BMC Infectious Diseases最新文献

The co-infection of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) remains a significant public health challenge both in Thailand and globally. This dual burden exacerbates disease severity, complicates treatment strategies, and increases mortality rates. In this study, we developed a mathematical model of TB-HIV co-infection to examine the dynamics of TB prevalence, HIV prevalence, co-infection prevalence and combined (aggregated) disease burden across Thailand. The model was calibrated using real-world incidence data of TB-HIV co-infection in the country. The global sensitivity analysis revealed that the transmission rates of TB and HIV had the most significant influence on the basic reproduction numbers, [Formula: see text]​ and [Formula: see text]​, highlighting critical targets for intervention. The model was further used to evaluate the potential impact of various intervention strategies on reducing the prevalence of TB, HIV, co-infection, and combined disease burden over the period 2022-2039. We found that increasing treatment coverage for TB patients reduces TB prevalence, while HIV prevalence and TB-HIV co-infection prevalence increase over time due to the prolonging the survival of HIV-positive individuals and improving case detection. Additionally, treating individuals co-infected with TB and HIV significantly lowers the prevalence of co-infections. Our findings further suggest that reducing the progression rates of both TB and HIV leads to more substantial and sustained reductions in TB prevalence, HIV prevalence, and TB-HIV co-infection prevalence in Thailand. Our findings also indicate that higher HIV acquisition among TB patients amplifies the burden of co-infection, whereas increased TB acquisition among HIV patients accelerates its progression. Therefore, targeting the dual burden of TB and HIV is essential for lower the prevalence of both diseases, protect vulnerable populations, and ultimately work towards eliminating the diseases as a public health threat.

Background: Ixodes ricinus is the most abundant tick species in Europe and a primary vector for multiple pathogens affecting human and animal health. Over the past 70 years in Europe, including Italy, the geographical distribution of I. ricinus has expanded, increasing the opportunities for tick-human interactions. This observational retrospective study evaluates tick-borne disease (TBD) diagnostic activities conducted from 2015 to 2022 in northeastern Italian hospitals, focusing on areas with significant I. ricinus presence.

Methods: Data from over 49,000 human samples that underwent serological screening for Lyme borreliosis (LB), rickettsiosis, anaplasmosis, babesiosis, and tick-borne encephalitis (TBE) were extracted from the information systems of the 4 participating hospitals.

Results: Over 52,000 individual serological tests on this population with suspected TBD were performed, primarily for LB (78.4%) and TBE (16.7%), with positivity rates of 14.8% and 21%, respectively, showing significant increasing trend between 2015 and 2022. Male patients predominated (51% for LB and 61% for TBE), especially for IgG positivity, with the 60-69 (LB) and 40-49 (TBE) age groups most affected. Rickettsiosis testing revealed 11.5% positivity with a stable trend, affecting both genders equally, predominately in the 30-39 age group. Anaplasmosis diagnostics (248 tests) showed a maximum positivity rate of ~ 9%, while limited babesiosis testing (64 tests) indicated up to 50% positivity in recent years.

Conclusions: The findings underscore the need for enhanced diagnostic tests, vigilant surveillance, and ongoing public education on TBD risks as crucial strategies to mitigate infection risk and reduce the public health impact of TBDs in the northeastern of Italy.

Clinical trial number: Not applicable.