PLoS Neglected Tropical Diseases最新文献

{"title":"Unravelling genetic differentiation between Glossina brevipalpis populations from two distant National Parks in Mozambique.","authors":"Denise R A Brito, Adeline Ségard, Fernando C Mulandane, Nióbio V Cossa, Hermógenes N Mucache, Sophie Ravel, Thierry De Meeûs, Luis Neves","doi":"10.1371/journal.pntd.0012953","DOIUrl":"10.1371/journal.pntd.0012953","url":null,"abstract":"<p><p>African trypanosomosis (AT), caused by protozoan parasites of the genus Trypanosoma, has plagued the African continent for centuries, affecting both humans and animals. Its principal vector, tsetse flies, can be found across sub-Saharan Africa. Vector control represents an efficient way to reduce the burden of AT. In Mozambique, control campaigns reshaped tsetse fly distribution to what it is today, with four species presently found: Glossina brevipalpis, G. pallidipes, G. morsitans and, G. austeni. Additionally, G. brevipalpis can be observed in two National parks, Gorongosa National Park in the Centre and Maputo National Park in the South, with an 840 km wide tsetse-free zone between them. In order to improve our knowledge on the genetic diversity in these populations, and their probable isolation, we undertook a population genetics study with 11 microsatellite loci. We found that these two zones behave as strongly isolated subpopulations, only exchanging a few individuals per year. To explain this finding, we suggest the existence of undocumented pocket populations between the two parks, or, in the absence of these, the accidental translocation of tsetse flies during human-driven animal transportation. We suggest that translocation through human-driven animal movement should be explored in future studies investigating Glossina populations. If eradication were to be attempted, re-invasion of the tsetse via motorized human transport should be considered in conjunction with the exploration of other sites within a 30 km radius to validate that no sources of re-invasion exist around these parks.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012953"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12157922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188352","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":"Evaluating the effectiveness and sustainability of a primary healthcare strategy to reduce the prevalence of strongyloidiasis in endemically infected Indigenous communities in Northern Australia.","authors":"Wendy A Page, David Blair, Karen Dempsey, Beverley-Ann Biggs, Jenni A Judd","doi":"10.1371/journal.pntd.0013136","DOIUrl":"10.1371/journal.pntd.0013136","url":null,"abstract":"<p><strong>Background: </strong>Strongyloidiasis is endemic in many remote Indigenous communities in Australia. Early diagnosis, treatment, and follow-up of chronic strongyloidiasis can prevent life-threatening clinical complications and decrease transmission in these endemic communities. The aim of this paper is to evaluate the effectiveness and sustainability of a primary healthcare strategy designed to measure and reduce the prevalence of strongyloidiasis in four remote communities in northeast Arnhem Land.</p><p><strong>Methodology: </strong>The primary healthcare strategy was a prospective, longitudinal, health-systems intervention designed to integrate serological testing for chronic strongyloidiasis into the Indigenous preventive adult health assessment utilising the electronic health-record systems in four Aboriginal health services. Positive cases were recalled for treatment, and opportunistic follow-up serology after six months. Results were tracked using Strongyloides reports generated by the electronic health-record system. This paper describes the changes in prevalence, effectiveness of treatment, and reinfection during the implementation phase, 2012-2016. An improved Strongyloides electronic report was developed to evaluate the effectiveness and sustainability of the intervention to the end of 2020.</p><p><strong>Principal findings: </strong>During the entire period 2012-2020, 84% (2390/2843) of the resident adults in the four communities were tested for strongyloidiasis at least once. Prevalence was reduced from 44% (1056/2390) ever-positive to 10% (232/2390) positive on their last test. Of positive, treated cases with a follow-up serology test, the last test was negative in 85% (824/967) of individuals. Point prevalence continued to decrease in each community four years after the end of the implementation phase.</p><p><strong>Conclusions: </strong>The results provided practice-based evidence of a significant decrease in the prevalence of strongyloidiasis attributable to the strategy which could be replicated in other health services utilising electronic health-record systems. The final evaluation demonstrated the sustainability and ongoing benefits for endemically infected communities, and the key role that health services can play in strongyloidiasis prevention and control programs.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013136"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188331","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":"School-aged Schistosoma mansoni infection levels after long-term programmatic control show failure to meet control programme targets and evidence of a persistent hotspot: evaluation of the FibroScHot trial baseline data.","authors":"Fred Besigye, Candia Rowel, Moses Adriko, Fredrick J Muyodi, John Joseph Kisakye, Rosemary Nalwanga, Birgitte J Vennervald, Fred Nuwaha, Edridah M Tukahebwa, Shona Wilson","doi":"10.1371/journal.pntd.0012708","DOIUrl":"10.1371/journal.pntd.0012708","url":null,"abstract":"<p><strong>Background: </strong>Treatment guidelines for schistosomiasis recommend increasing frequency of preventative chemotherapy (PC) administration of praziquantel to twice per annum in persistent hotspots of transmission, in combination with integrated control strategies. FibroScHot was an individual randomised superiority trial designed to examine twice per annum and four times per annum treatment frequency. It was conducted in two primary schools, Buhirigi and Kaiso, in Hoima District Uganda - a designated Schistosoma mansoni high transmission area in which PC is targeted at children and adults. The baseline parasitology data was assessed against international control programme thresholds of success and the criteria for persistent hotspots. Further, the study also assessed the potential for integrated control strategies within the surrounding communities.</p><p><strong>Methodology/principal findings: </strong>The prevalence of infection, heavy infection and the infection intensity were derived for 700 participants from Kato-Katz examination of one stool sample. Neither school met the threshold of morbidity control (<5% with heavy infection). A strong school effect was observed in models of prevalence and prevalence of heavy infection, with these being greater in Kaiso. By prevalence, Kaiso was a high transmission area and Buhirigi a moderate transmission area. Kaiso but not Buhirigi met the definition of a persistent hotspot. Persistent hotspot classification did not change when intensity of infection was used. Intermediate snail hosts were collected at both Kaiso landing site and from the River Hoimo in Buhirigi, though in smaller numbers in the latter. Questionnaire data indicates that reliance on water collection from transmission sites and open defecation occurs more frequently in Kaiso than in Buhirigi.</p><p><strong>Conclusions: </strong>The criteria for persistent hotspots were met in the high transmission but not the moderate transmission community despite neither community meeting the threshold of morbidity control. This disconnect indicates that endemic communities exist in which control has not been achieved but increased frequency of treatment is currently not recommended. FibroScHot will be able to inform on whether widening the current recommendation of increased treatment frequency to these communities will achieve improved control. Evidence provided also indicates scope for the integrated control strategies of vector control and WASH improvements in both the participating communities.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012708"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188347","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":"Wb5, a novel biomarker for monitoring efficacy and success of mass drug administration programs for Wuchereria bancrofti elimination.","authors":"Rachel E Pietrow, Catherine Bjerum, Benjamin G Koudou, Taniawati Supali, Philip J Budge, Peter U Fischer, Thomas B Nutman, Sasisekhar Bennuru","doi":"10.1371/journal.pntd.0013146","DOIUrl":"10.1371/journal.pntd.0013146","url":null,"abstract":"<p><p>The success of mass drug administration at reducing the prevalence of lymphatic filariasis in endemic areas has led to an increased need for highly sensitive and specific diagnostic assays. To be useful in post-elimination surveillance in areas with low to zero prevalence, high test performance characteristics are required to enable the early detection of infection recrudescence. As current testing suffers from either sensitivity or specificity levels that fail to meet adopted target product profiles, additional targets that could be used as confirmatory tests or in multiplexed assays could overcome these issues. To this end, bioinformatic analyses coupled with stage-specific expression data for W. bancrofti (Wb) and/or B. malayi (Bm) resulted in the identification of 12 targets that were: 1) present in Wb and/or Bm; 2) had very little to no homology with proteins from other filariae; and 3) were enriched in the microfilarial or L3 stages. Screening of these 12 antigens by a Luciferase Immunoprecipitation System assay for IgG with serum from Wb-infected and uninfected individuals identified a single antigen, termed Wb5, that was specific for Wb infections only. Recombinant Wb5 proteins were generated in multiple expression systems for use in a variety of IgG4-based immunoassays. To assess if Wb5 could provide additional sensitivity to assays using IgG4 antibodies to Wb123, head-to-head comparisons were performed using serum from 466 samples (231 Wb-infected, 235 controls). Using IgG4-based immunoassays at 100% specificity against uninfected controls and other helminth species (O. volvulus, L. loa, S. stercoralis, M. perstans), Wb5 and Wb123 had individual sensitivities of 53.7% and 75.3%, respectively, while a combination resulted in 81.0% sensitivity. Moreover, kinetic studies of patients that were treated and followed up longitudinally suggest that Wb5 titers may decline more sharply than those of Wb123, thus paving the way for Wb5 as a complementary tool to Wb123.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013146"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188353","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":"Repeat Ascaris challenge reduces worm intensity through gastric cellular reprograming.","authors":"Yifan Wu, Charlie Suarez-Reyes, Nina L Tang, Alexander R Kneubehl, Jill E Weatherhead","doi":"10.1371/journal.pntd.0013141","DOIUrl":"10.1371/journal.pntd.0013141","url":null,"abstract":"<p><p>Ascariasis (roundworm) is the most prevalent parasitic nematode infection worldwide, impacting approximately 500 million people predominantly in low- and middle-income countries (LMICs). While people of all ages are infected with Ascaris, infection intensity (defined by worm burden) paradoxically peaks in pre-school and school-aged children but then declines with age. The cause of age-dependent Ascaris worm intensity is not well understood but may be dependent on cellular changes in mucosal barrier sites. We have previously found that the gastric mucosa is a critical barrier site for Ascaris infection as ingested Ascaris larvae use acidic mammalian chitinase (AMCase) secreted by gastric chief cells and acid secreted by gastric parietal cells to hatch. After hatching, larvae translocate across the gastric mucosa to initiate the larval migratory cycle. However, mucosal injury induced by administration of Tamoxifen results in cellular changes that impair Ascaris hatching and reduce larval translocation across the gastric mucosa. Since individuals in endemic settings often experience recurrent infection throughout their lives, we set out to determine how repeated Ascaris exposures affect the gastric mucosa and the intensity of resultant infections. In this study, we established a repeated Ascaris suum challenge mouse model and found that repeated Ascaris challenge caused cellular changes in the gastric mucosa which reduced worm intensity in the liver. Importantly, these decreases in infection intensity following repeated infections occurred independent of the adaptive immune response. These findings indicate that gastric cellular changes may be a key mechanism leading to the observed age-dependent Ascaris worm intensity changes from childhood to adulthood.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013141"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188335","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":"Profiling of human IL-22+ T cell clones from patients affected with Schistosoma mansoni: Insights into macrophage regulation and liver fibrosis.","authors":"Fernanda Scopelliti, Caterina Cattani, Roberto Gimmelli, Valentina Dimartino, Cristiana Lalli, Giuliana Papoff, Christian Napoli, Giovina Ruberti, Andrea Cavani","doi":"10.1371/journal.pntd.0013132","DOIUrl":"10.1371/journal.pntd.0013132","url":null,"abstract":"<p><p>Tissue damage in Schistosoma mansoni infection results from a granulomatous, T cell-mediated response to parasite eggs, leading to liver fibrosis and portal hypertension. This immune response, initially Th1-dominated, progressively shifts toward a Th2 profile, contributing to hepatic stellate cell (HSC) activation and fibrosis. However, the precise regulatory mechanisms remain unclear. In this study, we analyzed T cell responses to soluble egg antigens (SEA) in 121 T cell clones (Tcc) from S. mansoni-infected patients. All clones produced high levels of IL-13 upon anti-CD3 stimulation; a minority secreted IFN-γ (n = 33) or IL-10 (n = 38). Notably, 51 clones co-produced IL-22 and IL-13. To investigate IL-22's role, we examined IL-22 receptor (IL-22R) expression on human M0 and M2 macrophages. Both subsets expressed IL-22R, and its engagement triggered phosphorylation of p38, STAT3, and STAT5. IL-22 also downregulated IL-13-induced M2 markers (CD163, CD200R). Furthermore, IL-22 treatment of HSCs inhibited IL-13-driven collagen I/III production and cell proliferation. These results suggest that IL-22-producing T cells modulate Th2 macrophage polarization and directly suppress fibrogenesis in HSCs. IL-22 may thus act as a regulatory cytokine counteracting liver fibrosis during schistosomiasis.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013132"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188334","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":"Bimodal distributions of anti-Trypanosoma cruzi antibody levels in blood donors are associated with parasite detection and antibody waning in peripheral blood.","authors":"Mirta C Remesar, Ester C Sabino, Lewis F Buss, Claudio D Merlo, Mónica G López, Sebastián L Humeres, Héctor A Pavón, Clara Di Germanio, Sonia Bakkour Coco, Léa C Oliveira-da Silva, Marcelo Martins Pinto Filho, Antonio L Ribeiro, Michael P Busch, Ana E Del Pozo","doi":"10.1371/journal.pntd.0012724","DOIUrl":"10.1371/journal.pntd.0012724","url":null,"abstract":"<p><strong>Background: </strong>In our previous study of blood donors in the Argentinian Chaco Province, we documented bimodal distributions of anti-Trypanosoma cruzi antibody (Ab) levels, suggesting potential self-cure in donors with low-reactive samples. This study aimed to correlate \"high\" and \"low\" Ab level groups, defined by a mathematical model, with parasitemia and electrocardiogram findings. Ab decline over time was also assessed.</p><p><strong>Methodology/ principal findings: </strong>We invited T. cruzi Ab reactive blood donors to enroll in the study from October 2018 to November 2019 with a follow up visit two years later. Blood samples were tested for T cruzi Ab by: Chagatest ELISA Lisado and Chagatest ELISA Recombinante v.4.0 (Wiener Lab, Argentina); VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) (Ortho-Clinical Diagnostics Inc., UK), and Architect Chagas (Abbott Laboratories, Germany). Target capture polymerase chain reaction (PCR) was performed on lysed whole blood samples from enrollment visits and electrocardiograms on second visits. Four hundred fifty donors were recruited, but 68 were excluded due to negative results on all study Ab assays. Ab level distributions were bimodal and classified as \"high\" or \"low\" at a calculated threshold for each of four assays. There were 160 donors with low and 179 with high Ab results on all assays. The remainder 43 were discordant reactive. Ninety-seven percentage of the PCR positive donors were among the concordant high Ab group. During the 2-4 year follow-up interval, relative Ab declines by three assays were significantly greater among those classified as low Ab and with negative PCR results.</p><p><strong>Conclusions/ significance: </strong>Ab reactivity is associated with PCR-detectable parasitemia. Greater Ab declines were detected among donors with low and/or discordant Ab reactivity and negative PCR results, suggesting spontaneous parasite clearance in these donors.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012724"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188330","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 prevalence and associated risk factors of post-transplant Toxoplasma gondii infection among kidney transplant recipients and patients with uremia in Central-southern China.","authors":"Xingxing Zheng, Junhui Li, Zhuolin Li, Xianshu Liu, Yufei Zhang, Jiang Zhu, Yu Zhang, Jie Jiang, Bo Li, Meng Xia, Yingzi Ming, Xiang Wu","doi":"10.1371/journal.pntd.0013063","DOIUrl":"10.1371/journal.pntd.0013063","url":null,"abstract":"<p><strong>Background: </strong>Toxoplasma gondii (T. gondii) is an opportunistic intracellular parasite and is a big threaten for patients with uremia and solid organ transplantation recipients, especially for kidney transplant recipients. However, Toxoplasma seroprevalence in these patient populations remain unclear, and the risk factors of post transplantation T. gondii infection were not well-defined in China and globally.</p><p><strong>Methods: </strong>Post-transplant or uremia patient's serum collected from transplant center of 3rd Xiangya hospital of Central South University were detected by IHA to detect anti-Toxoplasma IgG. A retrospective cross-sectional study was performed with these patient's medical records and a questionnaire was also conducted.</p><p><strong>Results: </strong>The results indicated that approximately 10.59% of the kidney recipients in central-southern China were seropositive for T. gondii post-transplant. While the prevalence in patients with uremia was about 24.12%. We identified that keeping cats and a lower percentage of CD3+T cells and CD8+T cells were associated with higher prevalence of T. gondii IgG+ in uremia patients when compared with kidney transplant recipients.</p><p><strong>Conclusions: </strong>This study suggested that kidney recipients and those uremia patients in the waiting list are susceptible to T. gondii infection. Immune status and keeping cats are associated with the seroprevalence in those patients. However, T. gondii infection is a neglected problem, screening and monitoring deserves more attention in the clinic.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013063"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12157834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188350","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":"TLR4 competence and mouse models of sublethal leptospirosis.","authors":"Olifan Zewdie Abil, Suman Kundu, Leonardo Moura Midon, Maria Gomes-Solecki","doi":"10.1371/journal.pntd.0013163","DOIUrl":"10.1371/journal.pntd.0013163","url":null,"abstract":"<p><p>Mice are slowly being accepted as alternative models for investigation of leptospiral infection. The strain often used to analyze sublethal disease (C3H/HeJ) expresses a hyporesponsive tlr4 gene in its cells and thus the model is deemed immunocompromised. To help resolve this scientific concern we compared infection of mice expressing competent tlr4 (C3H/HeN, C57BL6) versus tlr4 hyporesponsive mice (C3H/HeJ) with Leptospira interrogans serovar Copenhageni strain Fiocruz L1-130 over a period of two weeks. We found that the two mouse strains with a functional tlr4 gene (C3H/HeN and C57BL/6) developed clinical and molecular signs of leptospirosis less pronounced but not significantly different than tlr4 hyporesponsive C3H/HeJ, as quantified by weight loss, survival curves, presence of Leptospira 16S rRNA in blood and urine and burden of viable spirochetes in kidney as compared to the respective uninfected controls. Analysis of serologic immune factors in the three strains revealed increased IgM and IgG3, and a general absence of inflammatory markers at two weeks post infection. Our data suggests that TLR4 function is not sufficient to cause susceptibility to leptospirosis. We conclude that C3H/HeN and C57BL/6 are appropriate mouse models of sublethal leptospirosis.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013163"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188351","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":"Cognitive impairment in Chagas disease patients in Brazil, 2007-2021: A cross-sectional study.","authors":"Carla J Serrano, Maria E Lisbôa-Marques, Thiago Cerqueira-Silva, Leila S B Santos, Murilo A Oliveira, Iuri Ferreira Felix, Paulo R S P de Sousa, Leonardo G M Cardoso, Pedro J R Muiños, Renata M Maia, Marília B Catto, Eric Aguiar Wittlich, Lucy Rodrigues-Ribeiro, Victor L P P Botelho, Maria Carmo P Nunes, Antonio Luiz P Ribeiro, Lucas C Barbosa E Silva, Roque Aras, Karen L Furie, Jamary Oliveira Filho","doi":"10.1371/journal.pntd.0012981","DOIUrl":"10.1371/journal.pntd.0012981","url":null,"abstract":"<p><strong>Introduction: </strong>Chagas Disease (CD) is frequently associated with heart failure (HF). Cognitive impairment is reported, but whether it results from CD or is a nonspecific symptom of HF is unknown. We aimed to compare cognitive function of HF patients with or without CD.</p><p><strong>Methods: </strong>Multicenter cross-sectional study of HF patients. Investigators blinded to the etiology of HF evaluated global cognition and domains of memory, executive and visuospatial function. Logistic regression tested the association between CD and cognitive impairment (Z-score < -1.5) in each domain adjusted for age, sex, educational level and left ventricular ejection fraction.</p><p><strong>Results: </strong>We recruited 518 patients, 250 (48.3%) with CD. Cognitive impairment was more common in CD vs. non-CD patients (27.1% vs 13.1%, p < 0.001), mostly in memory (10.4% vs 5.0%, p = 0.022) and visuospatial function (45.2% vs 29.6%, p < 0.001). In the multivariable analysis, CD remained associated with global cognitive impairment (odds ratio 1.90; 95% CI 1.13-3.21, p = 0.016) and visuospatial function impairment (OR 1.56; 95% CI 1.02-2.39, p = 0.039).</p><p><strong>Discussion: </strong>Chagas disease is associated with cognitive impairment independently of heart failure severity, suggesting other competing mechanisms.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012981"},"PeriodicalIF":3.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180242","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}