses. Moxifloxacin-based therapy is effective, and patients require combination therapy if they have other bacterial infections.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"463-469"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-23DOI: 10.1089/vbz.2024.0056
Mikhail Yu Kartashov, Ekaterina I Krivosheina, Ekaterina V Naidenova, Kirill S Zakharov, Alexander N Shvalov, Sanaba Boumbaly, Vladimir A Ternovoi, Valery B Loktev
Background: Over the past decade, numerous new tick-associated flavi-like viruses with segmented genomes have been discovered almost worldwide. Kindia tick virus (KITV) was first detected in Rhipicephalus geigyi ticks in West Africa in 2017. The current study aimed to detect viral RNA in tick and cattle samples collected in Guinea and to perform complete sequencing of KITV isolates and their analysis. Methods: Adult ticks and blood samples were collected from cattle in Coyah, Dubréka, Forécariah, and Kindia prefectures of the Republic of Guinea in 2022. These samples were tested for KITV infection by RT-PCR with primers targeting the NS5 gene. Positive probes were sequenced using Illumina technology, and their analysis was performed for obtaining complete sequences of all KITV segments. Results: The RNA of the KITV was detected by RT-PCR in Rh. geigyi, Rh. annulatus ticks, and blood samples of cattle. The prevalence rates for cattle were 6.6%, for Rh. annulatus 6.9%, and for Rh. geigyi ticks 10.7%. The analysis of 15 complete sequences of KITV genomes showed 99.61-99.67% identity for amino acid sequences for segments 1 and 4 and 97.88-98.83% for segments 2 and 3 with previously detected KITV isolate in Guinea in 2017. Phylogenetic analysis demonstrated that obtained KITV sequences can be classified as typical for clade A of the Jingmen tick virus (JMTV) group together with Mogiana tick virus. Conclusion: The KITV isolates from cattle and feeding ticks show practically full identity sequences for all four viral segments, and these sequences can be classified as clade A of the segmented flavi-like virus JMTV group.
{"title":"Simultaneous Detection and Genome Analysis of the Kindia Tick Virus in Cattle and <i>Rhipicephalus</i> Ticks in the Republic of Guinea.","authors":"Mikhail Yu Kartashov, Ekaterina I Krivosheina, Ekaterina V Naidenova, Kirill S Zakharov, Alexander N Shvalov, Sanaba Boumbaly, Vladimir A Ternovoi, Valery B Loktev","doi":"10.1089/vbz.2024.0056","DOIUrl":"10.1089/vbz.2024.0056","url":null,"abstract":"<p><p><b><i>Background:</i></b> Over the past decade, numerous new tick-associated flavi-like viruses with segmented genomes have been discovered almost worldwide. Kindia tick virus (KITV) was first detected in <i>Rhipicephalus geigyi</i> ticks in West Africa in 2017. The current study aimed to detect viral RNA in tick and cattle samples collected in Guinea and to perform complete sequencing of KITV isolates and their analysis. <b><i>Methods:</i></b> Adult ticks and blood samples were collected from cattle in Coyah, Dubréka, Forécariah, and Kindia prefectures of the Republic of Guinea in 2022. These samples were tested for KITV infection by RT-PCR with primers targeting the NS5 gene. Positive probes were sequenced using Illumina technology, and their analysis was performed for obtaining complete sequences of all KITV segments. <b><i>Results:</i></b> The RNA of the KITV was detected by RT-PCR in <i>Rh. geigyi</i>, <i>Rh. annulatus</i> ticks, and blood samples of cattle. The prevalence rates for cattle were 6.6%, for <i>Rh. annulatus</i> 6.9%, and for <i>Rh. geigyi</i> ticks 10.7%. The analysis of 15 complete sequences of KITV genomes showed 99.61-99.67% identity for amino acid sequences for segments 1 and 4 and 97.88-98.83% for segments 2 and 3 with previously detected KITV isolate in Guinea in 2017. Phylogenetic analysis demonstrated that obtained KITV sequences can be classified as typical for clade A of the Jingmen tick virus (JMTV) group together with Mogiana tick virus. <b><i>Conclusion:</i></b> The KITV isolates from cattle and feeding ticks show practically full identity sequences for all four viral segments, and these sequences can be classified as clade A of the segmented flavi-like virus JMTV group.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"470-475"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-12DOI: 10.1089/vbz.2025.0007
Zahraalsadat Tavakolian, Amir Tukmechi, Abdulghaffar Ownagh, Ahmad Enferadi
Background: Zoonotic diseases pose a significant global health challenge, accounting for over half of all newly emerging infectious illnesses. One such pathogenic agent is the bacterium Francisella tularensis, which causes tularemia, a zoonotic disease spread in the Northern Hemisphere through various means, including tick bites. Unfortunately, there is limited literature on tick-borne bacteria affecting human and animal health. This research confirmed the presence of Francisella spp. in ticks in the Urmia region, highlighting the potential for ticks to act as vectors for transmitting the bacteria to livestock and humans. Materials and Methods: A total of 397 ticks, 315 blood samples, and 241 milk samples were gathered from sheep and goats to screen for the existence of Francisella spp. The nested PCR technique revealed the existence of Francisella spp. 16S rRNA gene in the samples. Results: Blood and milk samples from small ruminants did not show the presence of Francisella spp., but the bacteria were detected in 6 tick pools (n = 79; 7.59%; 95% CI: 3.52%-15.59%). The positive ticks identified were Hyalomma asiaticum 2 (n = 24; 8.33%; 95% CI: 2.31%-25.84%), Hyalomma eagyptum 3 (n = 9; 33.33%; 95% CI: 12.06%-64.58%), and Rhipicephalus sanguineus 1 (n = 15; 6.67%; 95% CI: 1.19%-29.82%) and the presence of Francisella tularensis subspecies holarctica was found to be positive in 3 out of 79 tick pools (3.80%; 95% CI: 1.3%-10.58%). The positive ticks identified in this experiment were female Hyalomma aegyptium (1 out of 3; 33.33%; 95% CI: 6.15%-79.23%), male Hyalomma asiaticum (1 out of 14; 7.14%; 95% CI: 1.27%-31.47%) and female Rhipicephalus sanguineus (1 out of 7; 14.29%; 95% CI: 2.57%-51.32%). Conclusion: The study explored the presence of Francisella species, especially the most dangerous, F. tularensis, in small ruminants and the ticks that attach to them using molecular techniques in the Urmia region of northwestern Iran. The research seeks to improve knowledge of Francisella spp. epidemiology. Understanding the risk of human-livestock transmission of this pathogen is crucial for public health, particularly for individuals working in animal-related fields.
{"title":"Molecular Detection of <i>Francisella</i> spp. in Blood, Milk, and Ticks Infesting Small Ruminants in Urmia, Iran.","authors":"Zahraalsadat Tavakolian, Amir Tukmechi, Abdulghaffar Ownagh, Ahmad Enferadi","doi":"10.1089/vbz.2025.0007","DOIUrl":"10.1089/vbz.2025.0007","url":null,"abstract":"<p><p><b><i>Background:</i></b> Zoonotic diseases pose a significant global health challenge, accounting for over half of all newly emerging infectious illnesses. One such pathogenic agent is the bacterium Francisella tularensis, which causes tularemia, a zoonotic disease spread in the Northern Hemisphere through various means, including tick bites. Unfortunately, there is limited literature on tick-borne bacteria affecting human and animal health. This research confirmed the presence of Francisella spp. in ticks in the Urmia region, highlighting the potential for ticks to act as vectors for transmitting the bacteria to livestock and humans. <b><i>Materials and Methods:</i></b> A total of 397 ticks, 315 blood samples, and 241 milk samples were gathered from sheep and goats to screen for the existence of Francisella spp. The nested PCR technique revealed the existence of Francisella spp. 16S rRNA gene in the samples. <b><i>Results:</i></b> Blood and milk samples from small ruminants did not show the presence of Francisella spp., but the bacteria were detected in 6 tick pools (<i>n</i> = 79; 7.59%; 95% CI: 3.52%-15.59%). The positive ticks identified were Hyalomma asiaticum 2 (<i>n</i> = 24; 8.33%; 95% CI: 2.31%-25.84%), Hyalomma eagyptum 3 (<i>n</i> = 9; 33.33%; 95% CI: 12.06%-64.58%), and Rhipicephalus sanguineus 1 (<i>n</i> = 15; 6.67%; 95% CI: 1.19%-29.82%) and the presence of Francisella tularensis subspecies holarctica was found to be positive in 3 out of 79 tick pools (3.80%; 95% CI: 1.3%-10.58%). The positive ticks identified in this experiment were female Hyalomma aegyptium (1 out of 3; 33.33%; 95% CI: 6.15%-79.23%), male Hyalomma asiaticum (1 out of 14; 7.14%; 95% CI: 1.27%-31.47%) and female Rhipicephalus sanguineus (1 out of 7; 14.29%; 95% CI: 2.57%-51.32%). <b><i>Conclusion:</i></b> The study explored the presence of Francisella species, especially the most dangerous, F. tularensis, in small ruminants and the ticks that attach to them using molecular techniques in the Urmia region of northwestern Iran. The research seeks to improve knowledge of Francisella spp. epidemiology. Understanding the risk of human-livestock transmission of this pathogen is crucial for public health, particularly for individuals working in animal-related fields.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"454-462"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-23DOI: 10.1089/vbz.2024.0092
Jieqin Song, Yan Dong, Yu Zhang, Guozhong Zhou, Xinya Wu, Li Gao, Hanxin Wu, Li Peng, Jiaru Yang, Zhenhua Ji, Bingxue Li, Yuxin Fan, Jingjing Chen, Meixiao Liu, Jing Kong, Weijie Ma, Lei Zhong, Weijiang Ma, Aihua Liu, Fukai Bao
Background: Lyme disease (LD, also known as Lyme borreliosis) is the most frequent tick-transmitted disease caused by the spirochete Borrelia in Europe and the United States. LD is distributed in the Northern Hemisphere, but the seroprevalence of LD in Asian human populations is unclear. Objectives: To investigate the seroprevalence of LD in Asian human populations. Data Sources: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and other sources were searched for relevant studies with MeSH terms from their inception up to 20 June 2022. Study Eligibility Criteria: Cross-sectional studies with no language restrictions. Participants: Healthy people, at-risk people, and patients with suspected LD. Moreover, the seroprevalence of LD was diagnosed by laboratory diagnosis (nzyme-linked immunosorbent assays (ELISA)/Immunofluorescence assays (IFA) or/and two-tier testing) in human populations. Assessment of Risk of Bias: Risk of bias was rated using the Joanna Briggs Institute (JBI) standardized critical appraisal instrument for prevalence studies (Critical Appraisal Checklist for Analytical Cross-Sectional Studies). Methods of Data Synthesis: Seroprevalence and proportion of LD in human populations in Asia were obtained from the included studies. Two authors independently screened and selected studies according to our predefined criteria (PROSPERO CRD42022362029) and assessed their risk of bias. A third author was available for arbitrating discrepancies. A random-effects model meta-analysis was conducted to determine the proportions of LD and related information, and further subgroup analyses of some studies were conducted, such as methods for diagnosing LD, gender, and human populations with and without tick bites. Results: There are 18 studies included after full-text screening and 11,498 people in the meta-analysis. These studies encompassed countries such as China, Japan, Korea, Türkiye, Singapore, and Indonesia. Regarding the risk of bias and the JBI checklist, 2 studies scored 7 points and 16 studies scored 8 points. All studies were rated as high quality (≥5 points). In the meta-analysis, the seroprevalences of LD were 12.1% (95% confidence interval [CI] 0.081-0.168) by ELISA/IFA and 5.7% (95% CI 0.034-0.085) for two-tier seropositivity testing in Asia. In subgroup analyses, the proportion of those diagnosed with LD by ELISA/IFA (14.7%, 95% CI 0.094-0.208) was significantly higher than the proportion diagnosed by two-tier testing (5.9%, 95% CI 0.032-0.095) (p < 0.01). The proportion of LD (two-tier testing) was slightly higher in women (7.4%, 95% CI 0.036-0.123) than in men (6.2%, 95% CI 0.026-0.111), but the difference was not significant (p = 0.70). In the study population, 47% (95% CI 0.159-0.795) were bitten by ticks (people with confirmed tick bites). The difference in the prop
背景:莱姆病(Lyme disease, LD,又称莱姆博氏螺旋体病)是欧洲和美国由博氏螺旋体引起的最常见的蜱传疾病。LD分布于北半球,但在亚洲人群的血清患病率尚不清楚。目的:调查亚洲人群LD的血清患病率。数据来源:检索PubMed、Embase、Cochrane Central Register of Controlled Trials (Central)和其他来源的相关研究,从其成立到2022年6月20日。研究资格标准:无语言限制的横断面研究。研究对象:健康人、高危人群和疑似LD患者。此外,通过实验室诊断(酶联免疫吸附测定法(ELISA)/免疫荧光测定法(IFA)或/和双层检测)在人群中诊断LD的血清阳性率。偏倚风险评估:使用乔安娜布里格斯研究所(JBI)流行病学研究的标准化关键评估工具(分析横断面研究的关键评估清单)对偏倚风险进行评估。数据综合方法:从纳入的研究中获得亚洲人群中LD的血清阳性率和比例。两位作者根据我们预定义的标准(PROSPERO CRD42022362029)独立筛选和选择研究,并评估其偏倚风险。有第三位作者可以对差异进行仲裁。采用随机效应模型进行meta分析,确定LD的比例及相关信息,并对部分研究进行亚组分析,如LD的诊断方法、性别、有无蜱叮咬人群等。结果:全文筛选后纳入18项研究,荟萃分析纳入11498人。这些研究涵盖了中国、日本、韩国、日本、新加坡和印度尼西亚等国家。关于偏倚风险和JBI检查表,2项研究得7分,16项研究得8分。所有研究均被评为高质量(≥5分)。在荟萃分析中,ELISA/IFA检测LD的血清患病率为12.1%(95%可信区间[CI] 0.081-0.168),两级血清阳性检测在亚洲的患病率为5.7% (95% CI 0.034-0.085)。在亚组分析中,ELISA/IFA诊断为LD的比例(14.7%,95% CI 0.094 ~ 0.208)显著高于两层检测诊断为LD的比例(5.9%,95% CI 0.032 ~ 0.095) (p < 0.01)。女性的LD比例(7.4%,95% CI 0.036-0.123)略高于男性(6.2%,95% CI 0.026-0.111),但差异不显著(p = 0.70)。在研究人群中,47% (95% CI 0.159-0.795)被蜱虫叮咬(确诊蜱虫叮咬的人)。遭受蜱虫叮咬的人群(7.9%,95% CI 0.019-0.166)和未被蜱虫叮咬的人群(2.7%,95% CI 0.013-0.089)的LD比例(两层测试)差异无统计学意义(p = 0.09)。结论:荟萃分析显示LD在亚洲的高血清患病率,表明它已成为该地区一个重要的公共卫生问题。亚洲的相关政府部门和卫生组织应加强对LD的监测和教育工作。本研究强调了可靠和准确的标准血清学诊断程序对LD诊断的重要性。严格实施双层检测对LD诊断尤其重要。如果只使用ELISA/IFA,可能会导致假阳性结果。其关于艾滋病流行情况的调查结果可作为今后研究该区域艾滋病监测和流行情况的基础。此外,这些发现可能对临床医生的工作有用。
{"title":"Seroprevalence of Lyme Disease in Asian Human Populations: A Systematic Review and Meta-Analysis.","authors":"Jieqin Song, Yan Dong, Yu Zhang, Guozhong Zhou, Xinya Wu, Li Gao, Hanxin Wu, Li Peng, Jiaru Yang, Zhenhua Ji, Bingxue Li, Yuxin Fan, Jingjing Chen, Meixiao Liu, Jing Kong, Weijie Ma, Lei Zhong, Weijiang Ma, Aihua Liu, Fukai Bao","doi":"10.1089/vbz.2024.0092","DOIUrl":"10.1089/vbz.2024.0092","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lyme disease (LD, also known as Lyme borreliosis) is the most frequent tick-transmitted disease caused by the spirochete <i>Borrelia</i> in Europe and the United States. LD is distributed in the Northern Hemisphere, but the seroprevalence of LD in Asian human populations is unclear. <b><i>Objectives:</i></b> To investigate the seroprevalence of LD in Asian human populations. <b><i>Data Sources:</i></b> PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and other sources were searched for relevant studies with MeSH terms from their inception up to 20 June 2022. <b><i>Study Eligibility Criteria:</i></b> Cross-sectional studies with no language restrictions. <b><i>Participants:</i></b> Healthy people, at-risk people, and patients with suspected LD. Moreover, the seroprevalence of LD was diagnosed by laboratory diagnosis (nzyme-linked immunosorbent assays (ELISA)/Immunofluorescence assays (IFA) or/and two-tier testing) in human populations. <b><i>Assessment of Risk of Bias:</i></b> Risk of bias was rated using the Joanna Briggs Institute (JBI) standardized critical appraisal instrument for prevalence studies (Critical Appraisal Checklist for Analytical Cross-Sectional Studies). <b><i>Methods of Data Synthesis:</i></b> Seroprevalence and proportion of LD in human populations in Asia were obtained from the included studies. Two authors independently screened and selected studies according to our predefined criteria (PROSPERO CRD42022362029) and assessed their risk of bias. A third author was available for arbitrating discrepancies. A random-effects model meta-analysis was conducted to determine the proportions of LD and related information, and further subgroup analyses of some studies were conducted, such as methods for diagnosing LD, gender, and human populations with and without tick bites. <b><i>Results:</i></b> There are 18 studies included after full-text screening and 11,498 people in the meta-analysis. These studies encompassed countries such as China, Japan, Korea, Türkiye, Singapore, and Indonesia. Regarding the risk of bias and the JBI checklist, 2 studies scored 7 points and 16 studies scored 8 points. All studies were rated as high quality (≥5 points). In the meta-analysis, the seroprevalences of LD were 12.1% (95% confidence interval [CI] 0.081-0.168) by ELISA/IFA and 5.7% (95% CI 0.034-0.085) for two-tier seropositivity testing in Asia. In subgroup analyses, the proportion of those diagnosed with LD by ELISA/IFA (14.7%, 95% CI 0.094-0.208) was significantly higher than the proportion diagnosed by two-tier testing (5.9%, 95% CI 0.032-0.095) (<i>p</i> < 0.01). The proportion of LD (two-tier testing) was slightly higher in women (7.4%, 95% CI 0.036-0.123) than in men (6.2%, 95% CI 0.026-0.111), but the difference was not significant (<i>p</i> = 0.70). In the study population, 47% (95% CI 0.159-0.795) were bitten by ticks (people with confirmed tick bites). The difference in the prop","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"444-453"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emanuela Olivieri, Sara Rigamonti, Nadia Vicari, Andrea Grassi, Iyad Karaman, Irene Bertoletti, Alessandro Bianchi, Claudio Marco Lodola, Giuseppe Polonini, Giulia Maioli, Paola Prati
Borrelia miyamotoi is a relapsing fever spirochete, first identified in Japan and later detected in various Ixodes species across the northern hemisphere. The pathogen was linked to human infections in North America, Europe, Asia, and Russia, causing symptoms ranging from flu-like illness to severe neurological damage. This study aimed to assess the presence of B. miyamotoi in Ixodes ricinus ticks collected from wildlife, dogs, and humans in Lombardy, Northern Italy, between 2020 and 2023. A total of 3,886 ticks were sampled, with a 1% positivity rate. The spirochete was detected in all life stages of ticks, with sequences 100% identical to European strains. The pathogen was found mostly in northern mountain regions. Although no human cases have been reported in Italy, these areas pose a potential risk due to high tourist activity.
{"title":"<i>Borrelia miyamotoi</i> in <i>Ixodes ricinus</i> Ticks Removed from Hosts in Northern Italy.","authors":"Emanuela Olivieri, Sara Rigamonti, Nadia Vicari, Andrea Grassi, Iyad Karaman, Irene Bertoletti, Alessandro Bianchi, Claudio Marco Lodola, Giuseppe Polonini, Giulia Maioli, Paola Prati","doi":"10.1089/vbz.2025.0017","DOIUrl":"https://doi.org/10.1089/vbz.2025.0017","url":null,"abstract":"<p><p><i>Borrelia miyamotoi</i> is a relapsing fever spirochete, first identified in Japan and later detected in various <i>Ixodes</i> species across the northern hemisphere. The pathogen was linked to human infections in North America, Europe, Asia, and Russia, causing symptoms ranging from flu-like illness to severe neurological damage. This study aimed to assess the presence of <i>B. miyamotoi</i> in <i>Ixodes ricinus</i> ticks collected from wildlife, dogs, and humans in Lombardy, Northern Italy, between 2020 and 2023. A total of 3,886 ticks were sampled, with a 1% positivity rate. The spirochete was detected in all life stages of ticks, with sequences 100% identical to European strains. The pathogen was found mostly in northern mountain regions. Although no human cases have been reported in Italy, these areas pose a potential risk due to high tourist activity.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-05-07DOI: 10.1089/vbz.2024.0099
Asako Haraguchi, Moeka Gonda, Kazuhiko Nakayama, Kanta Fujiwara, Jun Hakozaki, Sakure Nakamura, Kodai Kusakisako, Hiromi Ikadai
Objective:Anopheles mosquitoes transmit Plasmodium parasites through blood feeding. The oocyst stage in mosquitoes is crucial for Plasmodium transmission. Oocysts can form without a blood meal or the midgut passage and utilize nutrients from additional blood feeding. However, it remains unclear the impact of a blood meal during infection on oocysts. The present study evaluated how a blood meal during infection impacts oocyst growth to better understand oocyst development. Methods: We used a novel method for Plasmodium infection known as enema injection, which involves injecting Plasmodium berghei (ANKA strain) into the midgut lumen of Anopheles stephensi mosquitoes (STE2 strain) via the anus, traversing the midgut wall without a blood meal. We compared the size of oocysts in mosquitoes infected by enema injection alone, hemocoel injection alone, and each infection method combined with uninfected blood feeding, as well as those only with infected blood feeding. Results: By enema injection with Plasmodium ookinetes, oocysts formed solely in the mosquito's midgut. Oocysts from enema-injected mosquitoes were similar in size to those from hemocoel-injected mosquitoes. Oocysts from mosquitoes infected by enema injection combined with uninfected blood feeding were larger than oocysts from mosquitoes infected by enema injection alone. However, the size of oocysts from mosquitoes infected by hemocoel injection was not affected by the presence or absence of blood feeding. Conclusion: Enema injection with Plasmodium ookinetes is applicable to Anopheles mosquitoes. Using the enema injection method, we suggest that a blood meal during infection might facilitate oocyst growth within the midgut.
{"title":"Effect of a Blood Meal on <i>Plasmodium</i> Oocyst Growth Using the Enema Injection Method.","authors":"Asako Haraguchi, Moeka Gonda, Kazuhiko Nakayama, Kanta Fujiwara, Jun Hakozaki, Sakure Nakamura, Kodai Kusakisako, Hiromi Ikadai","doi":"10.1089/vbz.2024.0099","DOIUrl":"10.1089/vbz.2024.0099","url":null,"abstract":"<p><p><b><i>Objective:</i></b> <i>Anopheles</i> mosquitoes transmit <i>Plasmodium</i> parasites through blood feeding. The oocyst stage in mosquitoes is crucial for <i>Plasmodium</i> transmission. Oocysts can form without a blood meal or the midgut passage and utilize nutrients from additional blood feeding. However, it remains unclear the impact of a blood meal during infection on oocysts. The present study evaluated how a blood meal during infection impacts oocyst growth to better understand oocyst development. <b><i>Methods:</i></b> We used a novel method for <i>Plasmodium</i> infection known as enema injection, which involves injecting <i>Plasmodium berghei</i> (ANKA strain) into the midgut lumen of <i>Anopheles stephensi</i> mosquitoes (STE2 strain) via the anus, traversing the midgut wall without a blood meal. We compared the size of oocysts in mosquitoes infected by enema injection alone, hemocoel injection alone, and each infection method combined with uninfected blood feeding, as well as those only with infected blood feeding. <b><i>Results:</i></b> By enema injection with <i>Plasmodium</i> ookinetes, oocysts formed solely in the mosquito's midgut. Oocysts from enema-injected mosquitoes were similar in size to those from hemocoel-injected mosquitoes. Oocysts from mosquitoes infected by enema injection combined with uninfected blood feeding were larger than oocysts from mosquitoes infected by enema injection alone. However, the size of oocysts from mosquitoes infected by hemocoel injection was not affected by the presence or absence of blood feeding. <b><i>Conclusion:</i></b> Enema injection with <i>Plasmodium</i> ookinetes is applicable to <i>Anopheles</i> mosquitoes. Using the enema injection method, we suggest that a blood meal during infection might facilitate oocyst growth within the midgut.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"408-415"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-23DOI: 10.1089/vbz.2024.0126
Yake Lei, Ying Dai, Meng Guo, Lei Yi, Kun Cai, Bing Hu
Background: Tick-borne diseases pose a serious disease burden globally, with pathogens including viruses, bacteria, rickettsia, and spirochetes. This study aims to investigate ticks and pathogens in Huanggang and Suizhou, two regions with the highest tick-borne disease prevalence in Hubei, China. Methods: A total of 2,958 ticks were collected, and their species diversity was characterized. RNA and DNA were used for polymerase chain reaction detection and sequencing of Dabie bandavirus (DBV), spotted fever group rickettsioses (SFGR), Coxiella burnetii, Borrelia, Anaplasma phagocytophilum, Babesia, and Bartonella pathogens in ticks. Molecular evolutionary traits and phylogenetic linkages were further analyzed. Results: One family, four genera, and four species of ticks were identified, with Haemaphysalis longicornis being the predominant species. The overall DBV-positive rate was 2.63% in ticks from Huanggang City and 0.48% in those from Suizhou City. Phylogenetic analysis indicated that the DBV strains from Hubei Province belonged to genotypes A-F, with high evolutionary homology with those sampled from local human patients. The tick-borne SFGR-positive rate was significantly higher in samples from Huanggang City (48.23%) than in Suizhou City (8.29%). High levels of A. phagocytophilum sequences were detected in both regions, with 99% homologous. Borrelia burgdorferi was detected for the first time in Suizhou City, with a very low carriage rate (0.24%), and was not detected in Huanggang City. No Bartonella, Babesia, or C. burnetii pathogens were detected from either location. Conclusions: This study represents a substantial effort to investigate the diversity of tick-borne pathogens in Huanggang and Suizhou City. Our findings provide references and data to help develop effective tick-borne disease prevention, surveillance, and early warning systems.
{"title":"Molecular Survey and Phylogenetic Characterization of Tick-Borne Pathogens in Hubei Province, China.","authors":"Yake Lei, Ying Dai, Meng Guo, Lei Yi, Kun Cai, Bing Hu","doi":"10.1089/vbz.2024.0126","DOIUrl":"10.1089/vbz.2024.0126","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tick-borne diseases pose a serious disease burden globally, with pathogens including viruses, bacteria, rickettsia, and spirochetes. This study aims to investigate ticks and pathogens in Huanggang and Suizhou, two regions with the highest tick-borne disease prevalence in Hubei, China. <b><i>Methods:</i></b> A total of 2,958 ticks were collected, and their species diversity was characterized. RNA and DNA were used for polymerase chain reaction detection and sequencing of <i>Dabie bandavirus</i> (DBV), spotted fever group rickettsioses (SFGR), <i>Coxiella burnetii</i>, <i>Borrelia</i>, <i>Anaplasma phagocytophilum</i>, <i>Babesia</i>, and <i>Bartonella</i> pathogens in ticks. Molecular evolutionary traits and phylogenetic linkages were further analyzed. <b><i>Results:</i></b> One family, four genera, and four species of ticks were identified, with <i>Haemaphysalis longicornis</i> being the predominant species. The overall DBV-positive rate was 2.63% in ticks from Huanggang City and 0.48% in those from Suizhou City. Phylogenetic analysis indicated that the DBV strains from Hubei Province belonged to genotypes A-F, with high evolutionary homology with those sampled from local human patients. The tick-borne SFGR-positive rate was significantly higher in samples from Huanggang City (48.23%) than in Suizhou City (8.29%). High levels of <i>A. phagocytophilum</i> sequences were detected in both regions, with 99% homologous. <i>Borrelia burgdorferi</i> was detected for the first time in Suizhou City, with a very low carriage rate (0.24%), and was not detected in Huanggang City. No <i>Bartonella</i>, <i>Babesia</i>, or <i>C. burnetii</i> pathogens were detected from either location. <b><i>Conclusions:</i></b> This study represents a substantial effort to investigate the diversity of tick-borne pathogens in Huanggang and Suizhou City. Our findings provide references and data to help develop effective tick-borne disease prevention, surveillance, and early warning systems.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"377-389"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-28DOI: 10.1089/vbz.2024.0063
XiaoQin Cao, YaFei Jin, Hong Du, Wei Wang, YanYan Zhao, XuYang Zheng, XiaoYan Wang, PeiYu Bian, LiMei Wang, Hong Jiang
Objective: To study the clinical and laboratory characteristics of hemorrhagic fever with renal syndrome (HFRS) in Chinese elderly patients. Methods: The clinical data of hospitalized patients diagnosed with HFRS from 2011 to 2022 were extracted from the inpatient record system of the Second Affiliated Hospital of Air Force Medical University. A comparative analysis was conducted between young and elderly individuals regarding the male-to-female ratio, disease classification, clinical laboratory indices, and prognosis. Results: Among the patients diagnosed with HFRS, the elderly population accounted for 14.86%, comprising 199 males and 86 females. The proportion of severe-type cases among elderly patients was 25.96%, while the proportion of critical cases was 32.63%. Critically, the proportion of critical-type cases in this age group was significantly higher compared to individuals aged 20-60 years. Comparing the clinical indices of elderly patients with HFRS with different clinical outcomes, our findings revealed deceased cases exhibited significantly higher body temperature, hemoglobin (HGB) levels, and white blood cell (WBC) counts compared to surviving patients. Conversely, albumin (ALB) levels, fibrinogen (FIB) levels, and platelet counts were significantly lower in deceased patients than in surviving patients. Conclusion: The incidence of HFRS in the elderly presents a higher proportion of severe-type and critical-type cases and a greater mortality rate compared to younger individuals. Elevated body temperature, HGB levels, and WBC counts, and lower ALB and FIB levels suggest a poorer prognosis.
{"title":"Characteristics of Elderly Patients with Hemorrhagic Fever with Renal Syndrome: A Retrospective Study Conducted in Shaanxi Province, China.","authors":"XiaoQin Cao, YaFei Jin, Hong Du, Wei Wang, YanYan Zhao, XuYang Zheng, XiaoYan Wang, PeiYu Bian, LiMei Wang, Hong Jiang","doi":"10.1089/vbz.2024.0063","DOIUrl":"10.1089/vbz.2024.0063","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To study the clinical and laboratory characteristics of hemorrhagic fever with renal syndrome (HFRS) in Chinese elderly patients. <b><i>Methods:</i></b> The clinical data of hospitalized patients diagnosed with HFRS from 2011 to 2022 were extracted from the inpatient record system of the Second Affiliated Hospital of Air Force Medical University. A comparative analysis was conducted between young and elderly individuals regarding the male-to-female ratio, disease classification, clinical laboratory indices, and prognosis. <b><i>Results:</i></b> Among the patients diagnosed with HFRS, the elderly population accounted for 14.86%, comprising 199 males and 86 females. The proportion of severe-type cases among elderly patients was 25.96%, while the proportion of critical cases was 32.63%. Critically, the proportion of critical-type cases in this age group was significantly higher compared to individuals aged 20-60 years. Comparing the clinical indices of elderly patients with HFRS with different clinical outcomes, our findings revealed deceased cases exhibited significantly higher body temperature, hemoglobin (HGB) levels, and white blood cell (WBC) counts compared to surviving patients. Conversely, albumin (ALB) levels, fibrinogen (FIB) levels, and platelet counts were significantly lower in deceased patients than in surviving patients. <b><i>Conclusion:</i></b> The incidence of HFRS in the elderly presents a higher proportion of severe-type and critical-type cases and a greater mortality rate compared to younger individuals. Elevated body temperature, HGB levels, and WBC counts, and lower ALB and FIB levels suggest a poorer prognosis.</p>","PeriodicalId":23683,"journal":{"name":"Vector borne and zoonotic diseases","volume":" ","pages":"416-423"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}