Tropical Medicine and Infectious Disease最新文献

{"title":"RETRACTED: Jang, S.; Sohn, A. Awareness, Intention to Use Pre-Exposure Prophylaxis, and Factors Associated with Awareness among Men Who Have Sex with Men in the Republic of Korea. <i>Trop. Med. Infect. Dis.</i> 2024, <i>9</i>, 170.","authors":"Sarang Jang, Aeree Sohn","doi":"10.3390/tropicalmed10070178","DOIUrl":"10.3390/tropicalmed10070178","url":null,"abstract":"<p><p>The Journal retracts and removes the article, \"Awareness, Intention to Use Pre-Exposure Prophylaxis, and Factors Associated with Awareness among Men Who Have Sex with Men in the Republic of Korea\" [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 7","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of Untreated Bed Nets in the Retail Market in Tanzania: A Cross-Sectional Survey.","authors":"Benjamin Kamala, Dana Loll, Ruth Msolla, David Dadi, Peter Gitanya, Charles Mwalimu, Frank Chacky, Stella Kajange, Mwinyi Khamis, Sarah-Blythe Ballard, Naomi Serbantez, Stephen Poyer","doi":"10.3390/tropicalmed10060175","DOIUrl":"10.3390/tropicalmed10060175","url":null,"abstract":"<p><p>The private sector in Tanzania has played an essential role in improving coverage and access to mosquito nets. This follow-up study assessed the overall market share for untreated and insecticide-treated nets (ITNs) and misleading or counterfeit ITN products in commercial markets. This study was conducted from March to April 2024 in ten regions in Tanzania. The study used mixed methods: (1) a quantitative survey among sampled outlets supported by photographic documentation of all net products and (2) key informant interviews of retailers and wholesalers. We assessed the relationship between market share and population access using ANOVA and Pearson correlation. No counterfeit or misleading nets were found, consistent with results from 2017, 2021, and 2022 surveys. Untreated nets dominated all markets, comprising 99% of all products observed and 99% of estimated net sales 3 months before the survey. Legitimate ITNs were crowded out from the studied markets. Leaked nets from free distributions were present but extremely limited (1%) and at their lowest level of the survey rounds. Untreated nets were more expensive than leaked ITNs for both regular- and queen-size nets. Despite ongoing efforts, increasing the share of legitimate ITNs remains a significant challenge in a context of large-scale public sector distributions.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar Microsatellite Allelic Distribution Between <i>Anopheles darlingi</i> Population Collected by Human Landing Catch or Mosquito Magnet Traps in French Guiana.","authors":"Laetitia Ferraro, Sébastien Briolant, Mathieu Nacher, Samuel Vezenegho, Antoine Adde, Christophe Nguyen, Pascal Gaborit, Jean Issaly, Romuald Carinci, Vincent Pommier de Santi, Romain Girod, Isabelle Dusfour, Hervé Bogreau","doi":"10.3390/tropicalmed10060174","DOIUrl":"10.3390/tropicalmed10060174","url":null,"abstract":"<p><p><i>Anopheles darlingi</i> is a major malaria vector in South America. Understanding its population dynamics is critical for designing effective vector control strategies. While various <i>Anopheles</i> collection methods exist, they may sample distinct populations. Microsatellite genotyping across nine loci was performed to characterize <i>An. darlingi</i> populations, which were collected in French Guiana between 6:30 p.m. and 7:00 a.m. using human landing catch (HLC) or Mosquito Magnet^® (MM) traps. Traps were arranged in a 3 × 3 Latin square design to minimize possible effects of geographical position. Pairwise <i>F</i>_ST index and discriminant analyses of principal components (DAPC) were used to make comparisons. A total of 431 <i>An. darlingi</i> were analyzed. No significant genetic differentiation was observed between collection methods or time slots (<i>F</i>_ST values non-significant, <i>p</i> > 0.25), with DAPC revealing a single genetic cluster. Despite documented phenotypic variations, no significant population structure was detected among <i>An. darlingi</i> sampled in a rural village in French Guiana via collection methods or time slots. These findings confirm that mosquitoes collected with these various methods or time slots are suitable for the molecular studies of <i>An. darlingi</i> in French Guiana. In this context, Mosquito Magnet^® traps could also represent an alternative to the now controversial human landing catch.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Pyrethroid-Piperonyl Butoxide Nets Versus Standard Pyrethroid-Only Nets in Preventing Malaria in Children Under 10 Years Living in Kisantu Health Zone, Democratic Republic of the Congo.","authors":"Gillon Ilombe, Joris Losimba Likwela, Philippe Lukanu, Aimée Lulebo, Nicole Muela, Joachim Mariën, Kennedy Makola Mbanzulu, Baby Mabanzila, Junior Rika Matangila, Fiacre Agossa, Eric Mukomena, Sylvie Linsuke, Albert Kalonji, Pascal Lutumba, Jean-Pierre Van Geertruyden, Seth R Irish","doi":"10.3390/tropicalmed10060172","DOIUrl":"10.3390/tropicalmed10060172","url":null,"abstract":"<p><p>Democratic Republic of the Congo (DRC) is among the countries that have a high malaria incidence. In an effort to combat this public health challenge, innovative tools and strategies are being developed and evaluated. Among the new generation of nets with improved effectiveness of insecticides, those treated with a combination of piperonyl butoxide (PBO) and pyrethroids appear to be a promising malaria control tool. This study evaluated the effectiveness of this combination under community conditions of use in the DRC. A quasi-experimental study was carried out from January to December 2018, in Kisantu Health Zone. Thirty villages were randomly allocated as clusters (1:1) to receive one of two types of long-lasting insecticidal nets (LLIN) treated with deltamethrin alone, or PBO with deltamethrin. After the intervention, the assessments were conducted monthly, quarterly, and every six months for malaria infection, mosquito density, and LLIN durability, respectively. Comparison of changes in different indices between the two groups was made using generalized linear models to correct for non-linear effects. A total of 1790 children were included. There was a significant non-linear effect of time (months) on the malaria infection incidence. The malaria infection incidence was higher in January-March, May-June, and November. It remained higher in the control group compared to the intervention group over time. Similarly, there was a significant non-linear effect of time on the density of both <i>Anopheles funestus</i> s.l. and <i>Anopheles gambiae</i> s.l. These densities decreased after the first month following the intervention and increased after 6 months. Twelve months later, a cohort follow-up showed that the bio-efficacy of LLINs was better in the intervention group. The nets treated with the combination of PBO and deltamethrin appear to be more effective for malaria control under community conditions in the DRC, but a loss of chemical durability is noted after the first year of use.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends and Age-Period-Cohort Effects on Dengue Incidence Across High-Risk Regions from 1992 to 2021.","authors":"Yu Cao, Hanwu Chen, Hao Wu, Bin Wu, Lu Wang, Xin Liu, Yuyue Yang, Hui Tan, Wei Gao","doi":"10.3390/tropicalmed10060173","DOIUrl":"10.3390/tropicalmed10060173","url":null,"abstract":"<p><p>Dengue, an acute infectious disease caused by the dengue virus, remains a major public health problem in the 21st century. This study investigated the global dengue burden, identified high-risk regions, evaluated the long-term incidence trends, and can inform evidence-based control strategies. Using GBD 2021 data, we analysed the dengue incidence from 1992 to 2021 using age-period-cohort models. We determined the net drift (overall annual percentage change), local drift (annual percentage change for each age group), longitudinal age curves (expected longitudinal age-specific rates), and periods' (cohorts') relative risks. In 2021, the global age-standardised incidence rate reached 752.04/100,000 (95% UI: 196.33-1363.35), a 47.26% increase since 1992. High-risk regions included eastern sub-Saharan Africa, Southeast Asia, South Asia, and Latin America and the Caribbean. Southeast Asia experienced the largest rise (65.43%), with a net drift of 2.47% (1992-2021). While individuals aged 5-39 years bore the highest burden, those over 80 faced an elevated risk. Dengue remains a critical public health threat, disproportionately affecting younger populations but increasingly endangering older adults. Targeted interventions in high-risk regions and age groups, coupled with precision public health strategies, are essential to enhance prevention and control efforts.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Analysis of the COVID-19 Clusters in the Early Stages of the Epidemic in Shanghai, China: Pandemic-to-Epidemic Response Shift.","authors":"Dechuan Kong, Qiwen Fang, Jian Chen, Linjie Hu, Yihan Lu, Yaxu Zheng, Yiyi Zhu, Bihong Jin, Wenjia Xiao, Shenghua Mao, Chenyan Jiang, Xiaohuan Gong, Sheng Lin, Ruobing Han, Xiao Yu, Qi Qiu, Xiaodong Sun, Hao Pan, Huanyu Wu","doi":"10.3390/tropicalmed10060170","DOIUrl":"10.3390/tropicalmed10060170","url":null,"abstract":"<p><p>As COVID-19 transitions from pandemic to endemic, our prevention and control policies have shifted from broad, strict community interventions to focusing on the prevention of cluster outbreaks. Currently, information on the characteristics of cluster outbreaks remains limited. This study describes the features of COVID-19 clusters in Shanghai. It aims to provide valuable insights for managing localized outbreaks. We conducted a retrospective analysis of clusters of confirmed COVID-19 cases. Epidemiological descriptions, the transmission characteristics of clusters, and individual risk factors for contagiousness were analyzed. A total of 381 cases of COVID-19 were confirmed and 67 clusters were identified. Most clusters (58.21%, 39/67) only had two cases, with a declining proportion held by clusters of more cases. Familial transmission was predominant, accounting for 79.10% (53/67) of clusters. Although other types of cluster outbreaks, such as those in workplaces (1.49%, 1/67), occur less frequently compared to household clusters, they tend to involve larger scales and more cases. Workplaces and similar venues are more likely to experience large-scale cluster outbreaks. Contagiousness was higher among cases with runny nose (risk ratio [RR]: 4.8, 95% CI: 1.40-16.44, <i>p</i>-value = 0.01) and those with diabetes (RR: 3.8, 95% CI: 1.01-14.60, <i>p</i>-value = 0.05). In conclusion, household cluster outbreaks, in particular, are both a key priority and a foundational issue. Establishing an indicator system based on the transmissibility of cases holds significant practical value for infectious disease prevention and control. By enhancing household hygiene and developing a case classification and management system based on transmissibility, it is possible to better prevent and control regional COVID-19 outbreaks.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deltamethrin Selection Drives Transcriptomic Changes in Detoxification, Immune, and Cuticle Genes in <i>Aedes aegypti</i>.","authors":"Yamili Contreras-Perera, Lucy Mackenzie-Impoinvil, Dieunel Derilus, Audrey Lenhart, Iram P Rodriguez-Sanchez, Pablo Manrique-Saide, Adriana E Flores","doi":"10.3390/tropicalmed10060171","DOIUrl":"10.3390/tropicalmed10060171","url":null,"abstract":"<p><p>The rapid global expansion of <i>Aedes aegypti</i>-borne diseases such as dengue, chikungunya, and Zika has positioned this mosquito as a key target for vector control programs. These programs rely heavily on insecticide use, leading to the widespread emergence of insecticide resistance. Understanding the molecular basis of resistance is essential for developing effective management strategies. In this study, we employed a whole-transcriptome (RNA-seq) approach to analyze gene expression in three <i>Ae. aegypti</i> populations from Mexico that underwent four generations of laboratory selection with deltamethrin. Several cytochrome P450 genes (CYP6AG4, CYP6M5, CYP307A1) and a chitin-binding peritrophin-like gene (Ae-Aper50) were significantly overexpressed following selection, supporting roles for both detoxification and midgut protection. We also observed a consistent downregulation of cuticular protein genes in deltamethrin-selected groups relative to the baseline populations, suggesting their involvement in baseline tolerance rather than induced resistance. Additionally, the overexpression of immune- and stress-related genes, including the RNA helicase MOV-10, indicates that insecticide selection may trigger broader physiological responses. These findings highlight complex, multi-pathway transcriptomic changes associated with resistance development in <i>Ae. aegypti</i>.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological Vulnerability and Active Infection Detection Among Recently Arrived Migrants in Spain: Results from a Targeted Screening Program.","authors":"Guillermo Lens-Perol, Olalla Vázquez-Cancela, Magdalena Santana-Armas, Angeles Bouzas-Rodriguez, Victoria Tuñez-Bastida, Adrián Domínguez-Lago, Hugo Pérez-Freixo, Cristina Peiteado-Romay, Juan Manuel Vázquez-Lago, Cristina Fernández-Pérez","doi":"10.3390/tropicalmed10060169","DOIUrl":"10.3390/tropicalmed10060169","url":null,"abstract":"<p><strong>Background: </strong>Newly arrived migrants are at increased risk for vaccine-preventable and communicable diseases due to low immunization coverage, poor access to healthcare, and challenging migration trajectories. This study describes the implementation and outcomes of a one-stop public health intervention focused on serological screening and accelerated vaccination in recently arrived migrants in Galicia, Spain.</p><p><strong>Methods: </strong>We conducted a cross-sectional descriptive study in July and August 2024 involving 335 adult migrants from sub-Saharan Africa with irregular administrative status and asylum applications. A centralized mobile health unit provided point-of-care screening for immunity against measles, mumps, rubella, varicella, and hepatitis A, alongside testing for active infections, including hepatitis B and syphilis. Sociodemographic and clinical data were collected, and individuals were offered vaccination according to an accelerated immunization schedule.</p><p><strong>Results: </strong>Of 336 migrant adults invited to participate in the study, only 1 individual declined to participate (participation rate: 99.7%). Therefore, 335 migrants were assessed. A significant proportion of participants were susceptible to at least one vaccine-preventable disease, particularly hepatitis B (36.4%, 95% CI 31.3-41.6), measles (22.7%, 95% CI 18.2-27.2), and varicella (16.4%, 95% CI 12.5-20.4). Active infections were detected in 12.9% (95% CI 9.3-16.4) of individuals, including hepatitis B (9.9%, 95% CI 6.7-13.0) and syphilis (3.0%, 95% CI 1.2-4.8). The intervention allowed for timely vaccination and linkage to care, minimizing dependence on passive healthcare access.</p><p><strong>Conclusions: </strong>This study highlights substantial immunization gaps and the presence of undiagnosed infections in vulnerable migrant populations. Centralized and culturally adapted screening programs, combined with accelerated vaccination strategies, are feasible and effective. These findings support the integration of structured protocols into national health systems to ensure equity, reduce transmission risk, and align with WHO and ECDC public health frameworks.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Incidence and Lethality by Etiology of Severe Acute Respiratory Syndrome in Hospitalized Children Under 1 Year of Age in Brazil in 2024: A Cross-Sectional Study.","authors":"Tamires de Nazaré Soares, Natasha Cristina Oliveira Andrade, Suziane do Socorro Dos Santos, Marcela Raíssa Asevedo Dergan, Karina Faine Freitas Takeda, Jully Greyce Freitas de Paula Ramalho, Luany Rafaele da Conceição Cruz, Perla Katheleen Valente Corrêa, Marli de Oliveira Almeida, Joyce Dos Santos Freitas, Wilker Alves Silva, Marcos Jessé Abrahão Silva, Daniele Melo Sardinha, Luana Nepomuceno Gondim Costa Lima","doi":"10.3390/tropicalmed10060168","DOIUrl":"10.3390/tropicalmed10060168","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Severe Acute Respiratory Syndrome (SARS) represents a significant cause of morbidity and mortality in children under one year of age, a particularly vulnerable population due to immunological and respiratory immaturity. The diverse etiology includes multiple respiratory viruses such as Respiratory Syncytial Virus (RSV), influenza, rhinovirus, and SARS-CoV-2, each with distinct potential to cause severe illness and death. Understanding the specific incidence and lethality by etiological agents in the recent Brazilian context (2024), after the COVID-19 pandemic, is essential to guide surveillance and public health strategies. This study aimed to analyze the risk of incidence and lethality by specific etiology of SARS in children under one year of age hospitalized in Brazil during the year 2024. A descriptive cross-sectional study was performed using secondary data from the 2024 Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), obtained via OpenDataSUS. Reported cases of SARS hospitalized in children &lt;1 year of age in Brazil were included. Distribution by final classification and epidemiological week (EW) was analyzed; the incidence rate by Federative Unit (FU) (cases/100,000 &lt; 1 year) with risk classification (Low/Moderate/High) was assessed; and, for cases with positive viral RT-PCR, the etiological frequency and virus-specific lethality rate (deaths/total cases of etiology ×100), also with risk classification, were extracted. A multivariate logistic regression model was performed for the risk factors of death. A total of 66,170 cases of SARS were reported in children under 1 year old (national incidence: 2663/100,000), with a seasonal peak between April and May. The majority of cases were classified as \"SARS due to another respiratory virus\" (49.06%) or \"unspecified\" (37.46%). Among 36,009 cases with positive RT-PCR, RSV (50.06%) and rhinovirus (26.97%) were the most frequent. The overall lethality in RT-PCR-positive cases was 1.28%. Viruses such as parainfluenza 4 (8.57%), influenza B (2.86%), parainfluenza 3 (2.49%), and SARS-CoV-2 (2.47%) had higher lethality. The multivariate model identified parainfluenza 4 (OR = 6.806), chronic kidney disease (OR = 3.820), immunodeficiency (OR = 3.680), Down Syndrome (OR = 3.590), heart disease (OR = 3.129), neurological disease (OR = 2.250), low O&lt;sub&gt;2&lt;/sub&gt; saturation (OR = 1.758), SARS-CoV-2 (OR = 1.569) and respiratory distress (OR = 1.390) as risk factors for death. Cough (OR = 0.477) and RSV (OR = 0.736) were associated with a lower chance of death. The model had good calibration (Hosmer-Lemeshow &lt;i&gt;p&lt;/i&gt; = 0.693) and overall significance (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). SARS represented a substantial burden of hospitalizations, with marked seasonal and geographic patterns. RSV and rhinovirus were the main agents responsible for the volume of confirmed cases but had a relatively low to moderate risk of lethality. In contrast, less frequent viruses such as parainfluenza 4, influenza B,","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of Machine Learning Algorithms to Predict HIV Testing Using Evidence from the 2002-2017 South African Adult Population-Based Surveys: An HIV Testing Predictive Model.","authors":"Musa Jaiteh, Edith Phalane, Yegnanew A Shiferaw, Haruna Jallow, Refilwe Nancy Phaswana-Mafuya","doi":"10.3390/tropicalmed10060167","DOIUrl":"10.3390/tropicalmed10060167","url":null,"abstract":"<p><p>There is a significant portion of the South African population with unknown HIV status, which slows down epidemic control despite the progress made in HIV testing. Machine learning (ML) has been effective in identifying individuals at higher risk of HIV infection, for whom testing is strongly recommended. However, there are insufficient predictive models to inform targeted HIV testing interventions in South Africa. By harnessing the power of supervised ML (SML) algorithms, this study aimed to identify the most consistent predictors of HIV testing in repeated adult population-based surveys in South Africa. The study employed four SML algorithms, namely, decision trees, random forest, support vector machines (SVM), and logistic regression, across the five cross-sectional cycles of the South African National HIV Prevalence, Incidence, and Behavior and Communication Survey (SABSSM) datasets. The Human Science Research Council (HSRC) conducted the SABSSM surveys and made the datasets available for this study. Each dataset was split into 80% training and 20% testing sets with a 5-fold cross-validation technique. The random forest outperformed the other models across all five datasets with the highest accuracy (80.98%), precision (81.51%), F₁-score (80.30%), area under the curve (AUC) (88.31%), and cross-validation average (79.10%) in the 2002 data. Random forest achieved the highest classification performance across all the dates, especially in the 2017 survey. SVM had a high recall (89.12% in 2005, 86.28% in 2008) but lower precision, leading to a suboptimal F₁-score in the initial analysis. We applied a soft margin to the SVM to improve its classification robustness and generalization, but the accuracy and precision were still low in most surveys, increasing the chances of misclassifying individuals who tested for HIV. Logistic regression performed well in terms of accuracy = 72.75, precision = 73.64, and AUC = 81.41 in 2002, and the F₁-score = 73.83 in 2017, but its performance was somewhat lower than that of the random forest. Decision trees demonstrated moderate accuracy (73.80% in 2002) but were prone to overfitting. The topmost consistent predictors of HIV testing are knowledge of HIV testing sites, being a female, being a younger adult, having high socioeconomic status, and being well-informed about HIV through digital platforms. Random forest's ability to analyze complex datasets makes it a valuable tool for informing data-driven policy initiatives, such as raising awareness, engaging the media, improving employment outcomes, enhancing accessibility, and targeting high-risk individuals. By addressing the identified gaps in the existing healthcare framework, South Africa can enhance the efficacy of HIV testing and progress towards achieving the UNAIDS 2030 goal of eradicating AIDS.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}