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

{"title":"Association between blood group antigens ABO, Rh, Kell, Kidd, Duffy and MNS and clinical forms of Chagas disease.","authors":"Alexandre G Vizzoni, Andréa Rodrigues da Costa, Alejandro M Hasslocher-Moreno, Mauro Felippe F Mediano, Roberto M Saraiva","doi":"10.1093/trstmh/trae096","DOIUrl":"10.1093/trstmh/trae096","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms that determine the progression to cardiac or digestive forms of chronic Chagas disease (CD) are still unclear. We assessed the association between blood group antigens ABO, Rh, Kell, Kidd, Duffy and MNS, and chronic CD clinical forms.</p><p><strong>Methods: </strong>Patients were included consecutively between March 2013 and April 2016. Clinical and epidemiological data were obtained from electronic medical records and interviews. Classification of CD clinical forms followed the Brazilian Consensus on CD. The ID-Gel Card technology from Bio-Rad (Diamed/Bio-Rad Latin America, MG, Brazil) was used to analyze the blood group antigens.</p><p><strong>Results: </strong>A total of 619 adult patients (56.9% women, mean age 60±12 y) were included. Patients' clinical forms of CD were classified as follows: indeterminate 29.1%, cardiac 55.4%, digestive 5.5% and mixed 10.0%. Logistic regression analysis adjusted for age, comorbidities and time away from an endemic area revealed that the S+s- allele of the MNS blood type was associated with a lower odds of cardiac disease and that the B blood group type was associated with a higher odds of digestive disease. All other blood types did not have an association with CD clinical form.</p><p><strong>Conclusions: </strong>Blood group systems ABO and MNS were associated with chronic CD clinical forms.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"221-227"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676949","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":"Community-based snakebite risk mapping for resource prioritisation in Eastern Province, Rwanda.","authors":"Dileepa Senajith Ediriweera, Dieudonne Hakizimana, Peter J Diggle, Janna M Schurer","doi":"10.1093/trstmh/trae069","DOIUrl":"10.1093/trstmh/trae069","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenoming is a medical emergency that requires rapid access to essential medicines and well-trained personnel. In resource-poor countries, mapping snakebite incidence can help policymakers to make evidence-based decisions for resource prioritisation. This study aimed to characterise the spatial variation in snakebite risk, and in particular to identify areas of relatively high and low risk, in Eastern Province, Rwanda.</p><p><strong>Methods: </strong>Snakebite surveillance of people bitten in 2020 was conducted in Eastern Province through household visits and case verification. Geostatistical modelling and predictive mapping were applied to data from 617 villages in six districts to develop sector-level and district-level risk maps.</p><p><strong>Results: </strong>There were 1217 individuals bitten by snakes across six districts. The estimated population-weighted snakebite incidence in Eastern Province was 440 (95% predictive interval 421 to 460) cases per 100 000 people, corresponding to 13 500 (95% predictive interval 12 950 to 14 150) snakebite events per year. Two sectors in the southwest, Gashanda and Jarama, showed >1500 snakebite events per 100 000 annually. The lowest incidence was observed in the north.</p><p><strong>Conclusions: </strong>Considerable differences exist in snakebite risk between sectors in Eastern Province, with the highest risk concentrated in the southwest. Policymakers should consider prioritising resources related to snakebite prevention, essential medicines and health worker training in this region.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"310-316"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923385","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":"Special Issue Editorial: Sustainably reducing snakebite burden by prioritising research(ers) in high-risk areas.","authors":"Frank-Leonel Tianyi, Maya Gopalakrishnan, Thomas Pinfield","doi":"10.1093/trstmh/traf007","DOIUrl":"10.1093/trstmh/traf007","url":null,"abstract":"","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"278-282"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374675","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 imatinib in severe COVID-19: a systematic review and meta-analysis.","authors":"João Pedro Sarcinelli Chagas, Juliana Ribeiro de Oliveira, Vinicius Andreata Brandão, Ana Paula Brandão Bellucio, João Victor de Azevedo Dutra, Julia Ramos Dutra, Crispim Cerutti","doi":"10.1093/trstmh/trae095","DOIUrl":"10.1093/trstmh/trae095","url":null,"abstract":"<p><strong>Background: </strong>Considering the potential antiviral and immunomodulatory properties of imatinib, this drug has been investigated in several studies as a potential treatment option for severe cases of COVID-19, given that treatment modalities available remain limited.</p><p><strong>Objectives: </strong>To evaluate the benefits or otherwise of imatinib for COVID-19 in severely ill patients, we performed a systematic review of studies that tested the efficacy and the safety of imatinib for COVID-19 and executed a meta-analysis.</p><p><strong>Methods: </strong>We searched Medline, Embase and Cochrane with the following search terms: 'coronavirus', 'SARS-Cov2', 'covid', 'covid-19' and 'imatinib'. The latest search date was November 2023. We used Cochrane Collaboration's tool to assess bias in randomized trials.</p><p><strong>Results: </strong>We included three randomized controlled trials with 561 participants. A total of 276 patients received imatinib and 285 received placebo. The mortality results showed no statistically significant differences between imatinib and controls (RR 0.61; 95% CI 0.37 to 1.01; p=0.06). There was no significant difference in length of hospital stay or severe adverse events occurring between groups.</p><p><strong>Conclusions: </strong>Current evidence suggests that the potential benefits of imatinib should be further evaluated in randomized controlled trials in patients hospitalized for COVID-19.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"203-209"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717212","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":"Health-seeking behaviours and traditional healer practices for snakebite in rural and tribal communities in southern India.","authors":"Ravikar Ralph, Rohan Michael Ramesh, Mohan Jambugulam, Arpitha Anbu Deborah, Kumudha Aruldas, Neal A Moorthy, Sushil Mathew John, Judd L Walson, Anand Zachariah, Sitara Swarna Rao Ajjampur","doi":"10.1093/trstmh/trae083","DOIUrl":"10.1093/trstmh/trae083","url":null,"abstract":"<p><strong>Background: </strong>Nearly 60 000 Indians die of snakebite envenoming each year. Most deaths occur in rural communities and remote tribal settlements. We describe snakebite-related epidemiology and health-seeking behaviours in a rural (Timiri) and remote tribal block (Jawadhu Hills) in Tamil Nadu, India.</p><p><strong>Methods: </strong>This cross-sectional survey used structured questionnaires for information pertaining to snakebites and their treatment in the preceding year. Treatment-seeking behaviour from the moment reported until recovery was mapped. Traditional healers residing in the two blocks were also surveyed.</p><p><strong>Results: </strong>Snakebite incidence and mortality were 174/100 000 population and 2.7/100 000 population in Jawadhu Hills and 194/100 000 population and 2.6/100 000 population in Timiri, respectively. More snakebite victims applied tourniquets in Jawadhu Hills (90%) than in Timiri (69%). Traditional healers were the first contact for 64% in Jawadhu Hills. Ambulances and buses were reported as unavailable in Jawadhu Hills. Traditional healers in Jawadhu Hills did not refer snakebite victims to hospitals.</p><p><strong>Conclusions: </strong>Three challenges to snakebite mitigation in Indian rural and tribal communities highlighted in this study are potentially harmful first aid, a disconnect between traditional healers and the public health system and a lack of emergency transport to health facilities. Addressing these challenges would necessitate community awareness, traditional healer engagement and improved means of public transportation.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"317-326"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923422","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":"Overcoming the snakebite challenge in Sudan: a call to action.","authors":"Rawa Badri, Iyas Dawood, Rana Osman, Nayyrah Ahmed, Salma Ibrahim Mohammed Adam","doi":"10.1093/trstmh/trae061","DOIUrl":"10.1093/trstmh/trae061","url":null,"abstract":"<p><p>Snakebite envenomation is a neglected tropical disease that affects millions of people in sub-Saharan Africa, including Sudan. The severity of snakebite envenomation ranges from mild to severe, and can even lead to death. Sudan has a high burden of snakebite envenomation, with an estimated 12 632 cases and a mortality rate of 2.5% per year. The country faces several challenges in addressing snakebite envenomation, including a weak health system, limited access to healthcare facilities and a shortage of antivenom. This article highlights the challenges facing snakebite control in Sudan and provides recommendations for reducing the burden of this neglected tropical disease.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"327-329"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922923","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":"Evaluation of the immunogenicity of a DNA vaccine for Leishmania major based on the Leishmania-activated C kinase antigen using calcium phosphate and chitosan adjuvants.","authors":"Abdolaziz Gharaei, Mahmoud Rahdar, Oghlniaz Jorjani, Sedigheh Saberi, Molouk Beiromvand, Mohammad Hossein Feiz-Haddad","doi":"10.1093/trstmh/trae126","DOIUrl":"10.1093/trstmh/trae126","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis represents a significant parasitic disease with global health implications, and the development of an affordable and effective vaccine could provide a valuable solution. This study aimed to evaluate the immunogenicity of a DNA vaccine targeting Leishmania major specifically based on the Leishmania-activated C kinase (LACK) antigen, utilizing calcium phosphate nanoparticles (CaPNs) and chitosan nanoparticles (ChitNs) as adjuvants.</p><p><strong>Methods: </strong>Seventy female BALB/c mice, aged 4-6 wk and weighing 20-22 g, were selected and divided into five groups, each consisting of 14 mice. The first group received the plasmid LACK vaccine (pcDN3+LACK), the second group received the pcDN3+LACK vaccine with the CaPN adjuvant (pcDN3+LACK+CaPN), the third group received the pcDN3+LACK vaccine with the ChitN adjuvant (pcDN3+LACK+ChitN), the fourth group was administered phosphate-buffered saline as a negative control and the fifth group did not receive any vaccine, serving as a positive control. The vaccination program involved two intramuscular injections at 3-wk intervals. Three weeks following the final vaccination, the mice were challenged with wild-type L. major promastigotes via intradermal injection at the base of their tails. Clinical signs and lesion sizes were evaluated biweekly using Vernier calipers. Immune responses, including levels of interferon-gamma (IFN-γ) and interleukin-4 (IL-4), were assessed using ELISA.</p><p><strong>Results: </strong>The groups receiving pcDN3+LACK+ChitN, pcDN3+LACK+CaPN and pcDN3+LACK exhibited the highest increases in IFN-γ titers and the most significant reductions in IL-4 titers. Furthermore, lesion sizes associated with Leishmania infection were reduced in the vaccinated groups, with the most favorable outcomes observed in the pcDN3+LACK+ChitN group.</p><p><strong>Conclusions: </strong>These findings suggest that vaccination utilizing the LACK antigen in conjunction with CaPN and ChitN adjuvants may represent an effective strategy for the control of cutaneous leishmaniasis.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"266-273"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923391","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":"Haemotoxicity of snakes: a review of pathogenesis, clinical manifestations, novel diagnostics and challenges in management.","authors":"Bhawani Yasassri Alvitigala, Harsha A Dissanayake, Praveen N Weeratunga, P A Chanya D Padmaperuma, Lallindra Viranjan Gooneratne, Christeine Ariaranee Gnanathasan","doi":"10.1093/trstmh/trae058","DOIUrl":"10.1093/trstmh/trae058","url":null,"abstract":"<p><p>Haemotoxicity is the most common complication of systemic envenoming following snakebite, leading to diverse clinical syndromes ranging from haemorrhagic to prothrombotic manifestations. Key haematological abnormalities include platelet dysfunction, venom-induced consumption coagulopathy, anticoagulant coagulopathy and organ-threatening thrombotic microangiopathy. Diagnostic methods include the bedside whole blood clotting test, laboratory coagulation screening and other advanced methods such as thromboelastogram and clot strength analysis. The primary management strategies are venom neutralisation with antivenom and correction of coagulopathy with blood component transfusions, while options such as plasma exchange are utilised in certain cases. Recent advancements in understanding the pathogenesis of haemotoxicity have facilitated the development of new diagnostic and treatment modalities. This review summarises current knowledge on the pathogenesis, diagnosis, clinical and laboratory manifestations and treatment of the haematological effects of snake envenoming. Furthermore, it highlights important challenges concerning diagnosis and management. Addressing these challenges is crucial for achieving the WHO's goal of reducing deaths and disabilities caused by snakebites by 2030.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"283-303"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923414","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":"Randomized trial of BCG in healthcare workers to reduce absenteeism during the COVID-19 pandemic in sub-Saharan Africa.","authors":"I Silva, L Nhamússua, E Ca, F Schaltz-Buchholzer, A Nhama, M Cumbe, A P Delgado, M L Lima Mendonça, P Fontoura, M Sidat, P Ferrinho, I I Araújo, P Aide, C Benn, I Fronteira, S Nielsen","doi":"10.1093/trstmh/trae108","DOIUrl":"10.1093/trstmh/trae108","url":null,"abstract":"<p><strong>Background: </strong>We tested whether providing BCG vaccine to healthcare workers (HCWs) could reduce non-planned absenteeism and thereby reduce the potential impact of the COVID-19 pandemic on healthcare systems in Africa.</p><p><strong>Methods: </strong>We conducted a multicenter, single-blinded, placebo-controlled randomized trial in Guinea-Bissau and Mozambique between December 2020 and June 2022. Participants were randomized 1:1 to BCG vaccine or placebo (saline) and followed by biweekly telephone calls for 6 mo. The incidence of unplanned absenteeism due to illness was analyzed using Bayesian negative binomial regression yielding relative RRs. Secondary outcomes included infectious disease episodes, COVID-19 infection and all-cause hospitalizations.</p><p><strong>Results: </strong>We enrolled 668 HCWs (Guinea-Bissau, n=503; Mozambique, n=165). The RR for absenteeism of BCG vs placebo was 1.29 (0.81 to 1.94) with comparable effects by country. No protection against infectious disease episodes (HR=1.18 [0.97 to 1.45]) or COVID-19 infection (HR=1.19 [0.80 to 1.75]) was observed. Two trial deaths (1 BCG, 1 control) were registered and nine admissions (3 BCG, 6 control), the all-cause admission HR being 0.51 (0.13 to 2.03).</p><p><strong>Conclusions: </strong>With 64% of the planned sample size and unplanned absenteeism rates lower than expected, BCG did not reduce self-reported absenteeism due to illness. Rather, BCG tended to increase the risk of self-reported absenteeism, infectious disease episodes and COVID-19 infections.</p><p><strong>Short summary: </strong>This was a randomized control trial assessing non-specific effects of BCG vaccination in healthcare workers. There was no beneficial effect on self-reported absenteeism due to illness within 6 mo of follow-up during the COVID-19 pandemic, but a trend towards fewer all-cause hospital admissions.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"244-252"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682407","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 T-lymphotropic Virus infection among Quilombo communities in Central Brazil.","authors":"Carolina Amianti, Larissa M Bandeira, Lívia A Lima, Bárbara V do Lago, Antonio C R Vallinoto, Ana Rita C Motta-Castro","doi":"10.1093/trstmh/trae127","DOIUrl":"10.1093/trstmh/trae127","url":null,"abstract":"<p><strong>Background: </strong>This study estimated the sociodemographic characteristics and prevalence of Human T-lymphotropic Virus (HTLV) infection among Afro-Brazilians in the two largest remnant Quilombo communities in Mato Grosso do Sul State.</p><p><strong>Methods: </strong>Participants were interviewed from October 2015 to October 2016. Blood samples were collected and screened for anti-HTLV-1/2 antibodies using a commercial ELISA kit.</p><p><strong>Results: </strong>No positive results for HTLV-1/2 infection were detected among the 316 screened samples.</p><p><strong>Conclusions: </strong>These findings provide additional information on the sociodemographic characteristics and HTLV status of Quilombos in Mato Grosso do Sul State.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"274-277"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807969","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}