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

{"title":"Spatiotemporal patterns and factors associated with mortality from visceral leishmaniasis in a northern state of Brazil.","authors":"Helen Mariel Biazussi, Fernanda do Carmo Magalhães, Diogo Tavares Cardoso, David Soeiro Barbosa, Mariângela Carneiro","doi":"10.1093/trstmh/traf035","DOIUrl":"10.1093/trstmh/traf035","url":null,"abstract":"<p><strong>Background: </strong>This study analysed the spatiotemporal patterns of visceral leishmaniasis (VL) mortality and the prognostic factors associated with deaths in Tocantins, Brazil.</p><p><strong>Methods: </strong>We conducted an ecological and retrospective cohort study analysing deaths from VL (2010-2019). The univariate global and local Moran indexes were performed, Kulldorff scan statistics were investigated and multilevel logistic regression analysis was performed.</p><p><strong>Results: </strong>Among the 2437 confirmed cases, 156 patients died from VL, with mortality rates ranging from 0.4 to 1.9 deaths per 100 000 inhabitants. Spatial autocorrelation of VL mortality rates was observed between municipalities, distributed heterogeneously throughout the period. In the northern region of the state, a cluster with a high spatiotemporal risk of mortality from VL was detected. VL deaths were associated with age (≤1 y [odds ratio {OR} 9.4 {95% confidence interval (CI) 3.9 to 22.0}]; >10-≤20 y [OR 4.5 {95% CI 1.5 to 12.9}]; >20-≤40 y [OR 5.3 {95% CI 2.1 to 13.3}]; >40-≤60 y [OR 13.2 {95% CI 5.4 to 32.4}]; >60 y [OR 30.4 {95% CI 12.2 to 75.5}]), jaundice (OR 1.8 [95% CI 1.2 to 2.7]), haemorrhagic phenomena (OR 2.7 [95% CI 1.5 to 5.0]), splenomegaly (OR 1.7 [95% CI 1.1 to 2.5]) and human immunodeficiency virus co-infection (OR 2.0 [95% CI 1.1 to 3.8]).</p><p><strong>Conclusions: </strong>Knowing the spatiotemporal behaviour and factors associated with death from VL can contribute to the clinical management of patients and control of the disease.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"891-901"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773445","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":"Characteristics of snakebite patients due to Naja samarensis in the Philippines: a prospective hospital-based study.","authors":"Yoshihiro Aoki, Jonathan Paghubasan, Patrick Joseph Tiglao, Marvin Jay Sarmiento, Rustan Arrieta, Mariedel A Tan, Mardie S Sarsalijo, Grace Joy B Aquino, Mercy Grace Beronilla-Uraga, John David L Comandante, Emelia B Santamaria, Greco Mark B Malijan, Shuichi Suzuki, Kensuke Takahashi, Shuhei Yamano, Chris Smith, Koichi Hayakawa, Osamu Tasaki, Lourdes C Agosto, David A Warrell, Koya Ariyoshi","doi":"10.1093/trstmh/trae110","DOIUrl":"10.1093/trstmh/trae110","url":null,"abstract":"<p><strong>Background: </strong>Little is known about snakebites by Naja samarensis, a species unique to the Philippines. The aim here is to describe the clinical and epidemiological characteristics of patients bitten by this medically important cobra in the Eastern Visayas.</p><p><strong>Methods: </strong>A hospital-based prospective study analysed the features of snakebite patients attending Eastern Visayas Medical Center between June 2022 and May 2023. Logistic regression analysis identified the factors associated with severity.</p><p><strong>Results: </strong>A total of 175 snakebite patients with five fatalities were included. Naja samarensis was most commonly implicated (n=49, 28.0%), although it could be definitively identified, by examining photographs of the snake responsible, in only four cases. The N. samarensis bites occurred in grass or rice fields, in daytime, and during farming activities, but the people bitten were most frequently students (34.7%) who were bitten at home (36.7%). Patients bitten by N. samarensis often presented with cytotoxic (63.3%) and neurotoxic signs (46.9%). Traditional remedies were common, resulting in delayed presentation to the hospital. Bites by N. samarensis, and older age (>44 y) were independently associated with severity (adjusted OR of 10.33 and 7.89, respectively).</p><p><strong>Conclusion: </strong>Naja samarensis is a major cause of severe snakebites in this region. Pre-hospital treatment frequently involves wasted time and unproven traditional methods. Enhancement of public awareness is urgently needed. Development of a diagnostic test for species identification is warranted to improve future surveys and management.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"933-942"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923382","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":"Venom composition, toxicity and cross-neutralization by PoliVal-ICP antivenom, of Mesoamerican jumping pitvipers genus Metlapilcoatlus (Viperidae: Crotalinae).","authors":"Adriana Alfaro-Chinchilla, Bruno Lomonte, Luis Zúniga, Manuel Acevedo, Edgar Neri-Castro, Alejandro Alagón, Fabian Bonilla, Cecilia Diaz, Mahmood Sasa","doi":"10.1093/trstmh/trae120","DOIUrl":"10.1093/trstmh/trae120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The genus Metlapilcoatlus was recently erected to include six species of stout venomous snakes, known as the jumping pitvipers, which inhabit mountainous areas of Mesoamerica. This group maintains affinity with Atropoides picadoi, another jumping pitviper with restricted distribution in Costa Rica and Panama. Although the venom of A. picadoi and a couple of Metlapilcoatlus species has previously been characterized, little is known about the interspecific and intraspecific variation of the other species that comprise the genus. In this work, we characterize the venoms of five out of the six species that make up the genus Metlapilcoatlus: Metlapilcoatlus indomitus, Metlapilcoatlus mexicanus, Metlapilcoatlus nummifer, Metlapilcoatlus occiduus and Metlapilcoatlus olmec, and for three of them, we analyze whether ontogenetic change occurs in the composition of their venoms. Additionally, we evaluated the cross-neutralizing capacity of the antivenom PoliVal-ICP used in Central American countries to treat viper envenomation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We utilized sodium dodecyl sulfate-polyacrylamide gel electrophoresis and reverse-phase HPLC for venom characterization. Toxin identification was conducted using a bottom-up shotgun proteomic approach. We also estimated venom toxicity based on average lethality estimates in a murine model. The PoliVal-ICP neutralizing capacity on lethal activity was evaluated for all venoms. Using the venom of M. mexicanus as a model, we also tested the neutralizing capacity of this antivenom on hemorrhagic, myotoxic, proteolytic, phospholipase and coagulant activities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our analysis revealed that the venoms of jumping vipers are composed of proteins belonging to approximately 8-17 families, typically shared with other crotalines. Despite these general similarities, we observed variations at both intraspecific, including ontogenetic, and interspecific levels in venom composition and toxicity. The chromatographic pattern of Metlapilcoatlus venom exhibited peaks in the PLA2/PLA2-like eluting region, likely responsible for the myotoxic activity of these venoms. By contrast, these peaks were almost negligible in the chromatogram of A. picadoi, whose venom is significantly more hemorrhagic. Among the Metlapilcoatlus species, M. indomitus venom stood out as notably different from the others, and it was also the most lethal. The antivenom demonstrated its effectiveness in neutralizing the lethal activity of all the venoms tested, as well as the various biological activities studied in the venom of M. mexicanus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Beyond the scope of the variation revealed here, our preclinical results demonstrate that PoliVal-ICP antivenom effectively neutralizes toxins from the venom of all Mesoamerican jumping vipers, despite not including venom from any of them in its immunization mixture. This cross-neutralization capacity predicts ICP antiven","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"954-970"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923307","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 prevalence of anemia and its association with body mass index and obesity in adults: a community-based cross-sectional study.","authors":"Husham O Elzein, Ahmed A Hassan, Ishag Adam","doi":"10.1093/trstmh/traf031","DOIUrl":"10.1093/trstmh/traf031","url":null,"abstract":"<p><strong>Background: </strong>Anemia and obesity are health problems in Sudan. Data on the association between obesity and anemia in adults are scarce. We aimed to investigate the prevalence of anemia and its association with body mass index (BMI) and obesity among adults in Sudan.</p><p><strong>Methods: </strong>A community-based survey was conducted in northern Sudan. The participants' sociodemographic characteristics were assessed using a questionnaire. Multivariate binary analyses were performed.</p><p><strong>Results: </strong>Out of 405 adults, there were 204 (50.4%) males and 201 (49.6%) females. Their median (IQR) of age and BMI was 45.0 (33.0‒55.5) y and 26.2 (22.5‒30.4) kg/m2, respectively. Thirty-nine (9.6%), 131 (32.3%), 122 (30.1%) and 113 (27.9%) were underweight, normal weight, overweight and obese, respectively. Ninety-three (23.0%) had anemia and one (0.2%) had severe anemia. BMI values in adults with anemia were significantly lower than those without anemia. In a multivariate binary analysis, increasing BMI (adjusted OR [AOR]=0.94, 95% CI 0.90 to 0.98) and obesity (AOR=0.39, 95% CI 0.20 to 0.76) were associated with a lower risk of anemia.</p><p><strong>Conclusions: </strong>Increasing BMI and obesity were associated with a lower risk of anemia. Further research is needed to explore the association between obesity and anemia.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"865-871"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568277","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":"Dengue with liver involvement is associated with serum soluble thrombomodulin and P-selectin levels.","authors":"Yanxia Huang, Linxuan Xue, Longjiao Dou, Zhuoqi Liu, Xiaohui Lu, Zhihui Tu, Hongyi Chen, Xianglin Tu, Jianfeng Rao, Li Wang, Xuping Peng, Weihua Ju, Shumei Wang, Daya Luo","doi":"10.1093/trstmh/traf034","DOIUrl":"10.1093/trstmh/traf034","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of liver damage in dengue patients has not been clarified. In this study, we sought to identify the factors that are associated with dengue-induced liver damage and evaluate the associations of cytokines/chemokines, including platelets, neutrophils, activated endothelial cells and other inflammatory factors, with liver damage.</p><p><strong>Methods: </strong>We collected and analysed clinical data from 106 hospitalized dengue patients and evaluated the serum levels of platelet (soluble P-selectin [sP-selectin] and soluble CD40 ligand [sCD40L]), neutrophil (neutrophil elastase [NE] and neutrophil myeloperoxidase [MPO]) and endothelial cell (soluble thrombomodulin [sTM]) activation markers, as well as inflammatory mediators, including C-X-C motif chemokine ligand 2 (CXCL2), interleukin (IL)-2, IL-4, IL-6, IL-10, tumour necrosis factor-α and interferon-γ (which are associated with liver damage), in 32 patients.</p><p><strong>Results: </strong>In total, 106 dengue patients were included in this study. The patients were categorized into dengue with warning signs (DwWS), dengue without warning signs (DwoWS) and severe dengue (SD). Twenty-four patients (22%) had DwWS and 1 patient (1%) had SD. Compared with the DwoWS group, the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase levels in the DwWS/SD group were significantly greater (p<0.001, p<0.001 and p=0.001, respectively). A long time to onset (odds ratio [OR] 1.495 [95% confidence interval {CI} 1.063 to 2.101], p=0.021), thrombocytopenia (OR 4.166 [95% CI 1.11 to 15.629], p=0.034) and concomitant fatty liver (OR 6.326 [95% CI 1.57 to 25.493], p=0.009) were risk factors for dengue-related liver dysfunction. Compared with patients with normal liver enzyme levels, serum sP-selectin levels were significantly lower (p=0.012), sTM levels were higher (p=0.047), serum ALT and AST levels were positively correlated with sTM (r=0.411, p=0.02 and r=0.419, p=0.039; respectively) and AST levels were negatively correlated with sP-selectin levels (r=-0.441, p=0.011) in dengue patients.</p><p><strong>Conclusions: </strong>Dengue fever with hepatic involvement is related to serum sTM and sP-selectin levels, thus suggesting that platelet and endothelial cell activation may be involved in the pathogenesis of liver damage and can be used as early predictors of dengue liver damage.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"881-890"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804320","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":"Snakebite in Nicoadala District, central Mozambique: a first assessment based on hospital records.","authors":"Avelino R Miguel, Eliseu D Conceição, Célio Alfredo, Paulo N Miguel, Hinrich Kaiser","doi":"10.1093/trstmh/traf033","DOIUrl":"10.1093/trstmh/traf033","url":null,"abstract":"<p><strong>Background: </strong>Despite the significant impact of snakebite on public health in the tropics, there is a notable lack of research on this topic in Mozambique. We present an assessment of snakebite incidence in Nicoadala District, central Mozambique.</p><p><strong>Methods: </strong>We analysed hospital records of snakebite for a 6-y period (2015-2020). Data were obtained from registration books used in three health centres and descriptive statistics were generated to illustrate the results.</p><p><strong>Results: </strong>Records document 430 reported cases of snakebite over the 6 y (71.7 per year). The highest incidence was in 2017 with 48.2 per 100 000 people. The month with the highest frequency of snakebite was January, with an average of 51.9 cases per 100 000. Women were 26.7% more likely to be bitten than men (125.8 vs 99.1 per 100 000). Furthermore, people aged 20-39 y had the highest incidence (99.1 per 100 000).</p><p><strong>Conclusions: </strong>Most snakebite cases involved adult women and occurred in the months of November-January in 2016-18. While basic data allow for a preliminary assessment of snakebite incidence, our study was constrained by significant knowledge gaps. These include insufficient information on (1) patients' occupation and activity; (2) time and actions taken to seek medical attention; (3) acute or long-term symptoms; (4) treatments administered; (5) length of hospitalisation and clinical outcomes; and (6) the identity of the snake species responsible. This lack of detail underscores the need for training to standardise and improve clinical documentation of snakebite cases. In addition, community-focused snakebite education is a critical public health need that would likely save many lives.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"872-880"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731903","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":"From relief to resistance: implications of self-medication practice for malaria elimination in India.","authors":"Kanika Verma, Nitika Nitika, Praveen Kumar Bharti","doi":"10.1093/trstmh/traf008","DOIUrl":"10.1093/trstmh/traf008","url":null,"abstract":"<p><p>The self-medication practices in India may pose challenges to malaria elimination efforts. While individuals often seek immediate relief from symptoms, the indiscriminate use of antimalarial medications can lead to increased resistance among malaria parasites. This study highlights the implications of self-medication on public health, exploring their impact on malaria elimination. Public awareness campaigns highlighting the risks of self-treatment, necessity of professional medical consultation and the need for malaria diagnosis prior to initiating treatment should be carried out. Addressing self-treatment practices will improve patient outcomes, mitigate the development of drug resistance in parasites and contribute to the goal of a malaria-free India.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"919-921"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383404","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":"Cutaneous leishmaniasis in Afghanistan.","authors":"Bilal Ahmad Rahimi, Mohammad Amin Ghatee, Muhammad Naeem Habib, Khushhal Farooqi, Koert Ritmeijer, Huma Syed Hussain, M Asim Beg, Walter R Taylor","doi":"10.1093/trstmh/traf028","DOIUrl":"10.1093/trstmh/traf028","url":null,"abstract":"<p><p>Old World cutaneous leishmaniasis (OWCL) is a sand fly-transmitted skin infection caused by Leishmania species that extends from West Africa to China. Afghanistan probably has the highest burden of OWCL and is home chiefly to Leishmania  tropica and Leishmania  major, which cause anthroponotic and zoonotic CL, respectively. Although data on the species distribution in Afghanistan are patchy, L. tropica predominates over L. major, reflecting its concentration in large cities. CL prevalence in Afghanistan increases with increasing age to peak at 5-10 y, depending on the local epidemiology. Clinically, there is a spectrum of lesions common to both main species with nodules, ulcerated nodules and papules accounting for the majority (50-80%) of lesions at presentation. When healed, CL lesions leave pale scars that often have deleterious psychosocial effects. Leishmania control involves vector control and treating patients, but these are severely challenged by decades of war and disruption to the health system. In the public sector, only injectable antimonials, sodium stibogluconate or meglumine antimoniate, are available and, anecdotally, efficacy remains high. Few clinical trials have been conducted in Afghanistan and data support antimonial efficacy; small clinical series suggest good efficacy of oral miltefosine against the two main species. Herein, we focus our review on the epidemiological and clinical aspects of CL in Afghanistan and suggest avenues of future research.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"848-864"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033274","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":"Schistosomiasis japonicum burden in adult villagers of Qingshan Island, China: a cross-sectional study on prevalence, intensity, knowledge and risk factors.","authors":"Ying Zhang, Kai Liu, Jie Jiang, Yu Zhang, Zhen Yang, Shudong Xie, Yingzi Ming","doi":"10.1093/trstmh/traf078","DOIUrl":"https://doi.org/10.1093/trstmh/traf078","url":null,"abstract":"<p><p>Schistosomiasis has been endemic in China for >1000 y. With decades of effort, significant progress has been achieved in its prevention and control. However, certain regions, like Qingshan Island, continue to pose challenges, representing a 'dark corner' in the final stages of elimination and hindering national eradication efforts. This cross-sectional research was conducted on Qingshan Island, China, to investigate the burden of schistosomiasis japonicum among villagers. A total of 133 residents were enrolled. Data were analysed using Pearson's χ2 test and odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess risk factors. The prevalence in males was 93.22% while that among females was 60.81%. The majority of participants (95.49%) were engaged in fishing and farming. These occupations were associated with a higher risk of schistosomiasis, with an OR of 3.233 (95% CI 0.602 to 16.867). Although all participants confirmed having received schistosomiasis-related education, only 18.80% indicated that they had adopted appropriate preventive measures. The primary source of income for local residents has shifted from fishing to cultivating traditional Chinese medicine plants. At present, Qingshan Island residents face persistent high schistosomiasis prevalence with past infections. Insufficient knowledge application of protection poses a reinfection risk. Balancing economic development with effective disease control is essential, especially in the context of the island's growing tourism industry, in achieving the final goal of schistosomiasis elimination.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761433","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":"Beyond serology: using molecular methods for the detection of Rickettsia and Orientia in clinical samples.","authors":"Bashir Ahmad Fomda, Uksim Qadri, Mubashir Nazir, Altaf Hussain Khan","doi":"10.1093/trstmh/traf079","DOIUrl":"https://doi.org/10.1093/trstmh/traf079","url":null,"abstract":"<p><strong>Background: </strong>Serological assays and conventional PCR used for detecting Rickettsia and Orientia are time-consuming. Given that therapeutic approaches for these infections overlap, early molecular detection significantly enhances timely clinical management. This study evaluates the utility of real-time PCR for the detection of Rickettsia and Orientia compared with ELISA and the Weil-Felix test.</p><p><strong>Methods: </strong>A total of 243 patients (92 females and 151 males) were enrolled. The Weil-Felix test and ELISA were performed to detect the spotted fever group, the typhus group and Orientia. Molecular testing included Pan-Rickettsial PCR targeting Pan antigen and real-time PCR for Orientia targeting 47 kDa. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated.</p><p><strong>Results: </strong>Real-time PCR exhibited a sensitivity, specificity, PPV, NPV and accuracy of 88.5-95.0%, 83.25-96.0%, 81.91-96.0%, 89.42-95.0% and 85.68-95.0%, respectively. The ELISA showed a sensitivity, specificity, PPV, NPV and accuracy of 81.05-96.0%, 89.45-95.0%, 88-95.0%, 83.18-96.0% and 85.68-95.8%, respectively. The Weil-Felix test demonstrated a sensitivity, specificity, PPV, NPV and accuracy of 20.3-28%, 71-96.6%, 13-57%, 76.3-89% and 65-67%, respectively. Serological tests showed a positivity of 30-75% in convalescent-phase samples, whereas real-time PCR proved superior during the acute phase with a detection rate of 66.7-72.4%.</p><p><strong>Conclusions: </strong>This study highlights the utility of real-time PCR as a rapid and effective tool for detecting Rickettsia and Orientia, reducing the turnaround time and simplifying the workflow.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745157","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}