Tropical Medicine and Infectious Disease最新文献

{"title":"One Health Lens on Rabies: Human-Bat Interactions and Genomic Insights of Rabies Virus in Rural Lilongwe, Malawi.","authors":"Nathan Singano, Henson Kainga, Elisha Chatanga, Joseph Nkhoma, Gilson Njunga, Julius Chulu, Rabecca Tembo, Hirofumi Sawa, Walter Muleya","doi":"10.3390/tropicalmed10040095","DOIUrl":"10.3390/tropicalmed10040095","url":null,"abstract":"<p><p>Rabies, a fatal zoonotic disease, affects humans, domestic animals, and wildlife predominantly in Africa, Asia, and Latin America. In Malawi, rabies virus (RABV) is primarily transmitted by infected dogs, impacting humans and cattle. Lyssavirus has also been documented in insectivorous bats. A community survey near bat roosts assessed knowledge, attitudes, and practices regarding bat-borne zoonoses. Bat samples were tested for lyssavirus using RT-PCR, and RABV genomes from humans and domestic animals were sequenced and analysed phylogenetically. The survey revealed that 50% of participants consumed bat meat, and 47% reported bats entering their homes. Reduced bat presence indoors significantly lowered contact risk (aOR: 0.075, <i>p</i> = 0.021). All 23 bat samples tested negative for lyssavirus. Malawian RABV genomes, 11,801 nucleotides long, belonged to the Africa 1b lineage, showing >95% similarity with GenBank sequences. Phylogenetic analysis indicated close clustering with strains from Tanzania, Zimbabwe, and South Africa. Human and cattle strains shared 99% and 92% amino acid similarity with dog strains, respectively, with conserved critical sites and unique substitutions across all five RABV genes. Frequent human-bat interactions pose zoonotic risks. While no lyssavirus was detected in bats, ongoing surveillance is crucial. This first comprehensive genome analysis of Malawian RABVs highlights their regional transmission and signifies the need for regional collaboration in rabies control, community education, and further study of genetic adaptations.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039644","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":"Baseline Seroprevalence of Arboviruses in Liberia Using a Multiplex IgG Immunoassay.","authors":"Albert To, Varney M Kamara, Davidetta M Tekah, Mohammed A Jalloh, Salematu B Kamara, Teri Ann S Wong, Aquena H Ball, Ludwig I Mayerlen, Kyle M Ishikawa, Hyeong Jun Ahn, Bode Shobayo, Julius Teahton, Brien K Haun, Wei-Kung Wang, John M Berestecky, Vivek R Nerurkar, Peter S Humphrey, Axel T Lehrer","doi":"10.3390/tropicalmed10040092","DOIUrl":"https://doi.org/10.3390/tropicalmed10040092","url":null,"abstract":"<p><p>Insect-borne viruses may account for a significant proportion of non-malaria and non-bacterial febrile illnesses in Liberia. Although the presence of many arthropod vectors has been documented, the collective burden of arbovirus infections and baseline pre-existing immunity remains enigmatic. Our goal was to determine the seroprevalence of arbovirus exposure across the country using a resource-sparing, multiplex immunoassay to determine IgG responses to immunodominant antigens. 532 human serum samples, from healthy adults, collected from 10 counties across Liberia, were measured for IgG reactivity against antigens of eight common flavi-, alpha-, and orthobunya/nairoviruses suspected to be present in West Africa. Approximately 32.5% of our samples were reactive to alphavirus (CHIKV) E2, ~7% were reactive separately to West Nile (WNV) and Zika virus (ZIKV) NS1, while 4.3 and 3.2% were reactive to Rift Valley Fever virus (RVFV) N and Dengue virus-2 (DENV-2) NS1, respectively. Altogether, 21.6% of our samples were reactive to ≥1 flavivirus NS1s. Of the CHIKV E2 reactive samples, 8.5% were also reactive to at least one flavivirus NS1, and six samples were concurrently reactive to antigens of all three arbovirus groups, suggesting a high burden of multiple arbovirus infections for some participants. These insights suggest the presence of these four arbovirus families in Liberia with low and moderate rates of flavi- and alphavirus infections, respectively, in healthy adults. Further confirmational investigation, such as mosquito surveillance or other serological tests, is warranted and should be conducted before initiating additional flavivirus vaccination campaigns. The findings of these studies can help guide healthcare resource mobilization, vector control, and animal husbandry practices.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029783","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":"Combating Malaria: Targeting the Ubiquitin-Proteasome System to Conquer Drug Resistance.","authors":"Bazgha Sanaullah, Nguyen Van Truong, Tuyet-Kha Nguyen, Eun-Taek Han","doi":"10.3390/tropicalmed10040094","DOIUrl":"https://doi.org/10.3390/tropicalmed10040094","url":null,"abstract":"<p><p>Malaria primarily affects developing nations and is one of the most destructive and pervasive tropical parasite infections. Antimalarial drug resistance, characterized by a parasite's ability to survive and reproduce despite recommended medication doses, poses a significant challenge. Along with resistance to antimalarial drugs, the rate of mutation a parasite undergoes, overall parasite load, drug potency, adherence to treatment, dosing accuracy, drug bioavailability, and the presence of poor-quality counterfeit drugs are some of the contributing factors that elicit opposition to treatment. The ubiquitin-proteasome system (UPS) has become a promising drug target for malaria because of its central importance in the parasite's life cycle and its contribution to artemisinin resistance. Polymorphisms in the Kelch13 gene of <i>Plasmodium falciparum</i> are the best-known markers for artemisinin resistance and are associated with a highly active UPS. Certain proteasome inhibitors, which are the other key players of the UPS, have demonstrated activity against malarial parasites and the ability to work with artemisinin. This work describes how, through targeting the UPS, the greater effectiveness of antimalarial drugs-especially where there is strong resistance-can be achieved, which contributes to overcoming the drug resistance phenomenon in malaria.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016896","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":"Leveraging Artificial Intelligence to Predict Potential TB Hotspots at the Community Level in Bangui, Republic of Central Africa.","authors":"Kobto G Koura, Sumbul Hashmi, Sonia Menon, Hervé G Gando, Aziz K Yamodo, Anne-Laure Budts, Vincent Meurrens, Saint-Cyr S Koyato Lapelou, Olivia B Mbitikon, Matthys Potgieter, Caroline Van Cauwelaert","doi":"10.3390/tropicalmed10040093","DOIUrl":"https://doi.org/10.3390/tropicalmed10040093","url":null,"abstract":"<p><p>Tuberculosis (TB) is a global health challenge, particularly in the Central African Republic (CAR), which is classified as a high TB burden country. In the CAR, factors like poverty, limited healthcare access, high HIV prevalence, malnutrition, inadequate sanitation, low measles vaccination coverage, and conflict-driven crowded living conditions elevate TB risk. Improved AI-driven surveillance is hypothesized to address under-reporting and underdiagnosis. Therefore, we created an epidemiological digital representation of TB in Bangui by employing passive data collection, spatial analysis using a 100 × 100 m grid, and mapping TB treatment services. Our approach included estimating undiagnosed TB cases through the integration of TB incidence, notification rates, and diagnostic data. High-resolution predictions are achieved by subdividing the area into smaller units while considering influencing variables within the Bayesian model. By designating moderate and high-risk hotspots, the model highlighted the potential for precise resource allocation in TB control. The strength of our model lies in its adaptability to overcome challenges, although this may have been to the detriment of precision in some areas. Research is envisioned to evaluate the model's accuracy, and future research should consider exploring the integration of multidrug-resistant TB within the model.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039857","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":"Strongyloidiasis Treatment Outcomes: A Prospective Study Using Serological and Molecular Methods.","authors":"Ana Lucas Dato, Philip Wikman-Jorgensen, José María Saugar Cruz, Elisa García-Vázquez, Jara Llenas-García","doi":"10.3390/tropicalmed10040091","DOIUrl":"https://doi.org/10.3390/tropicalmed10040091","url":null,"abstract":"<p><p>Strongyloidiasis, caused by the soil-transmitted helminth <i>Strongyloides stercoralis</i>, is estimated to infect around 600 million people worldwide. Ivermectin is the current first-line treatment. This prospective study evaluated long-term treatment response in patients with chronic strongyloidiasis. Conducted from 2019 to 2022 at Vega Baja Hospital in Alicante, Spain, this study enrolled 28 patients diagnosed with <i>S. stercoralis</i> infection. Patients received ivermectin at a dosage of 200 mcg/kg for one or two days and were followed for at least 12 months, with evaluations at 3, 6, 12, and 18 months post-treatment. Assessments included hemogram, IgE, <i>Strongyloides</i> serology, larvae culture and direct visualization and <i>Strongyloides</i> PCR in stool. Twenty-three patients completed at least 12 months of follow-up. Twenty-one patients (91.3%) achieved treatment response. Two patients (8.6%) experienced parasitological treatment failure, with detectable <i>Strongyloides stercoralis</i> DNA during follow-up. Ivermectin is highly effective in treating strongyloidiasis, with serology aiding in monitoring treatment efficacy. However, PCR detected an additional case of persistent infection, underscoring its complementary role.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983155","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":"Building Pathogen Genomic Sequencing Capacity in Africa: Centre for Epidemic Response and Innovation Fellowship.","authors":"Eric Agboli, Molalegne Bitew, Christian N Malaka, Tiangay M P S Kallon, Alhaji M S Jalloh, Baron Yankonde, Doreen M Shempela, Jay F M Sikalima, Mutale Joseph, Mpanga Kasonde, Feleke M Demeke, Ayemfouo F I Valdese, Lele B Grace, Godwe Célestin, Ana Papkiauri, Sado Y F Berlange, Janet Majanja, Vane K Omwenga, Evalyne N Wambugu, Samuel M Kariuki, Alex A Mwanyongo, Ubheeram Jaykissen, Caroline Abanto Alvarez, Seyni Ndiaye, Benjamin Moswane, Ester K Adamson, Mariam Makange, Luka Sote, Ibrahimm Mugerwa, Julius Sseruyange, Patrick Semanda, Brian A Kagurusi, Abdualmoniem O Musa, Kourush Fassihi, Lavanya Singh, Monika Moir","doi":"10.3390/tropicalmed10040090","DOIUrl":"https://doi.org/10.3390/tropicalmed10040090","url":null,"abstract":"<p><p>The World Health Organization African region has the greatest infectious disease burden in the world. However, many African countries have limited capacity to rapidly detect, report, and respond to public health events. The Centre for Epidemic Response and Innovation (CERI), KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) in South Africa, and global Climate Amplified Diseases and Epidemics (CLIMADE) consortium are investing in building the capacity of African scientists in pathogen genomics and bioinformatics. A two-week long (11-21 April 2023) intensive training in wet-laboratory genomic data production, bioinformatics, and phylogenetic analyses of viral and bacterial pathogens was held in Cape Town, South Africa. Training was provided to 36 fellows with diverse backgrounds from 16 countries, 14 of which were low- and middle-income African countries. In this report, we, the fellows, share our collective experiences and describe how the learnt skills have been integrated into the operations of our home institutions to advance genomic surveillance capabilities. We identified the in-person and hands-on learning format of the training, taught by genomics experts and field application specialists, as the most impactful elements of this training event. Adaptation and miniaturisation of protocols to detect other pathogens is a great enhancement over the traditional method of using a single protocol for a pathogen. We note the duration of the training as the largest limiting factor, particularly for the computationally intensive bioinformatics sessions. We recommend this programme continue to build pathogen genomics capacity in Africa.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050250","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":"A Narrative Review on the Prevalence of <i>Plasmodium falciparum</i> Resistance Mutations to Antimalarial Drugs in Rwanda.","authors":"Muharib Alruwaili, Abozer Elderdery, Emad Manni, Jeremy Mills","doi":"10.3390/tropicalmed10040089","DOIUrl":"https://doi.org/10.3390/tropicalmed10040089","url":null,"abstract":"<p><p>Malaria has been and remains a significant challenge in Africa and other endemic settings. Roughly, 95% of global morbidity and mortality due to malaria occurs within African populations and affects millions of individuals, especially those living in sub-Saharan countries, predominantly due to disease complications. Cultural factors such as unawareness of and disinterest in using recommended preventive tools and combating the primary host (i.e., the female Anopheles mosquito) play a significant role. This host transmits the malaria-causing <i>Plasmodium</i> parasite by biting an infected individual and spreading it to humans. The current overview focuses on the molecular markers associated with antimalarial drug resistance in <i>Plasmodium falciparum</i> (<i>P. falciparum</i>) in Rwanda, considered an exemplar of sub-Saharan countries where malaria is prevalent and effective policies on the development of malaria treatment, approved recently by WHO in 2025, have been adopted. The prevalence of mutations in key resistance genes, including <i>pfcrt</i>, <i>pfmdr1</i>, and <i>pfdhfr/pfdhps</i>, are linked to resistance against common antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine (SP). In addition, the <i>Plasmodium falciparum</i> kelch13 (<i>pfk13</i>) gene is linked to resistance against artemisinin, as its mutations can cause delayed parasite clearance and treatment failure. Despite changes in therapeutic use policies owing to high prevalence of variant alleles, which reduce the drug's efficacy resistance to SP, the gene persists in Rwanda. Malaria parasites are becoming more resistant to chloroquine, leading to diminished effectiveness and slower recovery or treatment failure. Surveillance data reported from several studies provide crucial insights into the evolving trends of resistance markers and are vital for guiding treatment protocols and informing therapeutic use policy decisions. It is important that we continue to maintain and develop the effectiveness of malaria prevention strategies and treatments, due to the multiple types of resistance found in the population.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051636","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":"Epidemiological Scenario of American Trypanosomiasis and Its Socioeconomic and Environmental Relations, Pará, Eastern Brazilian Amazon.","authors":"Claudia do Socorro Carvalho Miranda, Bruna Costa de Souza, Tainara Carvalho Garcia Miranda Filgueiras, João Simão de Melo Neto, Amanda Sophia Carvalho Miranda da Silva, Hilton Pereira da Silva, Marcos Valério Santos da Silva, Frederico Itã Mateus Carvalho Oliveira Miranda, Edilene do Socorro Nascimento Falcão Sarges, Sérgio Luiz Althoff, Selma Kazumi da Trindade Noguchi, Nelson Veiga Gonçalves","doi":"10.3390/tropicalmed10040088","DOIUrl":"https://doi.org/10.3390/tropicalmed10040088","url":null,"abstract":"<p><p>Chagas disease is a serious public health problem worldwide. In Brazil, the state of Pará has the largest number of reported cases. This article analyzes the spatial distribution of this disease and its relationship with socioeconomic, environmental, and public policy health variables in three mesoregions in the Pará state from 2013 to 2022. This ecological study used secondary data obtained from official Brazilian agencies. Spatial analysis was carried out using the flow, kernel, and bivariate global Moran techniques expressed in thematic maps. A total of 3664 cases of the disease were confirmed, with the highest number of cases being reported in the northeast of Pará. A seasonal pattern of the disease, an epidemiological profile similar to other diseases in the Amazon region, and the spatial dependence between the disease prevalence and socioeconomic indicators were observed. The most intense movement of patients for treatment was to the Belém metropolitan mesoregion, which has the majority of the health services and professionals. The disease showed an inhomogeneous pattern of cases in terms of the spatial distribution, with a direct relationship between areas with a higher number of cases and those with human clusters. The socioenvironmental origins of the disease transcend mesoregion boundaries and stem from the historically unsustainable development model in the Amazon.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038743","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":"Assessing Insect Growth Regulator Resistance Using Bioassays: A Systematic Review and Meta-Analysis of Methoprene and Pyriproxyfen Inhibition of Emergence in Three Vector Mosquito Species.","authors":"Mark E Clifton, Kristina Lopez","doi":"10.3390/tropicalmed10040087","DOIUrl":"https://doi.org/10.3390/tropicalmed10040087","url":null,"abstract":"<p><p>This systematic review and meta-analysis aims to: (1) characterize the distribution of published inhibition of emergence (IE₅₀, IE₉₀, and IE₉₅) reference values for pyriproxyfen and methoprene in <i>Culex pipiens</i> [L.], <i>Aedes aegypti</i> [L.], and <i>Aedes albopictus</i> [Skuse]; (2) generate combined-effect IE values using a DerSimonian and Laird (DL) random-effects model to establish benchmarks for future resistance assessments; and (3) compare these combined-effect IE values with previously published literature. A systematic search was conducted in PubMed, SciELO, J-STAGE, and Google Scholar up to 10 February 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were primary, peer-reviewed literature that aligned with World Health Organization (WHO) protocols for insect growth regulator (IGR) resistance testing, specifically those reporting susceptible reference IE values from continuous immersion dose-response bioassays analyzed using probit regression. A total of 72 unique studies that aligned with WHO protocols were assessed for publication bias using a funnel plot and Egger's regression. Sensitivity and subgroup analyses were conducted to evaluate individual study contributions to the overall combined effect. Heterogeneity (I²) and combined effect values were estimated for 18 different species/active ingredient/IE concentration subgroup pairings. Heterogeneity (I²) ranged from 29.32 to 99.78% between the 18 subgroups, indicating inconsistency within the literature. The DL combined effect IE₅₀ varied from 0.048 ppb for <i>Cx. pipiens</i> exposed to pyriproxyfen to 1.818 ppb for <i>Ae. albopictus</i> exposed to methoprene. A certainty analysis indicated that 1 combined effect value exhibited high certainty, 8 out of 18 pairings were moderately certain, 6 exhibited low certainty and 3 exhibited very low certainty. The main causes of uncertainty (ranked) were inconsistency between studies, imprecision of the combined effect size, and possible publication bias. Our findings indicate that (1) robust DL combined effect IE₅₀ values could be established for all species/IGR pairings, providing essential benchmarks for future resistance assessments; (2) substantial heterogeneity among susceptible laboratory colonies complicates resistance detection in field-collected mosquitoes; and (3) a significant portion of the literature relies on reference mosquito strains that are likely not fully susceptible, further complicating resistance detection. This study was not registered and was supported by the North Shore Mosquito Abatement District.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040076","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":"Neonatal Mucormycosis: A Rare but Highly Lethal Fungal Infection in Term and Preterm Newborns-A 20-Year Systematic Review.","authors":"Alfredo Valdez-Martinez, Mónica Ingrid Santoyo-Alejandre, Roberto Arenas, Claudia Erika Fuentes-Venado, Tito Ramírez-Lozada, Fernando Bastida-González, Claudia Camelia Calzada-Mendoza, Erick Martínez-Herrera, Rodolfo Pinto-Almazán","doi":"10.3390/tropicalmed10040086","DOIUrl":"https://doi.org/10.3390/tropicalmed10040086","url":null,"abstract":"<p><strong>Background/objectives: </strong>Mucormycosis is a rare but life-threatening fungal infection, particularly in neonates, due to their undeveloped immune system. This systematic review aims to analyze the risk factors, clinical presentations, treatments, and outcomes of neonatal mucormycosis reported between 2004 and 2024.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Scopus, and Web of Science following PRISMA guidelines. Only studies reporting cases of mucormycosis in neonates (≤28 days old) were included. Data on risk factors, clinical features, diagnostic methods, antifungal therapies, surgical interventions, and outcomes were extracted and analyzed.</p><p><strong>Results: </strong>A total of 44 studies met the inclusion criteria, comprising 61 neonatal cases. The most common clinical presentations were gastrointestinal (n = 39), cutaneous (n = 19), rhino-orbito-cerebral (n = 2), and disseminated mucormycosis (n = 1). Diagnosis was primarily based on histopathology (93.4%) and fungal culture (26.2%). The main antifungal treatment was liposomal amphotericin B (63.9%), often combined with surgical debridement (60.6%). Mortality rates remained high (47.5%), particularly in cases of prematurely extreme neonates with angioinvasive disease or delayed diagnosis.</p><p><strong>Conclusions: </strong>Neonatal mucormycosis remains a severe condition with high morbidity and mortality. Early diagnosis through a combination of clinical suspicion and laboratory confirmation, along with prompt antifungal therapy and surgical management, apparently is crucial for improving outcomes. Further studies are needed to optimize treatment strategies and improve neonatal survival.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046854","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}