Transactions of The Royal Society of Tropical Medicine and Hygiene最新文献_第5页

Parents' challenges in identifying offending snakes during paediatric snakebites in Sri Lanka: a qualitative study. 斯里兰卡儿童蛇咬伤期间，父母在识别冒犯蛇方面面临的挑战：一项定性研究。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag069

Kavinda Dayasiri, Tharuka Perera, Nayani Suraweera

{"title":"Parents' challenges in identifying offending snakes during paediatric snakebites in Sri Lanka: a qualitative study.","authors":"Kavinda Dayasiri, Tharuka Perera, Nayani Suraweera","doi":"10.1093/trstmh/trag069","DOIUrl":"10.1093/trstmh/trag069","url":null,"abstract":"Objectives: Accurate identification of the offending snake can support clinical decision-making in snakebite management, particularly in settings without venom detection facilities.Methods: A qualitative exploratory study was conducted among parents of children admitted with suspected or confirmed snakebites to three high-incidence hospitals in Sri Lanka. From August 2024 to July 2025, 64 in-depth interviews were carried out. The interviews were audio-recorded, transcribed, translated, and analysed thematically using Braun and Clarke's six-phase approach.Results: Parents described considerable uncertainty and limited knowledge of local snake species. Identification was hindered by poor visibility, rapid snake movement, conflicting eyewitness accounts, and confusion during emergencies. Fear, panic, and emotional distress often overrode systematic observation. Misidentification was frequent and contributed to elevated community fear and unnecessary killing of snakes. Parents relied heavily on elders and informal social media groups due to a lack of structured educational resources. Many expressed a clear need for practical, community-based training and visual tools to support accurate recognition.Conclusion: Parents face multiple challenges in identifying snakes during paediatric bite incidents, shaped by limited knowledge, situational constraints, emotional overload, and systemic gaps in preventive education. Strengthening community-level snake identification training and incorporating visual educational tools into child health programmes may reduce misidentification and support timely, appropriate care-seeking.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"922-928"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278743","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}

引用次数: 0

Cryptosporidium infection in Zambian adults: prevalence, risk factors and molecular characterization. 赞比亚成人隐孢子虫感染：流行、危险因素和分子特征。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag079

Florence Mwaba, Lucy J Robertson, Owen Ngalamika, Andrew M Phiri, Ngonda Saasa, Joyce Siwila

{"title":"Cryptosporidium infection in Zambian adults: prevalence, risk factors and molecular characterization.","authors":"Florence Mwaba, Lucy J Robertson, Owen Ngalamika, Andrew M Phiri, Ngonda Saasa, Joyce Siwila","doi":"10.1093/trstmh/trag079","DOIUrl":"10.1093/trstmh/trag079","url":null,"abstract":"Background: Cryptosporidium is an important enteric parasite causing diarrhoea in humans and animals worldwide. Data on the molecular epidemiology of Cryptosporidium infection in adults in Zambia are limited.Methods: A total of 566 stool samples from adults (18-50 years) were examined for Cryptosporidium oocysts by light microscopy following modified Ziehl-Neelsen staining. Molecular analysis of positive samples targeted the 60-kDa glycoprotein and heat shock protein 70-kDa genes. Demographic and potential risk factor information was obtained by semi-structured closed questionnaires.Results: The prevalence of Cryptosporidium infection was 3.0% (17/566), affecting a higher proportion of people living with human immunodeficiency virus (HIV) compared with HIV-negative participants, with a significantly higher prevalence among people living with HIV not using antiretroviral therapy (ART) (p=0.001). Additional associated factors included the use of municipal water (p=0.016), moderate monthly income (p=0.01), watery stool and frequent diarrhoea (p=0.001) and haemoglobin levels <10 g/dl (p=0.001). Both Cryptosporidium parvum and Cryptosporidium hominis were identified and all C. parvum subtypes were associated with anthroponotic transmission (IIiA9 [n=4], IIiA6 [n=2], IIeA11G1 [n=1] and IIcA5G3 [n=2]). For C. hominis subtypes, IeA11G3T3 (n=2), IaA26R3 (n=1) and IdA13 (n=1) were identified.Conclusion: Cryptosporidium infection continues to be a significant issue among individuals living with HIV. Health education focusing on reducing anthroponotic transmission routes should be a priority.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"978-987"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536954","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}

引用次数: 0

Russell's viper envenomation in a 9-month pregnant mare saved with high-dose antivenom: a first-in-world case report. 罗素毒蛇中毒在怀孕9个月的母马被高剂量抗蛇毒血清拯救：世界首例病例报告。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag076

Sadanand Dagadu Raut, Phiroz Khambatta, Pallavi Raut, Sandesh Raut

{"title":"Russell's viper envenomation in a 9-month pregnant mare saved with high-dose antivenom: a first-in-world case report.","authors":"Sadanand Dagadu Raut, Phiroz Khambatta, Pallavi Raut, Sandesh Raut","doi":"10.1093/trstmh/trag076","DOIUrl":"10.1093/trstmh/trag076","url":null,"abstract":"Snakebite during pregnancy is an uncommon but potentially catastrophic event, with maternal and foetal outcomes closely related to the severity of envenomation. While snakebite in pregnant women has been sporadically reported and is known to be associated with significant obstetrical complications, envenomation in animals, particularly in pregnant horses, is exceedingly rare. Only a few isolated cases of snakebite in horses have been documented, and to the best of our knowledge, snakebite in a pregnant mare has not been previously reported in the medical or veterinary literature. Russell's viper (Daboia russelii) envenomation is a major cause of morbidity and mortality in South Asia. We describe the first documented case of severe Russell's viper envenomation in a 5.5-year-old Marwari mare at 9 months of gestation following confirmed double bites to the muzzle. The mare developed rapidly progressive craniofacial oedema, respiratory compromise and severe venom-induced consumption coagulopathy with recurrent rebound coagulopathy. Management required intensive monitoring and administration of an unusually high cumulative dose of equine polyvalent antivenom totalling 60 vials. Despite the high venom burden, pregnancy-associated bleeding risk and delayed venom redistribution from facial tissues, the mare achieved complete clinical recovery with preservation of foetal viability. This case highlights the unique challenges of snakebite management in pregnant large animals, including venom depot effects, recurrent coagulopathy and foetal risk. Aggressive antivenom therapy guided by coagulation monitoring can result in favourable maternal and foetal outcomes. This report represents the first documented case of Russell's viper envenomation in a pregnant horse.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"906-911"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669676","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}

引用次数: 0

Long-lasting helminthic infection in African migrants to Israel - Lessons from the field. 非洲移民在以色列的长期寄生虫感染——来自实地的教训。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag072

Daniel Leshin-Carmel, Valery Istomin, Miriam Kaufman, David Hassin

引用次数: 0

Ethno-etiology meets virology: land leeches (family: Haemadipsidae) as potential disease vectors. 民族病原学与病毒学相结合：陆地水蛭（水蛭科）是潜在的疾病媒介。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag077

Thomas S Kraft, Vivek V Venkataraman, Michael Gurven, Mohd Nazip Suratman, Tony L Goldberg

{"title":"Ethno-etiology meets virology: land leeches (family: Haemadipsidae) as potential disease vectors.","authors":"Thomas S Kraft, Vivek V Venkataraman, Michael Gurven, Mohd Nazip Suratman, Tony L Goldberg","doi":"10.1093/trstmh/trag077","DOIUrl":"10.1093/trstmh/trag077","url":null,"abstract":"Objectives: Hematophagous terrestrial leeches are common in rainforest habitats and widely regarded as pests. Despite limited research, circumstantial evidence raises the possibility that, beyond being an annoyance, terrestrial leeches could potentially transmit diseases.Methods: We explored this possibility using multiple approaches. First, we reviewed published literature to synthesize knowledge related to disease transmission by leeches. Second, we collected terrestrial leeches (genus Haemadipsa) from human-occupied rainforests in Peninsular Malaysia and applied metagenomic methods for virus discovery to their anterior segments. Finally, we conducted interviews to probe local knowledge and behavior related to leeches, testing whether cultures may encode information that recognizes and helps to prevent vector-borne disease transmission.Results: Results indicate that terrestrial leeches are potential disease vectors, particularly via mechanical vector-borne transmission stimulated by human removal techniques. Supporting this, we identified four novel viruses within leeches, three of which are distantly related to medically important animal and human viruses which could potentially be transmitted among animal species, including humans. However, ethno-etiological evidence suggests that local Indigenous cultures do not recognize land leeches as disease vectors or promote behaviors likely to reduce transmission, suggesting knowledge may not encompass difficult-to-observe vectors.Conclusion: We conclude that disease transmission by terrestrial leeches is plausible and merits experimental study. Accession numbers: PX094876, PX118495, PX118496, PX118497, PX118498, PX118499.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"958-968"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562845","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}

引用次数: 0

Long-acting antiretroviral injections: perspectives of people living with HIV in three Middle East countries. 长效抗逆转录病毒注射：三个中东国家艾滋病毒感染者的观点。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-02 DOI: 10.1093/trstmh/trag058

Rahma Mohamed, Salma M A Mansour, Heba Fahmy, Ahmed Cordie, Roaa Al Osaimi, Faryal Khamis, Batool Ali, Renad Al Ghurybi, Jaleela Al Namani, Muna Ba'Omar, Amany Ahmed Salem, Ibrahim Ali Kabbash

{"title":"Long-acting antiretroviral injections: perspectives of people living with HIV in three Middle East countries.","authors":"Rahma Mohamed, Salma M A Mansour, Heba Fahmy, Ahmed Cordie, Roaa Al Osaimi, Faryal Khamis, Batool Ali, Renad Al Ghurybi, Jaleela Al Namani, Muna Ba'Omar, Amany Ahmed Salem, Ibrahim Ali Kabbash","doi":"10.1093/trstmh/trag058","DOIUrl":"10.1093/trstmh/trag058","url":null,"abstract":"Background: Although daily oral antiretroviral therapy (ART) is effective, pill burden, adherence challenges, stigma, and confidentiality concerns remain problematic for people living with HIV (PLHIV). Long-acting injectable ART (LAI-ART) is a promising alternative; however, data from the Middle East and North Africa (MENA) are limited. This study assessed PLHIV interest in LAI-ART and explored perceived benefits and barriers to implementation.Methods: A multicenter cross-sectional survey was conducted from October 2023 to December 2024 among PLHIV in Egypt, the Kingdom of Saudi Arabia, and Oman who were receiving or had previously received ART.Results: Among 1010 respondents, 88.7% expressed an interest in LAI-ART. Reported benefits included avoiding daily pills (91.1%), improved adherence (87.8%), enhanced confidentiality (86.7%), support for treatment adherence with comorbidities (88.3%), and reduced missed doses (74.5%). Reported barriers included injection pain (31.9%), difficulty scheduling travel within injection windows (30.6%), and frequent clinic visits (23.3%) to receive the injection.Conclusion: High interest in LAI-ART suggests readiness for adoption in the MENA region. Successful implementation requires addressing injection-related concerns through patient education, ensuring trained healthcare personnel, and adopting flexible scheduling to accommodate travel and lifestyle needs, while leveraging confidentiality benefits to mitigate HIV-related stigma and support adherence.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"948-957"},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983444","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}

引用次数: 0

Predictive value of platelet indices as early markers of mortality in patients with Crimean-Congo haemorrhagic fever: a retrospective observational study. 血小板指数作为克里米亚-刚果出血热患者死亡率早期标志物的预测价值：一项回顾性观察性研究

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-01 DOI: 10.1093/trstmh/trag103

Rukiye İnan Sarıkaya, Ayten Yanık, Ömer Karaşahin

{"title":"Predictive value of platelet indices as early markers of mortality in patients with Crimean-Congo haemorrhagic fever: a retrospective observational study.","authors":"Rukiye İnan Sarıkaya, Ayten Yanık, Ömer Karaşahin","doi":"10.1093/trstmh/trag103","DOIUrl":"https://doi.org/10.1093/trstmh/trag103","url":null,"abstract":"Background: To evaluate the predictive value of admission platelet-related indices for in-hospital mortality in Crimean-Congo haemorrhagic fever (CCHF).Methods: This retrospective single-centre study included adults with laboratory-confirmed CCHF between May 2022 and May 2023. The primary outcome was in-hospital mortality. Admission laboratory parameters and platelet-related indices were analysed using receiver operating characteristics analysis, DeLong comparisons, 2000-replicate bootstrap internal validation and reduced Firth logistic regression adjusted for age.Results: A total of 167 patients (median age 47 y [interquartile range 34-62], 61.7% male) were included; 14 (8.4%) died. Non-survivors were older. Platelet count, platelet count multiplied by lymphocyte count (PLT×LYM) and plateletcrit were lower, whereas mean platelet volume:lymphocyte ratio, platelet distribution width:lymphocyte ratio and mean platelet volume:platelet count ratio were higher in non-survivors. Median PLT×LYM was lower in non-survivors than survivors (15.35 vs 49.56; p<0.001). PLT×LYM had the highest discriminatory performance (area under the curve 0.882, cut-off 39.33, sensitivity 100%, specificity 66.7%, positive predictive value 21.5%, negative predictive value 100.0%). In the logistic regression model, each 10-unit increase in PLT×LYM was associated with an adjusted odds ratio of 0.50 (95% confidence interval 0.30 to 0.73).Conclusion: Admission PLT×LYM may serve as practical early marker for mortality risk stratification in CCHF; external validation is required.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866115","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}

引用次数: 0

Sustaining interruption of leprosy transmission in Eswatini: lessons from years of programme transition. 在斯瓦蒂尼持续阻断麻风病传播：多年规划过渡的经验教训。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-09-01 DOI: 10.1093/trstmh/trag102

Mathobela Mbongiseni, Dhruv Kumar Pandey, Zulu Zulisile, Mhlanga Nhlanhla, Machekera Shepherd, Moonasar Devanand, Dlamini Nomthandazo, Tembo Susan

{"title":"Sustaining interruption of leprosy transmission in Eswatini: lessons from years of programme transition.","authors":"Mathobela Mbongiseni, Dhruv Kumar Pandey, Zulu Zulisile, Mhlanga Nhlanhla, Machekera Shepherd, Moonasar Devanand, Dlamini Nomthandazo, Tembo Susan","doi":"10.1093/trstmh/trag102","DOIUrl":"https://doi.org/10.1093/trstmh/trag102","url":null,"abstract":"Leprosy elimination programmes in low-endemic countries face a paradox: declining disease burden can weaken the surveillance, technical expertise, political commitment, and community awareness needed to sustain interruption of transmission. Eswatini, a low-endemic country in Southern Africa, transitioned over four decades from a centralized institutional model of leprosy care to integrated service delivery within primary healthcare. From 2000 to 2024, only sporadic adult cases were detected, with no child cases reported for over two decades. This paper describes lessons from sustaining elimination during this transition. Key interventions included integrating leprosy diagnosis and treatment into primary healthcare, maintaining referral-level clinical expertise, routine zero-reporting via DHIS2, case-based surveillance with household contact tracing, and embedding leprosy indicators within national neglected tropical disease policies. The programme also implemented the WHO-recommended Leprosy Elimination Monitoring Tool (LEMT) and Leprosy Programme and Transmission Assessment (LPTA) to support verification. The Eswatini experience shows that sustaining interruption in low-burden settings requires continuous surveillance, minimal technical expertise, social inclusion, sustained political commitment, and cross-border collaboration to prevent re-establishment among mobile populations. WHO-verification processes drove programme strengthening by identifying gaps and reinforcing accountability. These lessons may inform other low-endemic countries progressing toward verification and the WHO target of zero leprosy by 2030.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866403","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}

引用次数: 0

Entomological surveillance in Caribbean wetlands of Colombia reveals Madariaga virus Lineage III in mosquito populations. 哥伦比亚加勒比海湿地昆虫学监测发现蚊子种群中存在Madariaga病毒III系。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-08-31 DOI: 10.1093/trstmh/trag101

Richard Onalbi Hoyos-López, María Claudia Atencia-Pineda, Salim Mattar

{"title":"Entomological surveillance in Caribbean wetlands of Colombia reveals Madariaga virus Lineage III in mosquito populations.","authors":"Richard Onalbi Hoyos-López, María Claudia Atencia-Pineda, Salim Mattar","doi":"10.1093/trstmh/trag101","DOIUrl":"https://doi.org/10.1093/trstmh/trag101","url":null,"abstract":"Objectives: Madariaga virus (MADV) is an emerging arboviral pathogen in Central and South America, but systematic entomological surveillance data remain limited in Colombia. We investigated MADV circulation in mosquitoes from the Alto Cotocá wetlands, Córdoba department, Colombia.Methods: Adult mosquitoes were collected during November-December 2017 and February-March 2018 using CDC light traps, Shannon traps, and manual aspiration. A total of 2984 mosquitoes were processed in 136 pools of 1-20 specimens and screened using generic Alphavirus RT-PCR with MADV-specific confirmation, bidirectional sequencing, and Bayesian phylogenetic analysis.Results: MADV was detected in 8 of 136 pools (5.9%) across five mosquito taxa: Culex erraticus, Culex quinquefasciatus, Culex spp., Mansonia titillans, and Psorophora ferox. The overall minimum infection rate was 2.68 per 1000 specimens (95% CI: 1.16-5.28). All sequences (GenBank MK131010-MK131017) clustered within Lineage III with 96.59%-96.62% identity to Colombian equine reference strains. Two haplotypes were identified among positive pools.Conclusion: This baseline assessment provides molecular evidence of MADV Lineage III in Colombian mosquito populations, establishes methodology for expanded surveillance, and supports the inclusion of MADV in differential diagnostic and surveillance considerations for arboviral encephalitis in Colombia.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865966","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}

引用次数: 0

Out-of-pocket expenditure and catastrophic health expenditure in patients of leprosy at a tertiary care center in India. 印度三级保健中心麻风病患者的自付支出和灾难性卫生支出。

IF 1.6 4区医学

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-08-27 DOI: 10.1093/trstmh/trag094

Kavita Kavita, Sukhdeep Singh, Kittu Malhi, Manisha Upreti, Sushma Saini, Arushi Ghai, Ritin Mohindra, Tarun Narang, Sunil Dogra

{"title":"Out-of-pocket expenditure and catastrophic health expenditure in patients of leprosy at a tertiary care center in India.","authors":"Kavita Kavita, Sukhdeep Singh, Kittu Malhi, Manisha Upreti, Sushma Saini, Arushi Ghai, Ritin Mohindra, Tarun Narang, Sunil Dogra","doi":"10.1093/trstmh/trag094","DOIUrl":"https://doi.org/10.1093/trstmh/trag094","url":null,"abstract":"Objectives: Leprosy continues to impose a significant clinical and socioeconomic burden. Despite free multidrug therapy, patients incur substantial out-of-pocket expenditure (OOPE), leading to catastrophic health expenditure (CHE). Evidence on the economic burden of leprosy in India remains limited.Methods: A pilot prospective observational study was conducted at a tertiary care center in North India, enrolling 56 patients with leprosy. Data on sociodemographic characteristics, direct and indirect healthcare costs, and income were collected.Results: The study population had a median age of 30 years, with 73% males, and 68% from rural areas. Multibacillary disease predominated (93%), with complications in 73.2% and a median diagnostic delay of 24 months. Median monthly household income was Indian Rupees (₹)12 000, while median OOPE was ₹1625, largely driven by medicines and travel. CHE was observed in 55.4% of patients. OOPE was significantly higher in multibacillary cases compared with paucibacillary disease (P = .04). A considerable proportion of patients resorted to borrowing money, indicating financial distress.Conclusion: Leprosy imposes a substantial financial burden, with more than one-half of patients experiencing CHE. Strengthening early diagnosis, decentralizing care, and improving financial protection mechanisms are essential to mitigate economic hardship.","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832004","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}

引用次数: 0