Tropical Medicine & International Health最新文献

{"title":"Life Course Malaria Exposure and SARS-CoV-2 Seroepidemiology in Ugandan Adolescents: A Longitudinal Study Nested in a Birth Cohort.","authors":"Ludoviko Zirimenya, Doreen Nayebare, Claire Baine, Jacent Nassuuna, Milly Namutebi, Christopher Zziwa, Denis Nsubuga, Fred Kiwudhu, Florence Akello, Josephine Tumusiime, Gloria Oduru, Grace Kabami, Hellen Akurut, Rachel Nakyesige, Agnes Natukunda, Anne Wajja, Lawrence Lubyayi, Simon Kimuda, Gyaviira Nkurunungi, Jennifer Serwanga, Katie J Doores, Emily L Webb, Alison M Elliott","doi":"10.1111/tmi.70148","DOIUrl":"https://doi.org/10.1111/tmi.70148","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has had major global health impacts, yet reported morbidity and mortality have been lower in Africa despite serological evidence of widespread infection. Malaria has been proposed as a potential modifier of susceptibility to and outcomes of SARS-CoV-2 infection. We investigated whether prospectively measured life-course malaria exposure was associated with serologically defined SARS-CoV-2 infection among adolescents in a malaria-endemic setting and explored symptomatic COVID-19 during follow-up.</p><p><strong>Methods: </strong>We conducted a longitudinal study nested within the Entebbe Mother and Baby Study birth cohort in Uganda. Adolescents were enrolled and followed up 6 and 12 months later. Blood samples were collected at each visit for SARS-CoV-2 serology. Malaria exposure was defined using prospectively collected data on clinical malaria (from birth to 10 years), asymptomatic parasitaemia at annual visits and antibody responses to Plasmodium falciparum merozoite surface protein 2 (PfMSP-2) and apical membrane antigen 1 (PfAMA-1). The primary outcome was SARS-CoV-2 seropositivity, based on spike and nucleocapsid IgG responses, with seropositivity cut-offs derived from pre-pandemic samples. Secondary outcomes, including antibody concentrations and symptomatic PCR-confirmed disease, were explored. Vaccinated participants were excluded from subsequent serological analyses. Logistic and linear regression models assessed associations with seropositivity and log₁₀-transformed antibody concentrations, adjusting for key demographic, socioeconomic and exposure-related confounders.</p><p><strong>Results: </strong>Between August and November 2021, 476 adolescents (mean age 16.4 years (SD = 0.75); 205 (43.1%) female) were enrolled. Overall, 12.0% had ever had asymptomatic parasitaemia, and 61.3% had experienced clinical malaria. SARS-CoV-2 seropositivity among unvaccinated participants increased from 63% at baseline to 89.3% at 6 months and 94.9% at 12 months; no PCR-positive cases were reported. Multivariable analyses showed no consistent association between malaria exposure and SARS-CoV-2 seropositivity or antibody concentration levels.</p><p><strong>Conclusions: </strong>We found no consistent evidence that life-course malaria exposure was associated with SARS-CoV-2 infection as measured by serology or antibody levels.</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":"147783140","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":"The Contribution of Entomological Surveillance to the Control of Chagas Disease in Endemic Regions: An Integrative Literature Review.","authors":"Daniel Rodrigo de Lima Gomes, Gilliard do Nascimento, Pedro Mariano da Silva Rodrigues, Ana Beatriz da Silva, Ysabele Yngrydh Valente Silva, Ekarinny Myrela Brito de Medeiros, Cléber de Mesquita Andrade, Thales Allyrio Araújo de Medeiros Fernandes, José Antonio da Silva Júnior, Ellany Gurgel Cosme do Nascimento","doi":"10.1111/tmi.70128","DOIUrl":"https://doi.org/10.1111/tmi.70128","url":null,"abstract":"<p><p>Chagas disease remains a significant public health challenge in various endemic regions of Latin America. The persistence of vector-borne transmission highlights the complexity of the issue and the limitations of traditional strategies. In this context, entomological surveillance plays a strategic and multifaceted role, not only in the early detection of triatomine bugs but also in guiding control actions tailored to territorial realities. This study aimed to analyse the contributions of entomological surveillance to the control of Chagas disease in endemic regions, considering the integration of traditional approaches, technological innovations, and participatory strategies. An integrative literature review was conducted based on the guiding question: 'How does entomological surveillance contribute to the control of Chagas disease in different endemic regions?' This study is an integrative review conducted in the PubMed, EMBASE, BVS and Web of Science databases, with no time restriction, including primary studies in Portuguese, English and Spanish. A total of 484 studies were identified. After screening and application of the eligibility criteria, 79 articles comprised the final sample, which were analysed through thematic categorisation and descriptive synthesis of the findings. Publications in Portuguese, English, and Spanish, with no time restrictions, were classified into six thematic categories: entomological indices and spatial mapping; factors associated with household invasion; vector control strategies; surveillance methods; professionals' perceptions; and challenges to the sustainability of actions. The findings revealed that entomological surveillance significantly contributes to the control of Chagas disease, especially when it integrates classical indicators, technological tools, and community-based strategies. The role of entomological indices, interventions in peridomestic ecotopes, and the training of field agents stands out as essential pillars for the effectiveness of interventions. However, vector resistance to insecticides remains a critical obstacle, reinforcing the need for multisectoral, localised and sustainable actions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783059","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":"Serious Bacterial Infections in Hospitalized Neonates in Eastern Ethiopia: Investigating the Emerging Pathogen Pantoea dispersa Compared With Klebsiella pneumoniae.","authors":"Yunus Edris, Faisel A Hassen, Desalegn A Ayana, Fami Ahmed, Haleluya Leulseged, Dadi Marami, Jabir Aliye, Belete G Alem, Zelalem T Mariam, Gezahang Mengesha, Nega Assefa, Alexander M Aiken, J Anthony G Scott, Lola Madrid","doi":"10.1111/tmi.70140","DOIUrl":"https://doi.org/10.1111/tmi.70140","url":null,"abstract":"<p><strong>Background: </strong>Serious bacterial infections (SBIs) are major contributors to neonatal morbidity and mortality in low-income countries. We describe the aetiology and risk factors for neonatal bacteraemia and in-hospital mortality in eastern Ethiopia, focusing on Pantoea dispersa, a rarely studied pathogen, and Klebsiella pneumoniae.</p><p><strong>Methods: </strong>Prospective surveillance was conducted at Hiwot Fana Comprehensive Specialized Hospital (HFCSH), Harar, from December 2021 to November 2023. Blood for culture was drawn from neonates admitted with the WHO clinical definition of possible-SBI (pSBI). Isolates were identified using API kits and antimicrobial susceptibility tested by Kirby-Bauer method.</p><p><strong>Findings: </strong>Among 1375 neonates with pSBI, blood was cultured from 1335 (97%), and 356 (27%) cultured pathogens. The commonest infections were Pantoea species (n = 145, 40.7%) and K. pneumoniae (n = 63, 17.7%); 128 Pantoea isolates were identified as P. dispersa by Matrix-Assisted Laser Desorption Ionization-Time of Flight. Case-fatality-ratios were 25% (32/128), 19% (9/47) and 19% (30/160) for P. dispersa, K. pneumoniae and other monomicrobial infections, respectively. P. dispersa showed resistance to ampicillin (99%) and cefotaxime (85%) but was otherwise broadly susceptible, while K. pneumoniae showed resistance to cefotaxime (100%) and gentamicin (89%), remaining susceptible only to amikacin and meropenem. Compared to non-bacteraemic admissions, P. dispersa bacteraemia was associated with health-facility delivery outside HFCSH (aOR 1.9 [95% CI, 1.21-2.97]), low birth weight (aOR 2.1 [95% CI,1.22-3.47]), and the dry season (aOR 9.7, [95% CI, 4.61-20.31]). K. pneumoniae bacteraemia was associated with health-facility delivery outside HFCSH (aOR, 2.2, [95% CI, 1.09-4.27]) alone. Among admissions with pSBI, death was associated with low birth weight and P. dispersa bacteraemia.</p><p><strong>Interpretation: </strong>Bacteraemia was prevalent among neonates admitted with pSBI to HFCSH. P. dispersa and K. pneumoniae predominated and both had high mortality risks. Rigorous diagnostics and epidemiological associations support the interpretation of P. dispersa as a pathogen, necessitating local investigation into transmission and infection control interventions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783094","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":"The Role of Serum Ferritin Levels in Dengue Fever Severity in Elderly People.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1111/tmi.70141","DOIUrl":"https://doi.org/10.1111/tmi.70141","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700002","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":"Model-Based Assessment of the Effects of Selective Free Healthcare and Differentiated Diagnosis on Malaria Burden in the Republic of Guinea.","authors":"Elhadj Marouf Diallo, Mor Absa Loum, Ousmane Oumou Diallo, Lucien Diégane Gning, Khady Ndiaye, Almamy Yousouf Ly, Léontine Ndogou Bakhoum, Abdourahamane Diallo, Laurent Gerbaud, Alioune Camara","doi":"10.1111/tmi.70144","DOIUrl":"https://doi.org/10.1111/tmi.70144","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a public health issue in Guinea, despite strengthened control measures, including free diagnosis and treatment policy. This study assesses, the potential effects of optimizing case management on malaria burden across different epidemiological archetypes.</p><p><strong>Methods: </strong>The nine ecological archetypes, established during the subnational tailoring, were used as study settings. A cost function integrating out-of-pocket, distance, income and quality of care was developed to predict the Artemisinin-based combination therapy (ACT) access index. This model was used to construct the scenarios such as selective free healthcare, differentiated diagnosis (access to appropriate care from the first point of contact), and the combined. Simulations were performed using Epidemiological Modelling (EMOD) software to assess the effects, for the period 2025-2030. The main results included incidence, parasite prevalence, and severe cases averted. Analyses were performed using R software. The optimization scenarios were compared to the baseline reflecting current malaria control interventions.</p><p><strong>Results: </strong>Reducing financial and geographical barriers improves access to malaria treatment, although disparities remain across and within archetypes. Free healthcare for children under five and differentiated diagnosis are particularly effective, raising the early access index to ACTs from 0.60 (Tougue) to 0.81 (Nzerekore). The effects are more pronounced in areas with low initial incidence such as Tougue, Siguiri, and Lelouma, where incidence drops below 50 cases per 1000 in 2028. The results highlight the effectiveness of age-targeted interventions. The combined strategy is promising, with the potential to prevent 13,428 complicated cases of paediatric malaria between 2025 and 2030 (95% CI: 7768-19,088). However, atypical contexts such as Kouroussa require more targeted approaches.</p><p><strong>Conclusion: </strong>Given limited resources, it is crucial to focus investments on effective interventions. This study shows that targeted selective free healthcare and differentiated screening improve access to ACTs, reduces malaria incidence and prevents severe cases, especially in children under five of age.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699982","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":"Infectious Agents of Non-Malarial Febrile Illnesses in 20 African Countries, 2019-2024: A Systematic Review and Meta-Analysis.","authors":"Wilfred Ofosu, Alex Odoom, Isaac Anim-Baidoo, Eric S Donkor","doi":"10.1111/tmi.70097","DOIUrl":"https://doi.org/10.1111/tmi.70097","url":null,"abstract":"<p><strong>Background: </strong>The growing attention to non-malarial febrile illnesses (NMFIs), driven by the decline in malaria cases across the African continent, has revealed pathogens previously overshadowed by the burden of malaria. Recent outbreaks, the resurgence of diseases and the rising antimicrobial resistance burden, compounded with data gaps in previous studies, have underscored the need to closely examine this area in recent times.</p><p><strong>Methods: </strong>We searched for articles through PubMed, Scopus, ScienceDirect and Web of Science databases to identify the common causative agents of NMFIs and estimate their proportional morbidity rates (PMRs) in Africa, stratifying agents across setting (rural vs. urban), population status (inpatient vs. outpatient) and outbreak status. We included studies that enrolled patients presenting with acute undifferentiated fever defined as fever without an identified alternative cause.</p><p><strong>Results: </strong>We analysed 101 studies comprising 68,905 febrile patients across 20 African countries, most with high risk of bias. Viruses were most frequently reported, with dengue and chikungunya viruses showing high PMR estimates of 6.8% (95% CI: 2.7%-16.2%) and 24.1% (95% CI: 7.0%-57.1%) respectively. Bacteria were less common (pooled PMR: < 5% each) but predominated among inpatients (80.4%), with K. pneumoniae, S. aureus, E. coli and S. pneumoniae most frequently reported and often resistant to penicillins, fluoroquinolones and 3rd-generation cephalosporins. Among outpatients, viral infections dominated (82.9%), particularly dengue and chikungunya in urban and outbreak contexts. In rural areas, S. pneumoniae, C. burnetii and Borrelia spp. were common bacterial causes, while dengue, Crimean-Congo haemorrhagic fever and Rift Valley fever viruses predominated. Despite the predominance of molecular methods, most studies included the use of both molecular and serological methods.</p><p><strong>Conclusion: </strong>The causative agents of NMFIs in Africa are enormous and context-specific. These findings highlight the need to move beyond malaria-centric fever management toward context-specific diagnostic and surveillance strategies. Methodological harmonisation is necessary to yield reliable summary estimates in future studies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692605","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":"Two Decades of Dengue in Bangladesh (2001-2024): Epidemiologic Trends, Geographic Spread and Climatic Drivers.","authors":"Awnon Bhowmik, Mahmudul Hasan, Goutam Saha, Huaiping Zhu","doi":"10.1111/tmi.70136","DOIUrl":"https://doi.org/10.1111/tmi.70136","url":null,"abstract":"<p><p>Bangladesh has experienced a marked escalation in dengue since 2001, culminating in 321,179 reported cases and 1705 deaths in 2023. The objective of this narrative review is to analyse 24 years of surveillance data to describe temporal trends, the transition from urban-centric to nationwide endemicity and the influence of climatic drivers. This review synthesises national surveillance and published reports from 2001 to 2024 to assess demographic risk, geographic spread and environmental factors. Young adults (21-30 years) consistently account for the largest share of infections (28.82% in 2024). In contrast, adults over 50 years suffer disproportionate mortality (15.65% of deaths in 2024) despite a smaller share of infections (7.15%). Since 2019, transmission has extended beyond urban centres such as Dhaka into peri-urban and other districts. This geographical diffusion is driven by the rapid urbanisation of other peripheries, infrastructure development that creates new vector habitats and accelerated population mobility which connects hyper-endemic urban hubs with susceptible rural communities. We identify priority actions such as targeted risk communication for young adults, improved access to healthcare for older adults and climate-adaptive vector control strategies integrated with urban services and strengthened surveillance. It is essential to address these factors to reduce the dengue burden and improve health outcomes in Bangladesh to control mosquito populations. Lessons are transferable to other dengue-affected countries when adapted to local demographic and environmental contexts and embedded in regional collaboration and climate-responsive policy.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628768","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":"Global Donor Fatigue and Its Impact on Vaccination Coverage in Africa: Challenges and the Path Forward.","authors":"Michael Sarfo, Daniel Akuamoah Asirifi, John Kwame Agbenyeavu, Kwaku Obeng Boateng, Nelson Obeng, Sandra Konadu Bonnah, Betelhem Abebe Andargie, Gilbert Eshun","doi":"10.1111/tmi.70139","DOIUrl":"https://doi.org/10.1111/tmi.70139","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623889","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":"Persistent Hyperglycaemia and Transient Dysglycaemia in Tuberculosis: Evaluating the Bidirectional Interaction With Type-2 Diabetes Mellitus and Clinical Outcomes.","authors":"Augustine Asare Boadu, Prince Asare, Michelle Yeboah-Manu, Stephen Osei-Wusu, Emelia Danso Konadu, Adwoa Asante-Poku, Yayra Klinogo, Abraham Adjei, Desmond Omane Acheampong, Jane S Afriyie-Mensah, Dorothy Yeboah-Manu, Yacoba Atiase","doi":"10.1111/tmi.70102","DOIUrl":"10.1111/tmi.70102","url":null,"abstract":"<p><strong>Introduction: </strong>Poor glycaemic control, indicated by a haemoglobin A1c (HbA1c) level of 7% or higher, increases the risk of active tuberculosis (TB) in patients with diabetes, while active TB can worsen glucose tolerance and insulin resistance, contributing to type-2 diabetes mellitus (DM) progression. The bidirectional relationship between TB and DM is well recognised, but the evolution of glycaemic status during TB treatment, particularly the distinction between transient and persistent dysglycaemia, is not well understood in high-burden settings.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of 120 newly diagnosed pulmonary TB patients in Ghana, categorised as TB-Only (n = 66), TB with established DM on metformin (TB-DM_t, n = 39), and TB with dysglycaemia not requiring pharmacological therapy (TB-DM_nt, n = 15). HbA1c was measured at baseline, 3, 6 and 9 months.</p><p><strong>Results: </strong>TB-DM_t patients were older, had higher BMI and persistently elevated HbA1c (p < 0.001). In contrast, TB-DM_nt patients showed significant HbA1c decline during and after TB treatment, normalising by 6 months (p < 0.016). Most TB-Only patients maintained stable euglycaemia. Transient dysglycaemia resolved in TB-DM_nt, while persistent hyperglycaemia was confined to those with pre-existing DM (TB-DM_t).</p><p><strong>Conclusion: </strong>Routine HbA1c monitoring during TB therapy can distinguish transient dysglycaemia from true diabetes, supporting more precise risk stratification and tailored management of TB patients.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"523-531"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285326","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":"Incidence and Severe Outcomes of Acute Kidney Injury in Haff Disease: A Brazilian Cohort Study.","authors":"Raoni de Oliveira Domingues-da-Silva, Haicha Brarymi Oliveira, Thiago Afonso Teixeira, Gisele Rocha Lopes, Gabriel Cavalcante Lima Chagas, Alefe Islleyker Aguiar Santiago, Janaína de Almeida Mota Ramalho, Gdayllon Cavalcante Meneses, Karla Cristina Petruccelli Israel, Paula Bruna Sousa Santos, Lúcia da Conceição Andrade, Geraldo Bezerra Silva Junior, Alice Maria Costa Martins, Elizabeth De Francesco Daher","doi":"10.1111/tmi.70111","DOIUrl":"10.1111/tmi.70111","url":null,"abstract":"<p><strong>Introduction: </strong>Haff disease, characterised by rhabdomyolysis within 24 h of fish ingestion, is a rare but potentially severe condition. Acute Kidney Injury (AKI) is recognised as a significant complication, yet effective prognosis assessment is difficult due to clinical variability and the disease's low incidence. This study aimed to determine the incidence and severity of AKI in Haff disease patients from a recent outbreak, comparing clinical and laboratory features between those with and without this complication.</p><p><strong>Methods: </strong>This retrospective cohort study utilised medical records from a Brazilian tertiary hospital between 2021 and 2022. Adult patients presenting within 24 h of fish consumption with serum Creatine Phosphokinase (CPK) levels at least five times the upper reference limit and classic signs of rhabdomyolysis were included.</p><p><strong>Results: </strong>Eighteen patients met inclusion criteria, 56% male, mean age 52.6 ± 16.4 years, 28% with diabetes, 39% with hypertension. No patient died in our cohort. AKI occurred in 8 patients (44%), predominantly classified as KDIGO stage 3 (75%). Within the AKI group, 2 (25%) presented with oliguria, 5 (63%) required dialysis and 3 (38%) remained dialysis-dependent at discharge. Both patients requiring intensive care unit admission belonged to the AKI group. Peak levels of liver enzymes (AST p = 0.005, ALT p = 0.018), Lactate Dehydrogenase (p = 0.042) and both admission (p = 0.008) and peak (p = 0.003) CK-MB were significantly higher in patients who developed AKI.</p><p><strong>Conclusion: </strong>AKI incidence in this Haff disease cohort was notably high. The AKI group had a more severe clinical trajectory, encompassing all ICU admissions and frequent dialysis requirements, with a concerning rate of persistent dialysis dependence at discharge.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"567-575"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311073","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}