Tropical Medicine and Health最新文献

{"title":"Reinvigorating AMR resilience: leveraging CRISPR-Cas technology potentials to combat the 2024 WHO bacterial priority pathogens for enhanced global health security-a systematic review.","authors":"Olalekan John Okesanya, Mohamed Mustaf Ahmed, Jerico Bautista Ogaya, Blessing Olawunmi Amisu, Bonaventure Michael Ukoaka, Olaniyi Abideen Adigun, Emery Manirambona, Olakulehin Adebusuyi, Zhinya Kawa Othman, Olanegan Gloria Oluwakemi, Oluwaseunayo Deborah Ayando, Maria Ivy Rochelle S Tan, Nimat Bola Idris, Hassan Hakeem Kayode, Tolutope Adebimpe Oso, Musa Ahmed, M B N Kouwenhoven, Adamu Muhammad Ibrahim, Don Eliseo Lucero-Prisno","doi":"10.1186/s41182-025-00728-2","DOIUrl":"10.1186/s41182-025-00728-2","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) poses a global health threat, particularly in low- and middle-income countries (LMICs). Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system technology offers a promising tool to combat AMR by targeting and disabling resistance genes in WHO bacterial priority pathogens. Thus, we systematically reviewed the potential of CRISPR-Cas technology to address AMR.</p><p><strong>Methods: </strong>This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted using the Scopus and PubMed databases, focusing on publications from 2014 to June 2024. Keywords included \"CRISPR/Cas,\" \"antimicrobial resistance,\" and \"pathogen.\" The eligibility criteria required original studies involving CRISPR/Cas systems that targeted AMR. Data were extracted from eligible studies, qualitatively synthesized, and assessed for bias using the Joanna Briggs Institute (JBI)-standardized tool.</p><p><strong>Results: </strong>Data from 48 eligible studies revealed diverse CRISPR-Cas systems, including CRISPR-Cas9, CRISPR-Cas12a, and CRISPR-Cas3, targeting various AMR genes, such as blaOXA-232, blaNDM, blaCTX-M, ermB, vanA, mecA, fosA3, blaKPC, and mcr-1, which are responsible for carbapenem, cephalosporin, methicillin, macrolide, vancomycin, colistin, and fosfomycin resistance. Some studies have explored the role of CRISPR in virulence gene suppression, including enterotoxin genes, tsst1, and iutA in Staphylococcus aureus and Klebsiella pneumoniae. Delivery mechanisms include bacteriophages, nanoparticles, electro-transformation, and conjugative plasmids, which demonstrate high efficiency in vitro and in vivo. CRISPR-based diagnostic applications have demonstrated high sensitivity and specificity, with detection limits as low as 2.7 × 10<sup>2</sup> CFU/mL, significantly outperforming conventional methods. Experimental studies have reported significant reductions in resistant bacterial populations and complete suppression of the targeted strains. Engineered phagemid particles and plasmid-curing systems have been shown to eliminate IncF plasmids, cured plasmids carrying vanA, mcr-1, and blaNDM with 94% efficiency, and restore antibiotic susceptibility. Gene re-sensitization strategies have been used to restore fosfomycin susceptibility in E. coli and eliminate blaKPC-2-mediated carbapenem resistance in MDR bacteria. Whole-genome sequencing and bioinformatics tools have provided deeper insights into CRISPR-mediated defense mechanisms. Optimization strategies have significantly enhanced gene-editing efficiencies, offering a promising approach for tackling AMR in high-priority WHO pathogens.</p><p><strong>Conclusions: </strong>CRISPR-Cas technology has the potential to address AMR across priority WHO pathogens. While promising, challenges in optimizing in vivo delivery, mitigating potential res","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"43"},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773399","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":"Genetic structure and geographical distribution of Bithynia siamensis sensu lato from Khong and Mounlapamok districts, Champasak Province, Laos.","authors":"Naruemon Bunchom, Weerachai Saijuntha, Virasack Bounavong, Bounmixay Pakouakeu, Parita Hansana, Pheovaly Soundala, Chavanut Jaroenchaiwattanachote, Takeshi Agatsuma, Marcello Otake Sato, Philippe Buchy, Moritoshi Iwagami","doi":"10.1186/s41182-025-00720-w","DOIUrl":"10.1186/s41182-025-00720-w","url":null,"abstract":"<p><strong>Background: </strong>Bithynia spp., a key intermediate host of Opisthorchis viverrini, is widely distributed in the lower Mekong sub-region, where opisthorchiasis remains a major public health concern. Understanding the genetic diversity and population structure of these snails is crucial for disease control. Bithynia siamensis sensu lato has been classified into three genetic lineages (I-III) based on cytochrome c oxidase subunit 1 (cox1) and 16S ribosomal RNA (16S rRNA) sequence analysis. This study focuses on Champasak Province, Laos, a highly endemic area of opisthorchiasis with limited genetic data on Bithynia spp.</p><p><strong>Methods: </strong>Bithynia snails were collected from 12 villages in Khong and Mounlapamok districts, Champasak Province, Laos, between February and August 2024. To compare with previous reports, a total of 246 and 139 samples were analyzed using cox1 and 16S rRNA markers, respectively. Genetic diversity, genetic differentiation, and genetic structure were assessed based on these markers. Haplotype networks were constructed based on cox1 and 16S RNA sequences to elucidate the genetic lineage of these samples.</p><p><strong>Results: </strong>In the present study, only Bithynia siamensis goniomphalos was identified, while B. s. siamensis and B. funiculata were not found. Our findings revealed that both cox1 and 16S rRNA sequences exhibited high haplotype diversity among populations but relatively low nucleotide diversity. Two lineages of B. s. goniomphalos (lineages II and III) were detected in the studied areas, exhibiting significant genetic structuring among groups of snail populations from different villages in each lineage. Notably, lineage II was identified in Laos for the first time. The distribution of lineage II was observed near the southern border of Laos and Cambodia.</p><p><strong>Conclusions: </strong>This study is the first to use DNA analysis to investigate Bithynia spp. in opisthorchiasis-endemic areas of Champasak Province, where B. s. goniomphalos lineages II and III were detected, but lineage I was not found. Our finding suggested that geographic or environmental factors influence the distribution of specific Bithynia lineages in this region. Many O. viverrini endemic areas in Southeast Asia still lack genetic data on Bithynia snails which could provide valuable insights into the transmission dynamics of opisthorchiasis. Therefore, further investigations should be conducted in these areas using cox1 and 16S rRNA sequences for comparison with previous studies.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"44"},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773395","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":"Geospatial analysis of cholera outbreak in Lusaka, Zambia, between 2023 and 2024.","authors":"William Ngosa, Tadatsugu Imamura, Nyuma Mbewe, Joseph Seriki, Oscar Nzila, Fred Mfune, Godfrey Zulu, Chomba Mulando, Tizha Chiluba, Luo Miyanda, Agness Phiri, Lucy Sichone, Galion Mwape, Kapambwe Mulenga, Charles Chileshe, Nawa Mabuku, Dabwiso Banda, Fangyu Yan, Taro Kamigaki, Roma Chilengi, Nyambe Sinyange","doi":"10.1186/s41182-025-00718-4","DOIUrl":"https://doi.org/10.1186/s41182-025-00718-4","url":null,"abstract":"<p><strong>Background: </strong>Cholera outbreaks have plagued Zambia for decades, with Lusaka district, the capital, being particularly vulnerable. Although the lack of sanitary toilet facilities and inadequate drainage systems were shown to be associated with the high cholera incidence in the early 2000s, it is unknown whether these environmental risk factors persisted in the outbreak that occurred in 2023-2024, which turned out to be the largest outbreak in the country's history. We investigated the geospatial patterns of cholera cases and associated environmental factors during the October 2023 to March 2024 cholera outbreak.</p><p><strong>Methods: </strong>We conducted a geospatial analysis of the suspected cholera cases in Lusaka district, comprising seven constituencies and 94 townships. Patient information and geocoordinates were collected from suspected cases using electronic surveillance tools. The space-time scan statistics was performed to detect spatial and temporal clusters of cases. Spearman's rank correlation coefficient, were employed to examine the relationship between cholera incidence and various environmental factors, including access to Water, Sanitation, and Hygiene (WASH) facilities and equipment.</p><p><strong>Results: </strong>Over the study period, 4,591 suspected cholera cases with geocoordinate data were identified, with incidence rates varying across the constituencies. Median cholera incidence (IQR) was 0.55 (0.27-1.44) in Lusaka, with higher incidence rates observed in unplanned residential areas. After the first case identification in Kanyama, cases and clusters were observed in different parts of Lusaka. Among 94 townships in Lusaka, cholera-suspected cases were identified in 86 of them. Among environmental factors analyzed for associations with the high cholera incidence, the proportion of individuals without soap and detergent at home (ρ = 0.457, p < 0.001) and those without water for hand washing at home (ρ = 0.421, p < 0.001) were significantly associated with increased cholera incidence.</p><p><strong>Conclusion: </strong>The findings underscore the significance of environmental factors in cholera transmission, particularly in unplanned residential areas with inadequate access to WASH facilities which persist in the area. Improving WASH infrastructure and implementing tailored public health strategies, particularly for high-risk areas (e.g., unplanned residential areas), are crucial for mitigating cholera outbreaks in Lusaka District.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"42"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744050","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 association between 2017 American College of Cardiology/American Heart Association guideline for hypertension and neonatal outcomes in Kenya: a retrospective study.","authors":"Mami Hitachi, Kazuchiyo Miyamichi, Sumihisa Honda, Violet Wanjihia, Samson Muuo Nzou, Satoshi Kaneko","doi":"10.1186/s41182-025-00724-6","DOIUrl":"10.1186/s41182-025-00724-6","url":null,"abstract":"<p><strong>Background: </strong>Hypertension in pregnancy serves to screen for adverse perinatal outcomes. In 2017, the American College of Cardiology and American Heart Association recommended a new blood pressure category with lower hypertension thresholds, excluding pregnancy. This study aimed to explore the association between the 2017 redefined blood pressure categories in pregnancy and neonatal outcomes such as preterm birth and low birth weight.</p><p><strong>Methods: </strong>This retrospective study used electronic records of the Maternal and Child Health Handbook registered by the Women and Infant Registration System. All women who had at least one antenatal care visit and delivery between January 2017 and April 2020 and between May and December 2022 were included in the study. A birth of less than 37 weeks was defined as preterm delivery. LBW was identified based on a newborn's birthweight of less than 2500 g. The maximum blood pressure across all antenatal care visits was classified based on the newly recommended criteria. A generalized linear model with binomial distribution and logit link function was used to evaluate the association between new blood pressure categories and neonatal outcomes at different levels of health facilities.</p><p><strong>Results: </strong>We analyzed data from 825 women. Of these, the prevalence was 13.7% for elevated blood pressure, 15.2% for stage 1 hypertension, 4.5% for non-severe stage 2 hypertension and 1.2% for severe stage 2 hypertension. For lower-level facilities, no significant associations were identified between the redefined blood pressure category and preterm birth or low birthweight. At higher-level facilities, preterm birth was only significantly associated with severe stage 2 hypertension (adjusted odds ratio:10.94; 95% confidence interval:1.08-110.93; P = 0.04) and low birthweight showed no association with the redefined category.</p><p><strong>Conclusion: </strong>This study revealed no association between redefined lower blood pressure threshold and preterm birth and low birthweight in under-resourced settings. However, previous studies in well-resourced countries with larger sample sizes also reported a significant association. Therefore, further investigations are required.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"41"},"PeriodicalIF":3.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721628","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":"Genetic diversity of genus Chilomastix: molecular classification of C. mesnili and other potential species variations in humans and animals.","authors":"Chuanhao Jiang, Siti Arifah Lacante, Tetsushi Mizuno, Din Syafruddin, Masaharu Tokoro","doi":"10.1186/s41182-025-00725-5","DOIUrl":"10.1186/s41182-025-00725-5","url":null,"abstract":"<p><strong>Background: </strong>The genus Chilomastix, including C. mesnili, consists of protozoa that parasitize the gastrointestinal tracts of various host organisms, including mammals (humans and non-human primates [NHP]), birds, and amphibians. Despite its widespread presence, Chilomastix spp. are generally considered non-pathogenic, which has led to limited molecular epidemiological studies on this genus. Consequently, genetic reference data for this genus remain scarce in GenBank. In this study, we aimed to establish a molecular classification for Chilomastix spp. by investigating the genetic diversity of isolates from humans and animals in a parasite-endemic region of Indonesia.</p><p><strong>Methods: </strong>A cross-sectional molecular investigation was conducted in Wainyapu Village, Sumba Island, Indonesia. Stool samples were collected annually from 2013 to 2016 and screened using polymerase chain reaction (PCR) targeting the 18S small subunit ribosomal RNA gene (18S rRNA) of Chilomastix spp., followed by direct and subcloning sequencing. Genetic haplotypes of the partial 18S rRNA sequence (1386-1953 bp) from humans (n = 25), dogs (n = 1), pigs (n = 23), rats (n = 38), water buffaloes (n = 3), chickens (n = 10), and ducks (n = 1) were analyzed alongside reference sequences from humans, guinea pigs, leeches, frogs, and water sources using phylogenetic analyses.</p><p><strong>Results: </strong>The prevalence of Chilomastix spp. was 7.0% (25/356) in humans and 19.7% (75/380) in animals. Phylogenetic analyses revealed the following monophyletic clusters as subtypes (STs): C. mesnili ST1 (human-NHP genotype), C. mesnili ST2-1 (human genotype), and C. mesnili ST2-2 (pig genotype). In addition, C. gallinarum-like haplotypes (chicken genotype) and C. bettencourti-like haplotypes, including ST1 (rat genotype) and ST2 (rat-buffalo genotype), were also identified.</p><p><strong>Conclusions: </strong>The genetic references registered in this study, along with the revealed molecular classification of Chilomastix spp., are crucial for understanding the genetic diversity and host-specific dynamics of these parasites in endemic regions.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"40"},"PeriodicalIF":3.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721627","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":"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}