Tropical Medicine and Infectious Disease最新文献

{"title":"West Nile Virus in People with HIV: Immune Vulnerability, Neuroinvasive Disease, and Diagnostic Challenges.","authors":"Paolo Fusco, Francesco De Maria, Alessandro Russo","doi":"10.3390/tropicalmed11090250","DOIUrl":"10.3390/tropicalmed11090250","url":null,"abstract":"<p><p>West Nile virus (WNV) is an expanding mosquito-borne orthoflavivirus and an important cause of arboviral neuroinvasive disease. Whether HIV infection modifies WNV susceptibility, severity, or diagnostic performance remains uncertain. This narrative review was supported by structured PubMed/MEDLINE and Scopus searches updated to 22 August 2026 and a supplementary targeted citation search, identifying 23 peer-reviewed reports providing direct clinical or seroepidemiological evidence on WNV in people with HIV (PWH). The evidence remains heterogeneous, but recent data clarify several conclusions. A Northern Italian sero-repository study of 2843 PWH found neutralization-confirmed WNV antibodies in 3.0%, with no neuroinvasive disease and no association with HIV-related immunological variables. Comparative US cohorts likewise do not demonstrate that HIV status alone confers a uniform excess risk of WNV neuroinvasive disease. Conversely, individual reports of advanced HIV disease describe severe neuroinvasive presentations with delayed or absent WNV-specific antibody responses and molecular confirmation. HIV status alone should therefore not be considered a uniform WNV risk marker; the individual immune phenotype may be more clinically informative. In PWH with profound immunosuppression, negative early serology should not prematurely exclude WNV, and molecular testing should be considered when clinical suspicion remains high. Prevention, seasonal vigilance, and prospective HIV-specific studies remain priorities.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040769","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":"Measles Immunoglobulin G Positivity and Associated Factors Among Suspected Cases in Three Selected Zambian Provinces: A Bayesian Logistic Regression Study.","authors":"Priscilla Nkonde Gardner, Victor Daka, Paul Simusika, Walter Azibadighi, Charles Chileshe, Leah Kamulaza, Davie Simwaba, Roma Chilengi","doi":"10.3390/tropicalmed11090248","DOIUrl":"10.3390/tropicalmed11090248","url":null,"abstract":"<p><p>Measles remains a public-health concern where immunity gaps and incomplete vaccination coverage persist. This study assessed household and geographic factors associated with laboratory-confirmed measles among suspected cases in three Zambian provinces. A prospective cross-sectional study was conducted during measles outbreaks in five selected districts across Luapula, Northern and Northwestern provinces. Suspected cases meeting the IDSR case definition were consecutively enrolled. Blood samples were collected, transported to the UTH Virology Laboratory, and tested using procured IgG test kits. Participant characteristics were summarised descriptively. Bayesian logistic regression estimated associations between laboratory-confirmed (IgG positive) measles and age, sex, vaccination status, household size and previous measles history, with province added in a second model. Results were reported as posterior odds ratios with 95% credible intervals. Among the 172 suspected cases, 45 (26.2%) were laboratory confirmed (IgG positive). Vaccination status was verified using caregiver-provided immunization cards; status was unknown for 110 (64.0%) participants (all of whom tested negative), reflecting missing vaccination documentation. Vaccinated participants had 93% lower adjusted odds of laboratory-confirmed measles than unvaccinated participants (adjusted posterior OR: 0.07, 95% CrI: 0.02-0.18). Adjusted posterior probabilities were consistently lower among vaccinated participants across all three provinces (34% to 49%) than among unvaccinated participants (86% to 92%). Age, sex and household size were not clearly associated with measles positivity. All four participants reporting a previous measles history tested positive, and the unadjusted association was significant using Fisher's exact test (<i>p</i> = 0.004). Vaccination status was most strongly associated with laboratory-confirmed measles, with substantially lower adjusted odds among vaccinated participants. These findings reinforce the importance of measles vaccination in outbreak prevention and control.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040748","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":"Diagnostic Sensitivity of the McMaster Technique for Detecting Intestinal Parasites in Human Populations: A Systematic Review and Meta-Analysis.","authors":"Jurairat Jongthawin, Aongart Mahittikorn, Kinley Wangdi, Frederick Ramirez Masangkay, Manas Kotepui","doi":"10.3390/tropicalmed11090249","DOIUrl":"10.3390/tropicalmed11090249","url":null,"abstract":"<p><p>Intestinal parasitic infections, particularly soil-transmitted helminths (STHs), remain a major public health concern in low- and middle-income countries. As control programs reduce infection intensity, accurate diagnosis becomes increasingly challenging. The McMaster technique has been proposed as an alternative diagnostic method for detecting human intestinal parasites; however, its diagnostic performance in human populations remains unclear. This study aimed to evaluate the diagnostic sensitivity of the McMaster technique for detecting intestinal parasites, particularly STHs. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines and registered in PROSPERO (CRD420261298952). Electronic databases (PubMed, Scopus, Web of Science, Ovid, Nursing & Allied Health Premium, and Google Scholar) were searched up to January 2026. Studies assessing the McMaster technique in human populations and reporting sufficient data to calculate sensitivity were included. A random-effects model was used to estimate pooled sensitivity, with subgroup analyses by parasite species, geographic region, and population characteristics. Risk of bias was assessed using the the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Among the 1514 records identified through database searching, 10 studies were included in the final analysis. The pooled sensitivity of the McMaster technique was 73% (95% confidence interval [CI]: 67-78%; <i>I</i>² = 91.0%) for detecting any intestinal parasites and 72% (95% CI: 65-78%; <i>I</i>² = 93.5%) for STHs. Species-specific sensitivities were 67% (95% CI: 61-72%; <i>I</i>² = 80.7%) for <i>Ascaris lumbricoides</i>, 79% (95% CI: 57-91%; <i>I</i>² = 96.9%) for <i>Trichuris trichiura</i>, and 71% (95% CI: 61-80%; <i>I</i>² = 89.9%) for hookworms. The McMaster technique demonstrates moderate sensitivity for detecting intestinal parasites in humans. While it offers practical advantages for field applications, its reduced sensitivity in low-intensity infections limits its utility as a standalone diagnostic tool in control and elimination settings. Further research should focus on methodological standardization and integration with more sensitive diagnostic approaches.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040659","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 Validation of a Computer Vision-Based Artificial Intelligence System (FenoParasite) for the Microscopic Detection of <i>Ascaris lumbricoides</i> and <i>Giardia lamblia</i> in Stool Samples.","authors":"Miguel Hueda-Zavaleta, Exequiel Federico Espeche, Francisco Zea Gamboa, Mady Canelu Ramos Rojas, Enrique Lanchipa Valencia, Juan Carlos Gómez de la Torre Pretell","doi":"10.3390/tropicalmed11090246","DOIUrl":"10.3390/tropicalmed11090246","url":null,"abstract":"<p><strong>Background: </strong>Intestinal parasitic infections caused by <i>Giardia lamblia</i> and <i>Ascaris lumbricoides</i> remain a public-health problem in resource-limited settings, where conventional microscopy depends on expert personnel and shows variable sensitivity. Artificial intelligence (AI) could standardize and decentralize diagnosis. This study aimed to design and validate FenoParasite, an AI object-detection software (Azure Custom Vision) for the microscopic identification of <i>G. lamblia</i> cysts and trophozoites and <i>A. lumbricoides</i> eggs in stool samples.</p><p><strong>Methods: </strong>Diagnostic-accuracy study. The reference standard was consensus microscopy by two expert readers, with a third reader for discordant cases. An internal validation set (<i>n</i> = 159) and a prospective pilot validation set (<i>n</i> = 31) were analyzed. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy (95% Clopper-Pearson CI), AUC-ROC (bootstrap), and Cohen's kappa were computed; the confidence threshold was 90%.</p><p><strong>Results: </strong>The model achieved a mAP@0.30 of 98.3% (precision 98.2%; recall 96.4%). In internal validation, <i>G. lamblia</i> showed 100% sensitivity, 98.9% specificity, 99.4% accuracy, and AUC 0.98; <i>A. lumbricoides</i> reached 100% across all indices (AUC 1.00). In the prospective pilot validation, sensitivity and specificity were 100% for both taxa; however, the confidence intervals were very wide (lower sensitivity bounds of 39.8% and 75.3%, based on only 4 and 13 reference-positive specimens, respectively), and these estimates are correspondingly imprecise.</p><p><strong>Conclusions: </strong>FenoParasite showed high agreement with consensus expert microscopy for both a protozoan and a helminth. Because the reference standard was expert microscopy rather than a molecular assay, the reported performance estimates quantify agreement with microscopic reading rather than absolute diagnostic accuracy. These findings remain preliminary. Multicenter validation against molecular reference standards is required before clinical implementation can be considered.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040691","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":"Longitudinal Surveillance of Invasive Mosquitoes at Points of Entry in Northeastern Italy.","authors":"Sara Manzi, Martina Micocci, Luca Tassoni, Stefano Vettore, Davide Bonetto, Simone Martini, Francesco Gradoni, Federica Toniolo, Giulia Iandiorio, Lidia Iustina Danca, Giulia Chiarello, Patrizia Visentin, Matteo Cecconello, Sara Carlin, Federica Gobbo, Matteo Mazzucato, Francesca Russo, Chiara Ziprani, Barbra Bucci, Sergio Iavicoli, Vincenzo Severino, Fabrizio Montarsi","doi":"10.3390/tropicalmed11090247","DOIUrl":"10.3390/tropicalmed11090247","url":null,"abstract":"<p><p><i>Aedes</i> invasive mosquito (AIM) species are expanding worldwide, increasing the risk of arbovirus introduction and transmission. Points of Entry (PoEs), including airports and seaports, represent critical gateways for the introduction and spread of invasive vectors through international passenger and cargo traffic. This study evaluated the AIM long-term dynamics at three major PoEs (Treviso Airport, Venice Airport, and Venice Port) in northeastern Italy (Veneto region) between 2018 and 2024 through an integrated entomological surveillance programme designed to collect AIMs (adults and eggs) throughout the seasonal activity (June-October). Mosquitoes were identified morphologically and, where required, by molecular analyses. <i>Aedes albopictus</i> was the dominant AIM throughout the study period (eggs N = 96,192, adults N = 14,231), being detected at all three study sites and showing consistent interannual and seasonal dynamics, with peak abundance during summer despite routine vector control interventions. <i>Aedes koreicus</i> was detected at two of the three study sites, namely Venice and Treviso airports (eggs N = 1, adults N = 3). Phylogenetic analyses based on COI indicated that these specimens belonged to a distinct European lineage, revealing genetic diversity among European populations of <i>Ae. koreicus</i>. No evidence of newly established AIMs was found during the surveillance period. These findings highlight the importance of long-term surveillance at PoEs for the early detection of AIMs, monitoring temporal changes in established vector populations, and supporting integrated control and surveillance strategies to reduce the risk of vector establishment and mosquito-borne disease transmission.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040751","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":"Application of Genomics to Prevent and Combat Emerging Infectious Disease Threats in Latin America: Perspectives from an Overseas U.S. Navy Research Command.","authors":"Hugo O Valdivia, Maria Silva, Cristopher D Cruz, Paul Rios, Marisa E Lozano, Julia S Ampuero, Yeny Tinoco, Jeffrey Spiro, Yuliya S Johnson, Alden S Estep, Steev Loyola, Carmen Flores-Mendoza, Gissella M Vasquez, Jose A Garcia-Rivera, Henju Marjuki","doi":"10.3390/tropicalmed11090245","DOIUrl":"10.3390/tropicalmed11090245","url":null,"abstract":"<p><p>Endemic and (re)emerging infectious diseases pose a major threat to public health and military readiness in Central and South America. The high biodiversity and the differing transmission pathways require the use of highly sensitive methods to track the emergence and spread of these diseases. High-throughput sequencing technologies have become a critical resource for the field of infectious disease monitoring, specifically for tracking pathogen evolution, antimicrobial resistance, and transmission. This review provides an overview of the implementation of genomics-informed infectious disease surveillance conducted by the U.S. Naval Medical Research Unit SOUTH, focusing on operational, infrastructural, and logistical challenges in resource-limited settings and outlining strategies for building sustainable regional capacity. Selected case studies focused on prominent biothreats including dengue, Oropouche, malaria, and antimicrobial resistance demonstrate the significance and applicability of targeted and agnostic sequencing approaches to elucidate transmission pathways, pathogen discovery, and guide public health responses and field-deployable applications.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040625","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":"Rabies in Military Personnel: Epidemiology, Clinical Challenges, and Strategies for Prevention and Management.","authors":"Elodie Monchatre-Leroy, Diana Isabela Costescu Strachinaru, Oula Itani, Sophie Wensierski, Alexandre Servat, Patrick Soentjens","doi":"10.3390/tropicalmed11090243","DOIUrl":"10.3390/tropicalmed11090243","url":null,"abstract":"<p><p>For deployed military personnel, a single exposure from a rabies-infected animal can become a death sentence. With a case fatality rate approaching 100%, rabies remains a serious, yet insufficiently acknowledged hazard for service members, for whom prevention in operational environments poses unique challenges. We conducted a systematic literature search to identify relevant studies on rabies risk in armed forces personnel. By analysing rabies-related fatalities in the military, this review highlights the operational challenges posed by animal bites during deployment, including underreporting and delayed access to care, which compromise timely post-exposure prophylaxis (PEP) administration. Special emphasis is placed on prevention strategies, including pre-exposure prophylaxis (PrEP) and animal control protocols tailored to military settings. Its aim is to provide a comprehensive, evidence-based resource for healthcare professionals involved in the protection of deployed forces against this ancient yet still deadly infectious disease.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040815","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":"Circulating Leukocytes and Antibody Isotype Reactivity in Rats Experimentally Infected with Different Burdens of <i>Strongyloides venezuelensis</i>, Before and After Treatment with Ivermectin or Dexamethasone.","authors":"João Gustavo Mendes Rodrigues, Guilherme Silva Miranda, Genil Mororó Araújo Camelo, Caio Brandão Goes Gouveia, Deborah Aparecida Negrão-Corrêa","doi":"10.3390/tropicalmed11090242","DOIUrl":"10.3390/tropicalmed11090242","url":null,"abstract":"<p><p>Strongyloidiasis is a neglected, potentially lifelong disease caused by <i>Strongyloides stercoralis</i> that can lead to a high mortality rate in immunocompromised hosts; therefore, it is necessary to increase the accuracy of infection diagnosis. In the current study, we used Wistar rats experimentally infected with different burdens of <i>Strongyloides venezuelensis</i> to characterize circulating leukocytes and IgM, IgG, IgG1, IgG2a, and IgA reactivity before and after anthelmintic treatment or immunosuppression. Infection, especially with 500 L3, induced an increase in circulating leukocytes, particularly during the acute phase. Animals treated with ivermectin showed complete elimination of the parasite and an early reduction in circulating eosinophils. The production of IgM, IgG, and IgG1 anti-L3 (infective larvae) and anti-Sv (adult worm) antigens was significantly elevated in all infected groups but did not allow differentiation between cured and infected animals. Treatment with dexamethasone delayed worm elimination and temporarily reduced cellular response and parasite-specific IgG production but did not alter IgM reactivity. IgG2a anti-L3 and anti-Sv reactivity showed a progressive reduction, returning to baseline levels in ivermectin-treated rats. IgA anti-ES/L3 (excretory and secretory larval antigens) reactivity significantly decreased in intestinal wash after parasitological cure. These data would help the development of more efficient immunodiagnostic alternatives for human strongyloidiasis based on antibody isotype reactivity.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040611","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":"Toward Precision Vaccinology for Mpox: Rational Antigen Design, Next-Generation Platforms, and Immune Correlates of Protection.","authors":"Yithenthrathevinair K Paramasivam, Nur Syafiqah Mohamad Nasir, Mohd Zulkifli Salleh","doi":"10.3390/tropicalmed11090244","DOIUrl":"10.3390/tropicalmed11090244","url":null,"abstract":"<p><p>Mpox has emerged as a global public health concern, highlighting the limitations of traditional vaccinia-based vaccination strategies and the urgent need for precision vaccinology approaches. Advances in structural virology and immunoinformatics have enabled the identification of conserved immunodominant antigens from both mature virion and extracellular virion forms, supporting the development of multivalent antigen combinations capable of inducing broad neutralizing antibody (nAb) responses. Emerging delivery technologies including mRNA-lipid nanoparticles, viral vectors, and self-assembling protein nanoparticles offer rapid scalability, enhanced immunogenicity, and improved safety compared with conventional live-attenuated vaccines. Addressing antigenic evolution, vaccine supply limitations, and population-specific immune variability will be crucial for optimizing vaccine effectiveness. This review synthesizes current evidence on antigen design, vaccine delivery platforms, and immunological correlates of protection to outline a framework for next-generation mpox vaccines. Precision vaccinology therefore represents a transformative strategy for developing durable, clade-specific mpox vaccines and strengthening preparedness against future orthopoxvirus outbreaks worldwide.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040795","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":"Global Prevalence and Distribution of Human Sarcocystosis: A Systematic Review and Meta-Analysis.","authors":"Jurairat Jongthawin, Aongart Mahittikorn, Kinley Wangdi, Frederick Ramirez Masangkay, Manas Kotepui","doi":"10.3390/tropicalmed11090241","DOIUrl":"10.3390/tropicalmed11090241","url":null,"abstract":"<p><p>Human sarcocystosis is a neglected zoonotic infection caused by protozoa of the genus <i>Sarcocystis</i>. Although sporadic cases and outbreaks have been reported worldwide, the global burden of human infections has not been comprehensively synthesized. This study aimed to estimate the pooled prevalence and global distribution of <i>Sarcocystis</i> infections in humans. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251159944). PubMed, Scopus, Web of Science, Ovid, Nursing & Allied Health Premium, and Google Scholar were used for retrieving relevant studies. Observational studies published from 2000 onward reporting human <i>Sarcocystis</i> infections confirmed by microscopic and/or molecular methods were included. A random-effects model was used to estimate pooled prevalence. Heterogeneity was assessed using the <i>I</i>² statistic. Subgroup analyses and meta-regression were performed to explore sources of heterogeneity. Seventeen studies comprising 66,329 participants met the inclusion criteria. The pooled prevalence of human <i>Sarcocystis</i> infection was 0.85% (95% confidence interval [CI]: 0.33-2.19), with substantial heterogeneity (<i>I</i>² = 98.2%). Prevalence estimates showed marked variation across continents, countries, participant groups, diagnostic methods, <i>Sarcocystis</i> species, and clinical forms of sarcocystosis. Although human <i>Sarcocystis</i> infection appears relatively rare, its prevalence is geographically heterogeneous across studies published between 2000 and 2024. The robustness of the pooled prevalence estimate is limited by the small number of studies, uneven geographical coverage, and substantial heterogeneity. Differences in diagnostic approaches, study populations, infecting species, and disease phenotypes likely contributed to this variability. Enhanced surveillance and standardized application of sensitive molecular diagnostics are essential to better define the epidemiology, burden, and public health significance of human sarcocystosis.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040648","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}