Infectious Disease Reports最新文献

{"title":"Re-Emergence of the Great Mimicker: Congenital Syphilis in a Low Prevalence Setting.","authors":"Rabab AlGhaithi, Shawg AlSalamah","doi":"10.3390/idr18050107","DOIUrl":"10.3390/idr18050107","url":null,"abstract":"<p><strong>Background: </strong>Congenital syphilis remains a significant cause of adverse birth outcomes despite effective screening and treatment. Data on its epidemiology in Saudi Arabia are limited. This study aims to describe the incidence, clinical characteristics, and outcomes of congenital syphilis at a tertiary pediatric center in Riyadh, Saudi Arabia, and to identify gaps in antenatal care and prevention.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of all infants diagnosed with congenital syphilis (aged 0-24 months) and pregnant women with positive syphilis serology who presented to our center between January 2021 and December 2025. Cases were classified as highly probable, possible, less likely, or unlikely based on Center for Disease Control (CDC) and European criteria. Incidence rates were calculated per 1000 live births.</p><p><strong>Results: </strong>Over the five-year study period, there were 11,722 live births and 12 cases of probable or possible congenital syphilis, yielding an incidence rate of 1 per 1000 live births. An additional two cases were classified as less likely due to successful prevention of mother-to-child transmission. The majority of cases (<i>n</i> = 7) were attributed to inadequate maternal treatment. Three cases of abortion and intrauterine fetal demise were identified, probably due to untreated maternal syphilis. Most infants were asymptomatic at birth; however, one patient presented with hepatosplenomegaly, cytopenia, and cholestasis, while two had abnormal long bone findings. No cases of neurosyphilis were identified. Five infants were born to mothers with suspected false-positive serology but were managed as possible cases due to incomplete follow-up. Favorable neurodevelopmental outcomes were observed in all patients who completed follow-up (<i>n</i> = 5).</p><p><strong>Conclusions: </strong>We report congenital syphilis incidence rates that align with the global upward trend. We also identified multiple missed opportunities for screening and early treatment-findings that can inform future guidelines and enhance awareness among healthcare providers and the public.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virologic, Lipid, Renal and Hepatic Laboratory Outcomes After Switching to Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate in Treatment-Experienced People with HIV: Real-World Evidence from the SHINe-SHIC Cohort.","authors":"Manuela Ceccarelli, Emmanuele Venanzi Rullo, Andrea Marino, Andrea De Vito, Cristina Micali, Serena Spampinato, Ylenia Russotto, Antonio Albanese, Maria Chiara Frasca, Sonia Agata Sofia, Giovanni Francesco Pellicanò, Benedetto Maurizio Celesia, Paolo Maggi, Giordano Madeddu, Giuseppe Nunnari","doi":"10.3390/idr18050105","DOIUrl":"10.3390/idr18050105","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) is used as a switch regimen in treatment-experienced people with HIV (PWH), particularly when simplification, lipid improvement, or avoidance of interaction-prone regimens is needed. We evaluated 48-week virologic effectiveness and laboratory changes after switching to DOR/3TC/TDF in routine care. <b>Methods</b>: This multicenter retrospective study included adults with HIV who switched to fixed-dose DOR/3TC/TDF at seven Italian HIV centers within the Sardinian HIV Network-Sicilian HIV Cohort (SHINe-SHIC) network. The switch visit served as baseline; follow-up data were extracted at 24 and 48 weeks. The primary endpoint was HIV RNA < 50 copies/mL at 48 weeks in an observed analysis. Secondary endpoints were changes in lipid and lipid-derived parameters, renal function, and hepatic laboratory markers. <b>Results</b>: Ninety-eight participants were included; 75 (76.5%) were male, and the median age was 52.4 years. At 48 weeks, 72/81 participants (88.9%) had HIV RNA < 50 copies/mL and 78/81 (96.3%) had HIV RNA < 200 copies/mL. Total cholesterol decreased from 199 to 165 mg/dL (median paired change, -22 mg/dL; <i>p</i> < 0.001), low-density lipoprotein cholesterol from 118 to 106.5 mg/dL (-13.5 mg/dL; <i>p</i> = 0.001), and triglycerides from 112.5 to 94 mg/dL (-10.5 mg/dL; <i>p</i> = 0.021). Non-high-density lipoprotein cholesterol and the total cholesterol/high-density lipoprotein cholesterol ratio improved, whereas high-density lipoprotein cholesterol decreased modestly. Serum creatinine and estimated glomerular filtration rate remained stable. Alanine aminotransferase increased modestly; aspartate aminotransferase and gamma-glutamyl transferase did not significantly change. <b>Conclusions</b>: Switching to DOR/3TC/TDF maintained virologic control, improved lipid and lipid-derived parameters, and was not associated with renal function decline among participants with follow-up data. In selected treatment-experienced PWH, DOR/3TC/TDF may be useful when lipid improvement, simplification, or management of drug-drug interaction concerns are treatment goals.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dating Applications as HIV Prevention Ecosystems in the Era of Digital Sexual Networks.","authors":"Francesco De Maria, Paolo Fusco, Alessandro Russo","doi":"10.3390/idr18050106","DOIUrl":"10.3390/idr18050106","url":null,"abstract":"<p><p>Dating applications have become central components of contemporary sexual networks, yet HIV prevention remains largely organised outside these digital environments. We propose that dating applications should be conceptualised as potential HIV and sexual health prevention ecosystems, connecting testing, PrEP and PEP navigation, STI services, vaccination, telemedicine, partner notification, behavioural support, and artificial intelligence-enabled health navigation. Existing evidence supports the effectiveness of many of these digital interventions individually, while emerging integrated models suggest opportunities to connect digital engagement with real-world care pathways. Artificial intelligence may provide an additional navigation layer capable of improving personalisation and continuity across prevention services. However, implementation will require careful attention to privacy, governance, equity, healthcare accessibility, and differences across health systems. Rather than replacing existing healthcare services, digital prevention ecosystems could complement them by bringing prevention closer to the environments where sexual interactions increasingly originate.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Reactive Rapid Test Results for Sexually Transmitted Infections and Associated Factors Among Transgender People Attending Specialized Health Services in Brazil.","authors":"Talia Gomes Luz, Lariane Angel Cepas, Isadora Silva de Carvalho, Alvaro Francisco Lopes de Sousa, Talita Morais Fernandes, Camila Marcheto de Sousa, Lorena Marcheto de Sousa, Ruan Nilton Rodrigues Melo, Lucas Brandão Dos Santos, Mayara Souza Gomes, Lucia Alves da Silva Lara, Ariadne Ribeiro, Fatima Morales, Inês Fronteira, Ana Paula Morais Fernandes","doi":"10.3390/idr18050104","DOIUrl":"10.3390/idr18050104","url":null,"abstract":"<p><strong>Background/objectives: </strong>Transgender (trans) individuals experience a disproportionate burden of HIV and other sexually transmitted infections (STIs), although evidence based on point-of-care testing remains limited in Brazil. This study aimed to estimate the prevalence of reactive STI rapid test results and associated factors among transgender individuals receiving care in specialized health services in São Paulo, Brazil.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between July and December 2025 with 400 participants attending two specialized healthcare services. Sociodemographic, behavioral, substance use, clinical, and HIV prevention-related data were collected. The primary outcome was reactivity to at least one rapid test for HIV, syphilis, hepatitis B, or hepatitis C; reactive results could include previously known infections and therefore were not interpreted as newly diagnosed or active infections. Associations were estimated using Poisson regression with robust variance.</p><p><strong>Results: </strong>Overall, 19.2% of participants had at least one reactive rapid test result, with HIV accounting for the largest proportion of reactive results (14.8%). In the adjusted model, increasing age was associated with a higher prevalence of the outcome (PR = 1.04; 95% CI: 1.02-1.05), whereas transgender men had a lower prevalence than transgender women (PR = 0.38; 95% CI: 0.19-0.73). Reported HIV prevention through PrEP and/or PEP was inversely associated with the outcome (PR = 0.37; 95% CI: 0.17-0.82); however, this association should not be interpreted as a direct protective effect because most reactive HIV results occurred among participants with previously known HIV, who would not be eligible for PrEP.</p><p><strong>Conclusions: </strong>These findings indicate a substantial frequency of reactive STI rapid test results among transgender individuals attending specialized health services and support continued access to testing, prevention, and culturally competent sexual healthcare.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Basidiobolomycosis with Biliary Tract Involvement in the Early Postpartum Period: A Case Report and Literature Review.","authors":"Abdullah Mohammed Alshehri, Abdulaziz Hassan Alamri, Khaled Abdulwahab Amer, Anas Khalid Alqarni","doi":"10.3390/idr18050102","DOIUrl":"10.3390/idr18050102","url":null,"abstract":"<p><p><b>Introduction:</b> Gastrointestinal basidiobolomycosis is an uncommon invasive fungal infection caused by <i>Basidiobolus ranarum</i>, an environmental mould endemic to the arid south-west of Saudi Arabia and to a handful of other hot, dry regions. Its non-specific presentation routinely invites misdiagnosis as inflammatory bowel disease, tuberculosis or malignancy, and extension to the biliary tree is decidedly rare. <b>Case Presentation:</b> We report a 25-year-old Saudi woman who developed chronic watery diarrhoea and pronounced weight loss two months after her first delivery. Severe microcytic anaemia, leukocytosis, a very high erythrocyte sedimentation rate and multisegmental colonic wall thickening were initially attributed to inflammatory bowel disease complicated by <i>Clostridioides difficile</i> colitis. She subsequently required cholecystectomy for acalculous cholecystitis and then deteriorated, with gastric outlet obstruction and collections at the gallbladder bed. Re-examination of the gallbladder specimen revealed broad, pauci-septate hyphae enveloped by the Splendore-Hoeppli phenomenon, and culture yielded an isolate phenotypically identified as <i>B. ranarum</i>. Voriconazole followed by itraconazole achieved near-complete clinical and radiological recovery. <b>Discussion:</b> We hypothesise that the early puerperium could represent a possible, though as yet unproven, window of susceptibility to this infection. <b>Conclusions:</b> In endemic regions, gastrointestinal basidiobolomycosis should be considered when presumed inflammatory bowel disease behaves atypically; deep tissue sampling is often decisive, and prolonged triazole therapy can achieve an excellent outcome.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and Validation of a New Long-Term Mortality Risk Score in Community-Acquired Pneumonia: A Colombian Cohort.","authors":"Gabriela Guerron-Gomez, Eduardo Tuta-Quintero, Alirio Bastidas, Luis F Giraldo-Cadavid, Maria Pérez-Escobar, Luisa F Martínez, Maria Castillo-Páez, Isabella Criado-Quintero, Manuela Trujillo-Herrera, Angie Sandoval-Blanco, Gabriela Osorio-Betancourt, Laura Medellín-Ortiz, Laura Chaves-Pauwels, Paola Martínez-Sáenz, Luis F Reyes","doi":"10.3390/idr18050103","DOIUrl":"10.3390/idr18050103","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) causes significant long-term morbidity and mortality. Existing clinical scores focus on short-term outcomes, highlighting the need to validate tools that accurately predict 12-month mortality in hospitalized patients.</p><p><strong>Materials and methods: </strong>A retrospective cohort of adults hospitalized with CAP from 2012 to 2020 was analyzed. Clinical, laboratory, radiological, and hospitalization-related data were collected. A Cox proportional hazards model was developed to predict post-acute mortality between 30 days and 12 months after hospital admission among patients with CAP who survived the first 30 days, with the cohort split 50:50. Model performance was evaluated using Area Under the Receiver Operating Characteristic Curve (AUROC) and standard diagnostic accuracy metrics.</p><p><strong>Results: </strong>A total of 13,851 patients with CAP were included. In the derivation cohort, independent predictors were altered mental status (HR 2.08; 95% CI 1.49-2.90; <i>p</i> < 0.05), elevated BUN (>30 mg/dL; HR 1.98; 95% CI 1.48-2.63; <i>p</i> < 0.05), temperature extremes (<35 °C or >39.9 °C; HR 1.98; 95% CI 1.43-2.74; <i>p</i> < 0.05), corticosteroid use (HR 1.85; 95% CI 1.40-2.44; <i>p</i> < 0.05), neoplasia (HR 1.58; 95% CI 1.08-2.32; <i>p</i> < 0.05), and hospital stays longer than 8 days (HR 1.39; 95% CI 1.06-1.82; <i>p</i> < 0.05). The new score achieved the highest AUROC (0.69; 95% CI: 0.66-0.73), followed by PSI (0.65; 95% CI: 0.62-0.69), CURB-65 (0.63; 95% CI: 0.59-0.67), and CAPSI (0.62; 95% CI: 0.58-0.67). The optimal cutoff point for the new score was 3, as determined by the Youden index (0.339). The model sensitivity was 83.0%, specificity: 50.9%, PPV: 8.9%, and NPV: 99.0%. The LR+ was 1.69 (95% CI: 1.38-2.06), and the LR- was 0.33 (95% CI: 0.27-0.41).</p><p><strong>Conclusions: </strong>The new score demonstrated weak-to-moderate discriminatory capacity. The variables included in the new score reflect multiorgan involvement, disease severity, and comorbidity burden, all of which are associated with long-term mortality.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Environmental Surveillance of <i>Aspergillus</i> spp. During Hospital Renovation: Evidence of Potential Fungal Dissemination Through Shared Ceiling Voids.","authors":"Mieko Tokano, Norihito Tarumoto","doi":"10.3390/idr18050101","DOIUrl":"10.3390/idr18050101","url":null,"abstract":"<p><strong>Background: </strong>Hospital construction and renovation are recognized risk factors for healthcare-associated aspergillosis because demolition work can disperse airborne fungal spores into the air. However, environmental dissemination pathways during renovations remain incompletely understood.</p><p><strong>Methods: </strong>We conducted a prospective environmental surveillance study during the renovation of a high-care unit (HCU) at a 1000-bed tertiary care hospital in Japan. Air sampling was performed before, during, and after the renovation at five locations using an air sampler (500 L/sample). Fungal isolates were identified using internal transcribed spacer sequencing. Dust collected from the ceiling void above the HCU before the renovation was also cultured.</p><p><strong>Results: </strong><i>Aspergillus fumigatus</i> was isolated from dust collected from the ceiling void before renovation. During renovation, <i>Aspergillus</i> spp. were detected only in areas sharing the ceiling void with the construction site and on the floor immediately below the renovation area. No <i>Aspergillus</i> spp. were detected in the intensive care unit, which did not share the ceiling void. These findings suggest that demolition-related vibrations may have disturbed dust accumulated within the ceiling voids, suggesting a possible mechanism for localized fungal dissemination. Additionally, to assess the clinical impact of the renovation, the quarterly number of patients with positive <i>Aspergillus</i>-related microbiological or serological findings from 2015 to 2025 was reviewed. No apparent increase in the number of patients with positive <i>Aspergillus</i>-related microbiological or serological findings was observed during the renovation period. Our findings suggest that connected ceiling voids may represent potential pathways for localized fungal dispersal during demolition, while emphasizing that this proposed pathway was not directly confirmed.</p><p><strong>Conclusions: </strong>These findings highlight the importance of environmental surveillance and appropriate infection control measures during hospital renovation.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Field Investigation of the Bundibugyo Ebola Virus Disease (BDBV) Outbreak in Ituri Province, Democratic Republic of the Congo: Challenges, Strategies, and Priority Actions for Outbreak Control-An Outbreak Investigation Review.","authors":"Muambangu Jean Paul Milambo, Christian Ngandu","doi":"10.3390/idr18050100","DOIUrl":"10.3390/idr18050100","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The 2026 outbreak of Bundibugyo Ebola virus disease (BDBV) in eastern Democratic Republic of the Congo (DRC), centered in Ituri Province, represents the largest documented outbreak caused by &lt;i&gt;Bundibugyo ebolavirus&lt;/i&gt; since its discovery in Uganda in 2007. The outbreak evolved within a complex humanitarian setting characterized by armed conflict, population displacement, mining-related migration, weak health systems, extensive population mobility, and an infodemic environment marked by misinformation and reduced public trust. We conducted a field investigation to assess epidemiological, operational, laboratory, infection prevention and control (IPC), community engagement, risk communication, and infodemic management challenges and identify priority interventions to strengthen outbreak control.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A rapid field assessment was conducted between 12-15 June 2026 in Bunia, Rwampara Health Zone, and the Ituri Provincial Public Health Laboratory. Data were collected through direct observation, review of surveillance and laboratory reports, health facility assessments, stakeholder interviews, and analysis of outbreak response indicators. Epidemiological trends, surveillance performance, laboratory capacity, clinical care, IPC activities, logistics, risk communication, community engagement, and infodemic management approaches were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As of 12 July 2026, the outbreak had resulted in 1926 laboratory-confirmed cases and 702 deaths, corresponding to an overall case fatality rate (CFR) of 36.4% across affected provinces. Ituri Province remained the epicenter, accounting for 90.8% of confirmed cases (1705/1877) and 85.5% of reported deaths (577/675). During the preceding 24 h, 53 new confirmed cases and 30 deaths were reported, including 20 community deaths (66.7%), highlighting persistent delays in detection, referral, and access to care. Surveillance systems identified 766 alerts, of which 678 (88.5%) were investigated, resulting in 235 suspected cases. Contact tracing remained a major challenge, with only 64.4% (4171/6475) of registered contacts successfully followed, below the recommended ≥95% target. Laboratory activities included testing of 137 specimens, with 29 positive results and an overall positivity rate of 21.2%. Decentralized molecular diagnostic platforms improved access to testing; however, data inconsistencies, delayed investigations, and gaps in outcome classification affected response monitoring. Major operational challenges included limited treatment capacity, high occupancy of Ebola treatment centres, shortages of trained personnel and IPC supplies, insecurity affecting response teams, and insufficient preparedness in newly affected areas. Community resistance, attacks on burial teams, detention of frontline responders, misinformation, and rumors contributed to delayed care-seeking, reduced acceptance of public health measures, and incompl","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap Between Treatment and Accountability: DR-TB Outcomes and Governance Signals in Rural Eastern Cape, South Africa (2020-2024).","authors":"Kamvelihle Sabisa, Lindiwe Modest Faye, Ntandazo Dlatu, Teke Ruffin Apalata","doi":"10.3390/idr18050099","DOIUrl":"10.3390/idr18050099","url":null,"abstract":"<p><p><b>Background</b>: Monitoring treatment outcomes is central to evaluating drug-resistant tuberculosis (DR-TB) programmes and ensuring accountability, particularly in high-burden settings such as South Africa. However, routine surveillance data are often constrained by small sample sizes and incomplete reporting. The increasing proportion of outcomes classified as \"not evaluated\" raises critical concerns about the validity and interpretability of reported treatment success rates. This study examines longitudinal trends in DR-TB outcomes in two rural Eastern Cape facilities (2020-2024), conceptualising routine outcomes as governance signals reflecting health system performance and data management capacity, rather than clinical performance alone. <b>Methods</b>: A retrospective analysis of aggregated DR-TB treatment outcomes from 2020 to 2024 was conducted using routine programme data. Outcomes included treatment success, failure, loss to follow-up (LTFU), death, and \"not evaluated.\" Proportions were estimated using Wilson 95% confidence intervals, and year-to-year differences were assessed using chi-square tests, with cautious interpretation due to small sample sizes. Bounding analyses were applied to assess the sensitivity of treatment success estimates to alternative assumptions about incomplete outcome reporting. <b>Results</b>: Treatment success declined over time for both rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB), with a significant decrease observed in MDR-TB (80.9% in 2021 to 38.5% in 2024; <i>p</i> = 0.007). Concurrently, the proportion of outcomes classified as \"not evaluated\" increased substantially from 2023 onward, reaching 25.8% in RR-TB and 30.8% in MDR-TB by 2024 (<i>p</i> < 0.001). Mortality remained persistently high in RR-TB, while MDR-TB exhibited higher levels of treatment failure and LTFU. Analyses for pre-XDR-TB and XDR-TB were limited by small sample sizes. Bounding analyses demonstrated that treatment success estimates were highly sensitive to incomplete reporting of outcomes. <b>Conclusions</b>: Declining DR-TB treatment success in this setting is closely associated with increasing incomplete outcome reporting, suggesting that observed trends may reflect challenges in surveillance and governance systems rather than clinical deterioration alone. Interpreting routine DR-TB outcomes as governance signals provides a novel systems-based perspective for programme evaluation. Strengthening data completeness, patient tracking, and surveillance systems is essential to improve the reliability of programme indicators and support effective TB control in resource-constrained rural settings.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Infrared Thermography in the Diagnosis and Monitoring of Diabetic Foot Infection: A Systematic Review.","authors":"Carmen Cantarero-Lozano, Aroa Tardáguila-García, Esther García-Morales, Yolanda García-Álvarez, David Navarro-Pérez, José Luis Lázaro-Martínez","doi":"10.3390/idr18050098","DOIUrl":"10.3390/idr18050098","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot infection (DFI) is one of the most frequent diabetes-related complications requiring hospitalisation and is a major contributor to lower-extremity amputation. Infrared thermography has emerged as a non-invasive diagnostic tool capable of detecting temperature changes associated with inflammatory and infectious processes. This systematic review aimed to evaluate the role of thermography in the diagnosis and monitoring of diabetic foot infection.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. Risk of bias and methodological quality were assessed using design-specific validated tools, including QUADAS-2 for diagnostic and detection studies and Joanna Briggs Institute critical appraisal checklists for cohort and case-series studies. Original studies evaluating the use of thermography in patients with diabetic foot infection were included. Two authors independently performed study selection, data extraction, and methodological assessment.</p><p><strong>Results: </strong>Six studies met the inclusion criteria, comprising a total of 552 participants with type 1 or type 2 diabetes mellitus. Four observational studies and two pilot studies were included. Increased local skin temperature was consistently associated with acute diabetic foot complications and infection. Several studies identified a temperature difference of approximately 2.2 °C between contralateral foot regions as a clinically relevant threshold for detecting diabetic foot complications. However, no significant relationship was found between plantar thermal asymmetry and the severity or progression of infected diabetic foot ulcers. All included studies presented a level of evidence of 4 and a grade of recommendation of C.</p><p><strong>Conclusions: </strong>Infrared thermography appears to be a promising adjunctive tool for the early detection of diabetic foot infection. However, current evidence does not support its routine use for monitoring infection severity, treatment response, or prognosis, and further prospective studies are required before these applications can be recommended.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}