Transactions of The Royal Society of Tropical Medicine and Hygiene最新文献

{"title":"Prevalence of steatotic liver disease phenotypes and liver fibrosis in people with HIV in Egypt.","authors":"Ahmed Cordie, Rahma Mohamed, Giada Sebastiani, Naeema El Garhy, Lamiaa Al Sehemy, Andrew Saweres, Mohamed S Nagy, Reham Awad Awad, Remon Atef, Aya M Al-Sharif, Maryam Y Awadh, Dina Ramadan, Angee Al-Shayeb, Engy El Khateeb, Hend Hamed Tamim, Rania Soliman Hamza, Zainab El Saadany, Gamal Esmat, Heba Omar","doi":"10.1093/trstmh/trag110","DOIUrl":"https://doi.org/10.1093/trstmh/trag110","url":null,"abstract":"<p><strong>Background: </strong>Regional data on steatotic liver disease (SLD) in people with HIV (PWH) are scarce. This study aimed to determine the prevalence of SLD phenotypes and clinically significant fibrosis (CSF) in a cohort of Egyptian PWH.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 531 PWH who attended the HIV clinic at Cairo University Hospitals between July 2022 and September 2023. Hepatic steatosis and fibrosis were assessed using vibration-controlled transient elastography (FibroScan). SLD was defined by a controlled attenuation parameter (CAP) ≥248 dB/m and CSF was defined by a liver stiffness measurement (LSM) ≥8 kPa.</p><p><strong>Results: </strong>The prevalence of SLD was 26.0% (n=138/531), with metabolic dysfunction-associated SLD (MASLD) as the predominant phenotype (81.15%) followed by hepatitis C virus (HCV)-associated SLD (12.31%). The prevalence of CSF was significantly higher in patients with SLD (15.22%) compared with those without (3.56%). The risk for CSF was greatest among patients with HCV-associated SLD, with or without cardiometabolic risk factors (23.53%), followed by those with MASLD (15.18%).</p><p><strong>Conclusions: </strong>SLD is a common comorbidity among PWH in Egypt, predominantly driven by metabolic dysfunction. CSF was notably higher among those with MASLD and HCV coinfection, underscoring the need for integrating systematic SLD assessment into routine HIV care to enable early detection and management of progressive liver disease.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and discrimination among children affected by leprosy: a systematic review of a skin-related neglected tropical disease.","authors":"Madleina Daehnhardt, Chris Cecil, Srushti Bhorkar, Ayoposi Ogboye, Hugo Paula, Saba Lambert, Hugo Pessotti Aborghetti, Veronica Phillips, Becks Hill, Patricia Duarte Deps","doi":"10.1093/trstmh/trag105","DOIUrl":"https://doi.org/10.1093/trstmh/trag105","url":null,"abstract":"<p><p>Little is known about the stigma and discrimination children with leprosy are subject to and the subsequent impact on their psychological well-being. The aim of this study is to systematically review the literature for evidence that closes this knowledge gap and informs practice. In line with a PRISMA-P Protocol (PROSPERO CRD420251089128), we conducted a systematic review, underpinned by an extensive search strategy. There was no inclusion restriction on methodology, time period, country, or language. Data extraction was completed through a double-review process, which was guided by a deductive theoretical framework and shaped by inductive coding. This was followed by a data synthesis and double-blinded quality appraisal. The search strategy identified 914 items. Following a double-blind review with conflict mediation, we included 48 items. The review found evidence for nine domains of discrimination, 16 stigma types, and seven individual-level mental health responses. Social/interpersonal stigma and affective/cognitive mental health responses were the most prevalent findings. Fourteen moderating factors were identified, with disease awareness/knowledge the most frequent. Children affected by leprosy are subject to multiple stigma types and discrimination in numerous life domains, which adversely affects their mental health. Policy and practice recommendations include a multisectoral response including community engagement, public health and education sectors, a whole-family approach including all family members directly/indirectly affected by leprosy, and recognition of the inter-relationships between moderating factors. Despite the novel findings this review presents, there are limitations stemming from the dataset and from methodological choices. Given the gaps in primary academic research and the identified limitations, the topic deserves substantial future attention.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersectional analysis of patient information leaflets for neglected tropical diseases in Argentina.","authors":"Agustina Bongioanni, Camila Gomez, Santiago D Palma, Lorena Saletti-Cuesta","doi":"10.1093/trstmh/trag107","DOIUrl":"https://doi.org/10.1093/trstmh/trag107","url":null,"abstract":"<p><strong>Background: </strong>Neglected tropical diseases (NTDs) disproportionately affect vulnerable populations in Argentina, yet the equity dimensions of patient information leaflets (PILs) for NTD treatments remain unexplored. This study analysed PILs of drugs available in Argentina for treating NTDs from an intersectional and health equity perspective using the PROGRESS-Plus framework.</p><p><strong>Methods: </strong>A systematic documentary analysis was conducted on 139 PILs covering 13 endemic NTDs in Argentina, identified through official pharmaceutical databases (March-December 2024). A double-entry matrix recorded the presence or absence of equity content across adapted PROGRESS-Plus dimensions. Data were analysed using descriptive statistics in Python.</p><p><strong>Results: </strong>Critical equity gaps were identified across all PROGRESS-Plus dimensions. Religion, education, menopause and transgender individuals were entirely absent from all PILs. Only 5% included race and ethnicity considerations and 14% provided sex-disaggregated clinical data. Contradictory information on pregnancy and breastfeeding was identified across manufacturers for identical drugs. Disability considerations appeared in <1% of PILs. Only 62.5% of World Health Organization essential medicines for selected NTDs were commercially available in Argentina.</p><p><strong>Conclusions: </strong>PILs for NTD treatments in Argentina lack intersectional perspectives, creating barriers to equitable healthcare access. Regulatory reform of Argentina's PIL provisions and adoption of PROGRESS-Plus-informed standards are urgently needed to ensure that pharmaceutical communications serve all populations affected by NTDs.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial epidemiology of an adenovirus outbreak at the Vietnam National Children's Hospital in Hanoi, Vietnam.","authors":"Trang Thu Vu, Dien Minh Tran, Thai Quang Pham, Tung Viet Cao, Phuc Huu Phan, Ngai Kien Le, Nhung Thi Trang Nguyen, Anh Thi Van Dinh, Anh Viet Nguyen, Nghia Duy Ngu, Duong Nhu Tran, Khanh Cong Nguyen, Florian Vogt","doi":"10.1093/trstmh/trag108","DOIUrl":"https://doi.org/10.1093/trstmh/trag108","url":null,"abstract":"<p><strong>Objectives: </strong>Adenovirus disproportionately affects children, with limited surveillance in low- and middle-income countries such as Vietnam.</p><p><strong>Methods: </strong>We mapped the spatial distribution of laboratory-confirmed cases during a 2022 outbreak at Vietnam National Children's Hospital (VNCH) to identify areas with elevated case reporting. We analysed laboratory-confirmed adenovirus cases admitted to VNCH (January-October 2022), examining demographics and location. ArcGIS Pro was used to map case location and assess spatial clustering using Global Moran's I, Optimized Hot Spot Analysis, and Local Moran's I (LISA), followed by sensitivity analyses and evaluation of spatial efficiency using the predictive accuracy index (PAI).</p><p><strong>Results: </strong>Of 2687 cases, 89% occurred in children aged <5 years, predominantly boys (61%). Most cases were reported from Hanoi (74%). Spatial analysis revealed significant clustering, with hotspot communes concentrated in 12 core urban districts that were consistently detected across three sensitivity analysis specifications. LISA identified 83 High-High cluster communes, accounting for 44.3% of all Hanoi cases, and demonstrated the highest spatial efficiency (PAI = 9.37). Coldspots were primarily located in the outer districts.</p><p><strong>Conclusion: </strong>The observed spatial pattern is likely to reflect an indirect distance effect on case reporting to VNCH rather than true community-level disease intensity. These findings may support hospital-level surveillance and outbreak preparedness in resource-limited settings.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the potential of conversational artificial intelligence for maternal and child health literacy in Pakistan.","authors":"Salima Kerai","doi":"10.1093/trstmh/trag104","DOIUrl":"https://doi.org/10.1093/trstmh/trag104","url":null,"abstract":"<p><p>Pakistan has one of the highest neonatal mortality rates globally. At the same time, mobile phone access is near-universal, and an established community health worker program reaches most of the rural population. Together, these conditions create an opportunity to deliver health education on a scale by leveraging existing infrastructure. Conversational artificial intelligence (AI), particularly voice-enabled systems, offers a potentially accessible and scalable solution for improving health literacy and care-seeking behavior. While evidence is accumulating that people increasingly use AI for health information, there remains limited evidence that such use translates into measurable improvement in health outcomes. Pakistan offers a plausible case study setting to evaluate whether conversational AI, delivered through existing community health system infrastructure, can improve maternal and child health knowledge and influence care seeking, with potential implications for reducing maternal and neonatal mortality.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable machine-learning prognosis of mycetoma from routine clinical data.","authors":"Maha H Yousif, Abdallah Alsammani, Mohsin H Abdalla, Eihab B M Bashier, Mohammed A Y Mohammed, Ali Awadallah Saeed, Ahmed H Fahal","doi":"10.1093/trstmh/trag061","DOIUrl":"10.1093/trstmh/trag061","url":null,"abstract":"<p><strong>Background: </strong>Mycetoma is a chronic tropical infection with limited tools for predicting treatment outcomes.</p><p><strong>Methods: </strong>Routinely collected demographic, clinical, imaging, etiological, treatment, and follow-up data from 1,084 patients at the Mycetoma Research Centre were used to evaluate supervised machine learning models for outcome prediction. Binary and three-class tasks (cured, recurrence, disability) were assessed using stratified five-fold cross-validation with preprocessing, imputation, scaling, and class balancing. Logistic regression, support vector machine, and random forest models were compared.</p><p><strong>Results: </strong>Treatment mode, treatment duration, disease duration at presentation, adherence, lesion size, and imaging findings were the most important predictors. In eumycetoma, random forest achieved the best binary performance (accuracy 0.760 ± 0.036; ROC-AUC 0.835 ± 0.036). In actinomycetoma, random forest achieved accuracy of 0.719 ± 0.115 and ROC-AUC of 0.779 ± 0.138. For the three-class task, random forest performed best in eumycetoma (accuracy 0.612 ± 0.033; macro-AUC 0.777 ± 0.029), while logistic regression performed best in actinomycetoma (accuracy 0.735 ± 0.097; macro-AUC 0.713 ± 0.092).</p><p><strong>Conclusions: </strong>Standard clinical and imaging variables can support machine learning-based risk stratification in mycetoma, potentially improving early management and follow-up. External validation and clinical utility assessment are still required.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"929-947"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing spectrum of cutaneous leishmaniasis and HIV coinfection in Bolivian Amazonia: a case report.","authors":"Alfonso Gotor-Rivera, Mayber Lenin Aparicio-Loayza, Rodrigo Federico Matilla Naumionek, José Luis Rodríguez Peralto, María René Melendres-Moscoso, Yolanda López-Ochoa","doi":"10.1093/trstmh/trag096","DOIUrl":"10.1093/trstmh/trag096","url":null,"abstract":"<p><strong>Case report: </strong>A 34-year-old man with advanced HIV infection presented with localized cutaneous leishmaniasis, after unsuccessful trestment with pentavalent antimonials, progressive dissemination ocurred . On re-evaluation, he exhibited numerous widespread ulcerated papules and nodules , accompanied by systemic symptoms and significant weight loss. Skin smears and histopathology demonstrated intracellular amastigotes. A diagnosis of intermediate cutaneous leishmaniasis with HIV coinfection was established. Treatment with liposomal amphotericin B followed by oral miltefosine led only to transitory clinical resolution.</p><p><strong>Discussion: </strong>This case highlights the diagnostic and therapeutic challenges of leishmaniasis in immunocompromised patients and underscores the dynamic nature of the clinical classification of cutaneous leishmaniasis.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"991-994"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging a critical gap in leishmaniasis control: focus on immature sandfly ecology.","authors":"Sivagnaname Narayanasamy, Yuvarajan Sivagnaname, K Durga","doi":"10.1093/trstmh/trag070","DOIUrl":"10.1093/trstmh/trag070","url":null,"abstract":"<p><p>Leishmaniasis remains a major public health challenge in many tropical and subtropical regions despite long-standing emphasis on controlling adult sandflies. This commentary highlights an important ecological gap that has received limited attention: the immature stages of sandflies. Unlike mosquitoes, sandflies develop in cryptic terrestrial microhabitats that are rarely detected through routine surveillance. Consequently, most vector control programmes concentrate on suppressing adult populations, while the biological processes that generate new adult vectors remain poorly understood. Recent ecological studies indicate that breeding activity may be spatially structured and biologically detectable. Surveillance approaches that consider oviposition behaviour and breeding ecology may therefore help make vector population dynamics more measurable and support more sustainable, biology-based control strategies.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"988-990"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Wolbachia-infected Aedes aegypti on dengue incidence in endemic regions: a systematic review and meta-analysis.","authors":"Husni Mubarak Zainal, Ricardo Soares Guimarães, Abdullah Al Owesie, Laura Santos Ribeiro, Andrea Roman-Pimentel, Tanika Sharma, Vitoria Nallin de Godoy, Rafael Bezerra Mendes","doi":"10.1093/trstmh/trag063","DOIUrl":"10.1093/trstmh/trag063","url":null,"abstract":"<p><p>Dengue remains a major public health challenge in endemic regions, and conventional vector-control strategies have shown limited long-term effectiveness. The release of Wolbachia-infected Aedes aegypti mosquitoes has emerged as a novel biocontrol strategy to reduce dengue transmission. We conducted a systematic review and meta-analysis to evaluate the effectiveness of Wolbachia deployments in reducing dengue incidence. We searched PubMed, Embase, and the Cochrane Library until 30 April 2025 for randomized controlled trials and quasi-experimental studies conducted in dengue-endemic settings. Population-level effectiveness was assessed using pooled incidence rate ratios (IRRs), and individual-level protective efficacy using pooled odds ratios (ORs). Random-effects meta-analysis with restricted maximum likelihood with Hartung-Knapp adjustment was applied. Subgroup analyses examined geographic region and deployment coverage. Nine studies involving >8 million individuals were included. Wolbachia deployment was associated with a substantial reduction in dengue incidence (pooled IRR 0.15, 95% CI 0.05-0.39), corresponding to an estimated 85% reduction. Full-area deployments demonstrated greater reductions (IRR 0.046, 95% CI 0.038-0.055) than partial-area deployments (IRR 0.22, 95% CI 0.07-0.74). Exploratory individual-level analyses yielded a pooled OR of 0.29 (95% CI 0.01-8.41) with substantial heterogeneity (I² = 86.5%).</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"912-921"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular detection of Coxiella burnetii in ticks from livestock in Kashmir: first evidence and molecular insights.","authors":"Altaf Hussain Khan, Indrani Jadhav, Bashir Ahmad Fomda, Uksim Qadri, Idrees Mehraj Allaie, Qounsar Nisar, Mubashir Nazir, Azhar Shafi, Tahseen Bilal Rather","doi":"10.1093/trstmh/trag056","DOIUrl":"10.1093/trstmh/trag056","url":null,"abstract":"<p><strong>Background: </strong>Coxiella burnetii is a globally distributed zoonotic pathogen, but its presence in ticks from Kashmir has not been previously documented.</p><p><strong>Methods: </strong>This study investigated the prevalence, seasonal trends, and phylogenetic characteristics of C. burnetii in ticks collected from domesticated ruminants across eight districts of Kashmir. A total of 1800 ticks were harvested from 4965 cattle, sheep, and goats. Ticks were identified morphologically and subjected to PCR targeting the IS1111 insertion sequence. Positive amplicons were sequenced and analysed phylogenetically.</p><p><strong>Results: </strong>The tick infestation rate was 36.27%, with Haemaphysalis (84%) being the predominant genus, followed by Rhipicephalus (9.5%) and Ornithodoros (5.5%). C. burnetii DNA was detected in 10 ticks (0.55%) found in adult and nymphal stages of Haemaphysalis and Rhipicephalus from Srinagar and Kupwara districts. Infections were equally distributed between cattle and sheep, with no significant differences by tick gender or life stage. Peak prevalence was observed in summer in the month of July. Phylogenetic analysis revealed close clustering of Kashmir isolates (Cox-87 and Cox-81) with reference strains from the United States, Germany, and Indian goat-associated strains.</p><p><strong>Conclusions: </strong>This study provides the first molecular evidence of C. burnetii in ticks from Kashmir, highlighting low-level circulation and the need for integrated surveillance and One Health strategies.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"969-977"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}