PLoS Neglected Tropical Diseases最新文献

{"title":"Impact of temperature and imported cases on the spread and control of dengue fever: Case study of 2019 dengue fever epidemic in Guangzhou and Jinghong cities, China.","authors":"Yue Zhang, Xianghong Zhang, Kaifa Wang","doi":"10.1371/journal.pntd.0013472","DOIUrl":"10.1371/journal.pntd.0013472","url":null,"abstract":"<p><p>Dengue fever is an acute mosquito-borne disease transmitted by Aedes mosquitoes. In this paper, dengue fever outbreaks in Guangzhou, Guangdong Province and Jinghong, Yunnan Province from July 15 to November 20, 2019 were studied to explore the effects of temperature differences and imported cases on epidemic development patterns. In response to the practical issue of missing mosquito vector data, the feasibility of using meteorological data-driven dynamic model to obtain mosquito vector data was initially validated. Cross-correlation analysis was then used to assess the strong correlation between mosquito vector data and dengue cases. The relationship between bite rate, transmission rate, incubation period, mortality rate and effective reproduction number with respect to daily mean temperature (DMT) and daily temperature difference (DTR) was established by maximum likelihood estimation. The results of sensitivity analysis showed that the most sensitive parameters to basic reproduction number were mosquito mortality and transmission rate of dengue virus between mosquito vectors and humans. The results of comparative analysis showed that the temperature difference between Guangzhou and Jinghong was the main factor contributing to the difference of dengue epidemics in the two cities, because temperature could affect the development of dengue epidemics by affecting the living habits of mosquito vectors. In addition, imported cases and the intensity of epidemic prevention measures are also important factors leading to the difference in dengue epidemics between the two places. Therefore, the key to the prevention and control of dengue fever is to implement mosquito elimination as soon as possible according to the change of temperature, raise public awareness of mosquito prevention and epidemic prevention, and strengthen the control of imported cases.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013472"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126356","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":"Topical AuNPs-Cys-Sm29 gel modulates the course of lesion development in experimental cutaneous leishmaniasis.","authors":"Sayonara de M Viana, Luciana Cardoso, Pedro B Borba, Lucas P Carvalho, Juvana Moreira, Fabio Mambelli, Sergio C Oliveira, Edgar M Carvalho, Camila I de Oliveira","doi":"10.1371/journal.pntd.0013510","DOIUrl":"10.1371/journal.pntd.0013510","url":null,"abstract":"<p><p>The Sm29 antigen from Schistosoma mansoni has been shown to downregulate excessive inflammation associated with immune-mediated diseases. In contrast, cutaneous leishmaniasis (CL) caused by Leishmania (Viannia) braziliensis is marked by an inflammatory response that, when uncontrolled, contributes to disease pathology. In this study, we evaluated the therapeutic potential of topical rSm29 in combination with meglumine antimoniate (Sbv) in experimental murine CL. First, rSm29 was functionalized onto spherical gold nanoparticles using a cysteamine linker (AuNPs-Cys-Sm29). Topical application of this formulation of rSm29 significantly decreased ear lesion thickness, and the combination of topical AuNPs-Cys-Sm29 plus intraperitoneal Sbv also significantly reduced ear lesion thickness, parasite load in the infection site, and the local inflammatory infiltrate when compared to mice treated with Sbv only. The production of IFN-γ, TNF, and IL-10 was reduced in the draining lymph node, as well as the total number of CD3+CD4+IFN+ and CD3+CD4+TNF+ T cells in the infection site. This study demonstrated that combination therapy with topical AuNPs-Cys-Sm29 + systemic Sbv reduced inflammation without compromising parasite clearance. These findings highlight the potential of AuNPs-Cys-Sm29 as a host-directed strategy in treating cutaneous leishmaniasis (CL).</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013510"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126345","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":"Interleukin-10 limits immune-mediated pathology in chronic subclinical plasmodial infection.","authors":"Leandro de Souza Silva, Brian G Monks, Catherine S Forconi, Juliet N Crabtree, Nelsy De Paula Tamburro, Evelyn A Kurt-Jones, Ricardo T Gazzinelli, Katherine A Fitzgerald, Douglas T Golenbock","doi":"10.1371/journal.pntd.0013554","DOIUrl":"10.1371/journal.pntd.0013554","url":null,"abstract":"<p><p>Subclinical parasitemia constitutes the predominant proportion of Plasmodium spp. infections in hyperendemic regions of the world. Elevated levels of serum interleukin-10 (IL-10) are observed in both acute symptomatic and chronic subclinical Plasmodium spp. infections. The role of IL-10 in acute infection has been extensively studied; however, the role of sustained elevated levels of IL-10 in chronic subclinical plasmodial infections remains to be determined. We investigated the role of IL-10 in a long-term subclinical and patent Plasmodium chabaudi chabaudi-AS (Pc) infection using mice lacking humoral immunity (µMT-/- mice). Pc-infected µMT-/- mice exhibit a long-term (99 days) chronic infection, with microscopic levels of parasitemia and without any outward signs of disease. We found that chronically infected mice have slightly elevated levels of tumor necrosis factor α (TNFα) and interferon-γ (IFNγ), and high levels of IL-10 in the circulation. The source of IL-10 was CD4+ T cells. We found that elevated IL-10 levels were mechanistically linked to subclinical Plasmodium infection by blocking IL-10 signaling. Anti-IL-10R resulted in a marked, albeit transient, reduction of the parasitemia that was accompanied by a robust pro-inflammatory response and death of chronically infected µMT-/- mice. A similar outcome was observed in infected µMT-/- mice after CD4+ T cell depletion with anti-CD4 antibody. CD4-depleted infected µMT-/- mice exhibited reduced IL-10 and rapid weight loss, succumbing to infection by day 6 after CD4 neutralization. Our results showed that IL-10 from CD4+ T cells limits immune-mediated pathology in chronic subclinical Pc infection in µMT-/- mice by protecting against excessive inflammatory responses to blood-stage parasites.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013554"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092706","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":"Guaroa virus, a forgotten Latin American orthobunyavirus: A narrative review.","authors":"Carlos Ramiro Silva-Ramos, Patricia V Aguilar","doi":"10.1371/journal.pntd.0013523","DOIUrl":"10.1371/journal.pntd.0013523","url":null,"abstract":"<p><p>Guaroa virus (GROV) is a neglected arthropod-borne orthobunyavirus, primarily endemic to parts of Central and South America. Its epidemiological and clinical impact remains unclear due to limited research and underreporting. It has been sporadically associated with mild febrile illness in humans. GROV is thought to be transmitted by Anopheles spp. mosquitoes, but its natural reservoir hosts remain unknown. Clinically, GROV infection is characterized by fever, headache, malaise, chills, and myalgia. Co-infections with other pathogens related to febrile illnesses can occur in endemic areas. Diagnosis relies on viral isolation and reverse transcription polymerase chain reaction (RT-PCR) during the acute phase and serological testing in later stages. Although not directly oncogenic, GROV has been shown in experimental murine models to enhance the tumorigenic potential of certain oncogenic viruses; however, the underlying mechanisms remain unclear, and no evidence of this effect exists in humans. Risk factors include male gender, outdoor occupations, and living near mosquito habitats. Preventive measures focus on reducing vector contact. Future research is urgently needed to clarify GROV's ecology and importance, including the identification of natural reservoirs, the role of Anopheles mosquitoes as competent vectors, and its true public health burden, particularly in rural and low-resource areas where diagnostic capacity is limited and multiple febrile illnesses co-circulate.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013523"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092661","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 potential transmission foci of lymphatic filariasis using molecular xenomonitoring in Huahine, French Polynesia.","authors":"Reva Lannuzel, Tanagra Lambert, Farah Deen, Hmeniko Tourancheau, Jérôme Marie, Michel A Cheong Sang, Manfred Mervin, Benoit Stoll, Hervé C Bossin, Françoise Mathieu-Daudé","doi":"10.1371/journal.pntd.0013492","DOIUrl":"10.1371/journal.pntd.0013492","url":null,"abstract":"<p><strong>Background: </strong>In French Polynesia, substantial progress has been achieved in eliminating lymphatic filariasis (LF) caused by Wuchereria bancrofti var. pacifica, a parasite transmitted by the mosquito vector Aedes polynesiensis. However, despite multiple rounds of Mass Drug Administration (MDA), LF transmission persists on some islands, underscoring the need for robust surveillance to evaluate transmission risks and identify potential transmission foci.</p><p><strong>Methodology/principal findings: </strong>An extensive entomological survey combined with a Molecular Xenomonitoring (MX) study was conducted on Huahine Island in the Leeward Islands (Society Islands), where new LF cases continue to be reported. Adult mosquitoes were collected from 420 sampling points across 28 Primary Sampling Units (PSUs) to map mosquito species distribution and estimate infection prevalence in mosquitoes. Among the 5508 female mosquitoes collected, Ae. polynesiensis was the predominant species (74%), widely distributed across the island and particularly abundant in some PSUs. Other species included Aedes aegypti (20%) and Culex quinquefasciatus (4%). Mosquito pools from species of the genera Aedes and Culex were tested for the presence of W. bancrofti using real-time PCR. Positive pools were detected in 13 PSUs, involving both vector and non-vector Aedes species, Ae. polynesiensis (63.6%) and Ae. aegypti (36.4%). Estimated infection prevalence in mosquitoes was higher in Ae. aegypti (1.1%) than in Ae. polynesiensis (0.53%), likely reflecting the differences in species abundance and host preferences. Several potential transmission foci were identified, primarily concentrated in the northern part of the island.</p><p><strong>Conclusions/significance: </strong>Our study demonstrates the effectiveness of MX using female Aedes mosquitoes in identifying potential transmission foci and detecting the presence of LF cases in the vicinity on the island of Huahine. This approach constitutes a valuable tool for post-MDA surveillance in Pacific Islands, where Aedes mosquitoes are key vectors for W. bancrofti, and will effectively inform the targeted implementation of control interventions, including innovative vector control strategies.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013492"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092622","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":"MoLEP-Co-creating a Mycobacterium leprae transmission interruption program for the Morogoro region, Tanzania.","authors":"Tanja Barth-Jaeggi, Guy de Coulon, Issa Garimo, John Msaki, Liberate Mleoh, Riziki Kisonga, Sunil Modali, Shaishav Panchal, Shigela Marco Njebele, Shamez Sunderji, Kihulya Mageda, Peter Steinmann","doi":"10.1371/journal.pntd.0013507","DOIUrl":"10.1371/journal.pntd.0013507","url":null,"abstract":"<p><p>The global goal for leprosy elimination is the interruption of Mycobacterium leprae transmission, resulting in zero new leprosy patients. In alignment with this objective, Tanzania's updated national leprosy strategy emphasizes early detection, systematic contact tracing, post-exposure prophylaxis (PEP) with single-dose rifampicin (SDR), and integration of services into primary health care. However, the feasibility of accelerating M. leprae transmission interruption in high-burden areas with this strategy has yet to be demonstrated. In 2024, the Morogoro Leprosy Elimination Program (MoLEP) was launched in the country's most endemic region. Developed through a collaborative process, MoLEP aligns global practices with local conditions and needs. Key interventions include training frontline health workers and expanding contact tracing with SDR-PEP. Furthermore, targeted activities will respond to high transmission areas and the detection of child cases, which serve as indicators of recent transmission. Strengthening the drug supply chain is also a priority. MoLEP will generate critical data on the feasibility and effectiveness of these interventions in accelerating progress toward elimination. The implementation is guided by a comprehensive monitoring and evaluation framework, alongside clearly defined governance structures, to facilitate evidence-informed decision-making. Findings are expected to guide strategic scaling and replication in other high-burden regions across Tanzania and beyond.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013507"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092629","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 the need to implement mass drug administration against Wuchereria bancrofti infection using both human serology and xenomonitoring in the urban conurbation of Monrovia, Liberia.","authors":"Benjamin G Koudou, Rogers Nditanchou, Firmain N Yokoly, Abakar Gankpala, Karsor K Kollie, David Molyneux, Philip Downs, Ruth Dixon","doi":"10.1371/journal.pntd.0013446","DOIUrl":"10.1371/journal.pntd.0013446","url":null,"abstract":"<p><strong>Background: </strong>Lymphatic filariasis (LF) is a parasitic disease-causing severe pain, disfiguring, and disabling clinical conditions such as lymphoedema and hydrocoele that are associated with morbidity and stigma. The disease has been targeted for global elimination with the annual mass drug administration (MDA) strategy. We have evaluated the need to implement mass drug administration against W. bancrofti infection in urban zones of Monrovia using both serology and molecular Xenomonitoring (XM).</p><p><strong>Methodology: </strong>Confirmatory mapping protocols recommended by WHO were carried out in the four health districts of Monrovia. Schools were selected using probability proportionate to size (PPS) and eligible children aged 9-14 years were tested for circulating filarial antigen (CFA) using an Alere Filariasis Test Strip (FTS). Health Districts were assessed as requiring MDA if they exceeded the critical cut off of 3 positive tests corresponding to CFA ≥ 2%. Two health districts were selected for entomological investigations based on pre-disposing risk factors for mosquitoes. Mosquito collection was carried out using exit traps (ETs) and gravid trap (GTs) for 6 months. Mosquitos were tested for W. bancrofti DNA using qPCR.</p><p><strong>Principal findings: </strong>Ninety-six children in the sample had a positive serology test result, with a mean CFA prevalence of 5.3% (95% CI: 4.4 - 6.5%). All four health districts exceeded the critical cut off of 3 cases and in Somalia Drive there were 59 positive tests. In Central Monrovia which had 4 cases, 2 of them are likely locally imported from Somalia Drive where the children reported living. A total of 19,355 potential vector mosquitoes were collected, of which 84.4% (16,335) were Culex and 16.6% (3,020) An. gambiae. All mosquitoes were analyzed, and none were found to be infected with W. bancrofti.</p><p><strong>Conclusion: </strong>MDA is required in three health districts of Monrovia. Confirmatory mapping protocols require adaptation for urban settings. The sampling strategy for the XM was unable to identify transmission in this case and requires further research to optimise it for informing MDA implementation decisions.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013446"},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087883","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":"Scrub typhus in Nan province (Thailand): Seventeen years of data to understand the impact of land cover change.","authors":"Nolwenn Blache, Karine Chalvet-Monfray, Rawadee Kumlert, Soawapak Hinjoy, Serge Morand","doi":"10.1371/journal.pntd.0013552","DOIUrl":"10.1371/journal.pntd.0013552","url":null,"abstract":"<p><strong>Background: </strong>Scrub typhus, caused by Orientia tsutsugamushi and transmitted by chigger mites (Leptotrombidium), is a major health problem in northern Thailand, particularly in Nan province. Land cover change, by altering the ecosystem, could affect the ecology of the vector and consequently the risk of scrub typhus transmission.</p><p><strong>Methodology/principal findings: </strong>This study investigated the impact of land cover changes on scrub typhus transmission in 2.5 km buffer zones around each village of Nan Province between 2003 and 2019. Using the open land cover data of the European Spatial Agency Climate Change Initiative (ESA CCI), we quantified land cover composition and land cover changes and integrated public health data on scrub typhus cases, as well as information on elevation, population, and slope. Generalized Additive Models were applied to assess the effects of land cover changes on annual scrub typhus cases. Scrub typhus cases increased significantly during the study period, peaking in 2012 and 2016, mainly in mountainous areas rather than in the Nan River valley. Land cover associated with cases included shrubland, mosaic land, broadleaf forest, and needleleaf forest. Cases increased with shrubland and mosaic land, displayed an inverted U-shaped relationship with broadleaf forest, and decreased with needleleaf forest. Key land cover change factors included shrubland transitions, population, and geographic interactions. Reforestation (from shrubland to broadleaf forest) showed an inverted U-shaped relationship with cases, whereas stable broadleaf forest and loss of shrubland to grassland became non-significant. Male population increased cases.</p><p><strong>Conclusions/significance: </strong>This study highlights the importance of land cover changes in understanding disease transmission and suggests that landscapes disturbance may create optimal conditions for O. tsutsugamushi transmission. This is a novel regional-scale exploration of land cover impacts on scrub typhus in Thailand.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013552"},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087735","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":"Climate change, urbanisation and transmission potential: Aedes aegypti mosquito projections forecast future arboviral disease hotspots in Brazil.","authors":"Katherine Heath, Lincoln Muniz Alves, Michael B Bonsall","doi":"10.1371/journal.pntd.0013415","DOIUrl":"10.1371/journal.pntd.0013415","url":null,"abstract":"<p><strong>Background: </strong>Climate change and urban expansion pose significant challenges to controlling Aedes aegypti mosquito populations, a primary vector of arboviruses such as dengue, Zika, and chikungunya. This study aims assess how climate and anthropogenic factors will jointly shape Ae. aegypti densities in Brazil, which is crucial to forecasting transmission risks and informing public health strategies.</p><p><strong>Methods: </strong>This study combined a biologically informed, stage-structured delay-differential equation model with climate and anthropogenic data. Climate projections from the Coupled Model Intercomparison Project Phase 6 under different Shared Socioeconomic Pathways (SSPs) were used to forecast future climate scenarios from 2024 to 2080. Boosted Regression Trees integrated anthropogenic factors like urbanisation, population growth, and urban accessibility. Model outputs were validated with entomological surveillance data, and the basic reproductive number for dengue fever was used to assess changes in disease transmission potential.</p><p><strong>Findings: </strong>Our findings predicted that Ae. aegypti mosquito density will increase nationally, but unevenly, exceeding thermal limits in North Brazil while rising substantially in the South and Southeast. Increases in density were particularly pronounced under high greenhouse gas emission scenario SSP5-8.5 (up to 92% in the Southeast). These trends were projected to elevate the transmission potential for dengue fever, with Southeast Brazil facing the biggest increases due to mosquito population growth outpacing human population expansion. Validation against historical data confirmed model robustness.</p><p><strong>Interpretation: </strong>By directly linking mosquito abundance to SSP-specific emissions trajectories, our results show that climate mitigation can markedly reduce disease risk. Shifting from SSP5-8.5 to SSP1-2.6 could cut projected mosquito density increases from 31% to 11% nationally by 2080. The model's spatial granularity and integration of local administrative boundaries support its utility for national and sub-national health planning. Addressing compounded risks in vulnerable peri-urban and rural populations will require coordinated interventions that span climate policy, vector control, and health equity.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013415"},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087697","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":"Differentiating proven progressive disseminated histoplasmosis from other diagnoses in hospitalized persons with HIV and suspected progressive disseminated histoplasmosis: Findings from a clinical and demographic study in Mexico.","authors":"Maria Dolores Niembro-Ortega, Areli Martinez-Gamboa, Antonio Olivas-Martinez, Brenda Crabtree-Ramirez, Janeth Santiago-Cruz, Andrea Rangel-Cordero, Pedro Torres-Gonzalez, Armando Gamboa-Dominguez, Victor Hugo Lozano-Fernandez, Victor Hugo Ahumada-Topete, Pedro Martinez-Ayala, Marisol Manriquez-Reyes, Juan Pablo Ramirez-Hinojosa, Patricia Rodriguez-Zulueta, Jesus Ruiz-Quiñones, Christian Hernandez-Leon, Norma Erendira Rivera-Martinez, Alberto Chaparro-Sanchez, Jaime Andrade-Villanueva, Luz Alicia Gonzalez-Hernandez, Sofia Cruz-Martinez, Oscar Flores-Barrientos, Jesus Enrique Gaytan-Martinez, Axel Cervantes Sanchez, Nancy Guadalupe Velazquez-Zavala, Maria Del Rocio Reyes-Montes, Esperanza Duarte Escalante, Maria Guadalupe Frias De Leon, Jose Antonio Ramirez, Maria Lucia Taylor, Jose Sifuentes-Osornio, Alfredo Ponce de Leon","doi":"10.1371/journal.pntd.0013527","DOIUrl":"10.1371/journal.pntd.0013527","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Progressive disseminated histoplasmosis (PDH) is a leading cause of morbidity and mortality among persons with HIV (PWH) in the Americas. Clinical presentation often overlaps with other opportunistic infections -especially tuberculosis (TB)- and sensitive diagnostics are frequently unavailable. In Mexico, epidemiological data on histoplasmosis in PWH are scarce. This study aims to describe the clinical and demographic characteristics along with final diagnosis of hospitalized PWH who had clinical suspicion of progressive disseminated histoplasmosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology/principal findings: &lt;/strong&gt;We conducted a multicenter, prospective, cross-sectional study involving 415 hospitalized PWH and clinical suspicion of PDH across ten tertiary care hospitals in Mexico. Participants underwent comprehensive evaluation for Histoplasmosis infection, including cultures, histopathology, and urine antigen testing. Of the total cohort, 108 patients (26%) had proven PDH, 162 (39%) received an alternative diagnosis, and 145 (35%) had no definitive diagnosis. In univariate analyses, proven PDH was more frequently associated with skin lesions, thrombocytopenia, elevated AST and LDH levels (&gt;2x ULN), and micronodular infiltrates on chest imaging. In contrast, lymphadenopathy, tree-in-bud patterns, pleural effusion, hepatomegaly, and splenomegaly in imaging were more commonly observed in patients without proven PDH. Among patients without proven PDH, 41 met the criteria for probable PDH. Compared with proven PDH, probable cases exhibited higher rates of lymphadenopathy (73% vs 50%). Conversely, elevated AST (61% vs 39%) and LDH (74% vs 35%) levels were more frequent in proven PDH cases. While radiographic lung involvement was common in both groups, mediastinal lymphadenopathy (29% vs 12%), pleural effusion (17% vs 3.7%), and hepatomegaly (56% vs 37%) were significantly more frequent in probable PDH cases. Clinical response to antifungal therapy was higher in proven PDH (38% vs 24%), although this difference was not statistically significant. Compared to patients with tuberculosis (TB) alone, those with proven PDH alone showed more profound immunosuppression, with a greater proportion presenting CD4 + counts &lt;50 cells/mm3. Skin lesions, LDH elevation, and micronodular pulmonary infiltrates were also more frequent in the proven PDH group, underscoring their diagnostic relevance. In contrast, lymphadenopathy, tree-in-bud opacities, hepatomegaly, and splenomegaly were more common in TB. Importantly, TB coinfection was present in 13 patients with proven PDH (12%) and in 12 with probable PDH (29%). In an exploratory analysis of predictors for proven PDH, elevated LDH level was the strongest predictor (adjusted prevalence odds ratio [aPOR] of 6.82, 95% CI 3.56 - 13.4, p &lt; 0.001), followed by the presence of micronodular infiltrates on chest imaging (aPOR 1.94, 95% CI 1.06 - 3.62, p = 0.33). In contrast, pleural effusion on imaging was","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 9","pages":"e0013527"},"PeriodicalIF":3.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082328","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}