American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Spatial Patterns of Dengue Incidence in Nepal During Record Outbreaks in 2022 and 2023: Implications for Public Health Interventions.","authors":"Simrik Bhandari, Jason K Blackburn, Sadie J Ryan","doi":"10.4269/ajtmh.24-0747","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0747","url":null,"abstract":"<p><p>Dengue, which was first reported as a travel case in Nepal in 2004, was initially confined to the lower plains but has spread to higher elevations. Large outbreaks in 2022 and 2023 (54,784 and 51,243 cases, respectively), reached every district (n = 77). We calculated the district-wise incidence for 2022 and 2023 by digitizing case data from Nepal's Ministry of Health and Population and 2021 census data from the National Statistics Office. The incidence and peak incidence months for each year were mapped, and spatial clusters (hotspots and cold spots) and outliers of incidence rates were identified using Local Moran's I. In 2022, district-wise peak cases occurred from August to October. One hotspot (high-high cluster), with high values surrounded by high-value neighbors, including six districts around Kathmandu, and one cold spot (low-low cluster), with low values surrounded by low-value neighbors, comprising eight high-elevation districts in Nepal's northwest region were identified. In 2023, cases peaked from March to November, indicating more distributed peaks that started earlier; hotspots shifted to the north-central and eastern regions, and a low-high outlier district in the central region was identified. Identifying the timing of peaks and spatial clusters of dengue incidence can inform targeted management, thereby improving effectiveness and cost-efficiency. A baseline examination of recent dengue incidence in Nepal, highlighting timing and spatial clustering in incidence, is provided in this study. The mountainous northwest cold spots align with expectations of fewer mosquitoes because of the geography and climate. However, the 2022 dengue incidence peaked across all 77 districts in 3 months, suggesting that ecological and climatic factors may no longer be effective barriers.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265107","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 Knowledge, Attitudes, and Practices Toward Ticks and Tick-Borne Zoonoses among Mixed Farming and Pastoral Communities in Gairo and Monduli Districts, Tanzania.","authors":"Isihaka Haji, Walter S Magesa, Martin Simuunza","doi":"10.4269/ajtmh.24-0439","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0439","url":null,"abstract":"<p><p>Tick-borne zoonoses (TBZ) are a group of infectious diseases whose pathogens can be transmitted to animals and humans by ticks. They are among the emerging and reemerging infectious diseases that cause significant global health concerns. There is inadequate information about the occurrence and awareness of TBZ in some endemic areas, especially in rural communities in countries like Tanzania. In this study, a questionnaire was used to assess the knowledge, attitudes, and practices regarding ticks and TBZ infection among 102 respondents (50 from the Monduli District, a livestock-wildlife area and 52 from Gairo District, not a livestock-wildlife area) in Tanzania. Knowledge of ticks and TBZ varied significantly, with the majority of the respondents in Gairo 35 (67.3%), but only 7 (14%) in Monduli, being aware that ticks can transmit pathogens to humans. A total of 70% of the respondents reported having been bitten by ticks, and the frequency varied significantly with respect to the locality, daily activities, and sex of the respondent. Many of the respondents from Gairo (55.8%) and Monduli (26%) mentioned muscle pain, flu-like symptoms, and fever as symptoms that often appear after a tick bite. None of the participants reported attending a healthcare facility after a tick bite. We recommend comprehensive community health education and campaigns to impart knowledge about potential zoonotic disease transmission by ticks, presenting symptoms of commonly known TBZ, along with advice to seek medical care when residents experience symptoms after a tick bite.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265103","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":"Chromoblastomycosis, Phaeohyphomycotic Abscess, and Sporotrichosis Among American Indian/Alaska Natives, Indian Health Service, 2016-2022.","authors":"Dallas J Smith, Jordan L Kennedy, Kaitlin Benedict, Dana L Haberling, Uzo Chukwuma","doi":"10.4269/ajtmh.25-0051","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0051","url":null,"abstract":"<p><p>Chromoblastomycosis, phaeohyphomycotic abscesses, and sporotrichosis are fungal diseases usually caused by traumatic inoculation that cause substantial morbidity and can lead to long-term sequalae and inability to work. Few studies have analyzed the epidemiological and clinical characteristics of these mycoses in the United States, particularly among minority populations. We estimated prevalence and described features of American Indian and Alaska Native (AI/AN) persons with these diseases using Indian Health Service (IHS) data during 2016-2022. Chromoblastomycosis and phaeohyphomycotic abscess prevalence was 9 per 1,000,000, and sporotrichosis prevalence was 5 per 1,000,000 IHS user population. Prevalence was highest in the Southern Plains region for both diseases. Several patients experienced amputation, tissue fibrosis or scarring, or lymphedema. These findings provide baseline data for monitoring prevalence or changes in geographic distribution of implantation mycoses in AI/AN persons. Although cases are rare, these findings underscore the need for standardized clinical guidance to prevent long-term disability and decreased quality of life.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265056","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":"Severity of Primary and Secondary Dengue Virus 1 Infections: A Hospital-Based Study in Puerto Rico, 2012-2014.","authors":"Daniel Camprubí-Ferrer, Brenda Torres-Velásquez, Janice Perez Padilla, Joshua Wong, Liliana Sánchez-González, Jorge L Munoz-Jordan, Dania M Rodriguez Vargas, Vanessa Rivera-Amill, Laura E Adams, Gabriela Paz-Bailey","doi":"10.4269/ajtmh.24-0508","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0508","url":null,"abstract":"<p><p>Dengue is the most common mosquito-borne viral disease in humans. Although many dengue virus (DENV) infections are asymptomatic or produce only mild illness, DENV can occasionally cause severe and fatal disease. In this study, we compared the severity of primary and secondary DENV-1 infections among patients enrolled in a prospective, hospital-based, acute febrile illnesses surveillance system in Puerto Rico (2012-2014). Serum samples collected <7 days after symptom onset were tested for DENV-serotypes by a real time-polymerase chain reaction assay. The positive samples that were collected ≤5 days after onset were then tested by a DENV IgG antibody ELISA to classify primary (IgG negative) and secondary (IgG positive) infections. Overall, 720 dengue infections (679 DENV-1, 3 DENV-2, and 38 DENV-4) were diagnosed during the study period. Of the 679 DENV-1 patients, 595 were included in the study, 445 (75%) were classified as secondary infections, and 150 (25%) as primary infections. Among these patients, 150 (25%) were classified as severe dengue. Severe dengue occurred in 28% of secondary DENV-1 infections. Severe disease was also common among primary DENV-1 infections, including 27% with plasma leakage, 15% with severe dengue, and 9% requiring admission to the intensive care unit. Even though DENV-1 has caused thousands of cases in Puerto Rico, this is the first report describing DENV-1 as the cause of severe primary infection in this country. Although secondary DENV-1 infections have an increased risk for severe disease, it is important for clinicians to be aware that any individual with dengue should be considered at risk for severe dengue.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265106","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":"Classic Cervical Lymphadenopathy and Ulceration: A Case of Scrofula.","authors":"Ibrahim Nagmeldin Hassan, Nagmeldin Abuassa","doi":"10.4269/ajtmh.24-0634","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0634","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265057","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":"Statistical Modeling for the Identification of Determinants of Dengue Transmission in Different Districts of Khyber Pakhtunkhwa Province, Pakistan: A Cross-Sectional Study.","authors":"Ijaz Ul Haq, Zafar Mehmood, Humood Fahm Albugami, Raghad Hussain Alaithan, Sohail Akhtar","doi":"10.4269/ajtmh.25-0077","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0077","url":null,"abstract":"<p><p>Dengue is a major vector-borne disease and a significant public health concern in developing countries like Pakistan. The lack of preventive measures against dengue often results in fatalities across various age groups in the country. This study aimed to analyze the determinants of dengue prevalence in selected districts of Pakistan. A cross-sectional study using a two-stage cluster sampling design was conducted across various districts of Khyber Pakhtunkhwa (KP). Data were collected using a validated questionnaire, and logistic regression analysis was performed to identify the determinants of dengue. Of 492 suspected dengue cases, 64.4% were males, 41.3% lacked dengue knowledge, 53.9% reported one to three mosquito bites daily, and 43.3% did not protect stagnant water at home. The majority (63.0%) were not using bed nets for mosquito protection. Binary regression identified significant risk factors for dengue (P <0.05), including male gender, age 16-30 years old, joint or large family living situation, lack of education, low income, not using bed nets, poor dengue knowledge, more than three mosquito bites daily, and unprotected stagnant water. The final multiple logistic regression model highlighted family income, long distance to the nearest health center, lack of bed net usage, and unprotected stagnant water as key socioeconomic determinants (P <0.05) of dengue. Several significant risk factors for dengue were identified across different districts of KP. This information is crucial for policymakers to design targeted prevention strategies aimed at reducing dengue prevalence and associated fatalities.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265108","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":"An Antibody Biomarker Associated with Onchocerca volvulus Microfilariae Identified by Proteomic Analysis of Parasite Tissues Isolated from Paraffin Embedded O. volvulus Nodules by Laser Capture Microdissection.","authors":"Sarah E Greene, Kerstin Fischer, Lucia S Di Maggio, Bruce A Rosa, Yuefang Huang, Irina Diekmann, Byoung-Kyu Cho, Jessica Lukowski, Young A Goo, Makedonka Mitreva, Nicholas Opoku, Gary J Weil, Peter U Fischer","doi":"10.4269/ajtmh.24-0793","DOIUrl":"10.4269/ajtmh.24-0793","url":null,"abstract":"<p><p>Onchocerciasis (river blindness), a neglected tropical disease caused by the filarial nematode Onchocerca volvulus, impacts millions of people in sub-Saharan Africa. The WHO coordinates global efforts to eliminate onchocerciasis and has prioritized development of improved diagnostic tests to aid these efforts. To find new microfilarial-associated diagnostic targets to help identify active infections, we used laser capture microdissection to isolate embryonic stages from histologic sections of O. volvulus worms in subcutaneous nodules excised from onchocerciasis patients. Proteomic analysis identified 2,512 O. volvulus proteins in those tissues, including 264 found only in the microfilariae (Mf). From this pool of diagnostic candidates, we selected OVOC12404, a putative cuticular collagen, for further study because of its abundance and lack of close homologues in other filarial species. Immunolocalization detected this antigen on the surface of coiled, stretched, and tissue Mf. IgG antibodies to OVOC12404 were detected by ELISA in plasma from 124 of 162 (76.5%) people with O. volvulus Mf in their skin snips. ELISA specificity was 98% based on 42 samples from lymphatic filariasis patients from areas without co-endemic onchocerciasis. In contrast to antibodies to Ov16, a currently used diagnostic target, antibodies to OVOC12404 declined significantly after treatments that cleared O. volvulus Mf from the skin. This study showed that proteomic analysis of parasite tissues recovered from histological sections can be used to identify stage-specific filarial diagnostic targets. Further studies are needed to assess the potential value of an OVOC12404 antibody test as an additional diagnostic tool to support the onchocerciasis elimination efforts.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214688","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":"Characteristics of Hand Hygiene Adherence in Selected Healthcare Settings in Latin America and East Africa as Part of COVID-19 Response Efforts, 2020-2021.","authors":"Denisse Vega Ocasio, David Berendes, Zainab Salah, Paulina Garzaro, Brooke M Ramay, Natalie Fahsen, Michelle Pieters Arroyo, Douglas Ruben Call, Celia Cordon-Rosales, Ramiro Quezada, Caroline Pratt, Kristy O Murray, Nicholas Bivens, Anh N Ly, Gerhaldine Morazan, Russell Manzareno, Francis Morey, Charles Daniel Schnorr, Alexandra Medley, Maureen Kesande, Mohammed Lamorde, Victoria Trinies, Isaac Ngere, Eric Nilles, Cecilia Jocelyn Then Paulino, Eulogia C Payano, Paloma Martínez Guzmán, Michael de St Aubin, Devan Dumas, William Duke, Ronald Skewes-Ramm, Matthew Lozier","doi":"10.4269/ajtmh.24-0066","DOIUrl":"10.4269/ajtmh.24-0066","url":null,"abstract":"<p><p>Proper hand hygiene (HH) is crucial to prevent healthcare-associated infections, including coronavirus disease 2019 (COVID-19), which disproportionately affects patients in low-and middle-income countries. As part of COVID-19 response, we evaluated key factors associated with HH practices in healthcare facilities (HCF) across five countries. From December 2020 to June 2021, we observed HH practices among healthcare personnel in 88 HCFs; observations occurred before and after patient contact. HH adherence (HHA) was defined as the use of alcohol-based hand rub (ABHR) or handwashing with soap and water. HH materials (soap and water, ABHR, or gloves) in patient care areas during observation were recorded in Belize, Uganda, and Kenya, and whether HHA occurred during invasive or noninvasive procedures. Descriptive methods and regression models were conducted. Overall, 3,940 HH observations were completed; average HHA was 32% (23-52% by country). Adjusted odds ratios (aORs) of HHA among nurses (aOR = 0.58; 95% CI = 0.44-0.77) and laboratory technicians (aOR = 0.41; 95% CI = 0.25-0.67) were lower than those among physicians, higher after versus before patient contact (aOR = 2.84; 95% CI = 2.44-3.28), higher with invasive procedures versus noninvasive (aOR = 1.45; 95% CI = 1.18-1.78), and higher when both ABHR and water and soap were available (aOR = 2.04, 95% CI = 1.73-3.53) or only ABHR was available (aOR = 1.86, 95% CI = 1.12-3.06) versus only water and soap were available. Our assessment highlights the need for behavioral and infrastructural interventions to improve HH practices in five resource-limited countries across two regions globally.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214689","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-Associated Mortality in the 19th Century.","authors":"Sean N Gannon, Michael Waller, George Dennis Shanks","doi":"10.4269/ajtmh.24-0722","DOIUrl":"10.4269/ajtmh.24-0722","url":null,"abstract":"<p><p>Malaria can kill directly, as well as contribute to indirect or malaria-associated mortality. Data from French prison colonies and the Panama Canal in the 19th century had high mortality rates and comparison populations, which allowed the estimation of malaria-associated mortality. French Guiana and New Caledonia had similar French Imperial Prison systems with consistent mortality records, but French Guiana had malaria whereas New Caledonia did not, enabling rough estimates of malaria-associated mortality by comparing death rates in these otherwise similar colonies. A statistical model developed from the prison colonies estimated that malaria-associated mortality was equal to or greater than the number of deaths directly attributed to malaria in Panama consistent with the contemporaneous civilian records in Panama City. Malaria mortality in French Panama Canal workers was highly correlated (R2 = 0.73) with deaths because of all other causes in the late 19th century. Malaria control and elimination programs are successful beyond direct impacts on malaria deaths by helping to prevent many additional deaths due primarily to other causes.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214692","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":"Isolated Adrenal Abscess Due to Melioidosis.","authors":"Saritha Teerajetgul, Methus Jantarapootirat, Sirinapa Traiwanatham, Suppachok Kirdlarp, Chutintorn Sriphrapradang","doi":"10.4269/ajtmh.25-0154","DOIUrl":"10.4269/ajtmh.25-0154","url":null,"abstract":"<p><p>Melioidosis is a potentially life-threatening infectious disease that is endemic to tropical regions such as Southeast Asia and northern Australia. We report a case of melioidosis presenting as an isolated right adrenal abscess in an elderly woman with diabetes mellitus. The patient presented with fever and nonspecific abdominal pain, which was initially misdiagnosed as a urinary tract infection. Blood cultures identified Burkholderia pseudomallei, prompting further investigation using computed tomography, which revealed a multiloculated abscess in the right adrenal gland. Management included an intensive phase of intravenous ceftazidime combined with trimethoprim-sulfamethoxazole, followed by an eradication phase with oral trimethoprim-sulfamethoxazole. The patient showed clinical and radiologic improvement with antibiotic therapy alone. No clinical or biochemical evidence of adrenal insufficiency was observed. This case highlights the diagnostic and therapeutic challenges of adrenal melioidosis, emphasizing the need for early recognition, tailored antimicrobial therapy, and vigilant follow-up to prevent relapse and manage complications such as adrenal insufficiency.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214691","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}