American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Bacteria Pathogen Distribution in Late-Onset Neonatal Sepsis: Trends from a South African Neonatal Intensive Care Unit.","authors":"Oluseyi Ajayi, Tanusha Ramdin, Tobias Chirwa, Daynia Ballot","doi":"10.4269/ajtmh.25-0419","DOIUrl":"10.4269/ajtmh.25-0419","url":null,"abstract":"<p><p>Late-onset sepsis (LOS) in neonates is defined as a bloodstream infection occurring after 72 hours of life and is primarily caused by bacterial pathogens, often associated with catheter use and prolonged hospitalization. Despite its clinical and policy relevance, limited data exist on the etiology of neonatal infections in sub-Saharan Africa. This 8-year retrospective study investigated microbial patterns and antibiotic trends of LOS in a South African neonatal unit to inform infection control and antibiotic stewardship strategies. Data from neonates weighing 500 to 2,500 g admitted to the neonatal unit of a public tertiary hospital in Johannesburg (2013-2020) were analyzed for culture-confirmed LOS. Microbial prevalence was stratified by birth weight and year, and temporal shifts were assessed using Joinpoint regression. Among 7,468 neonates, 1,454 LOS episodes occurred (194 per 1,000 live births), with males accounting for 51.1%. Gram-positive bacteria predominated (55.4%), mainly coagulase-negative staphylococci (CoNS; 37%), followed by Gram-negative bacteria (44.4%), notably extended-spectrum beta lactamase-producing Klebsiella (13.2%) and Acinetobacter baumannii (12.8%). A marked decline in CoNS incidence was observed in 2016 (annual percentage change: -17.6%). Meropenem (35%) and vancomycin (30.5%) were most frequently used, with extreme-low-birth-weight (ELBW) neonates disproportionately affected. Late-onset sepsis remains a persistent challenge, with CoNS as the leading pathogen and increasing multidrug-resistant Gram-negative infections, particularly in ELBW and very-low-birth-weight infants. The observed decline in CoNS may signal improved infection control, whereas reliance on last-line antibiotics underscores an urgent need for enhanced surveillance, prevention, and antimicrobial stewardship.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190328","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":"Outcomes in Patients with Tuberculous Meningitis: A Prospective Cohort Study in North India.","authors":"Deepti Vibha, Suman Kushwaha, Shishir Kumar Chandan, Manabesh Nath, Wajid Rafi, Rajesh Kumar Singh, Awadh Kishor Pandit, Bhargavi Ramanujam, Divya M Radhakrishnan, Animesh Das, Arunmozhimaran Elavarasi, Sada Nand Dwivedi, Achal Kumar Srivastava, Manjari Tripathi, Kameshwar Prasad","doi":"10.4269/ajtmh.26-0194","DOIUrl":"10.4269/ajtmh.26-0194","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis, carrying the highest mortality among all forms. This multicentric prospective cohort study conducted in North India aimed to determine the incidence of complications, functional outcome (modified Rankin scale [mRS]), and mortality in TBM. Patients 12 years old and older with TBM were followed up until completion of 9 months of antitubercular treatment. Patients with concomitant HIV infection, other infections causing meningitis, or multidrug-resistant tuberculosis were excluded. The primary outcome was mRS at 9 months. Secondary outcomes included mRS at 6 months, poor mRS (>2), Barthel Index, and mortality at 6 and 9 months. Between October 1, 2019 and March 31, 2024, 585 eligible patients were enrolled, of whom 495 (84.6%) completed follow-up. The median age was 24.0 years old, and the majority were female (n = 304/495; 61.4%). Complications were present in 377 patients (76.2%): focal neurological deficits (41.6%), seizures (38.6%), immune reconstitution inflammatory syndrome (32.7%), hydrocephalus (24.8%), and drug-induced liver injury (14.1%). Complications were associated with worse mRS on unadjusted analysis (odds ratio [OR]: 2.5 [1.7-3.7]; P <0.001); however, this association was no longer statistically significant after adjustment for age, sex, baseline mRS, study center, and disease stage and category (OR: 1.3 [0.8-2.0]; P = 0.30). The median mRS improved from 4.0 at presentation to 2.0 at 6 months and 1.0 at 9 months. Death occurred at a median of 91.0 days after presentation. Mortality at 6 months was 9.3% and at 9 months was 10.7%.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178783","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":"Computed Tomographic Features Associated with Pulmonary Melioidosis versus Pulmonary Tuberculosis in Diabetic Patients: A Retrospective Comparative Cohort Study.","authors":"Nitin Gupta, Chiranjay Mukhopadhyay, Tirlangi Praveen Kumar, Kavita Salian, Priya P S, Sundeep Malla, Rahul Magazine, Steven Van Den Broucke, Erika Vlieghe, Emmanuel Bottieau","doi":"10.4269/ajtmh.26-0337","DOIUrl":"10.4269/ajtmh.26-0337","url":null,"abstract":"<p><p>Pulmonary melioidosis is frequently mistaken for pulmonary tuberculosis because of overlapping clinical and radiological features, often delaying appropriate treatment. We conducted a retrospective comparative cohort study at a tertiary care center in southern India between January 2018 and August 2025 to compare chest computed tomography (CT) features of microbiologically confirmed melioidosis and tuberculosis in diabetic adults who underwent CT within 30 days of symptom onset. A total of 151 patients were included: 46 with melioidosis and 105 with tuberculosis. Cavitation (n = 81/105 [77.1%] versus n = 20/46 [43.5%], P <0.001) and hydropneumothorax (n = 11/105 [10.5%] versus n = 0/46 [0%], P = 0.019) were more common in tuberculosis. In contrast, when compared with tuberculosis, melioidosis was associated with more frequent bilateral lung involvement (n = 37/105 [35.2%] versus n = 26/46 [56.5%], P = 0.015), pleural effusion (n = 28/105 [26.7%] versus n = 23/46 [50.0%], P = 0.005), and hilar lymphadenopathy (n = 6/105 [5.7%] versus n = 8/46 [17.4%], P = 0.032). Despite these differences, there was substantial overlap in CT findings, with upper-lobe predominance, centrilobular nodules, and mediastinal lymphadenopathy seen in both groups. In multivariable analysis, cavitation was associated with significantly lower odds of melioidosis than tuberculosis (adjusted odds ratio: 0.25, 95% CI: 0.12-0.54, P <0.001). Pulmonary melioidosis and pulmonary tuberculosis, therefore, show substantial overlap on chest CT in diabetic patients, and imaging should be interpreted as an adjunct to targeted microbiological diagnosis rather than a substitute for it.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178787","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":"Increased Insulin Resistance after Praziquantel Treatment in Human Opisthorchiasis.","authors":"Hendra Kurniawan, Pornphutthachat Sota, Eimorn Mairiang, Veerasak Punyapornwithaya, Suranut Charoensri, Sutas Suttiprapa, Sangduan Wannachart, Pattapong Kessomboon, Banchob Sripa","doi":"10.4269/ajtmh.26-0222","DOIUrl":"10.4269/ajtmh.26-0222","url":null,"abstract":"<p><p>Opisthorchiasis caused by Opisthorchis viverrini is a significant public health problem in northeast Thailand, a region where the prevalence of type 2 diabetes mellitus (T2DM) substantially exceeds the national average. Although recent evidence suggests that hyperglycemia may occur after praziquantel (PZQ) treatment, the underlying mechanisms remain poorly understood. We conducted a prospective 12-month follow-up study of 110 O. viverrini-infected patients receiving PZQ treatment, assessing fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and fasting serum insulin (FSI) at baseline and 12 months posttreatment. Praziquantel treatment was associated with significant increases in FPG (87.4 ± 1.0 versus 92.4 ± 1.7 mg/dL; P = 0.010), FSI (9.6 ± 0.7 versus 13.4 ± 1.1 µU/mL; P = 0.003), and homeostatic model assessment of insulin resistance (HOMA-IR; 2.2 ± 0.2 versus 3.0 ± 0.3; P = 0.001) at 12 months, whereas OGTT values did not differ significantly (P = 0.790). General linear model analysis identified age 50 years old and older and baseline obesity as significant factors associated with elevated FPG, whereas female sex, alcohol consumption, and baseline obesity correlated with higher OGTT values. Interestingly, HOMA-IR was significantly associated with underweight status at both baseline and follow-up. These findings suggest that O. viverrini eradication by PZQ increases insulin resistance in opisthorchiasis patients, potentially elevating T2DM risk. This effect likely reflects the loss of helminth-induced immunomodulation after parasite clearance, which is potentially compounded by improved appetite and increased food consumption after treatment, suggesting that metabolic surveillance should be integrated into liver fluke control programs.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178790","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":"Disseminated Histoplasmosis Presenting as Mucocutaneous Lesions in an Immunocompetent Patient.","authors":"Prudhvi Krishna Nukala, Ayan Basu, Yogiraj Ray, Kokila Banerjee","doi":"10.4269/ajtmh.26-0160","DOIUrl":"10.4269/ajtmh.26-0160","url":null,"abstract":"<p><p>A case of an immunocompetent male patient in his 50s, an oil field worker from the northeastern part of India who presented with fever, weight loss over 4 months, and multiple umbilicated papulonodular lesions on his face and nodular lesions over the hard palate, is reported. The initial suspicion was talaromycosis, which is endemic in that part of the country. Periodic acid-Schiff and Grocott-Gomori's methenamine silver staining of the skin biopsy specimen from the forehead revealed numerous yeast-like bodies morphologically resembling Histoplasma within the histiocytes. A culture of the skin biopsy grew Histoplasma capsulatum. The patient received liposomal amphotericin B (3 mg/kg/day) but later was shifted to oral itraconazole because of acute kidney injury. The patient exhibited improvement, with flattening of skin lesions and no development of new lesions during treatment. This case highlights histoplasmosis mimicking talaromycosis and the importance of tissue diagnosis for accurate identification.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178816","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":"Case of Bundibugyo Virus Disease in Goma, Democratic Republic of the Congo with Lack of Transmission to Breastfeeding Infant.","authors":"Felicien M Maisha, Kahatwa K Serge, Kambale Kasonia, Zebedée Luhavo Kakule, Jayakrishnan Ajayakumar, John A Lednicky, Andrew J Curtis, J Glenn Morris","doi":"10.4269/ajtmh.26-0480","DOIUrl":"10.4269/ajtmh.26-0480","url":null,"abstract":"<p><p>Disease due to Bundibugyo virus (BDBV), an Orthoebolavirus species, reemerged in April 2026, in Ituri Province, Democratic Republic of the Congo. A 35-year-old woman transported the body of a possible BDBV-infected patient from Bunia in Ituri Province to Goma for burial; she was accompanied by an 8-month-old breastfeeding child. Six days after arrival in Goma, she noted onset of fever and malaise and was empirically started on therapy for malaria; 4 days later she developed bloody diarrhea and a bloody vaginal discharge and was started on metronidazole for possible amebic dysentery. When her condition worsened she was admitted to hospital in Goma, where a blood sample was positive by real-time polymerase chain reaction (RT-PCR) test for BDBV, with a second positive test on hospital day 7. By day 14 of hospitalization fever and major symptoms had resolved and repeat RT-PCR tests × 2 were negative. Her child did not show evidence of infection, and no family members or health care workers at HEAL Africa Hospital developed illness.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178807","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":"Immunological Discordance in People with HIV Receiving Contemporary Integrase Inhibitor-Based Antiretroviral Therapy: A Multicenter Retrospective Cohort Study from Türkiye.","authors":"Enes Dalmanoğlu, Yeşim Çağlar, Rukiye İnan Sarıkaya, Selçuk Kaya, Esra Erdem Kıvrak, Ayten Yanık, Gülce Eylül Aldemir, Serenay Çakmak Uzun","doi":"10.4269/ajtmh.26-0399","DOIUrl":"10.4269/ajtmh.26-0399","url":null,"abstract":"<p><p>Immunological discordance, the persistence of CD4+ T-cell depletion despite sustained virological suppression on antiretroviral therapy (ART) in people with HIV, remains incompletely characterized in the contemporary integrase strand transfer inhibitor (INSTI) era. A multicenter, retrospective cohort study was conducted through chart review at four Turkish tertiary infectious diseases units across three regions. Adults with HIV-1 who had received ART for at least 12 consecutive months were eligible. The primary outcome was immunological discordance, defined as a current CD4+ count <350 cells/µL despite plasma HIV-1 RNA <50 copies/mL. Associations were examined using Firth-penalized logistic regression with bootstrap internal validation and E-value sensitivity analysis. Among 207 participants (median age 38 years, 85.5% male, 99.0% on INSTI-based regimens), 23 (11.1%; 95% CI: 7.5-16.2) had immunological discordance, 180 (87.0%) had concordant responses, three (1.4%) had virological discordance (HIV-1 RNA ≥50 copies/mL despite CD4+ ≥350 cells/µL), and one (0.5%) had dual nonresponse. In the multivariable Firth-penalized analysis, advanced disease at diagnosis (adjusted odds ratio: 5.74; 95% CI: 2.08-16.34), age greater than 50 years (3.71; 1.25-11.07), and previous AIDS-defining opportunistic infection (3.42; 1.09-10.85) were independent predictors of immunological discordance (area under the curve: 0.81; optimism-corrected: 0.78). In this contemporary INSTI-treated cohort, approximately one in nine virologically suppressed patients failed to achieve adequate CD4+ recovery. Late HIV diagnosis emerged as the principal modifiable upstream driver of incomplete immune recovery, reinforcing the need for earlier diagnosis and rapid linkage to care in Türkiye.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134868","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":"Facial Balamuthia mandrillaris Infection.","authors":"Zhen Li, Hongzhi Zhang, Shengli Chen, Lele Sun, Hong Liu","doi":"10.4269/ajtmh.26-0280","DOIUrl":"10.4269/ajtmh.26-0280","url":null,"abstract":"<p><p>This case report describes a rare cutaneous facial infection caused by Balamuthia mandrillaris. A 5-year-old boy presented with a red plaque on his left cheek lasting 14 months that had been previously misdiagnosed as a fungal infection without response to treatment. Routine fungal microscopy, histopathology, and molecular testing failed to identify the pathogen. Ultimately, next-generation sequencing of the skin lesion detected sequences of B. mandrillaris, which was subsequently confirmed by quantitative polymerase chain reaction testing. Examination of head magnetic resonance imaging confirmed no central nervous system involvement. The patient was treated with a combination regimen including lincomycin, sulfamethoxazole, and albendazole. After 3 months of therapy, the skin lesions subsided significantly, resulting in a favorable prognosis without the development of fatal granulomatous amebic encephalitis.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102823","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":"Geographical Variation in Antimalarial Drug Resistance Marker Prevalence across the Southern African Elimination Eight Region.","authors":"Jaishree Raman, Andrés Aranda-Díaz, Maxwell Mabona, Mukosha Chisenga, Maria Florinda João, Domingos Jandondo, Pedro Rafael Dimbu, Nomcebo Nhlengethwa, Sabelo V Dlamini, Lydia Eloff, Stark Katokele, Davis R Mumbengegwi, Qedusizi Nyawo, Mbavhalelo Shandukani, Sydney Mwanza, Moonga Hawela, Simone Boene, Arlindo Chidimatembue, Bernardete Rafael, Eduard Rovira-Vallbona, Brighton Mangena, Sonja B Lauterbach, Takalani I Makhanthisa, Hazel Gwarinda, Blaženka D Letinić, Faith De Amaral, Isobel Routledge, Beatriz Arregui-Gallego, Mishalan Moodley, Jonathan Featherston, Power B Tshikae, Arshad Ismail, Jose Franco Martins, Quinton Dlamini, Baltazar Candrinho, Petrina Uusiku, Ednah Baloyi, Busiku Hamainza, Alfredo Mayor, Bryan Greenhouse, Amy Wesolowski, Chadwick Sikaala, John Chimumbwa, Jennifer L Smith","doi":"10.4269/ajtmh.26-0299","DOIUrl":"10.4269/ajtmh.26-0299","url":null,"abstract":"<p><p>Global efforts to control and eliminate malaria are threatened by antimalarial drug resistance. The WHO recommends molecular surveillance of resistance markers as a complementary approach to therapeutic efficacy studies. Here, the first regional analysis of antimalarial resistance markers across six southern African countries spanning diverse transmission intensities and geographies is reported. Dried blood spots, collected from rapid diagnostic test-positive individuals in Angola, Eswatini, Namibia, and Zambia in 2023, Mozambique in 2022, and South Africa between 2022 and 2024 using a standardized collection method, were analyzed using a Plasmodium falciparum-targeted amplicon sequencing protocol. The distribution of resistance markers was spatially heterogeneous. Validated markers of artemisinin partial resistance (ART-R) were rare. However, more than 30% of samples from eastern Namibia and Zambia's Western and Central Provinces carried the candidate kelch13 P441L ART-R marker. Other ART-R markers (kelch13 R515K, P553L, P574L, A675V) were detected at a prevalence rate <1.3% in all countries except Mozambique, where these markers were absent. The wild-type multidrug resistance 1 N86 allele, potentially associated with reduced lumefantrine susceptibility, was near fixation (>99%) across all countries, whereas the chloroquine resistance marker K76T, in the chloroquine resistance transporter (crt) was nearly absent in most districts. The sulfadoxine-pyrimethamine resistance dihydropteroate synthase (dhps)-dihydrofolate reductase quintuple mutation was approaching fixation (>95%) in 35% of districts. Northern Angola was a clear outlier, with a lower dhps K540E prevalence (≤20%) but a higher crt K76T prevalence (48% to 56%). This pronounced spatial heterogeneity underscores the need for timely high-resolution local resistance data generation and sharing to safeguard antimalarial drug efficacy and guide malaria control and elimination strategies across the region.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102946","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 Characteristics and Predictors of Hospitalization of Leprosy in the United States: A Multicenter Network Analysis.","authors":"Samantha Kaplan, Oscar Bernat, Christian Olivo-Freites, Nelson I Agudelo Higuita, Luis A Marcos, Edgar A Ramírez-García, Martin Casapia, Daniel B Chastain, Norman Beatty, Amir M Mohareb, Andrés F Henao-Martínez, Charlotte Avanzi, John S Spencer, Carlos Franco-Paredes","doi":"10.4269/ajtmh.26-0065","DOIUrl":"10.4269/ajtmh.26-0065","url":null,"abstract":"<p><p>Leprosy, also known as Hansen's disease, is a chronic infection caused by Mycobacterium leprae or Mycobacterium lepromatosis. Although global prevalence has decreased, the number of cases each year has plateaued at ∼200,000. In the United States, sporadic cases continue to occur, primarily in the southern states. A retrospective cohort study was conducted from 1992 to 2024 using the TriNetX Research Network (Cambridge, MA, USA), an international electronic health record network, to characterize the clinical features of leprosy and identify factors predicting hospitalization among individuals diagnosed with the disease. Of 215 patients, 30 (14%) required hospitalization. These hospitalized patients were generally older and had other health conditions. Stepwise logistic regression was used to identify a higher absolute neutrophil count and a higher Charlson Comorbidity Index value as predictors of hospitalization. Most patients were from the United States, and the slight majority of cases were clustered in the southern states. These results provide one of the largest recent descriptions of leprosy, highlighting how leprosy reactions and other health issues may influence outcomes, including hospitalization, and emphasizing the importance of ongoing surveillance of leprosy in the southern United States and other regions.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102840","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}