Tropical Medicine and Infectious Disease最新文献

{"title":"Helminth/Protozoan Coinfections in Chronic Fascioliasis Cases in Human Hyperendemic Areas: High Risk of Multiparasitism Linked to Transmission Aspects and Immunological, Environmental and Social Factors.","authors":"M Adela Valero, M Manuela Morales-Suarez-Varela, Davis J Marquez-Guzman, Rene Angles, Jose R Espinoza, Pedro Ortiz, Filippo Curtale, M Dolores Bargues, Santiago Mas-Coma","doi":"10.3390/tropicalmed10080224","DOIUrl":"10.3390/tropicalmed10080224","url":null,"abstract":"<p><p>Research is required to determine whether the coinfections by <i>Fasciola</i> spp. and other parasite species result from poor rural hygiene or reflect underlying epidemiological patterns and causes. Therefore, the role of fascioliasis is analyzed concerning coinfection complexity, risk of multiparasitism, parasite associations, pathogenic implications and their multifactorial causes. Helminth and protozoan coinfections are studied in 2575 previously untreated individuals from four rural hyperendemic areas (Northern Bolivian Altiplano, Peruvian Altiplano and Cajamarca valley, and the Egyptian Nile Delta). This cross-sectional study was conducted from January 2011 to December 2023. Coinfections were coprologically assessed by the merthiolate-iodine-formalin and formol-ether concentration techniques. Infection intensity was measured as eggs/gram of feces (epg) with the Kato-Katz technique. Parasite and coinfection prevalences were stratified by age, sex and geographical location. High mixed infections, fascioliasis prevalences and very low non-coinfected <i>Fasciola</i>-infected subjects were associated with the following regions: Bolivian Altiplano, 96.5%, 16.8% and 3.5%; Peruvian Altiplano, 100%, 24.6% and 0%; Cajamarca valley, 98.7%, 21.4% and 1.8%; Nile Delta, 84.1%, 13.0% and 15.9%. Transmission routes and human infection sources underlie fascioliasis associations with protozoan and other helminth infections. Prevalence pattern of protozoan-helminth coinfections differed between <i>Fasciola</i>-infected individuals and individuals not infected with <i>Fasciola</i>, presenting higher prevalences in individuals with fascioliasis. Multiparasitism diagnosed in <i>Fasciola</i>-infected subjects included coinfections by up to nine parasite species, eight protozoan species, and five helminth species. The most prevalent pathogenic protozoan was <i>Giardia intestinalis</i>. The most prevalent helminth species differ according to environmental conditions. Several parasites indicate fecal environmental contamination. When the fascioliasis burden increases, the total number of parasite species also increases. The fascioliasis risk increases when the total helminth species number/host increases. <i>Fasciola</i>-infected subjects may present a modification in the clinical phenotypes of coinfecting parasitic diseases. Fascioliasis coinfection factors include transmission ways and immunological, environmental and social aspects. Coinfections must be considered when assessing the health impact of fascioliasis, including the analysis of the fascioliasis effects on malnutrition and physical/intellectual child development. Fascioliasis-control schemes should, therefore, integrate control measures mainly against other helminthiases.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970493","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 Economic Landscape of Global Rabies: A Scoping Review and Future Directions.","authors":"Molly Selleck, Peter Koppes, Colin Jareb, Steven Shwiff, Lirong Liu, Stephanie A Shwiff","doi":"10.3390/tropicalmed10080222","DOIUrl":"10.3390/tropicalmed10080222","url":null,"abstract":"<p><p>Rabies remains a significant global public health concern, causing an estimated 59,000-69,000 human fatalities annually. Despite being entirely preventable through vaccination, rabies continues to impose substantial economic burdens worldwide. This study presents a scoping review of the economic research on rabies to determine overlaps and gaps in knowledge and inform future research strategies. We selected 150 studies (1973-2024) to analyze. The review categorizes the literature based on geographic distribution, species focus, and type of study. Findings indicate that economic studies are disproportionately concentrated in developed countries, such as the United States and parts of Europe, where rabies risk is low, while high-risk regions, particularly in Africa and Asia, remain underrepresented. Most studies focus on dog-mediated rabies, reflecting its dominant role in human transmission, while fewer studies assess the economic impacts of wildlife and livestock-mediated rabies. Case studies and modeling approaches dominate the literature, whereas cost-benefit and cost-effectiveness analyses-critical for informing resource allocation-are limited. The review highlights the need for more economic evaluations in rabies-endemic regions, expanded research on non-dog reservoirs, and broader use of economic methods. Addressing these gaps will be crucial for optimizing rabies control and supporting global initiatives to eliminate dog-mediated rabies by 2030.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970564","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":"High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study.","authors":"Waleed Attia Hassan, Haidi Karam-Allah Ramadan, Mona Gaber, Samia S Alkhalil, Alzahraa Abdelraouf Ahmad","doi":"10.3390/tropicalmed10080221","DOIUrl":"10.3390/tropicalmed10080221","url":null,"abstract":"<p><p>Triclabendazole (TCBZ) is the gold standard treatment for fascioliasis. However, reports on resistance are increasing, emphasizing the need for alternative therapy. Combining TCBZ with ivermectin (IVM) was found to be effective for treating animal fascioliasis. Building on this, we aimed to evaluate the efficacy of the TCBZ/IVM combination therapy for human fascioliasis. This study enrolled 136 patients with <i>Fasciola</i> from Upper Egypt, and they were divided into the first group (<i>n</i> = 65), who received TCBZ monotherapy, and the second group (<i>n</i> = 71), who received the TCBZ/IVM combination. Assessments were to evaluate treatment response based on clinical, eosinophilic, and radiological parameters. Chronic fasciolosis was diagnosed in 17 patients (12.5%). No differences were observed in age and sex. Significant improvements were noted in all parameters in both groups, with more pronounced effects observed in the second group. A significantly higher complete response, including clinical, eosinophilic, and radiological improvements, was reported in the combined therapy group, with 53.3% compared to 26.2% in the monotherapy group (<i>p</i> < 0.001). A high baseline eosinophilic count was significantly associated with response. The efficacy of the TCBZ/IVM combination for treating human fascioliasis suggested a possible boosting effect, which can benefit regions of TCBZ failure. Further large-scale randomized studies are warranted to confirm these findings.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970501","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 Approach to <i>Trypanosoma cruzi</i>: Serological and Molecular Detection in Owners and Dogs Living on Oceanic Islands and Seashore Mainland of Southern Brazil.","authors":"Júlia Iracema Moura Pacheco, Louise Bach Kmetiuk, Melissa Farias, Gustavo Gonçalves, Aaronson Ramathan Freitas, Leandro Meneguelli Biondo, Cristielin Alves de Paula, Ruana Renostro Delai, Cláudia Turra Pimpão, João Henrique Perotta, Rogério Giuffrida, Vamilton Alvares Santarém, Helio Langoni, Fabiano Borges Figueiredo, Alexander Welker Biondo, Ivan Roque de Barros Filho","doi":"10.3390/tropicalmed10080220","DOIUrl":"10.3390/tropicalmed10080220","url":null,"abstract":"<p><p>Via a One Health approach, this study concomitantly assessed the susceptibility of humans and dogs to <i>Trypanosoma cruzi</i> infections on three islands and in two mainland seashore areas of southern Brazil. Human serum samples were tested using an enzyme-linked immunosorbent assay (ELISA) to detect anti-<i>T. cruzi</i> antibodies, while dog serum samples were tested using indirect fluorescent antibodies in an immunofluorescence assay (IFA). Seropositive human and dog individuals were also tested using quantitative polymerase chain reaction (qPCR) in corresponding blood samples. Overall, 2/304 (0.6%) human and 1/292 dog samples tested seropositive for <i>T. cruzi</i> by ELISA and IFA, respectively, and these cases were also molecularly positive for <i>T. cruzi</i> by qPCR. Although a relatively low positivity rate was observed herein, these cases were likely autochthonous, and the individuals may have been infected as a consequence of isolated events of disturbance in the natural peridomicile areas nearby. Such a disturbance could come in the form of a fire or deforestation event, which can cause stress and parasitemia in wild reservoirs and, consequently, lead to positive triatomines. In conclusion, <i>T. cruzi</i> monitoring should always be conducted in suspicious areas to ensure a Chagas disease-free status over time. Further studies should also consider entomological and wildlife surveillance to fully capture the transmission and spread of <i>T. cruzi</i> on islands and in seashore mainland areas of Brazil and other endemic countries.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970463","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":"Evaluating the Metrics of Insecticide Resistance and Efficacy: Comparison of the CDC Bottle Bioassay with Formulated and Technical-Grade Insecticide and a Sentinel Cage Field Trial.","authors":"Deborah A Dritz, Mario Novelo, Sarah S Wheeler","doi":"10.3390/tropicalmed10080219","DOIUrl":"10.3390/tropicalmed10080219","url":null,"abstract":"<p><p>Insecticide resistance monitoring is essential for effective mosquito control. This study compared CDC Bottle Bioassays (BBAs) using technical and formulated insecticides (deltamethrin/Deltagard and malathion/Fyfanon EW) against the <i>Culex pipiens</i> complex (Fogg Rd) and <i>Culex tarsalis</i> Coquillett (Vic Fazio). BBAs indicated resistance to deltamethrin and emerging resistance to malathion in Fogg Rd, as well as resistance to both in Vic Fazio. Field trials, however, showed high efficacy: Deltagard caused 97.7% mortality in Fogg Rd and 99.4% in Vic Fazio. Fyfanon EW produced 100% mortality in Fogg Rd but only 47% in Vic Fazio. Extended BBA endpoints at 120 and 180 min aligned better with field outcomes. Deltagard achieved 100% mortality at 120 min in both populations; technical deltamethrin reached 85.7% (Fogg Rd) and 83.5% (Vic Fazio) at 180 min. Fyfanon EW and malathion showed similar performance: 100% mortality was achieved in Fogg Rd by 120 min but was lower in Vic Fazio; malathion reached 55%; and Fyfanon EW reached 58.6% by 180 min. Statistical analysis confirmed that BBAs using formulated products better reflected field performance, particularly when proprietary ingredients were involved. These findings support the use of formulated products and extended observation times in BBAs to improve operational relevance and resistance interpretation in addition to detecting levels of insecticide resistance.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970455","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 Intersection Between <i>Schistosoma mansoni</i> Infection and Dyslipidemia Modulates Inflammation in the Visceral Adipose Tissue of Swiss Webster Mice.","authors":"Thainá de Melo, Isadora do Monte Silveira Bruno, Luciana Brandão-Bezerra, Silvia Amaral Gonçalves da Silva, Christiane Leal Corrêa, Luciana Silva Rodrigues, José Roberto Machado-Silva, Renata Heisler Neves","doi":"10.3390/tropicalmed10080217","DOIUrl":"10.3390/tropicalmed10080217","url":null,"abstract":"<p><p><b>Background:</b> Dyslipidemia and schistosomiasis are major public health challenges, particularly in endemic regions where their coexistence may influence host metabolism and immune responses. This study aimed to evaluate visceral adipose tissue (AT) remodeling in a murine model of acute <i>Schistosoma mansoni</i> infection combined with diet-induced dyslipidemia. <b>Methodology:</b> Female Swiss Webster mice were fed either a standard or high-fat diet (HFD) for 29 weeks and infected with <i>S. mansoni</i> at week 20. Nine weeks after infection, biochemical, morphometric, histopathological, and immunological analyses were performed. <b>Results:</b> The HFD promoted weight gain and dyslipidemia, while <i>S. mansoni</i> infection alone did not alter lipid profiles but partially mitigated the metabolic effects of the HFD. Morphometric analysis revealed adipocyte hypertrophy and reduced cell number in HFD-fed animals. In HFD-fed infected mice, infection partially reversed hypertrophy, suggesting a modulatory effect on AT remodeling. Histopathological examinations showed that while a HFD induced mild inflammation, infection led to intense leukocyte infiltration, hyperemia, and plasma cell degeneration. Peritoneal lavage confirmed a proinflammatory immune profile. <b>Conclusions:</b> These findings indicate that the interaction between a HFD and <i>S. mansoni</i> infection exacerbates adipose tissue inflammation and metabolic alterations, highlighting the complex interplay between parasitic infection, diet, and immune-metabolic regulation.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970690","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":"Polyparasitic Infections: Associated Factors and Effect on the Haemoglobin Level of Children Living in Lambaréné Remote and Surrounding Rural Areas from Gabon-A Cross-Sectional Study.","authors":"Paul Alvyn Nguema-Moure, Bayode Romeo Adegbite, Moustapha Nzamba Maloum, Jean-Claude Dejon-Agobé, Roméo-Aimé Laclong Lontchi, Yabo Josiane Honkpehedji, Danny-Carrel Manfoumbi Mabicka, Christian Chassem-Lapue, Pavel Warry Sole, Stephane Ogoula, Fabrice Beral M'Baidigium, Jenny Mouloungui-Mavoungou, Michael Ramharter, Peter Gottfried Kremsner, Ayôla Akim Adegnika","doi":"10.3390/tropicalmed10080218","DOIUrl":"10.3390/tropicalmed10080218","url":null,"abstract":"<p><strong>Background: </strong>Polyparasitic infections remain widespread in endemic regions, yet its contributing factors and health impact are not well understood. This study aims to estimate the prevalence and associated factors and examines the effect of polyparasitic infection on haemoglobin levels among children.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Lambaréné, Gabon, among children aged 2-17 years from November 2019 to December 2020. Haemoglobin levels, environmental conditions, and sociodemographic data were collected. Stool, urine, and blood samples were analysed using light microscopy for parasite detection. Factors associated with polyparasitism were explored.</p><p><strong>Results: </strong>Out of 656 participants, 65.4% had at least one infection, with intestinal protozoa species (21.3%), <i>Trichuris trichiura</i> (33%), <i>Ascaris lumbricoides</i> (22%), <i>Schistosoma haematobium</i> (20%), and <i>Plasmodium falciparum</i> (10%) being the most common. Polyparasitic infection was identified in 26% of children, mostly as bi-infections (69.2%), and was negatively associated with haemoglobin levels (β = -0.06).</p><p><strong>Conclusions: </strong>These findings emphasise the burden of polyparasitic infections and adverse health effects in Lambaréné, Gabon.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970485","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":"Tuberculosis-Related Knowledge, Attitudes, and Practices Among Healthcare Workers in Atlantic Canada: A Descriptive Study.","authors":"Harold Joonkeun Oh, Moira A Law, Isdore Chola Shamputa","doi":"10.3390/tropicalmed10080214","DOIUrl":"10.3390/tropicalmed10080214","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the key role of healthcare workers (HCWs) in tuberculosis (TB) prevention and control, there is a lack of regional data on their knowledge, attitudes, and practices (KAPs) regarding the disease in Atlantic Canada.</p><p><strong>Objectives: </strong>To assess the KAPs of HCWs and identify targets for educational interventions to enhance TB care and control.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among HCWs in Atlantic Canada aged ≥19 years from October 2023 to February 2024. Participants were recruited via multiple channels such as social media, collegiate email lists, and snowball sampling. Survey data were collected using an online platform and analyzed using IBM SPSS Statistics v29. KAPs were assessed using Likert-type scales and internal consistency was evaluated using Cronbach's alpha.</p><p><strong>Results: </strong>A total of 157 HCWs participated in this study (age range: 19 to 69 years); most were women (<i>n</i> = 145, 92%), born in Canada (<i>n</i> = 134, 85.4%), with nearly three-quarters (<i>n</i> = 115, 73.2%) who had never lived outside of Canada. Study participants demonstrated moderately high knowledge <i>(M =</i> 29.32, <i>SD</i> = 3.25) and positive attitudes (<i>M</i> = 3.87, <i>SD</i> = 0.37) towards TB and strong practices (<i>M</i> = 4.24, <i>SD</i> = 0.69) in TB care; however, gaps were identified in HCW abilities to recognize less common TB symptoms (e.g., rash and nausea), as well as inconsistent practices in ventilation and pre-treatment initiation. Internal consistency analysis indicated suboptimal reliability across all three KAP domains, with Cronbach's alpha values falling below 0.7, thwarting further planned analyses.</p><p><strong>Conclusions: </strong>This study found overall moderate-to-strong TB-related KAPs among HCWs in Atlantic Canada; however, critical gaps in knowledge and practice were noted. This new information can now guide future educational initiatives and targeted training to enhance TB preparedness and ensure equitable care for patients in the region.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970719","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":"Patterns of Reverse Transcriptase Inhibitor Resistance Mutations in People Living with Human Immunodeficiency Virus in Libreville, Gabon.","authors":"Guy Francis Nzengui-Nzengui, Gaël Mourembou, Euloge Ibinga, Ayawa Claudine Kombila-Koumavor, Hervé M'boyis-Kamdem, Edmery Muriel Mpouho-Ntsougha, Alain Mombo-Mombo, Angélique Ndjoyi-Mbiguino","doi":"10.3390/tropicalmed10080216","DOIUrl":"10.3390/tropicalmed10080216","url":null,"abstract":"<p><p><b>Objective:</b> To characterize the profiles of resistance mutations to HIV reverse transcriptase inhibitors in Gabon. <b>Design:</b> Cross-sectional study conducted over 37 months, from October 2019 to October 2022, at the IST/HIV/AIDS Reference Laboratory, a reference center for the biological monitoring of people living with the human immunodeficiency virus (PWHIV) in Gabon. <b>Methods:</b> Plasma from 666 PWHIV receiving antiretroviral treatment was collected, followed by RNA extraction, amplification, and reverse transcriptase gene sequencing. Statistical analyses were performed using Stata^® 14.0 software (USA). <b>Results:</b> Six hundred and sixty-six (666) PWHIV plasma collected from 252 male and 414 female patients were analyzed and 1654 mutations were detected in 388 patients, including 849 (51.3%) associated with nucleoside reverse transcriptase inhibitors (NRTIs) and 805 (48.7%) with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Three of the most prescribed treatment regimens were associated to the appearance of both NRTIs and NNRTIs resistance mutations: TDF + 3TC + EFV (24.02%; 160/666); TDF + FTC + EFV) (17.2%; 114/666) and AZT + 3TC + EFV (14.6%; 97/666). Additionally, stage 3 of CD4 T-lymphocyte deficiency, the higher viral load, and treatment duration are risk factors influencing the appearance of virus mutations. Also, treatment containing TDF-3TC + DTG is more protective against mutations. <b>Conclusions:</b> Drug resistance mutations are common in Gabon and compromise the efficacy of ART. Further study must search for other causes of therapeutic failure in Gabon in PWHIV.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970451","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 Impact of a Community Pharmacy-Led Deworming-Related Counselling Service: An Interventional Study in a Low-to-Middle Income Country.","authors":"Amira B Kassem, Ahmad Z Al Meslamani, Mohamed AbdElrahman, Nadia Al Mazrouei, Sherouk M Okda, Noha A El-Bassiouny, Asmaa Abdel-Hamed Hamedo, Doaa Abdelrazek Shaban, Dina Fathy Elsmadessy, Ammena Y Binsaleh, Asmaa Saleh, Hebatallah Ahmed Mohamed Moustafa","doi":"10.3390/tropicalmed10080215","DOIUrl":"10.3390/tropicalmed10080215","url":null,"abstract":"<p><p><b>Background:</b> Since the current increase in antimicrobial resistance globally, parasitic infectious diseases have become a greater public health crisis than ever before and an absolute priority. The Egyptian community pharmacist, as a health care provider and advisor, has a potential role to play in deworming. <b>Objective</b>: To evaluate the outcomes of community pharmacist-led deworming-related counseling services. <b>Methods:</b> A prospective randomized controlled study was conducted in Damanhur, Behera, Egypt. The intervention group received community pharmacy counseling, and the control group received the usual care. Both groups were monitored for 12 months for recurrence evaluation. <b>Results:</b> A total of 173 patients were included, of whom 96 (55.5%) received patient counseling. The types of infection included <i>Oxyuris</i> (44.5%), <i>Entamoeba histolytica</i> (28.9%), Ascaris (8.7%), <i>Entamoeba Cyst</i> (8.7%), <i>Giardiasis</i> (4.6%), <i>Schistosomiasis</i> (2.9%), and <i>pinworm</i> (1.7%). A total of 119 participants (68.8%) reported a need for dose repetition. Personal hygiene practices were reported by 71 participants (41%). Recurrence of infection was observed in 101 cases (58.4%). Patient counseling was significantly associated with lower recurrence rates and higher rates of personal hygiene application (<i>p</i> < 0.001). Multivariate logistic regression analysis revealed that patient counseling and personal hygiene measures were the only significant predictors of infection recurrence rate. <b>Conclusions:</b> Community pharmacists' deworming-related counseling had positive behavioral and clinical outcomes.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970605","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}