American Journal of Tropical Medicine and Hygiene最新文献

Cystic echinococcosis (CE), a zoonotic infection caused by Echinococcus granulosus, primarily affects the liver and lungs. However, cardiac involvement is uncommon. This case report presents an unusual instance of heart involvement in a patient with CE. A 28-year-old man from India presented with a persistent cough and hemoptysis. Imaging revealed bilateral lung lesions along with cystic lesions in his right ventricle. The echinococcal serology result was positive, and a surgical biopsy from the lung demonstrated necrotizing granulomatous inflammation with laminated eosinophilic material, consistent with echinococcosis. This case highlights the possibility of cardiac involvement in CE and the challenges associated with its diagnosis and management.

Rotavirus (RV) is a leading cause of severe gastroenteritis in infants and young children, often resulting in dehydration and hospitalization. Although global data on RV is well-documented, there is limited information on its prevalence and genetic diversity in Bihar, India. This study aimed to investigate the prevalence of RV infections in the patient, from January 2021 to June 2024, and assess the associated molecular and epidemiological patterns. In this retrospective study conducted at the Rajendra Memorial Research Institute of Medical Sciences, Patna, 1,820 stool samples from patients suspected of RV infection were collected. Enzyme immunoassays were used to detect RV antigens, and positive samples were confirmed by real-time polymerase chain reaction targeting the VP4, VP6, and VP7 genes. Phylogenetic analysis was performed to examine genetic diversity. Results showed a 10% positivity rate for RV, with 5% showing equivocal results. The highest prevalence was in the 6-11 years age group (72 positive cases), followed by the 0-5 years group (62 positive cases). Prevalence decreased in older age groups, suggesting immunity through natural infection or vaccination. Phylogenetic analysis revealed distinct regional clusters and genetic variability between strains from Bihar and other parts of India, such as New Delhi and Kolkata. This study provides valuable baseline data on RV prevalence and genetic diversity in Bihar, emphasizing the need for vaccination and surveillance, particularly for younger children at higher risk. The observed genetic diversity suggests regional variations, highlighting the importance of continuous surveillance across India.

Children in low-resource settings often consume microbially contaminated food, risking their health. We evaluated the impact of a food hygiene intervention on complementary food contamination in Bangladesh. A 3-year homestead food production intervention was complemented by an 8-month behavior change module to improve household food hygiene practices and evaluated in a cluster-randomized controlled trial, including a dedicated study measuring outcomes along the hygiene pathway to intestinal health. We used multilevel regression to assess the intervention's impact on microbial food contamination as well as food hygiene knowledge (n = 518) and reported practices (n = 531) among mothers of children 6-23 months of age. Complementary food samples were collected from 342 households with children 6-18 months of age and tested for Escherichia coli. Overall, 46% of food samples were contaminated with E. coli (43% intervention, 51% control), and there was no evidence that the intervention reduced food contamination (odds ratio: 0.65, 95% CI: 0.35-1.21). A higher proportion of intervention mothers could name all key food hygiene practices (23% intervention versus 1% control), had access to a basic handwashing station near the kitchen (24% versus 14%), reported washing hands before food preparation and child feeding (21% versus 8%), reported washing and storing feeding utensils safely (61% versus 49%), and reported preparing food fresh or reheating stored food (88% versus 79%) compared with control mothers. The intervention thus improved knowledge and reported food hygiene practices among mothers, but this improvement did not result in a substantial reduction of complementary food contamination.

Local alcohol-based hand rub (ABHR) production systems in low-resource settings, such as in health care facilities (HCFs) in low- and middle-income countries, frequently reuse containers for storing and dispensing ABHR. Cleaning/disinfection (C/D) of ABHR containers is necessary to safely reuse them and is an integral part of the WHO's guidelines on local ABHR production. However, HCFs may not be aware of the need for C/D; combined with suboptimal implementation, this poses a risk of contamination of ABHR. As part of district-led ABHR production in HCFs in five rural districts in Uganda, we developed a standard operating procedure (SOP) for C/D of reused ABHR containers and provided on-site training for infection prevention and control personnel. Using in-person surveys, we assessed the availability of C/D supplies and equipment and the self-reported C/D practices before and after the training. At baseline, almost all (n = 90/91) HCFs reported reusing ABHR containers; 8% and 12% of HCFs routinely had all of the key C/D materials needed for adequately cleaning and disinfecting containers using chlorine and thermal disinfection methods, respectively. HCFs that reported adequately cleaning containers per the SOP increased from 3% (n = 2) at baseline to 18% (n = 16) after the training, whereas adequate disinfection increased from 0% (n = 0) to 5% (n = 5). All HCFs that performed disinfection reported using chlorine, and none reported using thermal disinfection. Improving access to C/D supplies, providing routine mentorship, and monitoring ABHR container C/D are needed to further improve C/D practices.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease primarily reported in Asia. This review aims to summarize studies on the epidemiological characteristics of SFTS. Literature from PubMed and Scopus was searched up to February 14, 2024. A total of 76 articles were eligible. Infections were reported in China, Japan, South Korea, and several other countries in Asia. The incidence of SFTS has been rising and reported from new areas across Asia. The incidence rate was highest in China, ranging from fewer than 0.1 to 4.2 cases per 100,000 population and reaching up to 127.6 cases per 100,000 population in some areas. Most cases occurred between April and December. Elderly farmers and veterinarians were the most affected group. Key epidemiological factors included direct contact with animals, outdoor work, vegetation near homes, rural or hilly residency, tick bites, and direct contact with blood or saliva from infected animals or humans.

Mucosal leishmaniasis (ML) is a parasitic disease affecting the mucosa of the upper respiratory tract and oral cavity. It is most prevalent in Central and South America, whereas cases in the Old World are relatively rare. Herein, we present the case of an immunocompetent man from Tunisia with a long-delayed diagnosis of ML, characterized by lesions in the nasal mucosa without cutaneous involvement. This report underlines the importance of multidisciplinary care and adherence to follow-up in managing this disease. Clinicians should remain vigilant regarding this parasitosis, its potential complications, and the need for accurate diagnosis and treatment.

Efforts to eliminate schistosomiasis in Africa have advanced, with most countries evaluating the impact of preventive chemotherapy (PC) on disease burden. WHO has recommended eight distinct methodologies for such assessment. We, therefore, investigated the sensitivity of three prominent methodologies-sentinel, cluster, and practical, each varying in site selection, sampling approach, and data interpretation. We conducted a cross-sectional study among 2,093 children across 45 schools in Ese-Odo, Ile-Oluiji, and Irele local government areas (LGAs) of Ondo, Nigeria. Fresh stool and urine samples were processed using Kato-Katz and urine filtration techniques to estimate prevalence, which was compared with 2014 baseline estimates. Findings showed significant prevalence reductions in Ese-Odo from 1.3% (95% CI: 0.5-3.3) at baseline to 0.1% (95% CI: 0.01-0.95) at impact (d = -92.3%, P = 0.03) and in Ile-Oluiji from 58.0% (95% CI: 53.9-62.1) to 1.8% (95% CI: 0.9-3.3; d = -97%, P = 0.00). However, it increased from 3.0% (95% CI: 1.6-5.6) to 5.3% (95% CI: 3.8-7.3) in Irele (d = 66%, P = 0.13). Higher prevalence estimates were observed with the practical method compared with cluster and sentinel across the three LGAs: 0.3% versus 0.1% versus 0.0% in Ese-Odo, 5.8% versus 5.3% versus 5.4% in Irele, and 2.2% versus 1.8% versus 1.5% in Ile-Oluiji (all P >0.05). Sentinel and cluster methodologies suggest stopping PC, whereas the practical method suggests continued PC in Irele. Our findings demonstrate that practical assessment is a sensitive method for refining PC decisions.

Data on the burden of extended-spectrum β-lactamase producing Enterobacterales are limited in Jamaica. This study aims to identify factors associated with the isolation of ceftriaxone-resistant Enterobacterales in patients at a private hospital in Jamaica through a retrospective case-control study comparing patients with and without ceftriaxone-resistant Enterobacterales in 2021. The case subjects had at least one Enterobacterales isolate resistant to ceftriaxone, and the controls had at least one culture, all without cephalosporin resistance, including those without growth. The data extracted included antibiotics received, organism, sex, and age. Older age, male sex, and the isolation of Enterobacter species were independently associated with increased odds of ceftriaxone-resistant Enterobacterales on logistic regression. Age and male sex may be markers for past exposure to β-lactam antibiotics or nosocomial infection with ceftriaxone-resistant Enterobacterales and may have a greater influence on isolation of ceftriaxone-resistant Enterobacterales compared with the receipt of antibiotics in the past six months, with which no association was observed on final analysis.