Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

{"title":"Pathological characterization of hepatic and mesenteric neotropical Echinococcosis in Brazilian Amazonian patients using light and scanning electron microscopy.","authors":"Fernanda Barbosa de Almeida, Alba Cristina Miranda de Barros Alencar, Christiane Leal Corrêa, Eduardo José Lopes Torres, Fernanda Bittencourt de Oliveira, Rosângela Rodrigues-Silva, Nilton Ghiotti Siqueira, Tuan Pedro Dias Correia, José Roberto Machado-Silva","doi":"10.1590/S1678-9946202567069","DOIUrl":"10.1590/S1678-9946202567069","url":null,"abstract":"<p><p>Neotropical Echinococcosis (NE) is an emerging parasitic zoonosis of significant public health concern. The disease is caused by the larval stage (metacestodes) of Echinococcus vogeli and affects humans in tropical forests of Central and South America. While clinical presentation, radiological imaging, and surgical procedures have been investigated, the pathological features of NE remain partially understood. We performed a comparative study of hepatic and mesenteric metacestodes obtained from Brazilian patients in Acre and Amazonas States during surgical procedures, using both light and scanning electron microscopy for detailed analysis. Liver metacestodes showed three characteristic layers: adventitious, laminated, and germinal. In contrast, mesenteric cysts lacked a consistent layer organization, as the adventitious layer was absent, and the laminated layer was the most prominent membrane within the cyst. Compression exerted by the metacestodes led to hepatic and mesenteric hypertension, characterized by passive hyperemia. Other features induced by hypertension included an expanded sinusoidal bed and extensive areas of hemorrhage resulting from vascular rupture and subsequent blood leakage. In conclusion, the development of mesenteric and hepatic cysts follows distinct patterns, and scanning electron microscopy proves to be a valuable investigative tool for evaluating the pathology of Neotropical Echinococcosis.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e69"},"PeriodicalIF":1.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the malaria transmission profile in a low-endemic area of the Brazilian Amazon: a cause for concern.","authors":"Francisco Marques de Oliveira-Neto, Hermano Gomes Albuquerque, Antonio Rafael da Silva, Eloisa da Graça do Rosario Gonçalves, Martha Cecilia Suárez-Mutis","doi":"10.1590/S1678-9946202567070","DOIUrl":"10.1590/S1678-9946202567070","url":null,"abstract":"<p><p>Since 2015, there has been a renewed global commitment to malaria elimination. Understanding the dynamics of the disease in regions with declining cases is essential to prevent reintroduction. This study aims to analyze the epidemiological indicators of malaria in Maranhao, a Brazilian state with a significant decline in cases. This is a descriptive, retrospective, and ecological study, with data from the malaria surveillance system, from 2003 to 2022. Demographic, spatial, temporal, and parasitological variables were analyzed. During this period, 83,517 malaria cases were reported, of which 67.8% were autochthonous, and among these, 83.1% occurred in rural areas. The Annual Parasitic Incidence (API) has recently been considered low risk in most municipalities. The analysis of seasonality was important at the beginning of the series, but with the reduction of cases, it lost relevance. The epidemiological profile has shifted, with an increase in imported cases initially from abroad and more recently from other Brazilian states. There was also a significant reduction in the proportion of P. falciparum, from 17.7% in 2003 to 6.01% in 2022. Most infected individuals were male, predominantly aged 15 to 45 years, of which increased from 59.1% to 70.5%. Although the overall trend is downward, recent changes in the disease profile are concerning, as they could reverse progress and cause a new rise in cases in a state close to elimination. Surveillance must be strengthened and adapted to prevent the reintroduction and resurgence of endemic transmission.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e70"},"PeriodicalIF":1.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrosis as a reaction to a wasp sting: a case report.","authors":"Abraão Aires Urquiza Carvalho, João Vitor Parente Mendes, Cristine Hirsch, Marcelo Dantas Tavares de Melo","doi":"10.1590/S1678-9946202567073","DOIUrl":"10.1590/S1678-9946202567073","url":null,"abstract":"<p><p>A 62-year-old Brazilian woman with type 2 diabetes mellitus developed necrosis in her right arm following a single wasp sting. Severe reactions such as hers are typically associated with multiple stings and often manifest as anaphylactic shock rather than necrosis.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e73"},"PeriodicalIF":1.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmission risk of Trypanosoma cruzi through blood donors in a third-level care hospital.","authors":"Viridiana Gonzalez-Lopez, Carlos Alberto Zuñiga-Cruz, Sahara Vázquez-Ramírez, Emilio Rendon-Franco, Guiehdani Villalobos, Lucia Rangel-Gamboa, Fernando Martinez-Hernandez","doi":"10.1590/S1678-9946202567072","DOIUrl":"10.1590/S1678-9946202567072","url":null,"abstract":"<p><p>Blood transfusion is a major way of Trypanosoma cruzi transmission, a neglected parasite infection that produces Chagas disease (CD). CD has high morbidity and is potentially fatal in the chronic phase due to the parasite's ability to invade the myocardium, colon, and esophagus. CD prevalence focuses on Latin America; however, its presence in non-endemic areas has been increasing in the last decade, particularly in North America and Europe, due to high migration rates of infected people. This study established the CD seroprevalence in a blood bank located in Mexico City. A total of 851 donor samples were analyzed by ELISAn and Western blotn (ELISA and WB using native antigens obtained from Mexican strains). Positive samples were analyzed by a commercial ELISA kit, named Chagatest (non-native antigens). Average donor age was 36.5 years, and most were men. Seroprevalence by ELISAn and WBn was 3.9% (33/851); whereas by Chagatest only six samples (0.7%) were reactive. Mexico City is not considered an endemic CD area; however, the high mobility of infected people increases the transmission risk in all receptor areas, particularly in blood banks, as seen in this study. Our findings showed a difference between native and non-native serological tests, and the need to maximize the identification of infected people to curb CD spread.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e72"},"PeriodicalIF":1.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective interventions to prevent catheter-associated urinary tract infections: a systematic review.","authors":"Na Li, Rongjie Shi, Yan Sun, Qingli Chen","doi":"10.1590/S1678-9946202567061","DOIUrl":"10.1590/S1678-9946202567061","url":null,"abstract":"<p><p>Catheter-associated urinary tract infections (CAUTIs) are a prevalent and preventable healthcare-associated infection that significantly impacts healthcare systems, contributing to increased patient morbidity, length of stay, and costs. This systematic review aims to evaluate the effectiveness of various interventions in reducing CAUTI incidence in healthcare settings. Following the PRISMA guidelines, we conducted a thorough literature search across multiple databases-Web of Science, Scopus, PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar-up to August 8, 2024. Eligible studies included randomized controlled trials, case-control studies, and experimental designs that met inclusion criteria, namely CAUTIs prevention among hospitalized adult patients. After screening 9,476 titles and abstracts, we reviewed 163 texts in full. Of these, 12 studies were included in this review. Results showed that antiseptic solutions like chlorhexidine, specialized catheters (e.g., BIP Foley and silver alloy-coated types) and educational sessions all significantly reduced CAUTI rates, with some interventions achieving reductions as high as 94%. Reminder systems promoting timely catheter removal and amikacin bladder washing also showed notable effectiveness. Adverse effects were minimal. This review underscores the importance of evidence-based CAUTI prevention strategies and the need for consistent implementation across healthcare facilities. Enhanced catheter maintenance practices and judicious catheter use can significantly reduce CAUTI rates, thereby improving patient outcomes and reducing healthcare-associated costs. Future research should continue exploring diverse, context-specific interventions to address barriers to CAUTI prevention.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e61"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of aminoglycoside resistance in multidrug-resistant Klebsiella pneumoniae isolates.","authors":"Saidy Vásconez Noguera, Ana Paula Marchi, Marina Farrel Côrtes, Nazareno Scaccia, Roberta Cristina Ruedas Martins, Maura Salaroli de Oliveira, Flavia Rossi, Anna Sara Levin, Silvia Figueiredo Costa, Lauro Vieira Perdigão Neto","doi":"10.1590/S1678-9946202567062","DOIUrl":"10.1590/S1678-9946202567062","url":null,"abstract":"<p><p>Multidrug-resistant (MDR) Klebsiella pneumoniae, particularly the lineages resistant to carbapenems and aminoglycosides, is an escalating global public health threat across human, animal, and environmental reservoirs. We examined phenotypic and genetic features of MDR K. pneumoniae isolates. A total of 70 K. pneumoniae strains were collected from clinical (n=55), environmental (n=7), and animal (n=8) sources. To better understand the evolutionary relationship between these isolates, a phylogenetic analysis was performed alongside 35 publicly available K. pneumoniae genomes from NCBI and Pathogenwatch. Whole-genome sequencing (WGS) revealed that 43 isolates carried the blaKPC gene, including blaKPC-2 and blaKPC-3 variants, with different susceptibility profiles to aminoglycosides. Among all isolates, 84% (n = 59/70) were resistant to amikacin and 53% (n = 37/70) were resistant to gentamicin. Aminoglycoside resistance was primarily associated with aminoglycoside-modifying enzymes, including aph(3')-Ia (52%), aac(3)-IIa/aadA2 (49%), and aac(6')-Ib-cr (37%). Additionally, 16S rRNA methyltransferases rmtB and rmtG were detected in 14% of isolates and were associated with high-level amikacin MICs. Overall, 81% of strains were non-susceptible to at least one aminoglycoside, underscoring the clinical importance of these determinants. Phylogenetic analysis based on WGS data showed two main clusters (A and B), and the multilocus sequence type ST11 predominated among Brazilian isolates. Our findings showed a heterogeneous distribution of sequence type profiles across the two clusters and a close relationship between K. pneumoniae strains from human, animal, and environmental sources, highlighting the need for integrated One Health surveillance.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e62"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the Notch ligand DLL4 in the immune response of children with Mycoplasma pneumoniae pneumonia.","authors":"Heting Dong, Zhiao Du, Yaru Liao, Jiying Sun, Huiming Sun, Peng Mo, Ge Dai, Li Huang, Feng Huang, Chuangli Hao, Zhengrong Chen, Yongdong Yan","doi":"10.1590/S1678-9946202567065","DOIUrl":"10.1590/S1678-9946202567065","url":null,"abstract":"<p><p>Mycoplasma pneumoniae pneumonia (MPP) is a common pediatric respiratory infection linked to excessive immune-inflammatory responses. This study investigated the role of the Notch ligand DLL4 in the immunopathogenesis of MPP by assessing its expression in peripheral blood mononuclear cells of affected children. A total of 128 children with MPP and 35 controls were recruited. PBMCs were analyzed for the expression of Notch ligands (Jagged1, Jagged2, DLL1, DLL4) using real-time PCR. Lymphocyte subsets were assessed via flow cytometry, and cytokine levels were measured using ELISA. Clinical data were compared between severe and mild MPP cases, and correlations between DLL4 expression and immune indicators were evaluated. DLL4 expression was significantly higher in the MPP and severe MPP groups than in controls (P < 0.01). MPP patients showed lower CD3+ and CD3+CD4+ lymphocyte levels, and higher CD3+CD8+ and CD3-CD19+ levels compared with controls (P < 0.001). Plasma levels of IFN-γ, IL-17, and IL-36α were elevated in MPP patients (P < 0.001), whereas IL-4 and IL-10 levels were reduced (P < 0.01). Severe cases had higher IFN-γ, IL-17, and IL-36α levels than mild cases (P < 0.05). DLL4 expression positively correlated with plasma IFN-γ and IL-17 levels in MPP patients (P < 0.05). Elevated DLL4 expression in MPP patients, particularly in severe cases, suggests its role in enhancing Th1/Th17-mediated immune responses while suppressing Th2 pathways. Such findings implicate the Notch signaling pathway, via DLL4, in the immunopathogenesis of MPP and highlight its potential as a therapeutic target for modulating immune responses in severe MPP.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e65"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative performance of BD-BACTEC® Mycosis IC/F versus standard aerobic and anaerobic bottles in simulated fungemia and mixed bloodstream infections.","authors":"Juliene Carla Endo Borges, Lumena Pereira Machado Siqueira, Vera Lucia Teixeira de Freitas, Vítor Falcão de Oliveira, Adriana Satie Gonçalves Kono Magri, Afonso Rafael da Silva Junior, Evangelina da Motta Pacheco Alves de Araujo, Ana Paula Cury, Marcello Mihailenko Chaves Magri","doi":"10.1590/S1678-9946202567064","DOIUrl":"10.1590/S1678-9946202567064","url":null,"abstract":"<p><p>Candidemia is a leading cause of bloodstream infection-associated morbidity and mortality, particularly among critically ill patients. Time to detection (TTD) is crucial, but standard blood culture systems often fail to recover yeasts, filamentous fungi, or identify fungi in polymicrobial infections. The BD BACTEC™ Mycosis IC/F bottle was designed to improve fungal detection, yet comparative performance data are limited. This study aimed to compare the detection rate and TTD of BD BACTEC™ Mycosis IC/F with those of standard BD BACTEC™ Plus Aerobic/F and BD BACTEC™ Plus Anaerobic/F bottles using simulated models of fungemia and mixed fungal-bacterial bloodstream infections. This in vitro study included 333 blood culture bottles inoculated with Candida spp., Cryptococcus neoformans, Trichosporon asahii, Fusarium spp., and Aspergillus terreus, as well as bottles simulating coinfections with multidrug-resistant Gram-negative bacteria. All bottles were incubated in the BD BACTEC™ FX system for up to 14 days. BD BACTEC™ Mycosis IC/F achieved 100% detection for Candida spp., outperforming BD BACTEC™ Plus Anaerobic/F (58.5%) and matching BD BACTEC™ Plus Aerobic/F. It showed shorter TTDs for Nakaseomyces glabratus, Candidozyma haemuli, Meyerozyma guilliermondii, and molds. In mixed infections, BD BACTEC™ Mycosis IC/F provided better fungal recovery, especially at low inocula, although recovery was impaired when coinoculated with carbapenemase-producing bacteria. In conclusion, BD BACTEC™ Mycosis IC/F improved fungal detection and recovery compared with standard bottles, including in polymicrobial settings. Its use may enhance diagnostic yield in suspected fungemia, though cost and limited availability may limit widespread adoption.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e64"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for anti-Leishmania antibodies and Leishmania infections in kidney transplant recipients and donors from Brazil.","authors":"Gustavo Henrique Johanson, Maria Carmen Arroyo Sanchez, Regina Maia de Souza, Beatriz Julieta Celeste, Ruth Tamara Valencia-Portillo, Elias David Neto, Ligia Camera Pierrotti, Valdir Sabbaga Amato","doi":"10.1590/S1678-9946202567067","DOIUrl":"10.1590/S1678-9946202567067","url":null,"abstract":"<p><p>This study examines the prevalence of anti-Leishmania IgG antibodies and Leishmania spp. infections among Brazilian kidney transplant recipients and their living donors before and after transplantation. A total of 48 donor-recipient pairs were recruited from July 14, 2022, to December 18, 2023. ELISA was used to test donors and recipients with a crude antigen of Leishmania major-like (Lm-ELISA), along with recombinant Lb6H (rLb6H-ELISA) and K39 (rK39-ELISA). Additionally, PCR was used to test recipients. Of the 48 donors, 25 (52.1%, 95%CI: 38.3-65.5) tested positive with Lm-ELISA, 4 (8.3%, 95%CI: 2.8-20.1) with rLb6H-ELISA, and 2 (4.2%, 95%CI: 0.4-14.8) with rK39-ELISA. Before transplantation, 31 recipients (64.6%, 95%CI: 50.4-76.6) were positive with Lm-ELISA, 5 (10.4%, 95%CI: 4.1-22.6) with rLb6H-ELISA, 1 (2.1%, 95%CI: <0.01-11.9) with rK39-ELISA, and 2 (4.2%, 95%CI: 0.4-14.8) with PCR. At 365 days post-transplant, 35 recipients underwent serological and molecular testing. Of these, 14 (40.0%, 95%CI: 25.5-56.5) tested positive with Lm-ELISA, 4 (11.4%, 95%CI: 3.9-26.5) with rLb6H-ELISA, 0 (0.0%, 95%CI: 0.0-11.8) with rK39-ELISA, and 2 (5.7%, 95%CI: 0.6-19.6) with PCR. Combining serological and molecular methods showed promising potential for early detection and ongoing monitoring of leishmaniasis in kidney transplant recipients and their donors. These findings highlight the urgent need for regulatory measures to implement Leishmania-specific donor screening and recipient monitoring using PCR and targeted serological tests, as well as close observation of signs and symptoms of leishmaniasis.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e67"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasmodium vivax circumsporozoite surface protein (PvCSP) as a vaccine candidate: a brief review.","authors":"Kessia Caroline Souza Alves, Emmily Myrella Vasconcelos Mourão, Joyce Marinho Melo, Maria Edilene Martins Almeida, Juliana Gomes de Souza Oliveira, Luís André Morais Mariúba, Victor Calebe Alves da Costa","doi":"10.1590/S1678-9946202567066","DOIUrl":"10.1590/S1678-9946202567066","url":null,"abstract":"<p><p>For decades, research and development toward malaria vaccine has prioritized infections caused by Plasmodium falciparum, since it is the species responsible for the most severe cases of malaria, which results in a comparatively smaller number of studies devoted to Plasmodium vivax. This disparity is due to complexities inherent in the biology of P. vivax, including the formation of hypnozoites in the pre-erythrocytic phase, difficulties in establishing robust in vitro culture systems, and the absence of fully representative experimental models. Among the antigens investigated for vaccine formulations, the Plasmodium vivax circumsporozoite surface protein (PvCSP) stands out for its immunogenic potential and the partial protection observed in preclinical studies. However, clinical trials with PvCSP-based vaccines have not yet demonstrated a consistent protective response. This review aims to show a historical overview of the studies that have evaluated the potential of vaccines based on the PvCSP protein, as well as to explore the innovative approaches that have been investigated in the last decade to overcome the challenges and advance the development of an effective vaccine against malaria caused by P. vivax.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e66"},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}