Tropical Medicine and Infectious Disease最新文献

{"title":"The Effect of a Life-Stage Based Intervention on Depression in Youth Living with HIV in Kenya and Uganda: Results from the SEARCH-Youth Trial.","authors":"Florence Mwangwa, Jason Johnson-Peretz, James Peng, Laura B Balzer, Janice Litunya, Janet Nakigudde, Douglas Black, Lawrence Owino, Cecilia Akatukwasa, Anjeline Onyango, Fredrick Atwine, Titus O Arunga, James Ayieko, Moses R Kamya, Diane Havlir, Carol S Camlin, Theodore Ruel","doi":"10.3390/tropicalmed10020055","DOIUrl":"10.3390/tropicalmed10020055","url":null,"abstract":"<p><p>Depression among adolescents and young adults with HIV affects both their wellbeing and clinical care outcomes. Integrated care models are needed. We hypothesized that the SEARCH-Youth intervention, a life-stage-based care model that improved viral suppression, would reduce depressive symptoms as compared to the standard of care. We conducted a mixed-methods study of youth with HIV aged 15-24 years in SEARCH-Youth, a cluster-randomized trial in rural Uganda and Kenya (NCT03848728). Depression was assessed cross-sectionally with the PHQ-9 screening tool and compared by arm using targeted minimum loss-based estimation. In-depth semi-structured interviews with young participants, family members, and providers were analyzed using a modified framework of select codes pertaining to depression. We surveyed 1,234 participants (median age 21 years, 80% female). Having any depressive symptoms was less common in the intervention arm (53%) compared to the control (73%), representing a 28% risk reduction (risk ratio: 0.72; CI: 0.59-0.89). Predictors of at least mild depression included pressure to have sex, physical threats, and recent major life events. Longitudinal qualitative research among 113 participants found that supportive counseling from providers helped patients build confidence and coping skills. Integrated models of care that address social threats, adverse life events, and social support can be used to reduce depression among adolescents and young adults with HIV.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493834","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":"Chikungunya Fever and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.","authors":"José Kennedy Amaral, Robert Taylor Schoen, Michael E Weinblatt, Estelita Lima Cândido","doi":"10.3390/tropicalmed10020054","DOIUrl":"10.3390/tropicalmed10020054","url":null,"abstract":"<p><p>Chikungunya fever (CHIKF) is a re-emerging infectious disease caused by the chikungunya virus (CHIKV), transmitted primarily by Aedes mosquitoes. A significant number progress to chronic chikungunya arthritis, which shares similarities with rheumatoid arthritis (RA). Despite evidence of a link between CHIKV infection and subsequent RA development, a comprehensive analysis of the relationship between these two diseases is lacking. This study systematically analyzes the incidence of RA after CHIKV infection and its immunological mechanisms, following PRISMA guidelines with literature searches across multiple databases up to 3 September 2024. Eligible studies included retrospective and prospective designs reporting RA diagnoses after CHIKV infection. Data extraction was performed independently, and the risk of bias was assessed using appropriate tools. Sixteen studies involving 2879 patients were included, with 449 individuals diagnosed with RA following CHIKV infection, resulting in a combined incidence of 13.7% (95% CI: 6.12% to 27.87%). High heterogeneity between studies was observed (<i>I</i>² = 96%), indicating variability related to diagnostic criteria and population characteristics. This review highlights the significant RA incidence after CHIKV infection, emphasizing the need for research on autoimmune mechanisms, long-term rheumatological follow-up, early diagnostic biomarkers, and CHIKV's long-term health impacts.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493945","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":"HIV/AIDS Mortality Trends in Lang Son, Vietnam: Insights from a Population-Based Mortality Registration from 2005 to 2018.","authors":"Ngoan Tran Le, Linh Thuy Le, Ngan Dieu Thi Ta, Hung Manh Nguyen, Toan Ha","doi":"10.3390/tropicalmed10020052","DOIUrl":"10.3390/tropicalmed10020052","url":null,"abstract":"<p><p>The HIV epidemic remains a major public health issue globally and in Vietnam. This study assesses changes in HIV/AIDS-related mortality rates over time in Lang Son Province, Vietnam, from 2005-2018. We performed a descriptive epidemiological study using a population-based mortality registration system to examine HIV/AIDS-related mortality. HIV/AIDS-related mortality was converted to a crude and adjusted rate per 100,000 person-years using the World Health Organization's standard population for 2000-2025. The mortality rate ratio and 95% confidence interval were estimated to examine the province's time trend from 2005 to 2018. The adjusted mortality rate for HIV/AIDS in Lang Son Province was 12.3 and 2.4 per 100,000 for men and women, respectively, with a male-to-female ratio of 5.1. The province experienced a 94% reduction in HIV/AIDS-related deaths between 2005 and 2018. The mortality rate ratio for 2018 compared to 2005 was lower for men (0.056, 95% CI: 0.029, 0.110) than for women (0.080, 95% CI: 0.019, 0.338). The findings show a gradual decline in HIV/AIDS-related mortality rates in Lang Son Province, Vietnam. However, significant gender disparities in mortality remain a major concern, and HIV remains a significant burden. This highlights the urgency for major efforts to prevent HIV transmission and address these disparities to effectively end the HIV epidemic in Lang Son and throughout Vietnam.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493569","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":"A Case of Persistent KSHV Viremia in the Context of HIV, SARS-CoV-2, and Other Co-Infections.","authors":"Humaira Lambarey, Melissa J Blumenthal, Prishanta Chinna, Vincent N Naude, Lauren Jennings, Catherine Orrell, Georgia Schäfer","doi":"10.3390/tropicalmed10020053","DOIUrl":"10.3390/tropicalmed10020053","url":null,"abstract":"<p><p>Despite the high prevalence of latent Kaposi's sarcoma-associated herpesvirus (KSHV) infections in patients from endemic areas with a high human immunodeficiency virus (HIV) prevalence, KSHV lytic reactivation in the context of other co-infections is not well understood. Lytic KSHV infections can contribute to severe inflammatory symptoms and KSHV-associated pathogenesis. We have previously reported on KSHV reactivation upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in a non-hospitalised cohort of people living with HIV (PLWH). From this cohort, we identified a 34-year-old male who presented for routine HIV care in May 2021 with an unusually high KSHV viral load (VL) of 189,946.3 copies/10⁶ cells, before SARS-CoV-2 infection. The patient was invited into a 2-year follow-up study where his peripheral blood was analysed for selected virological, clinical, and inflammatory parameters every 6 months. He remained highly viremic for KSHV throughout the 2-year study period, during which he was infected with SARS-CoV-2 and developed disseminated tuberculosis, with steadily increasing levels of the inflammatory markers C-reactive protein (CRP), and interleukin-6 (IL-6). His HIV VL remained controlled (<1000 copies/mL) and his CD4 count bordered immunosuppression (±200 cells/µL), suggesting some responsiveness to antiretroviral treatment (ART). However, the patient's uncontrolled lytic KSHV infection may increase his risk for developing a KSHV-associated pathology manifesting with inflammation which should be closely monitored beyond the study period.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493927","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 a Novel Prediction Nomogram (EASTAR) for Patients with Hemorrhagic Fever with Renal Syndrome: A Multicenter Retrospective Study.","authors":"Ke Ma, Ting Wu, Wei Guo, Jun Wang, Quan Ming, Jun Zhu, Hongwu Wang, Guang Chen, Xiaojing Wang, Weiming Yan, Xiaoping Luo, Tao Chen, Qin Ning","doi":"10.3390/tropicalmed10020051","DOIUrl":"10.3390/tropicalmed10020051","url":null,"abstract":"<p><strong>Background: </strong>The fatality rate of hemorrhagic fever with renal syndrome (HFRS), due to hantavirus transmitted by rodents, ranges from 1% to 12%. This study aims to delineate the clinical and laboratory characteristics of HFRS, identify factors associated with disease severity, and construct and validate a nomogram for prognosis prediction of HFRS in the central part of China.</p><p><strong>Methods: </strong>Out of 598 HFRS patients diagnosed via serology tests from four hospitals in Hubei Province, 551 were included. Clinical data were gathered and analyzed, followed by logistic univariate and multivariate analyses to identify independent prognostic factors. A nomogram was developed and validated to forecast the patient's prognosis.</p><p><strong>Results: </strong>Vaccination led to a notable drop in HFRS incidence from 2018 to 2019, and seasonal trends exhibited bimodal changes with peaks from May to July and November to January. The 30-day mortality rate was 4.17% (23/551). Red blood cell count (RBC), age, two-stage overlap, qSOFA ≥ 2, aspartate aminotransferase (AST), and three-stage overlap were identified as independent prognostic factors. A predictive risk classification system using a nomogram chart was developed, and Kaplan-Meier curves indicated that the new system accurately distinguished 30-day mortality among the three risk groups.</p><p><strong>Conclusions: </strong>The risk score (EASTAR) system demonstrated good predictive performance for prognostic prediction, and it can be applied to quickly screen patients who require ICU admission.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493946","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":"Large-Scale Deployment of Lehmann's Funnel Entry Traps to Control Malaria Mosquito Populations.","authors":"Hamidou Maïga, Roger Sanou, Bazoumana B D Sow, Adama Ouema, Abdoul Azize Millogo, Koama Bayili, Aristide Sawdetuo Hien, Simon P Sawadogo, Souro Abel Millogo, Adrien Marie Gaston Belem, Léa Paré Toé, Roch K Dabiré, Abdoulaye Diabaté","doi":"10.3390/tropicalmed10020049","DOIUrl":"10.3390/tropicalmed10020049","url":null,"abstract":"<p><p>Effective tools to prevent mosquito bites are essential for malaria control. The Lehmann Funnel Entry Trap (LFET), a window screen proven effective in reducing mosquito density, was tested for its large-scale impact on malaria vector control and community acceptance. A total of 1313 traps were deployed in Vallée du Kou 3 (VK3), with 12 traps randomly selected for detailed evaluation against untrapped houses in Vallée du Kou 5 (VK5). Traps were placed in windows with doors blocked by curtains. From July to October, mosquitoes were collected for nine days per month from VK3 traps and VK5 control houses. Morphological identification, density analysis, resistance gene screening, and female age structure determination were conducted. The trap's impact was assessed via pyrethrum spray catch (PSC) and for nine days per month, while trap fabric integrity and community perceptions were also evaluated. Traps reduced mosquito entry density by more than 90% in VK3 houses. VK3 had 33% higher house mosquito density pre-intervention and 47% lower house mosquito density post-intervention than VK5. Old female mosquito numbers rose in VK5 but not VK3. Pyrethroid resistance was high (kdr mutation frequency > 0.9) in both control and intervention sites. VK3 residents appreciated the traps for reducing bites and improving sleep. The LFET effectively controls malaria vectors and is well-suited for widespread use in malaria elimination efforts.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493738","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":"Development and Characterization of Innovative Nifurtimox Formulations as Therapeutic Alternative for Chagas Disease.","authors":"Ana Lia Mazzeti, Karolina Ribeiro Gonçalves, Patrícia Ferreira Boasquivis, Maria Terezinha Bahia, Vanessa Carla Furtado Mosqueira","doi":"10.3390/tropicalmed10020050","DOIUrl":"10.3390/tropicalmed10020050","url":null,"abstract":"<p><p>Chagas disease, caused by <i>Trypanosoma cruzi</i>, remains a neglected tropical disease with limited and often suboptimal chemotherapeutic treatment options. The WHO recommends nifurtimox (NFX) for treating Chagas disease, which, although it is effective in the early stages of infection, has variable efficacy in the chronic phase and induces adverse effects that frequently compromise the continuity of the treatment. This study focused on the development and characterization of innovative lipid-based self-emulsifying drug delivery systems (SEDDSs) and poly(ε-caprolactone) implants containing NFX. The SEDDS formulations modified the NFX release extent and rate. The implant characterization included thermal analysis, X-ray diffraction, thermo-optical analysis, and scanning electron microscopy, confirming the low interaction between NFX and the polymer. In vitro assays demonstrated the enhanced anti-<i>T. cruzi</i> activity of the NFX-SEDDS, with minimal cytotoxicity in mammalian cells. In vivo studies using <i>T. cruzi</i>-infected mice revealed that both formulations effectively suppressed parasitemia, achieving cure rates comparable to those of the standard oral NFX treatment. Additionally, the implants showed improved tolerability and sustained efficacy, delivering a prolonged effect equivalent to 40 oral doses. These findings highlight the potential of these innovative NFX formulations as promising alternatives for treating Chagas disease, particularly in the chronic phase, offering improved adherence and comparable efficacy to the existing therapies.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492482","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":"Enhancing Healthcare Preparedness: Lessons from a Tabletop Exercise on Highly Pathogenic Avian Influenza (HPAI).","authors":"Priya Dhagat, Joshua Coan, Ayanava Ganguly, Cole Puetz, David Silvestri, Syra Madad","doi":"10.3390/tropicalmed10020047","DOIUrl":"10.3390/tropicalmed10020047","url":null,"abstract":"<p><p>Tabletop exercises offer a structured opportunity to assess strengths and potential gaps in preparedness and response plans in a safe learning environment. The New York City Health + Hospitals System-Wide Special Pathogens Program conducted an innovative and multidisciplinary tabletop exercise involving escalating scenarios of highly pathogenic avian influenza (HPAI) H5N1 in 2023. The goals were to assess patient screening processes for infectious diseases within healthcare facilities, infection prevention and control strategies, risk communication, and notification and involvement of public health stakeholders. Participants reflected on previous outbreak responses, discussed the importance of risk communication, and shared insights on tools and resources that would better support healthcare professionals in identifying and managing patients with HPAI/H5N1 infection. Key takeaways included establishing clear protocols for HPAI/H5N1 management, providing timely education to healthcare professionals, and assessing useful communication modalities.</p><p><strong>Methods: </strong>The exercise included escalating scenarios involving a single case of HPAI/H5N1 advancing to community transmission. Key participants spanned clinical departments, infection prevention and control, emergency management, and local public health stakeholders. Structured discussions targeted triggers for escalation, infection prevention strategies, and communication pathways.</p><p><strong>Results: </strong>Findings highlighted the need for tailored screening criteria, robust infection prevention protocols, clear communication strategies, and collaboration with public health authorities. Specific improvements included refining triage and isolation protocols, enhancing staff education, and leveraging syndromic surveillance systems.</p><p><strong>Conclusion: </strong>This exercise underscored the importance of proactive planning, multidisciplinary collaboration, and integration of biosafety measures to strengthen healthcare system resilience against HPAI/H5N1.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493362","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":"Seasonal and Meteorological Drivers of Hand, Foot, and Mouth Disease Outbreaks Using Data-Driven Machine Learning Models.","authors":"Pakorn Lonlab, Suparinthon Anupong, Chalita Jainonthee, Sudarat Chadsuthi","doi":"10.3390/tropicalmed10020048","DOIUrl":"10.3390/tropicalmed10020048","url":null,"abstract":"<p><p>Hand, Foot, and Mouth Disease (HFMD) predominantly affects children under the age of five and remains a significant public health concern in the Asia-Pacific region. HFMD outbreaks are closely linked to seasonal changes and meteorological factors, particularly in tropical and subtropical areas. In Thailand, a total of 657,570 HFMD cases were reported between 2011 and 2022 (12 years). This study aimed to identify the high- and low-risk HFMD outbreak areas using machine learning models: Logistic Regression (LR), Support Vector Machine (SVM), Decision Tree (DT), Random Forests (RF), Gradient Boosting Machine (GBM), and Extreme Gradient Boosting (XGBoost). Our findings showed that the XGBoost model outperformed the other models in predicting unseen data and defining the best model. The best model can be used to detect high-risk outbreak areas and to explore the relationship between meteorological factors and HFMD outbreaks. The results highlighted the seasonal distribution of high-risk HFMD outbreak months across different provinces in Thailand, with average maximum temperature, average rainfall, and average vapor pressure identified as the most influential factors. Furthermore, the best model was used to analyze HFMD outbreaks during the COVID-19 pandemic, showing a notable reduction in high-risk outbreak months and areas, likely due to the control measures implemented during this period. Overall, our model shows great potential as a tool for warnings, providing useful insights to help public health officials reduce the impact of HFMD outbreaks.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493824","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":"Malaria in Nepal: A Spatiotemporal Study of the Disease Distribution and Challenges on the Path to Elimination.","authors":"Kiran Raj Awasthi, Jonine Jancey, Archie C A Clements, Kefyalew Addis Alene, Suman Thapa, Pramin Ghimire, Justine E Leavy","doi":"10.3390/tropicalmed10020046","DOIUrl":"10.3390/tropicalmed10020046","url":null,"abstract":"<p><p>Malaria incidence (MI) has significantly declined in Nepal, and this study aimed to investigate the spatiotemporal distribution and drivers of MI at the ward level. Data for malaria cases were obtained from the National Surveillance System from 2013 to 2021. Data for covariates, including annual mean temperature, annual mean precipitation, and distance to the nearest city, were obtained from publicly available sources. A Bayesian spatial model was used to identify factors associated with the spatial distribution of MI. Between 2013 and 2021, 7278 malaria cases were reported in Nepal, with a crude incidence rate of 3.0 cases per 100,000 person-years at risk (PYR). MI showed a seasonal variation, with the highest number of cases reported between May and September. The annual MI decreased in recent years from 1.9 per 100,000 PYR in 2018 to 0.1 per 100,000 PYR in 2021. Spatial clustering of MI was observed at the ward level, with most hotspot areas detected in the western Terai plains and upper river valley (URV) areas. Incidence was associated with annual mean precipitation in mm (<i>β</i> = 0.201; 95% CrI: 0.042, 0.360). The shift of the malaria hotspots to the URVs presents a challenge for implementing timely prevention and control activities.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493801","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}