Tropical Medicine & International Health最新文献

{"title":"Diagnostic Accuracy of Point-of-Care Devices for Glucose-6-Phosphate Dehydrogenase Deficiency Detection Among Malaria Patients: A Systematic Review and Meta-Analysis.","authors":"Greeshma Unnikrishnan, Abhinav Singh","doi":"10.1111/tmi.70108","DOIUrl":"10.1111/tmi.70108","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of various point-of-care devices for detecting deficiency of glucose-6-phosphate dehydrogenase among malaria patients.</p><p><strong>Methods: </strong>A comprehensive literature search was performed. Data extracted include the number of true positives, false negatives, false positives and true negatives to calculate sensitivity and specificity for various devices. CareStart G6PD rapid diagnostic test and the STANDARD G6PD Biosensor were assessed against spectrophotometry (gold standard) at clinically relevant activity thresholds of 30% and 70%. Pooled estimates were generated using a random-effects model in R (version 4.3.1). Risk of bias was assessed using the QUADAS-2 tool. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with reference ID CRD420251122222.</p><p><strong>Results: </strong>A total of 13 cross-sectional studies were included. At the 30% threshold the pooled sensitivity of CareStart was 0.82 (95% CI: 0.55-0.95) and specificity was 0.96 (95% CI: 0.93-0.98). At a 70% threshold the pooled sensitivity of CareStart was 0.54 (95% CI: 0.31-0.76), although specificity remained high at 0.96 (95% CI: 0.84-0.99). For the STANDARD G6PD Biosensor, the pooled sensitivity at 30% and 70% was 0.99 (95% CI: 0.96-1.00) and 0.96 (95% CI: 0.90-0.98), respectively, while the pooled specificity values for the above thresholds were 0.98 (95% CI: 0.97-0.99) and 0.96 (95% CI: 0.89-0.99).</p><p><strong>Conclusion: </strong>Quantitative point-of-care testing using STANDARD G6PD Biosensor demonstrates superior diagnostic performance, particularly for identifying intermediate G6PD activity, supporting its preferential use for guiding safe radical cure with 8-aminoquinoline therapies in malaria-endemic settings.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"643-650"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349099","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":"Environmental Distribution of Pathogenic Leptospira spp. in Subtropical Rivers of Japan and Implications for Human Infection.","authors":"Atsuhiro Kanayama, Hiroko Ejiri, Yuki Chiko, Ikumi Namihira, Tomoki Yonaha, Kanetaka Kuba, Miyu Yoshimi, Nobuo Koizumi, Shigeto Takeshima, Koki Kaku","doi":"10.1111/tmi.70157","DOIUrl":"https://doi.org/10.1111/tmi.70157","url":null,"abstract":"<p><strong>Objectives: </strong>Leptospirosis is a zoonotic disease caused by Leptospira spp. often linked to freshwater exposure in subtropical and tropical regions. Okinawa Prefecture reports the highest number of leptospirosis cases in Japan based on national surveillance data. Although recreational river activities in Okinawa are a major opportunity for exposure, direct evidence connecting environmental contamination with human infection remains limited. We investigated the spatiotemporal distribution of pathogenic Leptospira spp. in rivers on Iriomote Island, Okinawa, a subtropical region with a high leptospirosis incidence.</p><p><strong>Methods: </strong>Ten laboratory-confirmed patients treated at the regional hospital and affiliated clinics in 2024 were assessed for demographics, onset dates and exposure histories. Water samples were collected monthly from seven major rivers (June-September and December 2024). Pathogenic Leptospira spp. were detected by nested polymerase chain reaction targeting flaB, followed by sequencing and phylogenetic analysis.</p><p><strong>Results: </strong>A cluster of six cases occurred with onset on August 26-27; all reported river activities during incubation periods. In the environmental survey, highly and intermediately pathogenic genotypes were identified in all rivers (n = 84 water samples). Leptospira interrogans was frequently identified, particularly during summer. Novel sequences within the highly pathogenic group suggest potentially unreported species. Pathogenic Leptospira were detected in river water both before and after rainfall. The case cluster occurred following heavy rainfall, suggesting a possible temporal association between rainfall and increased exposure risk.</p><p><strong>Conclusion: </strong>Pathogenic Leptospira spp., including clinically relevant L. interrogans, were widely detected in rivers on Iriomote Island. Human case occurrence followed heavy rainfall where pathogenic Leptospira were already present in the environment. While this temporal pattern suggests that rainfall may have exacerbated exposure risk, exposures unrelated to rainfall cannot be excluded. This integrated approach may improve case detection and risk assessment in endemic settings and is adaptable to other tropical and subtropical regions with similar exposure risks.</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":"147821225","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":"Content and Factors Influencing Health Education in Immunisation Clinics in Nigeria.","authors":"Osayame A Ekhaguere, Nnette Ekpenyong, Esosa F Mohammed, Fatima Lawan Bukar, Angela Oyo-Ita, Jessica Kaufman","doi":"10.1111/tmi.70101","DOIUrl":"10.1111/tmi.70101","url":null,"abstract":"<p><strong>Background: </strong>Most parents in Nigeria receive childhood vaccine education in a group clinic setting. These health talks are not standardised, and little is known about the topics addressed, how these topics are chosen, and how parents experience these talks. This study aimed to fill this knowledge gap.</p><p><strong>Method: </strong>We conducted a qualitative study in eight immunisation clinics across rural and urban sites in Borno and Cross River State, Nigeria. We audio-recorded two health education talks at each clinic-one with the health worker unaware of being recorded. We interviewed 40 parents and 16 health workers to gather insights. Content analysis identified topics covered, while thematic analysis explored motivations for the health education content from health workers' and parents' perspectives on the talks.</p><p><strong>Results: </strong>The content and delivery method of the recorded health talks varied considerably within and between different health workers. Of the 16 analysed talks, 6 (37.5%) contained non-vaccine-related topics such as breastfeeding and family planning. The content of health talks was based on a clinic topic schedule, prevailing interests such as ongoing disease outbreaks, or the health workers' feelings and moods. Health workers mentioned they receive little to no formal training on the content and delivery of vaccine education. Current competency was primarily based on training received during formal schooling, embedded within other health programs or media outlets aimed at the general population. Parents generally perceived the educational sessions to be informative and important. However, short health talks, long clinic sessions and a lack of courtesy were barriers to a positive clinic experience.</p><p><strong>Conclusion: </strong>Inadequate and inconsistent health education on immunisation is prevalent at group-setting vaccine clinics in Nigeria and is driven by a lack of health worker training. Research and policy changes are critically needed to improve the quality of vaccine health education.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"603-611"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143730","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":"Comparison of Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae Respiratory Isolates: Systematic Review and Meta-Analysis.","authors":"Abdulhamit Cali, Rukiye Aslan, Cem Celik","doi":"10.1111/tmi.70106","DOIUrl":"10.1111/tmi.70106","url":null,"abstract":"<p><strong>Objectives: </strong>Streptococcus pneumoniae acquiring multidrug resistance globally, which poses a threat to the effective treatment of respiratory infections. This systematic review and meta-analysis aimed to evaluate global and regional antimicrobial susceptibility patterns of S. pneumoniae respiratory isolates collected between 2015 and 2024.</p><p><strong>Methods: </strong>Scopus, PubMed and Web of Science were searched from January 2015 to December 2024 following PRISMA guidelines. Inclusion criteria comprised English-language original studies reporting antibiotic susceptibility rates of S. pneumoniae isolated from respiratory samples of human origin, while studies with fewer than 10 isolates or lacking clear specification of sample type were excluded. Participants were respiratory samples yielding S. pneumoniae from human subjects across six WHO-defined regions. No interventions were applied, as this was an observational synthesis of surveillance and observational studies. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A random-effects model with double arcsine transformation was applied to pool susceptibility proportions, and subgroup analyses were conducted by geographical region.</p><p><strong>Results: </strong>Thirty-three studies comprising 20,768 isolates were included. Overall susceptibility rates were highest for linezolid (100%) and vancomycin (99%). Penicillin susceptibility was 77% (95% CI: 65-88), but markedly lower in the African (61%) and Eastern Mediterranean (26%) regions. Erythromycin (35%) and tetracycline (42%) susceptibility showed significant declines in the Western Pacific region (3% and 11%, respectively). Trimethoprim-sulfamethoxazole (48%) and clindamycin (60%) also displayed regional variability. Sensitivity analyses restricted to low-risk studies confirmed the robustness of findings.</p><p><strong>Conclusions: </strong>Antimicrobial susceptibility of S. pneumoniae respiratory isolates varies substantially by region. These results support the importance of regional antibiotic stewardship strategies and updated treatment guidelines to address declining susceptibility and emerging resistance patterns.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"612-622"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214500","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":"Recombinant LPG3 Protein From Leishmania chagasi as an Antigen for the Diagnosis of Canine Visceral Leishmaniasis.","authors":"Thaís Viana Fialho Martins, Anna Cláudia Alves de Souza, Bianca Meireles Miranda, Ronny Francisco de Souza, Daniel Silva Sena Bastos, Neverton José Silva Ferreira, Tiago Antônio de Oliveira Mendes, Celeste da Silva Freitas de Souza, George Luiz Lins Machado-Coelho, Maria Terezinha Bahia, Leandro Licursi de Oliveira, Juliana Lopes Rangel Fietto, Eduardo de Almeida Marques-da-Silva","doi":"10.1111/tmi.70151","DOIUrl":"https://doi.org/10.1111/tmi.70151","url":null,"abstract":"<p><p>Visceral leishmaniasis (VL) is a human neglected tropical disease in which dogs participate as reservoirs of the etiological agent Leishmania chagasi. The identification of infected dogs is important to the control of VL, and recombinant proteins are strong antigen candidates for canine visceral leishmaniasis (CVL) serodiagnosis. In this work, we evaluated the enzyme-linked immunosorbent assay (ELISA) using the L. chagasi LPG3 recombinant protein (rLPG3) as an antigen for the CVL diagnosis. The tests were performed on 242 serum samples and showed a remarkable 95.71% sensitivity and 87.50% specificity, with cross-reactivity observed in some samples positive for Ehrlichia canis and Trypanosoma cruzi. The performance of the rLPG3-ELISA test was similar to the performance of IFI-CVL and IFI-CVL plus ELISA-CVL Bio-Manguinhos tests, widely used in the diagnosis of CVL in Brazil, and presented better sensitivity results compared to those obtained in rapid tests available for CVL using other antigenic proteins. Further refinement is necessary to minimize the cross-reactivity and enhance the specificity of the test. Studies to discriminate cross-reactive epitopes of rLPG3, particularly those shared with E. canis protein sequences, may help improve diagnostic accuracy by excluding these epitopes from the detection reaction.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783097","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":"Task-Shifting to Nurses for Hypertension Control in Rural Sub-Saharan Africa: A Narrative Review of Effectiveness and Implementation Challenges.","authors":"Aime Ishimwe Mugisha, Olivier Uwishema, Lydia Daniel Bisetegn, Hubert Uwisanze, Boluwatife Samuel Fatokun, Subham Roy","doi":"10.1111/tmi.70155","DOIUrl":"https://doi.org/10.1111/tmi.70155","url":null,"abstract":"<p><strong>Background: </strong>Rising cardiovascular morbidity and mortality in rural sub-Saharan Africa are largely attributable to insufficient awareness, treatment and control of hypertension. The delivery of care is further constrained by health system limitations, including shortages of physicians, inadequate infrastructure, challenges in medication supply chains and geographical barriers to access. As a tactic to increase access, adherence and continuity of care, task-shifting hypertension management to nurses-often with the assistance of community health workers-has become popular. The evidence on the efficacy and implementation difficulties of nurse-led hypertension therapies in rural Sub-Saharan African settings is compiled in this narrative review.</p><p><strong>Methods: </strong>To investigate task-shifted and nurse-led hypertension care in rural SSA, a narrative evaluation was carried out. Terms associated with task-shifting, nurse-led care, hypertension and rural SSA were used to search PubMed, Scopus, Web of Science and Embase. Studies that met the eligibility requirements reported implementation results or patient outcomes. The effectiveness of the intervention, implementation difficulties and enabling variables were highlighted in the narrative synthesis of the data.</p><p><strong>Results: </strong>In rural Sub-Saharan Africa, nurse-led and task-shifted treatments enhanced medication adherence, blood pressure control and continuity of care. Protocol-driven nurse management, patient education, follow-up monitoring and assistance from mobile health tools or community health professionals were common elements. Drug stockouts, scope-of-practice limitations, inadequate training, supervision and partial integration into primary care were among the implementation obstacles. Alignment with current health systems, community involvement and structured mentoring were among the facilitators.</p><p><strong>Conclusion: </strong>Evidence from rural Sub-Saharan Africa indicates that task-shifting hypertension care to nurses is feasible and, when adequately supported, can improve key care processes and outcomes. To optimize the potential benefit of nurse-led hypertension management in rural settings, it is imperative to address health system bottlenecks, improve training and supervision and align regulatory frameworks with task-shifting strategies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783102","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":"Factors Associated With Tuberculosis Treatment Failure Among Hill Tribe and Stateless People in Chiang Rai Province, Thailand: A Case-Control Study.","authors":"Panupong Upala, Tawatchai Apidechkul, Fartima Yeemard, Onn Laingeon, Manassawin Kumpun, Wachareewan Apidechkul, Danupon Yodkham","doi":"10.1111/tmi.70150","DOIUrl":"https://doi.org/10.1111/tmi.70150","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tuberculosis (TB) is a global public health challenge, especially for those who are living in economically disadvantaged families and have difficulty accessing health care services. The hill tribe and stateless people living in the border areas of northern Thailand have been identified as a population vulnerable to TB. This study aimed to determine the factors associated with tuberculosis treatment failure amongst hill tribe and stateless people in Chiang Rai, Thailand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A case-control study was performed to collect data from TB patients who were registered in one of 18 district hospitals in Chiang Rai Province, Thailand, between 2019 and 2023. The cases were hill tribe and stateless, with TB treatment failure, while the controls were TB successful treatment outcomes. A validated questionnaire was used to collect data between June and August 2024. Backward stepwise logistic regression was used to determine the factors that were significant at α = 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 133 cases and 267 controls were included in the study: 56.5% were males, 41.8% were aged 61 years and older, 55.3% were Akha and Lahu members, 23.0% were nonThai, 73.8% had never attended school, 46.5% worked as farmers and 51.3% had an annual family income ≤ 10,000 baht ($332). In the multivariate model, eleven variables were found to be associated with tuberculosis treatment failure amongst the hill tribe and stateless TB patients: those who were females (AOR = 3.83; 95% CI = 1.77-8.29), those aged 61 years and over (AOR = 4.63; 95% CI = 1.62-13.23), those who were non-Thai citizens (AOR = 4.36; 95% CI = 1.74-10.87), those who had an annual family income of 5001-10,000 (AOR = 8.63; 95% CI = 2.55-29.18), those who had a family income of 10,001 baht and above (AOR = 4.28; 95% CI = 1.32-13.91), those who visited a TB clinic alone (AOR = 3.00; 95% CI = 1.33-6.78), those who ever missed a medical appointment (AOR = 21.06; 95% CI = 4.32-102.58), those who had side effects from TB medication (AOR = 7.88; 95% CI = 1.76-35.25), those who had a family member with TB (AOR = 2.80; 95% CI = 2.29-18.97), those who used traditional materials for their housing (AOR = 2.91; 95% CI = 1.76-4.80), those who experienced stress (AOR = 9.95; 95% CI = 2.85-34.80) and those who had little knowledge of TB prevention and control (AOR = 6.60; 95% CI = 2.81-16.57) had greater odds of having a TB treatment failure than those with opposite characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Hill tribe and stateless people who are female, are older, are non-Thai citizens, have missed appointments, have side effects from medication, are experiencing stress, used traditional materials for their housing and have poor knowledge of TB prevention and control are more likely to experience tuberculosis treatment failure. These findings strongly suggest that clinical staff who are working at TB clinics should focus on patients with","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783081","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":"Short-Course Low-Dose Primaquine for Radical Cure in G6PD-Normal Patients in the Pre-Elimination Context of Nepal.","authors":"Prakash Ghimire, Gokarna Dahal, Nabaraj Adhikari, Komal Raj Rijal, Sanjib Adhikari, Megha Raj Banjara, Hellen Mnjala, Grant Lee, Sophie Weston, Angela Rumaseb, Anjana Rai, Benedikt Ley, Mohammad Sharif Hossain, Julie A Simpson, Megha Rajasekhar, Bipin Adhikari, Ric N Price, Bibek K Lal, Kamala Thriemer","doi":"10.1111/tmi.70145","DOIUrl":"https://doi.org/10.1111/tmi.70145","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium vivax remains a challenge for malaria elimination in Nepal due to its ability to relapse. Radical cure with primaquine is effective but limited by poor adherence to the standard 14-day low-dose regimen. In 2022, the WHO recommended administering the same total dose (3.5 mg/kg) over 7 days to improve adherence. This study aimed to evaluate the 7-day low-dose primaquine regimen in G6PD-normal patients with uncomplicated P. vivax and/or P. falciparum malaria in the pre-elimination context of Nepal.</p><p><strong>Methods: </strong>A randomised study was conducted in south-west Nepal. Adult patients with microscopically confirmed P. vivax and/or P. falciparum malaria and glucose-6-phosphate dehydrogenase (G6PD) activity ≥ 30% were randomised 1:1 to receive either a 7-day low-dose primaquine regimen (0.5 mg/kg/day; total 3.5 mg/kg) or standard of care (14-day primaquine [0.25 mg/kg/day; total 3.5 mg/kg] for patients with P. vivax malaria and single-dose primaquine for P. falciparum malaria patients) in addition to their schizonticidal treatment. All treatment was directly observed, and patients were followed for 6 months. The primary outcome was the risk of P. vivax recurrence at 6 months. Safety outcomes included adverse events, gastrointestinal symptoms and haematological parameters.</p><p><strong>Results: </strong>Of 5842 individuals screened, 27 eligible participants were enrolled. Among these, 21 had P. vivax, four had P. falciparum and two had mixed infections. Eleven participants had intermediate G6PD activity (≥ 30%-70% activity). At 6 months there were no recurrences in the 7-day primaquine arm (n = 14) and the risk of P. vivax recurrence in the standard primaquine arm (n = 13) was 9.1% (95% CI: 1.3-49.2). No participants vomited study drugs, and gastrointestinal symptoms were infrequent. Three participants experienced a ≥ 25% haemoglobin drop between baseline and Day 2, all of whom had baseline values > 15 g/dL. No presentations of haemoglobinuria, severe anaemia, serious adverse events, or deaths occurred during the study period.</p><p><strong>Conclusions: </strong>In this small study, the 7-day low-dose primaquine regimen was well tolerated, including among individuals with intermediate G6PD activity. Although the small sample size limits conclusions about efficacy, the findings support the feasibility and safety of this regimen in Nepal, offering potential programmatic advantages for radical cure delivery in a setting close to elimination.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov: NCT04079621.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783071","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":"Assessment of Antimicrobial Resistance in M. leprae Strains From Kiribati.","authors":"Patrick O Campbell, Temea Bauro, Erei Rimon, Nabura Ioteba, Trevor Anderson, Arturo Cunanan, Taulanga Naniseni, Jacqui Gardner, Emma Trowbridge, Nicholas M Douglas, Stephen T Chambers","doi":"10.1111/tmi.70146","DOIUrl":"https://doi.org/10.1111/tmi.70146","url":null,"abstract":"<p><strong>Objectives: </strong>Kiribati has one of the highest rates of leprosy worldwide. A nationwide screening and chemoprophylaxis program for household leprosy contacts was introduced in 2018. In 2022, population-wide screening and rifamycin-based treatment or chemoprophylaxis for leprosy and tuberculosis was introduced as part of the PEARL and COMBINE studies. Largescale rifamycin use theoretically risks selection of resistant Mycobacterium leprae strains. This study aimed to elucidate the baseline antimicrobial resistance (AMR) profile of M. leprae isolates in Kiribati using a novel molecular method.</p><p><strong>Methods: </strong>Mycobacterium leprae genomes from skin biopsies of patients clinically diagnosed with leprosy in Kiribati between 2017 and 2024 were analysed. We used an M. leprae specific repetitive element (RLEP) PCR to confirm the presence of M. leprae DNA. Samples with sufficient DNA (cycle threshold (CT) value < 30) proceeded for resistance testing. A combination of nested and heminested PCR assays was used to amplify the drug resistance determining regions (DRDR's) for dapsone (folP1), rifampicin (rpoB) and fluoroquinolones (gyrA) followed by DNA Sanger sequencing.</p><p><strong>Results: </strong>216 skin biopsies (multibacillary [MB], n = 155, paucibacillary [PB], n = 61) underwent confirmatory testing. 192/216 (89%) samples were PCR positive (median Ct value 24.5 [range 12.0-44.4]), including 145 MB cases (median CT 21.1 [range 12.0-42.0]) and 47 PB cases (median CT 34.0 [range 14.8-37.0]). Twenty-four (11%) samples were PCR negative and 21 of these underwent histopathological testing, with 12 (57%) showing changes consistent with leprosy. 116 (60%) positive samples proceeded to AMR testing (MB, n = 106; PB, n = 10). In 10 cases (9%), dapsone resistance-conferring mutations were identified in the folP1 region. No mutations were identified in the rpoB or gyrA genes.</p><p><strong>Conclusion: </strong>Molecular analysis of skin biopsies revealed moderate-level dapsone resistance but no rifampicin resistance in Kiribati. Establishing this baseline AMR profile will enable a before-versus-after intervention analysis of antimicrobial resistance in M. leprae isolates in Kiribati.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783122","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":"Strong Cross-Reactivity of Anti-Plasmodium falciparum pLDH Monoclonal Antibodies With Plasmodium malariae pLDH in the Abbott Bioline Malaria Ag P.f/P.f/P.v Rapid Diagnostic Test.","authors":"Gabriel Montoia, Maria Carmen Arroyo Sanchez, Giselle Lima-Cooper, Maria de Lourdes Rego Neves Farinas, Juliana Inoue, Silvia Maria Di Santi","doi":"10.1111/tmi.70142","DOIUrl":"https://doi.org/10.1111/tmi.70142","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe the cross-reactivity of the Abbott Bioline Malaria Ag P.f/P.f/P.v rapid diagnostic test, designed to detect Plasmodium falciparum and P. vivax, with other Plasmodium species, based on the detection of parasite lactate dehydrogenase enzymes.</p><p><strong>Methods: </strong>Blood samples from 40 patients with positive thick and thin blood smear results were analysed: 10 infected with P. falciparum, 10 with P. vivax, 15 with P. malariae and five with P. ovale. Parasitemia was quantified as parasites/μL of blood. All samples were tested using the Abbott Bioline Malaria Ag P.f/P.f/P.v RDT, and species identification was confirmed by nested PCR. To compare test line intensities and assess potential nonspecific reactions, images of the RDT lines were analysed using ImageJ software. For statistical analyses, PCR was considered the gold standard. Sensitivity, specificity and accuracy were calculated using MedCalc 2026. Fisher's exact test was applied using GraphPad/Quick Calcs to compare the specificity of the anti-Pf-pLDH antibodies, with a significance level of 0.05 (p < 0.05).</p><p><strong>Results: </strong>The RDT accurately detected all P. falciparum and P. vivax samples. However, 12 of 14 P. malariae samples yielded positive results on the T2 line, intended to be specific for Pf-pLDH, as did four P. ovale isolates. The specificity of the anti-Pf-pLDH monoclonal antibodies against P. malariae was only 14.29% (p < 0.05). ImageJ analysis showed that the T2 line signal intensity in P. malariae-infected samples exceeded that observed in P. falciparum-infected samples.</p><p><strong>Conclusions: </strong>This study provides the first evidence of cross-reactivity of anti-Pf-pLDH monoclonal antibodies in the Abbott Bioline Malaria Ag P.f/P.f/P.v RDT with P. malariae and P. ovale isolates. Moreover, highlights the imperative need to validate alternative biomarkers and novel point-of-care platforms, to enhance the rapid and accurate diagnosis of malaria, ensure species-specific treatment and ultimately support effective malaria control and elimination strategies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783106","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}