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

{"title":"Clinico-epidemiological study of snakebite: an audit of 13 years of data from a community-based treatment centre in eastern Nepal.","authors":"Srista Manandhar, Sunit Chhetri, Rohan Basnet, Arun Gautam, Urza Bhattarai, Manish Uprety, Aarjav Sharma, Ujwal Gautam, Madhav Bhushal, Sanjib Kumar Sharma","doi":"10.1093/trstmh/trae119","DOIUrl":"10.1093/trstmh/trae119","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenomation is a global public health concern, especially in tropical and subtropical regions. We describe the demography, presentations, treatments and outcomes of snakebites from a community snakebite treatment centre in Nepal.</p><p><strong>Methods: </strong>This was a retrospective study of snakebite cases from 2008 to 2021 presenting in a community-based treatment centre in eastern Nepal. The data were collected from predesigned forms in the centre.</p><p><strong>Results: </strong>The median age of the victims (N=13 825) was 29 y (interquartile range 18-43) predominantly comprising farmers (39.5%). Cobras (Naja spp.) were the predominant species. Self-treatment practices like the application of tourniquets are common (74.5%) and antivenom was infused to 3.3% of victims. Motorcycles (57.9%) were the primary mode of transport, significantly reducing the time to reach healthcare centres compared with other means (p<0.001). The majority of patients visiting the community snakebite centre exhibited improvement (98.4%), with a low referral rate (0.6%) and case fatality rate (1.26%).</p><p><strong>Conclusions: </strong>Snakebites are a common problem in rural Nepal. Neurotoxic envenomation, inflicted by the common cobra, predominates in this area. This community-based snakebite treatment centre, managed by paramedics, exemplifies the successful outcome of snakebite management in Nepal.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"804-812"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923384","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":"Human-snake conflict and snakebite envenoming: a planetary health perspective.","authors":"Patrick Joseph Tiglao, Yoshihiro Aoki, Nguyen Tien Huy","doi":"10.1093/trstmh/traf068","DOIUrl":"https://doi.org/10.1093/trstmh/traf068","url":null,"abstract":"","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529685","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":"Exploring the spectrum of headaches in neurocysticercosis: a systematic review and meta-analysis.","authors":"Ravindra Kumar Garg, Imran Rizvi, Raza Abbas Mahdi, Ravi Uniyal, Vinay Suresh","doi":"10.1093/trstmh/traf066","DOIUrl":"https://doi.org/10.1093/trstmh/traf066","url":null,"abstract":"<p><strong>Background: </strong>Understanding the prevalence, characteristics, diagnosis and management of headaches associated with neurocysticercosis (NCC) is essential for optimizing patient care.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We examined case reports, case series and cohort studies that explored headaches in NCC patients. The review protocol was registered in PROSPERO (CRD42024530164).</p><p><strong>Results: </strong>A total of 53 isolated NCC cases presenting with headache and 8 cohort studies were included. Severe or progressive headaches, often resembling migraines, were most prevalent (35.2%). Brain parenchymal cysts were the most frequently observed lesion type (39.6%), followed by ventricular cysts (28.3%). Treatment primarily consisted of cysticidal therapy (66.2%), with surgical intervention required in 25.4% of cases. The majority of patients (96.2%) experienced clinical improvement. The meta-analysis addressed three key questions. Patients with primary headaches exhibited a significantly higher prevalence of calcified NCC (odds ratio [OR] 2.82, I2=0%). Likewise, primary headaches were more common in individuals with calcified NCC (OR 2.82, I2=0%). However, headache frequency (mean difference=1.93, I2=86%) and severity (mean difference=4.45, I2=99%) did not differ significantly.</p><p><strong>Conclusions: </strong>Brain parenchymal cysts, particularly ring or disk-enhancing colloidal cysts, may present with new-onset headaches mimicking primary headache syndromes. Our meta-analysis indicates a significant association between calcified NCC and primary headaches, but no substantial differences were found in headache frequency or severity.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508433","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":"Strongyloidiasis in end-stage renal disease in Sri Lanka: urging research, improved diagnostics and access to ivermectin.","authors":"Chamarika Jayanetti Weerasekera, Nayana Gunathilaka, Nilanka Perera, Nilanthi Renuka de Silva, Renu Wickremasinghe","doi":"10.1093/trstmh/traf067","DOIUrl":"https://doi.org/10.1093/trstmh/traf067","url":null,"abstract":"","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498092","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":"Early detection of subclinical neuropathy and its evolution in newly diagnosed patients of leprosy started on multidrug therapy.","authors":"Arun Somasundaram, Rashmi Kumari, Malathi Munisamy, Rajeswari Aghoram, Chanaveerappa Bammigatti","doi":"10.1093/trstmh/traf062","DOIUrl":"https://doi.org/10.1093/trstmh/traf062","url":null,"abstract":"<p><strong>Background: </strong>Early detection of nerve impairment and its progression is critical in all leprosy cases, regardless of spectrum and treatment. This study aims to identify subclinical neuropathy at presentation in newly diagnosed leprosy patients and to monitor its progression after initiating multidrug therapy (MDT) using a combination of clinical nerve palpation, small fibre neuropathy tests (e.g. vibration, temperature, touch, pain, sweat), monofilament testing (MFT), voluntary muscle testing (VMT) and nerve conduction studies (NCSs).</p><p><strong>Methods: </strong>We studied 38 nerves among 19 patients and followed them for 12 months to assess neuropathy progression. Nerve palpation was evaluated clinically at baseline, while MFT was performed on the ulnar, median and posterior tibial nerves at baseline and 1 y. VMT and NCSs were conducted at both baseline and 12 months. Small fibre neuropathy was assessed using temperature (test tube), vibration (vibration perception threshold), sweating (starch iodide test) and pain responses at baseline.</p><p><strong>Results: </strong>Among the study cohort, 52.6% had borderline tuberculoid leprosy, followed by lepromatous leprosy (31.5%). Seven patients (36.8%) presented with a reaction at baseline. Major nerve trunks that were thickened included the ulnar nerve (52.6%) and common peroneal nerve (31.6%). Five patients had normal NCSs at baseline and 14 (73.4%) had abnormalities at baseline through NCSs and MFT. Thickened nerves had decreased nerve conduction and amplitude at baseline and more in the lepromatous spectrum. When they were followed up, two patients improved, five had no change and seven worsened from baseline in the NCSs. One patient had an abnormal NCS when followed up from the normal baseline NCS. The pattern of neuropathy was predominantly axonal and two of them were mixed (both axonal and demyelinating). MFT, compared with NCSs, was found to help detect both small and large fibre involvement.</p><p><strong>Conclusions: </strong>A combination of clinical tests and periodic NCSs is essential for detecting the progression of leprosy neuropathy. Neuropathy continued to progress despite 1 y of MDT, particularly in patients with early involvement at baseline.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529684","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":"Genetic markers at the crossroads: toll-like receptor polymorphisms and Plasmodium vivax malaria parasitological aspects from the Brazil-French Guiana border.","authors":"Marcelo Cerilo-Filho, Aína D R Ramirez, Vanessa S Barbosa, Renata B Correa, Myrela C S de Jesus, Marrara P Sampaio, Leonardo A Miceli, Nathália F Reis, Rubens A O Menezes, Margarete S M Gomes, Tamirys S Pimenta, Gustavo C Cassiano, José R S Silva, Luciane M Storti-Melo, Andrea R S Baptista, Ricardo L D Machado","doi":"10.1093/trstmh/traf061","DOIUrl":"https://doi.org/10.1093/trstmh/traf061","url":null,"abstract":"<p><strong>Background: </strong>Studies relating allelic variants in toll-like receptor (TLR) genes to the parasitological profile of Plasmodium vivax malaria are scarce. Therefore, we sought to assess whether polymorphisms in these genes can influence the clinical and parasitological aspects of individuals with P. vivax malaria in an endemic area from the Brazil-French Guiana border.</p><p><strong>Methods: </strong>We analyzed 76 patients with P. vivax malaria. Parasitological parameters were collected, and genomic DNA was extracted from whole blood. The single nucleotide polymorphisms (SNPs) of TLR4 (rs4986790, rs4986791), TLR6 (rs5743810) and TLR9 genes (rs187084, rs5743836) were genotyped by qPCR. Association between the levels of parasitemia and gametocytes with the SNPs was performed using Kruskal-Wallis and Mann-Whitney tests. Parasitemia and gametocyte levels were adjusted for the polymorphisms using a linear regression model.</p><p><strong>Results: </strong>There was a correlation between the TLR4 rs4986790, TLR6 rs5743810 and TLR9 rs187084 SNPs and parasitological aspects.</p><p><strong>Conclusions: </strong>The results described here suggest that these genes' polymorphisms may have a role in the development of the inflammatory response during P. vivax malaria. The potential implications of these findings are discussed.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512534","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":"Utility of anakinra in Crimean Congo haemorrhagic fever with haemophagocyctic lymphohistiocytosis: a case report.","authors":"Ümit Çelik, Ayşe Hitay Telefon, Tuğba Kandemir Gülmez, Elif Afat Turgut, Rabia Miray Kisla Ekinci, Merve Kılıç Çil, Mehmet Deniz Erhan","doi":"10.1093/trstmh/traf056","DOIUrl":"https://doi.org/10.1093/trstmh/traf056","url":null,"abstract":"<p><p>Crimean Congo haemorrhagic fever (CCHF) is an emerging, life-threatening tick-borne infection that can be fatal. As yet, there is no definitive treatment. In this case report we present a severe paediatric CCHF case that was successfully treated with anakinra. A previously healthy 13-year-old female presented with high fever, fatigue, rash and loss of appetite. Bone marrow aspiration showed rare haemophagocytocis and the patient's clinical condition continued to deteriorate. Anakinra was given on the day 5 of admission, as she was in the midst of cytokine storm syndrome. By the third day of anakinra, the patient's symptoms and laboratory tests improved. After 14 d of anakinra, she was discharged in full recovery. Anakinra may be a new therapeutic agent in CCHF, in which inflammation plays important role.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267290","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":"Anti-M2-pyruvate kinase autoantibodies are correlated with digestive damage in human Chagas disease.","authors":"Denis Dantas da Silva, Nathalie de Sena Pereira, Daniela Ferreira Nunes, Ramayana Morais de Medeiros Brito, Luanderson Cardoso Pereira, Andressa Noronha Barbosa da Silva, Carlos Ramon do Nascimento Brito, Cléber de Mesquita Andrade, Lúcia Maria da Cunha Galvão, Antonia Claudia Jácome da Câmara, Manuela Sales Lima Nascimento, Paulo Marcos Matta Guedes","doi":"10.1093/trstmh/trae144","DOIUrl":"10.1093/trstmh/trae144","url":null,"abstract":"<p><strong>Background: </strong>Determining esophageal and colon involvement in patients with Chagas disease occurs through invasive and uncomfortable examinations, which in most cases are not performed. The objective of this study was to assess the involvement of anti-M2-pyruvate kinase (M2-PK) autoantibodies in the development of digestive alterations and/or in the diagnosis of the digestive form of human Chagas disease.</p><p><strong>Methods: </strong>The total IgG and isotype (IgG1, IgG2, IgG3, IgG4) production was quantified using the antigen of Trypanosoma cruzi and the human M2-PK recombinant protein via the ELISA technique. The tests were conducted with serum samples from patients with indeterminate, cardiac, digestive and cardiodigestive clinical forms of Chagas disease, and the results were correlated with the dilatation degree of the esophagus and colon.</p><p><strong>Results: </strong>Patients with the digestive form of Chagas disease had higher IgG4 anti-M2-PK autoantibody production compared with patients with the indeterminate and cardiac forms and the healthy control group. Furthermore, a positive correlation was observed between sigmoid and rectum size with IgG4 anti-M2-PK autoantibody production.</p><p><strong>Conclusions: </strong>These results demonstrate that IgG4 anti-M2-PK autoantibodies correlate with digestive damage in human Chagas disease, and their presence may also be implicated in the development of digestive lesions.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"578-585"},"PeriodicalIF":1.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972205","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":"Conflict between sea snakes and humans on the coast of West Bengal and Odisha, India: perception, attitudes and incidents.","authors":"Anweshan Patra, Ardhendu Das Mahapatra, Anita Malhotra, Vishal Santra, Sudipta Kumar Ghorai, D Annadurai","doi":"10.1093/trstmh/trae086","DOIUrl":"10.1093/trstmh/trae086","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenoming is a critical medical emergency and significant global public health issue, with India experiencing the highest annual snakebite deaths. Sea snakes in the Indian Ocean pose a severe threat to rural fishermen due to their potent neurotoxins.</p><p><strong>Methods: </strong>From December 2020 to December 2021, we conducted surveys at 15 fishing ports in East Medinipur, West Bengal, and Balasore, Odisha, India (between 21.805651 N 87.874188 E and 21.574851 N 87.374059 E). We interviewed 2301 fishermen in 421 group sessions to document sea snake bite incidents, outcomes and perceptions from 2012 onwards. Historical data were also retrieved from various databases and social media platforms.</p><p><strong>Results: </strong>We recorded 166 sea snake bite cases, with 55.4% fatalities, 2.4% permanent disabilities and 41% survivors. Gill net fishermen were the most affected, with most bites occurring while handling snakes caught in nets, particularly at dawn and dusk. Fishermen reported a significant decline in sea snake populations over the past decade due to by-catch and killing practices.</p><p><strong>Conclusions: </strong>Sea snake bites are a major occupational hazard for Indian fishermen, with high fatality rates due to limited medical access. Increased awareness, safer handling practices and improved medical infrastructure are essential to reduce mortality and conserve sea snake populations. This study highlights the need for targeted interventions in affected communities.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"671-678"},"PeriodicalIF":1.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923324","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":"Challenges of researching snakes in India.","authors":"Sourish Kuttalam, Anita Malhotra","doi":"10.1093/trstmh/trae104","DOIUrl":"10.1093/trstmh/trae104","url":null,"abstract":"<p><p>The ambitious WHO goal of halving snakebite mortality by 2030 is challenged by a number of logistical hurdles, none more so than in India where snakebite envenomation presents a multifaceted challenge. We have collaborated with several organizations focused on snakebite in India over the last 11 years, with an emphasis on fieldwork to collect samples from venomous snakes in various regions, particularly understudied regions in the northeast and western Himalayas. This programme has encountered several significant obstacles, including securing permits from government organizations to collect snake samples in the field, obtaining long-term research funding, coordinating multidisciplinary collaboration on snakebite projects and engaging with grassroots stakeholders who are most affected by snakebite incidents. We emphasize the necessity of adopting a nationally coordinated yet regionally diversified approach that accounts for the biogeographical and cultural complexity of the country.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"632-634"},"PeriodicalIF":1.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923379","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}