High mortality rates are commonly found in critically ill patients with tuberculosis (TB), which is due partially to limitations in the existing prognostic evaluation methods. Therefore, we aimed to find more effective prognostic evaluation tools to reduce the mortality rate. Data from critically ill patients with TB admitted to the intensive care unit of The Second Hospital of Nanjing, Nanjing, China, between January 2020 and December 2022 were analyzed retrospectively. A total of 115 patients were enrolled and divided into a survival group (n = 62) and a death group (n = 53) according to 30-day survival. Univariate and least absolute shrinkage and selection operator (LASSO) regression analyses were used to investigate the risk factors for 30-day death in critically ill patients with TB. A prediction model for risk of 30-day mortality was developed for critically ill patients with TB in the intensive care unit. The LASSO regression model showed that the prognostic nutritional index (PNI) and Acute Physiology and Chronic Health Status (APACHE II) scores on the third day after admission to the intensive care unit were independent risk factors for 30-day mortality in critically ill patients with TB (P <0.05). The area under the curve value and that PA3 represents the combination of the PNI and APACHE II score on the third day, which was 0.952 (95% CI: 0.913-0.991, P <0.001), was significantly higher than that of the PNI or the APACHE II score on the third day. The new model is as follows: PA3 = APACHE II score (on the third day) × 0.421 - PNI × 0.204. The PNI combined with the APACHE II score on the third day could well predict the 30-day mortality risk of critically ill patients with TB.
肺结核（TB）重症患者的死亡率通常很高，部分原因是现有的预后评估方法存在局限性。因此，我们希望找到更有效的预后评估工具来降低死亡率。我们对南京市第二医院重症监护室在2020年1月至2022年12月期间收治的肺结核重症患者的数据进行了回顾性分析。共纳入115名患者，根据30天存活率分为生存组（62人）和死亡组（53人）。采用单变量和最小绝对收缩与选择算子（LASSO）回归分析来研究肺结核重症患者30天死亡的风险因素。为重症监护室的肺结核重症患者建立了 30 天死亡风险预测模型。LASSO 回归模型显示，预后营养指数（PNI）和重症监护病房入院后第三天的急性生理学和慢性健康状况（APACHE II）评分是肺结核重症患者 30 天死亡的独立风险因素（P <0.05）。曲线下面积值和 PA3 代表第三天 PNI 和 APACHE II 评分的组合，PA3 为 0.952（95% CI：0.913-0.991，P＜0.001），明显高于第三天 PNI 或 APACHE II 评分的组合。新模型如下PA3 = APACHE II 评分（第三天）×0.421 - PNI ×0.204。PNI 结合第三天的 APACHE II 评分可以很好地预测肺结核重症患者 30 天内的死亡风险。
{"title":"Predictive Mortality of the Prognostic Nutritional Index Combined with APACHE II Score for Critically Ill Tuberculosis Patients.","authors":"Qi Yuan,Wen Li,Kai Yang,Jing Guo,Yishan Zheng","doi":"10.4269/ajtmh.23-0661","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0661","url":null,"abstract":"High mortality rates are commonly found in critically ill patients with tuberculosis (TB), which is due partially to limitations in the existing prognostic evaluation methods. Therefore, we aimed to find more effective prognostic evaluation tools to reduce the mortality rate. Data from critically ill patients with TB admitted to the intensive care unit of The Second Hospital of Nanjing, Nanjing, China, between January 2020 and December 2022 were analyzed retrospectively. A total of 115 patients were enrolled and divided into a survival group (n = 62) and a death group (n = 53) according to 30-day survival. Univariate and least absolute shrinkage and selection operator (LASSO) regression analyses were used to investigate the risk factors for 30-day death in critically ill patients with TB. A prediction model for risk of 30-day mortality was developed for critically ill patients with TB in the intensive care unit. The LASSO regression model showed that the prognostic nutritional index (PNI) and Acute Physiology and Chronic Health Status (APACHE II) scores on the third day after admission to the intensive care unit were independent risk factors for 30-day mortality in critically ill patients with TB (P <0.05). The area under the curve value and that PA3 represents the combination of the PNI and APACHE II score on the third day, which was 0.952 (95% CI: 0.913-0.991, P <0.001), was significantly higher than that of the PNI or the APACHE II score on the third day. The new model is as follows: PA3 = APACHE II score (on the third day) × 0.421 - PNI × 0.204. The PNI combined with the APACHE II score on the third day could well predict the 30-day mortality risk of critically ill patients with TB.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gerardo Álvarez-Hernández,Ruy López-Ridaura,Ricardo Cortés-Alcalá,Gabriel García Rodríguez,J R Tadeo Calleja-López,Cristian N Rivera-Rosas,José Luis Alomía-Zegarra,Maureen Brophy,Carina Berenice Brito-Lorán,Maria Del Carmen Candia-Plata,Santa Elizabeth Ceballos-Liceaga,Fabián Correa-Morales,Karla R Dzul-Rosado,Janet Foley,José Manuel Galván-Moroyoqui,Roman Ganta,Verónica Gutiérrez-Cedillo,Néstor Saúl Hernández-Milán,Andrés M López-Pérez,Luis Fernando López-Soto,Juan Manuel Martínez-Soto,Ana Lourdes Mata-Pineda,Christopher D Paddock,Irma Leticia J Ruiz-González,Juan Edmundo Salinas-Aguirre,Johanna S Salzer,Sokani Sánchez-Montes,Adriana Soto-Guzmán,Óscar Tamez-Rivera,David M Wagner,David H Walker
Rocky Mountain spotted fever (RMSF) is an ongoing public health crisis in Mexico, particularly in states bordering the United States. The national highest incidence and mortality of RMSF occur in this region, resulting in a case-fatality rate that ranges annually between 10% and 50%, primarily affecting vulnerable groups such as children, elderly adults, and persons living in poverty. Multiple biological, environmental, and social determinants can explain its growing presence throughout the country and how it challenges the health system and society. It is necessary to integrate resources and capacities from health authorities, research centers, and society to succeed in dealing with this problem. Through a scientific symposium, a group of academicians, U.S. health officials, and Mexican health authorities met on November 8-10, 2023, in Hermosillo, Mexico, to discuss the current situation of RMSF across the country and the challenges associated with its occurrence. An urgent call for action to improve national capacity against RMSF in the aspects of epidemiological and acarological surveillance, diagnosis, medical care, case and outbreak prevention, health promotion, and research was urged by the experts. The One Health approach is a proven multidisciplinary strategy to integrate policies and interventions to mitigate and prevent the burden of cases, deaths, and suffering caused by RMSF in Mexico.
{"title":"Rocky Mountain Spotted Fever in Mexico: A Call to Action.","authors":"Gerardo Álvarez-Hernández,Ruy López-Ridaura,Ricardo Cortés-Alcalá,Gabriel García Rodríguez,J R Tadeo Calleja-López,Cristian N Rivera-Rosas,José Luis Alomía-Zegarra,Maureen Brophy,Carina Berenice Brito-Lorán,Maria Del Carmen Candia-Plata,Santa Elizabeth Ceballos-Liceaga,Fabián Correa-Morales,Karla R Dzul-Rosado,Janet Foley,José Manuel Galván-Moroyoqui,Roman Ganta,Verónica Gutiérrez-Cedillo,Néstor Saúl Hernández-Milán,Andrés M López-Pérez,Luis Fernando López-Soto,Juan Manuel Martínez-Soto,Ana Lourdes Mata-Pineda,Christopher D Paddock,Irma Leticia J Ruiz-González,Juan Edmundo Salinas-Aguirre,Johanna S Salzer,Sokani Sánchez-Montes,Adriana Soto-Guzmán,Óscar Tamez-Rivera,David M Wagner,David H Walker","doi":"10.4269/ajtmh.24-0265","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0265","url":null,"abstract":"Rocky Mountain spotted fever (RMSF) is an ongoing public health crisis in Mexico, particularly in states bordering the United States. The national highest incidence and mortality of RMSF occur in this region, resulting in a case-fatality rate that ranges annually between 10% and 50%, primarily affecting vulnerable groups such as children, elderly adults, and persons living in poverty. Multiple biological, environmental, and social determinants can explain its growing presence throughout the country and how it challenges the health system and society. It is necessary to integrate resources and capacities from health authorities, research centers, and society to succeed in dealing with this problem. Through a scientific symposium, a group of academicians, U.S. health officials, and Mexican health authorities met on November 8-10, 2023, in Hermosillo, Mexico, to discuss the current situation of RMSF across the country and the challenges associated with its occurrence. An urgent call for action to improve national capacity against RMSF in the aspects of epidemiological and acarological surveillance, diagnosis, medical care, case and outbreak prevention, health promotion, and research was urged by the experts. The One Health approach is a proven multidisciplinary strategy to integrate policies and interventions to mitigate and prevent the burden of cases, deaths, and suffering caused by RMSF in Mexico.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In areas where malaria is endemic and microscopes are unavailable, rapid diagnostic tests (RDTs) are essential tools for early diagnosis and prompt and effective treatment. However, HRP2-based RDTs are threatened by the emergence of Plasmodium falciparum parasites that do not carry the pfhrp2 or pfhrp3 gene, leading to false-negative results. Therefore, the aim of this study was to evaluate the performance of the ParaHIT RDT together with the proportion of pfhrp2/3 gene-deleted P. falciparum parasites in Togo. The performance of RDTs compared with microscopy and polymerase chain reaction (PCR) was determined using capillary blood collected by finger prick during a cross-sectional study conducted from September 2021 to January 2022 in children aged 6-59 months at two sentinel sites. Blood spots were collected for molecular analysis. Amplicons from the target regions (exon 2 of hrp2 and hrp3 genes) were generated by multiplex nested PCR and sequenced using Illumina's MiSeq protocol. A total of 278 samples were analyzed for ParaHIT RDT evaluation. The sensitivity and specificity of the RDT test compared with microscopy were 96.4% and 85.7%, respectively, which increased to 97.9% and 90.7%, respectively, when compared with PCR. Of the microscopically and PCR-positive P. falciparum samples, 138 were sequenced to detect pfhrp2/3 deletions. None of the parasites had a single pfhrp2 deletion or a single pfhrp3 deletion. The ParaHIT RDT demonstrated an acceptable level of performance in this evaluation, confirming the use of HRP2-based RDTs for the detection of P. falciparum infection in areas where microscopy is not available in Togo.
{"title":"Performance of ParaHIT® HRP2-Based Rapid Diagnostic Test and Proportions of Plasmodium falciparum Histidine-Rich Protein 2/3 Gene Deletions in Togo.","authors":"Diwaba Carmel Teou,Ameyo Monique Dorkenoo,Essoham Ataba,Kossi Yakpa,Efoe Sossou,Laurence Ma,Emmanuelle Caspar,Manani Hemou,Agueregna Abdou-Kerim,Didier Menard","doi":"10.4269/ajtmh.24-0197","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0197","url":null,"abstract":"In areas where malaria is endemic and microscopes are unavailable, rapid diagnostic tests (RDTs) are essential tools for early diagnosis and prompt and effective treatment. However, HRP2-based RDTs are threatened by the emergence of Plasmodium falciparum parasites that do not carry the pfhrp2 or pfhrp3 gene, leading to false-negative results. Therefore, the aim of this study was to evaluate the performance of the ParaHIT RDT together with the proportion of pfhrp2/3 gene-deleted P. falciparum parasites in Togo. The performance of RDTs compared with microscopy and polymerase chain reaction (PCR) was determined using capillary blood collected by finger prick during a cross-sectional study conducted from September 2021 to January 2022 in children aged 6-59 months at two sentinel sites. Blood spots were collected for molecular analysis. Amplicons from the target regions (exon 2 of hrp2 and hrp3 genes) were generated by multiplex nested PCR and sequenced using Illumina's MiSeq protocol. A total of 278 samples were analyzed for ParaHIT RDT evaluation. The sensitivity and specificity of the RDT test compared with microscopy were 96.4% and 85.7%, respectively, which increased to 97.9% and 90.7%, respectively, when compared with PCR. Of the microscopically and PCR-positive P. falciparum samples, 138 were sequenced to detect pfhrp2/3 deletions. None of the parasites had a single pfhrp2 deletion or a single pfhrp3 deletion. The ParaHIT RDT demonstrated an acceptable level of performance in this evaluation, confirming the use of HRP2-based RDTs for the detection of P. falciparum infection in areas where microscopy is not available in Togo.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela P Venegas-Montero,María J Alfaro-Vellanero,Diana Rojas-Araya,Ólger Calderón-Arguedas,Cinthya M Vargas-Castro,Andrés Baldioceda-Villarreal,Luis Enrique Chaves-González,Jacqueline Camacho-Leandro,Adriana Troyo
The New World screwworm, Cochliomyia hominivorax Coquerel (Diptera: Calliphoridae), was officially eliminated from Costa Rica in 2000, but it was reintroduced in 2023. A myiasis by C. hominivorax in a 71-year-old man with a 4-month history of foot hyperkeratosis and interdigital ulcers is reported. The myiasis was detected before sampling for bacterial culture. Approximately 160 first- and second-instar larvae were recovered and identified as C. hominivorax. Morphological identification was based mainly on characteristics of the cephalopharyngeal skeleton, spiracles, and pigmented dorsal tracheal trunks. Sequencing of a cytochrome c oxidase subunit I gene fragment confirmed the identity. The ulcers healed after extraction of the larvae and ciprofloxacin treatment of a concurrent Staphylococcus aureus and Pseudomonas aeruginosa infection. Given the reintroduction of C. hominivorax in Costa Rica and the risk of northward expansion, this report highlights its impact on public health and calls for awareness among clinicians and healthcare practitioners.
新大陆螺虫 Cochliomyia hominivorax Coquerel（双翅目：Calliphoridae）于 2000 年被哥斯达黎加正式消灭，但在 2023 年又被重新引入。据报道，一名 71 岁的男子患有 C. hominivorax 蠅蛆病，4 个月前出现足部角化过度和趾间溃疡。蠅蛆病是在取样进行细菌培养之前发现的。回收的约 160 条一、二龄幼虫被鉴定为人癣菌。形态学鉴定主要基于头咽部骨骼、气旋和色素背气管的特征。细胞色素 c 氧化酶亚单位 I 基因片段的测序证实了其身份。在提取幼虫并用环丙沙星治疗同时感染的金黄色葡萄球菌和铜绿假单胞菌后，溃疡愈合。鉴于哥斯达黎加再次出现同形蝇并有向北扩展的风险，本报告强调了同形蝇对公共卫生的影响，并呼吁临床医生和医疗从业人员提高对同形蝇的认识。
{"title":"Case Report: Re-Emergence of Cochliomyia hominivorax in Costa Rica: Report of a Human Myiasis Case 23 Years after Elimination.","authors":"Daniela P Venegas-Montero,María J Alfaro-Vellanero,Diana Rojas-Araya,Ólger Calderón-Arguedas,Cinthya M Vargas-Castro,Andrés Baldioceda-Villarreal,Luis Enrique Chaves-González,Jacqueline Camacho-Leandro,Adriana Troyo","doi":"10.4269/ajtmh.24-0342","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0342","url":null,"abstract":"The New World screwworm, Cochliomyia hominivorax Coquerel (Diptera: Calliphoridae), was officially eliminated from Costa Rica in 2000, but it was reintroduced in 2023. A myiasis by C. hominivorax in a 71-year-old man with a 4-month history of foot hyperkeratosis and interdigital ulcers is reported. The myiasis was detected before sampling for bacterial culture. Approximately 160 first- and second-instar larvae were recovered and identified as C. hominivorax. Morphological identification was based mainly on characteristics of the cephalopharyngeal skeleton, spiracles, and pigmented dorsal tracheal trunks. Sequencing of a cytochrome c oxidase subunit I gene fragment confirmed the identity. The ulcers healed after extraction of the larvae and ciprofloxacin treatment of a concurrent Staphylococcus aureus and Pseudomonas aeruginosa infection. Given the reintroduction of C. hominivorax in Costa Rica and the risk of northward expansion, this report highlights its impact on public health and calls for awareness among clinicians and healthcare practitioners.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Almamy Diabaté,Ryo Fukaura,Chiaki Terashima-Murase,Bamba Vagamon,Rie R Yotsu
Cutaneous leishmaniasis (CL) is classified as one of the skin-related neglected tropical diseases by the WHO. There have been limited reports of CL in Côte d'Ivoire, with fewer than 20 cases reported from Côte d'Ivoire in the literature since 1967, when it was first identified. Here, we report a case of CL originating in Côte d'Ivoire that we diagnosed during our active case finding activity in the Zounan Hounien District. The patient, a 15-year-old male, presented with multiple noninflammatory skin lesions on the face and trunk that had progressed from nodular to ulcerated lesions over the previous 3 months. Concurrent symptoms included fever, chest pain, cough, and malaise. Investigations for infectious diseases such as HIV and tuberculosis returned negative results. Histopathological analysis of a skin biopsy specimen from the nasal base demonstrated the presence of Leishman-Donovan bodies, confirming a diagnosis of CL. Although treatment with intralesional meglumine antimoniate (Glucantime) injections was intended, the drug could not be administered because the patient unfortunately died shortly after our consultation visit. Because of the rarity of CL in Côte d'Ivoire, awareness remains low, resulting in delayed diagnosis and treatment. Urgent strategies to improve awareness of CL among clinicians practicing in Côte d'Ivoire is required, first to appropriately diagnose and treat CL and second to generate epidemiological data of adequate quality.
{"title":"Case Report: Cutaneous Leishmaniasis-A Hidden Disease in Côte d'Ivoire.","authors":"Almamy Diabaté,Ryo Fukaura,Chiaki Terashima-Murase,Bamba Vagamon,Rie R Yotsu","doi":"10.4269/ajtmh.23-0900","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0900","url":null,"abstract":"Cutaneous leishmaniasis (CL) is classified as one of the skin-related neglected tropical diseases by the WHO. There have been limited reports of CL in Côte d'Ivoire, with fewer than 20 cases reported from Côte d'Ivoire in the literature since 1967, when it was first identified. Here, we report a case of CL originating in Côte d'Ivoire that we diagnosed during our active case finding activity in the Zounan Hounien District. The patient, a 15-year-old male, presented with multiple noninflammatory skin lesions on the face and trunk that had progressed from nodular to ulcerated lesions over the previous 3 months. Concurrent symptoms included fever, chest pain, cough, and malaise. Investigations for infectious diseases such as HIV and tuberculosis returned negative results. Histopathological analysis of a skin biopsy specimen from the nasal base demonstrated the presence of Leishman-Donovan bodies, confirming a diagnosis of CL. Although treatment with intralesional meglumine antimoniate (Glucantime) injections was intended, the drug could not be administered because the patient unfortunately died shortly after our consultation visit. Because of the rarity of CL in Côte d'Ivoire, awareness remains low, resulting in delayed diagnosis and treatment. Urgent strategies to improve awareness of CL among clinicians practicing in Côte d'Ivoire is required, first to appropriately diagnose and treat CL and second to generate epidemiological data of adequate quality.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The movement of people contributes to the spread of COVID-19 between communities. Hence, we evaluated the feasibility, acceptability, and impact of offering intercity bus travelers testing prior to their departure. We conducted baseline and endline surveys to map COVID-19 prevention practices in travel agencies in western Cameroon. As interventions, buses were randomly assigned to three study arms: 1) offering systematic COVID-19 rapid diagnostic testing (RDT) to all passengers (arm A); 2) offering testing to suspected cases (arm B); or 3) no testing (arm C). All travelers were called 7-10 days after their trip to identify potential cases. Fifty-five (90.2%) of the 61 travel agencies that were reached consented to participate in a baseline survey. Although only 27 (49.1%) of the agencies implemented at least one of the recommended COVID-19 preventive measures, 39 (70.9%) agreed to host a testing station. Six agencies were selected, and 669 buses were enrolled, including 223, 224, and 222 in arms A, B, and C, respectively. A total of 31,484 departing passengers were approached and 9,594 (30.5%) agreed to participate: 1,177 (12.3%) in arm A, 4,086 (42.6%) in arm B, and 4,331 (45.1%) in arm C. In all, 1,731 tests were performed, including 1,177 in arm A and 554 in arm B. Fourteen (0.8%) tests were positive, and two participants (14.3%) agreed to postpone their travel. Offering testing with antigen RDTs in travel agencies is feasible and acceptable. One-third of passengers consented, and testing did not delay any travels. Although this approach can detect COVID-19 cases, actions are needed to increase the proportion of positive cases postponing their travels.
{"title":"Assessing the Benefit of Two Detection Approaches in Screening COVID-19 Using SARS-CoV-2 Antigen Rapid Diagnostic Tests among Intercity Public Bus Travelers.","authors":"Jerome Ateudjieu,Ketina Hirma Tchio-Nighie,Anne Hoppe,Etienne Guenou,Imelda Sonia Nzinnou Mbiaketcha,Landry Beyala Bita'a,Claudine Sen Henriette Ngomtcho,Anne Cecile Bissek","doi":"10.4269/ajtmh.23-0778","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0778","url":null,"abstract":"The movement of people contributes to the spread of COVID-19 between communities. Hence, we evaluated the feasibility, acceptability, and impact of offering intercity bus travelers testing prior to their departure. We conducted baseline and endline surveys to map COVID-19 prevention practices in travel agencies in western Cameroon. As interventions, buses were randomly assigned to three study arms: 1) offering systematic COVID-19 rapid diagnostic testing (RDT) to all passengers (arm A); 2) offering testing to suspected cases (arm B); or 3) no testing (arm C). All travelers were called 7-10 days after their trip to identify potential cases. Fifty-five (90.2%) of the 61 travel agencies that were reached consented to participate in a baseline survey. Although only 27 (49.1%) of the agencies implemented at least one of the recommended COVID-19 preventive measures, 39 (70.9%) agreed to host a testing station. Six agencies were selected, and 669 buses were enrolled, including 223, 224, and 222 in arms A, B, and C, respectively. A total of 31,484 departing passengers were approached and 9,594 (30.5%) agreed to participate: 1,177 (12.3%) in arm A, 4,086 (42.6%) in arm B, and 4,331 (45.1%) in arm C. In all, 1,731 tests were performed, including 1,177 in arm A and 554 in arm B. Fourteen (0.8%) tests were positive, and two participants (14.3%) agreed to postpone their travel. Offering testing with antigen RDTs in travel agencies is feasible and acceptable. One-third of passengers consented, and testing did not delay any travels. Although this approach can detect COVID-19 cases, actions are needed to increase the proportion of positive cases postponing their travels.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dawn Blackburn,Nwando Mba,William Nwachukwu,Hong Zhou,Andrew Hill,Andrew Abbott,Nishanth Parameswaran,Samuel Awala,Stacie Greby,Matthias Alagi,Nnaemeka C Iriemenam,McPaul I Okoye,Mahesh Swaminathan,Jeffrey W Priest,Diana Martin,Anne Straily,Chikwe Ihekweazu
Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8-27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures.
{"title":"Seroprevalence and Risk Factors for Toxoplasma gondii Infection in Women of Reproductive Age in Nigeria in 2018.","authors":"Dawn Blackburn,Nwando Mba,William Nwachukwu,Hong Zhou,Andrew Hill,Andrew Abbott,Nishanth Parameswaran,Samuel Awala,Stacie Greby,Matthias Alagi,Nnaemeka C Iriemenam,McPaul I Okoye,Mahesh Swaminathan,Jeffrey W Priest,Diana Martin,Anne Straily,Chikwe Ihekweazu","doi":"10.4269/ajtmh.24-0107","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0107","url":null,"abstract":"Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8-27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anopheles jamesii, considered to be a non-malaria vector, is an abundant mosquito species found in coastal India and several countries in Asia. In Goa, western India, An. jamesii is the dominant anopheline species by numbers, and in recent epidemiological surveys, they have tested positive for Plasmodium carriage. To assess An. jamesii's capacity as a malaria vector, we carried out six controlled membrane feeding assays with the F1 generation of field-caught An. jamesii and Plasmodium vivax-infected patient blood samples. As a control, the established local vector, Anopheles stephensi, was fed in parallel to compare the oocyst and sporozoite loads. The average oocyst load of An. jamesii was 3.29, while for An. stephensi it was 10.23. Furthermore, An. jamesii's blood feeding rate (21.7% versus 85%), oocyst positivity rate (60% versus 90.6%), and sporozoite positivity (45.16% versus 83%) were significantly lower (P <0.05, unpaired t test) than those of An. stephensi, suggesting a recent adaptation to support Plasmodium sporogony.
詹氏按蚊被认为是一种非疟疾病媒，是印度沿海和亚洲一些国家发现的大量蚊子物种。在印度西部的果阿，按数量计算，詹氏按蚊是主要的按蚊物种，在最近的流行病学调查中，它们的疟原虫携带检测呈阳性。为了评估詹氏疟蚊作为疟疾病媒的能力，我们用现场捕获的詹氏疟蚊和间日疟原虫感染的病人血样的 F1 代进行了六次对照膜饲喂试验。作为对照，我们同时喂养了当地的成熟病媒史蒂芬按蚊，以比较卵囊和孢子虫的载量。詹姆士疟蚊的平均卵囊量为 3.29 个，而史蒂芬斯疟蚊的平均卵囊量为 10.23 个。此外，詹氏疟蚊的采血率（21.7% 对 85%）、卵囊阳性率（60% 对 90.6%）和孢子虫阳性率（45.16% 对 83%）都明显低于史蒂芬斯疟蚊（P <0.05，非配对 t 检验），这表明詹氏疟蚊最近才适应支持疟原虫孢子生殖。
{"title":"Anopheles jamesii Supports Plasmodium vivax Sporogony under Laboratory Conditions.","authors":"Ajeet Kumar Mohanty,Debattam Mazumdar,Abhishek Govekar,Charles De'souza,Abhipsa Mohapatra,Praveen Balabaskaran Nina","doi":"10.4269/ajtmh.24-0267","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0267","url":null,"abstract":"Anopheles jamesii, considered to be a non-malaria vector, is an abundant mosquito species found in coastal India and several countries in Asia. In Goa, western India, An. jamesii is the dominant anopheline species by numbers, and in recent epidemiological surveys, they have tested positive for Plasmodium carriage. To assess An. jamesii's capacity as a malaria vector, we carried out six controlled membrane feeding assays with the F1 generation of field-caught An. jamesii and Plasmodium vivax-infected patient blood samples. As a control, the established local vector, Anopheles stephensi, was fed in parallel to compare the oocyst and sporozoite loads. The average oocyst load of An. jamesii was 3.29, while for An. stephensi it was 10.23. Furthermore, An. jamesii's blood feeding rate (21.7% versus 85%), oocyst positivity rate (60% versus 90.6%), and sporozoite positivity (45.16% versus 83%) were significantly lower (P <0.05, unpaired t test) than those of An. stephensi, suggesting a recent adaptation to support Plasmodium sporogony.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Betcy Evangeline Pamela,Subashini Thamizhmaran,Elias Jackson,Prabhakaran Vasudevan,Ranjith K Moorthy,Josephin Manoj,Anupriya Thanigachalam,Douglas A Drevets,Hélène Carabin,Anna Oommen,Vedantam Rajshekhar
Solitary cysticercus granulomas (SCG), prevalent among Indian patients with new-onset seizures, either resolve completely or transform into calcified granulomas. This study aimed to identify serum proteins through liquid chromatography-tandem mass spectrometry that could predict calcification of SCGs in 20 patients with SCG with at least 6-months of follow-up. At a median follow-up of 14 months, the SCG had calcified (n = 5), resolved (n = 11), or persisted (n = 4). Two serum proteins, ECM1 and MST1, were present in significantly higher serum concentrations, and AZGP1 in significantly lower concentration in subjects with calcifying SCGs than in those with lesions that resolved or persisted. On multivariate analysis, only ECM1 (odds ratio: 1.7, 95% CI: 0-2.8) and MST1 (odds ratio: 3.3, 95% CI: 0-4.1) were independent predictors of calcification of SCG. Combining elevated levels of serum ECM1 and MST1 had a sensitivity of 100% and specificity of 100% in differentiating granulomas that calcified from those that resolved/persisted. Increased expression of serum ECM1 and MST1 in patients with SCG might predict calcification.
{"title":"Serum Proteomic Predictors of Calcification of Solitary Cysticercus Granuloma.","authors":"Betcy Evangeline Pamela,Subashini Thamizhmaran,Elias Jackson,Prabhakaran Vasudevan,Ranjith K Moorthy,Josephin Manoj,Anupriya Thanigachalam,Douglas A Drevets,Hélène Carabin,Anna Oommen,Vedantam Rajshekhar","doi":"10.4269/ajtmh.24-0325","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0325","url":null,"abstract":"Solitary cysticercus granulomas (SCG), prevalent among Indian patients with new-onset seizures, either resolve completely or transform into calcified granulomas. This study aimed to identify serum proteins through liquid chromatography-tandem mass spectrometry that could predict calcification of SCGs in 20 patients with SCG with at least 6-months of follow-up. At a median follow-up of 14 months, the SCG had calcified (n = 5), resolved (n = 11), or persisted (n = 4). Two serum proteins, ECM1 and MST1, were present in significantly higher serum concentrations, and AZGP1 in significantly lower concentration in subjects with calcifying SCGs than in those with lesions that resolved or persisted. On multivariate analysis, only ECM1 (odds ratio: 1.7, 95% CI: 0-2.8) and MST1 (odds ratio: 3.3, 95% CI: 0-4.1) were independent predictors of calcification of SCG. Combining elevated levels of serum ECM1 and MST1 had a sensitivity of 100% and specificity of 100% in differentiating granulomas that calcified from those that resolved/persisted. Increased expression of serum ECM1 and MST1 in patients with SCG might predict calcification.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nazareth Jaramillo Correa,Arunima Vijay,John W Merriman,Rochelle G Hardie,Norman L Beatty
Histoplasma capsulatum is a thermally dimorphic fungal pathogen endemic to the Mississippi and Ohio River Valley regions of North America and much of Central and South America. As an opportunistic pathogen, H. capsulatum can assume a latent infection that can be reactivated by immunocompromised states or immunosuppressive therapy. We report a case of a 72-year-old man who lived in rural regions of Panama, Honduras, and Nicaragua while serving in the U.S. military from 1987 to 1991. Three decades after his initial exposure, the patient presented for evaluation of a painful tongue ulcer that originated when he began taking adalimumab to manage his psoriatic arthritis 2 years earlier. Tissue scraping of the tongue ulcer grew a whitish to cream-colored, fluffy-textured mold that was morphologically identified as Histoplasma. Molecular analysis of the fungus confirmed H. capsulatum var. Latin American group A, known as Histoplasma suramericanum. Further testing showed a positive H. capsulatum antibody mycelial complement fixation, and a 1-cm calcified nodule in the lower lobe of the left lung on computed tomography. Here, we highlight the importance of recognizing disseminated histoplasmosis in patients with exposure to endemic regions before initiating immunosuppressive therapy.
{"title":"Case Report: Disseminated Histoplasmosis of the Tongue Presenting Decades after Exposure in Latin America.","authors":"Nazareth Jaramillo Correa,Arunima Vijay,John W Merriman,Rochelle G Hardie,Norman L Beatty","doi":"10.4269/ajtmh.23-0718","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0718","url":null,"abstract":"Histoplasma capsulatum is a thermally dimorphic fungal pathogen endemic to the Mississippi and Ohio River Valley regions of North America and much of Central and South America. As an opportunistic pathogen, H. capsulatum can assume a latent infection that can be reactivated by immunocompromised states or immunosuppressive therapy. We report a case of a 72-year-old man who lived in rural regions of Panama, Honduras, and Nicaragua while serving in the U.S. military from 1987 to 1991. Three decades after his initial exposure, the patient presented for evaluation of a painful tongue ulcer that originated when he began taking adalimumab to manage his psoriatic arthritis 2 years earlier. Tissue scraping of the tongue ulcer grew a whitish to cream-colored, fluffy-textured mold that was morphologically identified as Histoplasma. Molecular analysis of the fungus confirmed H. capsulatum var. Latin American group A, known as Histoplasma suramericanum. Further testing showed a positive H. capsulatum antibody mycelial complement fixation, and a 1-cm calcified nodule in the lower lobe of the left lung on computed tomography. Here, we highlight the importance of recognizing disseminated histoplasmosis in patients with exposure to endemic regions before initiating immunosuppressive therapy.","PeriodicalId":520106,"journal":{"name":"The American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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