Infectious Diseases of Poverty最新文献

{"title":"One Health: enabler of effective prevention, control and elimination of emerging and re-emerging infectious diseases.","authors":"Tianyun Li, Xiao-Nong Zhou, Marcel Tanner","doi":"10.1186/s40249-025-01337-1","DOIUrl":"https://doi.org/10.1186/s40249-025-01337-1","url":null,"abstract":"<p><p>Emerging and re-emerging infectious diseases in different soci-ecological settings create unprecedented challenges for global public health and socio-economic development. The One Health concept is based on a systemic, transdisciplinary approach and hence captures the interactions between humans and animals, in a given socio-ecological setting. It could comprehensively address the human-animal-environment interface, the core of zoonotic diseases. Consequently, One Health approach is effective in controlling and eliminating the promoting factors of emerging infectious diseases (EIDs). We explored key principles for the prevention, control and elimination of EIDs through reviewing the transition of public health and global health strategies towards One Health and summarizing some successful experiences in effectively controlling EIDs. Recognizing heterogeneities and strengthening \"surveillance-response systems\" are the two key principles. It is recommended to promote health equity and conduct cost-effectiveness analysis to address the challenges of heterogeneity. Cross-sectoral collaboration and transdisciplinarity should be strengthened to facilitate the utilizing of systems thinking.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"77"},"PeriodicalIF":5.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test accuracy of loop-mediated isothermal amplification for schistosomiasis in low endemicity areas: a systematic review and meta-analysis.","authors":"Xinjie Zhou, Jiajia Li, Jiayin Qiu, Ting Feng, Chao Lv, Wangping Deng, Robert Bergquist, Jing Xu, Shizhu Li, Zhiqiang Qin","doi":"10.1186/s40249-025-01346-0","DOIUrl":"https://doi.org/10.1186/s40249-025-01346-0","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis, caused by parasitic flatworms of the genus Schistosoma, remains a significant public health challenge in tropical and subtropical regions, affecting over hundreds of millions of people in these areas. Accurate diagnosis is crucial for effective disease control, particularly in low-endemic areas where traditional methods like microscopy are no longer effective. We aimed to evaluate the diagnostic performance of loop-mediated isothermal amplification (LAMP) for Schistosoma infection.</p><p><strong>Methods: </strong>Adhering to Preferred reporting items for systematic reviews and meta-analyses guidelines, we conducted a comprehensive search on 10 May 2025 across multiple databases including PubMed, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, Embase, China National Knowledge Infrastructure, and Wanfang Data, using keywords such as \"schistosom*\", \"LAMP\", and \"loop-mediated isothermal amplification\". Based on available literature, pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and 95% confidential interval (CI) were calculated using STATA18.0 software. Subgroup analyses and univariable meta-regression were performed to explore the source of heterogeneity. Specifically, subgroup analyses were performed by categorizing into species (S. japonicum, S. mansoni, S. haematobium), sample type (stool, urine, serum, snails), and DNA extraction methods to explore factors influencing test performance.</p><p><strong>Results: </strong>The study finally included 24 individual studies derived from 14 published articles. The pooled analyses of LAMP data from all included studies resulted in a sensitivity of 0.90 (95% CI: 0.80-0.90), specificity of 0.82 (95% CI: 0.60-0.93), PLR of 4.98 (95% CI: 2.01-12.29), NLR of 0.13 (95% CI: 0.06-0.26) and diagnostic odds ratio of 39 (95% CI: 10-158). The area under the summary receiver operating characteristic curve reached 0.93, indicating excellent diagnostic performance. Subgroup analyses revealed optimal performance for S. japonicum and snail samples with lower heterogeneity (I² < 50%).</p><p><strong>Conclusions: </strong>LAMP shows promise as a rapid, sensitive and specific diagnostic tool for schistosomiasis, particularly in resource-limited settings. This technique enables field application, supporting global efforts toward elimination of schistosomiasis by 2030.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"78"},"PeriodicalIF":5.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A spatial clustering-based approach to design monitoring networks of infectious diseases: a case study of hand, foot, and mouth disease.","authors":"Shuting Li, Yuanhua Liu, Ke Li, Zengliang Wang, Michael P Ward, Wei Tu, Jiayao Xu, Rui Yuan, Lele Zhang, Na Wang, Jidan Zhang, Yu Zhao, Henry S Lynn, Zhaorui Chang, Zhijie Zhang","doi":"10.1186/s40249-025-01331-7","DOIUrl":"10.1186/s40249-025-01331-7","url":null,"abstract":"<p><strong>Background: </strong>Effective monitoring of infectious diseases is crucial for safeguarding public health. Compared to comprehensive nationwide surveillance, selecting representative sample cities to constitute the monitoring network for surveillance provides similar effectiveness at a lower cost. We developed Spatial Cluster Stratified Sampling (SCSS) to select sample cities for infectious diseases exhibiting spatial autocorrelation.</p><p><strong>Methods: </strong>To improve monitoring efficiency for hand, foot, and mouth disease (HFMD), we used SCSS to design a monitoring network, which involved four main steps. First, we used Spatial Kluster Analysis by Tree Edge Removal (SKATER) to stratify the data. Second, we applied the cost-benefit balance to determine the optimal sample size. Third, we performed simple random sampling within each stratum to establish an initial monitoring network. Fourth, we used cyclic optimization to finalize the monitoring network. We evaluated the spatiotemporal representativeness using root mean square error (RMSE), Spearman's rank correlation, global Moran's I, local Getis-Ord G*, and Joinpoint Regression. We also compared the effectiveness of SCSS with K-means, traditional stratified sampling, and simple random sampling using RMSE.</p><p><strong>Results: </strong>The optimal sample size was determined to be 103. Overall, the predicted values for each city significantly correlated with the true values (r = 0.81, P < 0.001). Both the predicted and true values showed positive spatial autocorrelation (Moran's I > 0, P < 0.05), and the sensitivity, specificity, and accuracy of the predicted local Getis-Ord G* values, evaluated against the true values as the gold standard, were 0.76, 0.91, and 0.87, respectively. The weekly predicted values for each city showed significant correlation with the true values (P < 0.05). The 95% confidence intervals (CI) for the predicted values of joinpoint locations, annual percent change (APC), and average annual percent change (AAPC) encompassed the true values, and the number of joinpoints matched the true values. Among the four methods compared, SCSS exhibited the lowest and most centralized RMSE.</p><p><strong>Conclusions: </strong>SCSS proved to be more accurate and stable than traditional methods, which overlook spatial information. This method offers a valuable reference for future design of monitoring networks for infectious diseases exhibiting spatial autocorrelation, enabling more efficient and cost-effective surveillance.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"76"},"PeriodicalIF":5.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are there differences in efficacy and safety between local and imported direct-acting antiviral agents for hepatitis C in China?","authors":"Zhitao Wang, Youbing Ran, Yihan Fu, Jing Sun, Yuanli Liu","doi":"10.1186/s40249-025-01344-2","DOIUrl":"10.1186/s40249-025-01344-2","url":null,"abstract":"<p><strong>Background: </strong>Despite price advantages, local direct-acting antiviral agents (DAAs) for hepatitis C (hep C) have not been widely used in China compared with the imported ones. There is no evidence on their relative efficacy and safety, nor whether the small market share of local DAAs was attributable to the potential differences.</p><p><strong>Methods: </strong>This study systematically evaluated the efficacy and safety evidence of 5 local and 6 imported DAAs with valid Chinese registration numbers as of January 25, 2024. Meta-analyses, subgroup analyses and meta-regressions were performed to synthesize evidence and compared the outcomes by using the random-effects empirical Bayes model.</p><p><strong>Results: </strong>Nineteen randomized controlled trials and 82 single-arm trials (SATs) were included. The results demonstrated no statistically significant difference in 12-week sustained virological response [0.97, (95% confidence interval (CI) 0.95, 0.99) vs 0.96, (95% CI: 0.94, 0.98), P = 0.21], relapse [0.02, (95% CI: 0.01, 0.04) vs 0.02, (95% CI: 0.01, 0.03), P = 0.65], virological breakthrough [0.003, (95% CI: < 0.001, 0.02) vs 0.0000002, (95% CI: < 0.001, 0.0006), P = 0.51] and serious adverse events (SAEs) [0.04, (95% CI: 0.03, 0.06) vs 0.03, (95% CI: 0.02, 0.03), P = 0.12] between local and imported DAAs. By controlling for ethnicities of patients in multiple meta-regression, the local DAAs had a 33.7% higher rate of adverse events (AEs) [0.337, (95% CI: 0.188, 0.486), P < 0.001]. No statistically significant difference was found in the interaction test between local and imported pan-genotypic DAAs regarding the rate of AEs [0.72, (95% CI: 0.64, 0.79) vs 0.73, (95% CI: 0.65, 0.50), P = 0.81].</p><p><strong>Conclusions: </strong>Current evidence demonstrates no statistically significant differences in efficacy and SAEs between local and imported DAAs. Given that simplified pan-genotypic DAA regimens are now standard care, local pan-genotypic DAAs hold potential to increase hepatitis C virus treatment rates in China. It is critical for local DAA developers to generate more evidence with expanded patient population in terms of age, treatment experience and genotype of hepatitis C virus, conducting head-to-head studies directly comparing the efficacy and safety. Clinical and policy decision-making should be adaptive and evolve as new evidence is generated.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"75"},"PeriodicalIF":5.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical confirmation of an infection with Echinococcus multilocularis (Mongolian genotype): first case report of human alveolar echinococcosis in Inner Mongolia, China.","authors":"Xu Wang, Zhan-Jun Xiao, Chui-Zhao Xue, Wen-Ting Wu, Jiang-Hui Yang, Chun Yan, Ying Wang, Yan Kui, Wen-Bo Luo, Xi Du, Run-Na Zan, Rong-Jian Shang, Sa Li, Rigen Na, Shuai Han, Shi-Zhu Li","doi":"10.1186/s40249-025-01342-4","DOIUrl":"10.1186/s40249-025-01342-4","url":null,"abstract":"<p><strong>Background: </strong>Alveolar echinococcosis (AE), caused by the larval stage of Echinococcus multilocularis, poses a substantial global health challenge due to its high mortality profile. This study reports the inaugural human infection of echinococcosis caused by the Mongolian genotype of E. multilocularis in China, also the first reported indigenous AE case in Inner Mongolia.</p><p><strong>Case presentation: </strong>A 58-year-old female pastoralist from Inner Mongolia, who had no endemic region exposure history but prolonged occupational contact with dogs, presented with severe AE. Clinical examinations revealed a massive hepatic lesion exceeding 10 cm in diameter, accompanied by elevated eosinophils (0.90 × 10⁹/L) and basophils (0.08 × 10⁹/L). Despite undergoing liver transplantation, the patient succumbed postoperatively. Histopathological confirmation and molecular phylogenetics identified the Mongolian genotype of E. multilocularis infection, distinct from the predominant Asian genotype in China. Potential evidence of zoonotic transmission was discovered through genotype-matched E. multilocularis detection in corsac fox (Vulpes corsac) feces from the grasslands along the shores of Hulun Lake (Hulun Buir City, northeastern Inner Mongolia, China).</p><p><strong>Conclusions: </strong>This report provides the primary evidence of a locally acquired human AE infection in China caused by the Mongolian genotype of Echinococcus multilocularis. The discovery of this case challenges historical classifications of echinococcosis endemic areas. The findings call for revised AE-endemic identification criteria, improved AE diagnostic protocols, and enhanced AE surveillance in the Inner Mongolia region to generate further epidemiological evidence and information on disease progression.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"74"},"PeriodicalIF":5.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass drug administration trials of azithromycin: an analysis to inform future research and guidelines.","authors":"Alex C Kong, Anthony D So","doi":"10.1186/s40249-025-01322-8","DOIUrl":"10.1186/s40249-025-01322-8","url":null,"abstract":"<p><strong>Background: </strong>In 2020, the World Health Organization published a guideline on the use of mass drug administration (MDA) of the broad-spectrum antibiotic azithromycin to reduce childhood mortality. As MDA-azithromycin to reduce mortality is considered for expansion to more settings and populations, care must be taken to maximize benefits and reduce risks (e.g., antimicrobial resistance or AMR) of this intervention. Completed and ongoing MDA-azithromycin cluster-randomized clinical trials can provide evidence on the extent to which these benefits and risks accrue and identify practices to monitor these effects and address evidence gaps in future trials.</p><p><strong>Methods: </strong>We examined azithromycin clinical trials registered on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform from registry inception to December 31, 2023. We included trials for which azithromycin was administered for the prevention or treatment of a disease or condition that was not explicitly diagnosed or necessary for participant inclusion, and for which treatment was randomized by geographic units. We identified evidence, knowledge gaps, and trends and highlights across five domains: (1) targeting of MDA-azithromycin, (2) clinical endpoints, (3) co- and competing interventions, (4) spillover effects, and (5) AMR monitoring.</p><p><strong>Results: </strong>Of 1589 screened studies, 30 met all inclusion criteria. These trials were conducted in 13 countries, predominantly (26/30) in sub-Saharan Africa. Nearly a third (9/30) of the trials included mortality endpoints, but few (2/9) included cause-specific mortality endpoints. New evidence suggests the benefits of widening the target age group and the persistence of mortality benefits in settings with competing interventions. Published practices to ensure geographic separation of communities in different treatment arms to reduce spillover effects were not customary. We found information on AMR monitoring practices for just over half the trials (16/30). Of these, half (8/16) included both phenotypic and genotypic AMR testing, and more than half collected specimens to assess the nasopharyngeal and gut microbiomes (9/16) and tested for non-macrolide resistance (11/16).</p><p><strong>Conclusions: </strong>Further long-term MDA-azithromycin studies to determine which additional countries could benefit, interventions to accompany or replace this intervention, and the extent to which AMR spillover occurs may prove valuable as guidelines are revised.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"73"},"PeriodicalIF":8.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging urban-rural disparities in malaria care during pregnancy in Senegal: evidence from household and health facility surveys.","authors":"Yongsheng Jiang, Di Liang, Jinkou Zhao, Shailendra Prasad, Medoune Ndiop, Serigne Amdy Thiam, Ibrahima Diallo, Doudou Sene, Rose Mpembeni, Jiayan Huang","doi":"10.1186/s40249-025-01341-5","DOIUrl":"10.1186/s40249-025-01341-5","url":null,"abstract":"<p><strong>Background: </strong>Despite the World Health Organization's recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP.</p><p><strong>Methods: </strong>Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization.</p><p><strong>Results: </strong>From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95% CI: 1.65-1.68), higher in urban areas [1.73 (95% CI: 1.71-1.75)] than rural areas [1.63 (95% CI: 1.62-1.65)]. Each one-point increase in malaria service readiness led to a rise of 0.251 doses in IPTp-SP. The significant interaction (Coef. = - 0.523, P < 0.001) indicated that women in rural areas received fewer doses of IPTp-SP (0.089) than in urban areas (0.612) for every unit increase in malaria service readiness.</p><p><strong>Conclusions: </strong>Linking household and health facility surveys revealed significant room for improvement in malaria service readiness and IPTp-SP utilization in rural areas in Senegal. For better IPTp-SP coverage, differential strategies are required for urban and rural settings. Urban areas need to enhance malaria service readiness, while rural areas should focus on improving service readiness alongside infrastructure and community engagement to bridge the urban-rural disparities.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"71"},"PeriodicalIF":8.1,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for healthcare: restrained development despite impressive applications.","authors":"Robert Bergquist, Laura Rinaldi, Xiao-Nong Zhou","doi":"10.1186/s40249-025-01339-z","DOIUrl":"10.1186/s40249-025-01339-z","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) remains poorly understood and its rapid growth raises concerns reminiscent of dystopian narratives. AI has shown the capability of producing new medical content and improving management through optimization and standardization, which shortens queues, while its complete reliance on technical solutions threatens the traditional doctor-patient bond.</p><p><strong>Approach: </strong>Based on the World Economic Forum's emphasis on the need for faster AI adoption in the medical field, we highlight current gaps in the understanding of its application and offer a set of priorities for future research. The historic review of AI and the latest publications point at barriers like complexity and fragmented regulations, while assisted analysis of big data offers new insights. AI's potential in healthcare is linked to the breakthrough from rule-based computing, enabling autonomy through learning from experience and the capacity of reasoning. Without AI, protein folding would have remained unsolved, as emphasized by the Nobel-honored AlphaFold2 approach. It is expected that AI's role in diagnostics, disease control, geospatial health and epidemiology will lead to similar progress.</p><p><strong>Conclusions: </strong>AI boosts efficiency, drives innovation, and solves complex problems but can also deepen biases and create security threats. Controlled progress requires industry collaboration leading to prompt acceleration of proper incorporation of AI into the health sphere. Cooperation between governments as well as both public and private sectors with a multi-actor approach is needed to effectively address these challenges. To fully harness AI's potential in accelerating healthcare reform and shorten queues, while maintaining the compassionate essence of healthcare, a well-coordinated approach involving all stakeholders is necessary.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"72"},"PeriodicalIF":8.1,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Naegleria fowleri meningoencephalitis diagnosed via combined molecular biology and metagenomic sequencing techniques: a case report.","authors":"Yuanjing Kou, Jiayao Zhang, Dan Wang, Lidan Cui, Qi Sun, Yanqi Lv, Ying Liu, Zhiquan He, Yuling Zhao, Hongwei Zhang, Jun Su, Yaobao Liu, Yan Deng","doi":"10.1186/s40249-025-01347-z","DOIUrl":"10.1186/s40249-025-01347-z","url":null,"abstract":"<p><strong>Background: </strong>Naegleria fowleri, a pathogenic free-living amoeba, causes primary amoebic meningoencephalitis (PAM), a rare but devastating disease with acute onset, rapid progression, and > 95% mortality. Despite its rarity, the catastrophic outcomes associated with this infection underscore the critical importance of prevention. In this report, we present a rare pediatric fatality caused by PAM in China, highlighting the challenges of diagnosis and treatment.</p><p><strong>Case presentation: </strong>A 6-year-old child from Lushan County, Henan Province, developed persistent high fever, headache, vomiting, and altered mental status on December 5, 2024. After receiving ineffective local treatment, the child was transferred to the Eastern District of Henan Children's Hospital on December 7 for further evaluation and management. Upon admission, cerebrospinal fluid was collected for laboratory analysis, and antimicrobial therapy, including amphotericin B, fluconazole, and rifampicin, was promptly initiated. Despite these interventions, the patient's condition deteriorated rapidly, and the child succumbed to the infection on December 9.</p><p><strong>Conclusions: </strong>Clinical and laboratory findings strongly suggest that the child was infected with N. fowleri, resulting in PAM. Epidemiological investigation suggests possible exposure at a public bathhouse. Given the survival characteristics of the N. fowleri and potential habitat expansion due to global warming, this sporadic case underscores PAM's lethal potential. With mortality exceeding 95%, early recognition and prompt intervention are crucial. Clinicians should maintain high suspicion for PAM in patients with compatible symptoms, especially in regions with warm freshwater exposure.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"69"},"PeriodicalIF":8.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of regional characteristics in mortality trends of three chronic infectious diseases among the elderly in China, 2004-2021.","authors":"Yi-Ran Xiao, Xiang Ren, Meng-di Zhang, He Zhu, Xin Wang, Wen-Shan Sun, Xiao-Min Guo, Fei Huang, Jian-Jun Liu, Hong-Yan Yao, Qi-Qi Wang, Wen-Jing Zheng","doi":"10.1186/s40249-025-01345-1","DOIUrl":"10.1186/s40249-025-01345-1","url":null,"abstract":"<p><strong>Background: </strong>HIV/AIDS, hepatitis B, and tuberculosis (TB) are chronic infectious diseases prioritized by the United Nations Sustainable Development Goals (SDGs) and China's \"Healthy China Initiative (2019-2030),\" posing persistent challenges to global and Chinese public health systems. This study analyzed mortality trends and regional/urban-rural disparities of these three diseases among Chinese elderly individuals aged 60 years and older from 2004 to 2021 to identify priority areas for targeted prevention strategies.</p><p><strong>Methods: </strong>Data were sourced from the \"China Cause-of-Death Surveillance Dataset (2004-2021)\" published by the Chinese Center for Disease Control and Prevention. The study population comprised Chinese elderly individuals aged 60 years and older from 2004 to 2021. Joinpoint 4.9.0.1 software was used for joinpoint regression analysis to characterize dynamic mortality trends, calculating average annual percentage change (AAPC), annual percentage change (APC), and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>From 2004 to 2021, 100,934 deaths from the three chronic infectious diseases occurred among Chinese elderly. The overall age-standardized mortality rate (ASMR) decreased from 51.00 to 13.37 per 100,000 (AAPC: - 7.54%, 95% CI: - 9.38%, - 5.67%). Notably, the ASMR for HIV/AIDS increased from 0.11 to 0.85 per 100,000 population, while the ASMR for hepatitis B declined from 17.96 to 6.84 per 100,000 population and TB declined from 32.92 to 5.68 per 100,000 population. The three chronic infectious diseases collectively demonstrated the most significant ASMR reduction in central China (AAPC: - 7.85%, 95% CI: - 12.11%, - 3.39%), followed by eastern China (- 7.57%, 95% CI: - 9.02%, - 6.09%) and western China (- 7.10%, 95% CI: - 9.52%, - 4.62%). Rural areas experienced substantially steeper ASMR declines compared to urban areas (AAPC: - 7.81%, 95% CI: - 9.40%, - 6.18% vs. AAPC: - 6.05%, 95% CI: - 8.20%, - 3.85%).</p><p><strong>Conclusion: </strong>China achieved a continuous decline in the overall ASMR for the three chronic infectious diseases among elderly populations during 2004-2021, suggesting initial success in prevention efforts. However, the rising ASMR for HIV/AIDS necessitates disease-specific strategies. Notable regional disparities persist: hepatitis B and TB remain concentrated in western/rural areas, while the ASMR for HIV/AIDS is higher in urban regions. Future efforts should tailor resource allocation to local contexts to enhance intervention outcomes and protect elderly health.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"14 1","pages":"70"},"PeriodicalIF":8.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}