Tropical Medicine and Infectious Disease最新文献

{"title":"Host-Seeking and Sugar-Feeding Behaviors of <i>Aedes aegypti</i> in Nouakchott, Mauritania: Implications for Dengue Transmission.","authors":"Mohamed Haidy Massa, Mohamed Aly Ould Lemrabott, Osman Abdillahi Guedi, Nicolas Gomez, Sébastien Briolant, Ali Ould Mohamed Salem Boukhary","doi":"10.3390/tropicalmed11040109","DOIUrl":"https://doi.org/10.3390/tropicalmed11040109","url":null,"abstract":"<p><p><i>Aedes aegypti</i>, the main urban vector of dengue fever, poses a major public health problem in Nouakchott, Mauritania. This study analyzed the host-seeking and sugar-feeding behaviors of <i>Ae. aegypti</i>. Mosquitoes were collected using a vacuum cleaner in four districts between December 2023 and October 2024. Biting activity on humans was studied in May 2024, exclusively in the districts of Ksar, Tevragh Zeina and Arafat, between 5:00 a.m. and 9:00 p.m. A negative binomial model was performed to analyze the effect of location and time on the human biting rate (HBR) of mosquitoes. In Nouakchott, except in the Arafat district, <i>Ae. aegypti</i> bites occur mainly outdoors, between 8:00 a.m. and 1:00 p.m., with a peak between 11:00 a.m. and noon (HBR = 20 bites/person), and between 5:00 p.m. and 7:00 p.m., with a peak between 6:00 p.m. and 7:00 p.m. (HBR = 11 bites/person). Inside homes, <i>Ae. aegypti</i> biting activity remains low everywhere (HBR ≤ 1.5 bites/person/hour). Molecular analysis of the origin of the blood meals showed that the females collected in Nouakchott were exclusively anthropophilic. Molecular analysis of the sugar sources revealed a great diversity with sweet potato being among the most common. These results highlight the need for targeted outdoor interventions and larval control measures to reduce the risk of dengue transmission in Nouakchott.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782251","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":"Clinical Characteristics and Outcomes of Malaria Patients in the Aseer Region, Saudi Arabia: A Retrospective Study (2022-2025).","authors":"Fouad Ibrahim Alshehri, Dhaifullah Ahmed Alkhosafi, Essam Abdullah Al Asmari, Abdulrahman Bin Saeed, Anas Mohammed Zarbah, Saeed Ali Algarni, Mohammed Gasim Ahmed, Marim Abdallah Mohamed, Fatma Anter Mady, Saleh Mohammed Zafer Albakri, Ramy Mohamed Ghazy","doi":"10.3390/tropicalmed11040108","DOIUrl":"https://doi.org/10.3390/tropicalmed11040108","url":null,"abstract":"<p><strong>Background: </strong>Saudi Arabia has made significant progress toward malaria elimination; however, imported cases continue to occur, particularly in the southwestern regions. This study aimed to describe the clinical characteristics and outcomes of patients with malaria in the Aseer Region, Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at Khamis Mushait General Hospital, Aseer Region, Saudi Arabia, including all patients with malaria from January 2022 to December 2025. Demographic, clinical, laboratory, and outcome data were extracted from the electronic medical records. Severe malaria was defined according to the World Health Organization criteria. Multivariate logistic regression using Firth's penalized maximum likelihood estimation was performed to identify independent predictors of severe malaria (≥1 WHO criterion). Statistical analysis was performed using R software (version 4.2.1).</p><p><strong>Results: </strong>A total of 311 patients were included, predominantly male (90.0%), with a mean age of 28.8 ± 11.3 years. Ethiopian nationals comprised nearly half the cases (48.2%), followed by Saudi (16.4%) and Yemeni (15.1%) nationals. <i>Plasmodium vivax</i> was the most common species (51.1%), followed by <i>Plasmodium. falciparum</i> (40.2%). Fever was the most frequent symptom (89.4%), followed by fatigue (50.8%), chills (46.9%), and vomiting (39.5%). Low parasitemia (<1%) was the most frequent finding (33.8%), followed by moderate (27.3%) and mild (18.3%) levels, while high (4.2%) and very high parasitemia (1.9%) were uncommon. Severe malaria (≥1 criterion) was diagnosed at 43.7%, with severe anemia (26.0%) and jaundice (23.2%) being the most frequent WHO severity criteria. Notably, 84% of the cases occurred during 2024-2025, indicating a recent outbreak, with a sharp peak of 43 cases in October 2024. Multivariate logistic regression identified two independent predictors of having at least one WHO severity criterion: higher parasitemia level (adjusted OR = 1.70 per 1% increase, 95% CI: 1.40-2.11, <i>p</i> < 0.001) and non-Saudi nationality (adjusted OR = 2.40, 95% CI: 1.10-5.62, <i>p</i> = 0.027).</p><p><strong>Conclusions: </strong>Malaria in the Aseer Region predominantly affects young adult male expatriates, suggesting its imported nature. The predominance of <i>P. vivax</i> represents a shift from historical patterns. Parasitemia level and being of non-Saudi nationality independently predict severe malaria and may therefore support risk stratification and clinical decision-making. The dramatic case surge in 2024-2025 highlights regional vulnerability to outbreaks despite control progress. These findings support enhanced screening for at-risk populations, maintenance of clinical capacity for severe malaria management, and robust surveillance systems for early outbreak detection.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782368","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":"Urban Animal Exposures and Rabies Post-Exposure Prophylaxis in Istanbul, Turkey: Insights from a Metropolitan Emergency Department.","authors":"Cansel Askin, Behcet Al, Cihad Unsal Karahaliloglu, Yunus Emre Gemici, Ibrahim Coban, Abdulkerim Emre Yanar","doi":"10.3390/tropicalmed11040107","DOIUrl":"https://doi.org/10.3390/tropicalmed11040107","url":null,"abstract":"<p><strong>Background: </strong>Rabies remains a major zoonotic disease worldwide, particularly in regions with large populations of free-roaming animals. In urban settings, animal-related injuries constitute a substantial healthcare burden and frequently result in the administration of rabies post-exposure prophylaxis (PEP). This study aimed to evaluate the epidemiological characteristics of animal exposures and real-world PEP practices in a metropolitan emergency department.</p><p><strong>Methods: </strong>This retrospective descriptive study included 1960 patients presenting to a tertiary metropolitan emergency department between 1 March and 1 September 2025 with suspected animal exposure. Demographic data, animal species involved, exposure mechanisms, animal ownership and vaccination status, time to presentation, and PEP practices were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Most exposures were cat-related (86.3%) and were caused by scratching (81.5%). Nearly all injuries were superficial (99.8%), while deep injuries were rare (0.2%). The majority of animals were classified as strays (90.1%), and vaccination status was unknown in 81.2% of cases. Rabies immunoglobulin was administered to only 0.6% of patients; however, rabies vaccination was initiated in 98.8% of patients. Approximately 74.5% of patients presented within 24 h. Post-exposure animal observation was documented in only 20.2% of cases.</p><p><strong>Conclusions: </strong>Urban animal exposures in this metropolitan setting were predominantly superficial and cat-related, yet nearly all patients received rabies vaccination. Limited animal observation and incomplete vaccination documentation appear to constrain risk stratification and may contribute to the use of precautionary PEP. Strengthening surveillance systems, improving documentation, and implementing evidence-based risk-stratification strategies are essential for optimizing rabies prophylaxis practices in urban environments.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782325","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":"Public Health Perspectives on Integrating <i>Artemisia annua</i> Tea for Uncomplicated Malaria Treatment: A Cross-Sectional Study of Perceptions and Acceptability Among Healthcare Workers in Kalima District, Maniema, DRC.","authors":"Jérôme Munyangi Wa Nkola, Pierre Akilimali Zalagile, Hendrick Lukuke Mbutshu, Spartacus Kabala Munyemo, Imani Ramazani Bin Eradi, Alioune Camara","doi":"10.3390/tropicalmed11040105","DOIUrl":"https://doi.org/10.3390/tropicalmed11040105","url":null,"abstract":"<p><p><b>Background:</b> The Democratic Republic of the Congo accounts for approximately 12-13% of the global malaria burden. While international guidelines oppose the use of <i>Artemisia annua</i> infusions due to risks of sub-therapeutic dosing and resistance selection, the plant remains widely used in resource-limited regions. This study evaluates the clinical acceptability and perceptions of healthcare providers regarding the integration of <i>Artemisia annua</i> tea into formal malaria control in the Maniema province. <b>Methods:</b> A cross-sectional survey was conducted among <b>337 healthcare professionals</b> in the Kalima health district using the KoboCollect digital platform. Multivariate logistic regression was employed to identify the primary socio-professional determinants of clinical acceptability. <b>Results:</b> The overall clinical acceptability of <i>Artemisia annua</i> integration <b>was 81.0%,</b> with <b>82.8%</b> of providers perceiving the preparation as effective. Rural residency was the strongest predictor of adherence <b>(AOR = 6.847; <i>p</i> = 0.003),</b> reflecting a pragmatic response to frequent ACT stockouts and high treatment costs. Despite high acceptability, <b>49.0%</b> of providers identified the lack of clinical evidence as a major barrier, and 91.4% demanded formal training on standardized dosage and biological mechanisms. <b>Conclusions:</b> A significant \"policy-practice gap\" exists between international guidelines and field realities in the DRC. Healthcare providers demonstrate high readiness for integration but emphasize the absolute necessity of galenic standardization to mitigate resistance risks. To address these concerns, a complementary genomic investigation is currently underway in the same study area, comparing <i>PfKelch13</i> mutation prevalence among <i>Artemisia</i> tea users versus ACT-treated patients. This molecular surveillance will provide essential evidence to define safety parameters for future phytopharmaceutical integration.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782233","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":"Neglected Tropical Diseases Elimination in the Philippines: Challenges and Gaps.","authors":"Josephine Abrazaldo, Patrick de Vera, Sheila Grace Martin, John Leo Dayrit, Daryl Christian Mejos, Ferdinand Mortel","doi":"10.3390/tropicalmed11040106","DOIUrl":"https://doi.org/10.3390/tropicalmed11040106","url":null,"abstract":"<p><p>Neglected tropical diseases (NTDs) such as soil-transmitted helminthiasis, lymphatic filariasis, schistosomiasis, leprosy, rabies, and food-borne trematodiasis are endemic in the Philippines. Despite global and national elimination efforts, these six NTDs remain a persistent burden to the poor, those living in Geographically Isolated and Disadvantaged Areas (GIDAs), and other vulnerable groups. This narrative review synthesized data from Field Health Services Information System (FHSIS) reports of the Philippine Department of Health (DOH) from 2020 to 2024, the available literature from electronic databases, and DOH and WHO reports focusing on the challenges, barriers, and gaps in NTD control and elimination in the country. Core challenges include complex epidemiological landscapes, lapses in disease surveillance, infrastructure, and fragmented health care systems. Gaps include access to diagnostics, insufficient funding and human resource training, and scarcity of local studies focusing on endemic NTDs. With these challenges and gaps, this review highlights the need for a real-time feedback loop system in surveillance strategy, community-based interventions, full integration of NTDs in primary health care, and collaboration between government, NGOs and private entities. Addressing these challenges and gaps is key to shifting from control to elimination.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782196","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":"Early Warning Signs, Effects, Risk Factors, and Diagnostic Indicators of Toxoplasmosis in Pregnant Women in Africa: A Scoping Review.","authors":"Cherotich Jesca Tangus, Ndichu Maingi, James Chege Nganga, Davis Karanja Njuguna, Kariuki Njaanake, Bruno Enagnon Lokonon, Gloria Ivy Mensah, Kennedy Kwasi Addo, Andrée Prisca Ndjoug Ndour, Bassirou Bonfoh","doi":"10.3390/tropicalmed11040104","DOIUrl":"https://doi.org/10.3390/tropicalmed11040104","url":null,"abstract":"<p><p>Toxoplasmosis is a widely distributed zoonosis caused by the protozoan parasite <i>Toxoplasma gondii.</i> Infection during pregnancy is a major public health concern due to its potential impact on both maternal health and fetal development. Early detection of maternal infection is critical to prevent adverse outcomes; however, maternal signs are often subtle, non-specific or absent, complicating timely diagnosis. This scoping review aimed to map and synthesise existing evidence on early maternal signs, pregnancy and foetal outcomes, frequently assessed risk factors, and diagnostic approaches of toxoplasmosis in expectant mothers in Africa. The review was done in accordance with the PRISMA-ScR guidelines. A literature search of PubMed, Scopus, ResearchGate, and Google Scholar was performed to identify studies published between 2000 and 2025. Retrieved records were managed using Zotero (version 8.0.4) for deduplication and screening. Only English-language studies conducted in Africa and reporting relevant maternal or clinical data were included. A total of 28 cross-sectional studies were included. Lymphadenopathy (25.0%) was the most frequently reported maternal early sign, followed by flu-like illness, asymptomatic infection, low-grade or mild fever, and fatigue or malaise (each 10.7%). Congenital anomalies (50.0%) and miscarriage or spontaneous abortion (42.9%) were the most commonly reported foetal and pregnancy outcomes. Frequently reported risk factors were exposure to cat faeces (57.1%) and ingestion of undercooked or raw meat (42.9%). Diagnostic approaches were commonly enzyme-based immunoassays (78.6%), with limited use of RDTs and molecular methods. These findings suggest the need for improved early detection and prevention strategies in high-risk, low-resource African settings. Enhancing routine screening, health education, and access to appropriate diagnostics are considered. Future studies should consider adopting standardised reporting and integrating sensitive, affordable, rapid diagnostic approaches to enhance early detection and reduce the burden of congenital toxoplasmosis.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782403","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":"Systematic Evaluation of Four Cysteine Proteases (<i>Cs</i>CP1-4) from <i>Clonorchis sinensis</i> for Serodiagnosis: From Single-Antigen Screening to Multi-Antigen Modeling.","authors":"Shuai Wei, Xinyan Chen, Shangkun Cai, Xiaoqin Li, Ting Lu, Yaoting Li, Yuanlin Hou, Yanwen Li, Yunliang Shi","doi":"10.3390/tropicalmed11040103","DOIUrl":"https://doi.org/10.3390/tropicalmed11040103","url":null,"abstract":"<p><strong>Background: </strong>Cysteine proteases of <i>Clonorchis sinensis</i> are potential diagnostic antigens, yet the performance of individual members within this diverse enzyme family requires systematic evaluation. This study aimed to assess the diagnostic potential of four recombinant cysteine proteases (r<i>Cs</i>CP1-4) for human clonorchiasis.</p><p><strong>Methods: </strong>An indirect ELISA was developed to measure serum reactivity (IgG, IgG subclasses, IgA) against r<i>Cs</i>CP1-4. The assay was validated using 180 microscopy-confirmed positive and 148 negative control sera. Samples were randomly split into training and validation sets (7.5:2.5). Diagnostic performance of single antigens and their combinations was evaluated using univariate and multivariate logistic regression and compared with a commercial kit. Key metrics included the area under the curve (AUC), sensitivity, specificity, accuracy, F1-score, and Kappa coefficient.</p><p><strong>Results: </strong>Four single antigen-antibody pairs showed high performance: r<i>Cs</i>CP1-IgG4 (AUC = 0.928), r<i>Cs</i>CP2-IgA (AUC = 0.863), r<i>Cs</i>CP3-IgG1 (AUC = 0.920), and r<i>Cs</i>CP4-IgG4 (AUC = 0.958). Among these, r<i>Cs</i>CP1-IgG4, r<i>Cs</i>CP3-IgG1, and r<i>Cs</i>CP4-IgG4 outperformed the commercial kit, achieving higher sensitivity (92.0%, 96.0%, 96.0% vs. 86.0%), specificity (87.5%, 81.3%, 90.6% vs. 78.1%), accuracy (92.0%, 88.9%, 94.1% vs. 86.0%), and F1-scores (0.902, 0.902, 0.939 vs. 0.829). The Kappa values for r<i>Cs</i>CP1-IgG4 (0.768) and r<i>Cs</i>CP4-IgG4 (0.773) indicated substantial agreement with the microscopic standard. Multi-antigen combinations (triple or quadruple) further enhanced performance, achieving sensitivity and specificity > 98% with an AUC approaching 1.0.</p><p><strong>Conclusions: </strong>This study identifies r<i>Cs</i>CP1 and r<i>Cs</i>CP4, particularly in combination with IgG4 detection, as highly promising diagnostic targets for clonorchiasis. Multi-antigen combinations significantly improved diagnostic performance compared to single-antigen assays, offering a strategy for high-precision diagnosis. Furthermore, the efficacy of the r<i>Cs</i>CP2-IgA pair suggests that detecting fecal secretory IgA could be a novel avenue for non-invasive, self-testing applications.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782338","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":"Emerging Trends of Infectious Diseases in Canada.","authors":"Yazdan Mirzanejad","doi":"10.3390/tropicalmed11040102","DOIUrl":"https://doi.org/10.3390/tropicalmed11040102","url":null,"abstract":"<p><p>As we conclude this set of ten publications in <i>Tropical Medicine and Infectious Disease</i>, three clear themes emerge to the surface [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780931","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":"Characterization of Antimicrobial Resistance and Potential Zoonotic Risk in Uropathogenic <i>Escherichia coli</i> Isolated from Companion Animals, with Genomic Analysis of Virulence Determinants in a Representative Isolate.","authors":"Asanka R DeZoysa, Madeline Kwan, Lekshmi K Edison, Rebecca Barber, Lisa Glick, Thomas Denagamage, Subhashinie Kariyawasam","doi":"10.3390/tropicalmed11040101","DOIUrl":"https://doi.org/10.3390/tropicalmed11040101","url":null,"abstract":"<p><p>Uropathogenic <i>Escherichia coli</i> (UPEC) is a leading cause of urinary tract infections (UTIs) in companion animals. This study characterized 42 UPEC isolates recovered from dogs and cats at the University of Florida, College of Veterinary Medicine Diagnostic Laboratories between 2023 and 2024, focusing on antimicrobial resistance (AMR), virulence gene profiles, biofilm-forming ability, and phylogroup distribution of the isolates. Antimicrobial susceptibility testing (AST) showed that 40.48% of the isolates were resistant to at least one of the tested antibiotics, and 9.52% exhibited multidrug resistance (MDR). Phylogroup B2 was predominant (69.05%), and 61.90% of isolates demonstrated strong biofilm formation in artificial human urine. Virulence gene analysis revealed the presence of genes mediating adhesion (<i>fim</i>, <i>pap</i>, <i>sfa</i>), iron acquisition (<i>fyuA</i>, <i>iro</i>), biofilm formation (<i>csg</i>, <i>bcs</i>, <i>pga</i>, <i>ycg/ymg</i>), motility (<i>fli</i>, <i>mot</i>, <i>flh</i>), and stress response (<i>oxyR</i>, <i>soxR/S</i>, <i>kat</i>). Multiple plasmids carrying AMR and virulence determinants were also identified. The co-occurrence of the traits underscores the potential for persistent and recurrent infections, which can complicate therapeutic outcomes and facilitate horizontal gene transfer (HGT). The detection of antimicrobial-resistant, highly virulent UPEC strains possessing human UPEC traits in companion animals suggests the risk of zoonotic and reverse-zoonotic transmission, particularly in households with close pet-owner interactions. These findings emphasize the importance of judicious antimicrobial use, routine molecular surveillance, and integrated One Health strategies to mitigate the veterinary and public health threats associated with UPEC infections in companion animals.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782388","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 Characteristics and Treatment Outcomes of Drug-Resistant Tuberculosis in Limpopo Province, South Africa (2020-2024).","authors":"Ivy Rukasha, Kabelo Gabriel Kaapu","doi":"10.3390/tropicalmed11040100","DOIUrl":"https://doi.org/10.3390/tropicalmed11040100","url":null,"abstract":"<p><p><b>Background</b>: Drug-resistant tuberculosis (DR-TB) continues to pose a major challenge in Limpopo Province, a predominantly rural region of South Africa with high prevalence of HIV and mobility of the cross-border population. Despite the scale-up of short all-oral bedaquiline-based regimens, there is limited recent provincial evidence describing DR-TB epidemiological characteristics and treatment outcomes in the post-COVID-19 period. This study aimed to assess resistance patterns, treatment outcomes, and factors associated with unfavorable outcomes among patients with DR-TB in Limpopo Province from 2020 to 2024. <b>Methods</b>: A retrospective cohort study was conducted using routinely collected data from the Electronic Drug Resistant Tuberculosis Register (EDRWeb). All laboratory-confirmed DR-TB cases diagnosed between January 2020 and December 2024 were included. Descriptive statistics were used to summarize demographic and clinical characteristics. Multivariable logistic regression was performed to identify predictors of unfavorable outcomes (treatment failure, death, and loss to follow-up). Kaplan-Meier survival analysis was used to estimate survival probability following treatment initiation. <b>Results</b>: A total of 1240 DR-TB cases were recorded, of which 1165 (94%) had documented treatment outcomes. Rifampicin-resistant TB (RR-TB) predominated throughout the study period, accounting for 76% (951/1240) of cases and remaining stable over time. Treatment success improved from 173/260 (67%) in 2020 to 130/166 (78%) in 2024, while loss to follow-up declined from 34/260 (13%) to 4/166 (2%). Kaplan-Meier survival analysis showed that mortality occurred predominantly during the early phase of treatment. Patients receiving bedaquiline-containing regimens demonstrated significantly higher survival probability compared with those not receiving bedaquiline (log-rank <i>p</i> = 0.024; HR 0.58, 95% CI: 0.35-0.94). In multivariable analysis, HIV infection was independently associated with unfavorable outcomes (aOR 1.36; 95% CI: 1.04-1.77; <i>p</i> = 0.025), while increasing age showed a modest association with poorer outcomes. <b>Conclusions</b>: Treatment outcomes for DR-TB improved over the study period, accompanied by declining loss to follow-up and improved survival. The survival advantage observed among patients receiving bedaquiline-containing regimens supports continued prioritization of bedaquiline-based treatment strategies in DR-TB management. Strengthening access to these regimens, alongside integrated HIV care, may further improve treatment outcomes in Limpopo Province and similar high-burden settings in South Africa.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782130","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}