American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Periorbital Cutaneous Larva Migrans.","authors":"Carol Lobo, Sowmya Kaimal","doi":"10.4269/ajtmh.26-0270","DOIUrl":"10.4269/ajtmh.26-0270","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023601","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":"Management of Bullous Pemphigoid and Norwegian Scabies with Dupilumab Plus Ivermectin.","authors":"Yanli Zhang, Yuting Liu, Hengan Yi","doi":"10.4269/ajtmh.26-0186","DOIUrl":"10.4269/ajtmh.26-0186","url":null,"abstract":"<p><p>Bullous pemphigoid is a severe autoimmune blistering disease, and Norwegian scabies is a rare comorbidity. However, conventional treatment methods, such as systemic corticosteroids, carry a high risk in the treatment of elderly patients. Herein, this rare comorbidity is described in an elderly patient. After an initial induction treatment with a low-to-moderate dose of corticosteroid, this patient achieved complete remission with a combination therapy of dupilumab (a monoclonal antibody targeting the interleukin-4/13 signaling pathway) and ivermectin. Therefore, the successful treatment of this rare case provides a promising strategy for reducing reliance on corticosteroids in high-risk populations.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023661","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":"Predictors of Changes in Weight and Body Composition in Undernourished Children in Mozambique: A Longitudinal Study.","authors":"Idalécia Cossa-Moiane, Sara Simões Dias, Colleen Doak, Maiza Campos-Ponce, Clémentine Roucher, Amanda Durkin, Adilson Fernando Loforte Bauhofer, Jean-Pierre Van Geertruyden, Nilsa de Deus, Katja Polman","doi":"10.4269/ajtmh.26-0014","DOIUrl":"10.4269/ajtmh.26-0014","url":null,"abstract":"<p><p>Undernutrition is a major public health challenge in Mozambique, requiring a better understanding of changes in weight and body composition. In the present study, changes in weight and body composition were analyzed in undernourished children, and predictors of these changes were identified during and after hospitalization. A longitudinal cohort study was conducted in Maputo, Mozambique (2018-2020), in children aged 6 to 58 months hospitalized for malnutrition. On hospital admission, clinical data, including anemia, edema, and HIV infection status, were collected. Anthropometric measurements, height, weight, and skinfold thickness, were obtained during hospital and community follow-ups. Stool samples were collected to assess intestinal parasitic infections. Longitudinal linear mixed-effects models were used to identify factors associated with changes in weight and proxies of body composition (sum of skinfolds and percentage body fat [%BF]) over time. A total of 217 children were included, with a mean age of 19.2 ± 8.4 months. On admission, 43.7% (94/215) of patients had kwashiorkor, 88.7% (188/212) had anemia, and 55.8% (121/217) had edema. HIV infection was diagnosed in 25.7% (55/214) of patients, and 26.7% (58/217) were positive for intestinal parasitic infections. HIV infection was a strong predictor associated with lower weight gain and body composition change over time (sum of skinfold and estimated %BF), whereas edema was associated with increased gains (P <0.001). Intestinal parasitic infections were associated with weight changes only in univariate analysis (P <0.05). HIV infection and edema at admission were major determinants of recovery, emphasizing targeted HIV care and continued edema monitoring.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023622","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":"Recurrent Plasmodium falciparum Malaria after Delayed Hemolysis Induced by Artemether-Lumefantrine.","authors":"Kosuke Asano, Tokio Hoshina, Tomomi Miyamoto, Taichi Odagawa, Erisha Saiki, Tetsuya Horino, Hirotaka Kanuka, Masaki Yoshida","doi":"10.4269/ajtmh.26-0364","DOIUrl":"10.4269/ajtmh.26-0364","url":null,"abstract":"<p><p>Although artemether-lumefantrine is a first-line treatment for uncomplicated Plasmodium falciparum (P. falciparum) malaria, delayed hemolysis may occur after therapy. A previously healthy 39-year-old Japanese man developed P. falciparum malaria after traveling to Togo and was treated with artemether-lumefantrine in the Philippines. Because fever and fatigue persisted after treatment, he presented to the study hospital and was diagnosed with delayed hemolysis induced by artemether-lumefantrine. Supportive therapy, including blood transfusion, led to symptomatic improvement, and he was discharged. However, he was subsequently readmitted because of recrudescence of P. falciparum malaria accompanied by hemolytic anemia. Treatment with atovaquone-proguanil resulted in clinical improvement. Because delayed hemolysis and recrudescence may develop after treatment of P. falciparum malaria with artemether-lumefantrine, careful follow-up for at least 4 weeks after treatment with artemether-lumefantrine should be considered.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987580","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":"Status of Malaria Vaccine Introduction-Africa, 2019-2024.","authors":"Anh N Ly, Jenny A Walldorf, Mary J Hamel, Eliane Pellaux-Furrer, Rafiq Nii Attoh Okine, Mgaywa G M D Magafu, Jaymin C Patel, Terri B Hyde","doi":"10.4269/ajtmh.26-0338","DOIUrl":"10.4269/ajtmh.26-0338","url":null,"abstract":"<p><p>Malaria remains the primary cause of death among children younger than 5 years old in Africa. During 2019-2023, Ghana, Kenya, and Malawi piloted introduction of the first malaria vaccine, RTS,S/AS01, through the Malaria Vaccine Implementation Program. There are two malaria vaccines prequalified by the WHO: RTS,S/AS01 and R21/Matrix-M. The vaccines are recommended for children younger than 5 years old in endemic areas, prioritizing areas of moderate to high transmission. Data on vaccine introduction and doses shipped were obtained from the WHO and the United Nations Children's Fund. As of December 2024, 17 countries in Africa had introduced the malaria vaccine with support from Gavi, the Vaccine Alliance, and another eight countries had approval for Gavi support. During 2023-2024, a total of 13,250,098 vaccine doses were shipped to countries. The introduction of the malaria vaccine presents an integration opportunity with preventive health services to reduce child morbidity and mortality.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987652","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":"Beyond Eschar: Unusual Skin Findings in Scrub Typhus.","authors":"Tushar Biswas, Harpreet Singh, Atharva Pandharipande, Deba Prasad Dhibar, Manish Biswal, Aravind Sekar, Vikas Suri, Ashish Bhalla","doi":"10.4269/ajtmh.26-0240","DOIUrl":"10.4269/ajtmh.26-0240","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987639","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":"Wound-Only versus Weight-Based Rabies Immunoglobulin in Post-Exposure Prophylaxis: A Quasi-Randomized Asessor Blind Non-Inferiority Trial.","authors":"Aman Dev Singh, Simmi Oberoi, Satparna Ghosh, Kanwardeep Singh, Shailpreet Sidhu, Maninder Kaur, Tania Rajput, Bhavya Kapoor, Samridh Singla, Shefali Gajebasia","doi":"10.4269/ajtmh.26-0343","DOIUrl":"10.4269/ajtmh.26-0343","url":null,"abstract":"<p><p>Rabies is a fatal but preventable zoonotic disease that causes more than 20,000 deaths annually in India. Post-exposure prophylaxis (PEP) involves rabies vaccination and passive immunization with rabies immunoglobulin (RIG). Traditional RIG dosing is based on patient weight, whereas wound-only administration targets local viral neutralization at the exposure site. In the present study, antibody responses were compared after a three-dose anti-rabies vaccination in patients receiving either wound-only or weight-based RIG infiltration as part of PEP to assess the noninferiority of the wound-only approach. Patients with category III rabies exposure were enrolled in this noninferiority clinical trial, all of whom received a standard three-dose rabies vaccination. Rabies immunoglobulin was administered either according to body weight or infiltrated only around the wound. Serum rabies-neutralizing antibody titers were measured at predefined intervals. The primary outcome was the proportion of patients exhibiting protective antibody titers; secondary outcomes included RIG usage volume, adverse events, and feasibility in resource-limited settings. Both groups achieved adequate seroconversion with protective antibody titers. Wound-only RIG infiltration produced protective antibody responses comparable to weight-based RIG dosing while substantially reducing RIG volume used and could improve feasibility. Larger studies, including formal cost-effectiveness analyses, are needed to confirm the clinical and programmatic implications.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987562","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":"Reactivation of Cutaneous Leishmaniasis in a Rheumatoid Arthritis Patient Undergoing Tocilizumab Treatment.","authors":"Regina Maia de Souza, Felipe Francisco Tuon, Antônio Carlos Nicodemo, Christini Takemi Emori, Beatriz Julieta Celeste, Maria Carmen Arroyo Sanchez, Valdir Sabbaga Amato","doi":"10.4269/ajtmh.26-0345","DOIUrl":"10.4269/ajtmh.26-0345","url":null,"abstract":"<p><p>Cutaneous leishmaniasis is a neglected vector-borne disease caused by Leishmania spp., with viable parasites potentially persisting after clinical cure. Immunosuppressive therapies may favor reactivation of latent infection. The case of a 62-year-old Brazilian woman with a 25-year history of rheumatoid arthritis who developed a painful ulcerative lesion on her right leg 1 month after initiating tocilizumab therapy is reported. Molecular testing confirmed Leishmania (Viannia) braziliensis, consistent with reactivated cutaneous leishmaniasis. Tocilizumab was discontinued, and liposomal amphotericin B was initiated but interrupted because of nephrotoxicity and hepatotoxicity. Despite incomplete treatment, the lesion gradually healed after withdrawal of immunosuppression without requiring additional antiparasitic therapy. Secondary prophylaxis with liposomal amphotericin B was subsequently initiated under close clinical and laboratory monitoring, and no recurrence has been observed during follow-up. This case highlights the importance of screening clinical history for prior leishmaniasis, maintaining vigilance for reactivation in patients from endemic areas, and promptly adjusting immunosuppressive therapy to optimize clinical outcomes.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975519","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 Diagnostic Algorithm Based on Urine Antigen and Blood Polymerase Chain Reaction Testing for Visceral Leishmaniasis in HIV-Coinfected Patients in Northwest Ethiopia.","authors":"Ermias Diro, Koert Ritmeijer, Saskia van Henten, Aderajew Kibret, Mekibib Kassa, Hailemariam Beyene, Wim Adriaensen, Myrthe Pareyn, Johan van Griensven","doi":"10.4269/ajtmh.26-0104","DOIUrl":"10.4269/ajtmh.26-0104","url":null,"abstract":"<p><p>The diagnosis of visceral leishmaniasis (VL) in HIV patients relies on tissue aspiration, which is potentially life-threatening. Because antibody-based tests are unreliable for this group, Leishmania blood polymerase chain reaction (PCR) and urine antigen tests can serve as noninvasive alternatives. Using data from the PreLeisH cohort (ClinicalTrials.gov [NCT03013673]), the diagnostic accuracy of these two tests was determined individually, and an algorithm was designed for targeted tissue aspiration. Of the 490 PreLeish participants, 51 underwent diagnostic procedures for VL 118 times at different follow-up time points when clinically suspected. Of these, 48 (94.1%) patients with 102 (84.4%) procedures had complete data, including tissue aspiration, Leishmania kinetoplast DNA blood PCR, and urine antigen (KAtex [Kalon Biological Ltd., Guildford, United Kingdom]) results. The diagnostic performance of KAtex and blood PCR testing was assessed individually against tissue aspiration, and sequential and parallel algorithms were developed. Visceral leishmaniasis was confirmed via tissue microscopy in 55/102 (54%) episodes. The sensitivity and specificity of blood PCR testing were 98% and 64%, respectively; the sensitivity and specificity of KAtex testing were 93% and 81%, respectively. A sequential algorithm using KAtex first and restricting PCR to KAtex-negative suspects limited PCR testing to 42 (41.2%) episodes and tissue aspiration to 14 (13.7%) episodes, with sensitivity, specificity, and positive predictive value of 100%, 81%, and 86%, respectively. The parallel testing algorithm exhibited comparable performance but requires PCR testing for all suspects. The sequential KAtex and PCR testing algorithm, combined with targeted tissue aspiration, met the WHO target product profile, except for specificity. This approach supports efficient resource use and reduces the need for invasive procedures.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975525","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":"Pulmonary Tuberculosis and a Related Verrucous Plaque on the Sole of the Foot.","authors":"Akshay Meena, Saka Sowmya Susan, Sreerekha Jinkala, Sheetanshu Kumar","doi":"10.4269/ajtmh.26-0301","DOIUrl":"10.4269/ajtmh.26-0301","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975461","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}