American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Perceived Efficacy and Acceptability of a Spatial Repellent for Malaria Control in Western Kenya: Lessons from a Qualitative Social Science Study Conducted in Conjunction with an Epidemiological Efficacy Trial.","authors":"Steven A Harvey, Sheila M Ekodir, Lucy Baker, Julius I Odero, Moureen Ekisa, Jane Ikapesi, Samantha W Tsang, Albert Casella, Kaci McCoy, Anna Passaniti, Quentin Awori, Bernard Abong'o, Brian Polo, Vincent Moshi, Sean Blaufuss, Manothri Mallikarachchi, Ashley Hudson, Nicole L Achee, John P Grieco, Eric Ochomo","doi":"10.4269/ajtmh.25-0413","DOIUrl":"10.4269/ajtmh.25-0413","url":null,"abstract":"<p><p>Kenya recorded more than 3 million malaria cases in 2023. Insecticide resistance and changing mosquito behavior have reduced the effectiveness of insecticide-treated nets (ITNs) and indoor residual spraying. Spatial repellents (SRs) show promise for malaria control. The present social science study, which is nested within the Advancing Evidence for Global Implementation of Spatial Repellents clinical trial in Kenya, was conducted to explore SR acceptability and perceived efficacy. Modified trials of improved practices were used to assess participant response to Mosquito Shield™, a transfluthrin-impregnated SR. Structured observations and semi-structured interviews were conducted at 16 intervention and 14 control compounds during five visits over the 24-month clinical trial. The authors remained blinded to study assignment throughout data collection; data were then analyzed by study arm after unblinding. Both intervention and control participants reported reduced mosquito activity inside homes after initial installation. Over time, most intervention participants reported continued efficacy. Controls, who received identical-looking placebo products, reported decreased efficacy. In both arms, participants mentioned discontinuing ITN use. Closely tied to perceived efficacy, acceptability was also influenced by the installation method, the number of units required, the replacement interval, and perceived community opinion. Spatial repellents seem likely to be accepted in this setting when they are perceived as effective and installed satisfactorily. National programs considering SR distribution should anticipate decreased ITN use and emphasize that SRs are meant to complement, not replace, existing interventions. Spatial repellent-related communication should stress proper product use to maximize efficacy. Decreased expenses for products like mosquito coils might incentivize adoption. The present study illustrates the value of social science research parallel to an efficacy trial.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"766-777"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710929","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":"Multiple Subcutaneous Nodules Caused by Plant Fungus Thyridium flavostromatum in an Immunocompromised Patient.","authors":"Pranav Dinesh Kamat, Ayan Basu, Dipankar Paul, Yogiraj Ray, Kumkum Bhattacharyya, Subhranshu Mandal, Diptanu Paul, Sameeha Mandal","doi":"10.4269/ajtmh.26-0298","DOIUrl":"10.4269/ajtmh.26-0298","url":null,"abstract":"<p><p>Thyridium flavostromatum is a newly discovered species of plant fungus identified from the host plant Phyllostachys pubescens. It is a type of ascomycetes that has yellowish stromata and gets the name \"flavostromatum.\" Immunocompromised patients are infected with rare and opportunistic fungal infections. We here present a case of multiple subcutaneous tender nodules caused by T. flavostromatum in a man with rheumatoid arthritis on immunosuppressants. Aspirate from the nodules revealed yeast-like cells with chlamydospores that were not identified in the matrix-assisted laser desorption ionization/time of flight mass spectrometry database. Additional DNA sequencing analysis identified the plant fungus T. flavostromatum. He was treated successfully with voriconazole. To our knowledge, this is the first reported case of the plant fungus Thyridium causing nodules on human skin.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"833-836"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710894","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":"The Long Journey of a Bird: From Sangay to the Laboratory.","authors":"Glenda Pozo-Zamora, Emily Cadena-Castro, Ángel Sebastián Rodríguez-Pazmiño","doi":"10.4269/ajtmh.26-0073","DOIUrl":"10.4269/ajtmh.26-0073","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"709-710"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710871","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":"Update on the Pathophysiology of Yellow Fever Intoxication.","authors":"Amaro Nunes Duarte-Neto, Yeh-Li Ho, Esper G Kallas, Adam L Bailey","doi":"10.4269/ajtmh.26-0276","DOIUrl":"10.4269/ajtmh.26-0276","url":null,"abstract":"<p><p>Yellow fever virus (YFV) remains a major global health threat, driven by climate change, vector expansion, and vaccine shortages. Despite centuries of observation, the pathophysiology of severe yellow fever (YF), specifically the highly lethal \"intoxication phase,\" remains poorly understood. Recent clinical data from the 2016-2019 São Paulo epidemic and advances in animal models have shifted the understanding of YFV from a purely hepatocentric disease to a complex multiorgan syndrome. Emerging evidence indicates that YFV-induced endothelial damage and hypotension trigger profound intestinal ischemia and mucosal barrier breakdown, which allows gut bacteria to translocate into the portal system. Because the YFV-damaged liver cannot clear these pathogens, secondary polymicrobial sepsis ensues, likely contributing to the high mortality rates observed in severe YF. Our proposed gut-centered framework explains the distinct clinical presentation of YF intoxication. Recognizing secondary sepsis and vascular leakage highlights the urgent need for optimized fluid management, early dialysis, and targeted antimicrobial therapies to improve clinical outcomes.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"694-701"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710879","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":"Tuberculous Arthritis Diagnosed by Metagenomic Sequencing after Negative Microbiology Studies and a 4-Year Delay.","authors":"Lu Yang, Li Xiang, Jin Rilong, Hu Yihe","doi":"10.4269/ajtmh.26-0309","DOIUrl":"10.4269/ajtmh.26-0309","url":null,"abstract":"<p><p>Tuberculous arthritis of the knee is a rare form of extrapulmonary tuberculosis that often presents with nonspecific symptoms, leading to delayed or missed diagnosis, particularly in elderly patients with comorbidities. We report the case of a 70-year-old man with a 2-year history of left knee pain and recurrent swelling. The patient was under therapy for lung cancer. He underwent two arthroscopic procedures for both diagnostic and therapeutic purposes. Repeated standard tests for tuberculosis were negative before metagenomic next-generation sequencing (mNGS) identified Mycobacterium tuberculosis nearly 2 years later. After 1-year triple-antituberculous therapy, he remained asymptomatic at the 2-year follow-up. This case highlights a high index of suspicion for indolent infection in culture-negative chronic arthropathy. The use of mNGS-increasingly accessible and cost effective-enables rapid and sensitive diagnosis of paucibacillary extrapulmonary tuberculosis.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"754-757"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710925","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":"Secondary Hemophagocytic Lymphohistiocytosis Triggered by Mixed Plasmodium spp. and SARS-CoV-2 Coinfection.","authors":"Adelmo Henrique Daumas-Gabriel, Yara Leite Adami, Hye Chung Kang","doi":"10.4269/ajtmh.26-0249","DOIUrl":"10.4269/ajtmh.26-0249","url":null,"abstract":"<p><p>Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that may be triggered by infectious diseases, including malaria and viral infections. A case of mixed Plasmodium vivax and Plasmodium falciparum infection concomitant with severe acute respiratory syndrome coronavirus 2 in a patient who developed secondary HLH is described in the present study. Malaria was acquired in the endemic state of Mato Grosso, Brazil, but diagnosed in Macaé, Rio de Janeiro, a nonendemic region. The patient presented with high fever, pancytopenia, hypertriglyceridemia, and hyperferritinemia. Bone marrow aspirate revealed hemophagocytosis. The patient met six of the eight HLH-2004 criteria and had an HScore indicating a high probability of secondary HLH. Recovery was achieved after the initiation of antimalarial and corticosteroid therapies. This case suggests that parasitic and viral infections may synergistically trigger immunologic \"second hits,\" promoting macrophage hyperactivation. Recognition of overlapping infections, particularly outside endemic areas, may facilitate earlier diagnosis and timely management of secondary HLH.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"807-810"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683162","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":"A Complex Story of Multi-Species Vector-Malaria Parasite Interactions and Seasonality in Burkina Faso.","authors":"Colin J Sutherland","doi":"10.4269/ajtmh.26-0442","DOIUrl":"10.4269/ajtmh.26-0442","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"411-412"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682791","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":"Changing Species Dynamics and Species-Specific Associations Observed between Anopheles and Plasmodium Genera in Diebougou Health District, Southwest Burkina Faso.","authors":"Paula Lado, Lyndsey I Gray, Emmanuel Sougué, Ashley L Knight, Madeleine R Sorensen, Anna-Sophia Leon, Molly E Ring, Greg Pugh, Jenna C Randall, Kathryn L Coffin, Zane Wilson, Claire Stewart, Elizabeth Hemming-Schroeder, Justin Goodwin, Martina Wade, Hannah Sproch, Cheick Oumar W Ouédraogo, Sié Rodrigue Dah, A Fabrice Somé, Roch K Dabiré, Sunil Parikh, Brian D Foy","doi":"10.4269/ajtmh.25-0745","DOIUrl":"10.4269/ajtmh.25-0745","url":null,"abstract":"<p><p>The prevalence of malaria parasite species in parts of Africa is rapidly changing and influenced by detection methods. These trends could be influenced by differential vector competence/capacity of anophelines for Plasmodium species, but these factors have been well described only for P. falciparum (Pf) and are unclear in the context of mixed and non-falciparum infections. During two clinical trials testing ivermectin for malaria control in the same region of Burkina Faso in 2015 and 2019-2020, we sampled participants' blood and Anopheles spp. mosquitoes from their households and tested these samples for Plasmodium species. Plasmodium prevalence in participants' blood was high in both trials (samples with Pf monoinfections: 1st trial: 42% [95% CI: 34-49%]; 2nd trial: 40% [35-45%]). Although Pf monoinfections comprised most infections in the first trial, mixed and non-falciparum infections comprised 27% of infections in the second trial. An. gambiae s.l. were the most abundant mosquitoes captured during the trials, but An. funestus was prevalent in the second trial, and parasite species prevalence differed in abdominal and head-and-thorax tissues of these two vector species. Most notably, Pf sporozoites were significantly more prevalent than other parasite species in An. gambiae s.l. (Pf 66% [56% to 74%] versus P. ovale (Po)/P. malariae (Pm) 34% [26% to 44%]), whereas Po sporozoites were detected more than other parasite species in An. funestus (P. ovale 63% [46% to 78%] versus Pf/Pm 37% [22% to 54%]). Our data suggest potential differential vector competence or vectorial capacities for Plasmodium species at the study site, which may significantly impact malaria epidemiology, disease prevalence, and disease control efforts.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"504-518"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683192","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":"Carbapenem-Resistant Klebsiella pneumoniae in Clinical Specimens at the University Teaching Hospital of Butare, Rwanda: Antimicrobial Resistance Profiles and Carbapenemase Genes.","authors":"Innocent Nzabanterura, Samson Adewale Oyebadejo, Djibril Mbarushimana, Celestin Musabyumuremyi, Felix Habarugira, Olivier Tuyishimire, Evariste Ntezirizaza, Charles Muhinda, Alain Prudence Ishimwe, Masceline Jenipher Mutsaka-Makuvaza, Jules Ndoli Minega, Christian Ngarambe, Eric Seruyange, Jean Bosco Munyemana","doi":"10.4269/ajtmh.26-0248","DOIUrl":"10.4269/ajtmh.26-0248","url":null,"abstract":"<p><p>Klebsiella pneumoniae, a leading cause of health care-associated infections, increasingly exhibits multidrug-resistant phenotypes, including resistance to carbapenems, the last-resort antimicrobials, and thus compromises treatment options. However, there is a paucity of data on antimicrobial profiles and carbapenemase gene distribution in K. pneumoniae in Rwanda. A cross-sectional study was conducted from February 1 to June 30, 2025, at the University Teaching Hospital of Butare. One-hundred-fifty isolates were analyzed using traditional bacteriological identification with the API 20E system. Antimicrobial susceptibility was assessed by the modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute 2024 guidelines, and carbapenemase genes were detected through conventional polymerase chain reaction. Data were analyzed using descriptive and inferential statistical methods, and a P-value less than 0.05 was considered statistically significant. As a result, Klebsiella isolates exhibited high resistance rates to trimethoprim-sulfamethoxazole (78%), cefuroxime (71.3%), cefixime (72%), and ceftriaxone (66.7%). Moderate resistance to ciprofloxacin (30%) and amoxicillin-clavulanate (42.7%) was observed. In contrast, lower resistance to amikacin (9.3%), imipenem (12%), meropenem (13.3%), and ertapenem (14%) was observed. Of the Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates, 8 (38.1%) tested positive for the blaNDM gene, whereas none harbored the blaKPC gene. This study found a high resistance rate in K. pneumoniae to a widely used antibiotic and confirms the presence of blaNDM, highlighting the need for antimicrobial stewardship and strengthened local surveillance.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"724-728"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683022","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":"Considerations for Postrelease Environmental Safety Monitoring of Gene Drive-Modified Mosquitoes as a Tool for Malaria Control in Sub-Saharan Africa.","authors":"Paul K Abram, Jeremy Bouyer, Brinda Dass, Dorington Ogoyi, Fredros Okumu, Justin Overcash, Stephanie L James","doi":"10.4269/ajtmh.26-0049","DOIUrl":"10.4269/ajtmh.26-0049","url":null,"abstract":"<p><p>Progress on malaria elimination has stalled, especially in Africa where approximately 600,000 deaths occurred in 2024. Gene drive-modified mosquito (GDMM) technologies are a potentially transformational new tool to prevent malaria transmission by Anopheles mosquitoes. Gene drive-modified mosquito technologies have been successful in contained (caged) testing, and field testing is being planned. Gene drive-modified mosquitoes are designed to be more specific vector control tools than chemical insecticides. However, the potential for spread and persistence of engineered gene drive constructs within interbreeding mosquito populations has raised concerns about possible negative effects on biodiversity. Postrelease safety monitoring of GDMMs will be an important component of risk management, yet scientifically based strategies for evaluating the environmental safety of GDMMs are lacking. Drawing from experience with related technologies in use, we propose a systematic approach to safety monitoring that is risk proportionate, considers ecological priorities and stakeholder concerns, and is practicable to implement in malaria-endemic countries. Suggested methods aim to achieve maximal decision-making value within available resources. Indicators of possible adverse impacts are selected strategically according to ecological analyses using a transparent ranking system. Intensity and coverage of monitoring reflect characteristics of both the GDMMs and the ecological indicator species, with allowance for adjusting the plan in response to initial results, ongoing observations, and regulator feedback. Although developed for early field testing, the framework can also help to guide later phase research and postimplementation environmental monitoring of GDMMs for malaria control in Africa, and it may inform the development of other genetic biological control technologies.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"660-682"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676836","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}