Tropical Medicine & International Health最新文献

{"title":"Trends and patterns of injuries among children under five in Mongolia: A retrospective analysis of national injury surveillance data between 2018 and 2022.","authors":"Tsetsegee Sambuu, Emma M Rath, Feiyu Hu, Tumen-Ulzii Badarch, Yui Yumiya, Tatsuhiko Kubo, Oyunsuren Enebish, Odgerel Chimed-Ochir","doi":"10.1111/tmi.14117","DOIUrl":"10.1111/tmi.14117","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study aimed to analyse the pattern and trend of fatal and non-fatal injuries among children under five in Mongolia from 2018 to 2022, using hospital-based national injury surveillance data to inform targeted public health interventions.</p><p><strong>Methods: </strong>Data from 101,731 injury cases were analysed from the National Trauma and Orthopaedic Research Center's surveillance system. Injury incidence and mortality rates were calculated based on demographic characteristics and geographic distributions.</p><p><strong>Results: </strong>From 2018 to 2022, 101,731 children under five sustained injuries in Mongolia, with most occurring at home (78.9%) and in Ulaanbaatar (87.6%). Boys accounted for 55.7%. Ulaanbaatar had the highest non-fatal injury incidence rate (1003 per 100,000), primarily from falls (45.8%), burns (16.5%) and mechanical forces. Non-fatal injuries increased annually in Ulaanbaatar, especially among boys (6.6%) and girls (9.9%). Children aged 1-4 years and boys were at higher risk, with injuries more frequent in summer and at home. Fatal injuries (n = 715) were mostly due to suffocation (34.7%), traffic (20.7%) and drowning (13.7%). Ulaanbaatar saw a significant decrease in fatality rates (14.9% annually for boys), while traffic-related deaths rose in girls in provinces (18.6%). Mortality rates were higher among infants aged 0-11 months.</p><p><strong>Conclusion: </strong>There is an increase in non-fatal injuries among children under 5 years of age in Mongolia, particularly in Ulaanbaatar, despite a declining trend in fatal injury rates. Injury rates also vary significantly across rural provinces, highlighting the need for geographically tailored policy interventions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"640-651"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018937","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 and clinical profile of viral respiratory infections in children under 5 years at pre- and post-COVID-19 era in Praia, Cabo Verde.","authors":"Wilson Correia, Roberto Dorta-Guerra, Mitza Sanches, Basilio Valladares, Isabel Inês M de Pina-Araújo, Emma Carmelo","doi":"10.1111/tmi.14125","DOIUrl":"10.1111/tmi.14125","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease-19 (COVID-19) pandemic has affected global health, influencing the prevalence of different respiratory pathogens. The aim of this study is to evaluate the distribution of agents causing acute respiratory infections in children under 5 years old before and after the COVID-19 pandemic in Praia, Cabo Verde, and to describe associated clinical variables.</p><p><strong>Methods: </strong>Conducted at the University Hospital Dr. Agostinho Neto, this study replicated methods from a previous work from 2019 (Correia et al. 2021). Nasopharyngeal samples were analysed using FilmArray® Respiratory Panel 2.1 (BioFire) to identify agents of acute respiratory infections. Molecular identification of human respiratory syncytial virus subtypes was performed using a real-time duplex reverse transcription polymerase chain reaction. Statistical analysis was performed using IBM SPSS version 29 and R 3.5.1 software.</p><p><strong>Results: </strong>In 2022, 86.5% (83/96) of nasopharyngeal samples were positive for at least one pathogen. Human rhinovirus/human enterovirus was the most frequent agent, followed by human respiratory syncytial virus, adenovirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Co-infections were observed in 43.3% of positive cases. Infection rates were significantly higher in children under 1 year of age, particularly for SARS-CoV-2 and human respiratory syncytial virus. Seasonal variations were observed, with human respiratory syncytial virus predominating in November, SARS-CoV-2 in January and human parainfluenza virus-4 in May. Molecular analysis of human respiratory syncytial virus revealed a shift in subtype prevalence, with both human respiratory syncytial virus-A and -B co-circulating in the pre-pandemic period, whereas only human respiratory syncytial virus-B was detected in the post-pandemic period.</p><p><strong>Conclusion: </strong>Our data indicate changes in the distribution of respiratory viruses in the post-pandemic period compared to pre-pandemic period. The high prevalence of co-infections highlights the complexity of acute respiratory infection aetiology, emphasising the need for enhanced respiratory virus surveillance systems in Cabo Verde. Identifying seasonal trends and risk factors can contribute to targeted interventions and improved public health strategies to mitigate the burden of acute respiratory infections in young children.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"694-703"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102790","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":"Halzoun syndrome in Lebanon: Clinical and genetic insights into Dicrocoelium dendriticum.","authors":"Dalal Sabbagh, Ahmad El Khatib, Zahraa Zibara, Mohamad El Nahas, Ilham Mneimneh, Ali Hijab, Hasan El-Tawil, Lazo Ali, Jad Koweyes, Lyn Al Samra, Kelven Rahy, Serena El Rayes, Aia Sinno, Ruqayya Baghdadi, Charbel Al Khoury","doi":"10.1111/tmi.14113","DOIUrl":"10.1111/tmi.14113","url":null,"abstract":"<p><p>Halzoun syndrome is a rare parasitic infection associated with the consumption of raw liver, predominantly reported in the Eastern Mediterranean. The condition presents significant diagnostic challenges due to its symptom overlap with other parasitic and allergic disorders. We identified four cases of Halzoun syndrome in a family from the North Bekaa region of Lebanon. A detailed examination of the goat liver was conducted, followed by molecular characterisation using the ITS-2 region and phylogenetic analysis to establish the relationship of the local isolates with other Dicrocoelium species. Gross examination of the infected goat liver revealed small, pale nodules indicative of inflammation caused by flukes or their eggs. Molecular analysis confirmed D. dendriticum as the causative agent, with phylogenetic analysis placing the local isolates within the D. dendriticum clade, showing notable genetic divergence. Clinically, the patients experienced severe pharyngitis, nasal congestion, and allergic-like reactions typical of Halzoun syndrome, with one case requiring intensive treatment with corticosteroids and oxygen therapy. This study confirms D. dendriticum as the etiological agent of Halzoun syndrome in these cases, highlighting the potential presence of a distinct genetic lineage in Lebanon. The findings underscore the importance of accurate diagnosis and tailored treatment strategies in regions where raw liver consumption is common.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"569-575"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048085","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":"Risk stratification during antenatal care failed to identify most mothers who experienced adverse pregnancy outcomes: A prospective study from Kakamega County, Kenya.","authors":"Jan E Cooper, Margaret Kruk, David Kapaon, Kennedy Opondo, Jacinta Nzinga, Rose J Kosgei, Kevin Croke","doi":"10.1111/tmi.14110","DOIUrl":"10.1111/tmi.14110","url":null,"abstract":"<p><strong>Introduction: </strong>Risk stratification of pregnancies informs clinical care globally. Yet recent research has cast doubt on the ability of currently used population-level risk measures to accurately predict poor outcomes at the individual level. We examine the assumption that existing forms of risk stratification can successfully identify women likely to develop complications during delivery in a rural setting in Kenya.</p><p><strong>Methods: </strong>We conducted a prospective observational study of 19,653 pregnant women in Kakamega County in Western Kenya. Women were contacted three times during the perinatal period and surveyed about provider-identified risks and self-assessed concerns about pregnancy complications, delivery process outcomes, and adverse delivery outcomes. Measures of risk were derived from women's self-reporting. We compared delivery process outcomes and adverse delivery outcomes between high- and low-risk pregnancies, and between women with and without expressed concerns about delivery complications. Delivery process outcomes included intrapartum referral, unplanned caesarean section, blood transfusion, hysterectomy, or admission to an intensive care unit. Adverse delivery outcomes included stillbirth, neonatal mortality, and maternal mortality. We reported means and confidence intervals for each category, and tested for differences using bivariate linear regression.</p><p><strong>Results: </strong>Thirty-eight percent of pregnancies had at least one risk factor consistent with a high risk pregnancy; the remaining 62% were low risk by this criteria. Rates of most adverse process outcomes and delivery outcomes were higher among pregnancies with known risks. However, 64.5% of maternal deaths and 54.8% of all deaths in the sample took place among pregnancies characterised as low risk.</p><p><strong>Conclusions: </strong>Risk stratification using existing indicators of risk during pregnancy is inadequate to identify women at risk of adverse health outcomes in this setting.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"531-538"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796605","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":"Insecticide-treated nets distribution campaign: Physical integrity, usage and sustainable disposal of end-of-life insecticide-treated nets under operational settings in Odisha, India.","authors":"A N Shriram, Mustafa Baig, D K Panigrahi, B Vijayakumar, S S Sahu, Tatvadarshi Dash, Ashwani Kumar","doi":"10.1111/tmi.14107","DOIUrl":"10.1111/tmi.14107","url":null,"abstract":"<p><strong>Objectives: </strong>Prior to 2017, Odisha accounted for 50% of all Plasmodium falciparum cases in India. The 'National Strategic Plan' for malaria elimination had distributed 11.3 million insecticidal treated nets (ITNs) to 23 million individuals in Odisha's 17 malaria-endemic districts by 2017. In 2021, the National Centre for Vector-Borne Disease Control replaced end-of-life ITNs. India needs official regulations on end-of-life ITNs collection and disposal mechanisms. A pilot study was undertaken to understand community practices and perceptions on end-of-life ITNs.</p><p><strong>Methods: </strong>The 2021 study was conducted during mass ITN replenishment in a campaign mode at Koksara Community Health Centre in Odisha's Kalahandi region. ITN conditions were evaluated using structured questionnaires and household interviews. End-of-life ITNs were evaluated for chemical analyses. Door-to-door assessments of net conditions included noting their presence, attrition rates and fabric integrity. Officials from the Department of Health were consulted on eco-friendly disposal techniques.</p><p><strong>Results: </strong>In the study region, 6022 ITNs were distributed, of which 5879 (97.6%) were available and 143 (2.4%) were reported as missing 43 months after the campaign (2017). One net per 2.1 persons was distributed. Of the 5879 ITNs, 84.2% were torn, 931 (15.8%) were in good condition and 3472 (59.1%) were serviceable. When combining the ITNs in good condition and those that were serviceable, 74.9% were deemed usable. A total of 3050 respondents were interviewed. Most respondents (98%, 2935/3050) were willing to exchange old ITNs for new ones (92.5%, 5437/5879) when replaced with new ones, highlighting the need for a disposal mechanism at both programme and household levels. Additionally, 61.6% of respondents chose to keep their ITNs, while others repurposed them (7.3% for covering items, 3.0% for fencing, 4.6% for nursery saplings, 5.6% for fishing, 0.4% for other uses). The end-of-life PermaNet 2.0 nets contained an average of 0.33 ± 0.35 g/kg (15.3 mg/m²), while the new nets contained an average of 1.4 g/kg ± 25% (55 mg/m²).</p><p><strong>Conclusions: </strong>Community input on end-of-life ITN disposal contributes to the development of evidence-based decision support materials, facilitating the formulation of a strategy for the systematic collection and safe disposal of used nets. The lack of an operationally viable solution for the secure disposal of end-of-life ITNs within the National Programs underscores the urgent need for a comprehensive policy framework.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"509-520"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000879","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":"Regulator experiences of trials during Ebola epidemics in Sierra Leone, Guinea, and the Democratic Republic of the Congo.","authors":"Kambale Kasonia, Frank Baiden, Frédéric Le Marcis, Bruno Lapika, Joel Kiyulu, Henri Kimina, Freddy Bikioli, Fanny Attas, Anthony Mansaray, Rose Burns, Elysée Nouvet, Séverine Thys, Antea Paviotti, Daniela Manno, Mukeh Kenneth Fahnbulleh, Bailah Leigh, Mohamed Samai, Brian Greenwood, Shelley Lees, Patrick Mitashi Mulopo, Deborah Watson-Jones","doi":"10.1111/tmi.14111","DOIUrl":"10.1111/tmi.14111","url":null,"abstract":"<p><strong>Introduction: </strong>During the 2014-2016 Ebola epidemic in West Africa and the Ebola outbreaks between 2018 and 2020 in the Democratic Republic of Congo, vaccines and other tools for prevention and treatment had to be taken through trials in exceptional circumstances using accelerated processes.</p><p><strong>Materials and methods: </strong>We interviewed members of ethics committees, health authorities, health professionals, and political authorities in the Democratic Republic of Congo in 2021 and held a workshop with ethics committee members and regulatory authorities from Sierra Leone and Guinea in 2022 in order to document their experiences of reviewing, approving, and regulating current and new studies during epidemics and outbreaks, and to document lessons learnt and their recommendations for the rapid review of clinical trial protocols during public health emergencies.</p><p><strong>Results: </strong>Similar barriers were identified in the three countries. These were related to weak legal frameworks and partnerships between ethics committees and regulatory bodies. Inadequate human resources, outdated standard operating procedures and guidelines, and lack of finance to support timely reviews were identified. We also noted a lack of awareness from politicians, scientists, and communities about the existence and functions of regulatory bodies/ethics committees, a lack of independence, and low interest in research. Opportunities identified by the institutions in the countries concerned included training ethics committee members and networking with experienced international platforms like the African Vaccine Regulatory Forum. Laws on regulating research have been updated in Sierra Leone and in Guinea, but not yet in the Democratic Republic of Congo.</p><p><strong>Conclusion: </strong>Regulatory bodies have been facing many challenges in terms of a lack of a legal framework, a lack of finance, and a lack of support from politicians, scientists, and communities. Networking has been an opportunity for these regulators to mitigate these impediments.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"539-546"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773700","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":"Estimation of household level variation in per capita calorie intake by measures of economic well-being of the household in India.","authors":"Junaid Khan, Sanjay K Mohanty","doi":"10.1111/tmi.14097","DOIUrl":"10.1111/tmi.14097","url":null,"abstract":"<p><strong>Background and objective: </strong>Defining economic status of the household through household-based surveys remains a challenge and the measures vary across surveys and countries. This study identifies two exclusive measures of economic wellbeing of the household-wealth index and monthly per capita non-food expenditure (MPCNFE) and examines the comparative predictability of the two measures to predict the variation in per capita calorie intake across Indian households.</p><p><strong>Methods: </strong>Design This study has a cross-sectional design and households are the unit of analysis. Setting National Sample Survey consumption expenditure rounds, 2004-2005 and 2011-2012 for India. A total of more than 100,000 households in each of the two survey rounds were included in this study. The respective household heads were interviewed during the survey.</p><p><strong>Results: </strong>In 2004-2005, a wealth-poor household from the lowest decile consumed 1881 kcal while a consumption-poor household (lowest decile) consumed only 1690 kcal, a difference of 11.3%. A slight overall increase in average calorie intake between the two survey rounds was detected (from 2016 to 2049 kcal; 2%), but the consumption-poor households (lowest decile) still had a lower average calorie intake than the wealth-poor households (1856 kcal vs. 1958 kcal; a difference of 6%). In terms of inequality, the consumption measure of economic well-being showed higher concentration index values in calorie intake compared to the wealth measure. From the multivariate OLS estimation, it was evident that the consumption framework explained higher variability in calorie (log transformed) intake across Indian households than the wealth framework.</p><p><strong>Conclusion: </strong>Consumption-poor households in India are more economically underprivileged and consume fewer calories than wealth-poor households. MPCNFE as a measure of economic wellbeing better predicts the household level variation in calorie intake compared to the wealth-based measure of economic wellbeing.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"481-497"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048075","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":"Molecular evidence of Wolbachia and Orthoflavivirus infection in field-collected mosquitoes in three provinces of Türkiye.","authors":"Wilfrid Sewade, Ceylan Polat, Ozge Erisoz Kasap","doi":"10.1111/tmi.14099","DOIUrl":"10.1111/tmi.14099","url":null,"abstract":"<p><strong>Background: </strong>Mosquitoes transmit various pathogens causing diseases like Zika, Dengue, West Nile and Chikungunya. They also harbour insect-specific viruses (ISVs) and Wolbachia, which can block arbovirus transmission. This study investigated the prevalence of Orthoflavivirus and Wolbachia in mosquito populations from three provinces in Türkiye.</p><p><strong>Methods: </strong>Mosquitoes were collected using CDC Miniature Light traps in 2022-2023. Morphologically identified specimens were pooled (1-10 individuals) and screened for Orthoflavivirus and Wolbachia via PCR and confirmed by Sanger sequencing. Infection prevalence was estimated using the maximum likelihood method. Mosquito taxa richness across provinces was estimated using the abundance-based, non-parametric Chao1 index.</p><p><strong>Results: </strong>Among 8766 mosquitoes (11 taxa) collected, Culex perexiguus, Ochlerotatus caspius and Anopheles claviger were most abundant. Anopheles flavivirus (AnFV) detected in one Oc. caspius pool, while Wolbachia sequences belonging to supergroup B were detected in An. claviger, Cx. pipiens s.l., Cx. perexiguus and Oc. caspius, with an overall infection prevalence of 0.0119 (95% CI: 0.008-0.0161). The richest mosquito fauna was detected in Ankara, followed by Adana, and Çankırı.</p><p><strong>Conclusion: </strong>This study provides new insights into mosquito richness and the prevalence of Orthoflavivirus and Wolbachia in Türkiye, contributing to vector surveillance and the potential use of Wolbachia in mosquito control strategies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"498-508"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050622","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":"Mobile phone survey estimates of perinatal mortality in Malawi: A comparison of data from truncated and full pregnancy histories.","authors":"Georges Reniers, Julio Romero-Prieto, Michael Chasukwa, Funny Muthema, Sarah Walters, Bruno Masquelier, Jethro Banda, Emmanuel Souza, Boniface Dulani","doi":"10.1111/tmi.14109","DOIUrl":"10.1111/tmi.14109","url":null,"abstract":"<p><strong>Objectives: </strong>In many low- and middle-income countries, perinatal mortality estimates are derived retrospectively from periodically conducted household surveys. Mobile phone surveys offer advantages in terms of cost and ease of implementation. However, their suitability for monitoring perinatal mortality has not been established.</p><p><strong>Methods: </strong>We use data from the Malawi Rapid Mortality Mobile Phone Survey (RaMMPS) to estimate perinatal mortality rates from two versions of the survey instrument: a full pregnancy history and a shorter truncated pregnancy history. Female respondents of reproductive age were randomly allocated to either of these instruments. The sample was generated through random digit dialling with active strata monitoring. Post-stratification weighting was used to correct for sample selection bias, and estimates are reported with bootstrap confidence intervals. We estimated the stillbirth rate as the synthetic cohort probability of a foetal death with 28+ weeks of gestation over all pregnancies reaching the same gestational age. The perinatal and extended perinatal mortality rates were defined as the probabilities of dying between 28 weeks and 7 or 28 days of life, respectively. RaMMPS estimates are compared to the 2015-2016 Malawi Demographic and Health Survey and estimates published by the United Nations Inter-agency Group for Child Mortality Estimation.</p><p><strong>Results: </strong>Truncated and full pregnancy histories were administered for 2093 and 2067 women, respectively. Weighted point estimates of the stillbirth (19.81 deaths per 1000 pregnancies, 95%-confidence interval (CI): 14.11-25.62), perinatal (42.41, 95%-CI: 33.91-50.92), and extended perinatal mortality rates (50.11, 95%-CI: 41.56-58.84) from the full pregnancy history instrument are in line with Demographic and Health Survey and United Nations Inter-agency Group for Child Mortality Estimation estimates. In comparison, the mortality estimates from the truncated pregnancy history instrument are higher, but this difference only approaches statistical significance in the case of the stillbirth rate. Post-stratification weighting produces a small upwards adjustment in the estimates.</p><p><strong>Conclusion: </strong>Mobile phone surveys are a promising method for collecting perinatal mortality data. The full pregnancy history instrument produces more plausible results than the shorter truncated pregnancy history questionnaire where the window of retrospection is restricted.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"521-530"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000883","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":"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}