Tropical Medicine and Infectious Disease最新文献

{"title":"Eleven-Year Report of High Number of Diphtheria Cases in Children in East Java Province, Indonesia.","authors":"Dominicus Husada, Yustika Hartini, Kalista Wahyu Nuringhati, Sandy Grace Tindage, Rahma Ira Mustikasari, Leny Kartina, Dwiyanti Puspitasari, Parwati S Basuki, Ismoedijanto Moedjito, Zumaroh Zumaroh, Hugeng Susanto, Wahyu Wulandari, Sulvy Dwi Anggraini, Erwin Astha Triyono","doi":"10.3390/tropicalmed9090204","DOIUrl":"https://doi.org/10.3390/tropicalmed9090204","url":null,"abstract":"<p><p>A high incidence of diphtheria cases in children in East Java province, Indonesia, has been observed since the beginning of this century. Despite many efforts, the outbreaks continue. This study aims to explain the high incidence of diphtheria in children in East Java province since 2013. This cross-sectional surveillance report-based study used data from 38 districts in East Java since 1 January 2013. Collected data included demographics, clinical information, additional examinations, immunization history, and close contact management. Over eleven years, there were 4009 diphtheria patients, of whom 2921 (72.86%) were under 18 years of age. Boys (59.77%) outnumbered girls, and the most common age category was >60-144 months (51.66%). Most cases had incomplete or zero immunization (76.16%). Tonsillopharyngeal diphtheria was the most common type (69.60%). The five top districts with the most cases were Surabaya, Sidoarjo, Kabupaten Blitar, Kota Malang, and Kabupaten Malang. The eleven-year case fatality rate (CFR) was 2.36% (69/2921). This study shows that diphtheria cases in children and adolescents in East Java have consistently been high, and low immunization coverage might still be the leading cause. There has also been a shift in the district distribution. Diphtheria outbreaks require complete and sustainable efforts, not just outbreak response immunizations.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354658","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":"Detection of Genes Related to Antibiotic Resistance in <i>Leptospira</i>.","authors":"Santiago Pineda, Juliana María Martínez Garro, Jorge Emilio Salazar Flórez, Sergio Agudelo-Pérez, Fernando P Monroy, Ronald Guillermo Peláez Sánchez","doi":"10.3390/tropicalmed9090203","DOIUrl":"https://doi.org/10.3390/tropicalmed9090203","url":null,"abstract":"<p><p>Leptospirosis is a disease caused by the bacteria of the <i>Leptospira</i> genus, which can usually be acquired by humans through contact with urine from infected animals; it is also possible for this urine to contaminate soils and bodies of water. The disease can have deadly consequences in some extreme cases. Fortunately, until now, patients with leptospirosis have responded adequately to treatment with doxycycline and azithromycin, and no cases of antibiotic resistance have been reported. However, with the extensive use of such medications, more bacteria, such as <i>Staphylococci</i> and <i>Enterococci,</i> are becoming resistant. The purpose of this study is to determine the presence of genes related to antibiotic resistance in the <i>Leptospira</i> genus using bioinformatic tools, which have not been undertaken in the past. Whole genomes from the 69 described <i>Leptospira</i> species were downloaded from NCBI's GeneBank and analyzed using CARD (The Comprehensive Antibiotic Resistant Database) and RAST (Rapid Annotations using Subsystem Technology). After a detailed genomic search, 12 genes associated with four mechanisms were found: resistance to beta-lactamases, vancomycin, aminoglycoside adenylyltransferases, as well as multiple drug efflux pumps. Some of these genes are highly polymorphic among different species, and some of them are present in multiple copies in the same species. In conclusion, this study provides evidence of the presence of genes related to antibiotic resistance in the genomes of some species of the genus <i>Leptospira</i>, and it is the starting point for future experimental evaluation to determine whether these genes are transcriptionally active in some species and serovars.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354642","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":"Factors Contributing to In-Hospital Mortality in Dengue: Insights from National Surveillance Data in Mexico (2020-2024).","authors":"Eder Fernando Ríos-Bracamontes, Oliver Mendoza-Cano, Agustin Lugo-Radillo, Ana Daniela Ortega-Ramírez, Efrén Murillo-Zamora","doi":"10.3390/tropicalmed9090202","DOIUrl":"https://doi.org/10.3390/tropicalmed9090202","url":null,"abstract":"<p><p>This study aimed to identify the factors associated with all-cause in-hospital mortality in laboratory-confirmed dengue cases from 2020 to mid-2024. A nationwide retrospective cohort study was conducted in Mexico and data from 18,436 participants were analyzed. Risk ratios (RRs) and 95% confidence intervals (CIs), estimated using generalized linear regression models, were used to evaluate the factors associated with all-cause in-hospital mortality risk. The overall case-fatality rate was 17.5 per 1000. In the multiple model, compared to dengue virus (DENV) 1 infections, DENV-2 (RR = 1.81, 95% CI 1.15-2.86) and DENV-3 (RR = 1.87, 95% CI 1.19-2.92) were associated with increased mortality risk. Patient characteristics, such as increasing age (RR = 1.02, 95% CI 1.01-1.03), type 2 diabetes mellitus (RR = 2.07, 95% CI 1.45-2.96), and chronic kidney disease (RR = 3.35, 95% CI 2.03-5.51), were also associated with an increased risk of a fatal outcome. We documented the influence of both the virus and individual susceptibility on mortality risk, underscoring the need for a comprehensive public health strategy for dengue.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354661","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":"Spotlight on Leishmaniasis Research: Insights from the Special Issue \"Emerging Topics in Leishmaniasis Research\".","authors":"Sandra Regina Maruyama","doi":"10.3390/tropicalmed9090200","DOIUrl":"https://doi.org/10.3390/tropicalmed9090200","url":null,"abstract":"<p><p>Leishmaniases, caused by dixenous trypanosomatids from the Leishmaniinae subfamily (over 20 <i>Leishmania</i> species), manifest in three primary clinical forms: visceral (VL), cutaneous (CL), and mucocutaneous (MCL) [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354670","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":"Suitable Mouse Model to Study Dynamics of West Nile Virus Infection in <i>Culex quinquefasciatus</i> Mosquitoes.","authors":"Lívia Baldon, Silvana de Mendonça, Ellen Santos, Bruno Marçal, Amanda Cupertino de Freitas, Fernanda Rezende, Rafaela Moreira, Viviane Sousa, Sara Comini, Mariana Lima, Flávia Ferreira, João Paulo de Almeida, Emanuele Silva, Siad Amadou, Marcele Rocha, Thiago Leite, Yaovi Todjro, Camila de Carvalho, Viviane Santos, Marta Giovanetti, Luiz Alcantara, Luciano A Moreira, Alvaro Ferreira","doi":"10.3390/tropicalmed9090201","DOIUrl":"https://doi.org/10.3390/tropicalmed9090201","url":null,"abstract":"<p><p>West Nile Virus (WNV) poses a significant global public health threat as a mosquito-borne pathogen. While laboratory mouse models have historically played a crucial role in understanding virus biology, recent research has focused on utilizing immunocompromised models to study arboviruses like dengue and Zika viruses, particularly their interactions with <i>Aedes aegypti</i> mosquitoes. However, there has been a shortage of suitable mouse models for investigating WNV and St. Louis encephalitis virus interactions with their primary vectors, <i>Culex</i> spp. mosquitoes. Here, we establish the AG129 mouse (IFN α/β/γ R^-/-) as an effective vertebrate model for examining mosquito-WNV interactions. Following intraperitoneal injection, AG129 mice exhibited transient viremia lasting several days, peaking on the second or third day post-infection, which is sufficient to infect <i>Culex quinquefasciatus</i> mosquitoes during a blood meal. We also observed WNV replication in the midgut and dissemination to other tissues, including the fat body, in infected mosquitoes. Notably, infectious virions were present in the saliva of a viremic AG129 mouse 16 days post-exposure, indicating successful transmission capacity. These findings highlight the utility of AG129 mice for studying vector competence and WNV-mosquito interactions.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354671","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":"Mixed Methods Evaluation of a Youth-Friendly Clinic for Young People Living with HIV Transitioning from Pediatric Care.","authors":"Hannah Chew, Kemberlee Bonnet, David Schlundt, Nina Hill, Leslie Pierce, Aima Ahonkhai, Neerav Desai","doi":"10.3390/tropicalmed9090198","DOIUrl":"https://doi.org/10.3390/tropicalmed9090198","url":null,"abstract":"<p><p>(1) Background: Adolescents and young adults face challenges when transitioning to adult care due to emerging adulthood and changing providers and insurance. Young people living with HIV (YPLHIV) have additional obstacles with mental health and stigma. During transition, only 55% of YPLHIV are retained in care, and 65% are virally suppressed. To address these challenges, the Adolescent and Young Adult Health Care Transition Clinic (AYAHCTC) was created at Vanderbilt University Medical Center in 2017. This mixed methods study evaluates the initial cohort and solicits YPLHIVs' perspectives on transition barriers and facilitators. (2) Methods: Quantitative analyses (n = 21) characterized patients' demographics, clinical engagement, and retention. Qualitative interviews (n = 5) captured patients' transition experiences. (3) Results: This study, conducted in the Southeastern USA, included a cohort where 47.6% were born abroad, with all participants being US citizens by birth or naturalization. Patients' mean age at first visit was 19.6 years. The average AYAHCTC duration was 2.21 years. First-year engagement and retention were 100% and 95.5%, respectively. Viral suppression rates improved from 66.7% at the first visit to 81.0% at the last visit. Eleven patients transitioned out of AYAHCTC. Qualitative analyses indicate that barriers to transition include leaving trusted providers, reduced parental guidance, developing autonomy, and perceived loss of confidentiality in adult clinic environment. Transition was facilitated by youth-friendly services, clear communication, and strong relationships with AYAHCTC providers. (4) Conclusions: YPLHIV positively viewed AYAHCTC experiences. Future directions include optimizing services to build YPLHIVs' independence, supporting YPLHIV experiencing stigma, assuaging concerns about switching providers, collaborating with adult clinics to maintain confidentiality, and designing interventions focused on adherence during transition.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354662","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":"Comparative Genomic Analysis of <i>Mycobacterium tuberculosis</i> Isolates Circulating in North Santander, Colombia.","authors":"Diana Patricia Bohada-Lizarazo, Karen Dayana Bravo-Sanabria, Paola Cárdenas-Malpica, Raúl Rodríguez","doi":"10.3390/tropicalmed9090197","DOIUrl":"https://doi.org/10.3390/tropicalmed9090197","url":null,"abstract":"<p><p>Tuberculosis (TB) is an important infectious disease in relation to global public health and is caused species of the <i>Mycobacterium tuberculosis</i> complex (MTBC). In this study, we used whole-genome sequencing (WGS) and comparative genomics to investigate the genetic diversity of <i>M. tuberculosis</i> (<i>Mtb</i>) isolates circulating in North Santander (NS), Colombia. WGS was used for the phylogenetic and lineage characterization of 18 isolates of <i>Mtb</i> typed with orphan genotypes from 11 municipalities of NS between 2015 and 2018. The isolates studied were included in six sublineages from L4; the most frequent were 4.1.2.1, 4.3.3, and 4.3.4.2, corresponding to a proportion of 22.2%. The genome analysis conducted allowed the identification of a set of genetic variants mainly associated with determinants of virulence and evasion of the immune system (<i>PPE34</i> and <i>PE_PGRS2</i>); adaptation and survival (<i>PGL/p-HBAD</i>); stress response (<i>sigJ</i> and <i>sigM</i>); geographic variability (<i>PPE34</i>); and carbohydrate and lipid metabolism (<i>aldA</i>, <i>rocA</i>, and <i>cyp144</i>). This is the first description of the molecular epidemiology of <i>Mtb</i> isolates circulating in NS achieved through WGS. It was possible to perform comparative genomics analyses between <i>Mtb</i> isolates against the universal reference H37Rv and Colombian UT205 genome, which can help us to understand the local genetic diversity and is relevant for epidemiological studies, providing insight into TB transmission dynamics in NS.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354640","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":"Diagnosis and Management of Neonatal Bacterial Sepsis: Current Challenges and Future Perspectives.","authors":"Domenico Umberto De Rose, Maria Paola Ronchetti, Ludovica Martini, Jole Rechichi, Marco Iannetta, Andrea Dotta, Cinzia Auriti","doi":"10.3390/tropicalmed9090199","DOIUrl":"https://doi.org/10.3390/tropicalmed9090199","url":null,"abstract":"<p><p>Sepsis remains the second cause of death among neonates after the pathological consequences of extreme prematurity. In this review we summarized knowledge about pathogens causing early-onset sepsis (EOS) and late-onset sepsis (LOS), the role of perinatal risk factors in determining the EOS risk, and the tools used to reduce unnecessary antibiotics. New molecular assays could improve the accuracy of standard blood cultures, providing the opportunity for a quick and sensitive tool. Different sepsis criteria and biomarkers are available to date, but further research is needed to guide the use of antibiotics according to these tools. Beyond the historical antibiotic regimens in EOS and LOS episodes, antibiotics should be based on the local flora and promptly modulated if specific pathogens are identified. The possibility of an antibiotic lock therapy for central venous catheters should be further investigated. In the near future, artificial intelligence could help us to personalize treatments and reduce the increasing trend of multidrug-resistant bacteria.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354643","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":"Do <i>Babesia microti</i> Hosts Share a Blood Group System Gene Ortholog, Which Could Generate an Erythrocyte Antigen That Is Essential for Parasite Invasion?","authors":"Ryan P Jajosky, Audrey N Jajosky, Philip G Jajosky, Sean R Stowell","doi":"10.3390/tropicalmed9090195","DOIUrl":"https://doi.org/10.3390/tropicalmed9090195","url":null,"abstract":"<p><p>The United States of America (US) has the highest annual number of human babesiosis cases caused by <i>Babesia microti</i> (<i>Bm</i>). <i>Babesia</i>, like malaria-causing <i>Plasmodium,</i> are protozoan parasites that live within red blood cells (RBCs). Both infectious diseases can be associated with hemolysis and organ damage, which can be fatal. Since babesiosis was made a nationally notifiable condition by the Centers for Disease Control and Prevention (CDC) in January 2011, human cases have increased, and drug-resistant strains have been identified. Both the <i>Bm</i> ligand(s) and RBC receptor(s) needed for invasion are unknown, partly because of the difficulty of developing a continuous in vitro culture system. Invasion pathways are relevant for therapies (e.g., RBC exchange) and vaccines. We hypothesize that there is at least one RBC surface antigen that is essential for <i>Bm</i> invasion and that all <i>Bm</i> hosts express this. Because most RBC surface antigens that impact <i>Plasmodium</i> invasion are in human blood group (hBG) systems, which are generated by 51 genes, they were the focus of this study. More than 600 animals with at least one hBG system gene ortholog were identified using the National Center for Biotechnology Information (NCBI) command-line tools. Google Scholar searches were performed to determine which of these animals are susceptible to <i>Bm</i> infection. The literature review revealed 28 <i>Bm</i> non-human hosts (NHH). For 5/51 (9.8%) hBG system genes (e.g., <i>RhD</i>), no NHH had orthologs. This means that RhD is unlikely to be an essential receptor for invasion. For 24/51 (47.1%) hBG system genes, NHH had 4-27 orthologs. For the <i>ABO</i> gene, 15/28 NHH had an ortholog, meaning that this gene is also unlikely to generate an RBC antigen, which is essential for <i>Bm</i> invasion. Our prior research showed that persons with blood type A, B, AB, O, RhD+, and RhD- can all be infected with <i>Bm</i>, supporting our current study's predictions. For 22/51 (43.1%) hBG system genes, orthologs were found in all 28 NHH. Nineteen (37.3%) of these genes encode RBC surface proteins, meaning they are good candidates for generating a receptor needed for <i>Bm</i> invasion. In vitro cultures of <i>Bm</i>, experimental <i>Bm</i> infection of transgenic mice (e.g., a CD44 KO strain), and analyses of <i>Bm</i> patients can reveal further clues as to which RBC antigens may be essential for invasion.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354644","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":"Convergence between Cardiometabolic and Infectious Diseases in Adults from a Syndemic Perspective: A Scoping Review.","authors":"Silvia Quiroz-Mena, Juan Gabriel Piñeros-Jimenez, Wilson Cañon-Montañez","doi":"10.3390/tropicalmed9090196","DOIUrl":"https://doi.org/10.3390/tropicalmed9090196","url":null,"abstract":"<p><p><b>Objective</b>. Synthesize the approaches used to study the convergence between cardiometabolic and infectious diseases in adults from a syndemic perspective based on the scientific evidence available to date worldwide. <b>Methods</b>. Scoping review that follows the recommendations of the PRISMA statement. The protocol was registered in INPLASY202150048. The search for studies was carried out in MEDLINE, LILACS, Web of Science and Scopus. <b>Results</b>. Since the COVID-19 pandemic, there has been an increase in studies in the field of convergence between cardiometabolic and infectious diseases from a syndemic perspective, but only three studies were classified as true syndemics. There are weaknesses in the adherence to the elements of the syndemic theory, given a low incorporation of population measurements, and until now it has not been possible to find convincing empirical evidence that supports the bio-bio interface. Quantitative methods predominated through models focused on \"sum scores\". <b>Conclusions</b>. Future studies should comprehensively address the elements of syndemics, review discrepancies between additive analyses versus other modeling, and incorporate the influence of large-scale social forces. The lack of these aspects distances studies from the notion of syndemic, bringing them closer to comorbidity or multimorbidity approaches.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"9 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11435530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336642","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}