PLoS Neglected Tropical Diseases最新文献

{"title":"Qualitative risk assessment of Japanese encephalitis virus introduction and transmission in Pacific Island countries and territories.","authors":"Eloise B Skinner, Amanda K Murphy, Fan Yu, Kevin Thabo Moore, Liuyi Chen-Cao, David T Williams, Stephan Karl, Joelyn Goi, Colleen L Lau, Benn Sartorius","doi":"10.1371/journal.pntd.0014162","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014162","url":null,"abstract":"<p><strong>Background: </strong>The emergence of Japanese encephalitis virus (JEV) in Australia raises questions about transmission potential across neighbouring Pacific Island countries and territories (PICs), where surveillance infrastructure and diagnostic capacity are limited.</p><p><strong>Methodology: </strong>We conducted a qualitative risk assessment of 22 PICs structured around three components: (1) 'release assessment', evaluating JEV introduction pathways based on geographic proximity, migratory waterbird flyway connectivity, and windborne mosquito dispersal potential; (2) 'exposure assessment', evaluating ecological transmission suitability based on vector and host competence and occurrence; and (3) 'risk characterisation', integrating release and exposure components to stratify countries into transmission risk profiles (endemic, epidemic, and low potential). Introduction potential varied across the region, with northern and western PICs having greatest connectivity to endemic regions. Ecological suitability for transmission was sufficient to support JEV transmission in 13 of the 22 PICs if introduced. Eight PICs were characterised as having endemic transmission potential (Papua New Guinea, which already has confirmed circulation, Solomon Islands, New Caledonia, Vanuatu, Fiji, Palau, Guam, and Northern Mariana Islands), based on diverse competent vector communities, high ardeid waterbird diversity, and moderate-to-high introduction potential. Five PICs (Federated States of Micronesia, Tonga, Samoa, Tuvalu, and Nauru) were characterised as having epidemic transmission potential, supported by pig densities capable of amplifying viral titres and sufficient vector diversity, but lacking ardeid populations necessary to sustain endemic cycles. The remaining nine PICs had low transmission potential due to limited vector and host communities. These risk stratifications are relative; the absolute probability of JEV establishment in any PIC remains uncertain.</p><p><strong>Conclusions: </strong>Distinct transmission profiles require differentiated public health responses, from sustained surveillance in endemic-potential settings to early detection and rapid outbreak response in epidemic-potential settings. Regional coordination through shared diagnostic networks and vaccine access pathways is critical to support preparedness before JEV becomes established across the Pacific.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014162"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widespread circulation of West Nile and Usutu viruses in sedentary and migratory avifauna: A two-year study (2024-2025) of active surveillance in South of France.","authors":"Rachel Beaubaton, Justine Revel, Laetitia Pigeyre, Alexandre Lepeule, Julien Joly, Christophe de Franceschi, Anne Charmantier, Benjamin Vollot, Yannick Simonin","doi":"10.1371/journal.pntd.0014397","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014397","url":null,"abstract":"<p><p>West Nile virus (WNV) and Usutu virus (USUV) are neurotropic Orthoflaviviruses sharing a similar enzootic transmission cycle primarily involving Culex pipiens mosquitoes as vectors and birds as amplifying hosts. First identified in Africa, both viruses established endemicity across Europe over the past two decades, most likely introduced and spread by migratory bird species along Mediterranean flyways. In avian species, infection outcomes range from subclinical to fatal neuroinvasive disease, varying by viral strain, host immunity, and species susceptibility. Southern France emerges as a key hotspot for the circulation of these viruses, supported by diverse avian habitats conducive to year-round viral maintenance. This study investigated the RNA prevalence of WNV and USUV in more than 2500 sedentary and migratory wild birds from these regions during 2024-2025 using molecular surveillance. Samples were collected using mist net and bird boxes, across multiple passerine and non-passerine taxa, spanning wetlands, urban fringes, and agricultural zones. Our analyses revealed widespread viral detection across diverse species, mainly among passerines such as great tits, house sparrows, and barn swallows with USUV detected at higher rates than WNV in both study years. Overall RNA prevalence was markedly higher in 2024 than in 2025, potentially reflecting climatic or ecological drivers. These results highlight the pivotal role of mixed avifauna in arbovirus dynamics within Mediterranean Europe and emphasize the necessity for integrated, year-round surveillance targeting high-risk species and habitats.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014397"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing for the tiny predators: Community readiness and perceptions of copepod-based dengue control in eastern guatemala.","authors":"Valérie R Louis, Carlos Alberto Montenegro-Quinoñez, Till Bärnighausen, Peter Dambach","doi":"10.1371/journal.pntd.0014654","DOIUrl":"10.1371/journal.pntd.0014654","url":null,"abstract":"<p><strong>Background: </strong>Dengue remains a persistent public health challenge in eastern Guatemala, particularly in communities where irregular water supply, domestic water storage, and limited sanitation infrastructure create favorable conditions for Aedes aegypti proliferation. As concerns increase about the sustainability of chemical vector control, biological approaches such as the use of predatory copepods are receiving renewed attention. However, successful implementation depends not only on biological efficacy, but also on community awareness, acceptance, and willingness to adopt unfamiliar control methods.</p><p><strong>Methodology/principal findings: </strong>We conducted a cross-sectional Knowledge, Attitudes, and Practices (KAP) survey among 346 adult household representatives in eight urban and rural communities in the departments of Zacapa and Chiquimula, Guatemala. The study assessed dengue-related knowledge, household prevention practices, perceived risk, and attitudes toward potential future copepod-based biological control. Most respondents correctly identified mosquitoes as the vector of dengue, but knowledge of breeding sites and preventive measures was less comprehensive and varied by educational level. Preventive practices were inconsistent: 37% of households reported taking no action to eliminate mosquito breeding sites, and only a minority reported using multiple prevention strategies. Although prior familiarity with copepods was limited, willingness to consider their use was high when linked to clear information, technical support, and assurances regarding water safety. Concerns focused primarily on the introduction of organisms into stored water and lack of knowledge about the method, particularly in urban communities.</p><p><strong>Conclusions/significance: </strong>The findings indicate a substantial gap between basic dengue awareness and routine household prevention practices in eastern Guatemala. At the same time, the high conditional openness toward copepod-based control suggests that biological approaches may be socially acceptable if introduced through trusted local actors, transparent communication, and community engagement. These results support the further exploration of copepod-based interventions as a complementary, non-chemical vector control strategy. However, community acceptance should not be interpreted as evidence of effectiveness; rigorous field trials are needed to evaluate entomological impact, operational feasibility, safety, and sustainability under local environmental and household water-storage conditions.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014654"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive association between control measures and chikungunya fever incidence based on random forest and SHAP analysis.","authors":"Fengling Chen, Jinsen He, Huihui Liu, Zhilin Wu, Jiwen Wu, Kunlu He, Hongjuan Wen, Xiaohua Li, Hongwei Wu, Lang Lang, Lijie Zhang","doi":"10.1371/journal.pntd.0014675","DOIUrl":"10.1371/journal.pntd.0014675","url":null,"abstract":"<p><strong>Background: </strong>Using the 2025 Chikungunya fever (CHIK) outbreak in Chancheng District, Foshan City, this study applied a random forest (RF) regression model combined with SHapley Additive exPlanations (SHAP) to explore predictive associations, nonlinear relationships and potential thresholds between environmental-social factors and village/community-level cumulative incidence, to inform stratified control of mosquito-borne diseases.</p><p><strong>Methodology/principal findings: </strong>In this cross-sectional ecological study of 143 villages/communities, the outcome was cumulative incidence, and nine candidate covariates were assessed, including the hospitalization isolation rate, construction-site density, and population density. Multicollinearity was checked using the variance inflation factor. Model fit was evaluated by the out-of-bag (OOB) R², RMSE, and MAE, and variable importance by %IncMSE. Robustness was tested with 100 repeated runs, bootstrap thresholds from SHAP dependence plots, and a sensitivity analysis excluding the endogenous isolation rate. On the log(1 + incidence) scale, the OOB R² was 0.206, with underestimation of high-incidence areas. The hospitalization isolation rate had the highest importance (%IncMSE = 18.43) and was negatively correlated with predictions (ρ = -0.749), but this likely reflects reverse causation and is predictive only. Construction-site density was strongly positive (ρ = 0.855), with a stable threshold near 12.8 sites/km²; it remained the most robust predictor after removing the isolation rate (%IncMSE = 8.54).</p><p><strong>Conclusions/significance: </strong>Construction-site density was the most robust environmental predictor, whereas population density contributed little. These exploratory, predictive associations-not causal effects-should guide risk stratification and require prospective validation with time-matched longitudinal data.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014675"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endemicity and environmental reservoirs of schistosomiasis and soil-transmitted helminth infections in Ghanaian rural communities.","authors":"Rita Nyaaba Akologo, Isaac Williams, Dennis Adu-Gyasi, Dodzi Kofi Amelor, Rabbi Coffie Baidoo, Asenso Gideon, Akugre Alfred Akuka, Akua Obeng Forson, Samuel Fosu Gyasi, Emmanuel Timmy Donkoh","doi":"10.1371/journal.pntd.0014701","DOIUrl":"10.1371/journal.pntd.0014701","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis and soil-transmitted helminth (STH) infections remain major neglected tropical diseases in low- and middle-income countries despite ongoing preventive chemotherapy programmes. This study assessed the prevalence, associated risk factors, and household environmental contamination related to schistosomiasis and STH infections among children in Banda District, Ghana.</p><p><strong>Methodology: </strong>A community-based cross-sectional study was conducted in four endemic communities in the Banda District, Ghana, from February to April 2025. Pre-school and school-aged children (2-15 years) were recruited using systematic sampling. Urine samples were examined with urine sedimentation for S. haematobium ova, and stool samples were analyzed using Kato-Katz for STHs and S. mansoni ova. Household soil and animal faecal samples were examined using flotation and formalin-ether concentration techniques. Risk factors were assessed through structured questionnaires. Bivariate and multivariate logistic regression analyses were performed; variables with p ≤ 0.25 were included in the multivariate model, with a p < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The overall prevalence of schistosomiasis was 26.3%, and the prevalence of STH infections was 28.0%. In multivariate analysis, non-school attendance (AOR = 4.59; 95% CI: 2.49-8.47; p < 0.001) and children drinking from rivers/streams (AOR = 4.58; 95% CI: 1.73 - 12.10; p = 0.009) were associated with a higher odds of schistosomiasis. For STH infections, children aged 2-9 years (AOR = 2.18; 95% CI: 1.24-3.85; p = 0.007), non-school attendance (AOR = 5.91; 95% CI: 3.41-10.24; p < 0.001) and rearing of animal within house (AOR = 4.78; 95% CI: 2.32-9.86; p < 0.001) were associated with a higher odds of infection. Both soil and animal faecal samples harbored STHs with differing species distributions between matrices (soil: 7.08% positive; animal faeces: 10.67%).</p><p><strong>Conclusion: </strong>This study revealed that schistosomiasis and helminth infections are prevalent among humans, animals, and the surrounding soil within shared environments. The findings support extending MDA to the community level and implement WASH, improved livestock management and health education to reduce transmission.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014701"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why does local edema persist? Immunological mismatch between phospholipase A2 potency and antivenom affinity in Protobothrops mucrosquamatus envenomation.","authors":"Cheng-Hsuan Ho, Yu-Wei Chiang, Yan-Chiao Mao, Chih-Hsiung Hsu, Feng-Chen Chen, Shih-Hung Tsai, Shing-Hwa Liu","doi":"10.1371/journal.pntd.0014689","DOIUrl":"10.1371/journal.pntd.0014689","url":null,"abstract":"<p><strong>Background: </strong>Protobothrops mucrosquamatus is the primary species responsible for snakebite morbidity in Taiwan, typically resulting in severe localized tissue edema. Although freeze-dried hemorrhagic antivenom (FHAV) is the standard treatment, persistent swelling remains a frequent clinical challenge. This study aimed to identify primary edematogenic toxins and evaluate the neutralizing efficacy of FHAV and small-molecule inhibitors (SMIs) to address this therapeutic gap.</p><p><strong>Methodology/principal findings: </strong>Multiple linear regression of a retrospective cohort of 50 patients was used to identify predictors of edema remission. Experimentally, a murine paw edema model was established to evaluate the potency of crude venom and isolated fractions (PLA2, SVSP, and SVMP/CTL), whereas ELISA was used to determine FHAV immunoreactivity. Clinically, total FHAV dosage was the strongest independent predictor of the remission timeline (β = 0.658, T = 5.167, P < 0.001), accounting for 69.8% of the variance. Experimentally, the PLA2-enriched fraction was identified as the primary edematogenic driver, eliciting swelling at 100 μg/mL, which was statistically indistinguishable from that of crude venom, whereas the other fractions required fivefold higher concentrations to achieve similar effects. However, ELISA revealed a significant immunological mismatch: the SVMP/CTL fraction sequestered 81.49% of the FHAV, indicating that highly potent PLA2 was poorly targeted. Furthermore, SMIs (varespladib, marimastat, and batimastat) at 10 μM exhibited limited efficacy against crude venom-induced edema, suggesting that single-target interventions against the complex venom proteome are insufficient.</p><p><strong>Conclusions/significance: </strong>Persistent localized edema arises from an immunological mismatch in which FHAV recognizes primarily high-molecular-weight immunogens instead of the primary edematogenic driver, PLA2. Current clinical management necessitates increasing FHAV dosages to compensate for low specific affinity through increased total antibody volume. These findings highlight that robust prospective multicenter trials are urgently needed to transition from empirical dosing to standardized, potency-aligned FHAV protocols, potentially incorporating multimodal therapeutic cocktails to achieve comprehensive neutralization.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014689"},"PeriodicalIF":3.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the association between immune-modulating helminths and HPV or cervical cancer: A scoping review.","authors":"Allison Frank, Margarita Correa-Mendez, Alicia A Livinski, Kalina Duncan, Eva H Clark, Patti E Gravitt","doi":"10.1371/journal.pntd.0013308","DOIUrl":"10.1371/journal.pntd.0013308","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer disproportionately affects people living in low- and middle-income countries (LMICs). While access to effective preventive interventions explains some of the disparity, biological causes cannot be ruled out as important contributors to the observed disparities in cervical cancer outcomes. Since chronic infection with helminths which cause immune dysregulation and suppress anti-viral responses is common in LMICs, we sought to review the available epidemiologic evidence evaluating associations between helminth infection and HPV infection and/or cervical cancer.</p><p><strong>Methods: </strong>We searched five databases of scientific publications using search terms targeted towards journal articles published between 1990-2022 evaluating an epidemiologic association between helminth infection and HPV prevalence, persistence, or cervical cancer progression. Out of 93 reports assessed for eligibility, we identified eight relevant studies and describe them in this scoping review.</p><p><strong>Results: </strong>All eight studies suggest a possible positive association between helminth infection and HPV or cervical cancer. Six studies found a positive trend in association between schistosomiasis and cervical neoplasia; two studies between hookworm infection and HPV prevalence; and 1 study between Ascaris, Trichuris, and Strongyloides and HPV prevalence.</p><p><strong>Conclusions: </strong>Published evidence suggests positive trends towards an association between helminth infection and cervical neoplasia. Given the high burden of helminth and HPV co-infection in LMICs, further evaluation of the association between helminth infection and HPV or cervical cancer is warranted.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0013308"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating enteric fever seroincidence in rural western Cambodia: Findings from a population-based cross-sectional serosurvey.","authors":"Meiwen Zhang, Natnaree Saiprom, Rupam Tripura, Lek Dysoley, Phal Chanpheakdey, Vanna Moul, Arjun Chandna, Elizabeth M Batty, Sue J Lee, Richard J Maude, Nicholas P J Day, Thomas J Peto, Narisara Chantratita, Richelle Charles, Yoel Lubell, Kristen Aiemjoy","doi":"10.1371/journal.pntd.0014691","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014691","url":null,"abstract":"<p><strong>Introduction: </strong>Enteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi, remains an important cause of febrile illness in low- and middle-income countries (LMIC). However, the exact burden is difficult to estimate due to limitations in diagnosis and surveillance.</p><p><strong>Methods: </strong>Samples from a representative cross-sectional household serosurvey in rural western Cambodia were used to estimate enteric fever seroincidence among children and young adults. Participants were enrolled between April 7 and December 10, 2023, and 529 samples from individuals aged 5-25 years were analysed. Using IgA and IgG responses to hemolysin E antigen and established models of antibody decay after infection, we estimated seroincidence, conveying the rate of new infection in the population over time.</p><p><strong>Results: </strong>The overall enteric fever seroincidence rate was 161.8/1,000 person-years (95%CI: 147.5, 177.5). Among children 5-15 years, it ranged between 149.5 (95%CI: 120.8, 185.1) and 239.0 (95%CI:188.7, 302.7) across districts. Seroincidence was higher among children 5-15 years from households with unimproved drinking water sources or sanitation facilities, and in districts with a higher proportion of households with unimproved WASH.</p><p><strong>Conclusion: </strong>These findings potentially support the introduction of the typhoid conjugate vaccine in rural western Cambodia. However, additional data on the relative contribution of S. Typhi versus S. Paratyphi is needed. We also demonstrate seroincidence as an adjunctive valuable surveillance tool in LMICs where facility-based surveillance may be inadequate.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014691"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya waves in 2025 signal risk of endemicity in China.","authors":"Kok Keng Tee, Dongkui Mu, Xueshan Xia","doi":"10.1371/journal.pntd.0014685","DOIUrl":"10.1371/journal.pntd.0014685","url":null,"abstract":"<p><p>Chikungunya virus (CHIKV) transmission in Guangdong, southern China, intensified markedly in 2025, with successive outbreak waves in Foshan and Jiangmen followed by wider dissemination across all 21 prefectures during a peak domestic travel period. By late 2025, more than 25,000 cases had been reported, suggesting a departure from the historically import-driven and geographically limited outbreaks previously observed in China. These observations raise the possibility of an early transition towards more sustained transmission, although repeated introductions followed by local amplification remain an alternative explanation. Key contributing factors include mobility-associated amplification, climate variability, flood-related expansion of mosquito breeding habitats, favourable urban ecology, and incomplete interruption of transmission during cooler months. Although winter temperatures are suboptimal for sustained transmission, vector persistence and possible vertical viral transmission may permit low-level circulation between epidemic waves. In this context, distinguishing repeated importation from local persistence becomes critical. Preventing endemic establishment will require sustained inter-epidemic surveillance, anticipatory vector control, and clearer policy pathways for deployable vaccination strategies.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014685"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talaromycosis-associated immune reconstitution inflammatory syndrome exhibits immune dysregulation in patients with acquired immunodeficiency syndrome.","authors":"Bei Zhao, Qinzhi Zhang, Pengle Guo, Yingyin Yang, Feilong Xu, Xuemei Ling, Kaiyin He, Xiejie Chen, Xiaoping Tang, Huihua Zhang, Linghua Li","doi":"10.1371/journal.pntd.0014695","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014695","url":null,"abstract":"<p><strong>Background: </strong>Talaromycosis (TSM) is a severe opportunistic fungal infection that mostly infects patients with acquired immunodeficiency syndrome (AIDS). After antiretroviral therapy (ART), AIDS patients with TSM may develop immune reconstitution inflammatory syndrome (IRIS), leading to the paradoxical worsening of clinical symptoms. However, the immunological characteristics of TSM-related IRIS (TSM-IRIS) in AIDS patients remain poorly understood.</p><p><strong>Methodology/principal findings: </strong>We conducted a longitudinal cohort study of AIDS patients with TSM and analyzed the immunological features using flow cytometry, transcriptomes, and multiplex cytokine assays at admission, ART initiation, and at 2, 4 weeks after ART initiation. Patients with TSM-IRIS displayed significantly higher baseline CD3 ⁺ T cells at admission and lower frequencies of PD-1 ⁺ CD4 ⁺ T cells at ART initiation than those without IRIS (non-IRIS). After ART initiation, TSM-IRIS was associated with dynamic transcriptomic changes involving inflammatory and immune-related pathway enrichment, along with sustained elevations of interleukin (IL)-17, IL-21, C-X-C motif chemokine ligand (CXCL) 5, and CXCL12. Transcriptomic analysis revealed the dynamic enrichment of pro-inflammatory pathways prior to and during the early phase of ART.</p><p><strong>Conclusion/significance: </strong>AIDS patients with TSM-IRIS exhibited an immune profile associated with enhanced T cell activation, characterized by accelerated immune reconstitution accompanied by heightened inflammatory activity during the early phase of ART, may potentially acting as the immune markers for prediction or diagnosis of TSM-IRIS in AIDS patients.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 9","pages":"e0014695"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}