Tropical Medicine and Health最新文献

{"title":"Neurobrucellosis: a retrospective cohort of 106 patients.","authors":"Fatemeh Arazi, Mahboubeh Haddad, Fereshte Sheybani, Mohammad Taghi Farzadfard, Majid Khadem Rezaeian","doi":"10.1186/s41182-025-00680-1","DOIUrl":"10.1186/s41182-025-00680-1","url":null,"abstract":"<p><strong>Background: </strong>Neurobrucellosis, a serious central nervous system infection caused by Brucella species, presents significant challenges due to its diverse clinical manifestations and the risk of long-term complications and poor outcomes. Identifying predictors of adverse outcomes is critical for improving patient management and overall prognosis.</p><p><strong>Objectives: </strong>This study aimed to evaluate the long-term morbidity and mortality associated with neurobrucellosis and to identify key predictors of adverse outcomes.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 106 neurobrucellosis patients treated at two major referral centers in Mashhad, Iran, from March 21, 2011, to March 20, 2022. We analyzed clinical, neuroimaging, and laboratory data, and estimated survival probabilities using Kaplan-Meier analysis. Long-term morbidity was evaluated using the Glasgow Outcome Scale.</p><p><strong>Results: </strong>The median age of the cohort was 30 years (IQR: 21.8-46.3). The median length of hospital stay was 11 days (IQR: 7-19.8), with an in-hospital mortality rate of 4.7% (n = 5). Survival probabilities were 92.2% (SE = 0.027) at 1 month and 90.1% (SE = 0.030) at 6 months. The median follow-up duration was 52 months (IQR: 35-77). At follow-up, 23.5% (n = 20) of patients had an unfavorable outcome based on the Glasgow Outcome Scale. Predictors of mortality included older age, altered level of consciousness, seizures, elevated body temperature on admission, and white matter changes on neuroimaging.</p><p><strong>Conclusion: </strong>Neurobrucellosis is associated with significant long-term morbidity and mortality. Key predictors of mortality include older age, altered level of consciousness, seizures, elevated body temperature on admission, and white matter changes. Identifying these predictors can help in targeting therapeutic strategies and improving patient outcomes through early intervention and close monitoring.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"9"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012462","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":"Sero-molecular prevalence of toxoplasmosis in hemodialysis and peritoneal dialysis patients in Markazi Province, Iran.","authors":"Hossein Sarmadian, Mana Shojapour, Fereshteh Chegeni, Mohammad Amin Tabatabaiefar, Farshid Haghverdi, Roham Sarmadian, Reza Ghasemikhah","doi":"10.1186/s41182-024-00676-3","DOIUrl":"10.1186/s41182-024-00676-3","url":null,"abstract":"<p><strong>Background: </strong>Infectious diseases, particularly parasitic infections such as toxoplasmosis, contribute significantly to the morbidity and mortality of hemodialysis patients. Toxoplasma gondii infection poses serious risks, especially to immunocompromised individuals. This study aimed to assess the prevalence of latent toxoplasmosis in dialysis patients in Markazi Province, Iran.</p><p><strong>Methods: </strong>A total of 181 patients (168 hemodialysis and 13 peritoneal dialysis) were included in this cross-sectional study. Blood samples were collected and tested for anti-Toxoplasma IgG and IgM antibodies using ELISA, while PCR was used to detect T. gondii DNA. Data were analyzed using SPSS, with P < 0.05 considered significant.</p><p><strong>Results: </strong>Out of 181 patients, 123 (67.95%) were seropositive for IgG antibodies, with the highest prevalence in those aged over 60 years. No cases tested positive for IgM antibodies or T. gondii DNA. Age was significantly associated with higher seroprevalence (P < 0.05), but there were no significant differences regarding gender, dialysis type, or duration of dialysis.</p><p><strong>Conclusion: </strong>The high prevalence of latent toxoplasmosis in dialysis patients underscores the need for regular screening to prevent serious complications. Given the limitations of serological tests, molecular diagnostics like PCR should be considered for better detection in immunocompromised patients.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"7"},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984973","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 the impact of the state of emergency during the COVID-19 pandemic on childhood immunizations in Benguela Province, Angola.","authors":"Tadatsugu Imamura, Keiji Mochida, Balogun Olukunmi, Lino Tchicondingosse, Pedro Sapalalo, Ketha Rubuz Francisco, Ai Aoki, Akira Ishiguro, Kenji Takehara","doi":"10.1186/s41182-024-00668-3","DOIUrl":"10.1186/s41182-024-00668-3","url":null,"abstract":"<p><strong>Background: </strong>The impact of public health measures against the coronavirus disease 2019 on the rate of childhood immunization has not yet been fully defined. Particularly, measures which directly affect health-seeking behaviors (e.g., the State of Emergency; SoE) drew public health attention. We aim to describe this impact in Benguela Province, Angola, by comparing the immunization rates between infants who had their immunizations before and after the SoE, which was declared on March 27, 2020.</p><p><strong>Methods: </strong>We retrospectively reviewed the epidemiological data of infants born between November 2019 and February 2020 in Benguela Province, Angola. Immunization rates (i.e., the number of immunized infants divided by the number of infants in the group of same months of birth and residential areas) were calculated for 11 vaccines that infants received from at birth to the 4th month after birth. The rates for the 2nd month vaccines were compared between infants immunized before the SoE (post-SoE), and after the SoE (pre-SoE).</p><p><strong>Results: </strong>Among 9,595 infants, the overall immunization rates were higher in the post-SoE (71.9-77.8%) than in the pre-SoE groups (66.0-73.8%). The overall immunization rates were higher in the post-SoE group than in the pre-SoE group in both urban and rural municipalities, although the rates were > 20% higher in urban than in rural municipalities. The immunization rates in the recommended month showed a similar trend, except for the stratified analysis for rural municipalities, where the rates were 2.3-4.1% lower in the post-SoE than in the pre-SoE groups. The most common reason for missing immunization was vaccine unavailability at health units (19.9%, 684/3,440). Less than 10% of missed immunizations were due to the SoE, which occurred mostly in infants born in rural municipalities in February 2020 (9.8%, 52/532). Less than 2% of missed immunizations were due to health units not being open, and was highest in rural municipalities in January 2020 (1.6%, 27/1,673).</p><p><strong>Conclusions: </strong>Our study suggested that the disruptive impacts of public health measures against pandemics on rates of childhood immunization can be mitigated, and support is needed for areas with vulnerable health systems, such as rural areas.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"5"},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979960","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":"Presence of the Anopheles culicifacies complex species A in southeast Iran.","authors":"Seyed Massoud Madjdzadeh, Nahid Behi, Mohammad Amin Gorouhi, Arsalan Amirkafi, Mohammad Ali Oshaghi","doi":"10.1186/s41182-025-00683-y","DOIUrl":"10.1186/s41182-025-00683-y","url":null,"abstract":"<p><strong>Background: </strong>The Anopheles culicifacies complex is one of the most important malaria vectors in Southeast Asia and Southeastern Iran. Although the sibling species within this complex are morphologically indistinguishable, they differ significantly in their disease transmission potential, blood-feeding behaviour, and other biological traits. Cytogenetic and chromosomal studies have identified five sibling species within this complex: A, B, C, D, and E. Understanding the species composition and distribution of this complex is crucial for malaria control strategies.</p><p><strong>Objectives: </strong>This study aimed to identify the sibling species of the An. culicifacies complex in Qaleh Ganj County, Kerman Province, Southeastern Iran. Specifically, the study sought to determine the presence of species A, which is known to be a primary vector of malaria in the region.</p><p><strong>Methods: </strong>We employed allele-specific PCR and sequencing PCR techniques to identify the sibling species. DNA was extracted from mosquito specimens, and the D3 region of the 28S rDNA gene and a segment of the COII gene from the mitochondrial genome (mtDNA) were targeted for amplification and sequencing.</p><p><strong>Results: </strong>Data analysis revealed a positive correlation between An. culicifacies s.l. specimens and altitude, with most specimens collected from mountainous areas. Both allele-specific PCR and sequencing PCR confirmed the presence of species A in the study areas of Kerman Province.</p><p><strong>Conclusions: </strong>Given that species A is a primary malaria vector, the findings of this study provide valuable insights for guiding malaria control strategies in Southeastern Iran. Further studies are recommended to assess the vector competence and ecological dynamics of other species within the An. culicifacies complex in the region.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"8"},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984887","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":"Characteristics and long-term health outcomes of the first domestic COVID-19 outbreak cases in Da Nang, Vietnam: a longitudinal cohort study.","authors":"Miyuki Tsuruoka, Mai Kim Huynh, Michiko Toizumi, Thanh Tien Hoang, Trieu Bao Nguyen, Anh The Dao, Luong Dinh Nguyen, Huy Xuan Le, Chung Thanh Le, Anh Quang Dang, Hung Thai Do, Lay Myint Yoshida","doi":"10.1186/s41182-024-00670-9","DOIUrl":"10.1186/s41182-024-00670-9","url":null,"abstract":"<p><strong>Background: </strong>Vietnam experienced the first COVID-19 domestic outbreak due to the Wuhan strain (B.1.1) in Da Nang from July 2020. COVID-19 can cause acute as well as long-term health problems. We aimed to characterise clinical features and risk factors related to severe illness of COVID-19 among Da Nang outbreak cases and to describe long-term health outcomes among survivors of this outbreak.</p><p><strong>Methods: </strong>We conducted an ambidirectional cohort study. Study subjects were all hospitalised cases with positive real-time PCR test of SARS-CoV-2 in the three major hospitals in Da Nang from 25 July to 28 August 2020. Clinical and demographic information was retrospectively collected from medical charts. Then, the survivors were followed-up prospectively at 6 and 16 months after acute infection to assess their health status via standardized questionnaires, physical examinations, chest X-rays and pulmonary function tests.</p><p><strong>Results: </strong>A total of 362 cases including 20 fatal cases were enrolled into the study retrospectively. The median age of the participants included in the medical chart review was 46.5 years and 60.8% were female. Overall, 7.8% of the participants required respiratory support during hospitalisation and 20 of them died. Compared to the survivors, the fatal cases were significantly older (median age of survivors 45.0 yr vs fatal cases 66.5 yr, P < 0.001) and more likely to have underlying conditions. The proportions of participants who had at least one long COVID symptom within the 7 days of each follow-up at 6 and 16 months were 72.0% (134/186) and 63.5% (47/74), respectively. We also found that females and adults reported symptoms more often in the follow-up surveys, 78.9% (90/114) [females] vs 61.1% (44/72) [males] at 6 months, P = 0.008; 68.7% (46/67) [ <math><mo>≥</mo></math> 20 years] vs 14.3% (1/7) <math><mrow><mo>[</mo> <mo><</mo></mrow> </math> 20 years] at 16 months, P = 0.004.</p><p><strong>Conclusions: </strong>In the first domestic COVID-19 outbreak in Vietnam, the mortality rate was approximately 6% and associated with underlying medical conditions. In the follow-up surveys, a substantial proportion of participants reported long COVID related health problems, although the prevalence declined over time. Females and adults reported symptoms more often, which might be due to the pathophysiological differences according to sex and age.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"6"},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984946","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":"Risk Communication and Community Engagement (RCCE) implementations to control cholera outbreak in Oromia region, Ethiopia.","authors":"Dabesa Gobena, Esayas Kebede Gudina, Getahun Fetensa, Tizta Tilahun Degfie, Tessema Debela, Afework Tamiru, Zenebu Begna Bayissa, Dereje Diriba, Tarekegn Sarbessa, Daniel Bekele, Natinel Teferi, Achalu Layesa, Abate Zewdie, Dawit Worku Ayele, Meron Debebe Mersha, Chala Bafikadu, Senahara Korsa Wake, Lemi Abebe, Tesfaye Kebebew, Tefera Goshu, Birhanu Kenate, Yadeta Dessie, Zeleke Mekonnen","doi":"10.1186/s41182-024-00679-0","DOIUrl":"10.1186/s41182-024-00679-0","url":null,"abstract":"<p><strong>Background: </strong>Oromia regional state experiencing cholera outbreaks in a protracted pattern despite various interventions at local and regional levels. This study aimed to examine the implementation of Risk Communication and Community Engagement (RCCE) activities for cholera outbreak control in the region.</p><p><strong>Methods: </strong>We conducted a quantitative and qualitative mixed-method study. The study included 422 respondents for quantitative, 22 key informant interviews (KII), and 4 Focus Group Discussions (FGDs) for the qualitative methods. Risk Communication and Community Engagement (RCCE) activities were assessed using standard questionnaires adapted from national cholera guideline later categorized as poor, satisfactory and good. The findings have also been derived qualitatively from three distinct themes or pillars, specifically (coordination and logistics, RCCE, and the Oral Cholera Vaccine). The quantitative data were analyzed using Stata, version 14.0, and ATLAS.ti9 software was used for qualitative data analysis. An ordinal logistic regression model was applied to identify factors associated with the RCCE status, and a thematic content analysis was performed for the qualitative study. Odds Ratios with 95% confidence intervals (CI) were used to present the findings from the quantitative analysis.</p><p><strong>Results: </strong>Only 53% (223) of participants had received health information on cholera of whom 22.8% (96) had material for Social Behaviour Change (SBC) in the local language (Afan Oromo). The overall RCCE implementation status was rated as poor by 73% of the respondents, satisfactory by 23%, and only 4% rated it as good. Level of education and occupation of the house are among the factors affecting the implementation of RCCE. The qualitative findings revealed a lack of regular community dialogues, and community engagements were notably minimal during the early phase of the outbreak. Overall, the RCCE implementation activities were characterized by inconsistency, a lack of comprehensiveness, and uniformity across all levels.</p><p><strong>Conclusion: </strong>The RCCE-related intervention activities were found to be minimal, inconsistent and less focused. The RCCE interventions and awareness creation need to begin with the small units of the community structures, including individuals and families and have to happen continuously with the community, and health workers' involvement at all level. Preliminary evaluation of Social and Behaviour Change (SBC) materials before their distribution should be made, and adopting diverse communication modalities to control the outbreak.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"4"},"PeriodicalIF":3.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972285","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":"Scoping review of infectious disease prevention, mitigation and management in passenger ships and at ports: mapping the literature to develop comprehensive and effective public health measures.","authors":"Lemonia Anagnostopoulos, Sotirios Vasileiadis, Leonidas Kourentis, Zacharoula Bogogiannidou, Ioanna Voulgaridi, Gordon Nichols, Fani Kalala, Matthaios Speletas, Christos Hadjichristodoulou, Varvara A Mouchtouri","doi":"10.1186/s41182-025-00681-0","DOIUrl":"10.1186/s41182-025-00681-0","url":null,"abstract":"<p><strong>Background: </strong>With various infectious disease risks to passenger ship travellers, guidance for infectious disease prevention, mitigation and management (PMM) exists. Emerging infections and emergencies necessitate updated, context-specific guidelines and practices. New evidence for infection PMM must be translated into guidance for governmental authorities and the passenger ship industry. Under the European HEALTHY SAILING project, we conducted a scoping review of publications in PubMed, Scopus and grey literature for scientific articles, regulations, guidelines and policies describing infectious disease PMM in seaports, cruise, ferry, expedition and river cruise ships between 1990 and 2023.</p><p><strong>Main findings: </strong>Of 620 publications most were peer-reviewed articles (57.7%) and technical guidance (27.9%), followed by reports/other documents (9.1%), industry guidance (3.4%) and legislation (1.9%). Half (50.5%) of all publications addressed respiratory illnesses, fewer addressed gastroenteritis (11.5%), Legionnaire's (6.1%), other vaccine-preventable (3.2%), vector-borne (1.6%) and sexually transmitted (1.0%) diseases. Most publications focus on infectious disease in seagoing cruise ships (75.7%) compared to ferries, expedition and river cruise ships (26.6%, 16.9%, 16.3%, respectively). Fewer publications addressed seaports (39.0%), shore-side personnel (19.7%) and port communities (2.4%). Most literature was published between 2020 and 2023 (50.2%) with a peak addressing respiratory illnesses (264 publications) during this period. A trend in volume and type was observed based on public health emergencies associated with the publication year.</p><p><strong>Conclusions: </strong>Peer-reviewed articles and guidance primarily address respiratory and gastrointestinal illnesses, seagoing cruise ships and onboard populations. Gaps on the following topics exist: other infectious disease types; other passenger ship types; land-based personnel and port communities. Future research could assess risk factors and PMM measure effectiveness considering vaccine-preventable, vector-borne and sexually transmitted diseases. The evidence-base should be strengthened to produce guidelines targeting specificities of seaports, ferries, expedition and river cruise ships. Developing guidelines to standardise passenger ship outbreak investigation reporting could help evaluate PMM measure effectiveness, the impact of passenger ship travel on port communities and vice versa. Modern passenger ship experiences-from educational to elderly focused cruising-present diverse public health risks, requiring continuous efforts by public health authorities and the shipping industry. While outside the review's scope, measures may impact travellers' mental health, necessitating strategies when designing and implementing PMM measures.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"3"},"PeriodicalIF":3.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955674","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 rare case of acute myocardial infarction with heart failure following hump-nosed viper bite in a Sri Lankan female.","authors":"W M D A S Wanninayake, Tilan Aponso, Manohari Seneviratne, Dhanapala Dissanayake","doi":"10.1186/s41182-024-00645-w","DOIUrl":"https://doi.org/10.1186/s41182-024-00645-w","url":null,"abstract":"<p><strong>Background: </strong>Hump-nosed viper (Hypnale species) bites are an important cause of mortality and morbidity in southern India and Sri Lanka, accounting for 27 and 77% of venomous snake bites, respectively. Previously, we knew them to be moderately venomous snakes, primarily causing local envenomation. However, recent reports have indicated severe systemic envenomation incidents, which include hemostatic dysfunction, microangiopathic hemolysis, kidney injury, myocardial toxicity, and even death. The literature rarely reports cardiac manifestations from hump-nosed viper bites, and all reported cases show cardiac manifestations within hours of the snake bite. The literature did not report late presentations of cardiac manifestations. Here, we report a case of hump-nosed viper bite complicated with type 2 myocardial infarction and acute pulmonary oedema secondary to acute heart failure in a Sri Lankan female presented to the National Hospital of Colombo, Sri Lanka, on day 3 after the snake bite.</p><p><strong>Case presentation: </strong>A local hospital transferred a previously healthy 39-year-old female from Kegalle, Sri Lanka, to our hospital for further condition management. We identified the offending snake as a hump-nosed viper after she reported a history of snake bites 3 days ago. She complained of chest tightness on day 3 of the illness and was found to have acute heart failure precipitated by troponin-positive non-ST elevation myocardial infarction in initial investigations. We performed a CT coronary angiography along with a metabolic screening, revealing normal coronary arteries and a negative metabolic screening. Supportive therapy with loop diuretics and oxygen managed her condition, and a follow-up 2D echocardiogram revealed complete recovery of her cardiac function. She was asymptomatic 3 months into the follow-up. Therefore, we concluded that the case was a venom-induced type 2 myocardial infarction leading to heart failure with acute pulmonary oedema, as the CT coronary angiogram showed normal coronary arteries.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"2"},"PeriodicalIF":3.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932786","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":"Latent tuberculosis prevalence in healthcare workers in Laos: a cross-sectional study.","authors":"Sypaseuth Duangmixay, Siriphone Virachith, Judith M Hübschen, Phitsada Siphanthong, Sakhone Suthepmany, Somphou Sayasone, Antony P Black","doi":"10.1186/s41182-024-00677-2","DOIUrl":"https://doi.org/10.1186/s41182-024-00677-2","url":null,"abstract":"<p><strong>Background: </strong>Individuals with latent tuberculosis infection (LTBI) have a high risk of active infection, morbidity and mortality. Healthcare workers are a group who have increased risk of infection and onward transmission to their patients and other susceptible individuals; however, LTBI is often undiagnosed, and individuals are asymptomatic. Interferon gamma release assays (IGRA) can detect evidence of TB infection in otherwise asymptomatic individuals and are a good indication of LTBI. Laos, a resource limited country in southeast Asia, has limited data on TB prevalence in the general population or in healthcare workers. This study aimed to estimate the prevalence of LTBI in Lao healthcare workers in Vientiane Capital.</p><p><strong>Methods: </strong>Healthcare workers from high-risk departments from 3 central hospitals in Laos were included (n = 196) and venous blood was tested by IGRA. A questionnaire was administered to determine their knowledge, attitude and practice towards TB and LTBI.</p><p><strong>Results: </strong>10.2% of the participants were positive by IGRA, none of whom were previously aware of their TB status. The questionnaire revealed that knowledge and awareness of TB and LTBI were low.</p><p><strong>Discussion: </strong>A significant proportion of healthcare workers in this study had evidence of LTBI infection. These individuals were unaware of their TB status and we suggest that testing and treatment, as well as prevention strategies, should be routinely administered in Lao hospitals.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"1"},"PeriodicalIF":3.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927350","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":"Temporal changes in Plasmodium falciparum genetic diversity and multiplicity of infection across three areas of varying malaria transmission intensities in Uganda.","authors":"Alex Mwesigwa, Steven M Kiwuwa, Benson Musinguzi, Hakiim Kawalya, James Davis Katumba, Andrew Baguma, Irene M Mutuku, Ismail Abiola Adebayo, Samuel L Nsobya, Pauline Byakika-Kibwika, Joan N Kalyango, Charles Karamagi, Joaniter I Nankabirwa","doi":"10.1186/s41182-024-00672-7","DOIUrl":"10.1186/s41182-024-00672-7","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a significant public health challenge in Uganda, with Plasmodium falciparum (P. falciparum) responsible for most of malaria infections. The high genetic diversity and multiplicity of infection (MOI) associated with P. falciparum complicate treatment and prevention efforts. This study investigated temporal changes in P. falciparum genetic diversity and MOI across three sites with varying malaria transmission intensities. Understanding these changes is essential for informing effective malaria control strategies for the different malaria transmission settings.</p><p><strong>Methods: </strong>A total of 220 P. falciparum-positive dried blood spot (DBS) filter paper samples from participants in a study conducted during 2011-2012 and 2015-2016 were analyzed. Genotyping utilized seven polymorphic markers: Poly-α, TA1, TA109, PfPK2, 2490, C2M34-313, and C3M69-383. Genetic diversity metrics, including the number of alleles and expected heterozygosity, were calculated using GENALEX and ARLEQUIN software. MOI was assessed by counting distinct genotypes. Multi-locus linkage disequilibrium (LD) and genetic differentiation were evaluated using the standardized index of association (I_A^S) and Wright's fixation index (F_ST), respectively. Statistical comparisons were made using the Kruskal-Wallis test, and temporal trends were analyzed using the Jonckheere-Terpstra test, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Of the 220 samples, 180 were successfully amplified. The majority of participants were males (50.6%) and children aged 5-11 years (46.7%). Genetic diversity remained high, with mean expected heterozygosity (H_e) showing a slight decrease over time (range: 0.73-0.82). Polyclonal infections exceeded 50% at all sites, and mean MOI ranged from 1.7 to 2.2, with a significant reduction in Tororo (from 2.2 to 2.0, p = 0.03). Linkage disequilibrium showed a slight increase, with Kanungu exhibiting the lowest I_A^S in 2011-2012 (0.0085) and Jinja the highest (0.0239) in 2015-2016. Overall genetic differentiation remained low, with slight increases in pairwise F_ST values over time, notably between Jinja and Tororo (from 0.0145 to 0.0353).</p><p><strong>Conclusions: </strong>This study highlights the genetic diversity and MOI of P. falciparum in Uganda's malaria transmission settings, noting a slight decrease in both genetic diversity and MOI overtime. Continued surveillance and targeted control strategies are essential for monitoring the impact of malaria control efforts in Uganda.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"52 1","pages":"103"},"PeriodicalIF":3.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903553","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}