International Journal of Infectious Diseases最新文献

{"title":"Occurrence of macrolides resistance in Legionella pneumophila ST188: Results of the Belgian epidemiology and resistome investigation of clinical isolates","authors":"Charlotte Michel ,&nbsp;Fedoua Echahidi ,&nbsp;Geraldine De Muylder ,&nbsp;Max Sewell ,&nbsp;Ian Boostrom ,&nbsp;Olivier Denis ,&nbsp;Owen B. Spiller ,&nbsp;Denis Pierard","doi":"10.1016/j.ijid.2025.107786","DOIUrl":"10.1016/j.ijid.2025.107786","url":null,"abstract":"<div><h3>Objectives</h3><div>The incidence of Legionnaires’ disease steadily increases worldwide. Although <em>Legionella pneumophila</em> is known as pathogenic, systematic investigations into antibiotic resistance are scarce, and reports of resistance in isolates are recently emerging.</div></div><div><h3>Methods</h3><div>Clinical cases and metadata reported to the Belgian National Reference Centre between 2011 and 2022 were retrospectively analyzed. A total of 283 clinical isolates were typed by core genome multi-locus sequence typing (cgMLST). Acquired genes or mutations triggering resistance were extracted from all of them.</div></div><div><h3>Results</h3><div>The number of Legionnaires’ disease cases has increased in Belgium. Urinary antigen testing remains the main used test, but polymerase chain reaction and serology allow the diagnostic in 14.8% and 2.4% of cases, respectively. cgMLST showed a good discrimination between sequence typing (ST) and minimal variation for ST47 isolates, whereas ST1s were more diverse. Genotypic screening identified a 23S ribosomal RNA mutation linked to a high-level macrolide resistance in one isolate of ST188, which is genetically closed to resistant isolates from France.</div></div><div><h3>Conclusion</h3><div>The increase in incidence is of concern and likely an under-estimate due to the reliance on urine antigen testing. Routine typing by cgMLST allows good discrimination and the first clinical isolate reported as resistant for macrolides was cultured, underscoring the need to define resistance breakpoints and incorporate antimicrobial susceptibility testing as routine clinical investigation practice.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107786"},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphatic filariasis transmission 10 years after stopping mass drug administration in the Gomoa west district of Ghana.","authors":"Christian Akuamoah Boateng, Millicent Selassie Afatodzie, Angus McLure, Bethel Kwansa-Bentum, Dziedzom K de Souza","doi":"10.1016/j.ijid.2025.107790","DOIUrl":"10.1016/j.ijid.2025.107790","url":null,"abstract":"<p><strong>Objectives: </strong>A survey was conducted 10 years after stopping MDA in the Gomoa West District of Ghana to assess the Wuchereria bancrofti prevalence in both human and mosquito populations.</p><p><strong>Methods: </strong>In seven communities, infection in humans was assessed using the filariasis test strip (FTS). Mosquitoes were collected once a month over six months using pyrethrum spray catches (PSC). The mosquitoes were analyzed for W. bancrofti infections, using dissection followed by poolscreening PCR.</p><p><strong>Results: </strong>FTS results showed that 2/524 (0.38%; 95% CI, 0.0%-0.9%) individuals tested positive for antigen. Dissections revealed W. bancrofti infections in 5/107 Anopheles gambiae (4.7%: 95% CI, 2.2-8.5) from one community, with three mosquitoes harboring L3 larvae (2.8%: 95% CI, 0.9-7.5). PCR analysis of 683 mosquitoes in 57 pools revealed seven positive pools from two communities. The prevalence of infected mosquitoes by PCR for the district was 3.1% (95% CI, 0.5-24.0) for An. gambiae and 2.5% (95% CI, 0.4-23.5) for all Anopheles spp.</p><p><strong>Conclusions: </strong>The infection rate in the Anopheles spp. exceeds the provisional 1% threshold suggested by WHO, indicating ongoing transmission risk ten years after stopping MDA. Further district-wide assessments are recommended to inform the scope of any interventions required in the Gomoa West district.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"107790"},"PeriodicalIF":4.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining influenza epidemiology in the post–COVID-19 era: the need for complementary approaches","authors":"Marco Del Riccio ,&nbsp;Saverio Caini","doi":"10.1016/j.ijid.2025.107787","DOIUrl":"10.1016/j.ijid.2025.107787","url":null,"abstract":"","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107787"},"PeriodicalIF":4.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the last mile: The critical role of local civil society in advancing equity and inclusion for neglected tropical diseases.","authors":"Kelly Zongo, Martha Mberu, Liya Assefa, Terrill Kucera, Sara Pappa, Abdinasir Amin, Girija Sankar","doi":"10.1016/j.ijid.2025.107789","DOIUrl":"10.1016/j.ijid.2025.107789","url":null,"abstract":"<p><p>Neglected tropical diseases (NTDs) disproportionately affect vulnerable populations, exacerbating existing inequities in health, gender, and socioeconomic status. Civil society organizations (CSOs) play a vital but often undervalued role in addressing these inequities by engaging with communities and fostering accountability of NTD programs and governments while ensuring transparency in their own operations and responsiveness to community needs. Drawing lessons from the HIV/AIDS and leprosy responses, this paper argues that CSOs are indispensable for sustainable and inclusive NTD programming. By positioning CSOs as champions of equity and community-centered approaches, the NTD community can ensure that interventions address the structural drivers of inequity and promote lasting change.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"107789"},"PeriodicalIF":4.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clostridioides difficile infection and recurrence in cancer patients (CIRCA): A multicentre, international study","authors":"Pedro Puerta-Alcalde ,&nbsp;Jessica O'Keefe ,&nbsp;Rachel Woolstencroft ,&nbsp;Shipraa Kaul ,&nbsp;Néstor López ,&nbsp;Katie Cronin ,&nbsp;Andrew Lim ,&nbsp;Nicole Garcia-Pouton ,&nbsp;Míriam Álvarez ,&nbsp;Lynette Chee ,&nbsp;Mateu Espasa ,&nbsp;Ignacio Grafia ,&nbsp;Maria Suárez-Lledó ,&nbsp;Olivia Smibert ,&nbsp;Carolina Garcia-Vidal ,&nbsp;Monica A. Slavin ,&nbsp;Michelle K. Yong ,&nbsp;Alex Soriano ,&nbsp;Leon J. Worth","doi":"10.1016/j.ijid.2025.107785","DOIUrl":"10.1016/j.ijid.2025.107785","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe the characteristics of <em>Clostridioides difficile</em> infection (CDI) in cancer patients, analysing risk factors for 90-day recurrence and attributable mortality.</div></div><div><h3>Methods</h3><div>Retrospective analysis on all CDI episodes from 2020 to 2022 in three Australian hospitals and one Spanish hospital. Logistic regression analyses were performed.</div></div><div><h3>Results</h3><div>A total of 547 CDI episodes in cancer patients were documented. Treatment predominantly involved vancomycin (81.5%), followed by metronidazole (15.0%) and fidaxomicin (9.1%). Combined antibiotics were used in 61 (11.2%) episodes. The 90-day recurrence rate was 15.6%. Independent risk factors for CDI recurrence were female sex (OR 2.26, 95% CI 1.13-4.52), age &gt;75 years (OR 2.69, 95% CI 1.30-5.59), dialysis (OR 5.15, 95% CI 1.45-18.27), vomiting at presentation (OR 0.06, 95% CI 0.01-0.55), colonic wall thickening in the CT abdomen (OR 2.42, 95% CI 1.06-5.49) and vancomycin therapy (OR 4.60, 95% CI 1.34-15.84). Overall, 90-day mortality was 22.3%, but attributable mortality was 4.9%. Risk factors for mortality attributed to CDI were age &gt;65 years (OR 15.91, 95% CI 2.64-95.80), previous cerebrovascular disease (OR 20.27, 95% CI 3.12-131.84), antibiotic therapy within the last 30 days (OR 0.17, 95% CI 0.05-0.54), high-output diarrhoea (OR 6.68, 95% CI 1.68-26.56), high CRP-levels (OR 11.60, 95% CI 1.90-70.81) and need for treatment change (OR 6.65, 95% CI 2.20-20.08).</div></div><div><h3>Conclusions</h3><div>CDI recurrence rates among cancer patients remain significant. Nonetheless, fidaxomicin and other preventive strategies are seldom used. We identified several factors that could inform the implementation of these strategies in cancer patients.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107785"},"PeriodicalIF":4.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and preventive role of vaccination in adult tetanus fatality: a systematic review of reported cases (1990-2024) and meta-analysis","authors":"Selin Kolsuz ,&nbsp;Deniz Güllü ,&nbsp;Koçer Dilan Karahan ,&nbsp;Önder Ergönül","doi":"10.1016/j.ijid.2025.107781","DOIUrl":"10.1016/j.ijid.2025.107781","url":null,"abstract":"<div><h3>Objectives</h3><div>This study identifies key risk factors for fatality among adult tetanus patients, assesses the impact of vaccination status and antibody levels on disease severity and outcomes in tetanus cases. Despite widespread vaccination, fatality rates remain high due to diagnostic and management challenges.</div></div><div><h3>Design/Methods</h3><div>A meta-analysis of 182 tetanus cases from 36 countries, published since 1990, was conducted. The analysis focused on risk factors such as autonomic dysfunction, opisthotonus, incubation time, diabetes mellitus, cardiovascular diseases, and dermatological conditions.</div></div><div><h3>Results</h3><div>Key risk factors for fatality included autonomic dysfunction, opisthotonus, shorter incubation periods, diabetes mellitus, cardiovascular diseases, and ulcers and dermatological conditions. Interestingly, fatalities occurred in patients with antibody levels above the proposed protective threshold, showing that serological evidence of immunity is not absolute. Importantly, patients with a complete vaccination history experienced less severe disease, and no fatalities were observed among those who had received a full course of childhood vaccinations.</div></div><div><h3>Conclusions</h3><div>The findings highlight the importance of maintaining up-to-date vaccination schedules to reduce the severity of disease and improve outcomes in tetanus cases. The results suggest that while immunity may not always prevent infection, prior vaccination significantly mitigates disease severity. Given that immunity may not be entirely protective and up-to-date vaccinations seem to improve the outcomes, prompt diagnosis and effective booster vaccinations are crucial to further reduce mortality in tetanus patients.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107781"},"PeriodicalIF":4.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination strategies for Ebola in the democratic republic of Congo: the who-Ebola modeling collaboration","authors":"Marco Ajelli ,&nbsp;Jean-Jacques Muyembe ,&nbsp;Alhassane Touré ,&nbsp;Abdourahamane Diallo ,&nbsp;Maria Litvinova ,&nbsp;Stefano Merler ,&nbsp;Sabué Mulangu ,&nbsp;Aminata Bagayoko ,&nbsp;Aissatou Bah ,&nbsp;Ibrahima Bah ,&nbsp;Aissatou Barry ,&nbsp;Fatoumata Barry ,&nbsp;Mohamed Chérif ,&nbsp;Doussou Condé ,&nbsp;Alpha A. Diallo ,&nbsp;Fatoumata Diallo ,&nbsp;Mory Diakité ,&nbsp;Kassié Doré ,&nbsp;Koundouno A. Mapan ,&nbsp;Thérèse Koundouno ,&nbsp;Ira M. Longini Jr.","doi":"10.1016/j.ijid.2025.107779","DOIUrl":"10.1016/j.ijid.2025.107779","url":null,"abstract":"<div><h3>Objectives</h3><div>Assess the effectiveness of ring vaccination in controlling an Ebola virus outbreak in the Democratic Republic of Congo.</div></div><div><h3>Methods</h3><div>This analysis focuses on two areas of the Democratic Republic of Congo, Beni and Butembo/Katwa, which were affected during the 2018-2020 Ebola outbreak. To simulate Ebola virus transmission, we used a spatially explicit agent-based model with households, health care facilities, and Ebola treatment units. Model parameters were calibrated using data collected under the ring-vaccination expanded-access protocol implemented during the outbreak. The model was used to estimate the impact of the deployed ring vaccination strategy, compared to what would have happened if there had been no ring vaccination. The impact of alternative vaccination strategies (mass vaccination, targeted geographic vaccination, and ring-plus) was evaluated as well.</div></div><div><h3>Results</h3><div>Compared to a hypothetical scenario where vaccination was not implemented, ring vaccination was estimated to have averted 54.3% (SD, 32.5%) and 62.7% (SD, 23.2%) of potential cases in Beni and Butembo/Katwa, respectively. Under ring vaccination, the average number of averted cases per 1000 vaccine doses administered was 15.1 (SD, 16.8) and 27.8 (SD, 22.9), in Beni and Butembo/Katwa, respectively. In terms of number of averted cases per vaccine dose, ring vaccination was estimated to be more efficient than any of the other evaluated vaccination strategies.</div></div><div><h3>Conclusion</h3><div>Despite some level of social instability, ring vaccination with the rVSV-ZEBOV vaccine was highly effective during the 2018-2020 Ebola outbreak in the Democratic Republic of Congo. As compared to alternative vaccination strategies, ring vaccination was estimated to be the most efficient.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107779"},"PeriodicalIF":4.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of invasive Streptococcus dysgalactiae subsp. equisimilis in Spain (2012-2022): genomic insights and clinical correlations","authors":"Guillem López de Egea ,&nbsp;Aida González-Díaz ,&nbsp;Randall J Olsen ,&nbsp;Gérard Guédon ,&nbsp;Dàmaris Berbel ,&nbsp;Immaculada Grau ,&nbsp;Jordi Càmara ,&nbsp;Lucía Saiz-Escobedo ,&nbsp;Sara Calvo-Silveria ,&nbsp;Irene Cadenas-Jiménez ,&nbsp;José María Marimón ,&nbsp;Emilia Cercenado ,&nbsp;Antonio Casabella ,&nbsp;Sara Martí ,&nbsp;M. Ángeles Domínguez ,&nbsp;Nathalie Leblond-Bourget ,&nbsp;James M Musser ,&nbsp;Carmen Ardanuy","doi":"10.1016/j.ijid.2025.107778","DOIUrl":"10.1016/j.ijid.2025.107778","url":null,"abstract":"<div><h3>Objectives</h3><div>An increase in <em>Streptococcus dysgalactiae</em> subsp. <em>equisimilis</em> (SDSE) infections has been documented worldwide. This study aims to analyze invasive disease caused by SDSE (iSDSE) in adults over an 11-year period in Spain.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, laboratory-based study of iSDSE detected at Hospital Universitari de Bellvitge (HUB) from 2012 to 2022 (n = 89) and isolates collected in three Spanish hospitals in 2018 (n = 22). Clinical data from HUB were collected. Isolates were tested for antimicrobial susceptibility (European Committee on Antimicrobial Susceptibility Testing 2023), subjected to whole genome sequencing and analyzed for mobile genetic elements (MGEs). A mouse model was used to analyze virulence.</div></div><div><h3>Results</h3><div>iSDSE episodes at HUB occurred predominantly in older patients with comorbidities (particularly, diabetes, chronic heart disease, and malignancies). Whole genome sequencing revealed a high genetic diversity, with the most common lineages being CC15, CC17, and CC20. Various virulence factors, including the superantigen <em>spe</em>G, were identified. Macrolides, lincosamides, and tetracyclines exhibited the highest resistance rates (&gt;27%) and changed over time, linked to multiple MGEs. The mouse model highlighted the virulence of the CC20-stG62647 lineage, but these results were discordant with clinical data.</div></div><div><h3>Conclusion</h3><div>iSDSE incidence is increasing and associated with older patients with comorbidities. Genetically, SDSE is diverse with a high capacity to integrate MGEs carrying resistance determinants. Mouse model studies showed the enhanced virulence of the CC20-stG62647 lineage. These findings underscore the need for ongoing surveillance of this emerging pathogen.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107778"},"PeriodicalIF":4.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between congenital Zika syndrome and hospitalizations during early childhood: a nationwide cohort study","authors":"João Guilherme G. Tedde ,&nbsp;Thiago Cerqueira Silva ,&nbsp;Laura Rodrigues ,&nbsp;Maria da Conceição Costa ,&nbsp;Luciana Cardim ,&nbsp;Elizabeth B. Brickley ,&nbsp;Maria Gloria Teixeira ,&nbsp;Mauricio L. Barreto ,&nbsp;Enny S. Paixão","doi":"10.1016/j.ijid.2025.107780","DOIUrl":"10.1016/j.ijid.2025.107780","url":null,"abstract":"<div><h3>Objectives</h3><div>Congenital Zika Syndrome (CZS) has been linked to a wide spectrum of abnormalities. However, differences in hospitalization patterns between children with and without CZS have not yet been investigated.</div></div><div><h3>Methods</h3><div>We compared rates of hospital admissions for all and specific diseases, proportions of admission causes, and total length of hospital stay (LOS) between children with CZS and those without the syndrome. Adjusted incidence rate ratios (aIRR) and aLOS were estimated using negative binomial regression.</div></div><div><h3>Results</h3><div>Compared to those without CZS, the aIRR for all-cause hospitalizations in the CZS group ranged from 3.77 (95%CI: 3.47-4.06) in the neonatal period to 7.76 (95%CI: 6.91-8.61) at ages 2-4 years. Similar trends were observed for specific causes of admissions. Most admissions in the CZS group related to congenital malformations, neurological, respiratory and infectious diseases. aLOS ranged from 16.0 days [95%CI: 13.2-19.5] to 19.9 days among CZS patients and 6.0 days [95%CI: 5.9-6.2] to 9.3 days [95%CI: 9.3-9.4] for patients without the syndrome.</div></div><div><h3>Conclusion</h3><div>Children born with CZS face significantly higher rates of hospitalization and longer stays compared to those without the syndrome during early childhood.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107780"},"PeriodicalIF":4.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial mapping of drug-resistant tuberculosis prevalence in Africa at national and sub-national levels","authors":"Alemneh Mekuriaw Liyew ,&nbsp;Archie C.A. Clements ,&nbsp;Fasil Wagnew ,&nbsp;Beth Gilmour ,&nbsp;Kefyalew Addis Alene","doi":"10.1016/j.ijid.2025.107777","DOIUrl":"10.1016/j.ijid.2025.107777","url":null,"abstract":"<div><h3>Objectives</h3><div>To map subnational and local prevalence of drug-resistant tuberculosis (DR-TB) across Africa.</div></div><div><h3>Methods</h3><div>We assembled a geolocated dataset from 173 sources across 31 African countries, comprising drug susceptibility test results and covariate data from publicly available databases. We used Bayesian model-based geostatistical framework with multivariate Bayesian logistic regression model to estimate DR-TB prevalence at lower administrative levels.</div></div><div><h3>Results</h3><div>We estimated 148,239 DR-TB cases (95% uncertainty interval: 17,499-313,683) in Africa, showing significant variation by country. Eswatini and South Africa had highest case numbers, while Algeria and Egypt had the lowest. The highest DR-TB prevalence was estimated in Eswatini (53.26; 95% uncertainty interval 13.13-66.12), Morocco, Tunisia, and South Africa, while the lowest prevalence was found in Gabon, the Republic of Congo, Sierra Leone, and Mali. Marked subnational variation in DR-TB prevalence was noted, where 91 subnational areas across 12 countries had prevalence rates higher than their respective national averages. Factors such as mean temperature (<em>β</em> = 2.01; 95% CrI: 1.21, 3.42), population density (<em>β</em> = 0.41; 95% CrI: 0.19, 0.95), and fine particulate matter (<em>β</em> = 0.66; 95% CrI: 0.20, 0.80) were positively associated with DR-TB prevalence.</div></div><div><h3>Conclusion</h3><div>The study highlights substantial national and subnational variability in DR-TB prevalence across Africa, aiding policymakers in designing localized TB control interventions.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"153 ","pages":"Article 107777"},"PeriodicalIF":4.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}