Tropical Medicine and Health最新文献

{"title":"Access barriers to in vitro diagnostics in Cambodia, Indonesia, Lao PDR, and the Philippines: programmatic lessons from NEDL field missions.","authors":"Shogo Kanamori, Norielyn M Evangelista, Nenita G Marayag, Richard Albert J Ramones, Sau Sokunna, Weni Muniarti, Bouaphanh Khamphaphongphane, Youthanavanh Vonghachack, Antonio F Dela Resma Villanueva, Manami Uechi, Yuriko Egami, Naofumi Hashimoto, Eiichi Shimizu, Masataro Norizuki, Masami Fujita","doi":"10.1186/s41182-026-00956-0","DOIUrl":"https://doi.org/10.1186/s41182-026-00956-0","url":null,"abstract":"<p><strong>Background: </strong>Access to essential in vitro diagnostics (IVDs) remains limited in many low- and middle-income countries, where persistent challenges exist in financing, human resources, infrastructure, procurement, supply chain management, and health insurance arrangements. Despite growing regional initiatives, such as the Association of Southeast Asian Nations (ASEAN) Essential Diagnostics List Initiative, country-specific evidence on barriers to IVD access remains limited. This article summarizes barriers to accessing IVDs and related lessons identified from field missions conducted as part of a technical cooperation project supporting the development of the National Essential Diagnostics Lists (NEDLs) in Cambodia, Indonesia, Lao PDR, and the Philippines.</p><p><strong>Methods: </strong>Field missions were conducted in the four countries between December 2024 and May 2025. Mission reports and interview records derived from key informant interviews with government officials and health workers from ministries of health, health facilities, local health offices, and health insurance agencies were examined. Statements related to potential barriers to accessing IVDs were coded, and emergent concepts were organized into a thematic framework consisting of domains and key access barriers.</p><p><strong>Results: </strong>Seventeen barriers to IVD access were identified across six domains (resources; procurement and supply chain; equipment maintenance; documented rules and standards; health insurance coverage; and attitudes of service recipients). Resource constraints, including limited budgets, workforce shortages, and inadequate laboratory infrastructure, were widespread. Procurement and supply chain challenges-such as weak demand forecasting, limited supplier availability, and logistical constraints-frequently resulted in stockouts. An important operational insight was that delays in health insurance reimbursement disrupted supplier payments and contributed to stockouts. Additional barriers included limited equipment maintenance capacity, gaps in guidelines and regulations, insufficient insurance coverage, and demand-side constraints such as low awareness and trust in diagnostic tests.</p><p><strong>Conclusions: </strong>Access to IVDs in the four ASEAN countries is constrained by multifaceted health system barriers. This study highlights an underrecognized mechanism-insurance reimbursement delays leading to stockouts-that warrants policy attention in the Asian context. As countries progress from the NEDL development to implementation, the six-domain, 17-barrier framework offers a practical tool for identifying system bottlenecks and guiding targeted interventions to ensure equitable access to essential IVDs.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"54 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782227","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 trends in research on environmental chemical exposure and childhood learning disabilities: insights from a two-decade bibliometric and Latent Dirichlet Allocation analysis.","authors":"Qi Liu, Xinchen Shu, Jiaxin Cao, Yixin Wang, Yuxin Liu, Feng Jiang, Jin Shu","doi":"10.1186/s41182-026-00949-z","DOIUrl":"https://doi.org/10.1186/s41182-026-00949-z","url":null,"abstract":"<p><strong>Background: </strong>Childhood learning disabilities and neurodevelopmental disorders have been increasingly linked to early-life environmental chemical exposures, including air pollutants, heavy metals, endocrine-disrupting chemicals, and pesticides. Despite growing academic interest, a comprehensive analysis of global research trends and emerging themes in this interdisciplinary field remains lacking.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science Core Collection (WoSCC) database to identify studies published between January 2005 and December 2025. Articles and reviews written in English focusing on environmental exposure and childhood learning disabilities were included. CiteSpace software was employed to analyze annual publication trends, country and institutional contributions, co-authorship networks, co-cited references, and keyword clustering and evolution. In addition, we applied Latent Dirichlet Allocation (LDA) topic modeling to abstracts/keywords to uncover latent thematic structures and quantify topic prevalence across the corpus.</p><p><strong>Results: </strong>A total of 1056 publications were included. Global research output increased steadily, with a notable surge after 2017. The United States led in publication volume and international collaboration, followed by China, the United Kingdom, and Spain. Influential institutions included Harvard University, Columbia University, and ISGlobal. Key authors such as Jordi Sunyer, David Bellinger, and Brenda Eskenazi were identified as central contributors. Frequently co-cited journals included Environmental Health Perspectives and Environmental Research. Major research clusters focused on air pollution, endocrine disruptors, oxidative stress, and neurodevelopmental disorders. Timeline and burst analyses revealed a shift from traditional toxicants (e.g., lead, mercury) to complex outcomes such as academic performance and mental health, with growing attention to mechanisms like epigenetics and environmental justice. LDA topic modeling revealed 15 themes spanning exposure settings (indoor/residential/air pollution), neurodevelopmental outcomes (autism/ADHD/cognition), and key neurotoxicants (pesticides/PCB, arsenic, methylmercury), suggesting an evolving focus toward functional outcomes and mechanisms.</p><p><strong>Conclusions: </strong>This study highlights the evolving landscape of research linking environmental exposures to childhood cognitive and behavioral outcomes. The field is expanding from exposure identification to mechanistic understanding and real-world functional implications. Greater interdisciplinary collaboration and equity-focused research are needed to inform policy and protect child brain health globally.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729963","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":"Nationwide epidemiology of invasive meningococcal disease in Japan, 2017-2025: implications of post-COVID-19 mobility.","authors":"Yuhao Chen, Hirotake Mori, Shuhei Yokoyama, Tingwei Wang, Wenke Xie, Mai Suzuki, Mahoko Ikeda, Yoshiro Hadano, Rapeephan Rattanawongnara Maude, Toshio Naito","doi":"10.1186/s41182-026-00955-1","DOIUrl":"10.1186/s41182-026-00955-1","url":null,"abstract":"<p><strong>Background: </strong>Invasive meningococcal disease (IMD) is a severe but rare infection in Japan. Changes in population mobility before, during, and after the Coronavirus disease 2019 (COVID-19) pandemic may have influenced IMD trends; however, recent epidemiological patterns in Japan remain incompletely described.</p><p><strong>Methods: </strong>National surveillance data from January 2017 to October 2025 were analyzed. Temporal, age-specific, and geographic patterns were evaluated across three phases: Phase 1 (2017-2019, pre-COVID-19), Phase 2 (2020-2022, pandemic period), and Phase 3 (2023-October 2025, post-pandemic period with relaxed preventive measures). The relationship between annual IMD case counts and inbound international travel was explored using Spearman's rank correlation.</p><p><strong>Results: </strong>A total of 288 IMD cases were identified. Annual case numbers decreased markedly from 48 in 2019 to 1 in 2021 and subsequently increased to 66 in 2024 and 68 by October 2025. Case counts were significantly lower in Phase 2 than in Phase 1 (p = 0.0003) and significantly higher in Phase 3 than in Phase 2 (p < 0.0001). Older adults consistently accounted for the largest number of cases, and adolescents showed a clear rebound in Phase 3. Geographic patterns demonstrated substantial prefectural heterogeneity; Tokyo showed the largest proportional increase, whereas Osaka and the Kansai region did not show a corresponding increase. Importantly, no distinct short-term increase in IMD incidence was observed during the Osaka Expo 2025 period. IMD case counts and inbound international travel exhibited parallel temporal patterns over the study period (Spearman's ρ = 1.000).</p><p><strong>Conclusions: </strong>IMD incidence in Japan decreased during the COVID-19 pandemic and increased again following the relaxation of public health measures. The post-pandemic rebound occurred alongside recovery of social contact and population mobility, while most cases were domestically acquired, and no event-specific surge was detected during the Osaka Expo 2025 period. These findings suggest that multiple contextual factors, including societal reopening and travel-related dynamics, may have contributed to the observed trends; however, causal relationships cannot be determined from this ecological analysis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730059","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":"Spread of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in the community living spaces of patients identified as ESBL-E carriers: impact of the housing density in an African context.","authors":"Charles Declerck, Lola Ferrier, Alexandra Boccarrossa, Charlotte Michaux, Vincent Dubée, Harvey Johnson, Roch Christian Johnson, Estelle Marion, Laurent Marsollier, Vincent Cattoir, Matthieu Eveillard","doi":"10.1186/s41182-026-00948-0","DOIUrl":"10.1186/s41182-026-00948-0","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is a worldwide concern, especially in West Africa. Our objective was to study the impact of human presence on the dissemination of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in the environment by sampling feces from various animal species.</p><p><strong>Methods: </strong>ESBL-E fecal colonization was screened in patients from a Beninese hospital during their stay. Secondary sampling of 10-15 animal feces was conducted around the homes of 16 selected colonized patients. Each sample was cultured on selective media and tested for ESBL phenotype. Bacterial identification and antibiotic susceptibility were performed for ESBL-E. Patients' community living spaces were categorized according to the proportion of cumulative housing surface into rural (< 30%), semi-urban (30-70%) and urban (> 70%) areas. Escherichia coli isolates from 10 patient/neighborhood pairs were sequenced.</p><p><strong>Results: </strong>ESBL-E fecal carriage was 92% (56/61) among hospitalized patients and 69.7% (150/215) in animal samples from the community. There was evidence of a gradient of fecal carriage positively related to the proximity to human dwellings (domestic animals 86%, n = 18/21; poultry-pigs 78%, n = 61/78; sheep/goats 66%, n = 63/96; cattle-wild animals 35%, n = 7/20) (p < 0.001). Animals living in urban areas were significantly more frequently colonized than those living in semi-urban or rural areas (94% vs. 65%, p = 0.04 and 94% vs. 54%, p = 0.02, respectively). The predominant ESBL-E genes were bla_CTX-M (100% of ESBL-E including 91% of bla_CTX-M-15). Forty-six different sequence types (ST) were identified. Human isolates exhibited higher resistance to ciprofloxacin and to cotrimoxazole than animal isolates (45% vs. 17%, p < 0.001, and 86% vs. 60%, p < 0.001, respectively). Twenty-three clonal strains (SNPs < 10) were detected in 9 clusters. No cluster included both human isolates and animal isolates. However, some clonal strains have been isolated in feces separated from each other by more than 40 km.</p><p><strong>Conclusions: </strong>In the area under study, there is significant colonization of both human and animals by ESBL-E, and a major diversity among the isolated strains. Our geographic analysis suggests a human impact on animal colonization, even though the results do not support direct transmission. Concurrently, genomic analysis suggests the possibility of dissemination over significant distances.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718258","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":"Widespread pyrethroid resistance and high kdr L995F allele frequencies in Anopheles gambiae sensu lato populations from Southern Benin, West Africa.","authors":"Minassou Juvénal Ahouandjinou, Steve Zinsou Hougbe, Zul-Kifl Affolabi, Aboubakar Sidick, Koffi Djigbodi Koumodji, Arthur Sovi, Linda Towakinou, Zoulkifilou Sare Dabou, Mahuna Pierre Boko, Kayode Moudjadidou Oyeniran, Olivier Oussou, Haziz A Sina Orou, Lamine Baba-Moussa, Martin Akogbeto, Razaki A Ossé","doi":"10.1186/s41182-026-00957-z","DOIUrl":"10.1186/s41182-026-00957-z","url":null,"abstract":"<p><strong>Background: </strong>Pyrethroid resistance in Anopheles gambiae sensu lato threatens the efficacy of long-lasting insecticidal nets (LLINs) in Benin. District-level resistance data and evaluations of next-generation insecticides are needed to inform insecticide resistance management (IRM).</p><p><strong>Methods: </strong>We assessed insecticide susceptibility in An. gambiae s.l. populations from three southern Beninese districts (Porto-Novo, Akpro-Missérété, Lokossa) via WHO tube bioassays with pyrethroids (deltamethrin, permethrin, alpha-cypermethrin), pirimiphos-methyl, clothianidin, and chlorfenapyr. Molecular species identification and genotyping of the kdr L995F and Ace-1R G119S mutations were performed via allele-specific PCR.</p><p><strong>Results: </strong>Confirmed pyrethroid resistance was recorded at all sites, with permethrin mortality as low as 17.1% (95% CI 10.6-26.2%) in Porto-Novo. The kdr L995F allele was detected at near-fixation frequencies ranging from 82 to 93% across both An. coluzzii and An. gambiae s.s. Ace-1R G119S remained rare (3-7%), which is consistent with its retained susceptibility to pirimiphos-methyl. The species composition ranged from exclusive to An. coluzzii in Porto-Novo to near-equal distribution in Lokossa. Clothianidin was associated with ≥ 99% cumulative mortality by day 7, and chlorfenapyr was associated with ≥ 98.8% cumulative mortality within 24-48 h across all populations.</p><p><strong>Conclusions: </strong>Pyrethroid resistance is entrenched in southern Benin, driven by the near-fixation of kdr L995F along an urbanization gradient. The fully preserved efficacy of clothianidin and chlorfenapyr against these resistant populations supports the urgent scale-up of next-generation LLINs as a core IRM strategy in this high-burden region.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718250","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":"Building resilient and self-reliant systems for health for migrants and refugees in crisis-prone areas: lessons from the Thai-Myanmar border.","authors":"Watinee Kunpeuk, Hein Thu, Phitsanuruk Kanthawee, Surasak Thanaisawanyangkoon, John Patrick Almeida, Anuk Pitukthanin, Kyoko Sudo, Azusa Iwamoto, Masami Fujita","doi":"10.1186/s41182-026-00952-4","DOIUrl":"10.1186/s41182-026-00952-4","url":null,"abstract":"<p><p>Migrants and other vulnerable populations remain insufficiently integrated into health security preparedness and universal health coverage (UHC) in the Asia-Pacific region. Following the COVID-19 pandemic, which disproportionately affected migrants and displaced populations, the Asian Network for the Inclusion and Integration of Migrants and Other Vulnerable Populations in Health Security Preparedness and Achieving UHC (ANISE) was established to address gaps in pandemic preparedness frameworks. Since then, economic and political instability has driven large-scale and increasingly protracted displacement. At the same time, collapsing humanitarian financing and declining external support have placed severe pressure on migrant health responses, highlighting the need to move beyond short-term humanitarian approaches. This paper synthesizes lessons from the Myanmar border areas in Thailand by mapping insights from a regional pre-conference workshop onto three key elements of resilient and self-reliant systems for health. These elements include community-led and locally anchored capacities, cross-sectoral and cross-border institutional arrangements, and enabling governance with sustainable resource mobilization. The analysis illustrates how community networks, multisectoral collaboration, and integrated surveillance systems have supported communicable disease prevention and service delivery in border settings. The findings also highlight persistent barriers to achieving migrant-inclusive health security and UHC, including legal status constraints among undocumented migrants from Myanmar, limited affordability among migrants with low-socio-economic statuses, weak data coordination across health and local authorities for continuity of care, workforce shortages in border settings, and reliance on external donor funding affecting self-resilience. The recent United States Agency for International Development (USAID) funding cuts have further weakened nutrition, health protection, and disease control functions. Therefore, this crisis creates a stress test for systems for health serving migrants and refugees in crisis-prone border settings. Experiences from the Myanmar border areas in Thailand demonstrate that migrant health can no longer depend on temporary humanitarian responses or external funding alone. Strengthening resilient and self-reliant systems for health requires greater local ownership, domestic resource mobilization, and institutionalized governance that integrates migrant health within broader health security and UHC agendas.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718252","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":"Bacterial communities in Thai ticks: revealing geographical and methodological gaps in surveillance-a 25-year scoping review.","authors":"Artharee Rungrojn, Kittipong Chaisiri, Janjira Thaipadungpanit, Elizabeth M Batty, Stuart D Blacksell","doi":"10.1186/s41182-026-00950-6","DOIUrl":"https://doi.org/10.1186/s41182-026-00950-6","url":null,"abstract":"<p><p>Ticks serve as key vectors for a diverse range of bacterial pathogens that affect humans and animals worldwide. In Thailand, a comprehensive understanding of tick-associated bacterial diversity remains limited. This scoping review synthesises published data on tick-borne bacteria across Thailand from 2001 to 2025, focusing on bacterial diversity, host-vector associations, geographic distribution, and molecular detection methods. Literature searches in NCBI, Embase, and Web of Science identified 402 studies (272 after duplicate removal), of which 39 met the inclusion criteria. Ticks were collected from animals, humans, and the environment across four zoogeographical regions. Rhipicephalus, Haemaphysalis, Dermacentor, and Amblyomma were the most commonly studied genera. Eighteen bacterial genera, including both pathogens and endosymbionts, were identified, with Coxiella-like endosymbionts, Rickettsia, Anaplasma, and Ehrlichia being the predominant genera. Rhipicephalus ticks exhibited the highest bacterial diversity, while Rickettsia spp. were the most frequently detected pathogens. Conventional PCR remained the principal diagnostic method, with limited application of quantitative and metagenomic sequencing approaches. Geographic analysis revealed that most studies were concentrated in the Northern Peninsular and Central Peninsular regions, while the Continental section of the Indo-Chinese Mainland and Korat Plateau zones were under-represented, which may limit the accuracy of regional risk assessments, as surveillance gaps can underestimate both the diversity and prevalence of pathogenic organisms in these areas. This review emphasises the intricate nature of tick-host-pathogen interactions and highlights the importance of implementing standardised genomic surveillance nationwide within a One Health framework. The findings reveal key gaps in current surveillance efforts and advocate for incorporating genomic tick monitoring into Thailand's national One Health strategies to improve zoonotic disease preparedness.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"54 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718287","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":"Gut microbiota bidirectionally influences protection and severity in cerebral malaria in mice.","authors":"Tomoyo Taniguchi, Eiji Miyauchi, Reika Kawabata-Iwakawa, Masahiko Nishiyama, Rika Umemiya-Shirafuji, Hiromu Toma, Nobuo Sasaki, Hajime Hisaeda, Haruyoshi Tomita, Hiroshi Ohno, Hidehiro Kishimoto, Hiroshi Suzuki","doi":"10.1186/s41182-026-00947-1","DOIUrl":"10.1186/s41182-026-00947-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria caused by Plasmodium parasites leads to severe complications, such as cerebral malaria; however, the influence of the gut microbiota on the pathogenesis of cerebral malaria remains unclear. Here, the effects of antibiotic-induced microbiota alteration on experimental cerebral malaria (ECM) were examined.</p><p><strong>Methods: </strong>Male C57BL/6N mice that were administered drinking water containing a four-antibiotic cocktail, ampicillin, neomycin, metronidazole and vancomycin, from 2 weeks before P. berghei ANKA (PbA) infection were used for the experiments. Disease progression, blood-brain barrier (BBB) integrity, immune responses, and gut microbiota composition were evaluated.</p><p><strong>Results: </strong>Approximately 80% of mice with modified gut microbiota avoided ECM and showed reduced BBB disruption and lymphocyte infiltration into the brain. 16S rRNA gene sequencing revealed specific bacterial species that contributed to either the protection or pathogenesis of ECM. The mono-colonization of germ-free mice revealed that distinct bacterial species could attenuate or exacerbate ECM symptoms, independent of antibiotic effects.</p><p><strong>Conclusions: </strong>The findings highlight that distinct gut microbial populations can modulate host susceptibility or resistance to ECM, underscoring the important influence of the intestinal microbiota on infectious disease outcomes. This work broadens the understanding of host‒microbe interactions and may inform new strategies for managing cerebral malaria through microbiota modulation.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699856","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 of medicinal fern species used by communities bordering Kalinzu Central Forest Reserve, Western Uganda.","authors":"Herbert Nuwamanya, Grace Kagoro-Rugunda, Raphael Wangalwa, Eunice Apio Olet","doi":"10.1186/s41182-026-00954-2","DOIUrl":"10.1186/s41182-026-00954-2","url":null,"abstract":"<p><strong>Introduction: </strong>Across the globe, traditional medicine, particularly herbal remedies, is a cornerstone of healthcare. While the medicinal uses of ferns are widely recognized globally, their therapeutic potential in Uganda remains significantly underexplored compared to higher plants. This limited research creates a critical gap in our understanding of the medicinal capacities of ferns, leading to their neglect in drug development. The main aim of this study, therefore, was to document the medicinal fern species and their uses in communities bordering Kalinzu Central Forest Reserve (KCFR).</p><p><strong>Methods: </strong>An ethnobotanical survey was conducted for 3 months (October, November, and December), 2024 in 20 villages bordering Kalinzu Central Forest Reserve (KCFR) in Kyamuhunga. The study utilized a semi-structured questionnaire and face-to-face interviews with 71 key informants to collect data on the use of ferns in herbal medicine. The questionnaire data was analyzed using various ethnobotanical indices, including Relative Frequency of Citation (RFC), Use Value (UV), Relative Importance (RI), Fidelity Level (FL), Informant Consensus Factor (ICF), and Combination Use Diversity Index (CUDI).</p><p><strong>Results: </strong>Six fern species were documented for use in herbal medicine by communities around KCFR, and Pteridium capense was the most cited species. The use value (UV) index was highest for P. capense (0.72). The informant consensus factor (ICF) was highest for musculoskeletal illnesses (1.00), and the fidelity level (FL) was highest for Hypolepis sparsisora for treating burns (100%). Fronds were the most used part of the ferns in herbal medicine (76.06%), and dermal (smearing and rubbing) was the most common route of administration (57.75%).</p><p><strong>Conclusions: </strong>Medicinal ferns are an important component of traditional herbal medicine in communities bordering KCFR. The study documented different medicinal fern species for treating various ailments in communities bordering KCFR. Pteridium capense was the most frequently cited species, used to treat various illnesses. These findings highlight the significant ethnobotanical knowledge of the local communities and suggest that further research into the pharmacological properties of these fern species, especially P. capense, is warranted. Further research should characterize and elucidate bioactive compounds responsible for such therapeutic values.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692667","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":"Etiology of bloodstream infections in adult diabetic patients from a single tertiary hospital in southern Vietnam: a retrospective study.","authors":"Le Buu Chau, Dang Van Tri, Vo Truong Quy, Ranjit Tiwari, Quynh Phan, Truong Thi My Kieu, Duong Van Tho, Le Minh Khoi, Nguyen Thi Nhu Quynh, Rohat Muhyadeen Abdullah, Nguyen Thanh Dung, Nguyen Tien Huy","doi":"10.1186/s41182-026-00943-5","DOIUrl":"10.1186/s41182-026-00943-5","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus (DM) is a significant risk factor for the development of bloodstream infections (BSIs), particularly in settings with a high burden of antimicrobial resistance (AMR). However, data availability in countries with low to middle incomes remains scarce.</p><p><strong>Objectives: </strong>To describe the clinical characteristics, etiology, and AMR patterns of BSIs in patients with DM.</p><p><strong>Methods: </strong>An observational study was conducted on 99 adult diabetic patients with confirmed BSIs admitted to a tertiary hospital in southern Vietnam from January 2022 to May 2024. Information about clinical, laboratory, and microbiological findings was collected from electronic medical records.</p><p><strong>Results: </strong>The median age was 60 years, and 55.6% were female. The most common foci of infection were urinary tract infections (19.2%) and deep abscesses (10.1%), while multiple infectious foci were identified in 16.2% of cases. Escherichia coli (53.5%), Klebsiella pneumoniae (15.2%), and Burkholderia pseudomallei (10.1%) were the predominant pathogens. Resistance to third-generation cephalosporins (3GCs) was observed in 64.7% of E. coli and 26.7% of K. pneumoniae isolates evaluated. Empirical antimicrobial treatment most commonly involved β-lactam/β-lactamase inhibitor combinations (51.5%) and carbapenems (33.3%). Intensive care was required for 20.2% of patients, and one fatality was reported.</p><p><strong>Conclusions: </strong>BSIs in diabetic patients in southern Vietnam are predominantly caused by gram-negative bacteria with a high rate of AMR, particularly to 3GCs. These findings highlight the need for early diagnosis, rational empirical therapy, and enhanced AMR monitoring to improve outcomes.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646681","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}