Journal of Tropical Medicine最新文献

{"title":"Malaria Elimination in Suriname, Timor-Leste and Georgia: Strategic Lessons for Sub-Saharan Africa.","authors":"Christian Tague, Aymar Akilimali, Dujardin Makeda, Hermann Yokolo, Joshua Ekouo, Germain Cebweru Murhola, Johan Domga, Josias Silatchom Kamgang, Criss Koba Mjumbe","doi":"10.1155/jotm/2927281","DOIUrl":"10.1155/jotm/2927281","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major cause of morbidity and mortality worldwide, with over 263 million cases and 597,000 deaths estimated in 2023, of which 94% occurred in Sub-Saharan Africa. Despite this heavy burden, several low- and middle-income countries have recently succeeded in eliminating local malaria transmission.</p><p><strong>Objective: </strong>This article describes and synthesises malaria elimination experiences in Suriname, Timor-Leste and Georgia, all three certified malaria-free by the World Health Organization in 2025, to identify strategic lessons and contextual factors that may inform elimination efforts in malaria-endemic countries, including those in Sub-Saharan Africa.</p><p><strong>Methodology: </strong>A structured narrative review was conducted using official reports from WHO, the Global Fund and PAHO; national public health documents; and peer-reviewed articles indexed in PubMed, Scopus and Google Scholar between 2012 and 2025. Search terms included 'malaria elimination,' 'malaria-free certification,' 'Suriname malaria,' 'Timor-Leste malaria' and 'Georgia malaria.' Inclusion criteria required relevance to elimination strategies, publication in English or French and availability in full text. Grey literature from WHO, PAHO and the Global Fund was systematically included.</p><p><strong>Results: </strong>The three countries share several common determinants of success: strong and sustained political commitment, robust epidemiological surveillance systems, active community mobilisation and consistent financial support. Strategies were adapted to context: involvement of indigenous communities and cross-border control in the Amazon basin (Suriname), universal coverage and extensive partner support in a postconflict setting (Timor-Leste) and institutional resilience and postelimination vigilance in a context of political transition (Georgia).</p><p><strong>Conclusion: </strong>These experiences demonstrate that malaria elimination is achievable even in resource-limited or fragile contexts, provided interventions are tailored to the local setting and supported by coherent governance. Key lessons for malaria-endemic countries include strengthening community-based surveillance, cross-border cooperation, community education and securing sustainable financing. The risk of reintroduction remains real, and postelimination vigilance is essential.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"2927281"},"PeriodicalIF":2.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABO Blood Groups and Clinical Outcomes in Crimean-Congo Hemorrhagic Fever: Insights From a Large Turkish Cohort.","authors":"Caner Öksüz, Seyit Ali Büyüktuna, Murtaza Öz, Ertuğrul Keskin, Fatih Çubuk, Yasemin Çakır Kıymaz, Nazif Elaldı","doi":"10.1155/jotm/3461989","DOIUrl":"10.1155/jotm/3461989","url":null,"abstract":"<p><p>Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease in which host-related factors contributing to disease susceptibility and clinical outcomes remain incompletely understood. We aimed to evaluate the impact of ABO and Rh blood groups on susceptibility and prognosis in patients with CCHF and to investigate their relationship with epidemiological characteristics in a large real-world cohort. This retrospective study included 1143 adult patients with PCR-confirmed CCHF who were followed at our center between April 2015 and September 2024. ABO and Rh blood groups were determined using the Hitachi ElecSys 2010 Rack system, and hematological, biochemical, and coagulation parameters were evaluated simultaneously with CCHF PCR testing at hospital admission. Clinical outcomes, viral load, epidemiological characteristics, disease severity according to the Severity Grading Score (SGS), and laboratory findings were compared among blood groups. In addition, multivariable logistic regression analysis was performed to identify independent predictors of in-hospital mortality. Of the 1143 patients, 732 (64.0%) were male and 411 (36.0%) were female; 548 patients had blood group A, 353 group O, 154 group B, and 88 group AB. Overall in-hospital mortality was 8.5% (97/1143). No significant differences were observed among ABO or Rh blood groups regarding in-hospital mortality, intensive care unit (ICU) requirement, viral load, or reported tick exposure. Although no deaths or ICU admissions occurred in the AB Rh-negative subgroup, this subgroup comprised only 13 patients. Significant differences were identified only in amylase and lipase levels among blood groups, whereas SGS, ferritin, interleukin-6, and other laboratory parameters were comparable. In the multivariate analysis, ABO and Rh blood groups were also not independently associated with in-hospital mortality. These findings suggest that ABO and Rh blood groups are not associated with clinically meaningful differences in disease severity or prognosis in patients with CCHF. Further multicenter prospective studies are warranted to validate these findings.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"3461989"},"PeriodicalIF":2.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate-Sensitive Transmission of Human Brucellosis: A Systematic Review of Climatic and Environmental Determinants in the Middle East.","authors":"Aboozar Soltani, Kourosh Azizi, Mohammad Ebrahimi, Marziyeh Hamyali-Ainvand","doi":"10.1155/jotm/8884033","DOIUrl":"10.1155/jotm/8884033","url":null,"abstract":"<p><strong>Background: </strong>Human brucellosis (HB) is a climate-sensitive zoonotic disease whose transmission is influenced by complex interactions among climatic, environmental, livestock, and human behavioral factors. Although the Middle East is a major climate change hotspot and remains highly endemic for HB, evidence regarding climate-brucellosis relationships has not previously been systematically synthesized. This review aimed to evaluate the influence of climatic and environmental determinants on HB across the Middle East.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in the Open Science Framework. PubMed, Embase, Scopus, and Web of Science were systematically searched from database inception to February 9, 2025. Studies examining the association between climatic or environmental factors and HB in Middle Eastern countries were included. Owing to substantial methodological heterogeneity, findings were synthesized using a structured narrative approach.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria. Temperature and precipitation were each investigated in nine studies, whereas humidity was examined in five studies. Temperature demonstrated both positive and negative associations with HB incidence across different climatic settings, indicating context-dependent effects influenced by regional climate, ecological characteristics, and livestock management practices. Precipitation and humidity also showed heterogeneous associations, while wind speed consistently demonstrated a positive indirect association with disease occurrence. Seasonal analyses identified higher HB incidence during spring and summer, and vegetation cover was consistently associated with increased disease risk. Considerable heterogeneity was observed in study design, climatic settings, statistical methods, and adjustment for potential confounding factors. Because most included studies were observational, the reported associations should not be interpreted as evidence of direct causality.</p><p><strong>Conclusions: </strong>Climatic and environmental factors appear to play an important role in shaping HB transmission through interconnected human-animal-environment pathways in the Middle East. However, these relationships are highly context-dependent and influenced by ecological conditions, livestock management systems, and public health factors. Future multinational studies integrating climatic, environmental, veterinary, and epidemiological data within a One Health framework are needed to strengthen climate-informed surveillance, early warning systems, and brucellosis prevention strategies across the region.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8884033"},"PeriodicalIF":2.6,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Characterization of DENV-1 Isolates From Pakistan Reveals Immunogenic Variability and Antiviral Potential of Phytochemicals Targeting the CprM Region.","authors":"Sajid Ali Shah, Syed Ahsan Shahid, Sidra Rahman, Muhammad Ali","doi":"10.1155/jotm/9932618","DOIUrl":"10.1155/jotm/9932618","url":null,"abstract":"<p><p>Dengue virus (DENV), a mosquito-borne arbovirus, remains a critical global health concern, causing approximately 390 million infections annually. Dengue fever poses significant challenges to healthcare systems in endemic regions like Pakistan due to the presence of four established serotypes (DENV-1-DENV-4) and the potential emergence of a fifth serotype (DENV-5). The current study aimed to investigate molecular characteristics of DENV-1 isolates from Peshawar, Pakistan, focusing on serotyping, genetic variability in the CprM junction region, and identification of potential antiviral phytochemicals. A total of 45 patient samples were screened, with the highest infection rate (49%) observed among individuals aged 20-40 years. Phylogenetic analysis revealed that six isolates clustered within the DENV-1 clade and grouped closely related to isolates from China, India, Bangladesh, and Pakistan, suggesting a regional evolution and potentially cross-border transmission. The prominent amino acid substitutions were Q47H, G48E, P49H, K51 E/N, L52 M, and M57I, which may influence viral structure, immune evasion, and antigenic properties. To address the lack of effective antivirals, a library of 60 phytochemicals was screened. Nine compounds demonstrated favorable ADMET profiles and high binding affinity (docking scores < -100) with the CprM region. Silydianin exhibited the strongest interaction (-159.81), indicating promising inhibitory potential. This integrative molecular and computational approach enhances our understanding of circulating DENV-1 strains and highlights plant-derived compounds as candidates for future antiviral development, pending in vitro validation.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"9932618"},"PeriodicalIF":2.6,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Native <i>Bacillus</i> Strains Crude Culture Product Exhibits High Biocidal Activities Against Larvae and Adult <i>Anopheles</i> Mosquitoes.","authors":"Tirsit Tibebu, Gemechu Tafa, Teshome Korme, Endale Berhe, Mesfin Getachew Tadesse, Mesfin Tafesse, Musin Kelel","doi":"10.1155/jotm/8822832","DOIUrl":"10.1155/jotm/8822832","url":null,"abstract":"<p><p><i>Anopheles</i> mosquitoes are major vectors of malaria, a disease that continues to cause substantial morbidity and mortality worldwide. <i>Bacillus</i>-based insecticides are widely recognized as effective, environmentally friendly, and sustainable tools for mosquito control. Therefore, this study aimed to isolate native <i>Bacillus</i> strains from diverse environmental sources and evaluate their potential for mosquito control. <i>Bacillus</i> strains with high biocidal activity were isolated, identified, genetically characterized, and physiologically characterized. The larvicidal and adulticidal activities of culture supernatants and cell pellets were evaluated separately. Eight <i>Bacillus</i> strains exhibited strong biocidal activity in their culture supernatants at a concentration equivalent to 8 McFarland units (approximately 2.4 × 10⁹ CFU/mL) within 24 h. The culture supernatants showed significant larvicidal activity, with LC₅₀ and LC₉₅ values of 0.24 (95% CI: 0.01-0.69) CFU/mL and 1.57 (95% CI: 0.55-4.34) CFU/mL, respectively. The most active strains were identified by biochemical characterization and 16S rRNA gene sequencing. Laboratory bioassays demonstrated that the culture supernatants were effective against both larval and adult <i>Anopheles</i> mosquitoes. SDS-PAGE analysis revealed protein bands ranging from 15 to 130 kDa, including bands within molecular weight ranges commonly associated with putative Cry/Cyt-like proteins. These findings provide preliminary evidence of proteins that may be associated with the observed mosquitocidal activity. The most active <i>Bacillus</i> preparations also showed greater activity than clothianidin under the laboratory conditions tested. Overall, these findings highlight the potential of native <i>Bacillus</i> culture supernatants as environmentally friendly candidates for the development of biological mosquito control agents.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8822832"},"PeriodicalIF":2.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Viral Load Suppression Among Adolescents and Young Adults Living With HIV on ART in Rwanda: Data From Rwanda HIV Case-Based Surveillance, 2019-2025.","authors":"Gallican N Rwibasira, Jean Claude Kwizera, Steven Karera, Tafadzwa Dzinamarira, Charles Holmes, Ayman Ahmed, Albert Tuyishime, Eric Remera, Daniel Henry Paris, Tracy R Glass","doi":"10.1155/jotm/5304043","DOIUrl":"10.1155/jotm/5304043","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults living with HIV (AYALHIV) in sub-Saharan Africa have lower viral load (VL) suppression (VLS) rates than older adults. Rwanda lacks national-level evidence on predictors of VLS in this age group. This study assessed demographic and clinical determinants of VLS among AYALHIV aged 15-24 years on antiretroviral therapy (ART), using national case-based surveillance (CBS) data.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis of AYALHIV enrolled in Rwanda's CBS system who initiated ART between January 2019 and December 2025 and had a documented VL at least six months after ART initiation. The primary outcome, VLS, was defined as VL ≤ 1000 copies/mL. Modified Poisson regression with robust, facility-clustered standard errors was used to estimate prevalence ratios (PRs); missing covariate data were addressed using multiple imputation (<i>m</i> = 20), pooled using Rubin's rules.</p><p><strong>Results: </strong>A total of 4140 participants across 458 health facilities were included. Most were female (88%) and aged 20-24 years (90.7%); 91.6% were initiated on a dolutegravir-based regimen, 98.7% demonstrated good adherence, and overall, 96.1% achieved VLS. In multivariable analysis, good adherence was the only factor independently associated with VLS, corresponding to a 70% higher prevalence of suppression relative to bad/moderate adherence (adjusted PR = 1.70; 95% CI: 1.33-2.19; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>VLS among AYALHIV aged 15-24 years engaged in Rwanda's HIV care program is high, exceeding the UNAIDS 95% target. Country HIV programs should prioritize adherence-focused interventions and proactively address underlying barriers to adherence in order to sustain optimal treatment outcomes in this population.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"5304043"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunistic Coccidiosis in Brazil: Diagnostic Challenges and Epidemiological Gaps in Immunosuppressed Groups.","authors":"Willian Cardoso Ferreira Zorrer, Estefani Rinaldi, Bibiana Rodrigues de Freitas, Pedro Machado Medeiros de Albuquerque, Natalia Machado Rahal, Rodrigo Casquero Cunha, Fabio Raphael Pascotti Bruhn","doi":"10.1155/jotm/7297545","DOIUrl":"10.1155/jotm/7297545","url":null,"abstract":"<p><p>Opportunistic infections caused by the protozoa <i>Cryptosporidium</i> spp. and <i>Cystoisospora belli</i> represent a challenge for public health, particularly in immunocompromised patients. In Brazil, a country with continental dimensions and socioeconomic diversity, the epidemiology of these intestinal coccidioses is complex and often underestimated. This review article aims to consolidate current knowledge on <i>Cryptosporidium</i> and <i>Cystoisospora</i> infections in immunocompromised individuals within the Brazilian context, addressing clinical manifestations, epidemiology, risk factors, diagnostic methods, treatment options, prevention and control strategies, and challenges related to underreporting. A thorough understanding of these aspects is crucial for improving health policies, optimizing clinical management, and reducing the morbidity and mortality associated with these parasitic diseases.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"7297545"},"PeriodicalIF":2.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dog Bite Epidemiology and Postexposure Practices Among Dog Owners in Some Communities in the Upper West Region of Ghana.","authors":"Richard Dery Suu-Ire, Amos Sarpong Agyei, Issah Beninmie Alijata, Benjamin Tetteh Mensah, Samuel Asumah, Meyir Yiryele Ziekah, Sylvester Languon, Samuel Otis Bel-Nono, Henry Asigri Abugri, Benjamin Kissi Sasu, Bonodong Zongnukuu Guri, Victor Emmanuel Manieson","doi":"10.1155/jotm/1750043","DOIUrl":"10.1155/jotm/1750043","url":null,"abstract":"<p><strong>Background: </strong>Rabies remains a neglected tropical disease in northern Ghana, where dog bites are common, and postexposure prophylaxis access is limited. Community-level data on bite epidemiology and health-seeking practices are scarce.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 370 dog-owning households (1824 individuals) in Lawra and Jirapa municipalities, Upper West Region, using a multistage sampling approach. Three submunicipalities were randomly selected from each municipality, after which households were selected using systematic sampling. We captured lifetime dog bite history, postexposure practices and rabies prevention behaviours.</p><p><strong>Results: </strong>Overall rabies awareness was high (Jirapa 97.6% and Lawra 77.0%). Lifetime household-level dog bite prevalence was significantly higher in Jirapa (44.1%) than in Lawra (20.5%). Postbite care was suboptimal: 38.4% of victims in Jirapa first sought traditional remedies compared to 17.2% in Lawra. Death after a bite was reported in 33.3% of Jirapa victims and 16.4% of Lawra victims. Family members reported symptoms suggestive of rabies in some of these cases; however, none were clinically or laboratory confirmed. Higher education was positively associated with safer practices (<i>β</i> = 0.78, <i>p</i> = 0.008), while initial reliance on traditional healers was inversely associated (<i>β</i> = -1.12, <i>p</i> = 0.005).</p><p><strong>Conclusions: </strong>Dog bites and probable rabies deaths are underreported in these municipalities. The heavy reliance on traditional medicine and low formal health-seeking highlight critical barriers to rabies elimination. Strengthening community-based surveillance, integrated traditional healer referral, and targeted radio-based health education in local languages are urgently needed.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"1750043"},"PeriodicalIF":2.6,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Q Fever Infection in Türkiye.","authors":"Hatun Öztürk Çerik, Arzu Altunçekiç Yıldırım, Celali Kurt, Önder Ergönül","doi":"10.1155/jotm/1628136","DOIUrl":"10.1155/jotm/1628136","url":null,"abstract":"<p><strong>Objectives: </strong>Q fever, caused by <i>Coxiella burnetii</i>, is an underrecognized zoonotic infection with diverse clinical manifestations. The nonspecific nature and slow progression of Q fever frequently delay diagnosis, sometimes leading to severe or even fatal outcomes. This study describes 32 patients diagnosed with Q fever over an 18-month period in a previously unreported region, highlighting the emerging awareness of this neglected zoonosis.</p><p><strong>Methods: </strong>Patients with seropositive <i>C. burnetii</i> Phase I/II IgM and/or IgG antibodies between October 2023 and March 2025 (18-month period) were included. Cases were classified as acute, probable, chronic, or past infection according to established serological and clinical criteria.</p><p><strong>Results: </strong>Thirty-two patients were diagnosed during the study period, of whom 22 (68.8%) were male; the median age was 60.5 years (IQR: 48-66). More than half were farmers, and 40.6% reported animal exposure. Based on serological and clinical criteria, 11 patients were diagnosed with acute Q fever, 16 with probable infection, one with chronic infection, and four with past infection. Common manifestations included fever, myalgia, arthralgia, hepatitis, and endocarditis; cardiovascular involvement occurred in 40.6% of patients. Two patients died, and notably, three patients with prosthetic valve endocarditis had a history of care at the same cardiac surgery clinic.</p><p><strong>Conclusions: </strong>Given its heterogeneous clinical manifestations and variable serological responses, Q fever poses significant diagnostic challenges. This study presents the first and largest human case series of Q fever from the Black Sea region of Türkiye, highlighting the wide clinical spectrum of the disease and the need for enhanced awareness and diagnostic capacity.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"1628136"},"PeriodicalIF":2.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microscopic and Molecular Evaluation of Intestinal Microsporidia in Hemodialysis and Cancer Patients in Ilam Province.","authors":"Kosar Khezri, Nahid Maspi, Shahab Falahi, Hassan Nourmohammadi, Asad Mirzaei","doi":"10.1155/jotm/5072209","DOIUrl":"10.1155/jotm/5072209","url":null,"abstract":"<p><strong>Background and aims: </strong>Microsporidia are opportunistic intestinal pathogens causing chronic diarrhea in immunocompromised patients. Limited data exist on their prevalence in western Iran. This study aimed to investigate intestinal microsporidia in hemodialysis and cancer patients in Ilam Province.</p><p><strong>Methods: </strong>Stool samples from 78 immunocompromised patients (44 females, 34 males; mean age 53.5 ± 12.8 years) were examined microscopically after modified trichrome staining and molecularly by nested PCR targeting the ITS region. Phylogenetic analysis was performed using MEGA v10. Group comparisons were performed using the chi-square or Fisher's exact test, as appropriate.</p><p><strong>Results: </strong>Microscopy detected microsporidia in 10/78 samples (12.8%), while nested PCR identified 19/78 positive cases (24.4%; 95% CI: 16.2%-34.9%). <i>Enterocytozoon bieneusi</i> (<i>E. bieneusi</i>) was the predominant species (16/78; 20.5%), followed <i>by Encephalitozoon intestinalis</i> (2/78; 2.6%) and mixed infection (1/78; 1.3%). The prevalence was higher in hemodialysis patients (9/30; 30.0%) compared to cancer patients (10/48; 20.8%), but this difference was not statistically significant (<i>χ</i> ² = 0.84, df = 1, <i>p</i> = 0.36). Due to the small sample size, this finding should be interpreted with caution and is presented as exploratory. No significant difference was observed by microscopy (Fisher's exact test, <i>p</i> = 0.842). Phylogenetic analysis revealed the BEB6 genotype in all <i>E. bieneusi</i> isolates.</p><p><strong>Conclusion: </strong>This first report from Ilam Province demonstrates a notable prevalence of microsporidia, particularly <i>E. bieneusi</i> in hemodialysis and cancer patients. The BEB6 genotype raises the possibility of a zoonotic source, although no animal or environmental samples were analyzed to confirm transmission routes. While our findings are preliminary due to the limited sample size, they suggest that molecular diagnostic screening could be beneficial in similar high-risk populations. However, larger multicenter studies are needed to confirm these findings before routine screening can be recommended.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"5072209"},"PeriodicalIF":2.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}