American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Influence of Household Roof Types on the Development of Plasmodium vivax in Anopheles stephensi Mosquitoes.","authors":"Sangamithra Ravishankaran, Aswin Asokan, N A Johnson Amala Justin, Janani Surya R, Manu Thomas Mathai, Alex Eapen","doi":"10.4269/ajtmh.24-0243","DOIUrl":"10.4269/ajtmh.24-0243","url":null,"abstract":"<p><p>Urbanization and microclimate variation in cities can influence mosquito behavior and parasite development, thus affecting malaria transmission. This study investigates how the impact of microclimate variations due to household roof types can aid in the survival of Anopheles stephensi and the development of Plasmodium vivax in an urban slum setting. Understanding these vital environmental interactions is essential for devising effective control strategies to achieve malaria elimination. Anopheles stephensi (F1) mosquitoes were membrane-fed with blood collected from P. vivax-infected patients before (day 0) and during (day 1) antimalarial treatment. The parasite development and mosquito survival were monitored in simulated microclimatic conditions of a variety of household roof types (thatched, asbestos, tiled) against standard laboratory conditions. Mosquito dissections were undertaken to detect oocysts and sporozoites in An. stephensi mosquitoes (oocyst: day 3-5, sporozoites: day 7-11). The maximum number of oocysts were detected in infected mosquitoes in thatched-roof conditions, whereas the largest oocyst was in the asbestos roof type. Circumsporozoite-ELISA results indicated the presence of sporozoites in infected mosquitoes for up to 29 days under standard conditions, 18 days in thatched-roof and asbestos roof conditions, and 14 days in tiled conditions. The univariate binary logistic regression model indicated a significant influence of microclimatic conditions of thatched roofs on parasite development. The Kaplan-Meier survival analysis revealed that the median survival of P. vivax-infected An. stephensi in thatched-roof conditions was 14 days, followed by asbestos (11 days) and tiled (10 days) roof conditions. In conclusion, thatched-roof houses were favorable for the development and survival of P. vivax-infected An. stephensi.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"286-295"},"PeriodicalIF":1.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765722","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":"Hand Hygiene Knowledge and Hand Dirtiness Assessment to Inform Alcohol-Based Hand Rub Appropriateness in Community Settings in Uganda and Kenya.","authors":"Christiana Hug, Evelyn Makena Mugambi, Maureen Kesande, Caroline Pratt, Lorna Maru, Raymond Odinoh, Fred Tusabe, Matthew J Lozier, Victoria Trinies, Graeme Prentice-Mott, Alexandra Medley, Alexandra Kossik, Isaac Ngere, M Kariuki Njenga, Mohammed Lamorde, David Berendes","doi":"10.4269/ajtmh.24-0124","DOIUrl":"10.4269/ajtmh.24-0124","url":null,"abstract":"<p><p>During the coronavirus disease 2019 pandemic, alcohol-based hand rub (ABHR) availability and use increased as a prevention measure. ABHR is a convenient, effective way to kill microbes on hands but is hampered by the presence of organic material, whereas handwashing with water and soap (HWWS) can physically remove microbes and dirt. Although ABHR is preferred in most health care settings, the suitability of ABHR use in community settings has not been measured. We compared characteristics between community members and health care personnel (HCP) to inform considerations for promoting ABHR in community settings. We included data from community locations and health care facilities in Kenya and Uganda collected between 2021 and 2022. Hand dirtiness swabs were measured using the Quantitative Personal Hygiene Assessment Tool (qPHAT), a visual scale where 0 is very visibly dirty and 10 is no visible dirt. Participants were also asked about the appropriate method to use when hands were visibly dirty. Hand swabs were collected from HCP and community members. Both groups had median qPHAT scores of five. Neither the adjusted odds of having a qPHAT score less than or equal to five (1.4, 95% CI: 0.8-2.2) nor the adjusted odds of responding correctly to the knowledge question (0.8, 95% CI: 0.4-1.4) differed significantly by setting. People in community settings may, therefore, have comparable hand dirtiness and knowledge of appropriate hand hygiene practices to use ABHR as a HWWS complement. Further investigation into guidance and use of supportive messaging should be considered as completed elsewhere.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"441-450"},"PeriodicalIF":1.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765718","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":"Clinical Diagnosis of Acute Noma: Essential Infection Markers and Clinical Presentations.","authors":"Heron Gezahegn Gebretsadik","doi":"10.4269/ajtmh.24-0520","DOIUrl":"10.4269/ajtmh.24-0520","url":null,"abstract":"<p><p>In clinical settings, understanding the markers and clinical signs of infection is critical for timely diagnosis and treatment. However, a point-of-care diagnostic test is lacking for noma, a debilitating orofacial infectious disease. This retrospective study reviewed electronic medical records (EMRs) and paper medical records (PMRs) of noma patients from Facing Africa (235 EMRs), Yekatit 12 Hospital (68 PMRs), and Project Harar (33 PMRs) in Ethiopia to identify essential infection markers and clinical presentations of acute noma. The review identified seven acute noma patients aged 4-9 years. The patients presented with facial edema, pain, anorexia, ecchymosis, excessive salivation, and drooling, as well as specific symptoms such as visual disturbances, high fever, foul odor, halitosis, and local tenderness. Laboratory findings included elevated white blood cell counts (13,500-14,500 cells/mcL), C-reactive protein levels (107-148 mg/L), and erythrocyte sedimentation rates (65-90 mm/hour). At >85 ng/mL, procalcitonin levels were particularly high. Accurate diagnosis of noma requires a comprehensive approach that includes thorough clinical examination, appropriate disease stage classification, medical history review, and laboratory testing. The study highlights the critical infection markers and clinical presentations associated with acute noma that may aid in early diagnosis of the disease. Further research with a much larger number of participants is needed. However, given the difficulty in identifying acute noma cases due to the rapid progression and very high mortality of the disease and the challenge of accessing acute noma cases owing to various socioeconomic barriers, the results of this small study are still relevant.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765708","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":"A Case of Cryptococcosis Due to a New Cryptococcus Neoformans Sequence Type in a Patient with Human Immunodeficiency Virus Infection.","authors":"Fangfang Dai, Yanhua Yu, Jinli Lou, Xinxin Lu","doi":"10.4269/ajtmh.23-0818","DOIUrl":"10.4269/ajtmh.23-0818","url":null,"abstract":"<p><p>In this article, we report a male patient infected with HIV presenting with cryptococcal meningitis, pneumonia, and bloodstream infection, along with intestinal obstruction and gastrointestinal bleeding. Cerebrospinal fluid and bloodstream analyses revealed the presence of Cryptococcus neoformans complex. The isolated strain was sequenced and was found to belong to Cryptococcus neoformans var. grubii with a new sequence type (ST). The strain led to fatal multisystemic cryptococcosis in a short time, and the patient died due to hemorrhagic shock because of gastrointestinal bleeding despite emergency rescue efforts. There are few reports about cryptococcosis in HIV-infected patients caused by new ST isolates. We report a new Cryptococcus neoformans ST (ST702) isolate causing infection in an HIV-infected patient, which merits further study and clinical attention.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"373-376"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724577","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":"Splenic Modulation of Plasmodium vivax Relapses and Hypnozoite Activation during the Second World War?","authors":"G Dennis Shanks","doi":"10.4269/ajtmh.24-0465","DOIUrl":"10.4269/ajtmh.24-0465","url":null,"abstract":"<p><p>Despite their colonial experience with tropical medicine, Allied (United States, United Kingdom, Australia, and India) Armies in the Indo-Pacific region were surprised by the large number of Plasmodium vivax infections in their soldiers during the Second World War. Even after the institution of effective chemoprophylaxis with quinacrine, multiple cycles of clinical relapses often occurred when months of medication was discontinued. Nearly monthly symptomatic relapses (>10) were not unusual and resulted in important manpower losses after each campaign. Retrospective consideration suggests that small splenic size was associated with the risk of recurrent clinical episodes of vivax malaria. Potential non-mutually exclusive explanations for frequent relapses of vivax malaria in soldiers are reviewed. These include decreased retention of parasitized red blood cells by small spleens through greater filtration stringency preventing relapses from becoming clinically patent; small spleen size being a marker of lower innate and/or acquired immunity, modulating the risk of clinically patent recurrences; or small spleen size increasing the number of relapses through decreased removal of triggers of hypnozoite activation. Apparent splenic modulation of vivax malaria relapses suggests a complex interaction between the parasite and host that might be amenable to manipulation to facilitate malaria elimination.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"247-249"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724714","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":"One-Step Multiplex Polymerase Chain Reaction Assay for the Detection of Major Disease-Transmitting Mosquito Vectors in India.","authors":"Mintu Karan, Sharmistha Paul, Supriya Nath, Bedanta Das, Sanhita Ghosh, Suman Karmakar, Pritam Mandal, Biplab Bhowmik, Piyoosh Kumar Singh, Rajnikant Dixit, Chiranjib Pal","doi":"10.4269/ajtmh.24-0211","DOIUrl":"10.4269/ajtmh.24-0211","url":null,"abstract":"<p><p>Mosquitoes are important vectors that transmit viral, protozoan, and helminthic diseases across the world. Climate change and unplanned urbanization are accelerating the spread of these diseases. Controlling vector-borne diseases can be performed most effectively through vector control. Inadequate knowledge of vector bionomics is an impediment and can lead to inappropriate vector control efforts. However, the conventional methods of vector identification are based on morphological differences, demand a significant amount of time and specific skills, and are often misleading. An efficient and affordable solution is needed to quickly and accurately identify pooled samples from vast geographical territories. To ensure the correct identification of distorted or pooled samples in India, a set of definitive steps is required, including the construction of unique primers and the standardization of a one-step assay based on the second internal transcribed spacer gene of the ribosomal DNA. We have successfully developed and confirmed a highly efficient one-step multiplex reverse transcriptase polymerase chain reaction assay for the accurate identification of major mosquito vectors, especially in the cases of both the adult and larval forms of Anopheles sp., Aedes sp., and Culex sp. Hence, the specificity, universality, and uniqueness of these primers could serve as a critical tool for the rapid one-step and one-reaction identification of mosquitoes to control mosquito-borne disease outbreaks and public health emergencies.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"296-303"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724708","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":"Implementing SARS-CoV-2 Testing during a Large-Scale Sporting Event in Africa: Lessons Learned from the Africa Football Cup of Nations Tournament in Cameroon.","authors":"Boris K Tchounga, Boris Tchakounte Youngui, Emilienne Epée, Tatiana Djikeussi, Joseph Fokam, André P Goura, Loic Feuzeu, Muhamed Awulo Mbunka, Pallavi Dani, Shannon Viana, Anne Hoppe, Yap Boum, Rhoderick Machekano, Laura Guay, Anne-Cecile Zoung-Kanyi Bissek, John Ditekemena, Appolinaire Tiam, Alain G Etoundi, Patrice Tchendjou, Michelle M Gill","doi":"10.4269/ajtmh.23-0898","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0898","url":null,"abstract":"<p><p>During the 33rd Africa Cup of Nations (AFCON) football tournament in Cameroon, organizers and health authorities required a negative SARS-CoV-2 test result <48 hours before entry and provided free SARS-CoV-2 testing and vaccination at stadium and fan zone entrances. We describe the outcomes and implementation of mandatory SARS-CoV-2 testing at fan zones during AFCON. All consenting fan zones attendees were administered an electronic questionnaire capturing exposure factors, COVID-19-like symptoms, and COVID-19 vaccination status, before being tested for SARS-CoV-2 using an antigen rapid diagnostic test (Ag-RDT). Participants testing positive were sampled for confirmatory real-time SARS-CoV-2 polymerase chain reaction (PCR) and sequencing for variant surveillance. The case detection rate was estimated using PCR-confirmed cases, and the challenges were summarized from staff discussions and project/study documentation. In total, 4,820 fan zone attendees (median [interquartile range] age 30 [24-38], 27.7% females) were tested for SARS-CoV-2, including 1,228 (25.5%) fully vaccinated. Of 4,820 participants, 148 (3.1%) had a positive Ag-RDT result, of whom 67 consented to PCR testing and 19 of 64 (29.7%) were confirmed PCR-positive. The case detection rate was 40.1 (95% CI: 24.2-62.7) per 10,000 attendees. The Omicron variant (B.1.1.529) was found in all 11 samples successfully sequenced. The implementation of mandatory SARS-CoV-2 Ag-RDT at fan zone entrances was challenged by high attendance volume just prior to matches, lobbying of economic stakeholders, and inconsistent quality assurance when using test kits. Despite the challenges encountered, implementing mandatory SARS-CoV-2 Ag-RDT at fan zones, was a unique opportunity for SARS-CoV-2 case identification and genomic surveillance.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724703","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":"Current High Prevalence of Intestinal Parasitic Contamination in Fresh Vegetables in Northeast Thailand.","authors":"Worawan Poochada, Kodchakorn Uengchuen, Rittirong Junggoth, Tongpak Donprajum, Sakda Seesophon, Oranuch Sanpool, Pokkamol Laoraksawong","doi":"10.4269/ajtmh.24-0234","DOIUrl":"10.4269/ajtmh.24-0234","url":null,"abstract":"<p><p>Although fresh vegetables are a vital source of essential nutrients and dietary fiber, they can pose a significant health risk due to contamination by intestinal parasites (IPs). The consumption of contaminated vegetables can lead to intestinal parasitic infection, which is a major public health issue, particularly in tropical and subtropical regions, where sanitation, clean water, and agricultural practices are often inadequate. Northeast Thailand, with its warm, humid climate and predominant agricultural sector, exhibits a high prevalence of IPs in humans. This study aimed to determine the prevalence of intestinal parasitic contamination in vegetables in Khon Kaen, Thailand, because of its reported high prevalence of IPs. A total of 300 samples, including cilantro, celery, Thai basil, lettuce, cucumber, Chinese kale, white cabbage, Chinese cabbage, peppermint, and yard-long beans, were collected from 10 markets across five districts in the province. Each sample was washed with 1% normal saline, shaken for 15 minutes, and allowed to sediment. The sediment was then centrifuged and examined by parasitologists under a microscope. The overall prevalence of IPs was found to be 36.0%, with Blastocystis hominis (24.7%), Strongyloides stercoralis (13.0%), and Ascaris lumbricoides (8.7%) being the most common. Peppermint showed the highest prevalence rate at 70.0%, followed by celery and Thai basil at 53.3% each. These results suggest a necessity for key health policy interventions, including appropriate health education. Sanitary measures, such as washing vegetables before consumption and washing hands after harvesting vegetables, should be encouraged among farmers, sellers, and consumers.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"314-318"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724624","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":"Optimizing the Use of Severe Acute Respiratory Syndrome Coronavirus 2 Antigen Rapid Diagnostic Tests for the Timely Detection of and Response to COVID-19 in Schools and Markets in Uganda.","authors":"Jerry Mulondo, Susan Nayiga, Winnie Nuwagaba, Patience Nayebare, Jane Frances Namuganga, Isaac Ssewanyana, Moses R Kamya, Joaniter I Nankabirwa","doi":"10.4269/ajtmh.23-0758","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0758","url":null,"abstract":"<p><p>The early detection and management of infections is crucial to control epidemics. We evaluated the feasibility and utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen rapid diagnostic tests (Ag-RDTs) for the timely detection of and response to coronavirus disease 2019 in high-risk border communities in Uganda. Between May and September 2022, monthly cross-sectional surveys were conducted in 11 schools and two markets in two border districts. Only baseline and end-line testing were also performed in matched control communities. Antigen rapid diagnostic test results and demographic and clinical data were collected, and contacts of patients were traced and tested. All patients were advised to self-isolate, and compliance was assessed on day 5. We enrolled 10,406 participants out of 10,472 screened individuals. The participants had a 1.3% test positivity rate, with schools recording higher, but non-significant, positivity rates than markets (1.4% versus 0.9%; P = 0.149). We tracked 556 contacts, and 536 (96.4%) agreed to test. The test positivity rate was significantly higher among contacts than the index participants (8.8% versus 1.3%; P <0.001). Only 55 (29.7%) of the index participants self-isolated effectively. Settings that received monthly testing had lower end-line positivity rates than controls (0.3% versus 1.4%; P = 0.001). Repeated SARS-CoV-2 Ag-RDT testing is feasible and could reduce SARS-CoV-2 infections. However, the participation in testing may have been enhanced by the compensation provided. Also, isolation was limited, which may reduce the impact of the intervention when rolled out on a large scale. Innovative strategies to increase the isolation of patients could improve the utility of early testing for transmission reduction during epidemics.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724711","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":"Malaria, Dengue Fever, and Leptospirosis in the Urabá Antioqueño Region, Colombia: Etiological and Molecular Characterization among Patients with Acute Undifferentiated Febrile Illness.","authors":"Nicaela Restrepo-López, Carlos Ramiro Silva-Ramos, Juan David Rodas, Margarita Arboleda, Diana Fernández, Pablo Uribe-Restrepo, Piedad Agudelo-Flórez, Alberto Tobón-Castaño, Marylin Hidalgo, Peter C Melby, Patricia V Aguilar, Miguel M Cabada, Francisco J Díaz","doi":"10.4269/ajtmh.24-0490","DOIUrl":"10.4269/ajtmh.24-0490","url":null,"abstract":"<p><p>Acute undifferentiated febrile illness (AUFI) is the main cause of medical attention in the tropics worldwide. Malaria, arboviral diseases, and leptospirosis are the most important etiologies. These are highly endemic in the Urabá antioqueño, Colombia, being the main causes of fever in several municipalities in this region. However, up-to-date data regarding the infecting species and serotypes are lacking. Thus, we characterized the etiology of AUFI, focusing on malaria, arboviruses, and leptospirosis in this region and the circulating infecting species. An active surveillance was conducted between January and April 2022, and July and October 2023 in two local hospitals in the Urabá antioqueño. Febrile patients were enrolled voluntarily. Malaria, arboviral diseases, and leptospirosis were screened through direct, serological, molecular, and rapid diagnostic methods. Amplicons obtained for dengue virus (DENV) and Leptospira spp. were analyzed through phylogenetic analysis. A total of 184 febrile patients were enrolled. A confirmed etiology was detected in 43.4% of patients from Apartadó and 61.2% from Turbo. Malaria was the most frequent cause in both municipalities, which was caused mainly by Plasmodium falciparum in Apartadó and Plasmodium vivax in Turbo. Dengue virus serotype 1 genotype V, DENV genotype Asian-American, and DENV genotype Cosmopolitan were identified, as well as pathogenic Leptospira species closely related to Leptospira santarosai and Leptospira noguchii. The present study confirms the importance of malaria, dengue fever, and leptospirosis in the Urabá antioqueño. Plasmodium falciparum and P. vivax were identified, as well as two DENV serotypes and three DENV genotypes and two different Leptospira species.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"403-413"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724706","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}