American Journal of Tropical Medicine and Hygiene最新文献

Community-Based Point-of-Care Screening for Hepatitis B Virus and Hepatocellular Carcinoma in Rural Tanzania. 坦桑尼亚农村地区基于社区的乙型肝炎病毒和肝细胞癌定点筛查。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-11-05 DOI: 10.4269/ajtmh.24-0341

Manaswita Tappata, James Ford, Johnstone Kayandabila, Joseph Morrison, Samwel Seth, Benson Lyimo, Larissa May, Jose D Debes

{"title":"Community-Based Point-of-Care Screening for Hepatitis B Virus and Hepatocellular Carcinoma in Rural Tanzania.","authors":"Manaswita Tappata, James Ford, Johnstone Kayandabila, Joseph Morrison, Samwel Seth, Benson Lyimo, Larissa May, Jose D Debes","doi":"10.4269/ajtmh.24-0341","DOIUrl":"10.4269/ajtmh.24-0341","url":null,"abstract":"Sub-Saharan Africa has a high burden of hepatitis B virus (HBV) and hepatocellular carcinoma (HCC). The lack of surveillance programs has led to low rates of diagnosis and treatment, particularly in rural areas. We conducted mobile HBV-HCC screening clinics in rural Tanzania between March 2021 and February 2023. After undergoing informed consent, patients completed a questionnaire about HBV. A rapid point-of-care (POC) assay measured HBV surface antigen (HBsAg), and HBsAg-positive patients underwent POC ultrasound to screen for HCC and POC hepatitis C (HCV) antibody testing. The primary outcome was number of HBV diagnoses, and the secondary outcome was prevalence of liver masses in HBsAg-positive individuals. Data were analyzed with descriptive statistics. Five hundred and one patients were screened for HBV; 63% (n = 303) were female with median (interquartile range [IQR]) age of 40 (28-55) years. Only 6% (n = 30) reported being vaccinated against HBV, 92% (n = 453) reported no vaccination, and 2% (n = 12) did not know their vaccination status. Seventy-six percent (n = 340) did not know they should get vaccinated, and 4% (n = 16) reported that vaccination was too expensive. Two percent (n = 11) of patients were positive for HBsAg, with 55% (n = 6) of those being female with median (IQR) age of 36 (34-43) years. None of the HBsAg-positive patients reported being vaccinated against HBV, and all were negative for HCV. On ultrasound, one patient had a liver mass, and another had ascites. We demonstrated that community-based HBV and HCC screening can be implemented in Africa with local partnerships, and this model could be used to promote awareness and improve early detection of disease.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581815","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}

引用次数: 0

Key Factors Influencing Liver Function Injury in Elderly Patients with Newly Diagnosed Pulmonary Tuberculosis Complicated by Diabetes after Antituberculosis Treatment. 影响新诊断肺结核并发糖尿病老年患者抗结核治疗后肝功能损伤的关键因素

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-11-05 DOI: 10.4269/ajtmh.24-0248

Liangliang Ma, Henghua Fan

{"title":"Key Factors Influencing Liver Function Injury in Elderly Patients with Newly Diagnosed Pulmonary Tuberculosis Complicated by Diabetes after Antituberculosis Treatment.","authors":"Liangliang Ma, Henghua Fan","doi":"10.4269/ajtmh.24-0248","DOIUrl":"10.4269/ajtmh.24-0248","url":null,"abstract":"This study addressed the factors influencing liver injury in elderly patients newly diagnosed with pulmonary tuberculosis and diabetes after antituberculosis treatment. From January 2021 to June 2023, 218 elderly patients with early treatment of pulmonary tuberculosis (N = 218) combined with diabetes (N = 218) were collected as research subjects. All patients were treated with the same antituberculosis treatment regimen and were divided into a nonhepatotoxicity group (N = 92) and a hepatotoxicity group (N = 126) according to whether drug-induced liver injury occurred within 3 months after taking tuberculosis drugs. The levels of alanine aminotransferase and aspartate aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin, albumin, lipoprotein(a), prothrombin time, and hemoglobin A1c (HbA1c) were detected by biochemical analyzer. The extent of pulmonary tuberculosis lesions was examined by computed tomography imaging. Influencing factors of antituberculosis drug-induced liver injury were analyzed by logistic multivariate analysis. The hepatotoxicity group exhibited a higher average age than the nonhepatotoxicity group (P <0.05). Additionally, there was a greater prevalence of patients with a history of alcohol consumption in the hepatotoxicity group than in the nonhepatotoxicity group (P <0.05). And the hepatotoxicity group showed a greater extent of tuberculosis lesions (P <0.05). Logistic multivariate analysis identified advanced age, body mass index of <18.5, lesion range of ≥2 lung lobes, history of alcohol consumption, and HbA1c of ≥8% as relevant factors associated with liver function impairment in older adults patients undergoing early treatment of pulmonary tuberculosis combined with diabetes after antituberculosis therapy. These findings underscore the importance of monitoring and addressing these factors during antituberculosis therapy in the elderly population to mitigate the risk of liver function impairment.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581817","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}

引用次数: 0

Refugees. 难民

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-11-05 DOI: 10.4269/ajtmh.24-0728

Philip J Rosenthal

引用次数: 0

Case Report: Coinfection of Leprosy and Chronic Mucocutaneous Candidiasis in a Family with STAT1 Gain-of-Function Mutation. 病例报告：一个 STAT1 功能增益突变家族中的麻风病和慢性皮肤黏膜念珠菌病双重感染。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-11-05 DOI: 10.4269/ajtmh.24-0290

Lais Lima de Oliveira Rekowski, Gustavo Costa Caldas, Lucas Menezes-Silva, Camilla Natália Oliveira Santos, Lucas Sousa Magalhães, Rodrigo Anselmo Cazzaniga, Nailson Alves Dos Santos, Priscila Lima Santos, Ricardo Luís Louzada da Silva, Angela Maria da Silva, Steven M Holland, Amelia Ribeiro de Jesus

引用次数: 0

Analysis of Clinical and Laboratory Profiles of Patients Hospitalized with Hemorrhagic Fever with Renal Syndrome in Southwestern South Korea. 韩国西南部出血热合并肾综合征住院患者的临床和实验室资料分析。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0019

Ma Eum Park, Da Young Kim, Jun-Won Seo, Na Ra Yun, You Mi Lee, Choon Mee Kim, Dong-Min Kim

{"title":"Analysis of Clinical and Laboratory Profiles of Patients Hospitalized with Hemorrhagic Fever with Renal Syndrome in Southwestern South Korea.","authors":"Ma Eum Park, Da Young Kim, Jun-Won Seo, Na Ra Yun, You Mi Lee, Choon Mee Kim, Dong-Min Kim","doi":"10.4269/ajtmh.24-0019","DOIUrl":"10.4269/ajtmh.24-0019","url":null,"abstract":"Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses. Data of 34 patients with HFRS hospitalized at Chosun University Hospital, South Korea, between 2010 and 2021 were retrospectively analyzed. Nested reverse transcription polymerase chain reaction (RT-nPCR) targeting the L segment of hantavirus and sequencing were used for diagnosis. Most cases occurred in men and during the months of October through December. Common symptoms were fever, chills, gastrointestinal symptoms, and myalgia. The common laboratory abnormalities were thrombocytopenia, proteinuria, and elevated levels of serum creatinine, aspartate transaminase, alanine transaminase, and lactate dehydrogenase. Approximately 91.2% of patients had the Hantaan virus with a new genotype cluster, whereas 8.8% had the Seoul virus. Seropositivity based on IgM titer >1:32 on admission was noted in 20.6%, and a 4-fold increase in IgG titer of 1:512 was observed in 11.8%. This study demonstrated that RT-nPCR targeting the L segment of hantaviruses is a more reliable diagnostic method compared to serological testing.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556968","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}

引用次数: 0

Case Report: Hypercalcemia and Acute Kidney Injury Associated with Disseminated Paracoccidioidomycosis. 病例报告：与播散性副球孢子菌病有关的高钙血症和急性肾损伤。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0456

Renan Gomes Mendes Diniz, Betina Nogueira Da Silva, Raoni De Oliveira Domingues-Da-Silva, Marcelo Arnone, Walter Belda Júnior, Elizabeth De Francesco Daher, Lucia Andrade

{"title":"Case Report: Hypercalcemia and Acute Kidney Injury Associated with Disseminated Paracoccidioidomycosis.","authors":"Renan Gomes Mendes Diniz, Betina Nogueira Da Silva, Raoni De Oliveira Domingues-Da-Silva, Marcelo Arnone, Walter Belda Júnior, Elizabeth De Francesco Daher, Lucia Andrade","doi":"10.4269/ajtmh.24-0456","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0456","url":null,"abstract":"Paracoccidioidomycosis is an acute to chronic systemic mycosis caused by the fungi Paracoccidioides. Hypercalcemia is a rare and not fully understood presentation of this infection. We present a case report of paracoccidioidomycosis associated with hypercalcemia and acute kidney injury (AKI) in an immunocompetent patient. An immunocompetent 30-year-old man from Brazil presented with papular erythematous-violaceous skin lesions, disseminated lymphadenopathy, pain in the left hypochondrium, fever with night sweats, and loss of 25 kilograms in 5 months. The result of a biopsy of the lesions was positive for Paracoccidioides brasiliensis. Laboratory findings were high total calcium and 1,25-dihydroxy vitamin D, with low parathyroid hormone, low albumin, and AKI. Computed tomography scans revealed splenic infarcts without bone lesions. Treatment was performed with methylprednisolone and liposomal amphotericin B. Calcium levels and kidney function normalized within 20 days of hospitalization. The patient was discharged 49 days after admission. A follow-up 6 months later revealed total clinical and serological remission.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543156","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}

引用次数: 0

Causes and Consequences of Persistent Anemia after 6 Months of Antiretroviral Therapy in Tanzania: An Observational Comparative Cohort Study. 坦桑尼亚抗逆转录病毒疗法 6 个月后持续贫血的原因和后果：观察性队列比较研究》。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0273

Duncan K Hau, Salama Fadhil, Myung Hee Lee, Bernard Desderius, Megan Willkens, Samuel E Kalluvya, Erius Tebuka, Luke R Smart, Robert N Peck

{"title":"Causes and Consequences of Persistent Anemia after 6 Months of Antiretroviral Therapy in Tanzania: An Observational Comparative Cohort Study.","authors":"Duncan K Hau, Salama Fadhil, Myung Hee Lee, Bernard Desderius, Megan Willkens, Samuel E Kalluvya, Erius Tebuka, Luke R Smart, Robert N Peck","doi":"10.4269/ajtmh.24-0273","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0273","url":null,"abstract":"Anemia is common among people living with HIV (PLWH), particularly in Africa. Outcomes for PLWH on modern antiretroviral therapy (ART) regimens are not well documented. We conducted an observational study to determine the outcomes and predictors of anemia after ART initiation in Tanzania. We enrolled and followed ART-naïve PLWH and HIV-uninfected individuals at three clinics in Tanzania. We grouped participants into four longitudinal categories based on hemoglobin concentration measured at baseline and 6 months after ART initiation (normal, resolved anemia, incident anemia, and persistent anemia) and followed them for 24 months. There were 991 study participants (494 PLWH, 497 HIV uninfected). After 6 months of ART, 33.9% of PLWH had persistent anemia and 9.9% had incident anemia compared with 12.6% and 9.6% for HIV-uninfected controls. Female sex (adjusted odds ratio [aOR]: 2.62; 95% CI: 1.91-6.75) and low income (aOR: 3.10; 95% CI: 1.36-7.20) were strong predictors of persistent anemia for both PLWH and HIV-uninfected individuals. For PLWH, having a CD4+ T cell count of less than 350 cells/mm3 (aOR: 0.34; 95% Cl: 0.15-0.73) was significantly associated with anemia resolution. Mortality was higher for PLWH who had persistent anemia or incident anemia than for PLWH who had normal hemoglobin or improved anemia (hazard ratio: 4.0, 95% Cl 1.3-12.2). One-third of adults in Tanzania had persistent anemia after 6 months on ART, and persistent anemia was associated with increased mortality. PLWH with persistent or incident anemia after 6 months on modern ART deserve close follow-up, particularly women and low-income adults.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543160","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}

引用次数: 0

Th17 and T Regulatory Cytokines in Serum, Lesional Skin, and Stimulated Peripheral Blood Mononuclear Cell Culture Supernatants from Type 1 Leprosy Reaction Patients. 1型麻风反应患者血清、病变皮肤和受刺激外周血单核细胞培养上清中的Th17和T调节细胞因子。

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0358

Srishti Dabas, Ananta Khurana, Itu Singh, Vinay Kumar Pathak, Parul Goyal, Kabir Sardana, Sanjeet Panesar, Savitha Sharath

{"title":"Th17 and T Regulatory Cytokines in Serum, Lesional Skin, and Stimulated Peripheral Blood Mononuclear Cell Culture Supernatants from Type 1 Leprosy Reaction Patients.","authors":"Srishti Dabas, Ananta Khurana, Itu Singh, Vinay Kumar Pathak, Parul Goyal, Kabir Sardana, Sanjeet Panesar, Savitha Sharath","doi":"10.4269/ajtmh.24-0358","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0358","url":null,"abstract":"There are conflicting reports regarding the roles of T helper-17 (Th17) and T regulatory (Treg) cells in type 1 leprosy reactions (T1Rs). Also, literature on the correlation of immunological parameters with a validated scoring system and the effect of treatment on cytokines is lacking. Adult patients with untreated T1R and nonreactional spectrum-matched controls were included in the study for comparison of levels of Th17 and Treg pathway cytokines in serum, skin lesions (reactional), and peripheral blood mononuclear cells (PBMCs) culture supernatants. Venous blood samples were collected at baseline and after resolution of reaction (post treatment with nonsteroidal anti-inflammatory drugs [NSAIDs] or steroids) for serum cytokine estimation and PBMC stimulation assays, and lesional (reactional) skin biopsy for cytokine messenger RNA (mRNA) estimation. Thirty-two cases of T1R were recruited (23 patients completed follow-up). Serum levels of cytokines were not significantly different between cases and controls or between pre- and post-treatment samples. Tissue mRNA and Mycobacterium leprae (M. leprae) antigen-stimulated PBMC culture supernatant levels of Interleukin (IL)-17A, IL-17F, IL-6, and IL-23 were significantly higher in T1R than in controls. Levels of IL-10 and Transforming Growth Factor-beta (TGF-β) were comparable among the two groups. The levels of all cytokines were significantly reduced after treatment. There was no significant difference in magnitude of the fall between those treated with steroids versus NSAIDs. This study suggests heightened Th17 response in T1R, with a prominent inability of the regulatory cytokines IL-10 and TGF-β to control the associated inflammation. The dynamics of change after resolution of T1R were comparable between NSAID and oral steroid treatment groups.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543174","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}

引用次数: 0

Case Report: Oral Candidiasis in Acute Flaviviral Infection. 病例报告：急性黄病毒感染中的口腔念珠菌病

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0464

Mohammad Khalid, Prithvishree Ravindra, Praveen Kumar Tirlangi, Rachana Bhat, Chandrashekar Uk, Muralidhar Varma, Nitin Gupta

引用次数: 0

Sporotrichosis Presenting as a Severe Ulcer in an Elderly Diabetic Man. 一名老年糖尿病患者出现严重溃疡的孢子丝菌病

IF 1.9 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2024-10-29 DOI: 10.4269/ajtmh.24-0417

Xiujiao Xia, Zehu Liu, Hong Shen

引用次数: 0