Tropical Medicine and Infectious Disease最新文献

{"title":"<i>Enterococcus mundtii</i> CRL35 as a Dual-Route Treatment for Cutaneous Leishmaniasis: Preclinical Safety and Efficacy Assessment.","authors":"María A Occhionero, Daniela A Gaspar, Daniela E Barraza, María Elisa Vázquez, Brenda A Zabala, Rita A Sandoval, Lucila Saavedra, Cecilia Pérez Brandán, Natalia S Corbalán, Leonardo Acuña","doi":"10.3390/tropicalmed11090256","DOIUrl":"10.3390/tropicalmed11090256","url":null,"abstract":"<p><p>American tegumentary leishmaniasis (ATL) remains a therapeutic challenge due to the toxicity and limited effectiveness of conventional agents. This study evaluated <i>Enterococcus mundtii</i> CRL35, a food-grade lactic acid bacterium, as a dual-mechanism therapeutic platform against <i>Leishmania (L.) amazonensis</i>. Initial screening identified <i>E. mundtii</i> CRL35 as the most active strain among four enterococci tested, demonstrating high selectivity against promastigotes (SI = 95) and intracellular amastigotes (SI = 25). In a BALB/c murine model of cutaneous leishmaniasis, three treatment modalities were evaluated: topical application of cell-free supernatant (CFS-T), oral viable bacteria (LB-O), and their combination (CFS-T+LB-O). All three treatments achieved significant reductions in lesion parasite burden (approximately 2-3 orders of magnitude versus untreated controls), substantially exceeding the parasitological efficacy of amphotericin B under identical experimental conditions. CFS-T and CFS-T+LB-O additionally produced significant macroscopic lesion improvement. Importantly, no treatment was associated with adverse changes in organ indices or serum biochemical parameters. <i>E. mundtii</i> CRL35-based treatments promoted higher IgG2a/IgG1 antibody ratios compared to untreated controls and amphotericin B, generating an immune profile more favorable for intracellular parasite control. Taken together, these findings support the therapeutic potential of these modalities as safe, effective, and affordable alternatives for ATL, particularly in resource-limited endemic regions where toxicity and logistical barriers limit access to conventional therapy.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040604","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":"Co-Endemic Zoonoses, Divergent Dynamics: A Comparative Spatiotemporal Analysis of Crimean-Congo Hemorrhagic Fever and Brucellosis with Implications for Integrated Surveillance.","authors":"Serdar Karakullukçu, İrem Dilaver, Murat Topbaş, Merve Erdoğan, Hüsniye Ebru Çolak, Meral Fidan Uçan","doi":"10.3390/tropicalmed11090255","DOIUrl":"10.3390/tropicalmed11090255","url":null,"abstract":"<p><p>Co-endemic zoonoses may occur in the same broad geographic settings but not necessarily the same communities or time periods. This study investigated whether Crimean-Congo hemorrhagic fever (CCHF) and brucellosis exhibit convergent or divergent spatiotemporal patterns across geographic scales in a livestock-dependent, CCHF-endemic province of Türkiye. This retrospective study analyzed confirmed human CCHF and brucellosis cases reported to the national infectious disease surveillance system between 2011 and 2024. Temporal analyses, kernel density estimation, settlement-level random labeling, and within- and cross-disease Knox tests were performed. Among the 611 eligible cases, CCHF (<i>n</i> = 442; 72.3%) and brucellosis (<i>n</i> = 116; 19.0%) accounted for 91.3%. CCHF was strongly seasonal, with 99.3% of cases occurring between April and September, whereas brucellosis occurred throughout the year. Although broad density surfaces partially overlapped, same-settlement co-occurrence was substantially lower than expected (O/E = 0.37; <i>p</i> < 0.001) and remained so in the sensitivity analysis (O/E = 0.74; <i>p</i> = 0.001). Cross-disease analysis showed no evidence that CCHF and brucellosis occurred closer together in both space and time than expected. Annualized CCHF concentration peaked in 2020-2021, whereas brucellosis peaked in 2022-2024. Integrated surveillance may use shared regional infrastructure, but interventions should be tailored to disease-specific settlements, transmission pathways, and periods of risk.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040663","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":"Health-Related Quality of Life of People Living with Hansen's Disease Undergoing Multidrug Therapy.","authors":"Victor Feitosa de Freitas, Liliane Lins-Kusterer, Karen Valadares Trippo, Herman Henrique Silva Santana, Fernando Martins Carvalho","doi":"10.3390/tropicalmed11090254","DOIUrl":"10.3390/tropicalmed11090254","url":null,"abstract":"<p><strong>Background: </strong>Multidrug therapy (MDT) is the cornerstone of treatment for Hansen's disease. We aimed to identify factors associated with health-related quality of life (HRQoL) of people with Hansen's disease undergoing MDT.</p><p><strong>Methods: </strong>Sixty-six people of any sex, aged 18 and older, undergoing MDT, without adverse reactions, were enrolled as outpatients at a public health service in Salvador, Brazil. A physical examination was performed, during which the Simplified Neurological Evaluation Form was used to determine the Degree of Physical Disability. The HRQoL was evaluated using the RAND-36 questionnaire and its Physical Component Summary (PCS) and Mental Component Summary (MCS).</p><p><strong>Results: </strong>The PCS and MCS were negatively associated with pain and positively associated with the Degree of Physical Disability after controlling for MDT duration, bacilloscopy, schooling, race/color, age, sex, and monthly income; the PCS was negatively associated with smoking. Patients who reported pain had a PCS 14.282 percent units lower than those who did not report it, and patients that reported pain had an MCS 6.762 units lower. Differences in such magnitude are clinically important for patients with Hansen's disease being treated with MDT.</p><p><strong>Conclusion: </strong>Pain and the Degree of Physical Disability are strongly associated with the HRQoL of patients with Hansen's disease undergoing MDT.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040673","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":"Dengue and Chikungunya Seroprevalence in an Urban Low-Income Cohort in Delhi: A Cross-Sectional and Nested Longitudinal Study.","authors":"Nandini Sharma, Saurav Basu, Shivani Rao, Mrunali Zode, Himanshu Bachawandia, Meenakshi Bakshi, Mongjam Meghachandra Singh","doi":"10.3390/tropicalmed11090253","DOIUrl":"10.3390/tropicalmed11090253","url":null,"abstract":"<p><p><b>Objectives:</b> The aim of this study was to ascertain the seroprevalence and determinants of dengue virus (DENV) and chikungunya virus (CHIKV) seropositivity in Delhi, India. <b>Methods:</b> This cross-sectional serosurvey with a nested longitudinal immunological sub-study was conducted in an urban resettlement and slum settlement in the North-East district of Delhi in individuals aged ≥2 years. Dengue and Chikungunya virus IgG antibodies were screened using indirect enzyme-linked immunosorbent assay (ELISA), and a longitudinal subset of 100 paired IgG-seropositive samples was further characterized via a plaque reduction neutralization test (µPRNT50) to evaluate changes in functional neutralization over time. <b>Results:</b> A total of 752 participants, including 56.65% female participants, were included in the study. Of the participants studied, 81.91% (95% CI: 78.97, 84.60; n = 616) were positive for IgG antibodies against DENV, and 28.32% (95% CI: 25.13, 31.69; n = 213) were positive for CHIKV IgG antibodies. µPRNT50 confirmed stable, near-universal CHIKV neutralization (97% baseline, 98% endline). However, DENV neutralizing antibody showed a significant contraction for DENV-3 (79% baseline, 60% endline) and DENV-4 (69% baseline, 60% endline), while DENV-1 (76%) and DENV-2 (77% to 80%) antibodies remained stable. Individuals living in households with screened windows had significantly lower odds of contracting DENV infection (AOR: 0.36; 95% CI: 0.21, 0.61) and CHIKV infection (AOR: 0.63; 95% CI: 0.43, 0.90) compared with those living in households without screened windows. Further, individuals from households with uncovered containers with stagnant water had 50% higher odds of CHIKV infection than those without such containers (AOR: 1.55; 95% CI: 1.05, 2.29). <b>Conclusions:</b> This study revealed a high burden of DENV and CHIKV exposure in this high-risk urban population. While neutralization remained stable for CHIKV, DENV-1, and DENV-2, waning DENV-3 and DENV-4 antibodies suggest differential serotype-specific immunity in the participants.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040675","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":"Severe Dengue in Children: Pathogenesis, Early Recognition, and Evidence-Informed Management.","authors":"Hsien-Yi Wang, Shih-Bin Su, Chung-Yi Li, Kow-Tong Chen","doi":"10.3390/tropicalmed11090252","DOIUrl":"10.3390/tropicalmed11090252","url":null,"abstract":"<p><p>Severe dengue remains an important cause of pediatric hospitalization, morbidity, and mortality in tropical and subtropical regions, particularly where rapid triage and pediatric critical-care capacity are limited. This structured narrative review synthesizes the evidence on the epidemiology, pathogenesis, early recognition, diagnosis, management, and prevention of severe dengue in children. Severe disease reflects interactions among viral factors, pre-existing immunity, dysregulated host responses, and microvascular endothelial injury. Antibody-dependent enhancement, inflammatory mediators, dengue nonstructural protein 1, and endothelial glycocalyx disruption contribute to vascular hyperpermeability, plasma leakage, shock, severe bleeding, and organ impairment. Because deterioration often occurs abruptly around defervescence, serial clinical assessment, hematocrit trends, urine-output monitoring, and timely recognition of warning signs are central to risk stratification. Molecular assays and NS1 antigen testing are most useful during the early febrile phase, although diagnostic performance varies with illness timing and immune status. Carefully titrated isotonic crystalloid therapy remains the cornerstone of treatment; both delayed resuscitation and excessive fluid administration may worsen outcomes. Reducing mortality requires integrated clinical and public-health strategies combining standardized pediatric management, accessible diagnostics, effective referral systems, vaccination where appropriate, surveillance, and vector control.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040766","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":"Elevated Levels of Environmental Enteric Dysfunction Biomarkers Among Rural Indonesian Infants: Associations with Water, Sanitation, Hygiene and Linear Growth.","authors":"Callum Lowe, Tony Arjuna, Mubasysyir Hasanbasri, Haribondhu Sarma, I Nyoman Sutarsa, Severine Navarro, Darren Gray, Matthew Kelly","doi":"10.3390/tropicalmed11090251","DOIUrl":"10.3390/tropicalmed11090251","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the burden of environmental enteric dysfunction (EED) and its association with water, sanitation, and hygiene (WASH) and linear growth amongst infants in rural Central Java, Indonesia. <b>Study design:</b> A longitudinal study of 119 infants aged from 5-19 months was conducted in five villages of Wonosobo District, Central Java, Indonesia. Infant length and weight were measured at baseline and 5-month follow-up and stool samples were collected for the investigation of alpha-1-antitrypsin (AAT), neopterin (NEO), and myeloperoxidase (MPO) levels. Linear mixed-effects regression (LMER) models estimated the associations between WASH and height-for-age z-score (HAZ) on biomarker concentrations. <b>Results:</b> Biomarkers increased from baseline to follow-up where AAT, NEO, and MPO were elevated in 68.7%, 79.0%, and 71.4% of infants. Breastfed infants and infants with recent diarrhoea had higher biomarker levels than non-breastfed infants. After correction for multiple testing, few significant associations between EED biomarkers and WASH variables or HAZ were detected. EED biomarkers measured at baseline or follow-up were not significantly associated with growth faltering over the follow-up period. In cross-sectional analysis, compared to infants at risk of stunting (-2 < HAZ ≤ -1), infants with HAZ > -1 had lower AAT at baseline (β = -0.43, 95% CI = -0.82 to -0.05, p_adj < 0.05). <b>Conclusions:</b> Elevated EED biomarker levels were frequently observed and had mixed associations with WASH and HAZ, highlighting the complexity of EED and need to understand EED etiology through intervention studies.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"11 9","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040714","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":"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}