Tropical Medicine & International Health最新文献

{"title":"Renal and Functional Vulnerability in Hansen Disease: A Framework for Chronic Infectious Disability in Endemic Settings.","authors":"Kleberson de Oliveira, Lucas Maciel de Almeida Corrêa, Isabela Malerba Pinheiro, Alexandre de Assis Barbosa, Maria Eduarda Castro Gonçalves, Lara Lucena Fernandes Filgueiras, Lara Reis Gomes de Mello Queiroz","doi":"10.1111/tmi.70231","DOIUrl":"https://doi.org/10.1111/tmi.70231","url":null,"abstract":"<p><strong>Objectives: </strong>Hansen disease is a neglected infectious disease associated with reactional inflammation, neuropathy and long-term disability. Renal involvement and sarcopenia have been described separately, but their clinical coexistence has received limited attention. This review examines evidence for a hypothesised renal-functional vulnerability interface and proposes a pragmatic monitoring framework for endemic settings.</p><p><strong>Methods: </strong>We conducted a critical narrative review using structured, targeted searches of PubMed/MEDLINE, Embase, Scopus and Web of Science from database inception to 1 June 2026, supplemented by manual reference screening. Eligible sources addressed Hansen disease, renal involvement, urinary abnormalities, sarcopenia, body composition, muscle strength, disability, neuropathy, reactional states, nutrition and treatment exposure. No formal risk-of-bias tool was applied; greater interpretive weight was given to primary clinical data, systematic reviews, consensus statements and guidelines.</p><p><strong>Results: </strong>Evidence indicates heterogeneous renal manifestations in Hansen disease, including proteinuria, haematuria, albuminuria, urinary biomarker abnormalities, glomerulonephritis, tubulointerstitial disease and amyloidosis. Separately, older survivor cohorts show increased adiposity, reduced appendicular skeletal muscle mass and higher sarcopenia prevalence. Sarcopenia should be interpreted primarily through neuropathy, pain, deformity, ulcers, immobility, ageing, corticosteroid exposure and social or nutritional vulnerability; renal involvement is, at most, a plausible cofactor. Low muscle mass may also lead to under-recognition of renal impairment when creatinine-based eGFR is used.</p><p><strong>Conclusions: </strong>Current evidence does not prove a causal renal-muscle relationship, but supports a hypothesised renal-functional vulnerability interface. Integrated renal and functional assessment may help identify high-risk patients and guide prospective cohorts.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971532","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 Last Mile for Leprosy: From Multidrug Therapy to Sustainable Zero.","authors":"Nam T Nguyen, Omar Elnour, Rowan Haffner, Yuda Sule Paschal, Ketan Tamirisa, Atnatiyos Gizachew, Faraan O Rahim","doi":"10.1111/tmi.70223","DOIUrl":"https://doi.org/10.1111/tmi.70223","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963921","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":"Changes in Tuberculosis Incidence and Mortality Following the End TB Strategy and the COVID-19 Pandemic in Brazil: An Interrupted Time-Series Analysis.","authors":"Bruno Victor Barros Cabral, George Jó Bezerra Sousa, Thiago Santos Garcês, Luiz Henrique Arroyo, Mayara Nascimento de Vasconcelos, Maria Lúcia Duarte Pereira","doi":"10.1111/tmi.70226","DOIUrl":"https://doi.org/10.1111/tmi.70226","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains a major global public health challenge, particularly in high-burden countries such as Brazil. The End TB Strategy and the COVID-19 pandemic represent key events associated with changes in tuberculosis incidence and mortality, although their temporal patterns and combined effects remain insufficiently explored.</p><p><strong>Methods: </strong>An ecological study using interrupted time series analysis was conducted with annual tuberculosis incidence and mortality rates in Brazil from 2001 to 2024. Prais-Winsten regression with logarithmic transformation was applied to estimate level and trend changes, considering 2015 and 2020 as interruption points within the same analytical model. Model fit was assessed using the Durbin-Watson test and adjusted R².</p><p><strong>Results: </strong>In the combined two-intervention model, TB incidence showed no significant immediate change following the End TB Strategy but increased by 3.8% per year (95% CI: 2.1; 5.6; p < 0.001) between 2015 and 2020. Following the onset of the COVID-19 pandemic, incidence decreased immediately by 15.2% (95% CI: -20.6; -9.6; p < 0.001), followed by an annual increase of 3.1% (95% CI: 0.6; 5.6; p = 0.07). Mortality showed no significant immediate changes associated with either interruption but increased by 5.6% per year after 2020 (95% CI: 3.0; 8.2; p < 0.001).</p><p><strong>Conclusion: </strong>Changes in TB incidence and mortality were temporally associated with the selected interruption points, including an increase in incidence between 2015 and 2020 and a marked decline following the onset of the COVID-19 pandemic. However, causal attribution is limited by the ecological design, absence of a control group and the small number of observations between intervention points and after 2020.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945788","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":"Plasmodium falciparum Parasites With Histidine-Rich Protein 2 (pfhrp2) and pfhrp3 Gene Deletions in Frontier Endemic Regions of Brazilian Amazon.","authors":"Jéssica de Oliveira Bonsanto Gonçalves, Simone da Silva Santos, Rodrigo Medeiros Martorano, Jaime Louzada, Victoria Martins Roque Almeida, Lucas Rego Viana, Josely Oliveira Ferreira, Anielle Pina Costa, André Siqueira, Martha Cecília Suárez-Mutis","doi":"10.1111/tmi.70221","DOIUrl":"https://doi.org/10.1111/tmi.70221","url":null,"abstract":"<p><p>Studies reporting deletions of the pfhrp2 and pfhrp3 genes in P. falciparum populations in various malaria-endemic countries, including countries bordering Brazil, are increasing. Individuals infected with P. falciparum carrying deletions of the pfhrp2/3 genes may yield false-negative results in Rapid Diagnostic Tests (RDTs) based on the detection of these antigens. A total of 342 samples from symptomatic individuals infected with P. falciparum, collected during epidemiological surveillance activities in the municipalities of the international frontier between Brazil and Peru and between Brazil and Venezuela were analysed. Of the 342 samples evaluated, 86 (25.2%) showed pfhrp2-deletion, 32 (9.4%) double deletions of the pfhrp2/3 genes, and 168 (49.1%) had a single deletion of the pfhrp3 gene. The frequency of parasites with pfhrp2/3 deletions highlights the importance of genomic surveillance in international border areas, alongside the evaluation of the effectiveness of RDTs used in the country.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913555","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":"Sero-Diagnosis of Scrub Typhus Infection in India: A Systematic Review and Meta-Analysis.","authors":"Jogender Yadav, Santenna Chenchula, Ram Kumar Nema, Jyoti Kant Choudhari, Shashank Purwar","doi":"10.1111/tmi.70185","DOIUrl":"10.1111/tmi.70185","url":null,"abstract":"<p><strong>Background: </strong>Scrub typhus is a major yet often unrecognised cause of acute undifferentiated febrile illness (AUFI) in India. Delayed diagnosis contributes substantially to organ dysfunction and mortality, but accurate estimates of disease burden are limited by heterogeneous diagnostic practices. Understanding the proportion of clinically suspected cases attributable to scrub typhus is essential for improving early recognition and treatment.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of studies reporting IgM enzyme-linked immunosorbent assay (ELISA) confirmed scrub typhus among patients presenting with acute febrile illness in India. Searches of major databases were conducted through August 2025. A random-effects model with DerSimonian-Laird estimator and Hartung-Knapp-Sidik-Jonkman adjustment was used to estimate pooled prevalence. Freeman-Tukey double arcsine transformation was applied to stabilise variances. Study quality was assessed with the Joanna Briggs Institute checklist. Heterogeneity, publication bias and influence diagnostics were evaluated using both advanced and standard statistical tests and graphical tools.</p><p><strong>Results: </strong>A total of 44 studies involving 67,179 clinically suspected cases met eligibility criteria. The pooled prevalence of scrub typhus was 29.3% (95% CI: 22.3%-37.3%). Prevalence varied widely across regions (0.63%-93.10%). Sensitivity analyses demonstrated that no single study materially altered the pooled prevalence. Publication bias was minimal. The Doi plot showed minor asymmetry (LFK index, 1.47), whereas Egger's regression and Begg's test indicated no statistically significant publication bias.</p><p><strong>Conclusion: </strong>This meta-analysis reveals that scrub typhus accounts for nearly one-third of suspected febrile illnesses in India (pooled prevalence: 29.3%). Clinicians in endemic regions should maintain a high index of suspicion and initiate timely therapy. Improved access to standardised diagnostics and molecular testing is essential to reduce morbidity and mortality.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1172-1182"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253679","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":"Atypical Clinical Manifestations and Laboratory Predictors of Severe Scrub Typhus in Hospitalized Adults at Two Tertiary Care Hospitals in North India.","authors":"Anju Dinkar, Jitendra Singh, Rajeev Verma, Virendra Atam, Munna Lal Patel, Ajay Kumar Patwa","doi":"10.1111/tmi.70163","DOIUrl":"10.1111/tmi.70163","url":null,"abstract":"<p><strong>Introduction: </strong>Scrub typhus is a re-emerging, neglected tropical disease in India, often presenting with nonspecific symptoms. While classical features are well-documented, atypical and severe manifestations are underreported and frequently misdiagnosed.</p><p><strong>Objectives: </strong>Our objective was to describe uncommon clinical manifestations of scrub typhus in hospitalized patients at two tertiary care hospitals in Northern India.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 22 adult patients (no controls) with serologically confirmed scrub typhus (IgM ELISA positive) presenting between January 2024 and June 2025. Only cases with atypical manifestations were included. Demographic, clinical, laboratory, and imaging data were analysed descriptively.</p><p><strong>Results: </strong>The study of 22 hospitalized scrub typhus cases with atypical presentations revealed the presence of multi-organ involvement with marked hepatic and renal impairment. In severe cases, mean values of urea (97.7 vs. 10.2 mg/dL, p = 0.001), creatinine (2.14 vs. 0.84 mg/dL, p = 0.004), ALT (218.7 vs. 11.5 IU/L, p = 0.011), AST (208.5 vs. 37.2 IU/L, p = 0.008), and ALP (427.6 vs. 95.6 IU/L, p = 0.001) were markedly elevated. ROC analysis of urea (AUC = 0.902), creatinine (AUC = 0.888), and ALP (AUC = 0.875) confirmed them as strong predictors of severe disease.</p><p><strong>Conclusion: </strong>The correlation heatmap and boxplots highlighted strong associations between ALT and AST (r = 0.98) as well as urea and creatinine (r = 0.83), along with distinguishing outliers indicating associated hepatic injury, renal impairment, and thrombocytopenia.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1238-1249"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035936","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":"Epidemiological, Spatial and Predictive Analysis of Tuberculosis-Related Mortality in the Department of Risaralda (Colombia), 2020-2024.","authors":"Brayan Esneider Patiño-Palma, Sandra Yineth Chacón-Bambague, Farhlyn Paola Bermudez-Moreno","doi":"10.1111/tmi.70168","DOIUrl":"10.1111/tmi.70168","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the epidemiological characteristics, spatial distribution and predictors of TB-related mortality in Risaralda from 2020 to 2024.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using secondary data from the National Public Health Surveillance System (SIVIGILA). Descriptive statistics, spatial analysis (choropleth maps) and binary logistic regression were used to identify sociodemographic and clinical factors associated with TB case fatality. Model performance was evaluated using ROC curves, sensitivity, specificity and 5-fold cross-validation.</p><p><strong>Results: </strong>A total of 2081 confirmed TB cases were analysed, with a case fatality rate of 13.2%. Mortality was higher among individuals ≥ 65 years (OR: 3.87), hospitalized patients (OR: 7.33), HIV-positive individuals (OR: 3.49), those with undernutrition (OR: 1.89), males (OR: 1.45) and Indigenous persons (OR: 1.67). The logistic model showed good discrimination (AUC: 0.82), with sensitivity of 79.2% and specificity of 73.8%. Cross-validation confirmed model stability (AUC: 0.81). Spatial analysis revealed high mortality in rural municipalities with low case burden, suggesting health inequities.</p><p><strong>Conclusion: </strong>TB mortality in Risaralda is influenced by age, comorbidities and social determinants, with pronounced territorial disparities. These findings support the integration of spatial and predictive tools in TB surveillance to strengthen targeted interventions and reduce mortality in high-risk populations.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1284-1290"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975906","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":"Returned but Not Restored: Experiences of Health and Access to Care Among Return Migrants in Sub-Saharan Africa-A Scoping Review.","authors":"Sif Sofie Vange, Gershim Asiki, Ama de-Graft Aikins, Charles Agyemang, Eshetu Girma, Ernestina Korleki Dankyi, Marie Norredam","doi":"10.1111/tmi.70180","DOIUrl":"10.1111/tmi.70180","url":null,"abstract":"<p><strong>Introduction: </strong>Return migrants form a diverse group, ranging from highly skilled to low-skilled workers, who travel by regular or irregular migration routes and experience differing levels of physical and mental harm during transit and at destination. Further, their conditions of return may pose significant hardships and risks for their health. Despite the significant number of return migrants in Sub-Saharan Africa (SSA), limited research exists from the region addressing the health status of return migrants and their access to healthcare services.</p><p><strong>Objective: </strong>To examine experiences of health and access to care among return migrants in SSA.</p><p><strong>Methods: </strong>A scoping review was conducted including studies available at PubMed, Embase, Web of Science, Scopus, The Cochrane Library, PsychINFO, and Global Index Medicus from the database inception to January 2025. The primary outcomes included were: (re)migration-related risk factors for ill health, health outcomes upon return and re-integration and access to healthcare services.</p><p><strong>Results: </strong>This scoping review identified 15 studies from four SSA countries, with the majority originating from Ethiopia. Return migrants' health and wellbeing are affected by experiences of violence during their migration journey, which impacts their mental and physical health. Return migrants report experiencing stigma, mental health and physical health symptoms, as well as challenges to accessing health services both during the migration journey and upon return. After return, they report experiencing social isolation and stigma, which complicate their reintegration.</p><p><strong>Conclusion: </strong>Our findings underscore the scarcity of research on the health and wellbeing of return migrants in SSA, emphasizing the need for further studies to better understand the challenges they face and develop targeted interventions to address the health and wellbeing of return migrants in SSA.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1141-1153"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227792","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":"Early Warning Systems and Emergency Declarations During Brazil's Largest Dengue Outbreak.","authors":"Lorena Guadalupe Barberia, Alexandra Crispim Boing, Natália de Paula Moreira, Murilo Motta, Guilherme Pereira Ferreira, Dara Aparecida Vilela Pinto, Luiz Antonio Couto Soares, João de Oliveira Gusmão, Ana Paula Magalhães Brito, Sabrina Almeida, Tatiane C Moraes de Sousa","doi":"10.1111/tmi.70153","DOIUrl":"10.1111/tmi.70153","url":null,"abstract":"<p><strong>Objectives: </strong>Early warning systems (EWSs) are essential for alert, detection, and response to potential public health emergencies. Brazil's 2024 dengue epidemic, the largest ever recorded, offers a critical case for assessing correspondence between timely epidemic risk detection and health governance responsiveness.</p><p><strong>Methods: </strong>We collected data on dengue cases, deaths, and public health emergency declarations (PHEDs) at federal, state, and municipal levels. We evaluated the timeliness of 2024 emergency declarations by retrospectively mapping observed risk levels across all states and capitals, utilizing the 2023 federal endemic channel guidelines and the updated 2025 risk-level criteria. Using logistic regressions, we investigated whether epidemic severity was associated with the enactment of a PHED, accounting for primary health coverage and political dynamics that influence local government declarations.</p><p><strong>Results: </strong>The 2024 epidemic escalated rapidly. Brazil remained at an alert level for 19 consecutive weeks and at an epidemic level for 11, with epidemic risk thresholds reached unusually early. Eleven states and seven capitals issued PHEDs after epidemic thresholds were reached, and an additional five capitals were covered by overlapping state declarations. Despite prolonged epidemic conditions across 18 states and 20 capitals, only 11 states and 7 capitals issued emergency declarations. High-burden jurisdictions such as Bahia and Belém did not declare emergencies. Logistic regression models show that only the duration at elevated risk levels significantly predicted emergency declarations, while political factors and primary health care coverage did not. That declarations followed prolonged epidemic exposure rather than early detection underscores the need for institutional mechanisms that translate surveillance signals into timely governance responses.</p><p><strong>Conclusions: </strong>The EWS framework was insufficiently responsive to the rapid dynamics of the 2024 dengue epidemic. Strengthening responsive governance requires adaptive surveillance tools and institutional mechanisms that link early detection to timely, coordinated responses, while accounting for decentralized decision-making and uneven subnational capacities.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1183-1193"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875892","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":"Practices and Perspectives of Lead Implementers on Implementation of Antimicrobial Resistance Strategic Plan: A Cross-Sectional Descriptive Study in Ethiopia.","authors":"Desta Assefa, Mekonnen Damessa, Gemmechu Hasen, Belachew Umeta, Geremew Kinati, Alemseged Beyene Berha, Dessalegn Dadi, Habtewold Deti Waktola, Dereje Kebebe, Sultan Suleman","doi":"10.1111/tmi.70156","DOIUrl":"10.1111/tmi.70156","url":null,"abstract":"<p><strong>Background: </strong>Addressing the escalating threats of antimicrobial resistance (AMR) through developing and implementing context-specific strategy remains a worldwide priority response. However, its adoption and implementation have often been fragmented in low-resource settings and are currently under-researched. This study evaluates the multi-stakeholder perspectives, practices and operational challenges encountered across Ethiopian national lead implementers of the AMR strategic plan in combating AMR.</p><p><strong>Method: </strong>This cross-sectional, descriptive study recruited seven AMR stakeholders, recognised as lead implementers of the national AMR strategic plan across human, animal and environmental health sectors in Ethiopia. Data were gathered via face-to-face, semi-structured interviews and document review. Then the collected data were transcribed verbatim and thematically analysed.</p><p><strong>Results: </strong>The findings reveal the adoption and commencement of implementing the Ethiopian national AMR strategic plan at varying levels across One Health sectors in Ethiopia. While all key informants had positive perspectives towards implementation and were familiar with the strategic objectives, the practices were inconsistent. Among the five strategic objectives, sub-indicators associated with raising awareness, strengthening infection and prevention control practices and optimising antimicrobial use were better implemented with moderate to full engagement of lead implementers (≥ 75%). Meanwhile, no stakeholder initiated new vaccines and drug substances development and environmental risk assessment for antimicrobials yet. The cross-cutting barriers such as weak and fragmented inter-sectoral collaboration, inconsistent follow-up and scarcity of human and financial resources remained hampering effective implementation.</p><p><strong>Conclusion: </strong>Findings demonstrated that despite the existence of an AMR tackling strategy and initiatives, implementation and enforcement remain below the level required by the urgency of the AMR situation. It underscores the importance of bridging implementation gaps by prioritising AMR, strengthening equivalent engagement and collaborations, and capacity building.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1194-1204"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933934","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}