Tropical Medicine and Infectious Disease最新文献

{"title":"Passive Immunization Hesitancy Among Rabies-Exposed Individuals in China: A Multicenter Cross-Sectional Study.","authors":"Qisheng Hou, Xiaoliang Xu, Si Liu, Chen Sun, Fengfeng Zhu, Yang Yang, Jianchao Shao, Yifan Wang, Yanqiang Feng, Yingxiang Liu, Yan Yan, Song Wang, Yan Wang, Cheng Liu","doi":"10.3390/tropicalmed11090238","DOIUrl":"10.3390/tropicalmed11090238","url":null,"abstract":"<p><strong>Background: </strong>Rabies is an almost universally fatal disease for which post-exposure prophylaxis (PEP), including passive immunization (PI) with rabies immunoglobulin or monoclonal antibodies, remains the only effective intervention. Despite established clinical guidelines, real-world PI utilization remains suboptimal. This study aimed to investigate the prevalence and determinants of PI hesitancy among previously unvaccinated patients with Category III rabies exposure in China.</p><p><strong>Methods: </strong>This multicenter cross-sectional questionnaire study was conducted at 12 rabies PEP clinics or emergency departments in 12 provinces of mainland China. The analysis included 585 previously unvaccinated adults with Category III rabies exposure who initially hesitated to receive or declined PI. The questionnaire collected sociodemographic characteristics, exposure profiles, awareness of the early protection gap, reasons for initial PI hesitancy or refusal, the decision to receive PI during the same clinical encounter, and PI product selection. Multivariable logistic regression identified factors associated with PI treatment decisions, with results reported as adjusted odds ratios (aORs); reason-specific models used the Benjamini-Hochberg false discovery rate correction. All inferential analyses were restricted to adults.</p><p><strong>Results: </strong>Among 5068 eligible previously unvaccinated patients with Category III rabies exposure, 2866 (57%) initially hesitated to receive or declined recommended PI. Of 617 questionnaire respondents, 32 minors were excluded, leaving 585 adults for all inferential analyses. The leading reasons for initial hesitancy were lack of understanding of the immediate protective role of PI (199/585, 34%), belief that vaccination alone was sufficient (194/585, 33%), and high cost (178/585, 30%). During the same clinical encounter, 320/585 adults (55%) chose to receive PI. Awareness of the early protection gap (aOR 2.63, 95% CI 1.75-3.98, <i>p</i> < 0.001) and bachelor's degree or higher (aOR 1.61, 95% CI 1.07-2.43, <i>p</i> = 0.023) were positively associated with the decision to receive PI, whereas head/face wounds were negatively associated (aOR 0.53, 95% CI 0.30-0.92, <i>p</i> = 0.026). In reason-specific models, lack of knowledge about immediate protection was associated with higher odds of choosing PI (aOR 2.43, 95% CI 1.62-3.68, BH-FDR <i>p</i> < 0.001), whereas high cost was associated with lower odds (aOR 0.41, 95% CI 0.27-0.62, BH-FDR <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Hesitancy toward and refusal of PI were observed among previously unvaccinated adults with Category III rabies exposure, yet initial hesitation or refusal is not irreversible. Early protection gap awareness was positively associated with PI choice, whereas cost-related concern was negatively associated. Clear explanation of protection timing and attention to cost-related barriers may support informed PI t","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040824","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":"Climate-Aware Self-Retrospective Representation Learning for Spatio-Temporal Epidemic Forecasting.","authors":"Qi Yuan, Han Shu, Yizhi Pan, Tianshuo Li, Hangyi Shen, Weiqi Jiang, Zidan Zhu, Pengpeng Zhang, Ningli Xi, Junyi Xin, Kai Li, Guanqun Sun","doi":"10.3390/tropicalmed11090240","DOIUrl":"10.3390/tropicalmed11090240","url":null,"abstract":"<p><p>Spatio-temporal epidemic forecasting aims to predict future outbreak trajectories across interconnected regions from historical epidemiological observations and meteorological covariates. However, existing approaches often fail to preserve historically salient epidemic states or to fully exploit delayed and region-varying meteorological associations, leading to unstable temporal representations and insufficient meteorological-context-aware spatio-temporal context for prediction at later forecast horizons. In this paper, we propose CASRL, a <b>C</b>limate-<b>A</b>ware <b>S</b>elf-<b>R</b>etrospective Representation <b>L</b>earning network for stable and meteorological-context-aware spatio-temporal epidemic forecasting. CASRL first employs a Self-Retrospective Epidemic Encoder (SREE) to retrospectively aggregate historically salient epidemic states through query-guided weighting and adaptive gating, thereby preserving informative historical epidemic states within the look-back window. It then introduces a Climate-Adaptive Graph Message Passing (CAGMP) module that breaks away from traditional passive feature concatenation. Instead, it constructs a separate meteorological-view predictive graph conditioned on the static spatial prior and adaptively fuses it with the incidence-associated topology to model complex cross-regional predictive associations. By integrating self-retrospective epidemic representations with meteorological-view spatio-temporal interactions, CASRL produces forecasts with improved predictive stability at later forecast horizons. Extensive experiments on two public influenza benchmarks show that CASRL is competitive at shorter forecast horizons and provides clearer advantages at later forecast horizons, particularly in phase-alignment-related evaluation and 15-week-ahead forecasting.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040569","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":"Reply to Asgarian et al. Comment on \"Nejati et al. Spatiotemporal Patterns and Historical Overview of <i>Aedes</i> Mosquitoes in Iran: A Systematic Review. <i>Trop. Med. Infect. Dis.</i> 2026, <i>11</i>, 131\".","authors":"Jalil Nejati, Abedin Saghafipour, Rubén Bueno-Marí","doi":"10.3390/tropicalmed11090239","DOIUrl":"10.3390/tropicalmed11090239","url":null,"abstract":"<p><p>We thank Asgarian et al [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040807","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":"Deciphering the \"Doxycycline Deficiency Syndrome\": Defining the Characteristic Clinical, Laboratory and Imaging Findings in Patients Presenting with Leptospirosis, Q Fever and Rickettsial Diseases in Far North Queensland, Tropical Australia.","authors":"Hayley Stratton, Callum Pownell, Megan Sandeman, Patrick Rosengren, Cody Price, Alexandra G A Stewart, Roderick Gavey, Toni Kinneally, Kathy Petoumenos, Simon Smith, Josh Hanson","doi":"10.3390/tropicalmed11090237","DOIUrl":"10.3390/tropicalmed11090237","url":null,"abstract":"<p><p><b>Background</b>: The \"doxycycline deficiency syndrome\" is a colloquial term used in tropical Australia to describe the overlapping, non-specific findings seen in leptospirosis, Q fever, and the rickettsial diseases scrub typhus and Queensland tick typhus (QTT). A laboratory confirmed diagnosis is frequently delayed, however, early differentiation of these potentially life-threatening infections has important implications for clinical management. <b>Methods</b>: We examined consecutive laboratory-confirmed cases of leptospirosis, Q fever, and rickettsial diseases managed at a referral centre in tropical Australia. The patients' symptoms, clinical signs and simple laboratory and radiology investigations at presentation were compared. <b>Results</b>: There were 111 cases of leptospirosis, 59 cases of Q fever, and 34 cases of rickettsial disease (17 cases of QTT and 17 of scrub typhus). Patients with leptospirosis had a shorter duration of symptoms and were more likely to have gastrointestinal symptoms, arthralgia, haemoptysis, hypotension, conjunctival suffusion and abnormal chest auscultation at presentation than patients with the other infections. They were more likely to have renal impairment and an elevated creatine kinase but less likely to have an elevated serum ferritin and serum lactate dehydrogenase. Patients with leptospirosis were more likely to have alveolar and multilobar changes on chest imaging. Patients with Q fever were more likely to have abnormal liver function tests at presentation but were more likely to have preserved renal function and normal chest imaging. Patients with rickettsial disease were more likely to have a rash, an eschar, lymphadenopathy and splenomegaly. Overall, 76/204 (37%) required ICU admission, of whom 56 (74%) had leptospirosis, but all 204 patients survived to hospital discharge. <b>Conclusions</b>: Leptospirosis, Q fever, and rickettsial diseases can have a similar presentation, but simple clinical, laboratory and imaging findings can help distinguish these infections and expedite their optimal management.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040727","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":"Comment on Nejati et al. Spatiotemporal Patterns and Historical Overview of <i>Aedes</i> Mosquitoes in Iran: A Systematic Review. <i>Trop. Med. Infect. Dis.</i> 2026, <i>11</i>, 131.","authors":"Tahereh Sadat Asgarian, Mohammad Mehdi Sedaghat","doi":"10.3390/tropicalmed11080236","DOIUrl":"10.3390/tropicalmed11080236","url":null,"abstract":"<p><p>In this paper, we critically review the article entitled \"Spatiotemporal Patterns and Historical Overview of <i>Aedes</i> Mosquitoes in Iran: A Systematic Review\" published in <i>Tropical Medicine and Infectious Disease</i> (2026, 11, 131) [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832823","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":"Addressing the Gaps and Challenges of Autochthonous Mucocutaneous Leishmaniasis in Spain.","authors":"Diego Gayoso-Cantero, Begoña Monge-Maillo, Jose A Perez-Molina","doi":"10.3390/tropicalmed11080235","DOIUrl":"10.3390/tropicalmed11080235","url":null,"abstract":"<p><p>Autochthonous mucocutaneous leishmaniasis caused by <i>Leishmania infantum</i> is an under-recognised but established manifestation of endemic leishmaniasis in Spain. This review identified 65 confirmed autochthonous cases reported since 1990, showing a relatively consistent clinical pattern. Most patients were adults, predominantly men in the fifth or sixth decade of life. Nearly half were immunosuppressed, mainly due to HIV infection, corticosteroid use, biologic therapy, autoimmune diseases, or solid organ transplantation, although immunocompetent individuals were also affected. The laryngeal, nasal, and oral mucosa were the most commonly involved sites, with occasional tracheal and bronchial disease. Clinical presentation was typically chronic and non-specific, including ulcerative, nodular, polypoid, or tumour-like lesions that frequently mimicked malignancy or inflammatory disorders, often delaying diagnosis. Unlike classical New World mucocutaneous leishmaniasis, Spanish cases generally lacked a preceding cutaneous lesion, supporting recognition as a distinct form of <i>L. infantum</i> infection. Diagnosis required microbiological confirmation, ideally with species identification through culture or molecular methods, while serology showed limited reliability. Treatment approaches varied considerably, reflecting the absence of standardised protocols, although systemic therapy (particularly liposomal amphotericin B) was most commonly used. Improved recognition, surveillance, and inclusion in clinical guidelines are needed to reduce diagnostic delay and therapeutic variability.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832707","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":"How Imported Pathology Becomes Overlooked as Resources Increase: An Example of a Neglected Tropical Disease (NTD).","authors":"Fernando de la Calle-Prieto, Lucía Platero, Jorge Ligero-López, Marta Díaz-Menéndez, Guillermo Ruiz-Carrascoso","doi":"10.3390/tropicalmed11080234","DOIUrl":"10.3390/tropicalmed11080234","url":null,"abstract":"<p><p>This case report highlights how neglected tropical diseases (NTDs) may remain underdiagnosed in high-resource settings despite advanced healthcare systems. We describe an 18-year-old woman from Equatorial Guinea living in Spain who presented with chronic pruritus and episodic ocular symptoms and was ultimately diagnosed with ocular loiasis after the incidental extraction of a conjunctival filaria. Diagnostic evaluation included microscopy, serology, and molecular techniques, confirming <i>Loa loa</i> and <i>Mansonella perstans</i> co-infection alongside evidence of exposure to other parasitic infections. Management involved staged antiparasitic therapy with albendazole, ivermectin, praziquantel, and diethylcarbamazine, combined with corticosteroids to mitigate treatment-related reactions. The patient showed clinical improvement, although follow-up was irregular and microfilaremia persisted. This case illustrates key challenges in non-endemic settings, including low clinical suspicion, fragmented care pathways, and barriers to healthcare access among migrant populations. Despite the availability of sensitive diagnostic tools, delayed recognition remains common when tropical diseases are not considered in the differential diagnosis. Comprehensive, multidisciplinary approaches are essential, particularly in patients from endemic regions who may harbor multiple co-infections. Strengthening clinical awareness, referral pathways, and appropriate screening for NTDs may help reduce diagnostic delays and improve patient outcomes in increasingly globalized healthcare settings.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831853","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":"Correction: Khourcha et al. Assessing the Efficacy of Monovalent and Commercialized Antivenoms for Neutralizing Moroccan Cobra <i>Naja haje</i> Venom: A Comparative Study. <i>Trop. Med. Infect. Dis.</i> 2023, <i>8</i>, 304.","authors":"Soukaina Khourcha, Ines Hilal, Iatimad Elbejjaj, Mehdi Karkouri, Amal Safi, Abdelaziz Hmyene, Naoual Oukkache","doi":"10.3390/tropicalmed11080233","DOIUrl":"10.3390/tropicalmed11080233","url":null,"abstract":"<p><p>There was an error in the original publication [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832769","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":"One Health Prioritization of Rabies Risk in the Republic of Guinea: Integration of Human Knowledge, Canine Immunity, and Spatial Analysis.","authors":"Noumouké Kante, Abdoulaye Kuan Traore, Lanceï Kaba, Nafissatou Ouédraogo, Nicolas Barro","doi":"10.3390/tropicalmed11080232","DOIUrl":"10.3390/tropicalmed11080232","url":null,"abstract":"<p><strong>Background: </strong>Dog-mediated rabies remains a fatal but preventable zoonosis. Its elimination requires sufficient canine vaccination coverage, informed communities, and spatially targeted surveillance. In Guinea, human knowledge, attitudes, and practices (KAP) data and canine serological data had previously been analyzed separately, limiting their translation into operational priorities.</p><p><strong>Objective: </strong>To build an integrated One Health assessment of rabies risk by combining KAP indicators, canine immunity, and spatial analysis.</p><p><strong>Methods: </strong>A secondary integrated analysis was conducted using a KAP survey of 2733 respondents and canine rabies serology from 419 vaccinated dogs tested with the Platelia™ Rabies II ELISA, with a protection threshold set at 0.5 IU/mL. Indicators were regionalized, compared, and incorporated into a vulnerability index. Associations were estimated by logistic regression with 95% confidence intervals, and spatial findings were displayed on a real map of Guinea.</p><p><strong>Results: </strong>Knowledge was insufficient or intermediate among most respondents, unfavorable attitudes reached 88.84%, and poor practices reached 73.80%. Declared canine vaccination coverage remained below the 70% programmatic threshold in all regions. Overall canine seroprotection was high (88.78%), but 11.22% of dogs remained insufficiently protected. Among dog owners, knowledge of rabies was associated with dog vaccination (OR = 2.77; 95% CI: 1.49-6.29). The integrated One Health assessment ranked Kindia as priority 1, Siguiri as priority 2, Boké and Labé as priority 3, and N'Zérékoré as priority 4.</p><p><strong>Conclusions: </strong>The integrated analysis shows that a strong immune response among vaccinated dogs is not sufficient when coverage, human practices, and the spatial distribution of risk remain heterogeneous. The recommended strategy is a regionally differentiated intervention combining post-exposure education, proximity-based dog vaccination, and targeted surveillance.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832621","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":"Optimizing Dengue Surveillance Thresholds in Malaysia: A Comparative Evaluation of Endemic Channel Approaches.","authors":"Sarbhan Singh, Nuur Hafizah Md Iderus, Lonny Chen Rong Qi Ahmad, Sumarni Mohd Ghazali, Nur'ain Mohd Ghazali, Mohd Nadzmi Md Nadzri, Asrul Anuar, Mohd Kamarulariffin Kamarudin, Lim Mei Cheng, Teh Chien Huey, Chong Zhuo Lin, Wan Ming Keong, Chew Cheng Hoon","doi":"10.3390/tropicalmed11080231","DOIUrl":"10.3390/tropicalmed11080231","url":null,"abstract":"<p><p>Endemic channels are widely used in dengue surveillance to detect unusual increases in case counts. However, conventional approaches that rely on historical averages with fixed standard deviation (SD)-based multipliers may produce unstable thresholds and false alerts. This study compared a conventional SD-based endemic channel with a log-scale SD-based endemic channel incorporating an enhanced alert rule to identify the optimal approach for routine dengue surveillance in Malaysia. Weekly national dengue case data from 2014 to 2024 were analyzed. A rolling validation approach was used to evaluate outbreak detection performance from 2017 to 2023 using three-year historical baselines. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and the Youden Index were calculated and pooled across the validation years. The optimal multiplier was selected based on the highest pooled Youden Index using the rolling validation period (2017-2023). The selected approach was then applied independently to the 2024 surveillance data as an operational demonstration of its potential use in routine dengue surveillance. A total of 260 epidemiological weeks were analyzed, of which 42 (16.2%) were classified as outbreak weeks. The log-scale SD-based endemic channel incorporating an enhanced alert rule achieved the highest pooled Youden Index of 0.43 at the optimal multiplier of 0.50. At this multiplier, sensitivity was 0.60, specificity 0.82, positive predictive value 0.35, negative predictive value 0.93, and overall accuracy 0.79. Compared with the conventional SD-based endemic channel at its optimal multiplier (1.00), the proposed approach demonstrated improved sensitivity (0.60 vs. 0.56), specificity (0.82 vs. 0.70), positive predictive value (0.35 vs. 0.23), negative predictive value (0.93 vs. 0.91), accuracy (0.79 vs. 0.68), and Youden Index (0.43 vs. 0.26). The log-scale SD-based endemic channel incorporating an enhanced alert rule demonstrated superior overall outbreak detection performance and was selected as the optimal approach for routine dengue surveillance.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 8","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832588","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}