Tropical Medicine and Health最新文献

{"title":"Trends in the incidence of common sexually transmitted infections at the global, regional and national levels, 1990-2021: results of the Global Burden of Disease 2021 study.","authors":"Miao Deng, Jiaxi Chen, Zhi Wang, Rubin Zheng, Wenyi Pang, Rui Sun, Zhixun Bai","doi":"10.1186/s41182-025-00744-2","DOIUrl":"https://doi.org/10.1186/s41182-025-00744-2","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted diseases (STDs) are prevalent globally and represent a significant public health challenge. This study aims to evaluate the most recent estimates of the burden of common sexually transmitted infections (STIs) at global, regional, and national levels, which will aid in the development of more effective prevention strategies.</p><p><strong>Methods: </strong>Data for this study were obtained from the Global Burden of Disease (GBD) 2021 study via the Global Health Data Exchange (GHDx) query tool ( https://vizhub.healthdata.org/gbd-results/ ). We extracted the data in accordance with GBD operational guidelines, selecting the most recent results from the 2021 GBD study. The latest GBD study results provided data on incidence, prevalence, and disability-adjusted life years (DALYs) for 21 regions and 204 countries. We extracted the number of cases, incidence, and age-standardized incidence of sexually transmitted diseases (STDs) by sex, age group, and location, following GBD usage guidelines. The data were categorized into five groups based on sociological demographic indices (SDIs).</p><p><strong>Results: </strong>In 2021, the total number of STDs was ~ 289.17 million, reflecting an increase of about 58.38% compared to 1990. While the total number of cases was higher in males, the increase was more pronounced in females. Syphilis exhibited the highest age-standardized rate (ASR) in Equatorial Guinea (EAPC 0.57, 95% CI [- 2.97, 4.24]). Trichomoniasis had the greatest ASR in Tanzania (EAPC - 1.24, 95% CI [- 4.97, 2.64]). Gonococcal (EAPC - 0.52, 95% CI [- 4.33, 3.44]) and chlamydial infections (EAPC - 0.52, 95% CI [- 4.33, 3.44]) showed the highest ASR in South Africa, while genital herpes (EAPC - 1.3, 95% CI [- 4.89, 2.44]) had the greatest ASR in Zimbabwe. HIV/AIDS had the highest ASR in Lesotho (EAPC - 0.33, 95% CI [- 3.99, 3.46]), and the combined ASR for HIV/AIDS and STIs was highest in South Africa (EAPC - 0.47, 95% CI [- 0.58, 0.37]).</p><p><strong>Conclusion: </strong>The burden of STDs remains high and has been steadily increasing; the burden of STIs is more severe in low SDI areas and among young and middle-aged people; the prevalence, incidence, and disability-adjusted years of STIs during the period 1990-2021 are attributable to three main factors: population, disease epidemiology, and aging.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"70"},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of monoclonal antibodies against SARS-CoV-2 nucleocapsid protein for COVID-19 antigen detection.","authors":"Maurine Mumo Mutua, Bernard N Kanoi, Steven Ger Nyanjom, Sebastian Musundi, Mark Makau, Shingo Inoue, Samoel Ashimosi Khamadi, Jesse Gitaka, Ernest Apondi Wandera","doi":"10.1186/s41182-025-00756-y","DOIUrl":"10.1186/s41182-025-00756-y","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic underscored the global need for reliable diagnostic tools with quick turnaround time for effective patient management and mitigation of virus spread. This study aimed to express severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein and produce monoclonal antibodies (mAbs) against the expressed protein.</p><p><strong>Methods: </strong>Following successful expression and purification of His-tagged SARS-CoV-2 N protein using a wheat germ cell-free protein expression system (WGCFS), BALB/c mice were immunized, and generated hybridomas screened for mAb production. Indirect and sandwich ELISA were used to screen the reactivity of the monoclonal antibody against both our recombinant antigen and commercial antigen. The mAbs were also assessed for their performance using RT-PCR confirmed positive samples with varying cycle threshold (CT) values and their specificity screened using virus isolates of other respiratory viruses.</p><p><strong>Results: </strong>Our mAb demonstrated high reactivity against our recombinant antigen, commercial antigen, SARS-CoV-2 Beta and Omicron variants. There was no significant difference in the binding affinity of our mAb and commercial mAb against the study recombinant (p = 0.12) and commercial (p = 0.072) antigens. Our mAb detected SARS-CoV-2 from clinical samples with varying CT values and exhibited no cross-reactivity against other respiratory viruses.</p><p><strong>Conclusions: </strong>We successfully expressed SARS-CoV-2 N protein leveraging WGCFS in a resource-limited setting. Our mAb had a high binding affinity to the recombinant antigen, making it a suitable candidate for antigen detection kit development. Beyond diagnostics, the mAb holds potential for therapeutic applications as well as use in clinical and environmental surveillance platforms.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"69"},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of congenital musculoskeletal and limb anomalies, 1990-2021: a systematic analysis of the global burden of disease in 2021.","authors":"Yu Luo, Rubin Zheng, Jiaxi Chen, Miao Deng, Ziyang Zhang, Zhouke Tan, Zhixun Bai","doi":"10.1186/s41182-025-00750-4","DOIUrl":"10.1186/s41182-025-00750-4","url":null,"abstract":"<p><strong>Background: </strong>Congenital musculoskeletal and limb (CML) anomalies are uncommon, multifactorial conditions whose global incidence trends remain underexplored. This study delineates the epidemiology and temporal evolution of CML anomalies from 1990 to 2021.</p><p><strong>Methods: </strong>We extracted data from the 2021 global burden of disease (GBD) Study, stratifying by sex, region, country and socio-demographic index (SDI). We calculated age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and estimated annual percentage change (EAPC). Decomposition analysis quantified the contributions of population growth, aging, and epidemiological change. Projections to 2031 were made using an autoregressive integrated moving average (ARIMA) model. Health inequities were assessed via the slope index of inequality (SII) and concentration index (CI).</p><p><strong>Results: </strong>Global epidemiological patterns of CML anomalies exhibited significant disparities between 1990 and 2021. Brunei Darussalam demonstrated the highest ASIR, while Afghanistan and the United Mexican States recorded the highest ASMR and ASPR, respectively. Absolute case and death burdens predominantly clustered in populous nations, with India and China reporting the highest absolute numbers. ARIMA modeling projected a 0.85% increase in incident cases (from 2,437,890.12 to 2,458,596.45), a 25.46% decrease in mortality (from 13,599.83 to 10,137.02), and a 3.55% increase in prevalence (from 18,549,408.27 to 19,207,414.19) by 2031. Decomposition analyses revealed that population growth was the primary driver of increased cases in middle SDI regions, whereas epidemiological transitions and aging were the main contributors to mortality reductions. In lower-middle SDI regions, concurrent demographic expansion and epidemiological changes amplified case burdens. Health inequality significantly increased, with the incidence CI rising from 0.28 to 0.35 and the mortality CI from 0.34 to 0.42 between 1990 and 2021. Significant correlations were observed between EAPC and baseline ASIR/ASMR, with declining trends in mortality and rising prevalence driven by population growth and epidemiological transitions.</p><p><strong>Conclusion: </strong>From 1990 to 2021, CML anomalies' incidence and mortality exhibited divergent trends across SDI strata, with less favorable outcomes in lower-SDI countries. Tailored interventions are essential to mitigate the growing burden in these settings.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"68"},"PeriodicalIF":3.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ownership and utilization of mosquito bed net among pregnant women in Ghana: a national population-based survey.","authors":"Wise Awunyo, David Gameli Agbleta, Mary Adaeze Udeoha, Matilda Mawusi Kodjo, Agani Afaya","doi":"10.1186/s41182-025-00739-z","DOIUrl":"https://doi.org/10.1186/s41182-025-00739-z","url":null,"abstract":"<p><strong>Background: </strong>Despite mosquito bed net use being among the many evidence-based safe and successful interventions to avert plasmodium infection during pregnancy, its use remains low among pregnant women due to various barriers. This study, therefore, examined the factors associated with mosquito bed net utilization and ownership among pregnant women in Ghana.</p><p><strong>Methods: </strong>Data from the 2022 Ghana Demographic and Health Survey were analyzed for this cross-sectional study. A representative sample of 1111 pregnant women from the 16 regions of Ghana were included in the study. Multivariate logistic regression analysis was used to determine the factors associated with mosquito bed net ownership and utilization among pregnant women of reproductive age.</p><p><strong>Results: </strong>The prevalence of mosquito bed net ownership among pregnant women was 80.1% [CI 76.8-83.0] and that of mosquito bed net utilization was 47.6% [CI 43.9-51.4]. We also found that pregnant women with 1-3 children [aOR = 2.07, 95% CI 1.25-3.43] and 4 or more children [aOR = 2.52, 95% CI 1.38-4.59], had a partner with secondary level education [aOR = 2.11, 95% CI 1.10-4.06] and higher educational status [aOR = 2.47, 95% CI 1.06-5.74] had higher odds of mosquito bed net use. However, pregnant women who belonged to middle wealth quintiles [aOR = 0.41, 95% CI 0.21-0.82], richer wealth quintiles [aOR = 0.19, 95% CI 0.09-0.41], and richest wealth quintiles [aOR = 0.09, 95% CI 0.03-0.25] had decreased odds of mosquito bed net use. In addition, pregnant women who had female household heads [aOR = 1.73, 95% CI 1.03-2.91], resided in the rural areas [aOR = 1.97, 95% CI 1.12-3.49], had 1-3 children [aOR = 1.65, 95% CI 1.05-2.58] and 4 or more children [aOR = 2.08, 95% CI 1.03-4.20] had higher odds of mosquito bed net ownership. Meanwhile, pregnant women with active health insurance [aOR = 0.29, 95% CI 0.10-0.80] had lesser odds of mosquito bed net ownership.</p><p><strong>Conclusion: </strong>The rate of mosquito bed net ownership was high among pregnant women. However, the effective utilization of mosquito bed net among pregnant women was low. Considering the low utilization of mosquito bed nets, public health practitioners and clinicians should develop awareness and educational interventions tailored toward improving mosquito bed net use among pregnant women.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"66"},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-led intensive trapping reduces abundance of key plague reservoir and flea vector.","authors":"Marcela P A Espinaze, Soanandrasana Rahelinirina, Todisoa Radovimiandrinifarany, Fehivola Mandanirina Andriamiarimanana, Alain Berthin Andrianarisoa, Voahangy Soarimalala, Kathryn Scobie, Mireille Harimalala, Minoarisoa Rajerison, Steven R Belmain, Sandra Telfer","doi":"10.1186/s41182-025-00746-0","DOIUrl":"https://doi.org/10.1186/s41182-025-00746-0","url":null,"abstract":"<p><strong>Background: </strong>Zoonotic pathogens transmitted by rodents are highly prevalent in low-middle income countries and effective control measures that are easily implemented are urgently needed. Whilst rodent control seems sensible as a mitigation strategy, there is a risk that disease prevalence in reservoir populations can increase following control due to impacts on movement and demographics. Additionally, removing rodents from the population does not necessarily lead to reductions in abundance as populations can compensate for removal through increased breeding and immigration. In a previous study of intermittent control within houses, we showed that reduction in rodent abundance was only very short-term. Working in rural settings within the plague-endemic area of Madagascar, this study explores whether community-led daily intensive rodent trapping within houses can effectively reduce long-term rodent and flea abundance.</p><p><strong>Main text: </strong>A rodent management experiment was carried out in six rural villages of Madagascar during 2022-2023. Three villages were selected as intervention villages, where intensive daily rodent trapping inside houses was conducted. Surveillance of rodent and flea abundance using traps and tiles took place at 4-month intervals. We show that community-led intensive rodent trapping in rural Malagasy households effectively reduced abundance of the main rodent reservoir (Rattus rattus) and indoor flea vector (Xenopsylla cheopis) of plague. Importantly, indoor abundance of the outside flea vector (Synopsyllus fonquerniei) did not increase.</p><p><strong>Conclusions: </strong>Community-based intensive rodent trapping inside houses is an effective methodology in controlling key reservoirs and vectors of plague, which can be implemented by the communities themselves. Co-ordinated and sustained rodent control should be considered as an important plague mitigation strategy.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"67"},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of lost-to-follow-up (LTFU) among National Health Insurance Scheme-insured hypertension and diabetes patients attending accredited health facilities in Ghana.","authors":"Edward Nketiah-Amponsah, Solomon Ahimah-Agyakwah, Robert Kaba Alhassan, Gifty Sunkwa-Mills, G P Gómez-Pérez, Judith van Andel, Alex Yao Israel Attachey, Yaw Nyarko Opoku-Boateng, Vivian Addo-Cobbiah, Bernard Okoe-Boye, Tobias Floris Rinke de Wit, Maxwell Akwasi Antwi","doi":"10.1186/s41182-025-00743-3","DOIUrl":"https://doi.org/10.1186/s41182-025-00743-3","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HPT) and diabetes mellitus (DM) are major contributors to morbidity and mortality in Ghana. A key challenge in managing these conditions is non-adherence to follow-up visits, commonly referred to as \"lost- to- follow-up\" (LTFU). Data from the National Health Insurance Authority (NHIA) between 2017 and 2019 revealed that 37% (232,442/634,981) of patients were LTFU at NHIA-accredited health facilities. This study aimed to investigate the factors driving this high LTFU rate in Ghana.</p><p><strong>Methods: </strong>A total of 480 hypertensive and diabetic patients, randomly selected from the NHIA electronic claims database from facilities in the Greater Accra and Ashanti regions between 2019 and 2020, were interviewed. Participants were divided into two groups: LTFU, which consisted of only one visit (351, 73%), and follow-up (FU), which consisted of more than one visit (129, 27%). The sample included patients diagnosed with hypertension only (308, 64%), diabetes only (45, 9%), and both hypertension and diabetes (127, 26%).</p><p><strong>Results: </strong>No statistically significant socioeconomic differences were observed between the LTFU and FU groups, except in their adherence to follow-up visits. The likelihood of LTFU was higher among patients without follow-up awareness (OR = 2.5, 95% CI: 1.05-4.83), those who felt stigmatized (OR = 15.51, 95% CI: 1.01-238.90), those who attended facilities where physicians were available only some of the time (OR = 7.37, 95% CI: 1.07-50.61), those attending facilities without the necessary diagnostic equipment, those who described the NHIS coverage for DM diagnostic tests as inadequate, and those receiving traditional or herbal treatments (OR = 16.90, 95% CI: 3.12-91.45). Conversely, patients from the Ashanti Region (OR = 0.58, 95% CI: 0.35-0.96), those educated on diagnostic procedures (OR = 0.28, 95% CI: 0.08-0.98), and those whose treatment was not under control (OR = 0.04, 95% CI: 0.00-0.69) were less likely to be LTFU. Additionally, patients diagnosed more than ten years ago (OR = 0.44, 95% CI: 0.24-0.79) and those who were neutral about establishing support groups were less likely to be LTFU.</p><p><strong>Conclusions: </strong>The study found that lack of follow-up awareness, stigmatization, and preference for traditional or herbal treatments are key drivers of lost-to-follow-up behavior among hypertension and diabetes patients. Thus, remedial policies should include increasing patient education on the importance of follow-up visits, ensuring the availability of essential medications, diagnostic equipment, and physicians, expanding the NHIA financial coverage, and integrating traditional medicine into standard healthcare to improve treatment adherence and reduce LTFU rates.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"65"},"PeriodicalIF":3.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnobotanical survey and antimycobacterial activities of plants used against tuberculosis in Lubumbashi, DR Congo.","authors":"Evodie Numbi Wa Ilunga, Marsi Mbayo Kitambala, Kalunga Muya, Olivier Lachenaud, Joachim Mukekwa Maloba, Jean-Baptiste Lumbu Simbi, Véronique Fontaine","doi":"10.1186/s41182-025-00745-1","DOIUrl":"https://doi.org/10.1186/s41182-025-00745-1","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis is still a serious threat to public health in Africa and especially in the Democratic Republic of Congo, which is one of the eight countries with approximately two-thirds of the global cases of tuberculosis. Given the difficulties in accessing health care services and antitubercular treatments, indigenous population also uses plant-based traditional medicine. This study aimed to identify plants with antituberculosis potential in traditional Katangese medicine.</p><p><strong>Methods: </strong>Interviews were conducted on traditional healers using snowball sampling method. Ethnobotanical data were assessed by determination of the informant consensus factor and the relative frequency of citation. Guided field walks allowed to collect plants. Methanolic extracts were tested on Mycobacterium smegmatis and Mycobacterium bovis BCG using microdilution, diffusion and agar proportion methods. The cytotoxicity of the best extracts was evaluated by cell viability assay on the human cervical squamous carcinoma SiHa cell line. The 50% inhibitory concentration and minimal inhibitory concentration (MIC) were used to determine the selectivity index.</p><p><strong>Results: </strong>Thirty-eight plant species from 23 families were identified, most of which were from Fabaceae (16%). Eleven out of 17 plant extracts inhibited the growth of M. smegmatis at MIC ranging from 13 to 250 μg/mL. The methanolic extracts of Zanthoxylum chalybeum and Parinari curatellifolia showed MIC₉₉ of 62.5 and 62.5-125 μg/mL, respectively, on M. bovis BCG and showed IC₅₀ values of 28 and 20 μg/mL, respectively suggesting a low selectivity index. This study was the first to investigate the antimycobacterial activity of Terminalia mollis, Phyllanthus muellerianus, Ochna afzelii, and Rothmannia engleriana.</p><p><strong>Conclusions: </strong>The demonstration of antimycobacterial activity in the plants used in Lubumbashi against tuberculosis opens opportunities for more in-depth research into their chemical composition and toxicity, ultimately aiming to enhance their safety for treatment of tuberculosis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"64"},"PeriodicalIF":3.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Green synthesis of PEGylated iron oxide nanoparticles of Eriobotrya japonica leaves extract in combination with B3, against Plasmodium falciparum 3D7 strain.","authors":"Soudabeh Etemadi, Ahmad Mehravaran, Edris Yousefi Delcheh, Aram Khezri, Mehdi Nateghpour, Afsaneh Motevalli Haghi, Ahmad Gholami","doi":"10.1186/s41182-025-00733-5","DOIUrl":"https://doi.org/10.1186/s41182-025-00733-5","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium falciparum represents the most prevalent and lethal protozoan responsible for malaria in humans. This investigation aims to synthesize iron nanoparticles utilizing the polyethylene glycol (PEG) synthesis approach with an Eriobotrya japonica leaves extract and investigating its anti- P. falciparum activity in the in vitro environment in combination with nicotinamide and comparing its effect with chloroquine.</p><p><strong>Methods: </strong>Iron oxide nanoparticles were synthesized using Eriobotrya japonica leaf extract through a green synthesis method. The physicochemical properties of the nanoparticles were analyzed using DLS, FESEM, FTIR, XRD, and MTT assays. During the initial phase, varying concentrations of Japanese parsnip leaf extract, nicotinamide, iron nanoparticles synthesized through the PEGylated green synthesis technique, and chloroquine (as a control pharmacological agent) were individually administered to the culture medium of P. falciparum 3D7. Subsequently, the synergistic IC50 effects of these compounds were evaluated in relation to one another using the FIX RATIO methodology applied to the culture medium.</p><p><strong>Results: </strong>The DLS evaluation of iron oxide nanoparticles showed an average hydrodynamic size of 155 nm. The XRD examination exhibited the crystallinity of the particles. SEM images recognized the spherical nature of synthesized Fe₃O₄ nanoparticles. The relative combination of plant extract-nicotinamide had a synergistic effect and the best dose was observed in 70% plant extract-30% nicotinamide, resulting in a 70% reduction in parasitic load. The most pronounced growth-inhibitory effect was observed in the formulation comprising 50% PEGylated green synthesized Fe₃O₄ nanoparticles and 50% nicotinamide, yielding a 73% inhibition rate.</p><p><strong>Conclusions: </strong>The presence of a synergistic effect was evident across all combinations of plant extract-nicotinamide and iron oxide nanoparticles synthesized through the PEGylated green synthesis approach. Furthermore, the methodologies of green synthesis and PEGylation of iron oxide nanoparticles are deemed effective strategies for enhancing stability, minimizing toxicity, reducing particle size, and facilitating improved precision and efficacy in the application of these entities within biomedical research contexts.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"63"},"PeriodicalIF":3.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of trust in village health workers on the use of facility-based follow-up postnatal care services in two districts in the Lao People's Democratic Republic.","authors":"Noudéhouénou Credo Adelphe Ahissou, Manami Uehara, Daisuke Nonaka, Inthanomchanh Vongphoumy, Tiengkham Pongvongsa, Khamtoun Ounlienvongsack, Khampheng Phongluxa, Sengchanh Kounnavong, Jun Kobayashi","doi":"10.1186/s41182-025-00730-8","DOIUrl":"https://doi.org/10.1186/s41182-025-00730-8","url":null,"abstract":"<p><strong>Background: </strong>Despite high coverage of antenatal care services (89.8%) and facility-based deliveries (79.8%), delayed initiation or lack of follow-up postnatal care (PNC) visits remains a challenge in the Lao People's Democratic Republic (Lao PDR). Follow-up PNC encourages healthy lifestyles and monitoring mothers' and newborns' health to decrease postpartum complications and hospital readmissions. While village health volunteers and workers (VHVs/VHWs) are essential for health promotion in Lao PDR, the extent to which mothers' trust in VHVs/VHWs helps promote better service utilization has not been studied.</p><p><strong>Objectives: </strong>We investigated the trust levels in VHVs/VHWs among ethnic minority mothers and the influence on the use of facility-based follow-up PNC.</p><p><strong>Methods: </strong>We utilized cross-sectional data from July and August 2024, collected as a baseline survey for a quasi-experimental study conducted in 35 villages across the Sepone and Vilabuly districts. We compared the respondents' PNC usage and characteristics using chi-square tests and Fisher's exact tests. Standard binary logistic regression analyses were conducted to estimate the effects of various factors on the utilization of facility-based follow-up PNC. Trust in VHVs/VHWs was a construct variable based on their provision of emotional support, relevant information, adequate discussion time, effective care, and the likelihood of future pregnancy-related care.</p><p><strong>Results: </strong>The study enrolled 241 mothers (mean age 24 years, SD 5.7), including 110 from Sepone and 131 from Vilabuly. Overall, the follow-up PNC coverage rate was 19.0%, and there was no significant difference between Sepone and Vilabuly, despite variations in access to healthcare and engagement with VHVs/VHWs. High trust in VHVs/VHWs was linked to 12.25 times higher odds of utilizing follow-up PNC than low trust (95% CI 2.2-67.8). In addition, having an older child (9-12 months) and immediate PNC utilization were beneficial for subsequent PNC use. Unexpectedly, contact with VHVs/VHWs during prenatal and/or postnatal periods decreased the odds of utilizing follow-up PNC, with distance to health facilities and adherence to traditional gender norms also having a similar negative effect.</p><p><strong>Conclusions: </strong>Facility-based follow-up postnatal care was critically low among respondents; however, increasing trust in VHVs/VHWs may foster improvements. Along with increasing contact frequency, offering quality support to mothers through VHVs/VHWs while emphasizing the complementary nature of community-based and facility-based care could be beneficial. Effective interventions may also include enhancing immediate PNC and tackling physical accessibility challenges, as well as restrictive gender norms through male involvement.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"61"},"PeriodicalIF":3.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension in obstructive sleep apnea: the hidden role of renin-angiotensin-aldosterone system dysregulation.","authors":"Huai Heng Loh, Siow Phing Tay, Ai Jiun Koa, Mei Ching Yong, Asri Said, Chee Shee Chai, Natasya Marliana Abdul Malik, Anselm Ting Su, Bonnie Bao Chee Tang, Florence Hui Sieng Tan, Elena Aisha Azizan, Norlela Sukor","doi":"10.1186/s41182-025-00742-4","DOIUrl":"https://doi.org/10.1186/s41182-025-00742-4","url":null,"abstract":"<p><strong>Background: </strong>Hypertension commonly co-exists with obstructive sleep apnea (OSA). However, the role of renin-angiotensin-aldosterone system (RAAS) in the development of hypertension in OSA patients remains poorly defined, with inconclusive evidence regarding the activation of the RAAS in these patients. Herein, we aimed to evaluate the RAAS profile in OSA patients and to elucidate the influence of RAAS on hypertension in these individuals.</p><p><strong>Methods: </strong>In this observational study, patients referred from health clinics aged 18 years and older, with obesity, defined as body mass index greater than 27.5 kg/m², and confirmed OSA were recruited if they met study criteria. Anthropometric data were collected, and blood sampled for plasma aldosterone concentration (PAC) and plasma renin concentration (PRC). Treatment intensity was assessed using the therapeutic intensity score (TIS). The RAAS components were compared between the OSA patients, healthy controls, and patients with confirmed primary aldosteronism.</p><p><strong>Results: </strong>A total of 204 patients who fulfilled the study criteria were recruited, of which 160 had hypertension. Patients with hypertensive OSA demonstrated higher PAC with no significant difference in PRC compared to normotensive OSA; and higher PAC and ARR with lower PRC compared to healthy controls. PAC was positively correlated with TIS (β = 0.281, p < 0.001), systolic blood pressure (β = 0.156, p = 0.049), and hypertension duration (β = 0.168, p = 0.011), while negatively correlated with hypertension diagnosis (β = - 0.170, p = 0.024).</p><p><strong>Conclusions: </strong>This is the first study from Southeast Asia evaluating the impact of RAAS on hypertension severity in OSA patients. Findings suggest that hypertensive individuals with OSA exhibit greater RAAS dysregulation, highlighting the role of aldosterone in the development of hypertension and its severity in OSA. This also underscores the need for targeted management strategies particularly in tropical regions with a rising prevalence of metabolic disorders.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"62"},"PeriodicalIF":3.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}