Tropical Medicine & International Health最新文献

{"title":"Wolbachia Infection in Iranian Malaria Vectors: Prevalence and Biocontrol Implications.","authors":"Shahin Saeedi, Fateh Karimian, Seyed Hassan Moosa-Kazemi, Jalil Nejati, Mulood Mohammadi Bavani, Mona Koosha, Nayyereh Choubdar, Ghazal Khosravi, Mohammad Ali Oshaghi","doi":"10.1111/tmi.70031","DOIUrl":"10.1111/tmi.70031","url":null,"abstract":"<p><p>Wolbachia-based vector control is an emerging tool in malaria prevention research. This study evaluates Wolbachia infection in Iranian mosquitoes, focusing on seven known malaria vectors. Mosquitoes were collected from nine provinces of Iran (2016-2019), and Wolbachia infection status was analysed via PCR targeting eight genes: wsp, gatB, ftsZ, dnaA, groEL, gltA, CoxA and fbpA. We examined 1094 specimens from seven malaria vectors (Anopheles stephensi Liston, 1901; Anopheles culicifacies s.l. James, 1901; Anopheles fluviatilis s.l. James, 1902; Anopheles maculipennis s.l. Meigen, 1818; Anopheles sacharovi Favr, 1903; Anopheles dthali Patton, 1905; Anopheles superpictus s.l. Grassi, 1899), four non-malaria vectors (Anopheles mongolensis Linton, Lee and Curtis, 2005; Anopheles hyrcanus Pallas, 1771; Anopheles claviger Meigen, 1804; Anopheles turkhudi Liston, 1901) and three Culex species (Culex pipiens Linnaeus, 1758; Culex perexiguus Theobald, 1903; Culex theileri Theobald, 1903). PCR revealed Wolbachia DNA exclusively in An. dthali and Culex species, with infection rates of 73.4% for An. dthali and 77.78%-96.77% for Culex, notably higher in males. Wolbachia was detected in all regions except one in the north. Phylogenetic analysis revealed Wolbachia strains in An. dthali and Culex belong to supergroup B, closely related to strains in An. moucheti and An. demeilloni. This suggests broader applications for biocontrol strategies. The high Wolbachia prevalence in An. dthali is promising for malaria prevention. Future research should confirm cytoplasmic incompatibility and explore wAdth's potential to block malaria transmission.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971767","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":"Cross-Reactivity of SARS-CoV-2 Antibodies With Typhoid Flagellar-H Protein.","authors":"Aneela Pasha, Mohammad Saeed","doi":"10.1111/tmi.70027","DOIUrl":"https://doi.org/10.1111/tmi.70027","url":null,"abstract":"<p><strong>Background: </strong>Antigen cross-reactivity in infections may induce heterologous immunity, leading to immunological protection against widely divergent organisms. We hypothesised that this may be a factor in the varying intensity of COVID-19 infection globally.</p><p><strong>Methods: </strong>During the COVID-19 pandemic, we tested 46 symptomatic patients for both COVID-19 antibodies and the Typhidot test. The kappa statistic in STATA 16.0 was used to analyse agreement between the two tests. Python-based k-mer analysis was used to identify overlapping fragments between SARS-CoV-2 and Salmonella typhi proteins. PEP-Fold3, TM-align and RasMol software were used to evaluate the 3D-structural changes. World COVID-19 and Typhoid mortality and infection statistics were obtained from published data. Line graphs were used to assess correlations between Typhoid cases and COVID-19 mortality.</p><p><strong>Results: </strong>There was a high degree of agreement between Typhidot and COVID-19 antibody tests (Cohen's kappa = 0.43, p = 0.0016). A 5-amino-acid peptide, NGVEG, located in the receptor binding motif (RBM) of the SARS-CoV-2 Spike protein matched with the Typhoid flagellar-H protein on k-mer analysis. SARS-CoV-2 Delta (B.1.617.2) variant 3D structure displayed marked changes that may have altered this cross-reactivity. COVID-19 mortality between Pre-Delta (2020) and Post-Delta (2021) periods showed a negative correlation in Typhoid endemic regions and a reverse trend in non-endemic regions.</p><p><strong>Conclusion: </strong>Cross-reactivity of Typhoid flagellar-H protein antibodies with SARS-CoV-2, mediated by a peptide in the RBM, may have provided partial heterologous immunity to COVID-19 in Typhoid endemic regions and this was eliminated by the Delta variant.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971787","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":"Ebola Stigma and Its Impact on Outbreak Control: Lessons From Key Informant Interviews in Central Uganda.","authors":"Amy Paterson, Olive Kabajaasi, Francess Adlard, Kkunsa Hadson Dimitrios, Ashleigh Cheyne, Yasin Ssewankambo, David Kaggwa, Piero Olliaro, Nathan Kenya-Mugisha, Amanda Rojek","doi":"10.1111/tmi.70014","DOIUrl":"10.1111/tmi.70014","url":null,"abstract":"<p><strong>Objectives: </strong>The 2022 outbreak of Sudan ebolavirus in central Uganda was the country's largest in two decades. It was accompanied by reports of stigma towards affected individuals, households and communities. The objectives of this study were to (1) describe how Ebola disease stigma emerged and manifested during the 2022 Sudan ebolavirus outbreak in central Uganda, (2) examine its impacts, including on outbreak control and (3) identify insights that could inform stigma reduction strategies in future outbreaks.</p><p><strong>Methods: </strong>We conducted qualitative in-depth interviews with 12 key informants involved in the Ebola disease outbreak response using Microsoft Teams. Participants included frontline healthcare workers, burial team members, psychosocial support staff, survivor programme staff, village health team members, local outbreak response leadership and Ebola survivors. Transcribed interviews were coded in NVivo Release 1.7.2 and analysed using framework analysis.</p><p><strong>Results: </strong>Contextual drivers of stigma included mistrust of authorities, limited knowledge about the disease and conspicuous survivor follow-up. These drivers fuelled negative thoughts and emotions, predominantly blame and fear. Interviewees described how stigma manifested as negative attitudes, verbal and physical harm, unwarranted avoidance and structural disadvantage, which persisted beyond the outbreak itself. Stigma was seen to impact outbreak control by discouraging symptom reporting, delaying care-seeking and exacerbating workforce shortages in clinical centres. Factors that mitigated stigma included psychosocial support and survivor advocacy.</p><p><strong>Conclusions: </strong>Ebola-related stigma complicates outbreak control and has adverse psychosocial effects that linger long after the outbreak is declared over. We provide a range of multilevel strategies for reducing stigma, including engagement with trusted community leaders, survivor-centred support systems and provision of psychological support for responders.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1006-1017"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776329","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":"Burden of Chikungunya Fever and Its Economic and Social Impacts Worldwide: A Systematic Review.","authors":"Vaneide Daciane Pedí, Giovanny Vinícius Araújo de França, Viviane Bellini Rodrigues, Felipe Tavares Duailibe, Marcella T P Santos, Maria Regina Fernandes de Oliveira","doi":"10.1111/tmi.70012","DOIUrl":"10.1111/tmi.70012","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the social and economic impacts and disease burden of Chikungunya Fever globally through a systematic literature review.</p><p><strong>Methods: </strong>We performed a comprehensive literature search through MEDLINE (via PubMed), LILACS, and Embase databases, and grey literature, including studies of populations diagnosed with Chikungunya Fever or at risk of infection published in English, Spanish, French, or Portuguese, without date restrictions. Two reviewers independently performed study selection, data extraction, and quality assessment. Methodological quality was assessed using different tools.</p><p><strong>Results: </strong>Forty-three publications were included. Until 2013, publications originated solely from the Asian and African continents. From 2015 onwards, South America emerged as the predominant source. Publications were classified as cost studies (25), including cost-of-illness (18) and program cost (6); burden of disease studies (10); cost-outcome studies (4), including cost-effectiveness (3) and cost-utility (1); and quality-of-life studies (15). Reported total direct costs associated with Chikungunya Fever ranged from US$ 3.5 million (US Virgin Islands, 2014-2015) to US$ 83.6 billion (Region of the Americas, 2013-2015). Direct medical costs varied from US$ 308.94 (Tamil Nadu, India, 2006) to US$ 33.7 million (Réunion Island, 2005-2006). Vector control program costs ranged from US$ 888,000 annually (Greece, 2013-2017) to US$ 466 million (Brazil, 2016). Estimated disability-adjusted life years per 100,000 population ranged from 4.53 (India, 2006) to 2432 (Region of the Americas, 2013-2015). Quality-of-life studies demonstrated substantial declines across multiple domains, indicating significant functional impairment due to Chikungunya Fever.</p><p><strong>Conclusion: </strong>Chikungunya Fever imposes a considerable economic and social burden, surpassing that of other endemic arboviral diseases such as dengue and yellow fever. These findings underscore the need for further research to accurately quantify the full scope of Chikungunya Fever-related costs and impacts on affected populations.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"865-892"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683252","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":"High Burden of Symptomatic and Asymptomatic Sexually Transmitted Infections in a Routine Decentralised HIV Care Setting in Eswatini: A Cross-Sectional Study.","authors":"Bernhard Kerschberger, Nombuso Ntshalintshali, Mano Isaac Mafomisa, Edwin Mabhena, Michelle Daka, Esther Mukooza, Skinner Lekelem, Sindisiwe Dlamini, Mpumelelo Mavimbela, Lenhle Dube, Sindy Matse, Nomvuyo Mabuza, Roberto de Latour, Laurence Toutous Trellu, Hayk Karakozian, Nelly Staderini, Melat Haile, Pablo Valladares, Alexandra Calmy, Iza Ciglenecki","doi":"10.1111/tmi.70011","DOIUrl":"10.1111/tmi.70011","url":null,"abstract":"<p><strong>Objectives: </strong>Sexually transmitted infections are a global public health concern. We aimed to assess the burden of a diverse range of sexually transmitted infections in a high HIV burden setting in Eswatini and associated risk factors.</p><p><strong>Methods: </strong>This cross-sectional study enrolled adults accessing routine outpatient care at six sites in Shiselweni, from July 2022 to April 2023. Laboratory investigations included antibody-based tests for HIV, Treponema pallidum , hepatitis B, hepatitis C, and herpes simplex 2 viruses. The molecular-based Xpert platform tested urine samples for Chlamydia trachomatis , Neisseria gonorrhoea, Trichomonas vaginalis, self-collected vaginal/anal swabs for Human papillomavirus, and plasma for HIV viremia. We calculated the proportion of laboratory-confirmed sexually transmitted infections among available test results and identified predictors of combined Chlamydia trachomatis /Neisseria gonorrhoea/Trichomonas vaginalis infection.</p><p><strong>Results: </strong>Of 1396 study participants, 65.4% were women, the median age was 29 (IQR 23-36) years, and 19.6% were known HIV-positive. Overall, 68.6% had symptoms suggestive of Chlamydia trachomatis /Neisseria gonorrhoea/Trichomonas vaginalis infections. Laboratory-confirmed Chlamydia trachomatis /Neisseria gonorrhoea/Trichomonas vaginalis infection was found in 31.7% (n = 443/1396), of whom 20.8% were asymptomatic. Combined Chlamydia trachomatis /Neisseria gonorrhoea/Trichomonas vaginalis infections were common even among individuals with low risk of infection (e.g., no sexual intercourse: 20.7%) and were associated with young age, factory employment, and transactional sex. Prevalences for individual sexually transmitted infections were 16.9% (n = 236/1394) for Chlamydia trachomatis , 12.4% (n = 173/1394) for Neisseria gonorrhoea, 10.6% (n = 148/1390) for Trichomonas vaginalis, and 9.7% (n = 135) for Treponema pallidum . Viral infections were high for herpes simplex 2 viruses (n = 792/1279, 61.9%) and human papillomavirus (n = 166/324, 51.2%) and lower for hepatitis B virus (n = 55/1396, 3.9%) and hepatitis C virus (n = 3/1396, 0.2%). Of 1122 clients undergoing HIV testing, 4.1% (n = 46/1122) tested positive, with 21.7% (n = 10/46) being acute/early HIV infection.</p><p><strong>Conclusions: </strong>The substantial sexually transmitted infections burden highlights the urgent need to strengthen sexually transmitted infections service integration, expand access to affordable diagnostics, and target prevention in decentralised care. These findings support the development of context-adapted strategies to improve detection, treatment, and partner services in high-burden settings.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"987-1005"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691784","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":"Temporal trend and spatial analysis of oral cancer cases in Brazil: Correlation between socioeconomic factors and delay in diagnosis and treatment.","authors":"Deane Cristina da Rocha Rodrigues de Oliveira, Wandklebson Silva da Paz, Márcio Bezerra-Santos, Priscila Lima Dos Santos, Débora Dos Santos Tavares","doi":"10.1111/tmi.14141","DOIUrl":"10.1111/tmi.14141","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the temporal trend and spatial distribution of oral cancer cases in Brazil, and to evaluate the relationship between oral cancer cases and socioeconomic conditions.</p><p><strong>Methods: </strong>Data on oral cancer cases, between 2013 and 2019, were extracted from the Painel-Oncologia website, and the socioeconomic indicators selected were Municipal Human Development Index and Social Vulnerability Index. The endpoints were late diagnosis (staging III and IV) and delay in treatment (>60 days), along with oral cancer prevalence. Spearman's correlation was done between oral cancer cases and Municipal Human Development Index/ Social Vulnerability Index. Temporal trends were evaluated using a segmented linear regression model. As for spatial analysis, global and local Moran indices were applied, together with spatiotemporal scan statistics, to detect risk clusters.</p><p><strong>Results: </strong>In the period studied, there was a prevalence of 5.3 oral cancer cases/100,000 inhabitants. A significant inverse correlation was found with the Social Vulnerability Index, and a direct correlation linking the Municipal Human Development Index and oral cancer cases, delayed treatment, and diagnosis cases too. An increasing trend of oral cancer prevalence rate and a stable trend of delayed diagnosis and treatment cases were observed in the country. There was a concentration of oral cancer cases in the South and Southeast regions. A high-risk oral cancer cluster was identified covering the South and Southeast regions, and part of the Midwest region and four secondary clusters of delayed treatment cases in the Northeast region.</p><p><strong>Conclusion: </strong>There was no short-term improvement in data related to oral cancer in Brazil, since the prevalence trend was increasing and there was a correlation with socioeconomic conditions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"908-920"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369308","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":"Women's participation in mobile phone surveys in Mozambique: Findings from a qualitative study.","authors":"Rosemary Morgan, Yolanda Manganhe, Celso Monjane, Milly Nakatabira, Helen Kuo, Cremildo Manhiça, Ferão Mandlate, Milton Sengo, Midalia Uamba, Almamy Malick Kante, Ivalda Macicame, Agbessi Amouzou","doi":"10.1111/tmi.70006","DOIUrl":"10.1111/tmi.70006","url":null,"abstract":"<p><strong>Objectives: </strong>The use of mobile phone surveys in low- and middle-income countries is increasing as a low-cost and rapid alternative to in-person interviews. However, ensuring they are representative of women and, when women are included reducing potential response bias and harm are important considerations. To improve women's participation in phone surveys, we conducted a qualitative study in Mozambique to better understand women's experiences of participating in mobile phone surveys.</p><p><strong>Methods: </strong>This study was part of the Rapid Mortality Mobile Phone Survey (RaMMPS) project implemented in Mozambique to test the use of mobile phone interviews for childhood mortality measurement at the national level. We conducted a qualitative study with 32 women who had previously participated in the RAMMPS mobile phone survey. Interviews were conducted both in-person and over the phone. Thematic analysis was done manually using the Framework approach.</p><p><strong>Results: </strong>Gender-related considerations that emerged from the data regarding women's participation included women's access to mobile phones, the reduced time burden and convenience of participating in mobile phone interviews compared to in-person interviews, difficulties ensuring privacy in mobile phone surveys, the effect of the interviewer's gender on participant responses, and women's safety concerns.</p><p><strong>Conclusion: </strong>Important considerations for including women in mobile phone surveys relate to efforts to reduce response bias and mitigate harm, such as ensuring privacy and considering the gender of the data collector. Addressing these issues is crucial to improving women's participation and experience in mobile phone surveys.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"946-953"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668669","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":"Malaria and helminths co-infection-Effects on anaemia, iron and folate deficiencies in paediatric population in Ghana.","authors":"Opoku Bempah, Kwasi Baako Antwi, Mutala Abdul-Hakim, Ibrahim Alhadj Moussa Mahamat, Kwadwo Boampong, John Larbi, Kingsley Badu","doi":"10.1111/tmi.70003","DOIUrl":"10.1111/tmi.70003","url":null,"abstract":"<p><strong>Background: </strong>Helminthiasis co-exists with malaria in endemic areas; this co-existence can influence anaemia, iron, and folate levels in patients. This study was aimed at assessing the effect of malaria, helminthiasis, and co-infection on anaemia, iron, and folate deficiencies in children.</p><p><strong>Methods: </strong>The study participants comprised of 1003 children, from whom venous blood and stool samples were obtained. Structured questionnaires were used to assess sociodemographic and household data. Venous blood from children (aged 1-15 years) was analysed for malaria parasitaemia and full blood count. Kato Katz and formol ether concentration techniques were used to analyse stool samples for intestinal parasites. Indirect ELISA was performed on the serum samples to determine iron and folate levels.</p><p><strong>Results: </strong>Overall, malaria and intestinal helminths prevalence were 54.4% (546/1003) and 15.7% (172/1003), respectively. Ascaris lumbricoides, Taenia spp., hookworm, Trichuris trichiura and Strongyloides stercoralis were identified as mono-infection or in co-infection with malaria (11.4%) or intestinal protozoa (1.5%). These prevalence rates were significantly higher in less urbanised northern study sites (p < 0.0001) and among younger children (p < 0.0001). Malaria (p < 0.0320), intestinal helminths (p < 0.0001) and malaria-helminthiasis co-infection (p < 0.0320) were independent predictors of anaemia. Malaria and intestinal helminths co-infection significantly worsens anaemia (p < 0.001), folate deficiency (p < 0.001) and iron deficiency (p < 0.001) compared to those with malaria only.</p><p><strong>Conclusion: </strong>Malaria and helminthiasis predominantly affect children and are influenced by age, gender, locality, and urbanisation. Co-infection exacerbates the adverse outcomes associated with malaria.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"921-936"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561333","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":"Leprosy in blood donors.","authors":"Erika Vanessa Oliveira Jorge, Angélica Rita Gobbo, Izabelle Laissa Viana Costa, Raquel Carvalho Bouth, Sâmela Miranda da Silva, Ana Caroline Cunha Messias, Josafá Gonçalves Barreto, Patrícia Fagundes da Costa, Pablo Diego do Carmo Pinto, Moises Batista da Silva, John Stewart Spencer, Maurício Koury Palmeira, Claudio Guedes Salgado","doi":"10.1111/tmi.70007","DOIUrl":"10.1111/tmi.70007","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the prevalence of anti-phenolic glycolipid-I (PGL-I) IgM antibodies among temporarily unfit blood donors at the Pará State Blood Bank (HEMOPA), located in the Amazon region of northern Brazil. Using an arbitrary high cutoff for optical density (OD ≥0.750) in ELISA, a subset of donors was invited for clinical evaluation for leprosy.</p><p><strong>Methods: </strong>Temporarily unfit individuals were invited to participate, and blood samples were collected for anti-PGL-I IgM titration by ELISA. Donors with high OD values were referred for clinical examination, slit skin smear (SSS) bacilloscopy, and quantitative PCR (qPCR) targeting M. leprae-specific repetitive element (RLEP) sequences from dermal scrapes of the earlobes and peripheral blood.</p><p><strong>Results: </strong>From an annual average of 2762 temporarily unfit donors (2019-2023), 500 (16.6%) were tested for anti-PGL-I IgM. Of these, 20/500 (4.0%) had high antibody titres, and 8/20 (40.0%) attended clinical evaluation, resulting in 5/8 (62.5%) newly diagnosed cases of leprosy. Among these, Mycobacterium leprae detection yielded positivity rates of 2/8 (25.0%) by SSS bacilloscopy, 3/7 (42.9%) by qPCR of dermal scrapes, and 2/8 (25.0%) by qPCR of peripheral blood.</p><p><strong>Conclusions: </strong>Using an anti-PGL-I IgM cutoff of OD ≥0.750, we identified a significant proportion of undiagnosed leprosy cases among temporarily unfit blood donors. These findings support the need for targeted leprosy screening in this population. Regardless of qPCR results, individuals with clinical signs of leprosy require appropriate treatment and assessment of their eligibility for blood donation.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":"30 9","pages":"1018-1022"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971798","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":"Prevalence and risk factors for murine typhus, scrub typhus and spotted fever group rickettsioses among adolescent and adult patients presenting to Yangon General Hospital, Yangon, Myanmar.","authors":"Thomas R Bowhay, Tin Ohn Myat, Win Thandar Oo, Hla Kye Mone, Katrina J Sharples, Matthew T Robinson, Mayfong Mayxay, Paul N Newton, Stuart D Blacksell, Ampai Tanganuchitcharnchai, James E Ussher, David R Murdoch, Wah Win Htike, John A Crump","doi":"10.1111/tmi.70009","DOIUrl":"10.1111/tmi.70009","url":null,"abstract":"<p><strong>Objectives: </strong>To inform patient management and disease prevention, we sought to estimate the prevalence of, and identify risk factors for, scrub typhus, murine typhus, and spotted fever group rickettsioses (SFGR) among febrile patients presenting to hospital in Myanmar.</p><p><strong>Methods: </strong>We recruited patients ≥12 years old with fever ≥38°C among those seeking care at Yangon General Hospital from 5 October 2015 through 4 October 2016. Standardised clinical and risk factor assessments were conducted. Confirmed scrub typhus, murine typhus, and SFGR infections were defined as a positive polymerase chain reaction or ≥4-fold rise in immunofluorescence assay antibody titre to Orientia tsutsugamushi, Rickettsia typhi or Rickettsia honei or Rickettsia conorii, respectively. Probable infection was defined as IgM titre ≥1:400 to O. tsutsugamushi, an IgM titre of ≥1:800 or IgG ≥1:1600 to R. typhi or an IgG titre of ≥1:200 to R. honeii or R. conorii. Univariate and multivariable logistic regression was used to identify associations.</p><p><strong>Results: </strong>Among 944 participants, the median (range) age was 37 (12-94) years, 444 (47.0%) were female, and 704 (74.6%) resided in rural areas. Among participants, 63 (6.7%) had confirmed or probable scrub typhus and 15 (1.6%) had confirmed or probable murine typhus. No SFGR infections were identified. The odds of confirmed or probable scrub typhus were lower among females than males (adjusted odds ratio [aOR] 0.5, p = 0.014), lower among those earning >300,000 Kyat per month compared with those earning less than 100,000 Kyat per month (aOR 0.28, p = 0.039), and higher among agricultural workers compared with others (aOR 2.9, p = 0.004).</p><p><strong>Conclusion: </strong>Scrub typhus was common among patients presenting with fever in Yangon, murine typhus was uncommon, and SFGR was not found. Empiric treatment of severe febrile illness should include an antimicrobial with activity against rickettsial diseases. Public health campaigns targeting agricultural workers are recommended.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"966-977"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650719","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}