Tropical Medicine and Health最新文献

{"title":"Effects of solar radiation exposure on ischemic heart disease mortality: country-level spatial regression models.","authors":"Haruka Kato, Satomi Ikeuchi, Susumu Tanimura","doi":"10.1186/s41182-025-00813-6","DOIUrl":"https://doi.org/10.1186/s41182-025-00813-6","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have analyzed the association between sun exposure and ischemic heart disease (IHD). However, the association has not been assessed globally and may differ when adjusting for spatial dependency. This study aimed to clarify whether this global association remains even while incorporating spatial adjustment.</p><p><strong>Methods: </strong>The most recent age-adjusted IHD mortality data (per 100,000) by country (1987-2022) were obtained from the World Health Organization (WHO) database as the dependent variable. As the independent variable, global solar radiation (GSR) data (MJ/m²/day; mean of 1994-2018) were retrieved from the Global Solar Atlas, with values clipped to each capital's location. Covariates included smoking prevalence, alcohol consumption, salt intake, gross domestic product, and health expenditure. To assess associations by sex, ordinary least squares (OLS) regression and three spatial regression models (spatial lag model, spatial error model, and spatial Durbin model) were applied. Additionally, an income-level stratified analysis was conducted. All analyses were performed with R version 4.5.0.</p><p><strong>Results: </strong>After listwise deletion of missing values, 94 countries remained. The mean (SD) IHD mortality rates for males and females were 96.5 (80.4) and 52.4 (48.0), respectively. The mean (SD) GSR was 15.9 (3.7). In the OLS model, GSR showed a significant negative association with IHD mortality (males: β =  - 8.82, p = 0.002; females: β =  - 6.31, p < 0.001). The spatial lag model was the best fit for both sexes, and the association persisted (males: β =  - 4.78, p = 0.041; females: β =  - 3.86, p = 0.005). Stratified analysis largely supported these findings. However, coefficients substantially decreased after spatial adjustment.</p><p><strong>Conclusions: </strong>Sun exposure retained a significant inverse association with ischemic heart disease mortality after adjusting for spatial dependency, although adjustment markedly reduced the strength of association. However, our results require careful interpretation due to several limitations in the study.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"137"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275790","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":"Intrathoracic rupture of amebic liver abscess: a case report and literature review.","authors":"Kota Hasegawa, Akira Kawashima, Ryo Kuwata, Rieko Shimogawara, Mitsuko Sasaki, Yasuaki Yanagawa, Takato Nakamoto, Takahiro Aoki, Kenji Yagita, Koji Watanabe, Katsuji Teruya, Hiroyuki Gatanaga","doi":"10.1186/s41182-025-00809-2","DOIUrl":"10.1186/s41182-025-00809-2","url":null,"abstract":"<p><strong>Background: </strong>Amebic liver abscess (ALA) is a serious complication of Entamoeba histolytica infection. In rare cases, ALA may rupture into the thoracic cavity, leading to a high risk of death. Differentiating intrathoracic ALA rupture from reactive pleural effusion is essential for predicting the clinical course and appropriate management.</p><p><strong>Case presentation: </strong>A 46-year-old bisexual man with well-controlled human immunodeficiency virus infection presented with pain in the right shoulder and upper abdomen. Imaging revealed a solitary liver abscess with diaphragmatic rupture, right pleural effusion, and portal vein thrombosis. Results of stool microscopy, antigen testing, and cytology of pleural and liver aspirates were inconclusive. However, E. histolytica was identified in the stool, liver abscess aspirate, and pleural fluid using polymerase chain reaction tests. Despite the initial therapy with metronidazole, the thoracic fluid volume increased considerably, necessitating thoracic and hepatic drainage. After stabilization, anticoagulation therapy with edoxaban for portal vein thrombosis and luminal therapy with paromomycin were initiated. The patient showed progressive clinical improvement, and follow-up imaging confirmed shrinkage of the liver abscess and resolution of the thrombus and diaphragmatic rupture. No recurrence was observed during the 6-month follow-up period.</p><p><strong>Conclusions: </strong>We reported the case of a patient with a rapidly progressive ALA with intrathoracic rupture. In cases of ALA with thoracic rupture, performing drainage is important, considering that pleural effusion may progress rapidly. This case highlights the need for comprehensive management involving timely antimicrobial and anticoagulation therapy in cases of vascular thrombosis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"136"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259193","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":"Diagnostic puzzle of Anopheles species using morphological vs. molecular approach: a case study in Tripura, a hyperendemic malaria state, Northeast India.","authors":"Ashwarya Kumari Sihag, Jadab Rajkonwar, Phiroz Gogoi, S Vezhavendan, Savitha Chellappan, Sneha Suresh Satpute, Prantosh Malakar, Sangit Debnath, Kalpana Baruah, Harpreet Kaur, Sarala K Subbarao, Dibya Ranjan Bhattacharyya, Ipsita Pal Bhowmick","doi":"10.1186/s41182-025-00747-z","DOIUrl":"10.1186/s41182-025-00747-z","url":null,"abstract":"<p><p>The North-East India Region (NER), an area with several malaria-endemic pockets, differs from the rest of India in vector composition, with An. fluviatilis as the only common major vector, mostly reported during winter in NER but perennially in mainland India. However, in most cases, the most common method of morphological identification has been used, with few studies comparing both. During our longitudinal (2019-2024) entomological study in Tripura, a major malaria-contributing NER State, morphological techniques identified 9 An. fluviatilis collected during winter months, along with 500+ An. minimus. However, molecular investigations confirmed An. fluviatilis to be An. minimus, with 3 new haplotypes. Previously, An. fluviatilis identified morphologically and cytotaxonomically from another state of NER and was later molecularly shown to be a morphological variant of An. minimus. Due to hypermelanization, absence of presector pale spots on the wing and palpal banding pattern, An. minimus earlier probably during winter was misidentified as An. fluviatilis in NER while it may not be present in NER. These studies suggest that combined morphological and molecular methods should be employed for the correct identification of Anopheles species in NER. Morphological misidentification of NER vector as mainland vector can mislead vector control policies, causing public health havoc.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"133"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252829","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":"Prognostic value of low-cost white blood cell indices and procalcitonin for mortality in Rwandan sepsis patients: a prospective intensive care unit study.","authors":"Emmanuel Kundukundwe, Theodette Nizeyimana, Ayingeneye Grace Mutoni, Aline Muhimpundu, Enatha Mukantwari, Cedrick Izere, Solomon Ali, Araya Gebreyesus Wasihun, Tiruzer Bekele, Thaddee Nshimiyimana, Augustin Nzitakera, Ella Larissa Ndoricyimpaye, Schifra Uwamungu, Eliah Shema, Elizabeth Gori, Wossenseged Lemma, Cuthbert Musarurwa","doi":"10.1186/s41182-025-00815-4","DOIUrl":"10.1186/s41182-025-00815-4","url":null,"abstract":"<p><strong>Background: </strong>In resource-limited settings, early identification of sepsis and low-cost mortality predictors is critical for intensive care unit (ICU) triage. This study evaluated the prognostic value of baseline sociodemographic factors, routine hematological indices, and serum procalcitonin (PCT) levels for 40-day mortality among adult ICU patients meeting Sepsis-2 criteria in Rwanda.</p><p><strong>Methods: </strong>A prospective cohort of 125 ICU patients was followed for 40 days. Baseline variables included sex, age, PCT, total white blood cell (WBC) count, differential counts (neutrophils, basophils, eosinophils, monocytes, lymphocytes), and neutrophil-to-lymphocyte ratio (NLR). Survival probabilities were estimated using Kaplan-Meier curves and log-rank tests. Cox proportional hazards models identified independent mortality predictors, with assumptions tested via Schoenfeld residuals and multicollinearity assessed using variance inflation factors. Time-dependent receiver operator curve (ROC) analysis evaluated model performance at days 6, 10, and 15 using the area under the curve (AUC) values.</p><p><strong>Results: </strong>Of 125 patients, 56 (44.8%) were female. Median age was 41 years for survivors and 50 years for non-survivors (p = 0.097). In multivariable Cox regression, elevated neutrophil counts were independently associated with increased mortality [adjusted hazard ratio (aHR)] 1.99; 95% CI (confidence intervals) 1.37-2.88; p < 0.001), corresponding to a twofold higher hazard of death for approximately a threefold increase in neutrophil count. No significant associations were found for sex, age, or PCT. ROC analysis showed that models integrating neutrophils and total WBC (TotalWBC) achieved the highest predictive accuracy, with AUCs ranging from ~68% to 71% across all time points, outperforming simpler models.</p><p><strong>Conclusions: </strong>Elevated neutrophil counts at ICU admission are independently associated with increased mortality. Integrating absolute neutrophil and WBC data into predictive models enhances early mortality risk stratification. These findings underscore the value of routine biomarkers and robust modeling to guide timely interventions in resource-constrained ICU settings.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"135"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252851","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":"A step-by-step guide for conducting an umbrella review.","authors":"Mohammed Abdellatif, Mohammad Najm Dadam, Nguyen Tuan Vu, Nguyen Hai Nam, Nguyen Quoc Hoan, Zahraa Taoube, Phillip Tran, Nguyen Tien Huy","doi":"10.1186/s41182-025-00764-y","DOIUrl":"10.1186/s41182-025-00764-y","url":null,"abstract":"<p><strong>Background: </strong>The rapid increase in published research poses challenges for healthcare professionals aiming to stay updated. While systematic reviews help synthesize findings, their abundance can overwhelm readers. Umbrella reviews address this by summarizing multiple systematic reviews, offering a comprehensive perspective on specific topics.</p><p><strong>Methods: </strong>This article offers a practical, step-by-step guide for conducting an umbrella review, aimed at researchers and clinicians alike.</p><p><strong>Results: </strong>Umbrella reviews effectively integrate data from systematic reviews, ensuring clearer evidence synthesis. Tools like Rayyan and Covidence streamline processes such as screening and data extraction. Strategies for managing overlapping studies and assessing methodological quality enhance the validity of findings.</p><p><strong>Conclusion: </strong>Umbrella reviews are invaluable for evidence-based decision-making, especially in healthcare. This guide equips researchers and clinicians with a structured approach to navigate and synthesize the growing body of systematic reviews, fostering reliable and actionable insights.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"134"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252887","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":"Lessons from the elimination of trachoma in Senegal: implications for high-burden countries in sub-Saharan Africa.","authors":"Stephen Olaide Aremu, Akyala Ishaku Adamu, Legbel Ikenna Uguru, Abdillahi Abdi Barkhadle","doi":"10.1186/s41182-025-00801-w","DOIUrl":"10.1186/s41182-025-00801-w","url":null,"abstract":"<p><p>Senegal's achievement in eliminating trachoma as a public health problem offers a powerful model for countries still burdened by the disease. This success was driven by a holistic and context-sensitive implementation of the SAFE strategy. The country invested in training health workers to deliver trichiasis surgeries in hard-to-reach areas, ensured high coverage of azithromycin through consistent mass drug administration (MDA), and embedded hygiene promotion in schools and community structures. Importantly, Senegal tailored interventions to regional cultural and epidemiological contexts, enhancing local acceptance and effectiveness. Community ownership, intersectoral collaboration involving education, water, and sanitation ministries, and strong partnerships with international organizations further strengthened outcomes. The use of high-quality data through standardized tools like the Tropical Data platform enabled real-time surveillance, evidence-based programming, and course correction. Even post-elimination, Senegal has maintained vigilance through integrated surveillance and hygiene programs in primary healthcare, ensuring sustained gains and preventing re-emergence. These insights present actionable lessons for other high-burden countries like Nigeria, Ethiopia, and Chad.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"132"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252818","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":"Gram-negative bacterial bloodstream infections in cancer patients: a study of epidemiological trends and antibiotic susceptibility.","authors":"Bircan Kayaaslan, Ayşe Kaya Kalem, Fatıma Bolat, Tugba Cınar, Gulen Dönertas Turan, Sezgin Pepeler, Tugba Kos, Bedia Dinc, Rahmet Guner","doi":"10.1186/s41182-025-00811-8","DOIUrl":"10.1186/s41182-025-00811-8","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study was to determine the epidemiological characteristics of Gram-negative bloodstream infections (BSIs) and the susceptibility profiles of the causative microorganisms in hospitalized patients with hematological and oncological malignancies.</p><p><strong>Methods: </strong>This retrospective observational study investigated Gram-negative BSIs in patients over the age of 18 with a diagnosis of malignancy admitted to the hematology and oncology departments of Ankara Bilkent City Hospital between June 1, 2019, and September 1, 2023. Demographic data, disease activation status (new diagnosis, remission and relapse/refractory disease), causative Gram-negative microorganisms, and antibiotic susceptibilities were recorded.</p><p><strong>Results: </strong>A total of 435 patients with 569 Gram-negative bacteremia were included. The median age of the patients was 56 years (range: 18-90 years), and 60.7% were male. Among the BSI episodes, 11.1% were catheter related. The most common Gram-negative pathogens were E. coli (40.6%), Klebsiella spp. (28.8%), and Pseudomonas spp. (9.1%). Of all isolates, 47.7% were multidrug-resistant (MDR), and 26.7% produced extended-spectrum beta-lactamase (ESBL). The rates of ESBL resistance were 40.3% and 28.7% for E. coli and Klebsiella spp., respectively, whereas the carbapenem resistance rates were 9.1% and 27.4%, respectively. Meropenem susceptibility rates were 93.4% for E. coli, 79.1% for Klebsiella spp., and 72.9% for Pseudomonas spp. MDR was most frequent in Acinetobacter spp. (56.5%) and Klebsiella spp. (56.1%), with the highest carbapenem resistance in Acinetobacter spp. (52.2%).</p><p><strong>Conclusion: </strong>This study highlights the high prevalence of MDR Gram-negative pathogens, limiting options for effective empirical therapy. The elevated rates of ESBL production, and carbapenem resistance are concerning and underscore the need for strengthened antimicrobial stewardship, updated guidelines, and new treatment options for managing Gram-negative BSIs.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"131"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245225","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 childhood brain and central nervous system cancer burden: an analysis based on the Global Burden of Disease Study.","authors":"Zhenjin Su, Jie Lu, Yuheng Shi, Tian Li, Bin Qi, Zeshang Guo","doi":"10.1186/s41182-025-00810-9","DOIUrl":"10.1186/s41182-025-00810-9","url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the global, regional, and national burdens of childhood brain and central nervous system cancer from 1990-2021 (the latest year).</p><p><strong>Methods: </strong>We utilized data from the 2021 Global Burden of Disease Study and analyzed trends in childhood brain and central nervous system cancers through joinpoint regression. We assessed the global burden of childhood brain and central nervous system cancers from various perspectives. Finally, the Bayesian age‒period‒cohort model was employed to forecast future trends through 2030.</p><p><strong>Results: </strong>Childhood brain and CNS cancers are the most common solid tumors and the leading cause of death in children. From 1990 to 2021, the age-standardized incidence, prevalence, mortality, and DALYs decreased. The incidence is slightly greater in boys than in girls and peaks at 0-4 years of age, decreasing with age. The disease burden correlates with sociodemographic indices, with higher burdens observed in regions with higher sociodemographic indices. Future projections indicate a continued decline in incidence, prevalence, mortality, and DALYs.</p><p><strong>Conclusions: </strong>While the global burden of childhood brain and CNS cancer has significantly decreased due to medical advancements, childhood cancer continues to be a major cause of childhood mortality. Further optimization of global health resources is crucial for alleviating this burden.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"130"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213931","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":"Insecticide-treated bed net utilization and its determinants among pregnant women in Dembecha District, Northwest Ethiopia.","authors":"Abraham Teym, Gete Berihun, Mestet Yibeltal Shiferaw, Etsubdink Dessalew Abawa, Yibeltal Alemu, Bayou Tilahun Assaye, Rahel Belete Abebe, Tirsit Ketsela Zeleke","doi":"10.1186/s41182-025-00762-0","DOIUrl":"10.1186/s41182-025-00762-0","url":null,"abstract":"<p><strong>Background: </strong>Insecticide-treated nets (ITNs) are widely used and proven effective in preventing and controlling malaria. However, their utilization varies among households, which can significantly impact the benefits of insecticide-treated nets. This study aimed to assess the household utilization of ITNs and the associated factors among pregnant women.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from April to May 2024, including 415 randomly selected pregnant women. Data collection employed a pretested questionnaire, and logistic regression analysis was utilized to identify factors influencing insecticide-treated net (ITN) usage. Variables with a p-value < 0.25 in the univariable logistic regression were considered as candidate variables for inclusion in the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was set at p ≤ 0.05. The model's performance was assessed using the Hosmer-Lemeshow goodness-of-fit test.</p><p><strong>Results: </strong>The utilization of insecticide-treated bed nets among pregnant women was 46.5% (95% CI: 41.7-51.3%). Pregnant women without formal education (AOR = 0.48; 95% CI: 0.28-0.81), monthly income (AOR = 0.98; 95% CI: 0.44-1.97), pregnant women with a family size of less than five (AOR = 2.53; 95% CI: 1.61-3.87), and pregnant women who attended at least one antenatal care (ANC) visit (AOR = 2.08; 95% CI: 1.21-2.58) were significantly associated with insecticide-treated bed net utilization.</p><p><strong>Conclusion: </strong>Utilization of insecticide-treated bed nets by pregnant women was 46.5%, which was lower than the WHO recommendation (80%). Insecticide-treated bed nets utilization was significantly associated with education, monthly income, antenatal care (ANC) attendance, and family size. Targeted interventions in Dembecha District should include community training by health extension workers, strengthened household-level bed net supervision, and culturally tailored awareness campaigns via local media and health professionals.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"129"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207660","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":"Seroprevalence and associated behavioral factors of Toxoplasma gondii infection among pregnant women in Pokhara Valley, Nepal.","authors":"Mamata Thapa, Tulsi Ram Gompo, Tatsuki Sugi, Masahito Asada, Hiroaki Arima, Kishor Pandey","doi":"10.1186/s41182-025-00803-8","DOIUrl":"10.1186/s41182-025-00803-8","url":null,"abstract":"<p><strong>Background: </strong>Toxoplasma gondii is a protozoan parasite that can cause congenital infections with serious health implications. In pregnant women, T. gondii infection poses significant risks, including miscarriage, stillbirth, and congenital abnormalities in the fetus. The burden of toxoplasmosis is often underrecognized in many developing countries, including Nepal, where awareness and routine screening are limited. This study was aimed at determining the prevalence of T. gondii infection among pregnant women in Pokhara Valley, Nepal, and to identify behavioral risk factors associated with the transmission of this parasite.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Gandaki Medical College Teaching Hospital, Pokhara Valley, Nepal, from October 2024 to January 2025. A total of 257 serum samples were collected, 91 of which were randomly selected and tested for anti-T. gondii IgG/IgM antibodies using a rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA). Sociodemographic and behavioral data were collected using structured questionnaires. Statistical analyses included Fisher's exact test to assess associations and Cohen's kappa coefficient to evaluate the consistency between the two diagnostic methods.</p><p><strong>Results: </strong>The RDT detected IgG antibodies in 19.78% (18/91) of the participants, whereas the ELISA identified 38.46% (35/91) of the participants as seropositive. No IgM-positive cases were detected by either method. Compared with the ELISA, the RDT exhibited low sensitivity (34.3%) but high specificity (89.3%), with fair consistency (kappa = 0.26). Cat ownership showed a borderline significant association with seropositivity (OR = 3.79, p = 0.05). Notably, none of the participants demonstrated any knowledge of toxoplasmosis (0%).</p><p><strong>Conclusions: </strong>The findings reveal a significant public health concern. The relatively high seroprevalence of T. gondii, combined with a lack of awareness and identifiable risk factors, underscores the urgent need for educational interventions and prenatal screening programs to reduce the risk of congenital toxoplasmosis in Nepal.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"128"},"PeriodicalIF":3.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201534","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}