Infectious Diseases of Poverty最新文献

Background: The global outbreak of mpox that began in 2022 caused sustained human-to-human transmission and demonstrates distinct epidemiological characteristics compared to previous outbreaks. Our aim is to quantify temporal variation of mpox transmissibility within or between age groups and evaluate the effectiveness of interventions in real time.

Methods: The data used in this study is sourced from publicly available mpox confirmed cases data provided by WHO. We divided population into four age groups and constructed a transmission dynamics model with age structure of the population. And we estimated the transmissibilities of the monkeypox virus within or between age groups in real time by assimilation of global surveillance data from WHO, and performed intervention simulations in different scenarios we set up.

Results: The effective reproduction number of mpox in the 18-44 age group is significantly higher than in other age groups, and it initially experiences a rapid increase, enters a phase of steady decrease after reaching a certain point [ $R_{22}=1.33$ , 95% credible interval (CrI): 1.10-1.56]. Earlier implementation of interventions yields both superior effectiveness and greater cost-efficiency. Emergency vaccination for whole population initiated on June 15, 2022 reduced cumulative infections by 67.43% (95% CrI: 62.15-72.71) at only 40% coverage, whereas vaccination starting August 1, 2022 achieved only 47.86% (95% CrI: 42.70-53.01) reduction at 90% coverage. And high-risk-targeted and population-wide interventions showed limited effectiveness differences. Case management (3-day mean infectious period) initiated on July 15 achieved cumulative infection reductions of 59.84% (95% CrI: 54.28-65.40) when targeting the whole population, compared to 56.80% (95% CrI: 49.24-64.35) reduction when targeting only high-risk groups (aged 18-44 years).

Conclusions: The transmissibility of mpox within the 18-44 age group follows a distinct pattern of rapid growth-slow decline not observed to the same extent in other age groups. Real-time estimation of mpox transmissibility within or between age groups helps us to understand the dynamic process of mpox interpersonal transmission better and evaluate the effect of various interventions in real world more promptly.

Background: Histidine Rich Protein 2-based rapid diagnostic tests (HRP2-based RDTs) are widely used for malaria diagnosis in Malawi, but their accuracy may be compromised by Plasmodium falciparum parasites lacking the P. falciparum histidine rich protein 2 (pfhrp2) and P. falciparum histidine rich protein 3 (pfhrp3) genes. While such deletions have been reported in other malaria-endemic countries, their presence and diagnostic impact in Malawi remain unknown. This study aimed to determine the prevalence of pfhrp2/pfhrp3 gene deletions in Malawi and their effect on the diagnostic accuracy of HRP2-based RDTs relative to light microscopy and qPCR.

Methods: A cross-sectional study was conducted between December 2020 and June 2021, enrolling 1582 participants from referral hospitals in Mzuzu (n = 1186) and Lilongwe (n = 396). Malaria diagnosis was performed using RDTs, microscopy, and qPCR. A total of 391 P. falciparum positive samples were analyzed for pfhrp2/pfhrp3 gene deletions using multiplex qPCR. Diagnostic accuracy metrics, such as sensitivity and specificity, were calculated with 95% confidence intervals. Spearman correlation was applied to assess associations involving log-transformed parasitemia, unpaired t-tests were used to compare diagnostic methods, and Mann-Whitney tests were used to compare symptomatic and asymptomatic groups.

Results: Malaria prevalence was higher in Lilongwe (45.2%) than in Mzuzu (22.9%). Infections in Lilongwe were predominantly asymptomatic (94.2%), whereas Mzuzu had mostly symptomatic cases (97.1%) (P < 0.0002). RDTs demonstrated higher sensitivity of 78.5% (95% CI: 74.6-82.1%) than microscopy 64.8% (95% CI: 60.3-69.1), but slightly lower specificity, with 93.6% (95% CI: 92.0-95.0%) for RDT compared to 95.4% (95% CI: 94.0-96.6%) for microscopy. Dual pfhrp2/3 gene deletions were found in 24 (15.0%) isolates from Lilongwe and 24 (10.4%) from Mzuzu. All dual-deleted samples were false negative by RDT but were positive by microscopy and qPCR.

Conclusions: This study is the first to report pfhrp2/3 gene deletions in Malawi. The presence of these deletions may compromise the performance of HRP2-based RDTs, indicating the need to reassess diagnostic strategies in affected regions.

Background: While Schistosoma japonicum is endemic in the Yangtze River Basin and parts of Yunnan and Sichuan provinces in China, Mangshi City in Dehong Prefecture, Yunnan Province, is not recognized as an endemic area. Between 1996 and 2018, more than 20 suspected schistosomiasis cases were reported in this region. Despite clinical symptoms consistent with S. japonicum infection, no eggs were detected in feces, and the intermediate host Oncomelania hupensis was absent locally. Most patients had no travel history to known endemic areas, leaving the infections unconfirmed.

Findings: Rectal biopsy specimens from four suspected cases, preserved as formalin-fixed paraffin-embedded (FFPE) tissues, were re-examined. Microscopy revealed egg-like structures resembling Schistosoma spp. in the specimens. Due to severe DNA degradation from long-term storage (6-16 years), a micro-library construction method was applied to two samples to enable next-generation sequencing (NGS). Using two independent alignment strategies, multiple sequence reads corresponding to S. japonicum were identified in both samples, providing molecular confirmation of infection.

Conclusions: This study presents the first molecular evidence confirming S. japonicum infection in a non-endemic area of Yunnan Province. The findings highlight the diagnostic potential of combining FFPE samples with NGS to resolve long-standing suspected cases lacking conventional parasitological evidence and underscore the importance of continued surveillance in regions not currently classified as endemic.

Background: Dengue virus (DENV) is the most prevalent mosquito-borne virus worldwide, with approximately half of the world's population at risk of infection. Although it has been shown that parasitic infections can influence viral co-infections the role of schistosomiasis has not yet been explored. The objective of this exploratory study was to investigate the influence of schistosome infection on DENV infection in Madagascar.

Methods: Between March 2020 and October 2022 we recruited participants in the regions of Boeny and Atsinanana to assess the seroprevalence of DENV in the country using highly specific tests for the detection of IgG antibodies and investigated the influence of schistosome infections on DENV infections through a plaque reduction neutralisation test (PRNT). For this, additional participants were recruited in Haute Matsiatra between July 2022 and March 2023, Poisson regression models were used to assess the association of the PRNT results with schistosome infections.

Results: For the first time, we report a low seroprevalence of DENV (up to 3.3%) in areas with a high prevalence (> 50%) of schistosome infection. Additionally, we could demonstrate that sera derived from schistosome-infected individuals exert a significant antiviral activity against DENV infection (up to 27.5%). A Poisson regression analysis revealed that, among the possible factors assessed, the schistosome infection status was the only factor associated with the inhibitory effects against DENV infection in the PRNT. Finally, we could observe that highest IgE level were found in participants showing the greatest reduction in viral infection in the PRNT.

Conclusions: Our data suggest that schistosomiasis might play a protective role against DENV infections. These findings offer new perspectives regarding how chronic parasitic infections affect the dynamics of DENV infections in Africa.

Background: The incompatible insect technique (IIT), based on Wolbachia-induced conditional sterility, has proven highly effective in suppressing mosquito populations for dengue control. However, concerns that accidental release of infected females could drive population replacement have prompted integration of IIT with irradiation or advanced sex-separation technologies. Moreover, the broader ecological consequences of IIT-based suppression remain insufficiently understood. Here, we investigated whether standalone IIT, leveraging Wolbachia-associated fitness costs under real-world conditions, can effectively suppress Aedes albopictus populations without causing replacement, while also addressing key ecological concerns related to IIT-based mosquito population suppression.

Methods: We conducted field trials on Shazai Island, Nansha District, Guangzhou, China, releasing approximately 16,000 Wolbachia wPip-transinfected A. albopictus HC males per hectare per week from 2018 to 2019, following three years of combined IIT and sterile insect technique (SIT) application. Population suppression was monitored, with wPip infection frequency assessed to evaluate population replacement risks. Two-dimensional system of ordinary differential equations incorporating Wolbachia-induced fitness costs was established to predict population dynamics. Additionally, we assessed female mating preferences after three years of suppression and the impact on non-target Culex quinquefasciatus populations.

Results: We offer both empirical evidence and a mathematical model, demonstrating that the fitness costs associated with a Wolbachia triple-strain infection in A. albopictus, especially in adverse field conditions, empower a standalone IIT to effectively suppress mosquito populations without causing population replacement. Remarkably, reducing the previous release numbers to just 20% sustained a similar suppression level. We found no evidence of changes in female mating preferences after a three-year field suppression. The suppression of A. albopictus does not impact the population of the coexisting nontarget species C. quinquefasciatus. After stopping releases, the population rebounded partially in Year 1 and appeared to fully recover in Year 2, with the rate of this recovery likely influenced by mosquito immigration associated with population flow.

Conclusions: Our study demonstrates the robustness, cost-effectiveness, scalability, and ecological safety of IIT as a tool for controlling mosquito-borne diseases. These findings support the implementation of field-applicable, low-dose IIT for sustainable dengue control.

Background: Opisthorchiasis infected by Opisthorchis felineus has represented a significant but understudied public health issue for the population residing in Western Siberia and the Ural Region of the Russian Federation. This study aimed to produce high-resolution spatial-temporal disease risk maps for guiding prevention strategy in the above region.

Methods: Data on prevalence and surveillance data reflecting reported annual incidence rate of O. felineus infection in the study region were collected through systematic review and the annual reports of the Ministry of Health of the Russian Federation. Environmental, socioeconomic and demographic data were downloaded from different open-access data sources. An advanced multivariate Bayesian geostatistical modeling approach was developed to estimate the O. felineus infection risk at high-resolution spatial-temporal by joint analysis of survey and surveillance data, incorporating potential influencing factors and spatial-temporal random effects. The annual spatial-temporal risk maps of O. felineus infection at a resolution of 5 × 5 km² were produced.

Results: The final dataset included 76 locations of survey data and 303 locations of surveillance data on O. felineus infection. The infection risk was high (> 25%) in most part of central and eastern regions, and relatively low (< 25%) in most part of western region, while temporal variations were observed across the sub-regions in recent decades. Particularly, in the densely populated eastern region, there was an increased trend of infection risk from 30.46% (95% Bayesian credible intervals, BCI 10.78-53.45%) in 1980 to 53.39% (95% BCI 13.77-91.93%) in 2019 and gradually transformed into high-risk. In the study region (excluding the western region due to data sparsity), the population-adjusted estimated prevalence was 46.61% (95% BCI 15.09-76.50%) in 2019, corresponding to approximately 7.91 million (95% BCI 2.56-12.98 million) people infected.

Conclusions: The high-resolution risk maps of O. felineus in Western Siberia and the Ural Region of the Russian Federation have effectively captured the risk profiles, suggesting the infection risk remains high in recent years and providing substantial evidence for spatial-target control and preventive strategies.

Background: Although France is considered a low tuberculosis (TB) incidence country, TB remains a significant public health issue in certain high-risk groups and geographic areas, potentially linked to socioeconomic determinants. This study aims to assess the associations between TB notification rates and area-level socioeconomic variables in metropolitan France.

Methods: We conducted an ecological spatial study using TB cases reported to the French national surveillance system from 2008 to 2019. Using Bayesian Poisson regression, we modeled TB case counts at the ZIP code level. Standardized notification rates were estimated through indirect standardization by age, sex, immigration status, and housing type. The model included ZIP code level socioeconomic variables and a spatial random effect to account for spatial autocorrelation and residual variations in notification rates, which may relate to territorial disparities in reporting completeness.

Results: The study included 55,330 reported TB cases across 4478 of 5534 ZIP codes in metropolitan France. All tested socioeconomic variables showed varying associations with TB. In the multivariable model, an increase in population density from 'Low' to 'High' was associated with a 30% increase [95% credible interval (CrI): 21%, 38%] in standardized TB notification rates. An increase from the first to the ninth decile in the unemployment rate among those aged 15-64 was associated with a 28% increase (95% CrI: 19%, 37%). Similarly, an increase in the proportion of overcrowded households was associated with a 19% increase (95% CrI: 11%, 28%). Conversely, an increase in median household income was associated with a 7% decrease (95% CrI: 1%, 11%).

Conclusions: Our findings suggest that TB notification rates are independently associated with material deprivation, such as unemployment and low income, as well as crowded settings, including overcrowded households and densely populated areas. Enhancing TB control in metropolitan France could involve targeted outreach programs for screening and treatment in materially deprived areas, characterized by high unemployment rates and low median incomes, and adopting a 'Health in All Policies' approach to address urban and household crowding.

Background: As of July 22, 2025, the chikungunya virus transmission has been documented across 119 countries and territories of the world. In 2025, an outbreak of chikungunya fever (CF) occurred in Foshan, Guangdong Province, China. We aimed to analyze the epidemiological characteristics and transmission dynamics during the early stage of this outbreak.

Methods: We collected the data of CF cases in Foshan from July 8 to July 26, 2025. Case data were extracted from the National Notifiable Infectious Disease Reporting System. Demographics and tempo-spatial distributions of cases, incidence rates and the onset-to-report interval times were analyzed. Global spatial autocorrelation (Moran's I) to assess township-level clustering; Kruskal-Wallis tests with Dunn's post-hoc comparisons (Bonferroni-corrected) to analyze onset-to-report intervals across four epidemic phases. The basic reproduction number (R₀) was calculated using a maximum likelihood method, which was also compared with the R₀ from the CF outbreak in Dongguan City of Guangdong Province in 2010.

Results: A total of 4,754 local cases were reported during the study period. Persons aged 65 years or above had the highest incidence (116.57 per 100,000 population). Most cases were business/service workers, homemakers, and retirees. The median onset-to-report interval decreased from 4 days to 1 day after outbreak control measures were implemented. The outbreak, initially detected in Shunde District, spread rapidly to other districts of Foshan, forming a significant spatial cluster (Moran's I = 0.152, P = 0.029). The estimated R₀ was 16.3 (95% confidence interval: 15.0 to 17.5), substantially higher than the estimated R₀ of 5.5 for the Dongguan outbreak in 2010.

Conclusions: This outbreak was characterized by high transmissibility, with older persons being a primary high-risk group. The rapid reduction in case reporting delay highlights the effectiveness of response interventions. Sustained, integrated and prompt response has been essential to control the outbreak.

Background: Little is documented on key community-based One Health (OH) approach implementation, pro-activeness and effectiveness of interactions and strategies against Mpox outbreak public health emergency in international concern (PHEIC) in various African countries in order to stamp out the persisting Mpox outbreak threat and burden. Prioritizing critical community-based interventions and lessons learned from previous COVID-19, Mpox, Ebola, COVID-19, Rift Valley Fever and Marburg virus outbreaks revealed critical shortcomings in funding, surveillance, and community engagement that plague public health initiatives across the continent. The article provides critical insights and benefits of community-based One Health approaches implementation against Mpox outbreak management in Africa.

Main body: Our findings provides a comprehensive community and primary healthcare systems strategies essential to foster community engagement and resilience, while addressing the social determinants of health. Investing in targeted, effective and contextual community-based OH strategies implementation shows to improve immediate vulnerable communities integrated (human,animal and environment) preparedness and response and building sustainable resilience strategies against Mpox and future emergencies threats. The importance of global and regional multi-sectorial collaboration, solidarity and coordination cannot be over-emphasized, to mobilize resource, sharing knowledge and successes in enhancing local OH anticipatory and ownership programs capabilities for equitably shared benefits. Timely strengthening community empowerment and national health systems last miles, WASH and vaccination activities are essential to control, contain and sustainable recovery from the ongoing Mpox outbreak and future crises. Tackling survivors and at high risk affected populations stigma, fear and misinformation surrounding Mpox those hinder effective health communication and disease management, highlighting the need for culturally sensitive educational and empowerment strategies. A comprehensive assessment community-based one-health approaches implementation was performed to understand and prioritize key data-driven community-based OH strategies in infectious disease outbreaks beyond. Leveraging on outbreak valuable lessons learned and emerging technologies benefits in addressing the health social determinants, optimizing Mpox PHEIC implemented programs capabilities efforts, building communities resilience and sustainable solutions, and prioritizing strategies against outbreaks/pandemics threats and burden.

Conclusions: Catalyzing evidence-based community-based OH governance, leadership and domestic financing commitment serve as a critical engine connecting all stakeholders in prioritizing and optimizing unprecedented outbreaks threats preparedness and response initiatives implementation and upholding global health securi

Background: Colpodella species are classified within the domain Eukaryota, specifically under the order Colpodellida, family Colpodellaceae, and genus Colpodella, which are close relative of the phylum Apicomplexa. These organisms are unicellular, predatory flagellates. In recent years, their frequent detection in animal tissues, vector insect samples, and particularly in human has garnered significant attention as an emerging zoonotic threat. This review is to scope the biological characteristics and epidemiological features of Colpodella species.

Methods: The PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched to identify studies in English or Chinese published before 4 February 2025. We searched for Colpodella-related nucleotide sequences released in the GenBank before 31 December, 2024. The literature and sequences were selected based on predefined inclusion criteria. We extracted the characteristics of Colpodella spp. from included articles and performed a phylogenetic analysis based on the included sequences.

Results: Thirty-seven records and 83 sequences were included in the study, respectively. Colpodella spp. currently comprise only two formally named species, alongside at least 11 species uncultured or unnamed in GenBank. Their life cycle includes trophozoite and cyst stages, with nutrient acquisition mediated by myzocytosis. These organisms display structural and protein similarities in their apical complexes to apicomplexan protozoa, yet with distinct differences. They are currently found in a wide range of hosts, including humans, livestock, pets, wildlife and vectors, across multiple continents, including Europe, Asia, Africa, and the Americas. Phylogenetic analyses reveal that Colpodella spp. exhibit significant genetic diversity and can be divided into seven clades, each characterized by distinct host ranges and regional distributions, and three clades posed pathogenic potential and significant risk of human infection.

Conclusions: This study systematically elucidates the broad host/vector range, genetic diversity and public health implications of Colpodella species based on comprehensive integrated genomic and epidemiological analyses. We recommend establishing active surveillance networks using clade-specific molecular markers for hosts and vectors in high-risk regions, incorporating Colpodella screening into routine diagnostics for fever cases of unknown origin with anaemia, prioritizing studies on isolation and cultivation, biological characteristics, and clade-specific in vitro invasion assays to elucidate the pathogenic mechanisms.