Tropical Medicine and Infectious Disease最新文献

{"title":"Mortality Profile of Deaths Related to Infective Endocarditis in Brazil and Regions: A Population-Based Analysis of Death Records.","authors":"João Vitor Fazzio de Andrade Cordeiro, Letícia Martins Raposo, Paulo Henrique Godoy","doi":"10.3390/tropicalmed9120291","DOIUrl":"10.3390/tropicalmed9120291","url":null,"abstract":"<p><strong>Background: </strong>Studies of infective endocarditis (IE) are generally limited to institutions, underlining the need for more comprehensive epidemiological research.</p><p><strong>Objective: </strong>The aim of this study was to determine the mortality profile of IE-related deaths and related causes in Brazil at the national level and across regions.</p><p><strong>Method: </strong>We conducted a population-based study using data from the country's mortality information system for the period 2000 to 2019. We identified IE-related deaths and related causes based on the ICD-10 codes. Cluster analysis was performed to determine the relationship between the variables.</p><p><strong>Results: </strong>There were 52,055 IE-related deaths during the study period. Deaths occurred predominantly among men and people aged between 60 and 79 years. The Southeast accounted for the largest proportion of deaths. The most frequent ICD-10 chapter mentioned in relation to IE-related deaths was diseases of the circulatory system. We identified three distinctive profiles: 1-an age of 80 years and over and women, where the most frequent chapters were endocrine, circulatory and metabolic diseases and the South and Southeast accounted for the largest proportion of deaths; 2-an age between 30 and 79 years and men, where the most frequent chapters were infectious and genitourinary diseases and the South and Southeast accounted for the largest proportion of deaths; and 3-an age between 0 and 29 years without any difference between sexes, where the most frequent chapter was diseases of the respiratory system and the North, Northeast and Midwest accounted for the largest proportion of deaths.</p><p><strong>Conclusions: </strong>The findings of the cluster analysis revealed distinctive IE-related mortality profiles, indicating regional differences.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898461","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":"Evolving Landscape of Sickle Cell Anemia Management in Africa: A Critical Review.","authors":"Hazel W Musuka, Patrick Gad Iradukunda, Oscar Mano, Eric Saramba, Pierre Gashema, Enos Moyo, Tafadzwa Dzinamarira","doi":"10.3390/tropicalmed9120292","DOIUrl":"10.3390/tropicalmed9120292","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is a prevalent inherited blood disorder, particularly affecting populations in Africa. This review examined the disease's burden, its diverse clinical presentations, and the challenges associated with its management in African settings. Africa bears a significant burden of SCD, with prevalence varying across countries and age groups. Newborn screening programs have highlighted the high prevalence of SCD at birth, emphasizing the need for early diagnosis and intervention. The clinical manifestations of SCD in Africa are multifaceted, encompassing acute complications like vaso-occlusive crises, acute chest syndrome, and stroke, as well as chronic complications such as organ damage and leg ulcers. Biological factors, including fetal hemoglobin levels, and demographic factors, like age and sex, influence disease severity and outcomes. The management of SCD in Africa faces numerous challenges. Limited access to resources, including diagnostic tools, medications, and trained healthcare professionals, hinders optimal care. The high cost of advanced therapies further restricts patient access. Cultural stigma and a lack of awareness create additional barriers to effective management. To address these challenges, early diagnosis through newborn screening programs and point-of-care testing is crucial. Comprehensive care models, including hydroxyurea therapy, pain management, and patient education, are essential for improving outcomes. Collaboration with international networks and leveraging local resources can enhance the sustainability of SCD programs. In conclusion, SCD significantly impacts African populations. Overcoming the challenges associated with its management requires addressing resource limitations, affordability issues, and cultural barriers. Early diagnosis, comprehensive care models, and ongoing research focused on affordability and accessibility are crucial for improving the lives of individuals living with SCD in Africa.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898420","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":"Trend and Factors Associated with Medical-Surgical Complications in Patients Discharged from Leprosy Multidrug Therapy at the Specialized Regional Hospital in Macenta, Guinea, from 2012 to 2021.","authors":"Jean Hébélamou, Fassou Mathias Grovogui, Hawa Manet, Lavilé Povogui, Ismael Béavogui, Karifa Kourouma, Abdoulaye Sow, Alexandre Delamou","doi":"10.3390/tropicalmed9120290","DOIUrl":"10.3390/tropicalmed9120290","url":null,"abstract":"<p><p>This study analyzed the trend and factors associated with medical-surgical complications in patients discharged from leprosy multidrug therapy at the Centre Hospitalier Régional Spécialisé (CHRS), in Macenta, Republic of Guinea. This was a retro 2012 (<i>n</i> = 54) and 2013 (<i>n</i> = 35) and then a slight decrease between 2014 (<i>n</i> = 34) and 2017 (<i>n</i> = 26). From 2019 (<i>n</i> = 18) to 2021 (<i>n</i> = 1), a significant d spective study using routine secondary data from 2012 to 2021. The most represented age group ranged from 25 to 59 years (73.8%), with a male predominance of 72.6%. Farmers represented 60.7% of the patients, 74.5% of the patients had plantar wounds, and 48.8% resided in the N'zerekore region. A trend analysis showed an overall significant decrease in the number of patients with complications between ecline was found. In the patients with leprosy reactions, there was a reduction in numbers from 48 in 2012 to 2 in 2014, with a predominance in men. There were significant associations between region, plantar perforation disease (<i>p</i> = 0.013), and physical disability (<i>p</i> = 0.029) and between year and leprosy reaction after the cure (<i>p</i> < 0.001). In summary, there was a high proportion of patients with plantar ulcers, which predominantly affected farmers, and a significant proportion with leprosy reactions and physical disabilities. Community awareness around leprosy and capacity building of the providers in terms of appropriate management may contribute to improving patients' quality of life.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897781","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":"Intervention to Prevent Recurrent Intestinal Parasitic Infections in People Living with HIV in Selected Parts of Eastern Cape, South Africa.","authors":"Ifeoma Anozie, Mojisola Clara Hosu, Teke Apalata, Dominic T Abaver","doi":"10.3390/tropicalmed9120289","DOIUrl":"10.3390/tropicalmed9120289","url":null,"abstract":"<p><p>Interactions between parasites and hosts are not fully understood, though the dynamic pattern of infection and reinfection in humans varies with different demographic variables and behavioral changes. A community-based non-equivalent control group post-test-only design, an aspect of quasi-experimental design (QED), was carried out between March 2019 and February 2020. For the extraction of data from respondents, structural questionnaires were filled. Their CD4 count and viral load from the database of the National Health Laboratory Services, Mthatha were recorded. The method applied for the identification of intestinal parasites was a direct examination of the stool and the use of concentration methods. The post-test analysis showed that the intervention sites that received THEdS (Treatment, Health education, and Sanitation) bundle had a cure proportion of 60% and a re-infection proportion of 40%. The post-test results on control sites (treatment-only group) showed that the cure proportion was 51.4% and the re-infection proportion was 48.6%. The viral load significantly reduced from 377 to 44 copies/mL with a significant increment in CD4 count from 244 to 573 (cells µL) and (<i>p</i>-value) = 0.002. The combination of THEdS is an effective measure to reduce infection and reinfection of intestinal parasites. The THEdS bundle is a sustainable control and prevention method for the control of helminthes and protozoan associated with unsanitary environment and poor personal hygiene among immune-compromised individuals like HIV/AIDS patients.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898453","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":"Gender and Intersecting Barriers and Facilitators to Access the HIV Cascade of Care in Manitoba, Canada, Before and During the COVID-19 Pandemic: A Qualitative Study.","authors":"Enrique Villacis-Alvarez, Cheryl Sobie, Katharina Maier, Margaret Lavallee, Chantal Daniels, Heather Pashe, Joel Baliddawa, Nikki Daniels, Rebecca Murdock, Robert Russell, Clara Dan, Freda Woodhouse, Susie Cusson, Lisa Patrick, Marj Schenkels, Michael Payne, Ken Kasper, Lauren J MacKenzie, Laurie Ireland, Kimberly Templeton, Kathleen Deering, Margaret Haworth-Brockman, Yoav Keynan, Zulma Vanessa Rueda","doi":"10.3390/tropicalmed9120287","DOIUrl":"10.3390/tropicalmed9120287","url":null,"abstract":"<p><p>Marginalized groups in Manitoba, Canada, especially females and people who inject drugs, are overrepresented in new HIV diagnoses and disproportionately affected by HIV and structural disadvantages. Informed by syndemic theory, our aim was to understand people living with HIV's (PLHIV) gendered and intersecting barriers and facilitators across the cascade of HIV care before and during the COVID-19 pandemic. This study was co-designed and co-led alongside people with lived experience and a research advisory committee. We employed semi-structured interviews with thirty-two participants and three questionnaires. Interviews were audio-recorded, transcribed, and coded, and descriptive statistics were performed on the first two questionnaires. Qualitative data analysis used thematic analysis and focused on identifying categories (individual, healthcare, and social/structural) related to the barriers and facilitators to HIV care. A total of 32 PLHIV completed this study and over 70% of females and 50% of males reported severe and moderate sexual abuse among other traumatic childhood experiences. Barriers to accessing or continuing in the cascade of HIV care included navigating the initial shock of receiving an HIV diagnosis, mental health challenges and inaccessible supports, substance use, violence (including intimate partner), internalized and enacted compounded stigma related to houselessness and substance use, discrimination by primary care service providers and social networks, lack of preventative and social supports, lack of accessible housing, and programmatic issues. COVID-19 increased mental health problems and disrupted relationships with HIV service providers and peers living with HIV. Facilitators to HIV care included stopping substance use, caring service providers particularly during HIV diagnosis, welcoming healthcare environments, social opportunities and integrated supports, and supportive social networks. Women, men, and non-binary PLHIV experience interconnected factors complicating their experiences with HIV care. Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research and appropriately serve PLHIV.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898422","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":"Identification of Anti-Tuberculosis Drugs Targeting DNA Gyrase A and Serine/Threonine Protein Kinase PknB: A Machine Learning-Assisted Drug-Repurposing Approach.","authors":"Dongwoo Lee, Md Ataul Islam, Sathishkumar Natarajan, Dawood Babu Dudekula, Hoyong Chung, Junhyung Park, Bermseok Oh","doi":"10.3390/tropicalmed9120288","DOIUrl":"10.3390/tropicalmed9120288","url":null,"abstract":"<p><p>Tuberculosis (TB) is a global health challenge associated with considerable levels of illness and mortality worldwide. The development of innovative therapeutic strategies is crucial to combat the rise of drug-resistant TB strains. DNA Gyrase A (GyrA) and serine/threonine protein kinase (PknB) are promising targets for new TB medications. This study employed techniques such as similarity searches, molecular docking analyses, machine learning (ML)-driven absolute binding-free energy calculations, and molecular dynamics (MD) simulations to find potential drug candidates. By combining ligand- and structure-based methods with ML principles and MD simulations, a novel strategy was proposed for identifying small molecules. Drugs with structural similarities to existing TB therapies were assessed for their binding affinity to GyrA and PknB through various docking approaches and ML-based predictions. A detailed analysis identified six promising compounds for each target, such as DB00199, DB01220, DB06827, DB11753, DB14631, and DB14703 for GyrA; and DB00547, DB00615, DB06827, DB14644, DB11753, and DB14703 for PknB. Notably, DB11753 and DB14703 show significant potential for both targets. Furthermore, MD simulations' statistical metrics confirm the drug-target complexes' stability, with MM-GBSA analyses underscoring their strong binding affinity, indicating their promise for TB treatment even though they were not initially designed for this disease.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898424","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":"Impact of COVID-19 Vaccination in Thailand: Averted Deaths and Severe Infections Across Age Groups.","authors":"Chaiwat Wilasang, Pikkanet Suttirat, Dhammika Leshan Wannigama, Mohan Amarasiri, Sudarat Chadsuthi, Charin Modchang","doi":"10.3390/tropicalmed9120286","DOIUrl":"10.3390/tropicalmed9120286","url":null,"abstract":"<p><p>The COVID-19 pandemic has underscored the pivotal role of vaccines in mitigating the devastating impact of the virus. In Thailand, the vaccination campaign against SARS-CoV-2 began on 28 February 2021, initially prioritizing healthcare professionals before expanding into a nationwide effort on 7 June 2021. This study employs a mathematical model of COVID-19 transmission with vaccination to analyze the impact of Thailand's COVID-19 vaccination program from 1 March 2021 to 31 December 2022. We specifically assess the potential loss of lives and occurrence of severe infections across various age groups in a hypothetical scenario where vaccines were not administered. By fitting our model with officially reported COVID-19 death data, our analysis reveals that vaccination efforts prevented a total of 300,234 deaths (95% confidence interval: 295,938-304,349) and averted 1.60 million severe COVID-19 infections (95% confidence interval: 1.54-1.65 million). Notably, the elderly population over 80 years old benefited the most from vaccination, with an estimated 84,518 lives saved, constituting 4.28% of this age group. Furthermore, individuals aged between 70 and 74 years experienced the highest reduction in severe infections, with vaccination potentially preventing 8.35% of this age bracket from developing severe COVID-19.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenge of Bacterial Strain Identification: <i>Leptospira interrogans</i> Serovars Australis in a Dog and Long-Term Clinical Follow-Up.","authors":"Tommaso Furlanello, Elisa Mazzotta, Cristina Bertasio, Mario D'Incau, Laura Bellinati, Laura Lucchese, Alda Natale","doi":"10.3390/tropicalmed9120285","DOIUrl":"10.3390/tropicalmed9120285","url":null,"abstract":"<p><p>Leptospirosis is a widespread disease throughout the world, presenting in severe clinical forms in dogs. The pathogenicity of the different serovars in field infections is not fully documented, and clinical diagnosis is often limited to a combination of serological tests and molecular analyses. The latter, although a fundamental tool, cannot identify the infecting strain without further analysis. This study reports the use of various indirect (microscopic agglutination test, MAT) and direct (microbiological culture, real-time PCR) laboratory techniques, followed by typing protocols (Multi-locus Sequence Typing (MLST), Multiple Loci Variable number tandem repeat Analysis (MLVA), serotyping) that allowed for the identification of the <i>Leptospira</i> serovar Australis in a symptomatic and previously vaccinated dog (vaccine containing heterologous strains). This study reports long-term clinical follow-up (0-640 days) and describes the possible role of the infection in the development of chronic renal failure. This study aims to highlight how a combination of different techniques can be useful to better characterise the environmental circulation of zoonotic agents. Therefore, the identification and isolation of circulating <i>L.</i> strains would facilitate the updating of epidemiological data, enhance the knowledge of pathogenicity and long-term clinical effects, and provide a valuable resource for improving the efficacy of a specific serovar vaccination.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11679144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898488","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":"Genotyping and Characterizing <i>Plasmodium falciparum</i> to Reveal Genetic Diversity and Multiplicity of Infection by Merozoite Surface Proteins 1 and 2 (<i>msp-1</i> and <i>msp-2</i>) and Glutamate-Rich Protein (<i>glurp</i>) Genes.","authors":"Muharib Alruwaili, Abozer Y Elderdery, Hasan Ejaz, Aisha Farhana, Muhammad Atif, Hayfa Almutary, Jeremy Mills","doi":"10.3390/tropicalmed9110284","DOIUrl":"10.3390/tropicalmed9110284","url":null,"abstract":"<p><p>Resistance to current antimalarial drugs is steadily increasing, and new drugs are required. Drug efficacy trials remain the gold standard to assess the effectiveness of a given drug. The World Health Organization (WHO)'s recommendation for the optimal duration of follow-up for assessing antimalarial efficacy is a minimum of 28 days. However, assessing antimalarial drug efficacy in highly endemic regions can be challenging due to the potential risks of acquiring a new infection in the follow-up period, and thus, it may underestimate the efficacy of the given drugs. A new treatment should be introduced if treatment failure rates exceed 10%. Overestimation occurs as a result of retaining a drug with a clinical efficacy of less than 90% with increases in morbidity and mortality, while underestimation may occur due to a misclassification of new infections as treatment failures with tremendous clinical and economic implications. Therefore, molecular genotyping is necessary to distinguish true new infections from treatment failures to ensure accuracy in determining antimalarial efficacy. There are three genetic markers that are commonly used in antimalarial efficiency trials to discriminate between treatment failures and new infections. These include merozoite surface protein 1 (<i>msp-1</i>), merozoite surface protein 2 (<i>msp-2</i>), and glutamate-rich protein (<i>glurp</i>). The genotyping of <i>P. falciparum</i> by nested polymerase chain reaction (n-PCR) targeting these markers is discussed with the inherent limitations and uncertainties associated with the PCR technique and limitations enforced by the parasite's biology itself.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 11","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11597988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732980","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":"Evaluation of Serological Tests for Different Disease Stages of Leptospirosis Infection in Humans.","authors":"Virginia C Rodríguez-Rodriguez, Ana María Castro, Ronald Soto-Florez, Luis Urango-Gallego, Alfonso Calderón-Rangel, Piedad Agudelo-Flórez, Fernando P Monroy","doi":"10.3390/tropicalmed9110283","DOIUrl":"10.3390/tropicalmed9110283","url":null,"abstract":"<p><strong>Background/objectives: </strong>Leptospirosis is a zoonotic disease that is widely distributed around the world and presents symptoms similar to other febrile illnesses in tropical regions, which complicates clinical diagnosis. This study aimed to evaluate the performance and agreement between serological diagnostic tests for detecting both acute and convalescent human leptospirosis, using the micro agglutination test (MAT) as a reference in an endemic region of the Colombian Caribbean.</p><p><strong>Methods: </strong>A prospective descriptive study was conducted on 275 participants with suspected leptospirosis. Paired serum samples were obtained, and an epidemiological survey was conducted. Using the MAT as the gold standard, we calculated positive and negative predictive values, sensitivity, specificity, and kappa index. A Bayesian latent class model was also used to compare the diagnostic tests.</p><p><strong>Results: </strong>In 223 paired serum samples, the sensitivity values for various stages of the disease ranged between 10.8% to 54.1% in the acute and 6.1% to 66.7% during the convalescent phase compared to the MAT. According to the Bayesian model, sensitivity was 9.5% to 75.3% in the acute phase and 5.7% to 85.3% in the convalescent phase. The Kappa value, an indicator of agreement, was moderate for the IgM ELISA in the acute phase (0.553) and substantial in the convalescent phase (0.692).</p><p><strong>Conclusions: </strong>The MAT was the best confirmatory test in both acute and convalescent phases of leptospirosis. Despite the high specificity of ELISA, 21.62% of participants identified as negative by IgM-ELISA in both phases were subsequently confirmed as positive by the MAT. It is necessary to re-evaluate diagnostic guidelines that do not employ the MAT for confirmation and to enhance the diagnostic and clinical identification of leptospirosis within healthcare institutions and public health laboratories while providing a rapid and reliable test for its implementation.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 11","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732916","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}