American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Global Perceptions of the Term \"Tropical Medicine\": Results from a Cross-Regional Multilingual Survey.","authors":"Mirna Safia Abd El Aziz, Viktoria Schneitler, Paul Rahden Aries, Sabine Bélard, Sophie Schneitler","doi":"10.4269/ajtmh.26-0458","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0458","url":null,"abstract":"<p><p>The term \"tropical medicine\" has sparked many discussions on its appropriateness because of its colonial history. The aim of this study was to analyze perceptions of the term among international medical professionals. An open online survey, conducted between August 2023 and September 2024, was distributed via professional networks and social media. Of 590 respondents from 66 countries, 80% were employed in the global north. Participants employed in the global south associated \"tropical medicine\" more with a geographical connotation (77/85 versus 346/471, P <0.001). Only 21% saw the need to replace the term, with stigmatization (35%) mentioned as a major association. Free-text responses showed varying perceptions. Some respondents pointed out that replacing the term is not sufficient to achieve \"genuine change\". The study's results raise the question whether a change in terminology can act as a driver of decolonization, stressing that the need for structural reforms is far more important.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Rapid Loop-Mediated Isothermal Amplification-Based Test for the Detection of Shigella from Rectal Swab.","authors":"Farina Naz, Sampa Dash, Eva Sultana, Mohammad Ali, Shaniram Das, Md Razibur Rahman, Tahmeed Ahmed, Asg Faruque, Subhra Chakraborty","doi":"10.4269/ajtmh.26-0232","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0232","url":null,"abstract":"<p><p>The rapid loop-mediated isothermal amplification-based diagnostic test (RLDT) has been validated as a simple, sensitive, and rapid tool for detecting Shigella spp. from fresh or frozen stool. When stool is unavailable or difficult to transport, rectal swabs (RSs) in Cary-Blair medium, stool collected in buffered glycerol saline (BGS), or stool-dipped swabs (SDSs) in Cary-Blair medium offer alternatives that can be easily collected and transported without maintaining a cold chain. This study evaluated the performance of RLDTs for detecting Shigella spp. from RSs, stool collected in BGS, and SDSs compared with fresh stool (FS). Paired RSs and FS were collected from 105 children younger than 5 years old at two hospitals in Bangladesh. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were determined along with the agreement between assays using kappa statistics. The RLDTs detected Shigella in approximately 38-40% of samples across all sample types. Rectal swabs in Cary-Blair medium and SDS each showed 97.6% sensitivity and 100% specificity, with PPVs of 100% and NPVs of 98.5% (RSs) and 98.4% (SDSs) compared with FS; stool collected in BGS samples demonstrated the highest sensitivity (100%) and NPV (100%), with 98.4% specificity and 97.6% PPV. All alternative specimen types showed almost perfect agreement with FS. The RLDT performed well using RSs, indicating a practical alternative to stool for detecting Shigella. The assay was also reliable with stool collected in BGS and SDSs. Broader adoption of RLDTs could improve diagnostic capacity and strengthen surveillance and control efforts.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Acute Respiratory Distress Syndrome Supported by Extracorporeal Membrane Oxygenation due to Leptospirosis at Réunion Island and a Literature Review.","authors":"Elora Bordier, Charles Vidal, Benjamin Delmas, Julien Jabot, Nicolas Traversier, Guillaume Miltgen, Olivier Belmonte, Jérôme Allyn, Nicolas Allou","doi":"10.4269/ajtmh.26-0044","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0044","url":null,"abstract":"<p><p>Leptospirosis is a zoonosis prevalent on Réunion Island. Severe forms with acute respiratory failure can lead to refractory hypoxemia, requiring the use of extracorporeal membrane oxygenation (ECMO). The aim for the present study was to describe all cases of leptospirosis complicated by refractory acute respiratory distress syndrome (ARDS) requiring veno-venous ECMO on Réunion Island and to conduct a literature review. This retrospective observational study was conducted in a multidisciplinary intensive care unit of the University Hospital of Réunion Island. The aim was to describe the clinical, biological, and prognostic characteristics of patients who developed leptospirosis complicated by refractory ARDS requiring ECMO between January 2011 and December 2024. A total of 14 patients with a median age of 38 years and few comorbidities were included. The organ failure most commonly associated with respiratory involvement was acute kidney injury (93%). The median delay between mechanical ventilation and ECMO support was 0 (0-1) days. The median duration of ECMO support was short (7 [4-12] days). The mortality rate in this population was 29%. A systematic literature review revealed 50 cases of patients with leptospirosis requiring ECMO, with a median age of 34 years and a mortality rate of 20%. The favorable prognosis of patients with refractory ARDS due to leptospirosis justifies the use of ECMO. Early referral to a center equipped with ECMO is essential, given the rapid decline in respiratory function.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absence of Validated and Candidate Plasmodium falciparum Kelch13 Markers of Artemisinin Resistance and Low Frequency of a Pfcoronin Mutation in Igombe, Mwanza Region, Tanzania.","authors":"Karol J Marwa, Rafael Oliveira, Richard O Mwaiswelo, Welmoed van Loon, Frank P Mockenhaupt","doi":"10.4269/ajtmh.26-0347","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0347","url":null,"abstract":"<p><p>Tanzania recently identified partial artemisinin resistance in the Kagera region bordering Rwanda and Uganda, where resistance is established. Monitoring neighboring regions is critical to guide containment strategies. We, therefore, conducted molecular surveillance of Plasmodium falciparum Kelch13 (pfk13) and Plasmodium falciparum actin-binding protein coronin (pfcoronin; P76S) mutations in Igombe in Mwanza region. In a health facility-based cross-sectional study in 2025, P. falciparum DNA from patients with uncomplicated malaria was analyzed using polymerase chain reaction, Sanger sequencing, and allele-specific melting curve assays. Among 121 sequenced isolates, no validated or candidate pfk13 mutations were detected. The nonsynonymous, nonvalidated pfk13 variant N489K occurred in 2.5%. The pfcoronin P76S mutation was observed at low prevalence (3.6%). Despite proximity to Kagera hot spots, validated pfk13 markers have not yet been established in the Mwanza region. The presence of pfcoronin P76S, albeit at low levels, requires careful monitoring. Continued molecular surveillance is essential to support the early detection and containment of emerging artemisinin resistance in Tanzania.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Melioidosis Reactivation Following Immunosuppression in Malaysia: A Report of Two Cases.","authors":"Tonnii Sia, Teik Yiap Gan, Guat-Yee Lim, Wun-Khang Chong","doi":"10.4269/ajtmh.26-0316","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0316","url":null,"abstract":"<p><p>Melioidosis, caused by Burkholderia pseudomallei, is endemic in Southeast Asia. Over 90% of cases present acutely. The reactivation of latent melioidosis in endemic regions is difficult to diagnose, and the incidence is unknown. We report two previously healthy middle-age women from Limbang, Malaysian Borneo, who were newly diagnosed with systemic lupus erythematosus. They developed fulminant sepsis due to culture-confirmed melioidosis 4 to 8 weeks after starting immunosuppressive therapy. They had pneumonia and multiorgan microabscesses. One patient survived, whereas the other succumbed to illness. Diagnosing the reactivation of latent melioidosis in endemic regions is impeded by substantial gaps in clinical evaluation and laboratory diagnostic capacity, particularly within resource-limited health care systems. Maintaining high clinical vigilance for reactivation, promptly identifying disseminated disease, and initiating targeted therapy early are critical during the initiation and administration of immunosuppressive treatment. Pre-immunosuppression risk assessment and potential prophylactic strategies in high-risk individuals may help reduce the associated morbidity and mortality.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Headache in Calcified Neurocysticercosis: Emerging Insights into an Inflammation-Driven Phenotype.","authors":"Oscar H Del Brutto","doi":"10.4269/ajtmh.26-0374","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0374","url":null,"abstract":"<p><p>Calcified neurocysticercosis (NCC), traditionally considered an inert marker of past infection, is increasingly recognized as a clinically meaningful condition associated with migraine-like headaches. Evidence from population-based cohorts, clinical series, and imaging studies consistently shows that individuals with calcified NCC have a higher prevalence and severity of headache than those without lesions. Prospective neuroimaging demonstrates that intermittent perilesional inflammation, including edema and blood-brain barrier disruption, can activate migraine-generating pathways, with calcitonin gene-related peptide-mediated trigeminovascular sensitization emerging as a key mechanism. These findings challenge the assumption that calcified lesions are clinically irrelevant and instead, support the concept of a distinct inflammation-driven headache phenotype. Recognizing this entity has important implications for diagnosis, counseling, and therapeutic decision-making, particularly in endemic regions where calcifications are common and often dismissed as incidental. Calcified NCC also provides a unique human model for understanding how focal neuroinflammation shapes headache susceptibility.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Tissue Damage Induced by Snakebite Envenoming: Mechanisms and Therapeutic Advances.","authors":"Jianbiao Luo, Wenxin Xiong, Jiajie Gu, Yongsheng Xie, Xianglong Zheng, Wanchun Wang, Degang Dong","doi":"10.4269/ajtmh.26-0353","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0353","url":null,"abstract":"<p><p>Snakebite envenoming is a serious and often neglected tropical disease associated with high mortality and disability rates. Local tissue injury is one of the main causes of long-term functional impairment after snakebite. Clinically, it may present as local hemorrhage, edema, myonecrosis, and tissue fibrosis. Accumulating evidence indicates that several venom components, including snake venom metalloproteinases, snake venom phospholipase A2s, three-finger toxins, and L-amino acid oxidases, are involved in local tissue injury. These toxins can induce direct cellular and microvascular damage. They can also trigger inflammatory responses, immune dysregulation, and oxidative stress. Compared with systemic toxicity, local tissue damage often has more persistent effects on patients. Antivenom is currently the main treatment of snakebite envenoming. It can neutralize venom toxins and reduce mortality. However, its effect on established local tissue injury remains limited. In recent years, several adjunctive therapies have shown potential. These include small-molecule enzyme inhibitors, photobiomodulation therapy, and stem cell-based therapies. However, most studies still lack sufficient clinical evidence. This review summarizes the major venom components involved in snakebite-induced local tissue injury, the underlying pathophysiological mechanisms, and potential therapeutic strategies. The aim of this review is to provide new perspectives for future mechanistic studies and clinical intervention.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious, Environmental, and Chronic Disease Burden among 1,844 Newly Arrived Humanitarian Migrants in Oklahoma, 2019-2025.","authors":"Shelby Beamon, Sarah Kenney, Joanna George, Justin Cupps, Nelson Iván Agudelo Higuita","doi":"10.4269/ajtmh.26-0352","DOIUrl":"10.4269/ajtmh.26-0352","url":null,"abstract":"<p><p>Global displacement has brought increasingly diverse migrant populations into health systems with limited experience managing large-scale humanitarian arrivals, yet contemporary data describing infectious, environmental, and noncommunicable disease burden across heterogeneous newcomer groups remain scarce. A cross-sectional analysis of 1,844 consecutively screened newly arrived individuals who completed the U.S. domestic medical examination at the University of Oklahoma Center for Travel and Immigrant Health between October 2019 and May 2025 was conducted. Screening was performed in accordance with Centers for Disease Control and Prevention Refugee Health Domestic Guidance, with programmatic adaptations. The cohort represented more than 25 countries of origin, with substantial variation across key indicators. Strongyloides stercoralis seropositivity was 14.6% overall, highest among arrivals from Vietnam (27.1%) and Cuba (25.0%). Eosinophilia exhibited low sensitivity (∼12%) for S. stercoralis seropositivity. Elevated blood lead levels (≥3.5 µg/dL) occurred in 19.2% of those tested, concentrated among young Afghan children. Latent tuberculosis infection was identified in 8.9% of patients, with marked country-level gradients. Predeparture antiparasitic therapy coverage was modest (albendazole: 42.2%; ivermectin: 34.2%). Only 6.8% of eligible women had ever undergone cervical cancer screening. Noncommunicable disease burdens varied widely by country of origin. The diverse infectious, environmental, and chronic disease profiles observed across countries of origin highlight the limitations of uniform post-arrival screening. These data support risk-stratified approaches that include targeted infectious disease testing based on country of origin and epidemiological exposures, universal predeparture hepatitis B triple-panel screening, strengthened pediatric lead surveillance, and cancer screening pathways.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190381","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":"Antimicrobial Resistance and Molecular Epidemiology of Enterococcus Species Isolated at the University Hospitals of Sfax, Tunisia.","authors":"Sadok Bougharriou, Senda Mezghani Maalej, Hela Karray Hakim","doi":"10.4269/ajtmh.26-0005","DOIUrl":"10.4269/ajtmh.26-0005","url":null,"abstract":"<p><p>Enterococci are major causes of both community-acquired and healthcare-associated infections. The rapid global dissemination of multidrug-resistant clones poses a major challenge to clinical management and infection control. The aim for the present study was to investigate the prevalence, antimicrobial resistance patterns, virulence genes, and molecular epidemiology of Enterococcus species isolated from clinical specimens in university hospitals of Sfax, Tunisia. A descriptive, hospital-based, cross-sectional surveillance study was conducted between March 2020 and February 2021. It included all Enterococcus strains isolated in the Microbiology Department of Habib Bourguiba University Hospital. Enterococcus isolates were tested for antimicrobial susceptibility in accordance with European Committee on Antimicrobial Susceptibility Testing guidelines. Polymerase chain reaction assays were performed to detect resistance genes (vanA, vanB, ermA, ermB, ermC, msrA, mefE, vga, vat, vgb), virulence genes (gelatinase [gelE], aggregation substance, enterococcal surface protein [esp], cytolysin, hyaluronidase), and the IS16 marker associated with the clonal complex 17 (CC17) lineage. A total of 231 Enterococcus isolates were recovered, including Enterococcus faecalis (62.3%) and Enterococcus faecium (34.2%). All E. faecalis isolates were susceptible to ampicillin, vancomycin, and linezolid; all E. faecium isolates were resistant to ampicillin, and 7.6% exhibited vanA-mediated glycopeptide resistance. The ermB gene was the predominant macrolide resistance determinant. Among E. faecium, esp (74.7%) was the most prevalent virulence gene, whereas E. faecalis mainly harbored gelE (78.5%). The IS16 element, characteristic of CC17 clones, was detected in 86.1% of E. faecium isolates. The present study highlights the emergence of multidrug-resistant E. faecium strains with molecular features suggestive of CC17 affiliation in hospital settings in Sfax, Tunisia, underscoring the urgent need for stronger infection control and antimicrobial stewardship programs.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190335","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":"Persistent Brain Tuberculomas after Standard Antituberculous Therapy: A Systematic Review of Radiological Persistence, Treatment Duration, and Clinical Outcomes.","authors":"Ravindra Kumar Garg, Neeraj Kumar, Imran Rizvi, Sanjay Singhal","doi":"10.4269/ajtmh.26-0427","DOIUrl":"10.4269/ajtmh.26-0427","url":null,"abstract":"<p><p>Persistent magnetic resonance imaging (MRI) abnormalities after treatment of intracranial tuberculomas create uncertainty regarding the optimal duration of antituberculous therapy (ATT). We systematically reviewed evidence on treatment duration, persistent residual lesions, and factors leading to treatment prolongation from case reports, case series, and cohort studies reporting intracranial tuberculomas treated with ATT. The review included 124 reports describing 201 patients with intracranial tuberculomas, 39 reports of miliary brain tuberculomas, and 24 cohort studies. Complete radiological resolution at the completion of ATT occurred in 71 of 201 patients, whereas persistent residual lesions remained in 83 of 201, and there was progressive disease in 11 of 201. Paradoxical reactions developed in 94 of 201 patients and were the most common indication for treatment extension. Although 39 of 201 patients completed 12 months of ATT, 31 received 13 to 18 months, 28 received 19 to 24 months, and 24 received >24 months. Complete clinical and radiological recovery was achieved in 99 of 201, whereas 75 of 201 improved despite residual sequelae; recurrence occurred in only 7 of 201. Among the 24 cohort studies, 20 reported radiological outcomes. Of these, persistent residual lesions were reported in 16 studies, whereas 4 reported complete radiological resolution. Planned ATT ranged from 6 to 18 months, paradoxical reactions ranged from 3.4% to 51%, and mortality varied up to 23.1%. Persistent intracranial tuberculomas are common after standard ATT and frequently result in prolonged treatment. Our review indicates that persistent MRI abnormalities alone should not be used to determine treatment duration.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190383","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}