American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Characterization of Rheumatic Manifestations in Hansen's Disease: A Standardized Approach among Patients from Puerto Rico.","authors":"Luis M Vilá, Pedro D Gil de Rubio Cruz, Andrea B Lastra-Annexy, Naydi Perez-Ríos, Sonia M Santos-Expósito, Natalia Pelet Del Toro, Aida L Quintero-Noriega","doi":"10.4269/ajtmh.25-0662","DOIUrl":"10.4269/ajtmh.25-0662","url":null,"abstract":"<p><p>Rheumatic manifestations are the third most common clinical features of Hansen's disease (HD), after cutaneous and neurological involvement. However, few studies have systematically characterized these manifestations, and most lack appropriate controls and standardized assessments. To address this gap, the present cross-sectional study was conducted to evaluate the rheumatic manifestations associated with HD. The study included 23 patients with HD and 23 age- and sex-matched non-HD controls from Puerto Rico. All participants underwent a standardized evaluation and examination for rheumatic features. Demographic data, clinical manifestations, comorbidities, and pharmacologic treatments were documented. Statistical analyses were performed using bivariate methods. The mean (SD) age of HD patients was 51.3 (15.7) years, and 60.8% were female. Regarding treatment status, 8.7% had received <1 year of multidrug therapy (MDT), 8.7% had received at least 1 year of MDT, and 82.6% had completed therapy. Overall, 87% of HD patients presented with rheumatic manifestations, most commonly arthralgia (73.9%) and arthritis (69.6%). Compared with controls, HD patients exhibited a significantly higher proportion of arthritis, particularly involving the small joints of the hands, as well as tendinopathy, dactylitis, and swollen hand and foot syndrome. These manifestations were significantly associated with leprosy reactions and multibacillary disease. In conclusion, rheumatic manifestations were present in 87% of HD patients, with several being significantly more frequent than in controls. Moreover, a substantial proportion of patients continued to experience persistent rheumatic manifestations despite receiving or completing MDT. Given their potential to substantially impair functional status, these manifestations should be recognized early to ensure timely and appropriate management.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"624-628"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281959","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":"Non-Aeruginosa Pseudomonas Species Isolated from Bacteremia Patients at a Tertiary Care Center in India: A Retrospective Study.","authors":"Surbhi Singh, Gerlin Varghese, Nidhi Tejan, Ashima Jamwal, Akshay Arya, Deepika Sarawat, Sangram Singh Patel, Chinmoy Sahu","doi":"10.4269/ajtmh.25-0545","DOIUrl":"10.4269/ajtmh.25-0545","url":null,"abstract":"<p><p>Human infection with non-aeruginosa Pseudomonas (NAP) is not commonly observed but can be severe and associated with significant morbidity and mortality. The aim for the present study was to investigate the prevalence, patient characteristics, risk factors, and clinical presentation of patients with NAP bacteremia. Additionally, the antibiotic sensitivity patterns of NAP isolates were assessed. The current retrospective study was conducted in the microbiology laboratory of a tertiary care center from January 2022 to October 2024. Two sets of blood cultures were received in BACTEC bottles (Becton, Dickinson and Company, Franklin Lakes, NJ) and were incubated. The blood samples were cultured on blood and MacConkey agar, and microscopy was performed using Gram staining. Species identification was performed via matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Antibiotic sensitivity testing was performed using meropenem, colistin, levofloxacin, amikacin, piperacillin-tazobactam, imipenem, aztreonam, ceftazidime, and cefoperazone-sulbactam. During the 2-year study period, 42 blood cultures grew Pseudomonas species other than Pseudomonas aeruginosa. The majority of patients were <60 years of age (76.1%). The age range of the population was 4-75 years. The male-to-female ratio of the population was 1.1:1. In this study, most isolates belonged to Pseudomonas mosselii (n = 13; 31%), followed by Pseudomonas stutzeri (n = 11; 26.1%), Pseudomonas putida (n = 9; 21.4%), Pseudomonas fluorescens (n = 5; 11.9%), and Pseudomonasalcaligenes (n = 3; 7.1%). The most common risk factors were the presence of a central venous catheter (n = 34; 81%) and mechanical ventilation (n = 25; 59.5%). Among the Pseudomonas mosellii isolates, the highest resistance was observed to meropenem (70%), imipenem (70%), and ceftazidime (70%). Timely diagnosis and treatment can help in reducing mortality and morbidity among NAP bacteremia patients.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"633-638"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281934","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":"Tuberculosis-Immune Reconstitution Inflammatory Syndrome During Tuberculosis Treatment.","authors":"Melis Deniz, Özge Kaba, Ercan Ayaz, Ayşe Pervanlar Kakışım, Burak Kocaağa, Nurhayat Yakut, Canan Caymaz","doi":"10.4269/ajtmh.25-0641","DOIUrl":"10.4269/ajtmh.25-0641","url":null,"abstract":"<p><p>Pediatric patients with tuberculosis who are not infected with HIV may still be at risk of developing tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) during treatment. A case of TB-IRIS in an immunocompetent child with pulmonary tuberculosis is reported. On the 25th day of standard antituberculosis therapy, the patient experienced continuous fever and clinical deterioration, and new lesions were detected on follow-up radiographic imaging. Upon initiation of corticosteroid therapy, the patient showed marked clinical improvement and resolution of fever. This case highlights the importance of recognizing TB-IRIS in immunocompetent pediatric patients. After alternative causes are excluded, TB-IRIS should be suspected in children with tuberculosis who develop new or worsening symptoms accompanied by newly emerging radiological findings.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"629-632"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282000","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":"When the Cord Falls Off Early, We the Mothers Can Come Out of Confinement: Newborn Cord Care Practices in Urban Slums in Accra, Ghana.","authors":"Edward Akolgo Adimazoya, John Kumuuori Ganle, Emmanuel Asampong, Franklin Glozah, Philip Baba Adongo","doi":"10.4269/ajtmh.24-0706","DOIUrl":"10.4269/ajtmh.24-0706","url":null,"abstract":"<p><p>In Ghana, neonatal deaths account for >60% of infant deaths. Few studies have focused on umbilical cord care in Ghana's urban slums. This paper examines newborn cord care practices among mothers in two large urban slums in Accra, and the data come from a concurrent mixed-methods cross-sectional study. A quantitative survey was conducted among 279 randomly sampled mothers ages 15-49 years with live neonates. The qualitative component was conducted among women ages 15-49 years with live neonates, traditional birth attendants, community leaders, and public health managers who were purposively sampled. Descriptive analyses were used to describe cord care practices. Bivariate and multiple logistic regression analyses assessed factors associated with cord care practices at the 95% confidence level (CI). Qualitative data were analyzed thematically. Overall, the prevalence of appropriate cord care practices was low (28.3%). Despite a policy shift from the use of methylated spirit to chlorhexidine, >81% of mothers reported using methylated spirit for cord management. The adjusted odds of newborns receiving appropriate cord care (AOR: 2.82; 95% CI: 1.13-7.07; P = 0.027) were significantly greater among mothers who had skilled deliveries than among deliveries involving unskilled attendants. Mothers residing within a radius of 3-5 km of the nearest facility were more likely than those living within a 1-2 km radius (AOR: 2.34; 95% CI: 1.14-4.77; P = 0.020) to practice appropriate cord care. Improving cord care in slums requires strengthening antenatal care services and skilled delivery.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"756-766"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281952","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":"Artificial Intelligence and Public Health Data in Emergencies: A Critical Issue in the Middle East.","authors":"Osama Ali Maher, Giuseppe Pichierri, Christian Popescu, Saverio Bellizzi","doi":"10.4269/ajtmh.25-0721","DOIUrl":"10.4269/ajtmh.25-0721","url":null,"abstract":"<p><p>Timely access to reliable public health data is a critical determinant of effective response to health emergencies, including disease outbreaks, climate-related health shocks, and humanitarian crises. Although artificial intelligence (AI) has been promoted for its potential to enhance outbreak prediction, situational awareness, and resource allocation, its effectiveness depends on the speed, quality, and accessibility of underlying data systems. Inequities in digital infrastructure, particularly in low- and middle-income settings, undermine prompt public health data management and in turn weaken emergency response capacity. With examples from epidemics, climate-related health emergencies, and conflict-affected settings in and beyond the Middle East, we examine how delays arise across public health data transmissions that include reliance on paper-based data collection, fragmented and incompatible databases, linguistic barriers in non-English data processing, dependence on externally hosted cloud infrastructure, and vulnerability to telecommunications shutdowns. Geographical concentration of data centers in high-income regions compounds these challenges by introducing latency into time-critical data processing and limiting local control over surveillance and analytics. Case studies from Yemen, Iraq, Sudan, and regional refugee responses illustrate how such delays erode surveillance data operational value, rendering early warning systems reactive rather than anticipatory. In contrast, settings with locally hosted, interoperable, and resilient digital infrastructure demonstrate the capacity for nearly immediate analysis and faster public health action. AI should be understood not as a standalone solution but as a downstream tool within a broader public health data ecosystem. Strengthening local digital infrastructure and governance is thus essential for timely, equitable, and effective public health emergency management.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"606-608"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281941","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":"Interrater Reliability of Electroencephalogram Interpretations in Febrile Comatose African Children: Implications for Automated Interpretation Algorithm Creation.","authors":"Mrinmayee Takle, Alexander Andrews, Tesfaye Zelleke, Dana B Harrar, John Barber, Elizabeth Kalanga, Gladys W K Mkandawire, Cynthia Manyozo, Monica Sapuwa, Charlotte Fuller, Michael J Griffiths, Stephen T J Ray, Douglas G Postels","doi":"10.4269/ajtmh.25-0685","DOIUrl":"10.4269/ajtmh.25-0685","url":null,"abstract":"<p><p>Electroencephalography (EEG) is a diagnostic and prognostic tool used worldwide in the clinical care of comatose patients. Scalability of EEG use in resource-limited settings is constrained by multiple factors, including the lack of neurophysiologist interpreters. Although machine learning offers a path to creation of automated interpretation algorithms, development is constrained by the need for independent inputs from multiple neurophysiologists. Development may be accelerated if independent inputs have high concurrence. We assessed interrater reliability of key EEG variables from studies recorded from febrile comatose African children to better understand the need for numbers of inputs required in the development of future machine learning-driven EEG interpretation algorithms. Two independent electrophysiologists interpreted 171 electroencephalograms from children in febrile coma using standard methods. Interrater reliability was highest for the presence of electrographic seizures, with overall agreement of 96.5% and kappa of 0.781 (95% CI: 0.612-0.950). Electroencephalography variables commonly used in prognostication for cerebral malaria, a common cause of febrile coma, also had high agreement rates. Electroencephalography interpretation in Malawian children with febrile coma offers high interrater reliability in key variables used to guide clinical care and estimate prognosis. This suggests that automated interpretation methods could be developed using limited numbers of human expert trainers, accelerating development of data-driven diagnostic and prognostic algorithms for resource-limited locations. Deployment of automated EEG diagnostic and prognostic interpretation algorithms for use in high-disease-burden, low-resource settings would aid in the clinical care of febrile comatose children, increasing the possibility of favorable clinical outcomes.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"774-779"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479558","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 in Uropathogens at the University Teaching Hospital of Kigali, Rwanda: A 5-Year Surveillance Study.","authors":"Jean Bosco Munyemana, Gilbert Uwizeyimana, Marie Claire Ndayisaba, Angelique Dusabe, Masceline Jenipher Mutsaka-Makuvaza, Jean Paul Sinumvayo, Evelyne Kantarama, Nicolas Rubambana, Louise Mwiseneza, Innocent Hahirwa, Belson Rugwizangoga, Florence Masaisa, Martin Nyundo, Tharcisse Mpunga","doi":"10.4269/ajtmh.25-0558","DOIUrl":"10.4269/ajtmh.25-0558","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are a global health concern exacerbated by rising antimicrobial resistance (AMR), especially in developing countries where empirical therapy is common. Untreated UTIs can progress to sepsis with a poor prognosis. Understanding local AMR profiles of uropathogens is crucial for effective UTI treatment. This study aimed to identify the predominant uropathogens and determine their AMR profiles against a range of commonly used antimicrobials. This study was a 5-year retrospective cross-sectional surveillance study conducted on urine cultures processed from January 1, 2020 to December 31, 2024 at the University Teaching Hospital of Kigali. In total, 2,921 positive urine cultures and their antimicrobial susceptibility testing results were recorded and analyzed by pathogen and across care settings. Descriptive statistics were used to summarize the data. Associations were evaluated at a 5% significance level. This study found that among 2,921 isolates, Escherichia coli (64%) and Klebsiella pneumoniae (22.9%) were the predominant uropathogens. High resistance rates were observed against commonly used antibiotics, such as amoxicillin-clavulanic acid (>88%), third-generation cephalosporins (51-75%), and fluoroquinolones (∼55%) in both species, with K. pneumoniae showing a more extensive resistance profile. Conversely, the isolates were less resistant to carbapenems (imipenem and meropenem) and amikacin (<20%) across care settings. The findings reveal a significant burden of multidrug-resistant gram-negative pathogens at the University Teaching Hospital of Kigali, underscoring the urgent need for enhanced antimicrobial stewardship and sustained surveillance. Such measures are essential to preserve the efficacy of critical antibiotics, particularly carbapenems and aminoglycosides, and to guide effective clinical management.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"648-653"},"PeriodicalIF":1.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281966","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":"Local Surveillance Identifies High-Priority Gram-Negative Pathogens to Guide Antibiotic Stewardship in Ghana: A Cross-Sectional Study.","authors":"Gloria Amegatcher, Johnson Adu, Edwina Wilma Arcton, Esther N Okine, Thomas Kwesi Dankwah, Mary-Magdalene Osei, Isaac Kwame Sraku, Marjorie Ntiwaa Quarchie, Andrews Abedi Ofosu, Vincent Amarh, Moses Banyeh, Eric S Donkor","doi":"10.4269/ajtmh.25-0627","DOIUrl":"10.4269/ajtmh.25-0627","url":null,"abstract":"<p><p>Gram-negative pathogens are notable causes of diverse human infections. This study determined the antibiotic sensitivity profile of clinical isolates of gram-negative bacteria to provide insights into high-priority pathogens that are potential threats to public health in Ghana. Gram-negative isolates from urine, stool, wound, and blood samples of consenting participants were tested against 10 antibiotics using the Kirby-Bauer disc diffusion method. Escherichia coli and Klebsiella pneumoniae were the predominant bacteria isolated from the study participants. Resistance to colistin (4%) and meropenem (20%) was less prevalent, whereas isolates resistant to ampicillin (94%), tigecycline (85.5%), and chloramphenicol (76%) were widespread in the study participants. Acinetobacter baumannii exhibited the highest resistance phenotype among the clinical isolates of Gram-negative bacteria. Our data highlight the ineffectiveness of tigecycline, ampicillin, and chloramphenicol against several gram-negative pathogens isolated from the study participants. The utilization of meropenem and colistin should be strongly monitored to avoid misuse because they represent effective antibiotics for treatment of gram-negative infections.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"639-643"},"PeriodicalIF":1.6,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212010","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":"Interventions to Prevent Post-Discharge Mortality among Children in Sub-Saharan Africa: A Systematic Review.","authors":"Kaitlin Cole, Ramya Ginjupalli, Karim P Manji, Rodrick Kisenge, Adrianna Westbrook, Quique Bassat, Rosauro Varo, Lola Madrid, Inacio Mandomando, Claudia R Morris, Hannah Rogers, Nega Assefa, Richard Omore, Victor Akelo, Kitiezo Aggrey Igunza, Christopher P Duggan, Chris A Rees","doi":"10.4269/ajtmh.25-0567","DOIUrl":"10.4269/ajtmh.25-0567","url":null,"abstract":"<p><p>Post-discharge mortality (PDM), defined as deaths that occur in the weeks and months after hospital discharge, remains a critical, yet under-recognized, contributor to high childhood mortality rates in sub-Saharan Africa. However, a comprehensive understanding of effective interventions to prevent PDM is lacking. The aim for the present study was to evaluate the efficacy of published interventions to prevent PDM among neonates and children aged 0-18 years in sub-Saharan Africa. A systematic review was conducted to assess the efficacy of interventions for preventing PDM. The CABI Global Health, Cochrane Reviews, Cochrane Trials, ProQuest Dissertations and Theses, Embase, PubMed, and Web of Science databases were searched without language restriction. Publications that involved interventions for preventing PDM, included children, and were conducted in sub-Saharan Africa were included in the present study. Of 4,893 publications screened, 17 were included, with 12,938 participants in total (10.6% experienced PDM). The most common interventions included supplemental feeding programs, kangaroo mother care, antibiotic use, and micronutrient supplementation. Effectiveness varied within and between intervention types. Only two interventions resulted in statistically significant reductions in PDM: vitamin A supplementation for children with pneumonia (hazard ratio: 0.51; 95% CI: 0.29-0.90; low quality of evidence) and linkage to services for children with sickle cell disease (adjusted hazard ratio: 0.26; 95% CI: 0.08-0.83; low quality of evidence). No single intervention type provided consistent benefits across studies. Most interventions targeted children with specific diagnoses; however, some strategies addressed social determinants of health. Future research must prioritize cost-effective, scalable strategies across diverse sub-Saharan African settings to accelerate the prevention of PDM among children.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"787-795"},"PeriodicalIF":1.6,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211974","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":"Orientia tsutsugamushi a Likely Contributor to Stillbirths and Neonatal Deaths in Bangladesh, 2017-2024.","authors":"Muntasir Alam, Arpita Shyama Deb, Afsana Afrin, Afruna Rahman, Kazi Munisul Islam, M Ishrat Jahan, Rajib Biswas, Shammi Akter, Mohammad Sabbir Ahmed, Atique Iqbal Chowdhury, Mohammad Zahid Hossain, Mustafizur Rahman, Shams El Arifeen, Emily S Gurley","doi":"10.4269/ajtmh.25-0389","DOIUrl":"10.4269/ajtmh.25-0389","url":null,"abstract":"<p><p>Scrub typhus, caused by Orientia tsutsugamushi, is a mite-borne infection endemic to Asia, the Pacific Islands, and northern Australia. This study reports the first detection of O. tsutsugamushi DNA in postmortem specimens from stillbirths and neonatal deaths collected through the CHAMPS surveillance project from 2017 to 2024 in Bangladesh. O. tsutsugamushi DNA was detected in 11 cases including 1.7% of stillbirths (n = 461) and 0.7% of neonates (n = 443). Ninety percent of these deaths occurred between August and January; among stillbirths, detection was highest in cerebrospinal fluid samples (87.5%). Most stillbirths were preterm (75%) with low birth weight (87.5%), and maternal history of fever was recalled in 83.3% of stillbirth cases. These findings suggest scrub typhus may contribute to perinatal mortality in Bangladesh's endemic regions. Scrub typhus is treatable with inexpensive antibiotics such as doxycycline; early recognition and treatment could potentially reduce stillbirths and neonatal deaths in endemic areas.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"654-661"},"PeriodicalIF":1.6,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211969","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}