Tropical Medicine & International Health最新文献

{"title":"Predictive Ability of Sonographic Characteristics Alone to Diagnose Tuberculous Pleural Effusions in a Resource-Limited Setting: A Cross-Sectional Pilot Study in Zambia.","authors":"Lukonde Zimba, Salomé-Joëlle Gass, Mpundu C Makasa, Matthew S Haldeman","doi":"10.1111/tmi.70143","DOIUrl":"https://doi.org/10.1111/tmi.70143","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous pleural effusion (TPE), the second most common form of extra-pulmonary tuberculosis (TB), remains difficult to diagnose due to low-yield, invasive and often unavailable diagnostics in resource-limited settings. This study aimed to evaluate the diagnostic accuracy of sonographic characteristics alone to predict TB aetiology of pleural effusions using point-of-care ultrasound (POCUS).</p><p><strong>Methods: </strong>This cross-sectional study included 45 participants in Zambia who underwent ultrasound scanning and diagnostic thoracentesis. Key sonographic characteristics of pleural effusions-presence of septations, presence of plankton sign and unilateral location-were evaluated for their association with TB, using pleural fluid adenosine deaminase (ADA) ≥ 40 IU/L, combined with Xpert MTB/RIF and lipoarabinomannan, as the gold standard. Sensitivity, specificity, positive predictive values and negative predictive values were calculated for each characteristic alone and in combination and multivariate logistic regression was used to determine statistical significance. Interrater reliability between clinician and expert image interpretation was calculated using a kappa statistic.</p><p><strong>Results: </strong>Significant associations were found between TB positivity and unilateral location (either side) (p = 0.037), right-sided location (p = 0.043) and any two POCUS signs (p = 0.044). Diagnostic performance varied across the three POCUS signs, with the presence of any two POCUS signs demonstrating the highest sensitivity (90.9%) but moderate specificity (41.7%) and the presence of all 3 POCUS signs showing strong specificity (83.3%) but poor sensitivity (45.5%). Agreement also varied, with the lowest kappa score observed for the plankton sign and the highest for unilateral location.</p><p><strong>Conclusions: </strong>Multiple sonographic characteristics, including unilateral location (either side), unilateral right-sided location and any two positive signs were significantly associated with TB aetiology. Limitations included small sample size, potential selection bias, imperfect gold standard options, and inability to fully assess potential confounders. With additional study, these findings may be used to inform development of a non-invasive tool to predict TB aetiology of pleural effusions-and expedite initiation of anti-TB therapy-in high TB settings globally.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repositioning Antibiotics Against Plasmodium falciparum RAD5 and WD11 as Novel Antimalarial Targets.","authors":"Abdullah S Albaqami, Oluwafemi Adebayo Oyewole, Khalid Mohamed Adam","doi":"10.1111/tmi.70147","DOIUrl":"https://doi.org/10.1111/tmi.70147","url":null,"abstract":"<p><strong>Background: </strong>The emergence of artemisinin resistance in Plasmodium falciparum threatens the sustainability of malaria control programs and underscores the need for new therapeutic strategies. Recently, two proteins, RAD5 (PfRAD5) and WD40-repeat protein 11 (PfWD11), have been implicated in parasite survival and drug resistance. Their druggability, however, remains underexplored.</p><p><strong>Methods: </strong>We integrated computational and experimental approaches to assess PfRAD5 and PfWD11 as antimalarial targets. Structural models were retrieved from AlphaFold and aligned with orthologues across Plasmodium species. A library of 216 antibiotics was screened by molecular docking, and molecular dynamics simulations. Top-ranked compounds were tested against P. falciparum 3D7 cultures in vitro, alone and in combination, and gene expression changes in PfRAD5 and PfWD11 were quantified by qPCR. Docking identified strong binders to PfRAD5 (talampicillin, dicloxacillin, raltegravir) and PfWD11 (cervinomycin A2 monoacetate, eAmSPC 2593, puromycin).</p><p><strong>Results: </strong>Molecular dynamics confirmed the stability of protein-ligand complexes. In vitro, puromycin exhibited the highest inhibition (85% at 100 μg/mL), while combinations enhanced activity. The triple combination (puromycin + raltegravir + dicloxacillin) achieved complete inhibition, and puromycin + chloroquine exhibited synergistic effects at in a concentration-dependent manner. qPCR showed consistent downregulation of PfRAD5 and PfWD11 following puromycin-based treatments, whereas chloroquine alone upregulated PfRAD5 expression. PfRAD5 and PfWD11 represent novel antimalarial targets.</p><p><strong>Conclusion: </strong>Repurposed antibiotics, particularly puromycin in synergistic regimens, offer a cost-effective strategy to counteract emerging resistance and accelerate therapeutic development.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent-Reported Influenza Vaccination Uptake, Hesitancy and Willingness for In-School Children: Survey Findings From Shenzhen, China With Free Vaccination Services.","authors":"Yucheng Xu, Fangmei Ren, Ruiyin Zhang, Jingjie Fan, Wei Lin","doi":"10.1111/tmi.70158","DOIUrl":"https://doi.org/10.1111/tmi.70158","url":null,"abstract":"<p><strong>Objective: </strong>Understanding parental practices and attitudes towards vaccination is important to promote influenza vaccines among in-school children that can mitigate infection and spread of influenza. This study aimed to investigate influenza vaccination uptake, hesitancy and willingness among parents for their in-school children in the post-pandemic era of COVID-19 in South China.</p><p><strong>Methods: </strong>In April 2023, a cross-sectional survey was conducted to obtain a convenience sample of 3127 in-school children's parents in Shenzhen, China. Information about demographic characteristics, parent's psychological health status, child's health conditions, parent-reported influenza vaccination uptake, hesitancy and willingness among in-school children was collected. Binary logistic regression models were applied to detect parent-level and child-level associated factors of influenza vaccination uptake, hesitancy and willingness among parents.</p><p><strong>Results: </strong>According to 3127 parents' report, the rate of influenza vaccination uptake within the recent 12 months for their in-school children was 57.6%, and 49.2% of parents reported vaccine hesitancy. Among 1326 parents of children who have not yet been vaccinated, 74.2% were willing to vaccinate their children in the future. The most reported obstacle for unwillingness was concerns about vaccine safety and side effects. Parent-level factors associated with parent-reported uptake, hesitancy and willingness of influenza vaccination included gender, education level, employment status, health perceptions (awareness of influenza vaccination and the free policy for students, perceived risk and worry about contracting influenza for the child) and perceived stress. Child-level factors included age, gender, history of previous influenza vaccination and history of vaccine allergy.</p><p><strong>Conclusions: </strong>Our study suggests that there is considerable room for Chinese parents to increase the uptake of influenza vaccination and eliminate vaccine hesitancy for in-school children. Multi-aspect efforts are needed to increase parental confidence and trust in influenza vaccination, in particular, based on parent-level and child-level associated factors.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arbovirus Outbreak Reveals Co-Infection of Dengue and Chikungunya Viruses at Zona da Mata Region in Minas Gerais, Brazil, During 2024.","authors":"Giarlã Cunha da Silva, Rafael Reis de Rezende, Paula da Fonseca Pereira, Edvaldo Barros, Cristiene Queiróz Goretti, Simone Eliza Facioni Guimarães, Poliane Alfenas-Zerbini","doi":"10.1111/tmi.70099","DOIUrl":"10.1111/tmi.70099","url":null,"abstract":"<p><strong>Objectives: </strong>To characterise the recent circulation of dengue and chikungunya viruses in the Zona da Mata region of Minas Gerais, Brazil, during the major arbovirus epidemic of 2024, using publicly available RT-qPCR test results.</p><p><strong>Methods: </strong>We analysed data from DATASUS obtained by RT-qPCR tests for dengue, Zika and chikungunya viruses reported between January and September 2024 across 41 municipalities. Demographic and epidemiological patterns were assessed, including virus-specific incidence, re-infection, sequential infection and co-infection events, and associations with testing effort.</p><p><strong>Results: </strong>The investigation of DATASUS data showed that 5583 patients were tested by RT-qPCR, and 1663 dengue virus cases and 1756 chikungunya virus cases were detected, with most detections between March and April. Different co-infections were detected in 278 patients, and sequential and re-infections in two and five individuals, respectively. Most cases clustered temporally between March and April, coinciding with the rainy season. Dengue was more common among adolescents and young adults, while chikungunya predominated in individuals over 40. Higher detection rates were observed in females. No Zika virus cases were identified. The number of confirmed cases was strongly correlated with the number of samples tested but not with municipality population size, underscoring the limitations of passive surveillance.</p><p><strong>Conclusions: </strong>Our findings highlight dengue and chikungunya viruses' intense transmission and co-circulation in a historically understudied region. The high frequency of co-infections, age-specific risks and testing-dependent incidence patterns reinforce the importance of expanding molecular diagnostic capacity and strengthening surveillance networks in the face of increasingly severe arbovirus epidemics.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"595-602"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neisseria gonorrhoeae in Kenya: A Systematic Review and Meta-Analysis of Prevalence, Resistance and Mitigation Strategies.","authors":"Samuel K Ndegwa, Ivy J Mutai, Linet Lusimba, Amos Lucky Mhone, Jael Apondi Obiero, Ely Aboka, Nelson Wachira, Elkana Mudi, Alice Auko Owiti, Cateline Ouma, Gloria Maleche, Festus Nyamweya, James Munyao Kingoo, Victor Irungu Mwangi, Eric Omori Omwenga, Kevin Mbogo Omolo, Anthony Kebira Nyamache, Atunga Nyachieo","doi":"10.1111/tmi.70094","DOIUrl":"10.1111/tmi.70094","url":null,"abstract":"<p><strong>Introduction: </strong>Gonorrhoea remains a leading sexually transmitted infection worldwide, with an estimated 82 million new cases being reported annually. In Kenya, epidemiological and antimicrobial resistance data are fragmented and under-represent high-risk populations, hampering targeted interventions.</p><p><strong>Objective: </strong>To estimate the pooled prevalence of Neisseria gonorrhoeae and assess patterns of antimicrobial resistance in Kenya between 2019 and 2024.</p><p><strong>Methodology: </strong>We searched PubMed, Google Scholar, OpenAlex and Research4Life following PRISMA guidelines, yielding 1116 records. Two reviewers independently screened studies against predefined inclusion criteria. Prevalence and resistance data were extracted, and a random-effects meta-analysis was performed to compute pooled estimates with 95% confidence intervals. Heterogeneity among studies was assessed using the I² statistic.</p><p><strong>Results: </strong>Eleven studies comprising 5170 participants met inclusion criteria. The pooled prevalence of N. gonorrhoeae was 22.5% (95% CI: 17.2-27.8). Key risk factors included sex work, low educational attainment and multiple sexual partners. Resistance rates were highest for tetracycline (98.0%), ciprofloxacin (96.7%) and penicillin (94.7%) and lowest for azithromycin (2.0%), cefixime (2.6%) and ceftriaxone (1.3%).</p><p><strong>Conclusion: </strong>N. gonorrhoeae poses an urgent public health threat in Kenya. Strengthening surveillance, expanding access to reliable diagnostics and enforcing antibiotic stewardship are critical. Exploration of alternative therapies including phage therapy, alongside accelerated vaccine research, will be essential for sustainable disease control.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"623-633"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor Response to Albendazole in Hookworm-Infected Abnormal Haemoglobin Carriers.","authors":"Attarat Pattanawongsa, Manit Nuinoon, Prasit Na-Ek, Patthanasak Khammaneechan, Blego Sedionoto, Witthaya Anamnart","doi":"10.1111/tmi.70093","DOIUrl":"10.1111/tmi.70093","url":null,"abstract":"<p><strong>Background: </strong>In southern Thailand, the low efficacy of albendazole contributes to the unsuccessful elimination of hookworms. Individuals infected with hookworms exhibiting low albendazole efficacy show decreased mean corpuscular volume and mean corpuscular haemoglobin and are suspected carriers of abnormal haemoglobin. This observational study aimed to compare the treatment outcomes of albendazole for hookworm infection in individuals with normal versus abnormal haemoglobin types.</p><p><strong>Methods: </strong>227 stool samples were examined using the Kato-Katz and agar plate culture methods. Blood samples were collected from participants with hookworm-positive stool after oral administration of 400 mg albendazole to perform complete blood counts and haemoglobin typing. Treatment outcomes were evaluated 3 weeks after albendazole administration. Participants with persistent hookworm infection received a second 400 mg dose of albendazole, and outcomes were reassessed 3 weeks later.</p><p><strong>Results: </strong>Among 54 hookworm-positive participants, 38 were cured after the first round of treatment, and 5 were cured after the second round, all of whom had normal haemoglobin. However, 11 participants remained uncured after two treatment rounds, all with abnormal haemoglobin types: 7 with heterozygous haemoglobin E, 3 with heterozygous haemoglobin constant spring (CS) and 1 with compound heterozygous haemoglobin E/CS.</p><p><strong>Conclusion: </strong>These findings suggest that abnormal haemoglobin may be a host factor contributing to low albendazole efficacy in treating hookworm infections.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"589-594"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Related Absolute and Relative Inequalities in Hypertension Prevalence Among Adults Aged 30-79 in Ghana, 1990-2019.","authors":"Florence Gyembuzie Wongnaah, Samuel Salu, Richard Gyan Aboagye, Bright Opoku Ahinkorah","doi":"10.1111/tmi.70082","DOIUrl":"10.1111/tmi.70082","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major contributor to cardiovascular diseases in Ghana. However, long-term sex-specific trends in crude and age-standardised rates remain underexplored. This study evaluates the sex-related inequalities in crude and age-standardised hypertension prevalence rates among adults aged 30-79 in Ghana from 1990 to 2019.</p><p><strong>Methods: </strong>We used data from the World Health Organization's Global Health Observatory, which was available in the WHO's Health Equity Assessment Toolkit. Sex was the only stratifier available to examine disparities in hypertension prevalence. We analysed sex differences for both crude and age-standardised prevalence using four inequality indicators: Difference (D), Ratio (R), Population Attributable Fraction (PAF), and Population Attributable Ratio (PAR). We examined the absolute and relative disparities in hypertension prevalence between males and females.</p><p><strong>Results: </strong>In 1990, age-standardised prevalence was similar between women, 35.7% (95% CI: 22.0-50.8) and men, 34.7% (95% CI: 20.0-50.9), with a D of 1.0 and R of 1.0. By 2019, the prevalence among women increased slightly to 36.1% (95% CI: 26.6-46.3), whereas the prevalence among men declined markedly to 31.4% (95% CI: 22.0-41.2), resulting in an absolute difference of 4.7 and a sex ratio of 1.2. Relative inequality increased modestly from 1.0 in 1990 to 1.1 in 2019. PAF and PAR remained negative over the period, increasing from -1.7% and -0.6 in 1990 to -7.4% and -2.5 in 2019, respectively.</p><p><strong>Conclusion: </strong>Over three decades, Ghana has experienced a widening sex disparity in age-standardised hypertension prevalence, with women consistently having a higher burden than men. Given that a substantial portion of the national burden of hypertension could be averted by closing this gap, urgent gender-responsive public health strategies are required to advance cardiovascular equity in Ghana.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"634-642"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korat-Scrub Typhus Score: A Clinical Tool for Predicting Scrub Typhus in Patients With Acute Undifferentiated Febrile Illness.","authors":"Wilawan Thipmontree, Ekkarat Wongsawat, Saowaluk Silpasakorn, Yupin Suputtamongkol","doi":"10.1111/tmi.70154","DOIUrl":"https://doi.org/10.1111/tmi.70154","url":null,"abstract":"<p><strong>Objective: </strong>Scrub typhus is a major cause of acute undifferentiated febrile illness (AUFI) in the Asia-Pacific region. Nonspecific presentation, limited diagnostic accuracy and delayed treatment increase morbidity and mortality. This study aimed to develop a simple clinical score for early diagnosis in adults with AUFI.</p><p><strong>Methods: </strong>A cross-sectional study of adults (≥ 18 years) with AUFI was conducted at a tertiary hospital in northeastern Thailand from June 2021 to May 2022. The Korat-Scrub Typhus Score was developed by analysing all clinically relevant variables using multivariable logistic regression with backward stepwise selection. Model performance was assessed using the Hosmer-Lemeshow goodness-of-fit test and the area under the receiver operating characteristic curve (AUC), with internal validation via 1000 bootstrap replications.</p><p><strong>Results: </strong>Among 366 AUFI patients, 75 had scrub typhus. Most were male (66.7%), with mean age of 53.6 ± 17.6 years and median illness duration of 4 days (IQR 2-7). Five predictors were identified: outdoor activities, rash (excluding eschar), headache, abnormal chest radiograph findings and aspartate aminotransferase ≥ 100 U/L. The Korat-Scrub Typhus Score (0-13) stratified risk into low (< 5), moderate (5-6) and high (> 6) groups, with likelihood ratios of 0.55 (95% CI, 0.43-0.71), 2.20 (95% CI, 1.37-3.53) and 9.22 (95% CI, 4.19-20.25), respectively. The model showed good calibration, acceptable discrimination (AUC = 0.783, 95% CI 0.725-0.842) and minimal overfitting after internal validation.</p><p><strong>Conclusion: </strong>Scrub typhus is a common cause of AUFI. The Korat-Scrub Typhus Score uses simple clinical and laboratory data to support early diagnosis and timely treatment.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Serum Ferritin Levels and Their Correlation With Clinical Outcomes in Dengue Virus Infection in a Population of Older Adults.","authors":"Sacha Orberg Temer, Thaís Guimarães, Augusto Yamaguti, João Silva de Mendonça","doi":"10.1111/tmi.70113","DOIUrl":"10.1111/tmi.70113","url":null,"abstract":"<p><strong>Objectives: </strong>Prior studies have associated elevated ferritin levels with worse dengue outcomes but data from older adults remain limited. The aim of this study is to evaluate the serum ferritin levels and their correlation with disease severity in a population of older adults.</p><p><strong>Methods: </strong>We included 284 patients aged 60 years or older with a diagnosis of dengue attended during a high dengue fever outbreak. We analysed demographic variables, the presence of comorbidities, hospitalisation, death and correlated the serum ferritin level with three categories of dengue. Patients' ferritin levels were recorded during the febrile (P1), critical (P2) and convalescence (P3) phases.</p><p><strong>Results: </strong>Of the 284 patients, 59.1% of whom were women, with a mean age of 72 years, ranging from 60 to 99 years. Of these, 228 (80.2%) had some clinical comorbidity. 106 (37.3%) of patients were classified as dengue without warning signs; 122 (43%) as dengue with warning signs and 56 (19.7%) as severe dengue. During P1, 68 (23.9%) serum ferritin levels were collected with an average result of 511 ng/mL; during P2, 143 (50%) serum ferritin levels were collected with an average result of 1697 ng/mL, and during P3, there were 141 (49.6%) collections with an average level of 949 ng/mL. 111/284 (39%) of patients requiring hospitalisation and 9/284 (3.1%) died, all of them diagnosed with severe dengue. Our study found higher levels of ferritinemia in cases of severe dengue and in the critical (723 × 1420 ng/mL; p = 0.006) and convalescent (554 × 1261 ng/mL; p = 0.03) phases, with statistically significant differences.</p><p><strong>Conclusions: </strong>Our study found higher levels of ferritinemia in cases of severe dengue and in the critical and convalescent phases, with statistically significant differences. Age over 60 may be associated with the development of severe dengue, and hyperferritinemia may represent a biomarker of dengue severity.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"651-656"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366761","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":"Exploration of Various Diagnostic Modalities for Detection of Amoebic Liver Abscess and Co-Occurrence of Other Infective Aetiology, Eastern India.","authors":"P Harishni, Srujana Mohanty, Manas Kumar Panigrahi, Anupam Dey, Baijayantimala Mishra, Nonika Rajkumari, Vinaykumar Hallur","doi":"10.1111/tmi.70149","DOIUrl":"https://doi.org/10.1111/tmi.70149","url":null,"abstract":"<p><strong>Background: </strong>Liver abscess (LA) remains a major clinical entity across the globe. Pyogenic liver abscess (PLA) caused by bacteria and amoebic liver abscess (ALA) caused by Entamoeba histolytica (Eh) constitute the two predominant varieties, whilst other infective aetiologies such as tubercular and fungal LA are reported uncommonly. The true frequency of ALA often remains underestimated, owing to constraints related to the poor sensitivity of conventional methods. Hence, we performed this study to explore the usefulness of various diagnostic modalities for detection of ALA to select optimal strategies for incorporation in our routine diagnostic repertoire. The co-occurrence of other infective aetiologies of LA was also investigated.</p><p><strong>Methods: </strong>This observational, cross-sectional study conducted from August 2021 to July 2023 included provisionally diagnosed cases of LA whose pus samples obtained under relevant radio-imaging guidance were subjected to various conventional and molecular tests primarily for detection of amoebic aetiology, including microscopy, antigen detection, serology and nested multiplex polymerase chain reaction (PCR). Cultures and cartridge-based nucleic acid amplification test were performed for detection of pyogenic/fungal and tubercular aetiology, respectively.</p><p><strong>Results: </strong>Of 82 samples, a positive microbial yield was obtained in 69 patients (84.1%) with, ALA in 31 (44.9%), PLA in 26 (37.7%), ALA with superimposed bacterial co-infection in 10 (14.5%), tubercular in one (1.4%) and fungal in one (1.4%). Maximum number of ALA cases were detected by nested-multiplex PCR (41/82, 50.0%) followed by amoebic serology (28, 34.1%). Further, 45 bacterial isolates were obtained from 36 culture-positive specimens, with Escherichia coli as the predominant isolate followed by Klebsiella pneumoniae and Burkholderia pseudomallei.</p><p><strong>Conclusions: </strong>Molecular investigations are useful tests for the diagnosis of ALA and need to be incorporated in routine clinical practise for maximum detection of cases. Amoebic serology can serve as an alternative option.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}