American Journal of Tropical Medicine and Hygiene最新文献

Adolescents (10-19 years of age) in low-income settings face unique health challenges. This study explores adolescent health concerns and existing efforts to address them in Addis Ababa, Ethiopia. A qualitative study using in-depth interviews with key informants and focus group discussions was conducted with adolescents, parents, school staff, government officials, and nongovernmental organization representatives (n = 36). Data were analyzed thematically using Open Code qualitative software. Our results showed that menstrual hygiene, unintended pregnancy, sexually transmitted infections, and access to sexual and reproductive health information and services were among the most pressing health concerns of adolescents. Addiction, bullying, violence, and trauma are some of the main challenges concerning mental health. Adolescent health concerns are multiple. Multidimensional efforts are necessary to address their concerns.

Soil-transmitted helminths (STHs) predominantly affect resource-poor communities with poor access to water, sanitation, and hygiene (WASH) infrastructure. Understanding the risk factors for STH infections can help inform public health control strategies, including WASH interventions and preventive chemotherapy. In this school-based cross-sectional study, mixed-effects logistic regression was used to examine the associations between WASH and socioeconomic factors and STH infections in Timor-Leste. Two statistical analyses were conducted: the first included individual-level sanitation and hygiene factors, whereas the second also included household-level WASH and socioeconomic factors. In the sanitation and hygiene analysis, "always use household latrine" was associated with lower odds of undifferentiated STH infection (adjusted odds ratio [aOR]: 0.59; 95% CI: 0.37-0.96). "Always wash hands before eating" was associated with lower odds of Trichuris trichiura (T. trichiura) infection (aOR: 0.35; 95% CI: 0.13-0.97), whereas "always have soap to wash hands at home" was associated with higher odds of T. trichiura infection (aOR: 4.22; 95% CI: 1.56-11.43). In the WASH and socioeconomic factors analysis, "usually defecate at household/neighbor's latrine" was associated with lower odds of undifferentiated STH (aOR: 0.13; 95% CI: 0.04-0.43) and Ascaris lumbricoides infections (aOR: 0.19; 95% CI: 0.06-0.64). Additionally, the availability of school handwashing stations was associated with lower odds of T. trichiura infection (aOR: 0.21; 95% CI: 0.05-0.86). The present study indicates that sanitation and hygiene are important risk factors for STH infections, and therefore, efforts to reduce STH infections should also promote sanitation and hygiene infrastructure and practices.

Filter paper blood samples (i.e., dry blood spots [DBSs]) have been widely used for pathogen detection, especially in malaria control and elimination. Dried blood spot-based polymerase chain reaction (PCR) testing has also been increasingly used for diagnosis and gene monitoring. The current method of DNA extraction from DBSs is limited in practical application because of its low efficiency, time-consuming procedure, and high cost. Accordingly, a hemolysis preservation (HP) method was developed and compared with the most commonly used Tween-Chelex method and spin-column method kit (QIAamp DNA Mini) under equivalent conditions by extracting template DNA from the same batch of Plasmodium falciparum density-gradient DBSs. The HP method yielded the highest DNA recovery volume (557.32 ng/µL of blood) and the lowest limit of detection (LOD; equivalent to 0.1 parasites/µL) from DBSs with the minimum blood volume (4-5 µL) using the simplest reagent. Additionally, it had the shortest time (∼50 minutes) and the lowest cost ($0.27 per sample). The LOD of the direct PCR method also reached a value of 0.11 parasites/µL. Therefore, the DBS PCR test conducted using the HP method can detect asymptomatic low-density Plasmodium infection and is a cost-effective option in resource-deficient areas.

Two vaccines against Plasmodium falciparum, RTS,S and R21, have been recommended for widespread implementation by the World Health Organization. Both vaccines displayed safety and efficacy in clinical trials, and early RTS,S pilot implementation results suggested reductions in severe disease and death. However, RTS,S efficacy was lower in higher transmission settings during trials. Between- and within-site analyses suggest that reduced efficacy was partially due to greater natural immunity development in control groups in higher transmission settings, resulting in temporary periods of negative efficacy beginning approximately three years after the primary vaccine series. Results from RTS,S pilot implementation and seasonal administration for both vaccines are promising, but study designs have thus far precluded the identification of similar periods of negative efficacy. Because we expect delayed malaria cases of unknown severity in vaccinated individuals during implementation in high-transmission settings, we recommend enhanced surveillance and interventions that supplement malaria vaccination to strengthen prevention.

Occult hepatitis B infection (OBI) is a significant issue in high-risk groups, including drug users. Therefore, the present study was conducted to assess the prevalence of OBI among drug users in Fars Province in 2024. In this cross-sectional study, 460 hepatitis B surface antigen (HBsAg)-negative individuals with a history of drug addiction were included. A questionnaire was completed for each participant to collect demographic, social, and behavioral information. Hepatitis B core antibody (anti-HBc) was assessed using an ELISA. Total DNA from serum samples that tested positive for anti-HBc was extracted and tested for hepatitis B virus DNA (HBV-DNA) using quantitative polymerase chain reaction (qPCR) testing. Moreover, peripheral blood mononuclear cells (PBMCs) were separated using the Ficoll gradient method, and their DNA was extracted, followed by qPCR testing. The mean age of the participants was 44.1 years (SD = 11.2; range: 13-85 years), whereas the mean age of anti-HBc-positive individuals was 51.2 years (SD = 9.2; range: 24-72 years). Among the participants, 82.6% were male. The frequency of anti-HBc was 15%, and it was significantly associated with age, history of injection drug use, medical service utilization, anti-hepatitis C virus positivity, HIV status, national hepatitis B vaccination time, and city of residence. No significant association was observed among sex, marital status, tattooing, or unsafe sexual practices. A qPCR analysis revealed undetectable HBV-DNA in all 64 serum samples of anti-HBc-positive subjects, whereas 1 out of 14 PBMC samples (7.1%) was positive for HBV-DNA. A 15% prevalence rate for resolved HBV infection was indicated in the present study, with no evidence of OBI in serum samples and a very low frequency of OBI in PBMCs.

The American Committee on Clinical Tropical Medicine and Travelers' Health's Students/Trainees Leadership Group launched its essay contest in 2025 to encourage the involvement of emerging voices in tropical medicine in key issues shaping the field's present and future. The following authors won for their essays addressing the following prompt: "Tropical Medicine in the 21st Century" These essays were reviewed by a panel of clinician judges with experience in tropical medicine and writing, and the winning entries reflect both academic excellence and practical insight. Together, the two winning essays reveal the wide scope of tropical medicine, from policy and prevention to diagnosis and treatment, and the shared responsibility to confront these challenges wherever they arise.

Flea-borne typhus (FBT) is an infection caused by the bacteria Rickettsia typhi. It is usually an acute undifferentiated febrile illness; however, approximately one-quarter of patients suffer from organ-specific complications. In the present report, the case of a 51-year-old woman who originally presented to the clinic with a febrile illness is described. After being given supportive care with intravenous fluids and antiemetics for presumed viral infection, she returned to the emergency department the next day in a hypotensive state and experiencing respiratory distress, requiring emergent intubation in the context of developing severe acute respiratory distress syndrome (ARDS). An initial chest computed tomography scan revealed diffuse ground-glass opacities with interlobular septal thickening. Bronchoalveolar lavage was performed, revealing acellular eosinophilic aggregates consistent with pulmonary alveolar proteinosis (PAP). The clinical context of her serology strongly supported the diagnosis of FBT. This case illustrates the critical care complexities associated with FBT, in addition to a previously undescribed finding, PAP, in rickettsial infections. The patient's rapid progression of life-threatening ARDS and multiorgan dysfunction highlights the need for the timely diagnosis and treatment of FBT.

US Immigration and Customs Enforcement (ICE) detention centers are hot spots for infectious disease spread, as manifested during the COVID-19 pandemic. Mpox cases among ICE detainees during the 2022 global outbreak were investigated and a Freedom of Information Act request for mpox testing data from January to November 2022 was submitted, focusing on demographic and clinical information. Seven detainees across five facilities in Texas, Arizona, and New Jersey were tested. Two detainees tested positive, revealing a 28.6% positivity rate. One detainee received antiviral treatment. Overall, few migrant detainees have been evaluated for mpox. The limited number of mpox tests suggest that additional cases of mpox may have been missed. Adequate resources for mpox testing, treatment, and prevention within detention facilities are critical to limit spread among migrants.