American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Electronic Clinical Decision Support Tools to Manage Patients with Lower Respiratory Tract Infection: Clinicians' Perspectives in Sri Lanka.","authors":"Warsha De Zoysa, Dhammika Palangasinghe, Champica Bodinayake, Ajith Nagahawatte, Jayani Gamage, Maria Iglesias-Ussel, Stefany Olague, Christina Galdieri, Ruvini Kurukulasooriya, Senali Weerasinghe, Madureka Premamali, James Ngocho, Armstrong Obale, Hrishikesh Chakraborty, Truls Ostbye, Susanna Naggie, Christopher W Woods, Evan Myers, Melissa H Watt, L Gayani Tillekeratne","doi":"10.4269/ajtmh.24-0576","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0576","url":null,"abstract":"<p><p>In low-resource settings, providers often manage lower respiratory tract infections (LRTIs) without diagnostic tests, which may cause antibacterial overuse. Electronic clinical decision support tools (eCDSTs) can support evidence-based decision-making and judicious use of antibacterials. This study aimed to explore the potential of an eCDST to help providers in Sri Lanka effectively manage LRTI. Semi-structured interviews were conducted with 15 clinicians, including 10 males and five females, with an average of 11.6 years (range: 4-25 years) of clinical practice. The interview guide covered clinicians' interest in an eCDST to manage LRTI and their feedback regarding the desired features of such a tool. Interviews were audio-recorded, transcribed, and coded for themes related to: interest in an eCDST for LRTI, desired tool capabilities, development concerns, and tool design characteristics. All expressed interest in incorporating eCDSTs into their practice. However, the majority emphasized that clinical judgment must supersede recommendations from an eCDST. Four themes emerged regarding desired tool capabilities: information about the pathogen, treatment recommendations, severity of the LRTI, and monitoring of patient progress. Six themes emerged regarding tool development considerations: validated algorithms, regional specificity, seasonality, inclusion of patient's risk factors, scalability, and the importance of updated and locally relevant recommendations. Participants stressed that the tool design should be simple, timesaving, and internet-independent. Electronic clinical decision support tools are capable of improving patient care and reduce antibiotic overuse, which may impact downstream antibacterial resistance. Future research should develop an eCDST for LRTI with local input and evaluate its impact on appropriate antibacterial use and patient outcomes.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603577","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":"From Bites to Bytes: Evaluating User Engagement and Mosquito Bite Exposure Patterns with the Bite Diary Smartphone Application.","authors":"Panpim Thongsripong, Yasmin V Ortiz, Simon A Casas, Eva A Buckner","doi":"10.4269/ajtmh.24-0575","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0575","url":null,"abstract":"<p><p>Mosquito-borne diseases, including malaria, dengue, chikungunya, and Zika, significantly impact global health. Traditional methods for monitoring human-mosquito contact, such as human landing catch (HLC) and DNA profiling, have limitations, including biases and a lack of detailed temporal and spatial data. HLC may also raise ethical concerns in some settings. To address these challenges, we developed Bite Diary, a smartphone app for systematically recording mosquito bite exposure. Research participants in eastern Florida attended workshops to learn about the project and mosquito identification. They then used a pilot version of Bite Diary over predefined 7-day periods to log mosquito bites, providing data on bite frequency, timing, and context. Finally, they completed an online questionnaire post-monitoring. The study found high levels of participant engagement, and the technical usability of the app was well-received. The estimated bite exposure rate was 0.62 mosquito bites per person per day (SD = 1.63), with 94% of bite records occurring outdoors. A significant correlation was observed between repellent use and self-reported bite reactions. Several design and interface elements requiring improvement were identified for future studies to reduce survey biases. These findings highlight the utility of bite surveys in evaluating human factors that affect mosquito bite exposure and enhancing our understanding of human-mosquito interactions. Our use of a no-code app builder for Bite Diary may enable other research groups to easily create similar surveys, broadening the potential for bite data collection in diverse settings. This tool could significantly aid in developing targeted strategies for mosquito-borne disease prevention and control.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603579","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":"The Seroprevalence and Risk Factors for Spotted Fever Group and Typhus Group Rickettsia Along the Texas-Mexico Border.","authors":"Frederick M Cramer, Lauren M Leining, Timothy A Erickson, Josephine Tolan, Craig L Hanis, Eric L Brown, Sarah M Gunter","doi":"10.4269/ajtmh.24-0528","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0528","url":null,"abstract":"<p><p>Rickettsial pathogens are an endemic and emergent source of disease in Texas, with a historically high rate of transmission along the United States-Mexico border. To better understand the prevalence and risk factors for spotted fever group Rickettsia (SFGR) and typhus group Rickettsia (TGR) along the Texas-Mexico border, we conducted a seroprevalence study of adults residing in Starr County, Texas (N = 616). Plasma samples were screened for IgG reactivity to SFGR and TGR using commercially available ELISA. ELISA-positive samples were confirmed using a dual spot IgG indirect immunofluorescent assay. Seropositivity was defined as having a ≥1:128 titer. Analysis was conducted to assess risk factors associated with seropositivity. A higher seroprevalence of TGR (10.9%) was identified compared with SFGR (4.6%) and Rickettsia unspecified (2.0%). These findings add to the growing body of evidence suggesting that both SFGR and TGR are endemic along the Texas-Mexico border.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603590","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":"Occurrence of Melioidosis in an Adult Patient in Baja California Sur, México, After Hurricane Norma in October 2023.","authors":"Alfredo Ojeda-Garmendia, Saul Bladimir Castro-Durán, Cecilia Morales-de La Peña, Alma Delia Ojendis-Ojendis, Violeta Larios-Serrato, Georgina Meza-Radilla, J Antonio Ibarra, Paulina Estrada-de Los Santos","doi":"10.4269/ajtmh.24-0566","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0566","url":null,"abstract":"<p><p>Melioidosis, caused by Burkholderia pseudomallei, is an emerging infectious disease in Mexico. In November to December 2023, five cases of melioidosis were reported in Baja California Sur, Mexico, after Hurricane Norma. Burkholderia pseudomallei was isolated from the five patients, four of whom died. This report presents the survival case.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603586","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":"Development of Coup de Sabre in an HIV-Positive Patient: A Case Study from Lilongwe, Malawi.","authors":"Katherine Naeger, Kia Quinlan, Kelvin Jobo, Marietta DeGuzman, Brigid E O'Brien, Jacob L Todd","doi":"10.4269/ajtmh.24-0580","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0580","url":null,"abstract":"<p><p>Coup de Sabre is a subset of localized linear scleroderma disease influenced by autoimmune, vascular, and genetic factors. The disease often follows an active, relapsing, and remitting course causing the development of permanent sequelae, such as tissue atrophy, pigment alterations, and bony deformities. Treatment strategies have ranged from surgical to injectable and medical management approaches with varying success. Although more common in pediatric patients, Coup de Sabre remains rare, with limited literature available on disease course and treatment outcomes, particularly in the sub-Saharan African population. Furthermore, the existence of autoimmune conditions occurring simultaneously with HIV infection presents an interesting discussion of the interplay between antiretroviral medication, immune dysregulation, and autoimmunity. This case report describes an 11-year-old HIV-positive male in Lilongwe, Malawi with mixed subtype of localized scleroderma manifesting most prominently as Coup de Sabre that remained undiagnosed for 7 years.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603575","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":"Physicians' Perspectives Regarding Informal Health Practitioners in Bangladesh.","authors":"Zahid Hasan Khan, Olivia R Hanson, Mohammad Ashraful Amin, Ishtiakul I Khan, Debashish Biswas, Md Taufiqul Islam, Eric J Nelson, Aparna Mangadu, Firdausi Qadri, Melissa H Watt, Daniel T Leung, Ashraful Islam Khan","doi":"10.4269/ajtmh.24-0597","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0597","url":null,"abstract":"<p><p>Rural Bangladesh faces challenges of limited health care resources and a shortage of health care professionals. Informal providers, particularly village doctors, fill this void by being a first point of care and a bridge to the formal health care system. This study explores formally trained physicians' perspectives on village doctors' role in the health care system. This qualitative study was conducted in southeast Bangladesh and included 12 individual in-depth interviews with physicians. Data were analyzed using applied thematic analysis, focusing on both the contributions and shortcomings of village doctors. Three themes emerged for positive contributions of village doctors: 1) provision of essential services and resources in isolated areas, 2) enhanced accessibility and familiarity with the community, and 3) active involvement in public health education. Five themes emerged related to the shortcomings and negative impacts of village doctors: 1) insufficient education and training, 2) use of inappropriate treatments, 3) inappropriate referrals, 4) misuse and overuse of antibiotics, and 5) prioritization of financial gain. This study sheds light on the complex interplay between formal and informal health care providers, emphasizing both the contributions and shortcomings of village doctors in rural health care settings.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603588","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":"Geospatial Analysis of Hymenolepis (Rodentolepis) nana Infection Transmission in Schools among Children in Cusco, Peru.","authors":"Melinda B Tanabe, Maria Caravedo Martinez, Maria L Morales, Martha Lopez, Miguel M Cabada","doi":"10.4269/ajtmh.24-0615","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0615","url":null,"abstract":"<p><p>Hymenolepis nana is an emergent parasitosis, and the role of schools in infection transmission is unclear. Data from a cross-sectional study evaluating children for H. nana infection in schools in three districts of Anta province in Peru were analyzed. Geospatial information from the children's residence and school was obtained. A total of 2,961 children were included from 51 different schools. The median age was 9.6 years old (interquartile range [IQR]: 6.8-12.4), 1,479 (50%) were female, and the median H. nana prevalence per school was 15% (IQR: 3.61-24.20). Regression analysis demonstrated that those living in Ancahuasi and Zurite and those with higher poverty score and higher residence altitude were more likely to reside on a hot spot than a cold spot based on residence distribution, whereas being of school age was protective. Children living in low-risk areas (nonhot spots) who were attending schools with higher prevalence of H. nana (≥15%) were less likely to reside in Ancahuasi or Zurite than in Anta, had lower paternal education, and were older than 6 years of age. Our study shows that schools have a role in infection transmission among children in the highlands of Peru.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603584","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":"Advocate: A Tribute to Karen A. Goraleski.","authors":"Chandy C John, Patricia F Walker, Daniel G Bausch","doi":"10.4269/ajtmh.25-0090","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0090","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565588","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":"Successful Integration of Community-Based Rapid Antigen Testing for COVID-19 and Malaria in Mali.","authors":"Guillaume Breton, Issouf Maïga, Aboubacar Maïga, Gabrièle Laborde Balen, Luis Sagaon-Teyssier, Anne Hoppe, Odé Kanku Kabemba, Boubacar Cissé, Fatou Diawara Traore","doi":"10.4269/ajtmh.23-0855","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0855","url":null,"abstract":"<p><p>In Mali, access to health care facilities (HCFs) is limited due to distance and transportation costs, and this limitation may have led to an under detection of COVID-19 cases. This prospective randomized study compared a community-based, integrated COVID-19 and malaria testing strategy (intervention arm) to the national standard-of-care strategy (SOC arm). Four health areas were randomly assigned. All people seeking care who accepted the study were enrolled by community health workers (CHWs) and screened for COVID-19 symptoms. In the intervention arm, CHWs performed COVID-19 and/or malaria antigen rapid diagnostic tests (Ag-RDTs) for patients who met clinical criteria for possible COVID-19, including fever. In the SOC arm, CHWs referred patients who met clinical criteria for possible COVID-19, including fever, to the nearest health care facility (HCF) in where COVID-19 and/or malaria Ag-RDTs were performed. Febrile patients refusing referral were tested for malaria by CHWs. Among 1,164 patients enrolled, 73% had fever and 72% meet clinical criteria for possible COVID-19. Malaria Ag-RDTs were performed in 79% and 3% COVID-19 suspected patients in intervention and SOC arms, respectively (P <0.001). Only three patients tested positive for COVID-19. Among 449 patients referred to HCFs, 248 refused to go tho the HCFs, and only 10 of 201 who agreed to the referral actually reached one. Among febrile patients, 75% and 34% received malaria treatment in intervention and SOC arms, respectively (P <0.001). Integration of community-based testing for COVID-19 and malaria Ag-RDTs was found to be feasible. However, limited access to HCFs in rural areas highlights the need for treatment services to be available at the community level.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565593","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":"Acute-Subacute Paracoccidioidomycosis.","authors":"Carlos McFarlane, Omayra Chincha, Carlos Seas","doi":"10.4269/ajtmh.24-0563","DOIUrl":"10.4269/ajtmh.24-0563","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555610","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}