Tropical Medicine & International Health最新文献

{"title":"Scrub typhus-associated movement and gait disorders: A systematic review with principal component analysis and in silico mechanistic modelling.","authors":"Ritwick Mondal, Shramana Deb, Mrinmay Dhauria, Purbita Sen, Vramanti Sarkar, Shramana Sarkar, Dipanjan Chowdhury, Durjoy Lahiri, Jayanta Roy, Julián Benito-León","doi":"10.1111/tmi.14114","DOIUrl":"10.1111/tmi.14114","url":null,"abstract":"<p><strong>Background: </strong>Orientia tsutsugamushi, the causative agent of scrub typhus, is increasingly recognised for its neurological complications. Among these, movement and gait disorders are poorly understood. We systematically examined their clinical spectrum and explored underlying mechanisms through in-silico protein-protein interaction modelling.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, including studies published up to 5 November 2024. Principal component analysis was used to identify clinical patterns among neurological features. In-silico protein-protein interaction modelling was used to examine potential cross-reactivity between Orientia tsutsugamushi proteins and human targets proteins.</p><p><strong>Results: </strong>Among 76 cases, 50 presented with either isolated or combined movement disorders, most commonly opsoclonus (64.0%, 32/50), with the opsoclonus-myoclonus combination predominating (59.4%, 19/32). Other hyperkinetic features included tremor (4.0%, 2/50) and distinct forms of myoclonus (without opsoclonus) (8.0, 4/50%). Parkinsonism was present in 26.0% (13/50) of cases. Gait disorders, excluding parkinsonian gait and instability due to myoclonus, were well-characterised in 27 patients, one of whom had concomitant opsoclonus and cerebellar ataxia. Ataxic gait was the predominant pattern, observed in 96.3% (26/27), primarily cerebellar in origin. Principal component analysis revealed five principal components reflecting distinct clinical clusters: cerebellar dysfunction, tremor and parkinsonism, sensory ataxia and spinal involvement, myoclonus (diaphragmatic/action/segmental), and prolonged recovery and cranial nerve involvement. In-silico analyses revealed high-confidence interactions between bacterial epitopes and host proteins, including fibronectin-1 and Golgi-associated molecules, suggesting mechanisms of immune-mediated injury and neuroinflammation.</p><p><strong>Conclusions: </strong>Scrub typhus may lead to a range of movement and gait disorders through neuroimmune mechanisms and molecular mimicry. Principal component analysis offered a data-driven framework to classify these manifestations, highlighting clinically relevant patterns. Early recognition and targeted treatment are critical to improving outcomes. Future studies should validate the molecular targets identified and evaluate immunomodulatory strategies for therapeutic intervention.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"459-480"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039799","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":"Co-endemicity of schistosomiasis and tegumentary leishmaniasis: Spatial co-clustering in endemic areas.","authors":"Genil Mororó Araújo Camelo, Jeferson Kelvin Alves de Oliveira Silva, Dharliton Soares Gomes, Laura Maggi, Stefan Michael Geiger, David Soeiro Barbosa, Deborah Aparecida Negrão-Corrêa","doi":"10.1111/tmi.14118","DOIUrl":"10.1111/tmi.14118","url":null,"abstract":"<p><strong>Objectives: </strong>Schistosomiasis and tegumentary leishmaniasis simultaneously affect areas in tropical and subtropical regions. Co-infected individuals show a less-than-optimal response to treatment and increased regulatory immune responses. However, no study has determined where Schistosoma-Leishmania co-infections are more likely to occur.</p><p><strong>Methods: </strong>Data from The Global Health Observatory were collected to determine the worldwide endemicity status of schistosomiasis and tegumentary leishmaniasis in 2023. To determine co-endemic areas at a local level, an ecological study was conducted on confirmed cases of American tegumentary leishmaniasis and schistosomiasis in the State of Minas Gerais, Brazil, between 2013 and 2017. Local Indicators of Spatial Association analyses were used to search for co-endemic hotspots.</p><p><strong>Results: </strong>Thirty-one countries were considered co-endemic, 23 of which presented active transmission of both diseases. Univariate Local Indicators of Spatial Association indicated 13 municipalities as high-high clusters for both American tegumentary leishmaniasis and schistosomiasis in Minas Gerais. Furthermore, bivariate Local Indicators of Spatial Association analyses identified 61 municipalities as high-high clusters, grouped in seven co-endemic hotspots.</p><p><strong>Conclusion: </strong>Local Indicators of Spatial Association analyses are a useful tool for identifying areas where co-infection cases are more likely to occur. Similar analyses will assist authorities and healthcare providers when formulating policies and treating Schistosoma-Leishmania co-infected patients and will provide valuable data to enable researchers to explore the impact of this and other co-infections.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"556-568"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038529","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":"Improved genetic screening with zygosity detection through multiplex high-resolution melting curve analysis and biochemical characterisation for G6PD deficiency.","authors":"Usa Boonyuen, Beatriz Aira C Jacob, Kamonwan Chamchoy, Natnicha Pengsuk, Sirinyatorn Talukam, Chanya Petcharat, Emily R Adams, Thomas Edwards, Kobporn Boonnak, Syazwani Itri Amran, Nurriza Ab Latif, Naveen Eugene Louis","doi":"10.1111/tmi.14105","DOIUrl":"10.1111/tmi.14105","url":null,"abstract":"<p><p>Accurate diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency is crucial for relapse malaria treatment using 8-aminoquinolines (primaquine and tafenoquine), which can trigger haemolytic anaemia in G6PD-deficient individuals. This is particularly important in regions where the prevalence of G6PD deficiency exceeds 3%-5%, including Southeast Asia and Thailand. While quantitative phenotypic tests can identify women with intermediate activity who may be at risk, they cannot unambiguously identify heterozygous females who require appropriate counselling. This study aimed to develop a genetic test for G6PD deficiency using high-resolution melting curve analysis, which enables zygosity identification of 15 G6PD alleles. In 557 samples collected from four locations in Thailand, the prevalence of G6PD deficiency based on indirect enzyme assay was 6.10%, with 8.08% exhibiting intermediate deficiency. The developed high-resolution melting assays demonstrated excellent performance, achieving 100% sensitivity and specificity in detecting G6PD alleles compared with Sanger sequencing. Genotypic variations were observed across four geographic locations, with the combination of c.1311C>T and c.1365-13T>C being the most common genotype. Compound mutations, notably G6PD Viangchan (c.871G>A, c.1311C>T and c.1365-13T>C), accounted for 15.26% of detected mutations. The high-resolution melting assays also identified the double mutation G6PD Chinese-4 + Canton and G6PD Radlowo, a variant found for the first time in Thailand. Biochemical and structural characterisation revealed that these variants significantly reduced catalytic activity by destabilising protein structure, particularly in the case of the Radlowo mutation. The refinement of these high-resolution melting assays presents a highly accurate and high-throughput platform that can improve patient care by enabling precise diagnosis, supporting genetic counselling and guiding public health efforts to manage G6PD deficiency-especially crucial in malaria-endemic regions where 8-aminoquinoline therapies pose a risk to deficient individuals.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"437-457"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617418","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 hospital morbidity and mortality due to Chagas disease in Bahia state, Northeast Brazil, 2000-2022.","authors":"Gabriela Soledad Márdero García, Andreia Heitor Martins da Cunha Leite, Eliana Amorim de Souza, Anderson Fuentes Ferreira, Andrea Silvestre de Sousa, Ronir Raggio Luiz, Alejandro Luquetti Ostermayer, Jorg Heukelbach, Swamy Lima Palmeira, Cleudson Nery de Castro, Cristiane Medeiros Moraes de Carvalho, Suzana Cristina Silva Ribeiro, Cândida Carolina Lima Oliveira, Alberto Novaes Ramos","doi":"10.1111/tmi.14085","DOIUrl":"10.1111/tmi.14085","url":null,"abstract":"<p><p>Chagas disease (CD) is a chronic condition associated with high morbidity and mortality in endemic regions of Brazil, particularly in the state of Bahia. The clinical-epidemiologic analysis of hospital admissions is strategic due to limited data on chronic CD infections and the general lack of access to diagnosis and treatment. This study examines sociodemographic and clinical-epidemiological patterns of hospital morbidity and mortality from CD and its temporal trends from 2000 to 2022 in Bahia, Northeast Brazil. A mixed ecological study was conducted using data from hospital and mortality information systems. We calculated the hospital case fatality and all-cause mortality rates for CD, analysing temporal trends through joinpoint regression. Out of 20,189,658 hospital admissions, 4,557 (0.02%) were associated with CD, yielding a hospital lethality of 0.10 per 100,000 inhabitants. Of 1,832,325 Death Certificates, 16,960 (0.93%) were attributed to CD, equating to 5.16 deaths per 100,000 inhabitants. The risk ratios for hospital case fatality and mortality were higher among males, residents of municipalities with a 'medium' Brazilian Deprivation Index, those in the Central-North region, and patients with megacolon. Hospital case fatality significantly increased among males, the elderly (≥70 years) and residents in municipalities with 'high' or 'very high' Brazilian Deprivation Index in the Central-North and Central-East regions. The all-cause mortality trend for CD also rose among women and in municipalities with 'high' and 'very high' Brazilian Deprivation Index across the Southwest, West, North and Central-East regions. Programmatic vulnerabilities related to healthcare access within the Unified Health System likely contributed to delayed diagnoses and the increasing severity of specific forms of CD.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"368-381"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651059","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":"Multi-drug resistance and compensatory mutations in Mycobacterium tuberculosis in Vietnam.","authors":"Quang Huy Nguyen, Thi Van Anh Nguyen, Anne-Laure Bañuls","doi":"10.1111/tmi.14104","DOIUrl":"10.1111/tmi.14104","url":null,"abstract":"<p><strong>Background: </strong>Vietnam is a hotspot for the emergence and spread of multidrug-resistant Mycobacterium tuberculosis. This study aimed to perform a retrospective study on the compensatory evolution in multidrug-resistant M. tuberculosis strains and the association with drug-resistant mutations and M. tuberculosis genotypes.</p><p><strong>Methods: </strong>Hundred and seventy-three strains resistant to rifampicin (n = 126) and/or isoniazid (n = 170) (multidrug-resistant = 123) were selected according to different drug-resistant patterns and genotypes. The genes/promoter regions including rpoA, rpoB, rpoC, katG, inhA, inhA promoter, ahpC, ahpC promoter, gyrA, gyrB, and rrs were sequenced for each strain.</p><p><strong>Results: </strong>Frequency of rifampicin- and isoniazid-resistant mutations in multidrug-resistant strains was 99.2% and 97.0%, respectively. Mutations associated with low -high levels of drug resistance with low- or no-fitness costs compared to the wild type, including rpoB_Ser450Leu, katG_Ser315Thr, inhA-15(A-T), gyrA_Asp94Gly, and rrs_A1401GA, accounted for 46.3%, 76.4%, 16.2%, 8.9%, and 11.4%, respectively, in the multidrug-resistant strains. Beijing and Euro-American genotype strains were associated with high-level drug-resistant mutations, rpoB_Ser450Leu, katG_Ser315Thr, and gyrA_Asp94Gly, while East African-Indian genotype strains were associated with low to high-level drug-resistant mutations, rpoB_His445Asp, rpoB_His445Tyr, inhA-15(C-T) and rrs_A1401G. Multidrug-resistant strains (19.5%) harboured compensatory mutations linked to rifampicin resistance in rpoA, rpoB, or rpoC. Notably, the frequency of compensatory mutations in Beijing genotypes was significantly higher than in East African-Indian genotypes (21.1% vs. 3.3%, OR = 7.7; 95% CI = 1.0 to 61.2, p = 0.03). The proportion of multidrug-resistant strains with rpoB_Ser450Leu mutations carrying rpoA-rpoC mutations was higher than that of strains with other rpoB mutations (OR = 5.4; 95% CI = 1.4 to 21.1, p = 0.02) and was associated with Beijing strains. Only 1.2% (2/170) isoniazid-resistant strains carried aphC-52(C-T) mutation in the promoter region of the ahpC gene, which was hypothesised to be the compensatory mutation in isoniazid-resistant strains. Meanwhile, 11 isoniazid-resistant strains carried a katG mutation combined with either inhA-8(T-C) or inhA-15(A-T) mutations and were associated with East African-Indian strains.</p><p><strong>Conclusions: </strong>Mutations associated with high levels of drug resistance without/with low fitness costs (rpoB_Ser450Leu and katG_Ser315Thr) along with compensatory mutations linked to rifampicin resistance were strongly associated with multidrug-resistant M. tuberculosis Beijing strains in Vietnam.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"426-436"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617420","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":"The interplay of oil exploitation, environmental degradation and health in the Niger Delta: A scoping review.","authors":"Faithwin Gbadamosi, Jared Aldstadt","doi":"10.1111/tmi.14108","DOIUrl":"10.1111/tmi.14108","url":null,"abstract":"<p><strong>Rationale: </strong>Despite its abundance of oil resources and multiple remediation interventions, the Nigerian Niger Delta region is still faced with underdevelopment and environmental degradation. The contamination of the environment by oil exploitation activities has affected land quality, water sources, and air quality, hence influencing the livelihoods, health, and nutritional habits of the local population.</p><p><strong>Aim: </strong>This study synthesises evidence of the impacts of oil exploitation in the Niger Delta region, focusing on its effects on the environment, food systems, economy, and human health. While numerous studies have investigated various aspects of this issue, this review provides a comprehensive analysis of the intersection of these factors.</p><p><strong>Methods: </strong>A total of 28 peer-reviewed studies (2000-2024) from Scopus, PubMed, and Google Scholar were analysed, following JBI and PRISMA-ScR guidelines, focusing on pollution impacts, health outcomes, socioeconomic disruptions, and policy responses. These findings were organised by the themes of environment, health, economy, and regulatory landscape.</p><p><strong>Results: </strong>The findings reveal significant negative consequences. About 29% of studies documented oil pollution's severe agricultural impacts, including heavy metal contamination (e.g., lead in crops) and 240,000 annual oil spills degrading 60% of arable land. About 21% of studies on health linked pollution to significant health impacts, including respiratory disorders (prevalent in 35%-45% of exposed communities), reproductive risks, and increased psychological distress (40% reported anxiety or depression). Women are reported to be disproportionately affected by socioeconomic disruption, with 70%-80% of small-scale farmers and fishers facing livelihood losses.</p><p><strong>Conclusion: </strong>More research is required to identify the long-term health effects of oil pollution and psychological impacts on affected populations. Detailed analysis of food security issues and adaptive strategies employed by local communities is also needed.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"351-367"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754830","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":"Genetic diversity in the IIS6 domain of voltage gated sodium channel gene among Aedes aegypti populations from different geographical regions in India.","authors":"Melveettil Kishor Sumitha, G Navaneetha Pandiyan, Mariapillai Kalimuthu, Rajaiah Paramasivan, Bhavna Gupta","doi":"10.1111/tmi.14102","DOIUrl":"10.1111/tmi.14102","url":null,"abstract":"<p><p>This study provides critical insights into the genetic diversity of the IIS6 domain of the Voltage Gated Sodium Channel (VGSC) gene in Aedes aegypti populations across various regions in India, focusing on two mutations: S989P and V1016G. Samples were collected from seven different cities across the country, including Dibrugarh, Kolkata, Berhampur, Bhopal, Bengaluru, Ghaziabad, and Aurangabad. The IIS6 domain was amplified and sequenced, revealing that the V1016G mutation was found at a higher frequency compared to the S989P mutation. The S989P mutation was most prevalent in Berhampur, followed by Bengaluru, while the V1016G mutation showed high frequencies in Dibrugarh, followed by Berhampur. Additionally, the study identified intron polymorphisms within the VGSC gene, with the type A intron being relatively rare. However, the type A intron was observed in samples harbouring both mutant and wild alleles for both mutations. The regional variation in the frequencies of these mutations indicates complex evolutionary dynamics potentially influenced by local environmental factors and insecticide application practices. Interestingly, the high frequency of these alleles also correlated with the genetic structure of the mosquito populations, suggesting that gene flow might be playing a role in spreading these mutations. Regular monitoring of these mutations could serve as important indicators in assessing the status of resistance to pyrethroids and guide nationwide mosquito control efforts. This research underscores the necessity for localised vector control strategies and continuous genetic surveillance to manage insecticide resistance effectively.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"417-425"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587484","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":"Spatial prediction of immunity gaps during a pandemic to inform decision making: A geostatistical case study of COVID-19 in Dominican Republic.","authors":"Angela Cadavid Restrepo, Beatris Mario Martin, Helen J Mayfield, Cecilia Then Paulino, Michael de St Aubin, William Duke, Petr Jarolim, Timothy Oasan, Emily Zielinski Gutiérrez, Ronald Skewes Ramm, Devan Dumas, Salome Garnier, Marie Caroline Etienne, Farah Peña, Gabriela Abdalla, Beatriz Lopez, Lucia de la Cruz, Bernarda Henriquez, Margaret Baldwin, Adam Kucharski, Benn Sartorius, Eric J Nilles, Colleen L Lau","doi":"10.1111/tmi.14094","DOIUrl":"10.1111/tmi.14094","url":null,"abstract":"<p><strong>Background: </strong>To demonstrate the application and utility of geostatistical modelling to provide comprehensive high-resolution understanding of the population's protective immunity during a pandemic and identify pockets with sub-optimal protection.</p><p><strong>Methods: </strong>Using data from a national cross-sectional household survey of 6620 individuals in the Dominican Republic (DR) from June to October 2021, we developed and applied geostatistical regression models to estimate and predict Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spike (anti-S) antibodies (Ab) seroprevalence at high resolution (1 km) across heterogeneous areas.</p><p><strong>Results: </strong>Spatial patterns in population immunity to SARS-CoV-2 varied across the DR. In urban areas, a one-unit increase in the number of primary healthcare units per population and 1% increase in the proportion of the population aged under 20 years were associated with higher odds ratios of being anti-S Ab positive of 1.38 (95% confidence interval [CI]: 1.35-1.39) and 1.35 (95% CI: 1.32-1.33), respectively. In rural areas, higher odds of anti-S Ab positivity, 1.45 (95% CI: 1.39-1.51), were observed with increasing temperature in the hottest month (per°C), and 1.51 (95% CI: 1.43-1.60) with increasing precipitation in the wettest month (per mm).</p><p><strong>Conclusions: </strong>A geostatistical model that integrates contextually important socioeconomic and environmental factors can be used to create robust and reliable predictive maps of immune protection during a pandemic at high spatial resolution and will assist in the identification of highly vulnerable areas.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"382-392"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617422","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":"Geospatial distribution and risk factors of Strongyloides stercoralis in rural communities of Northeast Thailand.","authors":"Chivorn Leang, Apiporn Suwannatrai, Sutas Suttiprapa, Thewarach Laha, Banchob Sripa","doi":"10.1111/tmi.14100","DOIUrl":"10.1111/tmi.14100","url":null,"abstract":"<p><strong>Background: </strong>Strongyloides stercoralis is a neglected soil-transmitted helminth endemic in tropical and subtropical regions. This study aimed to determine the prevalence, risk factors, and spatial distribution of S. stercoralis infection in rural villages of Khon Kaen Province, Northeastern Thailand.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 260 participants from 201 households across five randomly selected villages. Stool samples were analysed using agar plate culture and formalin-ethyl acetate concentration techniques, and soil samples were assessed for S. stercoralis DNA by PCR and physicochemical properties including pH, porosity, bulk density, moisture, organic matter, and nitrate.</p><p><strong>Results: </strong>The prevalence of S. stercoralis infection was 16.15%, with agar plate culture detecting 41 cases (15.77%) compared to 12 cases (4.62%) by formalin-ethyl acetate concentration techniques. The highest prevalence was observed in Norng Thungmon village (31.80%). Risk factors included male gender, older age, being a head of household, living in homes with earthen floors, walking barefoot, and proximity to water sources. Soil samples from 169 households revealed an S. stercoralis detection rate of 8.3% via PCR. Positive soil samples were predominantly from Norng Huachang and Don Du villages. Spatial analysis identified significant clustering of infections within high-risk areas. Soil physicochemical properties, including pH, moisture, and organic matter, were measured, though no significant correlations were found with infection rates.</p><p><strong>Conclusion: </strong>In conclusion, S. stercoralis remains a significant health concern but is neglected in rural Khon Kaen, with identifiable human and environmental risk factors. Enhanced health education, improved sanitation, and targeted interventions are essential for reducing transmission in endemic areas.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"393-403"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574071","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":"Accuracy of computer-aided chest x-ray interpretation for tuberculosis screening in people with diabetes mellitus: A systematic review.","authors":"Reagan Daniel Emoru, Lucy Elauteri Mrema, Nyanda Elias Ntinginya, Irene Andia Biraro, Reinout van Crevel, Julia A Critchley","doi":"10.1111/tmi.14103","DOIUrl":"10.1111/tmi.14103","url":null,"abstract":"<p><strong>Objectives: </strong>Diabetes mellitus significantly increases the risk of tuberculosis, and active tuberculosis screening of people with diabetes mellitus has been advocated by WHO and other international bodies. This systematic review aimed to evaluate the accuracy of computer-assisted detection for identifying pulmonary tuberculosis among people living with diabetes mellitus.</p><p><strong>Methods: </strong>Medline, Embase, Scopus, Global Health, and Web of Science were searched from January 2010 to May 2024 using MeSH headings and keywords, supplemented with grey literature searches (Conference abstracts, Trial registries, MedRxiv.org, Google Scholar). Studies evaluating computer-assisted detection diagnostic accuracy for identifying tuberculosis in populations living with diabetes mellitus were included. Two researchers independently assessed titles, abstracts, and full texts, extracted data, and assessed the risk of bias using the QUADAS-2 instrument. Forest plots and Summary Receiver Operating Curves were generated using RevMan 5.4, and statistical pooling of studies was carried out in STATA v18 using the bivariate model.</p><p><strong>Results: </strong>Five eligible studies, all conducted in Asia between 2013 and 2023, were identified, including a total of 1879 individuals with diabetes mellitus, of whom 391 were newly diagnosed with tuberculosis. Four different computer-assisted detection software algorithms were used. The pooled sensitivity was 0.94 (95% CI: 0.85-0.97) and specificity was 0.77 (95% CI: 0.68-0.84). Area Under the receiver operating curve values varied from 0.7 (95% CI: 0.68-0.75) to 0.9 (95% CI: 0.91-0.96). False positive proportions ranged from 0.24% to 30.5%, while false negative proportions were 0%-3.2%. Overall heterogeneity was high (i² 55% for sensitivity and 93% for specificity) but much lower for sensitivity among the three studies using the same computer-assisted detection software (i² 0% for sensitivity; 93% for specificity). The risk of bias of the five studies was generally very low, although detailed information about diabetes management was lacking.</p><p><strong>Conclusions: </strong>Computer-assisted detection tools show potential in screening people living with diabetes for active tuberculosis and appear to show good sensitivity at the thresholds indicated, but data are scarce and performance varies across settings.</p><p><strong>Review registration: </strong>The protocol for this review was prespecified and published in PROSPERO (registration number CRD42024523384).</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"323-331"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626333","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}