Journal of Tropical Medicine最新文献

{"title":"Trachoma Prevalence and Associated WASH and Behavioral Risk Among Rural Communities of North Gondar Zone, Ethiopia: A Community-Based Cross-Sectional Study.","authors":"Gebre Ayanaw Alula","doi":"10.1155/jotm/8924826","DOIUrl":"10.1155/jotm/8924826","url":null,"abstract":"<p><p>Trachoma is a leading infectious cause of preventable blindness and remains a major public health problem in rural Ethiopia, where inadequate water, sanitation, and hygiene (WASH) conditions sustain transmission. This study assessed the prevalence of active trachoma and associated WASH and hygiene-related factors among children aged 1-9 years in rural communities of North Gondar Zone, Ethiopia. A community-based cross-sectional study was conducted among 456 children selected using a multistage sampling technique. Data on sociodemographic characteristics, household WASH conditions, and hygiene practices were collected using structured caregiver interviews and direct observation. Active trachoma was diagnosed using the WHO simplified trachoma grading system (trachomatous inflammation-follicular and/or trachomatous inflammation-intense). Poor face-washing practice was defined as washing the child's face less than twice per day or the presence of ocular or nasal discharge, while good practice was defined as washing the child's face at least twice per day and the absence of ocular or nasal discharge. High fly density was defined as the observation of three or more eye-seeking flies on or around the child's face during household assessment. Binary and multivariable logistic regression analyses were performed, with statistical significance set at <i>p</i> < 0.05. The overall prevalence of active trachoma was 20.6% (95% CI: 16.9%-24.3%). In multivariable analysis, higher odds of active trachoma were observed among children from households using unimproved water sources (AOR = 1.76; 95% CI: 1.01-3.05), households without latrines (AOR = 1.94; 95% CI: 1.15-3.28), children with poor face-washing practices (<i>A</i> <i>O</i> <i>R</i> = 2.63; 95% CI: 1.52-4.55), and children exposed to high fly density (AOR = 2.71; 95% CI: 1.60-4.58). These findings indicate significant associations rather than causal relationships due to the cross-sectional design. The study highlights the continued burden of trachoma in the area and supports strengthening integrated WASH and facial cleanliness interventions under the WHO SAFE strategy.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8924826"},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630746","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":"Disparities in Echinococcosis Control in Xizang, China: An Assessment Based on the Health Resource Density Index.","authors":"Zhiyi Wang, Quzhen Gongsang, Mingzhe Jiang, Jiaxi Lei, Pin Yang, Ying Wang, Liying Wang, Roger Frutos","doi":"10.1155/jotm/8891867","DOIUrl":"10.1155/jotm/8891867","url":null,"abstract":"<p><strong>Background: </strong>Echinococcosis remains a major public health concern in Xizang, China, characterized by high endemicity in remote and underserved areas. Despite long-term implementation of the national control program, the effectiveness of interventions may be constrained by insufficient and unevenly distributed health human resources (HHR).</p><p><strong>Objectives: </strong>To evaluate the distribution of HHR in Xizang and its association with echinococcosis prevalence at the township level using the health resource density index (HRDI).</p><p><strong>Methods: </strong>Township-level data on echinococcosis prevalence were collected from the Xizang Center for Disease Control and Prevention. HHR data were collected from the China Health Statistics Yearbook 2022. HRDI was constructed to quantify HHR allocation by integrating population size and geographic area. Differences in HRDI across regions and production types were analyzed using the Kruskal-Wallis test with Bonferroni correction for multiple comparisons. Spatial autocorrelation analysis using Moran's <i>I</i> and Getis-Ord Gi∗ statistics was performed to identify clustering patterns of HRDI. Spearman's rank correlation was used to evaluate the relationship between HRDI and echinococcosis prevalence.</p><p><strong>Results: </strong>The density of health technicians in Xizang (7.0 per 1000 population) was lower than the national average, with pronounced urban-rural disparities. Significant differences in HRDI were observed across cities (<i>p</i> < 0.05), with the lowest levels identified in Ali and Nagqu. In addition, HRDI varied significantly across production types (<i>p</i> < 0.05), with lower levels observed in semiagricultural and semipastoral areas and pastoral areas. Spatial analysis revealed significant clustering of HRDI, with low-value clusters predominantly distributed in pastoral areas such as Ali and Nagqu. HRDI was negatively correlated with echinococcosis prevalence (rs = -0.326, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Insufficient and uneven distribution of HHR is associated with increased echinococcosis prevalence in Xizang. Strengthening HHR allocation in high-endemic areas, alongside community-based interventions and improved health service accessibility, is essential for enhancing the effectiveness of echinococcosis control programs.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8891867"},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620761","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":"Knowledge and Attitudes Toward Trachoma Among Final-Year Clinical Medicine Students in Dar es Salaam, Tanzania: A Descriptive Cross-Sectional Study.","authors":"Laurent Elisaut Marishamu, Irene Masuki, Heveanlight Masuki, Vivian P Mushi, Celina Mhina, Ntsilane Suzan Mosenene, Milka Mafwiri","doi":"10.1155/jotm/8823107","DOIUrl":"10.1155/jotm/8823107","url":null,"abstract":"<p><strong>Background: </strong>Trachoma continues to pose a serious concern as one of the leading causes of blindness globally, particularly in areas with poor access to healthcare and hygiene services. Despite its importance, there is a conspicuous paucity of thorough data on medical students' awareness and attitudes toward trachoma. To fill this gap, a study was done to investigate the knowledge and attitudes toward trachoma among final-year clinical medicine students at Dar es Salaam Colleges, shedding light on the awareness levels and attitudes of this key group of future healthcare practitioners.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted at three colleges, with 384 individuals recruited using simple random selection for a questionnaire survey. Self-administered questionnaires were used to assess the knowledge and attitudes of trachoma among final-year clinical medicine students in Dar es Salaam colleges. The collected data were analyzed using descriptive statistics and the chi-square test to summarize the students' knowledge and attitudes toward trachoma. A <i>p</i> value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The study revealed that nearly half of the participants (49%) had a low level of knowledge about trachoma prevention, while approximately 43% held negative attitudes toward it. Significant associations were found between knowledge level and age (<i>p</i> = 0.037) as well as sex (<i>p</i> = 0.039). Notably, females and individuals aged 25-29 years demonstrated lower levels of knowledge.</p><p><strong>Conclusion and recommendations: </strong>A significant number of medical students had low knowledge about trachoma and harbored negative attitudes toward its prevention. Consequently, ongoing education and training are essential to enhance understanding among current students, alongside incorporating case studies for practical application.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8823107"},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630739","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":"RETRACTION: Uroprotective and Hepatoprotective Potential of <i>Anagallis Arvensis</i> Against the Experimental Animal Model.","authors":"Journal Of Tropical Medicine","doi":"10.1155/jotm/9817092","DOIUrl":"https://doi.org/10.1155/jotm/9817092","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/7241121.].</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"9817092"},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620672","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":"Predictive Modeling of Healthcare Workers' Priorities of the WHO 2030 Key Activities for Snakebite Prevention and Control in Ghana.","authors":"Eric Nyarko, Iddrisu Abugbil Atubiga, Fafa Shalom Tchorly, Nicholas Amani Hamman, Aashna Uppal, Nuhu Mohammed, Leonard Kyei, Eduardo Alberto Fernandez, Isaac Baidoo","doi":"10.1155/jotm/7078381","DOIUrl":"10.1155/jotm/7078381","url":null,"abstract":"<p><p>Snakebite is a serious public health issue that causes a significant amount of morbidity and mortality. This has led the World Health Organization (WHO) to develop a roadmap to reduce snakebite envenoming (SBE) by half by 2030. This study predicted the activities healthcare workers consider most important among the 24 WHO SBE roadmap activities for preventing and controlling snakebites. The research involved healthcare workers and took place in two poor and mostly rural districts in the Eastern Region of Ghana. The study used traditional MaxDiff and five machine learning (ML) models to analyze the data. Healthcare workers prioritized \"Making safe, effective antivenoms available, accessible, and affordable to all\" as the most important activity, with a utility estimate (UE) of 0.8256 (95% confidence interval (CI): 0.7300 to 0.9213). This was followed by \"Effective first aid care and ambulance transport\" (UE = 0.4348, 95% CI: 0.3266 to 0.5430), \"Coordinated data management and analysis\" (UE = 0.3744, 95% CI: 0.2353 to 0.5134), and \"Promoting advocacy, effective communication, and productive engagement\" (UE = 0.3630, 95% CI: 0.2528 to 0.4732). Using choice experiments and ML models has helped reveal healthcare workers' priorities regarding the WHO's SBE roadmap activities. This approach gives a clear view of local opinions on key WHO activities, which is crucial for tackling the snakebite problem. By using this information in the broader health system, we can improve health outcomes and enhance the quality of life for snakebite patients in Ghana and other low- and middle-income countries.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"7078381"},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620683","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":"Determinants of Male Involvement in the Prevention of Mother-to-Child Transmission of HIV in the Bamenda Health District, Cameroon.","authors":"Victorine Mulur Ngachangong, Charles Falang Doumta, Dickson Shey Nsagha, Emmanuel Yenshu Vubo","doi":"10.1155/jotm/9721872","DOIUrl":"10.1155/jotm/9721872","url":null,"abstract":"<p><strong>Background: </strong>Prevention of mother-to-child transmission (PMTCT) of HIV remains a major public health problem. Male involvement has been seen as one of the ways of scaling up the PMTCT of HIV. However, studies have shown a low male involvement; hence, the objective of this study was to assess the determinants of male involvement in the PMTCT of HIV.</p><p><strong>Method: </strong>The study was a community-based cross-sectional study in the Northwest Region of Cameroon. A total of 406 participants from the Bamenda Health District were selected using a consecutive sampling method. Data were collected through a well-structured questionnaire. Data entry and analysis were performed using SPSS Version 23. The results were presented at a 95% confidence interval.</p><p><strong>Results: </strong>The level of good knowledge, attitudes, and practices of PMTCT of HIV by men was 86.5%, 75.4%, and 42.6%, respectively. The knowledge of mother-to-child transmission was high at 98.5% (CI: 96.8-99.3) and significantly associated with education and MI (<i>p</i>∼0.001). Men who had attained tertiary and secondary education were more likely to have a higher MI (OR: 0.37, 95% CI: 0.2-0.7; 0.49, 95% CI: 0.2-0.49). Those who were married (OR: 0.17, 95% CI: 0.05-0.6) or living together (OR: 0.39, 95% CI: 0.2-0.7) were less likely to have a high male involvement in PMTCT.</p><p><strong>Conclusion: </strong>Although the men were highly knowledgeable and had a positive attitude toward PMTCT, this was not translated into practice, as less than 50% of the men were involved in PMTCT.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"9721872"},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604436","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":"Successes and Challenges in the Elimination of Congenital Syphilis in Brazil: Evidence of Progress and Persistent Challenges.","authors":"Iaron Leal Seabra, Nyla Lauane Costa de Almeida, Bianca Rafaele Souza Trindade, Arthur da Silva Costa Pedroza, Thayse Moraes de Moraes, Glenda Roberta Oliveira Naiff Ferreira, Eliã Pinheiro Botelho","doi":"10.1155/jotm/6589431","DOIUrl":"10.1155/jotm/6589431","url":null,"abstract":"<p><strong>Background: </strong>Brazil has implemented multiple policies targeting congenital syphilis (CS); however, evaluations of their effectiveness remain limited. This study aimed to analyze temporal trends in annual rates of gestational syphilis (GS) and CS from 2011 to 2022 across Brazil and its regions. It was hypothesized that effective prenatal care would enable early GS detection and that appropriate treatment of pregnant patients and their partners would reduce CS detection rate.</p><p><strong>Methods: </strong>This temporal study used GS and CS notification data from all Brazilian municipalities. National and regional annual rates were analyzed using the joinpoint regression model. Annual percent change (APC), average APC (AAPC), 95% confidence intervals, and <i>p</i> values were calculated.</p><p><strong>Results: </strong>A total of 586,855 new GS cases and 272,491 CS cases were reported during the study period. GS rates increased throughout Brazil and all regions, accompanied by a decline in APC values. For CS, rates achieved overall stabilization in Brazil as well as the North, Midwest, and South regions, whereas the Southeast and Northeast regions experienced continuous growth with a reduced APC from 2015 and 2017, respectively.</p><p><strong>Conclusion: </strong>Although CS trends stabilized or increased at reduced APC values over time, rates remain high. Additional efforts are required to eliminate the disease, including earlier initiation of prenatal care and improved prevention, diagnosis, and treatment of syphilis in pregnant patients and their partners.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"6589431"},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604477","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 Diagnosis of <i>Trichomonas vaginalis</i> in Women and Men: A Systematic Review.","authors":"Somayeh Mohamadi, Reza Faraji, Saeed Khoshnood, Abbas Maleki, Arezoo Bozorgomid, Saiyad Bastaminejad, Taha Rashidi, Amirhossein Salimi Mansouri, Kosar Khezri, Shahin Seidi, Sadegh Faraji","doi":"10.1155/jotm/7920568","DOIUrl":"10.1155/jotm/7920568","url":null,"abstract":"<p><strong>Background: </strong><i>Trichomonas vaginalis</i> (<i>T. vaginalis</i>) is a human protozoan parasite and the leading cause of nonviral sexually transmitted infections worldwide. Diagnosis of <i>T. vaginalis</i> is typically performed using vaginal discharge or urine samples, which are examined via wet prep, culture methods, or molecular tests. Compared to traditional culture-based methods, molecular diagnostic techniques have shown higher sensitivity, as they allow more precise identification of <i>T. vaginalis</i>-infected individuals. The present review evaluated the molecular diagnosis of <i>T. vaginalis</i> in male and female populations.</p><p><strong>Methods: </strong>A search was performed across international databases, including Google Scholar, Scopus, PubMed, ScienceDirect, Web of Science, Wiley, ClinicalKey, IEEE, EMBASE, Springer, Cambridge, Oxford Journal, Sage, Emerald, and Cochrane. The search included English-language publications available from inception to August 2025.</p><p><strong>Results: </strong>In total, 119 studies were eligible for this systematic review. The highest number of studies originated from the United States (<i>n</i> = 33), Iran (<i>n</i> = 16), and South Korea (<i>n</i> = 8). PCR was the most frequently employed molecular technique, reported in 58 studies, followed by real-time PCR (<i>n</i> = 12). 18 studies reported 100% sensitivity and 20 studies reported 100% specificity. Of the included studies, 91 focused only on women, 7 on men, 19 on both genders, and 2 did not specify the participants' gender. Study design was poorly reported in the majority of studies (<i>n</i> = 83), but among those with clear designs, cross-sectional studies predominated (<i>n</i> = 20). Vaginal swabs were the most frequently used sample type.</p><p><strong>Conclusion: </strong>The sensitivity and specificity of molecular methods for diagnosing <i>T. vaginalis</i> vary. However, given their overall superior performance, these techniques should be prioritized for accurate diagnosis and effective treatment of <i>T. vaginalis</i> infections.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"7920568"},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604426","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":"Epidemiology, Distinct Seasonal Dynamics, and Age-Specific Characteristics of Eight Respiratory Viruses in Thailand, 2025.","authors":"Nungruthai Suntronwong, Preeyaporn Vichaiwattana, Jiratchaya Puenpa, Siripat Pasittungkul, Ratchadawan Aeemjinda, Lakkhana Wongsrisang, Thanunrat Thongmee, Yong Poovorawan","doi":"10.1155/jotm/8908857","DOIUrl":"10.1155/jotm/8908857","url":null,"abstract":"<p><p>Acute respiratory infections (ARIs) impose a substantial annual public health burden, largely driven by a diverse range of respiratory pathogens. Given the dynamic and continuously evolving circulation of these pathogens, as well as their markedly different prevalence across age groups, ongoing surveillance is essential. To characterize the current prevalence, seasonal patterns, and age-related distribution of eight key respiratory pathogens among ARI patients in Thailand, from January to December 2025, a retrospective study of 4697 respiratory samples from ARI patients aged 1 month to 97 years was conducted. Using real-time RT-PCR to screen for eight respiratory viruses, 61.1% (2871) of samples tested positive, with coinfections identified in 267 of the positive cases. Influenza virus (IFV) was the most prevalent pathogen at 22.2%, demonstrating a clear biannual pattern with peaks in January-March and July-December. Human rhinovirus (HRV) was the second most frequently detected virus (16.6%) and circulated year-round, whereas SARS-CoV-2 accounted for 9.9% of cases, with a pronounced peak in May. Significant age-specific differences in viral detection were observed. HRV predominated in children < 5 years, while IFV exhibited a broader distribution, with higher prevalence among individuals aged 6-18 years and ≥ 19 years. In contrast, SARS-CoV-2 was more frequently detected in adults and older populations. Coinfections were most common in children aged 3-5 years and were frequently associated with HRV. Notably, IFV, HRV, and RSV showed a significant increase in 2025 compared with 2024. These findings provide updated insights into the circulation of respiratory viruses in 2025, revealing distinct seasonal patterns, increasing influenza activity significantly with prolonged circulation in the latter half of the year, and clear age-related differences in pathogen distribution. This provides effective support for continuous surveillance to inform effective public health strategies for ARI control.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"8908857"},"PeriodicalIF":2.6,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604493","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":"Unveiling Nutritional Disparities in Infantile Tremor Syndrome: A Focus on Holo-Transcobalamin and Essential Fatty Acids.","authors":"Rajesh Gupta, Puneet Agrawal, Jyoti Gupta, Jyoti Singh, Ashish Pathak","doi":"10.1155/jotm/3144439","DOIUrl":"10.1155/jotm/3144439","url":null,"abstract":"<p><p>Infantile tremor syndrome (ITS), a self-limiting disorder prevalent in the Indian subcontinent, is characterized by tremors, anemia, pigmentary skin changes, developmental delay or regression, and hypotonia. Although a nutritional etiology is suspected, particularly vitamin B12 deficiency, the roles of the bioactive marker holo-transcobalamin (holo-TC) and essential fatty acids (EFAs) remain unexplored. This comparative pilot study was conducted from December 1, 2023, to April 30, 2024, at Government Medical College, Datia, India. The study included 14 infants who were assigned to two groups. Group 1 (<i>n</i> = 7) comprised infants with ITS and tremors, and Group 2 (<i>n</i> = 7) included those with ITS without tremors to assess threshold-dependent biochemical markers across this clinical spectrum. Laboratory investigations included complete hemogram, serum vitamin B12, holo-TC, and EFA profiles. Data were summarized using medians and interquartile ranges. Between-group differences were expressed as effect sizes (median differences) with 95% confidence intervals. Severe developmental delays were more frequent in Group 1 (5/7) than in Group 2 (mild to moderate in 4/7). Both groups were anemic and had low serum vitamin B12 levels (median: 188 pg/mL in Group 1 vs. 198 pg/mL in Group 2). Holo-TC was undetectable (< 5 pmol/L) in Group 1 and in only one patient from Group 2 (median: 10.12 pmol/L in the remaining Group 2 patients). Macrocytosis was higher in Group 1 (median MCV: 98 fL vs. 75.5 fL), with a median difference of 22.5 fL (95% CI: 6.8 to 38.2). Clinical examination also revealed characteristic hair hypochromotrichia and progressive regression in both phenotypes. Both groups exhibited low omega (<i>ω</i>)-3 fatty acid levels, elevated saturated fatty acid levels, and high <i>ω</i>-6:ω-3 ratios (median: approximately 10:1), with small and imprecise between-group differences (confidence intervals crossing zero). Extremely low holo-TC levels were strongly associated with tremors in ITS, suggesting that holo-TC is a superior marker of bioactive vitamin B12 deficiency and a critical metabolic threshold for tremor manifestation. EFA imbalances were prevalent in both groups but not specific to tremor incidence, highlighting the need for larger studies. The overall pathophysiology points toward significant maternal nutritional depletion during pregnancy and lactation as the relevant origin of the syndrome.</p>","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"2026 ","pages":"3144439"},"PeriodicalIF":2.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497887","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}