IJID regions最新文献

{"title":"A systematic review of antimicrobial resistance among World Health Organization Bacterial Priority Pathogens in Syria (2015-2025)","authors":"Bayan Galal,&nbsp;Nadia Barouk,&nbsp;Ahmad Kejah,&nbsp;Marwan Osman,&nbsp;Nabil Karah,&nbsp;Salam Abbara,&nbsp;Yasir Farrouh,&nbsp;Shaffi Fazaludeen Koya,&nbsp;Antoine Abou Fayad,&nbsp;Souha S. Kanj,&nbsp;Ahmad Darwish,&nbsp;Omar Dewachi,&nbsp;Aula Abbara","doi":"10.1016/j.ijregi.2026.100980","DOIUrl":"10.1016/j.ijregi.2026.100980","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial resistance (AMR) is an urgent public health threat, but empirical data from Syria remain limited after prolonged conflict-related disruption of health care, laboratory, and surveillance systems. We aimed to synthesize the available evidence on AMR in Syria.</div></div><div><h3>Methods</h3><div>We searched PubMed, EMBASE, and Google Scholar for English- or Arabic-language studies published from 2015 to 2025 that reported AMR among organisms included in the World Health Organization Bacterial Priority Pathogen List organisms clinical or screening samples collected in Syria. Two reviewers independently screened records and extracted study, specimen, organism, susceptibility testing, and resistance data. Findings were synthesized narratively and summarized using study-level medians and interquartile ranges (IQRs).</div></div><div><h3>Results</h3><div>Of 203 records identified, 22 studies were included, representing 6367 samples. Studies were largely hospital-based and concentrated in Damascus, Aleppo, and Lattakia. Third-generation cephalosporin resistance was high among <em>Enterobacterales</em>, including <em>Escherichia coli</em> (83.6%; IQR 71.2-91.6), <em>Klebsiella pneumoniae</em> (96.3%; IQR 80.5-100.0), and <em>Enterobacter</em> spp. (90.5%; IQR 56.3-93.5). Median carbapenem resistance in <em>Acinetobacter baumannii</em> was 79.4% (IQR 51.3-91.7). Fluoroquinolone resistance was common across Gram-negative pathogens. Methicillin resistance among <em>Staphylococcus aureus</em> was 70.5% (IQR 68.2-72.8).</div></div><div><h3>Conclusion</h3><div>Syrian AMR data remain sparse and geographically uneven, but the available evidence suggests substantial resistance. Standardized national surveillance, microbiology capacity, local antibiograms, and context-specific empiric treatment guidelines are urgently needed.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"20 ","pages":"Article 100980"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149004510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival analysis of post-war mortality in conflict-affected communities of Laelay Maichew Woreda, Tigray Region, Ethiopia","authors":"Yemane Asmelash Gebretensae,&nbsp;Yemane Hailu Fissuh","doi":"10.1016/j.ijregi.2026.100966","DOIUrl":"10.1016/j.ijregi.2026.100966","url":null,"abstract":"<div><h3>Objectives</h3><div>The Tigray war devastated Laelay Maichew Woreda in terms of death and displacement, health care disruption, and food insecurity. This study analyzes the mortality trend with associated determinants and provides evidence that strengthens healthcare resilience.</div></div><div><h3>Methods</h3><div>The study analyzed 303 war-affected individuals from November 2020 to March 2024, utilizing Kaplan-Meier survival analysis, log-rank tests, Cox proportional hazards, parametric, and accelerated failure time models to identify possible factors impacting survival.</div></div><div><h3>Results</h3><div>This study revealed a mortality rate of 44.55% in conflict-affected vulnerable groups, where children aged ≤14 years constituted the majority of registered deaths. Direct combat was identified as the major cause of death (72%), with a median survival time of 17 weeks. The Gompertz model indicated that children <span><math><mrow><mo>(</mo><mrow><mrow><mtext>hazard</mtext><mspace></mspace><mtext>ratio</mtext><mspace></mspace></mrow><mo>[</mo><mtext>HR</mtext><mo>]</mo><mo>=</mo><mn>2.06</mn><mo>,</mo><mspace></mspace><mi>P</mi><mo>=</mo><mn>0.044</mn></mrow><mo>)</mo><mo>,</mo></mrow></math></span> young adults<span><math><mrow><mspace></mspace><mo>(</mo><mrow><mtext>HR</mtext><mo>=</mo><mn>3.15</mn><mo>,</mo><mspace></mspace><mi>P</mi><mo>=</mo><mn>0.007</mn></mrow><mo>)</mo></mrow></math></span>, males<span><math><mrow><mspace></mspace><mo>(</mo><mrow><mtext>HR</mtext><mo>=</mo><mn>1.68</mn><mo>,</mo><mrow><mspace></mspace><mi>p</mi></mrow><mo>=</mo><mn>0.011</mn></mrow><mo>)</mo></mrow></math></span>, individuals with poor health status (<span><math><mrow><mtext>HR</mtext><mo>=</mo><mn>2.68</mn><mo>,</mo><mspace></mspace><mi>P</mi><mo>=</mo><mn>0.001</mn></mrow></math></span>), those with acute health problems<span><math><mrow><mspace></mspace><mo>(</mo><mrow><mtext>HR</mtext><mo>=</mo><mn>1.56</mn><mo>,</mo><mspace></mspace><mi>P</mi><mspace></mspace><mo>=</mo><mspace></mspace><mn>0.018</mn></mrow><mo>)</mo></mrow></math></span>, and individuals with chronic illness and poor overall health status <span><math><mrow><mo>(</mo><mrow><mtext>HR</mtext><mo>=</mo><mn>3.28</mn><mo>,</mo><mspace></mspace><mi>P</mi><mo>=</mo><mn>0.002</mn></mrow><mo>)</mo></mrow></math></span> had significantly higher hazards of mortality, while disease outbreaks, lack of medicines and health facilities, and access to health care were associated with reduced hazards of mortality.</div></div><div><h3>Conclusion</h3><div>Post-conflict mortality risks in Laelay Maichew Woreda are higher for children, young adults, males, and those exposed to direct combat, disease outbreaks, or a lack of healthcare access. The long-term impact of war on survival necessitates targeted interventions and policies.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"20 ","pages":"Article 100966"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under-ascertainment of medically attended tick-borne encephalitis virus infections by tick-borne encephalitis surveillance in selected areas of Austria, Denmark, Finland, Germany, Latvia, Sweden, and Switzerland","authors":"Frederick J. Angulo,&nbsp;Gordon Brestrich,&nbsp;Gerhard Dobler,&nbsp;Per-Eric Lindgren,&nbsp;Franc Strle,&nbsp;Joanna Zajkowska,&nbsp;Pingping Zhang,&nbsp;Lisa R. Harper,&nbsp;Andreas Pilz,&nbsp;L. Hannah Gould","doi":"10.1016/j.ijregi.2026.100953","DOIUrl":"10.1016/j.ijregi.2026.100953","url":null,"abstract":"<div><h3>Objectives</h3><div>Antibodies against tick-borne encephalitis (TBE) virus (TBEV) nonstructural protein 1 (NS1) immunoglobulin G are elevated in TBEV-infected individuals, but not in TBE vaccinated individuals, enabling estimation of TBEV infection prevalence in countries where TBE vaccines are used.</div></div><div><h3>Methods</h3><div>We used data from NS1 seroprevalence studies to estimate the incidence of medically attended TBEV infections and then compared this incidence with the incidence of surveillance-reported TBE cases to estimate the under-ascertainment multiplier for medically attended TBEV infections identified by surveillance.</div></div><div><h3>Results</h3><div>The prevalence of NS1 antibodies ranged from 0.1% to 7.0% in the identified nine seroprevalence studies. Medically attended TBEV incidence in areas where seroprevalence specimens were collected ranged from 0.5/100,000 population per year in Denmark to 21.5/100,000 population per year in Latvia. The under-ascertainment multiplier was 0.9 in Finland, 2.2 in Latvia, 2.5 in Switzerland, 3.4 in Sweden, 3.6 in Austria(Northern), 3.8 in Germany (Bavaria), 5.0 in Austria (Western), 5.0 in Denmark, and 6.0 in Germany-Baden/Wuerttemberg.</div></div><div><h3>Conclusion</h3><div>Despite assumptions necessitated by data gaps, the results of this analysis indicate that more individuals are infected with TBEV and seek medical care than are ascertained by TBE surveillance. Given the increasing public health threat posed by TBE in Europe, further efforts are needed to improve TBE awareness and increase TBE vaccination among persons at increased risk of TBEV infection.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"20 ","pages":"Article 100953"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148854442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracing the evolutionary and spatial dynamics of the 2022-2023 chikungunya outbreak in Paraguay and its regional spread across the Southern Cone","authors":"Fátima Cardozo ,&nbsp;Roque Morel ,&nbsp;Sully Márquez ,&nbsp;Cynthia Bernal ,&nbsp;Alan Martínez ,&nbsp;Adriana Valenzuela ,&nbsp;Paúl Cárdenas ,&nbsp;Gabriel Trueba ,&nbsp;Alejandra Rojas ,&nbsp;Magaly Martínez","doi":"10.1016/j.ijregi.2026.100912","DOIUrl":"10.1016/j.ijregi.2026.100912","url":null,"abstract":"<div><h3>Objectives</h3><div>During 2022-2023, the chikungunya virus (CHIKV) caused a major outbreak in Paraguay. Previous genomic analyses attributed the epidemic to local circulation since early 2022, but increasing cases in neighboring countries raised questions about its origin and spread.</div></div><div><h3>Methods</h3><div>We analyzed 517 CHIKV East/Central/South African genomes from 2014 to 2023, including 49 generated during the 2023 outbreak in Paraguay. Time-scaled phylogenetic and discrete phylogeographic analyses were used to reconstruct viral introductions, regional dissemination, and the evolutionary dynamics of the E2:V264A substitution.</div></div><div><h3>Results</h3><div>The epidemic lineage circulating Paraguay was nested within Brazilian sequences. Three independent Brazil-to-Paraguay introductions were inferred between 2017 and 2022, but only the introduction around 2021 was associated with sustained local transmission and patterns consistent with southward spread into Argentina and Uruguay. Brazil to Paraguay was the only route with strong posterior support. The E2:V264A substitution was consistent with being present in the lineage introduced around 2021 or becoming fixed early during expansion, with no evidence of recurrent independent emergence or association with geographic dispersal.</div></div><div><h3>Conclusion</h3><div>The 2022-2023 outbreak is consistent with the expansion of a pre-existing Brazilian lineage introduced before sustained local transmission, with phylogeographic patterns suggestive of subsequent dissemination across the Southern Cone.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100912"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148231430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand hygiene knowledge and practices among patients in selected health facilities of Mukono and Kagadi districts in Uganda: A cross-sectional study","authors":"Fred Twinomugisha ,&nbsp;John Bosco Isunju ,&nbsp;Esther Buregyeya ,&nbsp;David Musoke ,&nbsp;Mary Nakafeero ,&nbsp;Henry Kajumbula ,&nbsp;Habib Yakubu ,&nbsp;Richard K. Mugambe","doi":"10.1016/j.ijregi.2026.100920","DOIUrl":"10.1016/j.ijregi.2026.100920","url":null,"abstract":"<div><h3>Background</h3><div>Hand hygiene (HH) is a cost-effective measure for preventing healthcare–associated infections, yet patient involvement in promoting HH in healthcare facilities remains underexplored in low-resource settings. This study assessed HH knowledge and practices among patients attending selected health facilities in Mukono and Kagadi districts in Uganda.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted between May and June 2025 among 854 adult patients from 32 purposively selected health facilities. Data were collected using an interviewer-administered structured questionnaire programmed in KoboCollect, including items on self-reported HH practices. Data were analyzed in Stata 14 using descriptive statistics and modified Poisson regression to identify factors associated with HH knowledge and practices.</div></div><div><h3>Results</h3><div>Overall, 61.5% of respondents had adequate HH knowledge, while only 29.6% demonstrated good HH practices. Most participants (92.9%) identified infection prevention as the main purpose of HH, and 59.5% reported receiving HH information from health care workers. Adequate knowledge was higher among patients from Mukono (adjusted prevalence ratio [aPR] = 1.38; 95% confidence interval [CI]: 1.22-1.57), older participants (aPR = 1.01; 95% CI: 1.00-1.01), and those of middle socioeconomic status (aPR = 1.15; 95% CI: 1.01-1.30). However, good HH practices were less prevalent in Mukono (aPR = 0.55; 95% CI: 0.44-0.69) and among rural residents of Kagadi districts (aPR = 0.70; 95% CI: 0.56-0.88).</div></div><div><h3>Conclusion</h3><div>Despite relatively high HH knowledge, patient practices were suboptimal. Targeted behavioral interventions are needed to bridge the knowledge–practice gap.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100920"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148231432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Lyme disease, a growing tick-borne disease of concern, in Japan from May 2013 to March 2024: a descriptive study","authors":"Kohei Goto ,&nbsp;Hirofumi Kato ,&nbsp;Minako Kanesaki ,&nbsp;Natsuko Nakamura ,&nbsp;Ayano Orime ,&nbsp;Chiaki Ikenoue ,&nbsp;Kozue Sato ,&nbsp;Tomoe Shimada ,&nbsp;Yu Takizawa ,&nbsp;Takuri Takahashi ,&nbsp;Taro Kamigaki ,&nbsp;Hiroki Kawabata ,&nbsp;Tomimasa Sunagawa","doi":"10.1016/j.ijregi.2026.100919","DOIUrl":"10.1016/j.ijregi.2026.100919","url":null,"abstract":"<div><h3>Objectives</h3><div>Lyme disease (LD) is a globally distributed zoonosis; however, limited epidemiological data are available from Japan. This study aimed to elucidate the characteristics of LD cases reported through the Japanese national surveillance system.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study based on data from the National Epidemiological Surveillance of Infectious Diseases for the fiscal years 2006-2023.</div></div><div><h3>Results</h3><div>Overall, 265 LD cases were reported, ranging from five in 2008 to 28 in 2023 (median: 12.5), including 216 domestic, predominantly from Hokkaido, and 43 imported cases. The median annual notification rate for domestic cases was 0.94 per 10 million population (range: 0.39-2.14). The median age was 53 years, and 62% were male. No fatal cases were reported. Most infections occurred between May and September. Common clinical features of the cases included erythema migrans, fever, and neurological symptoms. The median duration from onset to diagnosis was 28.5 days (interquartile range: 16-45 days).</div></div><div><h3>Conclusions</h3><div>The number of LD cases in Japan has increased, with cases predominantly occurring in middle-aged men from Hokkaido and other areas. Furthermore, patients having LD presented with non-specific symptoms, including neurological involvement, resulting in delayed diagnoses. These findings highlight the importance of increasing awareness of LD in Japan.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100919"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing isoniazid preventive therapy uptake among people living with human immunodeficiency virus in Tanzania, a resource-constrained setting with a high tuberculosis burden: A systematic review and meta-analysis","authors":"Emmanuel M. Sindato ,&nbsp;Violet Dismas Kajogoo ,&nbsp;Gabriel Jackob Mchonde ,&nbsp;Bonaventura C.T. Mpondo","doi":"10.1016/j.ijregi.2026.100908","DOIUrl":"10.1016/j.ijregi.2026.100908","url":null,"abstract":"<div><h3>Objectives</h3><div>Tuberculosis (TB) disease remains highly prevalent among people living with human immunodeficiency virus (PLHIV) in Tanzania, despite the implementation of the isoniazid preventive therapy (IPT) program in 2009. This study aimed to characterize the uptake of IPT in Tanzania.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, Google Scholar, and Embase for potentially eligible studies published in English from inception to February 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The research articles included participants aged ≥10 years living with HIV who had started IPT as per World Health Organization recommendations. We used STATA 17.0 software for data analysis. Random-effects models were used to pool the effect estimates and account for between-study heterogeneity.</div></div><div><h3>Results</h3><div>The overall prevalence of IPT uptake was 23.61% (95% confidence interval [CI]: 14.00-34.83, <em>P</em> &lt; 0.01). Cases of TB among those on IPT was 2.72%. The prevalence of IPT completion was 82.40% (95% CI: 50.54-99.41, <em>P</em> &lt; 0.01), with a greater prevalence among women 74.42% (95% CI: 71.48-77.27, <em>P</em> = 0.01) and those with CD4 &lt;350 cells/µl 52.74% (95% CI: 19.55-84.61, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The overall uptake of IPT is still low among PLHIV, but the completion rates among those taking the therapy is high. Measures are required to increase IPT uptake in this population group.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100908"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of the Dengue NS1 Ag Rapid Test during early-stage infections at epidemic-affected health care facilities in northeastern and eastern Ethiopia","authors":"Chalachew Sisay ,&nbsp;Netsanet Worku ,&nbsp;Tadesse Awoke ,&nbsp;Kassahun Alemu","doi":"10.1016/j.ijregi.2026.100915","DOIUrl":"10.1016/j.ijregi.2026.100915","url":null,"abstract":"<div><h3>Objectives</h3><div>Early detection of dengue through the non-structural protein 1 (NS1) antigen is critical for timely diagnosis. Although polymerase chain reaction (PCR) remains the reference standard, its cost and technical requirements limit routine use in many epidemic-prone settings. Rapid diagnostic tests (RDTs) provide a practical alternative but require validation against reference assays. This study aimed to evaluate the diagnostic accuracy of the STANDARD Q Dengue NS1 Ag RDT compared with the Trioplex real-time PCR assay for early dengue detection in healthcare facilities in northeastern and eastern Ethiopia between April and August 2024.</div></div><div><h3>Methods</h3><div>A cross-sectional diagnostic accuracy study was conducted using consecutive sampling of 339 febrile patients aged over 1 year who presented within 5 days of suspected dengue infection. Diagnostic performance was assessed using contingency table analysis, with sensitivity, specificity, predictive values, likelihood ratios, receiver operating characteristic curve analysis, and Cohen κ.</div></div><div><h3>Results</h3><div>Most participants were urban residents (90%) and aged 20-29 years. The NS1 Ag RDT demonstrated 82.9% overall accuracy, with a sensitivity of 82.6% (95% confidence interval [CI]: 76.3-87.8) and a specificity of 83.2% (95% CI: 76.4-88.7). Positive and negative predictive values were 85.4% (95% CI: 79.3-90.2) and 80.1% (95% CI: 73.1-86.0), respectively. The positive likelihood ratio was 4.92, receiver operating characteristic area was 0.829, and Cohen κ indicated substantial agreement (κ = 0.656). Test positivity peaked on illness days 2 and 3.</div></div><div><h3>Conclusion</h3><div>The NS1 Ag RDT demonstrated moderate diagnostic accuracy, supporting its application for early-phase dengue detection in epidemic-prone, resource-limited health care facilities where Trioplex reference real-time PCR is not feasible.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100915"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148231428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and prognostic factors in infective endocarditis: A Colombian multicenter cohort","authors":"Juan David Zuluaga Monroy ,&nbsp;Maria Alejandra Perez Ardila ,&nbsp;Henry Augusto Millan Prada ,&nbsp;Maria Estefania Peña Giraldo ,&nbsp;Joshua Kock Sierra ,&nbsp;Leonardo Ospina Navarro ,&nbsp;Gerson Arias ,&nbsp;Luis Guillermo Uribe","doi":"10.1016/j.ijregi.2026.100913","DOIUrl":"10.1016/j.ijregi.2026.100913","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to estimate in-hospital mortality and identify prognostic factors in infective endocarditis (IE) in a Colombian multicenter cohort.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study of 308 consecutive patients with definitive IE (modified Duke criteria) across four Colombian hospitals (2007-2017). Multivariate logistic regression identified independent mortality predictors. The primary outcome was in-hospital death.</div></div><div><h3>Results</h3><div>In-hospital mortality was 32.7% (101 of 308), with substantial across-center heterogeneity (9.6-45.9%), contrasting with European (EURO-ENDO 17.1%) and Latin American (25.1%) registries. Independent predictors of death in multivariable logistic regression were renal replacement therapy (adjusted odds ratio [aOR] 9.19, 95% confidence interval [CI] 4.61-18.34), perivalvular abscess (aOR 6.42, 95% CI 2.69-15.35), central nervous system embolism (aOR 3.07, 95% CI 1.63-5.80), older age (aOR 1.03 per year, 95% CI 1.01-1.05), and <em>Staphylococcus aureus</em> etiology (aOR 1.87, 95% CI 0.99-3.51). Surgery was independently protective (aOR 0.34, 95% CI 0.18-0.63), an estimate that persisted after propensity score adjustment. Of 199 patients with surgical indication, 78.9% underwent surgery; non-operated cases had prohibitive risk profiles. Model discrimination was good (area under receiver operating characteristic curve 0.842, 95% CI 0.791-0.894).</div></div><div><h3>Conclusion</h3><div>Renal replacement therapy and perivalvular abscess are the strongest independent predictors of in-hospital mortality in this Colombian multicenter IE cohort, whereas cardiac surgery is protective but frequently precluded by prohibitive risk profiles. The 32.7% mortality reflects the high-severity spectrum of a tertiary referral population and is not generalizable to lower-complexity settings. Early identification of patients at risk for dialysis-requiring acute kidney injury and timely multidisciplinary surgical evaluation represent priority clinical intervention targets. In this Colombian multicenter cohort, in-hospital mortality was 32.7%, with substantial across-center heterogeneity. Renal replacement therapy and perivalvular abscess emerged as the strongest independent mortality predictors, identifying patients with limited physiological reserve and advanced infection. Surgery was strongly and consistently protective, including after propensity score adjustment, although unmeasured confounding by indication cannot be fully excluded. Whether multidisciplinary endocarditis team implementation can translate this prognostic information into mortality reduction in Colombian tertiary settings is a hypothesis that should be tested prospectively.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100913"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imported cases of dengue in Rwanda: A call for One Health integrated surveillance and response system for arboviral diseases","authors":"Thierry Zawadi Muvunyi ,&nbsp;Pierre Gashema ,&nbsp;Emmanuel Kabalisa ,&nbsp;Patrick Gad Iradukunda ,&nbsp;Emmanuel Edwar Siddig ,&nbsp;Isabelle Mukagatare ,&nbsp;Jean de Dieu Harelimana ,&nbsp;Mariska Jacoba Kreuger ,&nbsp;Claude Mambo Muvunyi","doi":"10.1016/j.ijregi.2026.100914","DOIUrl":"10.1016/j.ijregi.2026.100914","url":null,"abstract":"<div><div>The true burden of dengue on the African continent is likely underestimated, with approximately 80% of confirmed cases originating from West Africa. In this report, we describe for the first time two imported mild dengue cases detected in travelers returning to Rwanda from Brazil and the Central African Republic. The first case involved a 58-year-old woman from Uganda traveling through Rwanda to Brazil, who presented with fever and lymphadenopathy on June 2, 2024. The second case was a 32-year-old man from Kicukiro District, who sought medical care on September 26, 2024 and exhibited fever and general weakness after visiting the Central African Republic. The traveler from Brazil was infected with dengue virus (DENV)-1, whereas the traveler from Central Africa carried DENV-2. This report underscores the growing risk of dengue being introduced into Rwanda through international travel and highlights the critical need to establish robust cross-border surveillance systems. It calls for improved early detection, active vector monitoring, and the enhancement of national and regional response strategies in line with the International Health Regulations.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"19 ","pages":"Article 100914"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148231431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}