PLoS Neglected Tropical Diseases最新文献

{"title":"Barriers to biomedical care: Qualitative insights into health-seeking behaviors and systemic challenges among people affected by leprosy in Tanzanian communities.","authors":"Sylivester Asimwe Muhigi, Kijakazi Mashoto, Mercy Chiduo","doi":"10.1371/journal.pntd.0014806","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014806","url":null,"abstract":"<p><strong>Background: </strong>Delayed diagnosis in leprosy reflects both how people interpret symptoms and seek care, and how effectively health systems recognize and manage the disease. Qualitative evidence from Tanzania remains limited on how the interaction between patients and health care workers affect provision of care to people affected by leprosy in a timely manner. The main aim of this study was to explore health-seeking behaviors and systemic challenges affecting access to biomedical care among people affected by leprosy in selected Tanzanian communities.</p><p><strong>Methods: </strong>Ethics Statement: Ethical approval for the study was obtained from the Medical Research Coordinating Committee (MRCC) through the National Health Research Ethics Committee (NatHREC) with reference number NIMR/HQ/R.8a/Vol.IX/4587. Written informed consent was obtained from all participants before data collection. Identifying information was removed from transcripts, data were anonymized before analysis, and audio files and transcripts were stored on password-protected computers accessible only to the data manager and the principal investigator. Data will be retained for up to 10 years per NIMR policy. An anonymized coding framework and de-identified extracts are available upon reasonable request. Given the sensitive nature of gender-based violence disclosures, referral procedures were established to ensure that participants requiring additional support could be linked to appropriate services This qualitative study was conducted in Tanga and Morogoro regions, Tanzania. Semi-structured interviews and focus group discussions were held with people affected by leprosy, community members, District Tuberculosis and Leprosy Coordinators, Community Health Workers, and Prevention of Disability officers. Data were audio-recorded, transcribed, translated into English, and analyzed thematically.</p><p><strong>Results: </strong>Our findings revealed various factors which contributed to delays in seeking for biomedical care among people affected with leprosy. First, early symptoms were often normalized or attributed to witchcraft and curses, prompting initial care from traditional healers. Second, stigma, fear of rejection, and advice from relatives and community members delayed disclosure and transition to biomedical care. Third, health-system barriers including misdiagnosis, limited provider familiarity with leprosy, referral delays, medicine shortages, and inadequate support for disability management delayed confirmation of diagnosis and initiation of appropriate treatment.</p><p><strong>Conclusion: </strong>Health-seeking behaviors among people affected by leprosy were shaped by stigma, social influence, and health-system barriers that delayed or limited access to biomedical care. Evidence-based interventions, including culturally sensitive education, stigma reduction, and strengthening of frontline biomedical services, can help overcome these barriers. Policy eff","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014806"},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197382","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":"From co-existence to collaboration: The need to move towards an inclusive (pluricultural) scabies management approach in Debre Elias (Ethiopia).","authors":"Dereje Wonde, Kibur Engdawork, Anne Roemer-Mahler, Getnet Tadele, Mei Trueba","doi":"10.1371/journal.pntd.0014773","DOIUrl":"10.1371/journal.pntd.0014773","url":null,"abstract":"<p><p>Several large scabies outbreaks have occurred in the Amhara region of Ethiopia since 2015, and biomedical interventions focused on mass drug administration are often deployed to contain the disease. However, there is a persistent scabies incidence in the Amhara region. To understand this, we sought to explore how people living in Debre Elias understand and seek to manage scabies in their everyday lives. We collected data via a rapid ethnographic approach which included observations and semi-structured interviews. Fieldwork was conducted from February to July 2022 and involved 57 interviews with individuals who had experienced scabies and those who hadn't but were at risk, as well as local health workers, traditional healers, and government officials. It also included participant and non-participant observation of persons with and without scabies in their homes and public spaces such as workplaces, social events, and treatment facilities. Critical analysis of scabies control and policy documents was also used to fully understand the local dynamics around scabies in Debre Elias. People living in Debre Elias commonly navigate both biomedical and traditional healing systems to manage various health problems, including scabies. However, this practice remains largely informal, as traditional healing is often marginalised in official scabies control strategies. Most individuals affected by scabies initially seek care from traditional healers, often turning to biomedical services only afterwards. Health-seeking and treatment decisions are shaped by the perceived causes of scabies, the cultural relevance and affordability of traditional medicine, and limited access to biomedical services. We conclude that traditional healing plays a central role in local scabies management. Recognising and engaging with existing medical pluralism may improve the acceptability, reach, and effectiveness of scabies programmes. Supporting pluralistic treatment pathways should therefore be considered an opportunity rather than a liability for scabies control.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014773"},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185508","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":"Detection of Plasmodium vivax and Plasmodium falciparum using colorimetric loop-mediated isothermal amplification from dried blood spots collected in active and passive malaria surveillance in the Peruvian Amazon.","authors":"Oscar Nolasco, Joaquín Gómez, Hugo Rodríguez-Ferrucci, Dionicia Gamboa, Christopher Delgado-Ratto","doi":"10.1371/journal.pntd.0014366","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014366","url":null,"abstract":"<p><strong>Background: </strong>As malaria transmission declines in regions approaching elimination, highly sensitive diagnostic tools are needed to detect low-density infections, particularly in active and passive surveillance settings. Loop-mediated isothermal amplification (LAMP) is a promising molecular alternative to conventional diagnostics. This study evaluated the performance of a colorimetric LAMP (cLAMP) assay for detecting Plasmodium vivax and Plasmodium falciparum from dried blood spots (DBS) in the Peruvian Amazon.</p><p><strong>Methodology/principal findings: </strong>The cLAMP assay was applied to DNA extracted from DBS collected through active case detection (ACD; n = 574) and passive case detection (PCD; n = 431). Two extraction methods were compared: mini spin column (MSC DNA) and a boil-and-spin (BS DNA) method. Diagnostic performance was evaluated against microscopy and real-time quantitative PCR (qPCR). In ACD samples, qPCR identified 125 malaria-positive cases (117 P. vivax, 8 P. falciparum). Microscopy showed a sensitivity of 57.6%, compared with 63.2% for cLAMP using BS DNA and 82.4% using MSC DNA. In PCD samples, qPCR detected 140 positives (129 P. vivax, 9 P. falciparum, and 2 mixed infections). Microscopy sensitivity was 72.9%, while cLAMP reached 77.1% with BS DNA and 82.1% with MSC DNA. Specificity remained high (> 99.0%) across methods.</p><p><strong>Conclusions/significance: </strong>cLAMP improved the detection of malaria infections from DBS compared with microscopy when combined with column-based DNA extraction in active surveillance activities. While the boil-and-spin method showed performance comparable to microscopy, column-based extraction substantially increased sensitivity, especially for low-density infections identified through active surveillance. These findings support cLAMP as a practical and sensitive complementary tool for malaria surveillance in low-transmission and elimination settings.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014366"},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185481","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":"Travel history and occupation among diagnosed Cutaneous Leishmaniasis cases in Guyana: A multi-site retrospective case series, 2017-2021.","authors":"Rajini Kurup, Tiffany Roberts, Jimmy Naipaul, Zeska Williams, Alexus Michael, Annastacia Sampson, Reza Niles-Robin, Rita Persaud, Abilash Nair, Tejroi Naipaul","doi":"10.1371/journal.pntd.0014800","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014800","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous Leishmaniasis (CL) in Guyana has not been systematically characterised in the peer-reviewed literature for several decades. This study aimed to describe the demographic, occupational, geographic, and clinical profile of diagnosed CL cases at Guyana's principal diagnostic sites, and to test, within this case series, whether field-based occupation is associated with reported interior travel and whether travel history is associated with time to presentation.</p><p><strong>Methodology/principal findings: </strong>Retrospective case series (chart review) of CL diagnoses recorded at three facilities in Georgetown and the interior (2017-2021). Of 223 available case records, a random subsample of 170 was abstracted. Occupation and interior travel were patient-declared; their association was tested directly, then via adjusted logistic regression. Most patients (61.8%) reported interior travel, and 45.3% held field-based occupations, chiefly mining and military. Interior travel was more common among field-based than non-field workers (84.4% vs 43.0%; OR = 7.18 [95% CI, 3.42-15.04]; p < .001), and this association persisted after adjustment for age and sex (OR = 7.08 [3.07-16.30]). Younger age was associated with interior travel (OR = 0.96 [0.94-0.98]; p = .001), whereas sex was not. The sample was predominantly male (81.8%; median age 33 years). Patients with interior travel presented earlier than those without (Mdn = 61 vs 243 days; p < .001).</p><p><strong>Conclusions/significance: </strong>Most diagnosed CL cases in this series occurred in people reporting interior travel, predominantly those in field-based occupations, and this travel history was associated with earlier presentation. All participants had CL and there was no comparison group, so these findings describe the case population and associations within it rather than risk factors for acquiring infection; they also rest on a single, retrospectively recorded travel variable. They nonetheless indicate where pre-deployment prevention, occupational screening, and traveller advisories could be focused, and they support a case-control study with validated exposure measurement.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014800"},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185451","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":"From molecular advances to limited clinical impact: The persistent gap in chromoblastomycosis.","authors":"Daniel Wagner C L Santos, Dallas J Smith, Vania Aparecida Vicente, Bruno Paulo Rodrigues Lustosa, Conceição de Maria Pedrozo E Silva de Azevedo","doi":"10.1371/journal.pntd.0014801","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014801","url":null,"abstract":"<p><strong>Background: </strong>Chromoblastomycosis (CBM) is a chronic implantation mycosis of considerable morbidity, first described more than a century ago, predominantly affecting rural populations in tropical and subtropical regions. Although historically associated with impoverished settings, an increasing number of cases have been reported in both endemic and non-endemic areas, including high-income countries, reflecting an underrecognized epidemiological landscape. Despite its burden, key metrics such as disability-adjusted life years (DALYs) remain undefined, as highlighted by recent global health initiatives. While advances in diagnosing and treating patients with CBM have been made, new technologies have not been incorporated into broader clinical and public health interventions.</p><p><strong>Methodology/principal findings: </strong>Herein, we synthesize recent advances in CBM, focusing on the expanding biodiversity of etiological agents driven by molecular taxonomy, the growing role of molecular diagnostics, and emerging therapeutic strategies. Novel genera and species have been identified, particularly among immunocompromised hosts, reshaping our understanding of host-pathogen interactions. Molecular tools, including PCR-based and genomic approaches, have improved species-level identification, although their availability remains largely restricted to reference centers. Therapeutically, extended-spectrum triazoles and terbinafine have shown the most consistent activity, while adjunctive immunomodulatory strategies, such as imiquimod, are emerging as promising alternatives. However, these advances sharply contrast with real-world clinical practice. In endemic settings, diagnosis continues to rely on low-cost conventional methods, which, given their sensitivity, should be more widely incorporated into public health screening and active case-finding strategies. Antifungal susceptibility testing lacks clear clinical correlation, and treatment decisions remain largely based on observational studies, in the absence of randomized controlled trials.</p><p><strong>Conclusions and significance: </strong>CBM exemplifies a neglected tropical disease in which substantial progress in basic science has not translated into improved patient outcomes. Strengthening public health strategies, expanding access to simple and effective diagnostic tools, and prioritizing implementation-focused research are urgently needed to bridge this persistent gap.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014801"},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185453","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":"Delay in initiation of rabies post-exposure vaccination and influencing factors in Gondar zones of Ethiopia.","authors":"Bezawit Kassaw Hailu, Yitayew Demessie, Asnakew Mulaw Berihun, Abebe Belete Bitew, Sefinew Alemu Mekonnen","doi":"10.1371/journal.pntd.0014729","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014729","url":null,"abstract":"<p><p>Rabies is a viral zoonotic disease of warm-blooded animals, which is preventable through proper administration of post-exposure prophylaxis (PEP). In controlling rabies, delays in initiating post exposure vaccination (PEV) are a challenge in endemic regions. A study was conducted to assess the delay in initiation of PEV and identify associated factors in Ethiopia. Data was collected by face-to-face interviews from 260 dog bite victims or their guardians between January and June, 2025 using a questionnaire. Post exposure vaccination was considered delayed if it was initiated after 48 hours of the exposure incident. The prevalence of delayed initiation of PEV was calculated as a percentage from the number of individuals who initiated PEV after 48 hours and the total number of individuals exposed to rabies. Factors associated with delay were identified using logistic regression models. The prevalence of delayed in initiation of rabies PEV was 86.1% (224/260); 13.9% (36/260) of participants commenced vaccination within 48 hours of exposure. Severity of bite and ownership of biting animal were factors associated with the outcome. Deep bite (OR = 0.22, 95% CI: 0.07 - 0.66, P = 0.008) and bitten by stray dogs (OR = 0.51, 95% CI = 0.27 - 0.95, P = 0.033) reduced delay in initiation of PEV. Majority of respondents (88.5%) are aware of the existence, the signs (71.5%), the way of transmission (75.4%), and the fatal nature (96.5%) of rabies, and the need for PEV (95.4%). Another majority believe that the cost of the vaccine is fair and PEV is effective (95%), and and costs of the vaccination (76.2%) was not a reason for delay. In conclusion, the study outlined that respondents know many aspects of rabies control and had fewer barriers to uptake the PEV; however, the delay in initiating PEV was high. This underscores that respondents may not be aware of the risk of delay. Therefore, interventions focusing on the risk of delayed PEV initiation are needed.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014729"},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185487","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":"Country-scale diversity, spatial genetic structure, and mitochondrial demographic history of Aedes aegypti populations in Colombia.","authors":"Andrés Gómez-Palacio, Johana Marín-Suarez, Laura Beltran-Rodriguez, Marcela Gomez, Weimar Briñez-Zabaleta, Abelgie Sanchez, Luz Helena Patiño, Sandra Uribe-Soto, Juan David Ramirez","doi":"10.1371/journal.pntd.0014808","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014808","url":null,"abstract":"<p><p>Aedes aegypti is the primary urban vector of major human arboviruses worldwide, yet the spatial genetic structure and demographic history of Colombian populations remain incompletely understood. Here, we analyzed mitochondrial cytochrome c oxidase subunit I (COX1) sequences from Colombian populations sampled across a broad geographic and temporal range to evaluate genetic diversity, haplotype distribution, spatial-temporal structure, and mitochondrial demographic history. The dataset combined publicly available COX1 records with 394 newly generated sequences from Colombian specimens, yielding 717 entries from the Caribbean, Andean, Orinoco, and Amazonian regions of Colombia, and was analyzed using population genetic, ordination, constrained spatial, and demographic inference approaches. Colombian COX1 diversity was mainly structured into two broad mitochondrial genetic clusters rather than by sampling locality, department, or collection year, suggesting the persistence of maternal lineages together with spatial mixing likely influenced by human-mediated dispersal and urban adaptation. Human population density and built-up intensity partially explained mitochondrial genetic structure, but this association varied through time, indicating that urbanization interacts with regional demographic heterogeneity and local habitat configuration. Demographic history analyses suggested temporal variation in mitochondrial effective population size, including an older increase followed by reduction and relative stabilization toward recent generations, rather than continuous demographic expansion. Climate-associated analyses further suggested that temperature, particularly minimum temperature, may contribute to mitochondrial demographic variation, although this relationship should be interpreted as correlative. Overall, Colombian Ae. aegypti populations appear to be shaped by historical maternal-lineage structure, urbanization-associated spatial heterogeneity, eco-regional demographic variation, and climatic context. This country-scale mitochondrial baseline can help prioritize regions for genomic, entomological, and epidemiological surveillance and guide future investigations of mosquito dispersal and population connectivity relevant to vector management in Colombia.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014808"},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185443","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":"Socio-environmental assessment of Aedes aegypti distribution and risk of chikungunya in vulnerable community.","authors":"Jaqueline S Cruz, Hernan D Argibay, Nivison Nery, Hammed Mogaji, Thiago da M Barreto, Lorena Ellen S Batista, Lara R S Silva, Victor Kaua Nery, Victoria C Dedavid Ferreira, Ianei de O Carneiro, Yeimi A Alzate López, Mitermayer G Reis, Albert I Ko, Petter Diggle, Michael Begon, Federico Costa, Hussein Khalil","doi":"10.1371/journal.pntd.0014776","DOIUrl":"https://doi.org/10.1371/journal.pntd.0014776","url":null,"abstract":"<p><p>Chikungunya virus (CHIKV), transmitted by Aedes mosquitoes, poses a major public health challenge in tropical regions. In Brazil, its incidence has increased, especially in socioeconomically vulnerable areas, where environmental conditions favor the proliferation of vectors. Our objective was to assess the socioeconomic and environmental vulnerabilities associated with the spatial distribution of a) Ae. aegypti and b) resident exposure to CHIKV in a low-income community. Identifying key exposure hotspots, our work improves our understanding of CHIKV transmission in informal settlements and facilitates community-based interventions to mitigate CHIKV risk. We monitored Ae. aegypti using ovitraps and conducted a serological survey from October 2021 to June 2022 in a vulnerable informal community in Salvador, Brazil. Blood samples and sociodemographic, household, and environmental data were collected from residents aged ≥5 years. CHIKV serology was performed, and spatial models using Integrated Nested Laplace Approximation assessed vector distribution, seropositivity, and associated factors. Among 194 ovitraps, posterior estimates indicated higher egg counts in peridomicile locations (IRR = 1  .99; CrI:1.3 1-3.0 6); households experiencing food insecurity (IRR = 1.77; CrI: 1.05 - 2.99), properties with unpaved yards (IRR = 3.76; CrI:2.31 -6.18), and areas with greater garbage density (IRR = 1.25; CrI:1.01 -1.56). Among 888 participants, Bayesian spatial modeling identified factors associated with CHIKV seropositivity: elderly (OR= 2.24; CrI:1.16-4.35), uncovered brick walls (OR=2.29; CrI:1.16-4.55), the presence of yards, either paved (OR=2.06; CrI:1.30-3.00) or unpaved (OR=2.71; CrI:1.73-4.25), and self-reported mosquito sightings (OR=1.94; CrI:1.19-3.18). In addition, remotely sensed Land Surface Temperature (OR=1.33; CrI:0.98-1.83) and the spatial ovitraps egg counts (OR=1.14; CrI:0.87-1.52) were relevant variables. Our high-resolution study identified fine-scale vulnerabilities linked to both Ae. aegypti abundance and heightened risk of CHIKV transmission. Based on our findings, effective control strategies should not only focus on traditional methods such as enhancing basic urban infrastructure and services and promoting community awareness, but also target specific breeding sites around homes, address garbage accumulation, and consider the influence of micro-scale temperature variations. These results emphasize the importance of tailored, neighborhood-specific interventions to effectively reduce chikungunya transmission in high-risk communities.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014776"},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170366","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":"Brought with the wind: A case of melioidosis acquired in the United States presenting with multiple pulmonary nodules.","authors":"Rodrigo Garcia-Santisteban, Maria Kaufman, Hac-Tu Jacqueline Chung, Raphael Khella, Angel Pousa, Winy Kujundzic, Ines Mbaga, Vlad Voin","doi":"10.1371/journal.pntd.0014790","DOIUrl":"10.1371/journal.pntd.0014790","url":null,"abstract":"<p><p>Burkholderia pseudomallei, the causative agent of melioidosis, is a gram-negative bacterium historically endemic to Southeast Asia and Northern Australia. However, recent environmental detection along the Gulf Coast and an increasing number of reported cases in non-travelers have raised questions regarding potential endemicity and environmental establishment in the Southern United States. We report a case of putatively locally acquired pulmonary melioidosis in a Florida resident with no recent international travel history, illustrating the diagnostic and therapeutic challenges posed by this rare pathogen. The patient presented with fever, pleuritic chest pain, and hypoxia following a period of severe weather. Computed tomography (CT) of the chest revealed multiple solid pulmonary nodules with ground-glass opacities and mediastinal lymphadenopathy. Given his underlying stage 3b chronic kidney disease (CKD), the patient was treated with an intensive course of intravenous ceftazidime followed by oral doxycycline monotherapy, achieving full clinical recovery. Follow-up imaging at 3 months demonstrated complete resolution of the pulmonary nodules. This case emphasizes the importance of considering melioidosis in the differential diagnosis for non-resolving community-acquired pneumonia or significant pulmonary nodules in the Southern United States, even in the absence of international travel. Risk factors such as diabetes mellitus and severe weather events are key clinical clues. While trimethoprim-sulfamethoxazole remains the preferred eradication therapy, doxycycline may serve as a potential alternative for patients with renal impairment when first-line therapy is contraindicated.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014790"},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170455","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":"Retraction: Country-level indices in predictive models of helminth infections: Perspectives from Southeast Asia.","authors":"","doi":"10.1371/journal.pntd.0014779","DOIUrl":"10.1371/journal.pntd.0014779","url":null,"abstract":"","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"20 10","pages":"e0014779"},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170866","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}