Tropical Medicine and Health最新文献

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

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

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

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

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

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

{"title":"Epidemiological trends of diarrheal viruses in central and western Kenya before and after Rotavirus vaccine introduction.","authors":"Maurine Mumo Mutua, Cyrus Kathiiko, Mary N Wachira, Betty Muriithi, James Nyangao, Samoel A Khamadi, Satoshi Komoto, Kouichi Morita, Yoshio Ichinose, Ernest A Wandera","doi":"10.1186/s41182-025-00716-6","DOIUrl":"https://doi.org/10.1186/s41182-025-00716-6","url":null,"abstract":"<p><strong>Background: </strong>Rotavirus, norovirus, adenovirus (type 40/41) and astrovirus are the most significant viral etiological agents of acute gastroenteritis in young children globally. Kenya introduced the rotavirus vaccine into her National Immunization Program in July 2014, which has led to a significant decline in the prevalence of rotavirus. We sought to assess the impact of rotavirus vaccination on the epidemiological trends of other diarrhea-associated enteric viruses across different regions in Kenya.</p><p><strong>Methodology: </strong>Using conventional and multiplex RT-PCR, we analyzed a total of 716 fecal samples for adenovirus, astrovirus and norovirus from children aged below 5 years presenting with acute gastroenteritis but tested negative for rotavirus at Mbita Sub-County Referral Hospital in Western Kenya and Kiambu County Referral Hospital in Central Kenya before (2011-2013) and after (2019-2020) rotavirus vaccine introduction.</p><p><strong>Results: </strong>Following the rotavirus vaccine introduction, there was no significant difference in norovirus and astrovirus prevalence post-vaccine introduction in both Central (norovirus- 5.4% vs 5.9%; astrovirus- 2% vs 2.4%) and Western Kenya (norovirus- 2% vs 3%; astrovirus 3.3% vs 5.9%). Although the prevalence of adenovirus increased substantially in Western Kenya (9% vs 12.4%), there was a significant decrease in adenovirus in Central Kenya (17%, vs 6%, p = 0.007). Before the introduction of the rotavirus vaccine, a large proportion of adenovirus cases occurred at 6-8 months in Central Kenya and 12-23 months in Western Kenya, while norovirus prevalence was highest at 12-23 months in Central and 3-5 months in Western Kenya. Astrovirus infections in Central Kenya were predominantly among children aged 12-23 months, both before and after the vaccine. Following vaccine introduction, a large proportion of adenovirus cases occurred among children aged 12-23 months in both regions. Norovirus peaked at 12-23 months in Central Kenya and showed dual peaks at 3-5 and 9-11 months in Western Kenya. Astrovirus infections in Western Kenya shifted from peaks at 6-8 and 24-59 months pre-vaccine to 9-11 months post-vaccine.</p><p><strong>Conclusion: </strong>Our data demonstrate the burden and changing epidemiology of enteric viruses in Western and Central Kenya and underscores the need for continued monitoring to guide the design and implementation of appropriate public health interventions.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"60"},"PeriodicalIF":3.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020337","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":"Attention to COVID 19 pandemic resulted in increased measles cases and deaths in Zambia.","authors":"Kelvin Mwangilwa, Cephas Sialubanje, Musole Chipoya, Chilufya Mulenga, Moses Mwale, Charles Chileshe, Danny Sinyange, Moses Banda, Priscilla Nkonde Gardner, Lilian Lamba, Precious Kalubula, John Simwanza, Davie Simwaba, Nathan Kapata, Jonathan Mwanza, Peter J Chipimo, Nyuma Mbewe, Nyambe Sinyange, Isaac Fwemba, Muzala Kapin'a, Roma Chilengi","doi":"10.1186/s41182-025-00736-2","DOIUrl":"10.1186/s41182-025-00736-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The COVID-19 pandemic had a devastating impact on childhood routine immunization programs, resulting in increased measles mortalities and complications. In Zambia, the likelihood of measles-related deaths and complications in children was possibly increased because of high rates of unvaccinated children, late diagnosis, and poor case management, which could have been a consequence of exclusive focus on COVID-19 interventions. This study aimed at examining the effect of the COVID-19 pandemic on measles mortality and its predictors among patients seen at health facilities in Zambia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used longitudinal data (January 2020 to August 2023) from outbreak investigations and time series data from 2017 to 2023 to understand the impact of COVID-19 on measles immunization and know the predictors of measles mortalities. The period running from January 2017 to February 2020, just before the first reported COVID-19 case, was defined as pre-COVID-19, and March 2020 to December 2023 as post-COVID-19. Multivariable logistic regression analysis was used to determine predictors of mortality. A segmented Poisson regression model was used to determine the correlation between the underlying patterns of measles mortality and the commencement of the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 3429 measles cases were reported during the study period. Of these, 1261 had complete metadata and were included in the analysis. The median age was 3 years (IQR, 1-7). Out of the 1261 enrolled, 54 (4.3%) were reported died. A total of 205 (21.0%) were IgM positive, and 207 (16.9%) were vaccinated. Monthly measles mortality increased by 220%, from 0.06 per 100,000 before COVID-19 to 0.23 during the pandemic. Predictors of mortality were younger age category (0-4) (AOR = 2.78; 95% CI 1.16-7.14), testing positive for measles IgM (AOR = 2.17; 95% CI 1.07-4.39), rush (AOR = 3.66; 95% CI 1.31, 6.21), and female sex (AOR = 1.90; 95% CI 1.04-3.50), which increased the odds of dying. However, being vaccinated (AOR = 0.06; 95% CI 0.01-0.42) reduced the odds of dying. Evidence for the COVID-19 effect was strongly associated with increased measles mortality (RR, 1.02; 95% CI 1.00, 1.04; 0.017) with a trend step change of 81% (RR, 1.81; 95% CI 1.14-2.87). There was also an increased trend of measles cases (RR, 1.04; 95% CI 1.01-1.06) during the pandemic. Measles dose 2 vaccination trends increased by about 0.3% during the COVID-19 pandemic due to the Supplementary Immunization Activity (SIA) (RR, 1.003; 95% CI 1.000-1.010). However, there was a dramatic drop of about 42% (RR = 0.58, 95% CI 0.46-0.72).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Measles caused a significant increase in child mortality during the pandemic period. A mix of systemic, clinical, and individual factors affected measles mortality. Prioritizing vaccine coverage, especially for younger children and marginalized populations; enhancing diagnostic a","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"59"},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996944","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":"Mortality predictors and diagnostic challenges in adult tuberculous meningitis: a retrospective cohort of 100 patients.","authors":"Mahboubeh Maleki Rad, Mahboubeh Haddad, Fereshte Sheybani, Matin Shirazinia, Maliheh Dadgarmoghaddam","doi":"10.1186/s41182-025-00738-0","DOIUrl":"https://doi.org/10.1186/s41182-025-00738-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the clinical characteristics, diagnostic certainty, outcomes, and predictors of mortality in patients diagnosed with tuberculous meningitis (TBM), using the Lancet scoring system for diagnostic certainty.</p><p><strong>Methods: </strong>A retrospective cohort was conducted on 100 patients diagnosed with TBM. Patients were classified based on the Lancet scoring system into definite, probable, and possible TBM categories. Clinical features, neuroimaging findings, cerebrospinal fluid (CSF) analysis, and outcomes were analyzed.</p><p><strong>Results: </strong>The median age of patients was 36.5 years, with 57.0% male. The most common symptoms were fever (64.7%), headache (63.6%), and altered consciousness (60.0%). Hydrocephalus was present in 40.0% of cases. Diagnosis certainty was classified as possible (63.0%), probable (22.0%), and definite (15.0%). The in-hospital mortality rate was 18.0%, with 12-month survival rates of 69.7%. There was no significant difference between the level of diagnostic certainty and the survival of patients. Significant predictors of mortality included hydrocephalus (hazard ratio [HR]: 3.65, 95% CI 1.67 to 7.97), hemoglobin levels (HR: 0.75, 95% CI 0.64 to 0.89), age (HR: 1.04, 95% CI 1.02 to 1.06), CSF pleocytosis (HR: 0.34, 95% CI 0.14 to 0.84), and altered consciousness at admission (HR: 19.23, 95% CI 2.57 to 143.85).</p><p><strong>Conclusion: </strong>TBM remains a critical concern with significant mortality and morbidity. Key predictors of mortality, including altered consciousness, hydrocephalus, and older age, highlight the need for early detection and tailored interventions. In most cases, the diagnosis cannot be definitively confirmed and is instead categorized as probable or possible. Our study demonstrates that survival rates were comparable across definite, probable, and possible TBM categories, supporting the value of empirical treatment when definitive confirmation is not feasible.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"58"},"PeriodicalIF":3.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039684","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 study of plants used for traditional control of mosquitoes and other arthropod pests in the Ghibe valley, southwest Ethiopia.","authors":"Zeyede Teshome, Alemtshay Teka, Abebe Animut, Mahlet Arage, Esayas Aklilu, Mirutse Giday","doi":"10.1186/s41182-025-00740-6","DOIUrl":"https://doi.org/10.1186/s41182-025-00740-6","url":null,"abstract":"<p><strong>Background: </strong>Medicinal plants have been used in the traditional healthcare system of Ethiopia, including controlling human biting mosquitoes. However, documented knowledge on such aspects remains scarce. In this study, plants used in the traditional control of mosquitoes and other arthropod vectors with the local knowledge and method of applications in the Ghibe valley of southwest Ethiopia were documented.</p><p><strong>Methods: </strong>Semi-structured interviews were used to collect ethnobotanical data between March and October 2024. A total of 361 informants consisting of 77 key informants and 284 general informants were selected using purposive and systematic random sampling methods, respectively, in Enor, Deri Saja Zuria, Misha and Sekoru districts of southwest Ethiopia. Frequency of citation and simple preference ranking were employed to determine the most used insecticidal and insect repellent plants. Relative importance of multipurpose plants was assessed using direct matrix ranking exercises. Independent samples t-test and one-way ANOVA tests were conducted to compare knowledge of informants on insecticidal and insect repellent plants.</p><p><strong>Results: </strong>A total of 53 plant species were used to control human biting insects. The most cited plant was Allium sativum L., (cited by 89%) followed by Croton macrostachyus Hochst. ex Delile (81%), Olea europaea subsp. cuspidata (Wall.G.Don) Cif. (77%), Coleus abyssinicus (Fresen.) A.J.Paton (69%; n = 361), Calpurnia aurea (Aiton) Benth. (63%), Juniperus procera Hochst. ex Endl. (63%), Echinops kebericho Mesfin (58%), Eucalyptus globulus Labill (56%), Melia azedarach L. (52%) and Phytolacca dodecandra L'Hér. (36%). The results of the current study showed that different informant groups had considerably different level of knowledge on traditional usage of insecticidal and insect repellent plants.</p><p><strong>Conclusions: </strong>Plant species Eucalyptus globulus, Calpurnia aurea, Phytolacca dodecandra, Echinops kebericho, Croton macrostachyus and Juniperus procera were more frequently cited to be insecticides against human biting arthropods while Melia azedarach L., Olea europaea subsp. cuspidata, Coleus abyssinicus, Croton macrostachyus, Eucalyptus globulus, Lippia abyssinica (Otto & A. Dietr.) Cufod., and Juniperus procera were more frequently reported to be repellents. Some of these plants (Coleus abyssinicus, Croton macrostachyus and Echinops kebericho) have not yet been investigated in depth and thus require scientific evaluation for their efficacy as insecticides and or repellents against malaria-transmitting mosquitoes in Ethiopia.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"56"},"PeriodicalIF":3.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001269","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}