Tropical Medicine and Health最新文献

{"title":"Time to consider doxycycline in the standard treatment of lymphatic filariasis? Emerging evidence on use of doxycycline as an adjunct to hygiene protocols.","authors":"Mian Zahid Jan Kakakhel, Shree Rath, Maheen Sheraz, Diya Rathi, Raheel Ahmed","doi":"10.1186/s41182-025-00726-4","DOIUrl":"10.1186/s41182-025-00726-4","url":null,"abstract":"<p><p>With lymphatic filariasis being a rampant condition in tropical countries, multiple treatment modalities are being explored for their efficacy and practicability of use in low resource settings. Doxycycline, a commonly available drug across the world, has been proposed to improve patient status in those suffering with lymphatic filariasis. In conjunct with hygiene protocols, emerging trials have highlighted the success of doxycycline as an add-on drug. In this letter, we highlight the major findings in recent trials, and the scope of integrating doxycycline into national elimination strategies against filariasis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"39"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693423","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 access to health facilities among under-five children with caregiver-reported fever in the context of seasonal malaria chemoprevention in Togo, 2020-2022.","authors":"Endeshaw Degie Abebe, Sikai Huang, Kevin Baker, Fantche Awokou, Meseret Zelalem, Tadesse Shiferaw Chekol, Abebe Tilaye Weldemichael, Sol Richardson","doi":"10.1186/s41182-025-00717-5","DOIUrl":"10.1186/s41182-025-00717-5","url":null,"abstract":"<p><strong>Background: </strong>Malaria is responsible for 580,000 deaths among children under 5, or 95% of all malaria deaths per year globally. Seasonal Malaria Chemoprevention (SMC) is a malaria control intervention in Togo and other African countries targeting children under 5 years old during the peak malaria transmission season. Delaying access to healthcare for children with malaria can result in serious health problems, including heightened morbidity and mortality, complications related to cerebral malaria and anemia, as well as impaired cognitive development. This study aimed to identify determinants of access to health facilities for children with caregiver-reported fever, in the context of SMC campaigns in Togo.</p><p><strong>Methodology: </strong>We analyzed data from three representative annual end-of-round SMC surveys on SMC-eligible children aged 3-59 months residing in the provinces of Savanes, Central and Kara in Togo, conducted during 2020-2022. We performed a descriptive analysis and fitted logistic regression models to assess predictors of health facility access. Our sample included all children with a caregiver-reported fever in the month before the survey. Model variables included household distance to their local health facility, quintiles of household wealth, household visit by SMC distributors in the previous month, household nomad status, literacy of primary caregivers, and the age and sex of both eligible children and their primary caregivers.</p><p><strong>Results: </strong>Our analytic sample included 6,252 SMC-eligible children, including 1,418 experiencing fevers. Most children with fever (62.6%, 95% CI 60.0-65.0%) accessed health facilities. Adjusted odds ratios and 95% confidence intervals obtained from the logistic regression analysis found a statistically significant linear relationship between children's adjusted odds of access to health facilities and their distance from the nearest facility, with 2% lower odds of access for each additional kilometer of distance (AOR = 0.98, 95% CI 0.97-0.99). Households with SMC distributor visits were significantly more likely to access health facilities (AOR = 2.20, 95% CI 1.22-3.96). Children of female primary caregivers had higher odds of access (AOR = 1.42, 95% CI 1.05-1.93).</p><p><strong>Conclusion: </strong>Febrile children's access to malaria testing and treatment in Northern Togo requires further improvement, particularly among those further from health facilities and with lower household wealth.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"38"},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606508","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":"Pulmonary manifestations and clinical management of echinococcosis in a low-endemic region of Mexico: a 15-year retrospective cohort study at a tertiary hospital.","authors":"Víctor Hugo Ahumada Topete, Misael Osmar Garcia Martin, Graciela Hernandez Silva, Alicia Jackeline Parra Vargas, David Martinez Briseño, Manuel Castillejos Lopez, Francisco Bernardo Perez Orozco, José Alberto Choreño Parra, Karina Danae Sevilla Gutiérrez, Elio Germán Recinos Carrera, Rosario Fernandez Plata, Anjarath Higuera Iglesias, Marco Villanueva Reza, Jolenny Jimenez Lopez, Arnoldo Aquino Gálvez, Luz María Torres Espindola, Joaquín Zúñiga Ramos","doi":"10.1186/s41182-025-00715-7","DOIUrl":"10.1186/s41182-025-00715-7","url":null,"abstract":"<p><strong>Background: </strong>Cystic echinococcosis has a low incidence even in endemic countries. It is a chronic and complex zoonosis that in many cases presents delay in diagnosis; it typically affects the liver in up to 90% of the cases, being disseminated pulmonary disease the most common in young subjects, while the rate of cases located only in the pulmonary parenchyma is low. In Mexico it is considered a disease of low endemicity.</p><p><strong>Material and methods: </strong>We retrospectively collected data from patients with suspected echinococcosis infection from the hospital discharge database.</p><p><strong>Results: </strong>Of the 70 patients in the database, 59 had a clinical history (84.3%), of whom 11 had a histopathological diagnosis of cystic echinococcosis and were included in this study, 67.6% were female, with a median age of 32 years (IQR 17-53.5). A total of 45.6% had some comorbidity, the most frequent being type II diabetes mellitus (80%); only 54.6% had lived in a rural area as a risk factor, while only 27.2% had exposure to canines. All cases were symptomatic, with a mean symptom duration of 49 days. A total of 81.8% had exclusive pulmonary disease, while the rest had simultaneous lung and liver involvement. No case presented spontaneous rupture. All cases received anthelmintic treatment and, in 9 cases, surgical resection of the pulmonary parenchyma. The only postsurgical complication was a chylothorax with adequate resolution. The median follow-up in months was 8.3 (IQR 3.7 to 10.7 months), and almost two-thirds of the cases presented dyspnea grade 2-3 (mMRC) as sequelae.</p><p><strong>Conclusion: </strong>Of all the patients studied with pulmonary echinococcosis, only two presented with hepatic-pulmonary hydatid disease, and spontaneous cyst rupture was not reported. About half had exposure to cattle as a risk factor, while no specific risk factor was identified in the rest of the subjects.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"37"},"PeriodicalIF":3.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597949","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 partnerships in combating tropical diseases: assessing the impact of a U.S. withdrawal from the WHO.","authors":"Ikponmwosa Jude Ogieuhi, Victor Oluwatomiwa Ajekiigbe, Stephen Olaide Aremu, Victory Okpujie, Peace Uchechi Bassey, Adetola Emmanuel Babalola, Pelumi Gbolagade-Jonathan, Chidera Stanley Anthony, Ifeoluwa Sandra Bakare","doi":"10.1186/s41182-025-00722-8","DOIUrl":"10.1186/s41182-025-00722-8","url":null,"abstract":"<p><strong>Background: </strong>Annually, tropical diseases are a major cause of mortality; for instance, in 2019, neglected tropical diseases (NTDs) caused 150,000 deaths and 19 million DALYs, with sub-Saharan Africa bearing over half the burden and the other concentrations in Asia and South America. Their impact, though significant, is lower than ischemic heart disease and respiratory infections. The World Health Organization is critical in combating these tropical diseases through surveillance, information campaigns and health promotion. Through international collaborations and initiatives, tropical diseases have been relatively mitigated; for example, global initiatives eradicated smallpox (1980), cut polio cases by 99% (1988-2022), and reduced Guinea worm cases from 3.5 million (1986) to 14 (2023), while NTD prevalence dropped significantly from 1990 to 2020. Main body The potential departure of a major player like the United States, the largest WHO donor, which contributed $1.284 billion (20% of its budget) in 2022-2023, surpassing the Gates Foundation ($689M), Gavi ($500M), and the EU ($412M), and its potential withdrawal threatens WHO's financial stability, jeopardizing emergency responses, disease prevention, and global health initiatives, urging stakeholders to reinforce global health systems. Governments, international organizations, and private partners must work together to create strong, flexible frameworks that prioritize prevention, research, and equitable healthcare delivery. By fostering collaboration, transparency, and mutual accountability, the global health community can continue to make progress toward eliminating the burden of major tropical diseases such as malaria and Dengue fever, among others. Failure to do so could reverse hard-won gains such as the 99% reduction in polio cases since 1988, the near-eradication of Guinea worm disease (from 3.5 million cases in 1986 to 14 in 2023), and declining NTD burdens, leading to resurgence and increased mortality among vulnerable populations worldwide, with devastating consequences for millions of people throughout the world.</p><p><strong>Conclusions: </strong>This review examines the role of countries and organizations in fighting tropical diseases, with a perspective on the potential consequences of the U.S. exit from the WHO. We also discuss the importance of cross-border collaborations in fighting tropical diseases, healthcare systems strengthening efforts, and a call to strengthen efforts through other sources of funding and collaborations.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"36"},"PeriodicalIF":3.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597945","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":"Challenges to implementing mandatory hepatitis B vaccination: bridging immunization gaps among health workers in sub-Saharan Africa.","authors":"Stephen Olaide Aremu, Akyala Ishaku Adamu, Babatunde Fatoke, Legbel Ikenna Uguru, Samuel Olusegun Itodo, Dorcas Oluwakemi Aremu, Deborah Bukola Aremu, Abdillahi Abdi Barkhadle","doi":"10.1186/s41182-025-00712-w","DOIUrl":"10.1186/s41182-025-00712-w","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) poses a major occupational risk for healthcare workers (HCWs) in sub-Saharan Africa (SSA), where endemicity and resource limitations hinder effective prevention. Mandatory Hepatitis B vaccination (HepB) policies for HCWs are critical to addressing vaccination gaps, yet their implementation is challenged by dosing inconsistencies, lack of post-vaccination immunity testing, and ethical considerations. In many countries in SSA, adults are given a four-dose pediatric formulation of the vaccine due to limited access to adult formulations that require fewer doses, creating logistical challenges and increasing the risk of incomplete immunization. In addition, the absence of routine post-vaccination immunity testing undermines efforts to ensure adequate protection, leaving vaccinated HCWs potentially vulnerable to HBV infection. Ethical issues, including inadequate informed consent, out-of-pocket vaccination costs, and inequities in access, further complicate mandatory vaccination programs. Addressing these barriers requires a multi-sectoral approach, including increased access to adult formulations of vaccines, integration of immunity testing into vaccination protocols, subsidized vaccine costs, and culturally tailored education campaigns. These strategies are essential for ensuring that vaccination policies are effective, equitable, and ethical. Protecting HCWs against HBV not only safeguards their health but also strengthens healthcare systems and public health outcomes in SSA.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"35"},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568351","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":"Barriers and facilitators for treatment-seeking among women with genital fistula: a facility-based qualitative study in Bangladesh.","authors":"Kanako Kon, Atsuko Imoto, Sabina Faiz Rashid, Ken Masuda","doi":"10.1186/s41182-025-00704-w","DOIUrl":"10.1186/s41182-025-00704-w","url":null,"abstract":"<p><strong>Background: </strong>Women living with genital fistula often endure prolonged suffering and face multiple barriers to accessing treatment. Bangladesh's government has enhanced referral mechanisms, enabling case detection in communities and facilitating surgical interventions at medical college hospitals through nationwide initiatives. However, research on barriers and facilitators for fistula treatment in Bangladesh remains limited. Detailed insights into treatment-seeking paths with time sequences are scarce. This study aimed to explore facilitators and barriers to completing fistula treatment with the description of treatment-seeking paths. This study is important to assist with future policy and program strategies for fistula treatment.</p><p><strong>Methods: </strong>A facility-based qualitative study was conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh. Data were collected from February to May 2024 through 18 in-depth interviews (IDIs) with in-patients, five IDIs with families, and 11 key informant interviews with health service providers. Participants' treatment-seeking paths were described chronologically and identified patterns of treatment-seeking paths. Thematic analysis, guided by the Partners for Applied Social Sciences model for health-seeking behavior and access to care, was used to analyze case histories.</p><p><strong>Results: </strong>The average duration of treatment-seeking by the women was 39 months, with a maximum of 22 years. Women with fistula often sought care at multiple facilities (up to eight), suspended treatment, and encountered systemic obstacles that delayed treatment. Key barriers included scarce information on illness and treatment in the community, less decision-making power, failure of medical communication, and systemic failures in cost, treatment, and referral systems. Facilitators that motivated women to complete treatment included informal peer support through shared treatment experiences and emotional, physical, and financial support.</p><p><strong>Conclusions: </strong>Analysis of treatment-seeking paths revealed the absence of standardized treatment routes for women with fistula. To ensure effective care, raising societal awareness about fistula, improving treatment and referral systems, enhancing medical communication, and providing peer and emotional support are strongly recommended.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"34"},"PeriodicalIF":3.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531851","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":"Predictors of attendance at the first follow-up and poor visual outcome after paediatric cataract surgery in Kinshasa for the years 2001-2021.","authors":"Helene Schulz, Elena Rakuša, Stefanie Frech, Thomas Stahnke, Ngoy J Kilangalanga, Rudolf F Guthoff, Gabriele Doblhammer","doi":"10.1186/s41182-025-00706-8","DOIUrl":"10.1186/s41182-025-00706-8","url":null,"abstract":"<p><strong>Background: </strong>About 90% of blind children come from low- and middle-income countries. The main cause of childhood blindness is cataract. Cataract surgery can improve vision, but regular follow-up is necessary. Low attendance at follow-up is a medical and statistical challenge, as missing information can lead to biased results. Two research questions arise: what social factors influence attendance at first follow-up? What social factors influence a poor outcome of visual acuity at first follow-up?</p><p><strong>Methods: </strong>An observational cohort study was conducted, and the total base population was analysed. The study includes children who received cataract surgery at Saint Joseph Hospital (Kinshasa, Democratic Republic of the Congo) from 2001 to 2021. Cox regression was used to examine attendance at the first follow-up (n = 1100 operated eyes), ordinal logistic regression to analyse visual acuity at the first follow-up (n = 699 operated eyes), both clustered by patient identification number. Due to the high number of missing values, multiple imputation was performed as a sensitivity analysis.</p><p><strong>Results: </strong>Female sex, young age, very good visual acuity after surgery, and disease in both eyes led to lower attendance at follow-up. Poor visual acuity outcome at follow-up was associated with female sex, young age, poor financial situation, blindness after surgery and nystagmus.</p><p><strong>Conclusions: </strong>As regular follow-up is crucial for an improved visual acuity outcome, it is recommended that special attention needs to be paid to the groups identified in our analysis to better integrate them into follow-up. In particular, the higher risk of poor outcome in younger children is surprising and requires further analysis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"32"},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504352","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":"From pox to protection: understanding Monkeypox pathophysiology and immune resilience.","authors":"Alagammai Ganesan, Thirumalai Arunagiri, Suganandhini Mani, Vamsi Ravi Kumaran, Kanaka Parvathi Kannaiah, Hemanth Kumar Chanduluru","doi":"10.1186/s41182-025-00708-6","DOIUrl":"10.1186/s41182-025-00708-6","url":null,"abstract":"<p><p>The Monkeypox virus (MPXV), which causes Monkeypox (Mpox) is an invasive ailment with global implications. MPXV, categorized within the Orthopoxvirus genus, exhibits diverse clades with varying fatality rates. Initially discovered in monkeys and later in humans, the disease predominantly affects regions across West and Central Africa. Clinical manifestations encompass a spectrum from mild flu-like symptoms to severe eruptions. This article aims to give the scientific community a comprehensive overview of Mpox Pathophysiology and delve into the intricate landscape of host immune responses against MPXV infection. It offers crucial insights into the virus's Pathophysiology, spanning its entry, replication, dissemination, and elicited host responses. The immune reaction to Mpox involves innate immunity, B-cell immunity, and T-cell immunity. Moreover, this review underscores the immunological response and resistance mechanisms against MPXV. It also highlights imperative research areas warranting prioritization to devise more efficacious treatments for controlling viral propagation within healthcare systems. In addition, it gives us a look into possible futures that could help the progress of immunotherapies and cutting-edge biotechnological solutions for protecting against MPXV.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"33"},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516917","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":"The burden of visually diagnosed female genital schistosomiasis among women with infertility in the Volta Region of Ghana.","authors":"Verner N Orish, Gladys Kaba, Anthony K Dah, Raymond S Maalman, Micheal Amoh, Adu Appiah-Kubi, Wisdom Azanu, David Adzah, William R Nyonator, Micheal B Kumi, Diana S Awutey-Hinidza, Irene Atachie, Portia Ahiaku, Precious K Kwadzokpui, Adam A Fatau, Cecila Smith-Togobo, Tai-Soon Yong, Young-Soon Cho, Emmanuel S K Morhe, So Yoon Kim, Margaret Gyapong","doi":"10.1186/s41182-024-00660-x","DOIUrl":"10.1186/s41182-024-00660-x","url":null,"abstract":"<p><strong>Background: </strong>Female genital schistosomiasis (FGS) is the outcome of the deposition of Schistosoma haematobium egg in the ovaries, fallopian tubes, uterus or cervix of women in schistosomiasis endemic areas. Chronic and untreated FGS can result in an increased risk of human immunodeficiency virus (HIV) acquisition and infertility. This study aimed to evaluate the burden of visual FGS among women with infertility in the Volta region of Ghana.</p><p><strong>Methods: </strong>This study was a comparative cross-sectional study involving women with infertility defined as women with inability to achieve pregnancy after 12 months or more of frequent (3-4 times a week) unprotected sexual intercourse and nursing mothers (fertile women) from selected districts in the Volta Region. Questionnaire administration was used to obtain sociodemographic information including recent and childhood contact with water bodies as well as the practice of open defecation and clinical information such as the presence of genital symptoms. Urine samples were collected for detection of eggs of S. haematobium, and the women's lower genital tracts were examined using a handheld colposcope by two gynecologists and a third to resolve discrepancies. Data were analyzed using SPSS version 23 with frequency distribution done for the sociodemographic variables and the prevalence of FGS in the women. Pearson Chi-square analysis was performed to find any significant difference between the prevalence of FGS among infertile and fertile women and any significant association between any socioeconomic and clinical variables with FGS. Logistics regression analysis was performed to investigate sociodemographic and other risk factors for FGS among women.</p><p><strong>Results: </strong>Of the 265 sampled women 132 (49.8%) were infertile and 133 (50.2%) were nursing mothers (fertile women). More women had visual FGS (155, 58.5%) and most with FGS were fertile [96, 76.1%; infertile, 59(45.3%); p < 0.001], with infertile women having lower odds of FGS in this study (AOR, 0.29 [95% CI 0.17-0.50]; p < 0.001); adjusted for childhood and current contact with rivers and streams, availability of toilets facility, practice of open defecation and age. More women with FGS had childhood contact with rivers and streams (68.4%, p = 0.007) with lower odds of FGS seen in women without childhood contact with rivers and streams (AOR, 0.52 [95% CI 0.31-0.88]; p = 0.015).</p><p><strong>Conclusion: </strong>In this study, infertile women unexpectedly had lower odds of FGS suggesting the need for more rigorous research on this topic to elucidate the true contribution of FGS on infertility.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"31"},"PeriodicalIF":3.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504354","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":"Evaluation of lateral flow devices for rabies diagnosis in decomposed animal brain samples.","authors":"Ryota Todoroki, Joely T Ongtangco, Kazunori Kimitsuki, Nobuo Saito, Milagros R Mananggit, Cornelio R Velasco, Jaira D Mauhay, Alyssa M Garcia, Catalino S Demetria, Yamada Kentaro, Akira Nishizono","doi":"10.1186/s41182-025-00699-4","DOIUrl":"10.1186/s41182-025-00699-4","url":null,"abstract":"<p><strong>Background: </strong>The Direct Fluorescent Antibody Test (DFAT), the standard rabies confirmatory test, is less sensitive when used with decomposed brain samples, a frequent issue in rabies-endemic regions. This study evaluates the diagnostic accuracy of the ADTEC lateral flow device (LFD) for rabies post-mortem diagnosis using decomposed brain samples.</p><p><strong>Methods: </strong>We used 34 animal heads submitted with a cold chain to an animal diagnostic laboratory located in central Philippines including 26 DFAT-positive and eight DFAT-negative samples. After defrosting the heads, the entire brain was extracted and left at room temperature to induce decomposition. The decomposition status was scored after 1 day, 3 days, and 4 days at room temperature. DFAT and LFD were performed using the brain samples at each timepoint to evaluate the diagnostic accuracy. The day of animal head submission to the laboratory was defined as day 0, and the DFAT results were used as the reference. Image analysis was performed to measure the intensity of the LFD-positive bands.</p><p><strong>Results: </strong>The decomposition scores dropped by day 3 and day 4, with all samples exhibiting signs of advanced decomposition. The sensitivity of DFAT was 96.2% (95% confidence interval 80.4-99.9) on day 1, but dropped to 61.5% (P < 0.01) by day 3 and further decreased to 38.5% (20.2-59.4) by day 4. In contrast, the sensitivities and specificities of LFD on day 1, day 3, and day 4 were consistently 100% (86.3-100) and 100% (63.1-100), respectively. Visual examination of the test band intensity on the LFD suggested that the intensity of the positive bands increased as decomposition progressed.</p><p><strong>Conclusions: </strong>ADTEC LFDs demonstrated consistently high sensitivity and specificity with decomposed brain samples observed up to day 4, making them a reliable screening tool for rabies post-mortem diagnosis in decomposed brain samples, particularly in resource-limited settings. Furthermore, LFD positive bands became more distinct as decomposition advanced.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"30"},"PeriodicalIF":3.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493859","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}