PLoS Neglected Tropical Diseases最新文献

{"title":"Socio-cultural and structural barriers influencing parents' knowledge and access to information on schistosomiasis in children around Ugandan Lakes.","authors":"Lisa Sophie Reigl, Maxson Kenneth Anyolitho, Stella Neema, Mary Amuyunzu-Nyamongo, Andrea Buhl, Jennifer Burrill, Marie Frese, Djouquou Alexise Gnahore, Eveline Hürlimann, Suzanne Lavry, Janet Masaku, Nora Monnier, Ashley Preston, Alice Sereti Sinkeet, Peter Steinmann, Alain Toh, Orkan Okan, Andrea S Winkler, Isabelle L Lange","doi":"10.1371/journal.pntd.0013050","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013050","url":null,"abstract":"<p><strong>Background: </strong>In Uganda, the national prevalence of schistosomiasis is 36.1% among the two-to-four-year age group. Knowledge about schistosomiasis and socio-cultural factors have been reported to influence adult participation in mass drug administrations of praziquantel, the standard medication used to treat the disease. In advance and support of the (pilot) introduction of the recently developed paediatric praziquantel formulation (arpraziquantel), we conducted research on parent and other community members' knowledge about paediatric schistosomiasis, their information sources, and potential perceived barriers that influence knowledge and access to information on schistosomiasis.</p><p><strong>Methods: </strong>This cross-sectional qualitative study consisted of 65 in-depth interviews and ten focus group discussions with parents/guardians of preschool-aged children (PSAC), Village Health Teams (VHTs), health professionals, community leading persons and district officials, in addition to direct observations. We collected data concurrently in Hoima District at Lake Albert and Bugiri at Lake Victoria, Uganda, in 2022. The analysis followed both an inductive and a deductive thematic approach.</p><p><strong>Results: </strong>Despite high parental awareness of the disease and knowledge of signs and symptoms, we identified less familiarity with its transmission and prevention. With limited communication channels, VHTs emerged as the primary information sources but reflected varied local understandings of schistosomiasis. Parents expressed a desire to be informed about the new paediatric treatment through VHTs, health professionals, and community leaders, and partly through the radio. Other mentioned socio-cultural and structural barriers to information flow included language barriers, illiteracy, high population movement, fears, and resentment from restrictive government fishing laws.</p><p><strong>Conclusions: </strong>Carefully designed information campaigns tailored to local circumstances and health literacy needs should be carried out by trained VHTs and preferably supported by health professionals and the local leadership structure. These components are essential to inform parents/guardians of PSAC, enabling them to make well-informed decisions for their children's health.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013050"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033922","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":"Unprecedented in vivo activity of telacebec against Mycobacterium leprae.","authors":"Aurélie Chauffour, Emmanuelle Cambau, Kevin Pethe, Nicolas Veziris, Alexandra Aubry","doi":"10.1371/journal.pntd.0013076","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013076","url":null,"abstract":"<p><strong>Background: </strong>New drugs targeting the electron transport chain (ETC) seem to be a promising advance in leprosy treatment. In this study, we evaluated the bactericidal activity of telacebec (TCB), a phase 2 drug candidate for tuberculosis, alongside known ETC-targeting antibiotics, bedaquiline (BDQ) and clofazimine (CFZ), as monotherapy or in combination.</p><p><strong>Methodology/ principal findings: </strong>We used the reference leprosy proportional bactericidal mouse footpad model. Four hundred and ten mice were inoculated in the footpads with 5x104 to 5x100 bacilli of M. leprae strain THAI53 for the untreated control group and groups treated with drug-monotherapies, and with 5x104 to 5x101 for groups treated with drug-combinations. Mice were randomly allocated into the following groups: 2 control groups (untreated or standard multi drug therapy (MDT), rifampin, dapsone and clofazimine with dosing equipotent to human dosing) and 7 test groups (TCB 10mg/kg, bedaquiline 25mg/kg (BDQ), clofazimine 20mg/kg (CFZ), CFZ + BDQ, TCB + BDQ, TCB + CFZ, TCB + CFZ + BDQ). Mice in the test groups received either one month treatment (MDT) or a single dose of the drugs (TCB, RIF, BDQ, CFZ). Twelve months later, mice were sacrificed to enumerate M. leprae bacilli in the footpad. All the footpads became negative in the MDT, TCB and combination groups except in the TCB + CFZ group where 2 mice remained positive in the 5x104 inoculum.</p><p><strong>Conclusion: </strong>We demonstrated that monotherapy of TCB exhibited bactericidal activity against M. leprae comparable to that of MDT and that all combination therapies were as effective as MDT, except the combination TCB + CFZ, possibly due to an antagonism between these two drugs.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013076"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065167","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":"The potential impacts of vector host species fidelity on zoonotic arbovirus transmission.","authors":"Tijani A Sulaimon, Anthony J Wood, Michael B Bonsall, Michael Boots, Jennifer S Lord","doi":"10.1371/journal.pntd.0012196","DOIUrl":"https://doi.org/10.1371/journal.pntd.0012196","url":null,"abstract":"<p><p>The interaction between vector host preference and host availability on vector blood feeding behaviour has important implications for the transmission of vector-borne pathogens. However, to our knowledge, the effect of bias towards feeding on the same host species from which a first meal was taken, termed fidelity, has not been quantified. Using a mathematical model we showed that vector fidelity to the host species they take a first blood meal from leads to non-homogeneous mixing between hosts and vectors. Taking Japanese encephalitis virus (JEV) as a case study, we investigated how vector preference for amplifying vs dead-end hosts and fidelity can influence JEV transmission. We show that in regions where pigs (amplifying hosts) are scarce compared to cattle (dead-end hosts preferred by common JEV vectors), JEV could still be maintained through vector fidelity. Our findings demonstrate the importance of considering fidelity as a potential driver of transmission, particularly in scenarios such as Bangladesh and India where the composition of the host community might initially suggest that transmission is not possible.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012196"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023599","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":"Assessing soil-transmitted helminths and Schistosoma mansoni infections using parasitological indicators after seven years of preventive chemotherapy among school-age children in Mizan-Aman town.","authors":"Mitiku Abera, Tariku Belay, Daniel Emana, Zeleke Mekonnen","doi":"10.1371/journal.pntd.0013058","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013058","url":null,"abstract":"<p><strong>Background: </strong>Soil-transmitted helminthiasis and Schistosomiasis are major public health problems mainly among school-age children. Despite the seven years of implementing elimination program, the ongoing prevalence and intensity of both diseases have not been assessed in the study area. Hence, this study aimed to determine the parasitological indicator (prevalence and intensity) of soil-transmitted helminths and Schistosoma mansoni infections after seven years of preventive chemotherapy among school-age children in Mizan-Aman town.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 615 school-age children from January to February 2022 in Mizan-Aman Town. Study participants were selected using a systematic random sampling technique. Sociodemographic and associated factors were collected using a structured questionnaire. The stool samples were collected and processed using the double-slide Kato-Katz technique. The parasitological indicator was evaluated based on the thresholds set by the elimination program.</p><p><strong>Results: </strong>The overall prevalence of soil-transmitted helminths infection was 50.7% (95% CI: 46.8-54.8); with 2.4% moderate and heavy intensity, and Schistosoma mansoni infection prevalence was 25.4% (95% CI: 22.1-28.6), with 3.3% heavy intensity infection. School-age children in public schools; AOR: 3.92, (95% CI: 2.33-6.60), drinking river water; AOR: 1.79, (95% CI: 1.08-2.98), irregular handwashing before meals; AOR: 3.18, (95% CI: 1.24-8.35), eating unwashed fruits; AOR: 2.47, (95% CI: 1.56-3.92), and habits of soil contact; AOR: 2.48, (95% CI: 1.69-3.62), were associated factors for soil-transmitted helminths infection, whereas river swimming habits; AOR: 3.46, (95% CI: 2.18-5.50), bathing in the river; AOR: 3.29, (95% CI: 2.18-5.50), male gender; AOR: 1.72, (95% CI: 1.15-2.58), and school-age children in public schools; AOR: 2.36, 95% CI (1.19-4.68), were predictors of Schistosoma mansoni infection.</p><p><strong>Conclusion: </strong>Despite the preventive chemotherapy that has been implemented in the study area, the prevalence of soil-transmitted helminths and Schistosoma mansoni infections persist at a high level. Hence, the preventive chemotherapy implementation could be revised and integrated with other control strategies for elimination.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013058"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058306","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":"Exploring community knowledge, perceptions, and the impacts of anthrax among farming communities living in game management areas in Zambia: A qualitative study using a hybrid approach.","authors":"Chisoni Mumba, Davies Phiri, Exillia Kabbudula, Laila Gondwe, Noanga Mebelo, Gubula Simweene, Mutinta N Hankolwe, Kezzy Besa, Suwilanji S Sichone, Mwila Kayula, Mainda Geoffrey, Kivaria M Fredrick, Charles Bebay, Soumare Baba, Mtui-Malamsha N Jesse, Suze P Filippini, Chitwambi Makungu","doi":"10.1371/journal.pntd.0012852","DOIUrl":"https://doi.org/10.1371/journal.pntd.0012852","url":null,"abstract":"<p><p>Anthrax remains a neglected zoonotic disease of critical public and animal health significance in Zambia, particularly in regions with active human-wildlife-livestock interfaces such as the Western, Southern and Eastern provinces of Zambia. This study explores the socio-ecological drivers of anthrax transmission and examines the role of legal and illegal wildlife trade value chains in sustaining outbreaks. Secondly, the study explores the methodology used to investigate community knowledge, perceptions, and the impacts of anthrax through focus group discussions (FGDs) and a hybrid approach combining traditional thematic analysis with artificial intelligence (AI) tools. The research was framed within the interpretivist paradigm, aiming to understand shared experiences and socio-cultural contexts. The study utilized focus groups to encourage interaction and generate rich, collective insights. The hybrid approach allowed for data analysis that combined researcher-led reflexivity with AI-driven thematic analysis. Findings reveal diverse levels of awareness about anthrax, widespread misconceptions, and the influence of cultural beliefs on health behaviours. Communities linked anthrax outbreaks to interactions with wildlife and the illegal game meat trade, highlighting the complex interplay of ecological, economic, and behavioural factors in disease dynamics. Additionally, the study underscores the socioeconomic toll of anthrax, including livestock losses, disrupted livelihoods, and food insecurity, compounded by inadequate public health and veterinary responses. The insights gained from this research emphasize the need for multi-sectoral interventions tailored to the specific needs of these communities.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012852"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023595","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":"Detection of Haemophilus ducreyi from environmental and animal samples in Cameroon.","authors":"Philippe Ndzomo, Serges Tchatchouang, Onana Boyomo, Tania Crucitti, Michael Marks, Sara Eyangoh","doi":"10.1371/journal.pntd.0013091","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013091","url":null,"abstract":"<p><strong>Background: </strong>Children in parts of Africa, the South Pacific, and Southeast Asia frequently develop cutaneous ulcers caused by two bacteria: Haemophilus ducreyi (HD) and Treponema pallidum subspecies pertenue (causative agent of yaws). The World Health Organization (WHO) aims to eradicate yaws using mass administration of azithromycin. This also leads to a temporary decrease in ulcers caused by HD followed by a rebound suggesting an ongoing reservoir of infection. The aim of this study was to investigate whether HD could spread through the environment or animals.</p><p><strong>Methods: </strong>Alongside detection of human cases of cutaneous ulcers from villages in Cameroon, we additionally collected samples from animals (dogs, cats, flies), fomites (bedsheets, clothing, benches, doors), and water sources (marigots and lakes). DNA was extracted and tested for HD and T. pallidum using two specific qPCR assays.</p><p><strong>Results: </strong>HD was not detected in any of the environmental samples but it was on both clothing (13.3%) and in flies (27%). Flies also tested positive for T. pallidum, but at a lower rate (2.6%).</p><p><strong>Conclusions: </strong>These results suggest that flies and some fomites may contribute to the transmission of HD. Future research should focus on determining whether either of these are capable of carrying live bacteria that can cause onward transmission.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013091"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055373","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":"Development and validation of a simple-to-use nomogram for predicting severe scrub typhus in children.","authors":"Yonghan Luo, Yan Guo, Yanchun Wang, Xiaotao Yang","doi":"10.1371/journal.pntd.0013090","DOIUrl":"10.1371/journal.pntd.0013090","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and validate a simple-to-use nomogram for predicting severe scrub typhus (ST) in children.</p><p><strong>Methods: </strong>A retrospective study of 256 patients with ST was performed at the Kunming Children's Hospital from January 2015 to November 2022. ALL patients were divided into a common and severe group based on the severity of the disease. A least absolute shrinkage and selection operator (LASSO) regression model was used to identify the optimal predictors, and the predictive nomogram was plotted by multivariable logistic regression. The nomogram was assessed by calibration, discrimination, and clinical utility.</p><p><strong>Results: </strong>LASSO regression analysis identified that hemoglobin count (Hb), platelet count (PLT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN), creatine kinase isoenzyme MB(CK-MB) and hypoproteinemia were the optimal predictors for severe ST. The nomogram was plotted by the six predictors. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.870(95% CI = 0.812 ~ 0.928) in training set and 0.839(95% CI = 0.712 ~ 0.967) in validation set. The calibration curve demonstrated that the nomogram was well-fitted, and the decision curve analysis (DCA) showed that the nomogram was clinically beneficial.</p><p><strong>Conclusions: </strong>This study developed and validated a simple-to-use nomogram for predicting severe ST in children based on six predictors including Hb, PLT, LDH, BUN, CK-MB and hypoproteinemia, demonstrating excellent predictive accuracy for the data, though external and prospective validation is required to assess its potential clinical utility.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013090"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055070","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":"The psychosocial and emotional burden of lymphatic filariasis: A systematic review.","authors":"Jorge Vasconez-Gonzalez, Camila Miño, María de Lourdes Noboa, Andrea Tello-De-la-Torre, Juan S Izquierdo-Condoy, Esteban Ortiz-Prado","doi":"10.1371/journal.pntd.0013073","DOIUrl":"10.1371/journal.pntd.0013073","url":null,"abstract":"<p><strong>Background: </strong>Lymphatic filariasis (LF) is a neglected tropical disease affecting an estimated 882.5 million people at risk of infection. It is caused by the filarial nematodes Wuchereria bancrofti, Brugia malayi, and Brugia timori, leading to lymphedema, and severe deformation of extremities and resulting in both physical and mental health consequences. Affected individuals often suffer from depression, anxiety, and anger, exacerbated by disability, marginalization, and societal rejection due to their physical disability.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted following the PRISMA guidelines, using the PubMed, Scopus, and Scielo databases without date restrictions, and including articles in both Spanish and English. The quality of selected articles was evaluated using the Newcastle-Ottawa Quality Assessment Scale and the JBI critical appraisal checklist. Our protocol was registered in PROSPERO under de code: CRD42024537760.</p><p><strong>Results: </strong>A total of 23 studies were included in this analysis, which identified the emotional impact of LF. Common symptoms include depression, anxiety, frustration, anger, and feelings of inferiority. Physical disability caused by lymphedema led to societal rejection, contributing to the development of these symptoms. We also found that the severity or advancement of the disease correlated with an increased emotional and social impact.</p><p><strong>Conclusions: </strong>LF significantly impacts the quality of life due to both its physical and emotional consequences. Psychological support for affected individuals is crucial from diagnosis, and the education of transmission and treatment of LF in endemic communities is essential to prevent discrimination and exclusion.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013073"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033514","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":"Cystatin antibodies interfere with ovary development in Haemaphysalis doenitzi (Acari: Ixodidae).","authors":"Songbo Zhang, Zhihua Gao, Ahmed H Ghonaim, Weijia Xing, Weikang Zhao, Jiayi Zhang, Xiaolong Yang","doi":"10.1371/journal.pntd.0013064","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013064","url":null,"abstract":"<p><p>Anti-tick vaccines are gaining attention as a strategy to prevent tick infestations by activating the immune response of the host. Antibodies produced by the host inhibit tick growth and reproduction, but the molecular mechanism remains to be clarified. In this study, we investigated the effects of cystatin antibodies on the ovarian function of Haemaphysalis doenitzi. Histological analysis revealed that exposure to cystatin antibodies resulted in a significant reduction in the number of eggs produced and caused severe damage to the ovarian tissue structure. Immunofluorescence experiments confirmed the significant expression of cystatin within the ovary. Proteomics and phosphoproteomics identified 31 and 10 differentially expressed proteins in the relevant pathways, respectively. These changes in protein levels were found to be regulated by various mechanisms, including ribosomes activity, regulation of actin cytoskeleton, RNA transport, the TCA cycle, drug metabolism, and mTOR signaling pathways. Notably, there was high expression of tropomyosin and low expression of glutathione S-transferase (GST) during ovarian detoxification. Enzyme activity assays indicated a significant down-regulation of GST enzyme activity in the immunized group, suggesting that cystatin antibodies impaired the detoxification capacity of the ticks. Both tropomyosin and GST were successfully cloned and designated as HD-TPMa and HD-GSTa, respectively. RNA interference (RNAi) successfully knocked down the target gene. Ticks subjected to immersion in cystatin antibodies exhibited a significantly increased mortality rate after 72 hours. This study elucidated the molecular mechanism by which cystatin antibodies inhibit the growth and development of tick ovaries, providing an important scientific basis for the development of effective tick ovary control strategies.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013064"},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035386","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":"(In)coherence between Chagas disease policy and the experiences of those affected in Mexico: The need for a transdisciplinary approach.","authors":"Mariela Aké-Chan, Mariana Sanmartino, María Teresa Castillo-Burguete, Adriana González-Martínez, Carlos N Ibarra-Cerdeña","doi":"10.1371/journal.pntd.0013052","DOIUrl":"https://doi.org/10.1371/journal.pntd.0013052","url":null,"abstract":"<p><p>Chagas disease, caused by the parasite Trypanosoma cruzi, remains a significant public health challenge in México, symbolizing systemic neglect in healthcare. Despite longstanding efforts to control its transmission, there are critical gaps in the alignment of public health policies with the lived experiences of affected individuals. This study examines these dissonances by analyzing qualitative interviews with 61 individuals diagnosed with T. cruzi and reviewing relevant Mexican public health regulations, including national standards and action programs. Findings reveal that most diagnoses occur incidentally, such as during blood donation or vector control campaigns, with minimal active case detection at the primary healthcare level. Affected individuals often encounter insufficient follow-up care, significant barriers to treatment, and misinformation that exacerbates psychological distress. Among the 14 participants who received etiological treatment, access was frequently due to individual persistence rather than systemic support, highlighting inequities in healthcare delivery. Additionally, structural barriers, including economic constraints and insufficient local healthcare infrastructure, further limit access to timely diagnosis and treatment, particularly in rural areas. Policy gaps include the absence of universal T. cruzi testing for pregnant individuals, lack of vertical transmission prevention strategies, and inadequate communication between healthcare providers and patients. Current public health initiatives disproportionately prioritize vector control and blood bank screening, neglecting the broader social and economic challenges faced by those already diagnosed. The study underscores the urgent need for a transdisciplinary approach to Chagas disease management in México, integrating biomedical, sociocultural, and policy perspectives. Recommendations include implementing universal prenatal screening for T. cruzi, enhancing health communication strategies, reframing Chagas as a manageable condition to reduce stigma, and improving follow-up care protocols. Addressing these challenges requires intersectoral collaboration and an inclusive approach that values the lived experiences of affected communities. By bridging the gap between policy and practice, this research contributes to the development of holistic strategies that not only control Chagas disease transmission but also improve the quality of life for those already impacted. These insights are essential for informing public health reforms in México and other endemic regions, advancing equity and effectiveness in neglected tropical disease management.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013052"},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008488","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}