American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Sensitivity of Three Impact Assessment Methodologies in Adjusting Preventive Chemotherapy Treatment Decisions for Schistosomiasis Elimination in Ondo State, Nigeria.","authors":"Uwem F Ekpo, Francisca O Olamiju, Hammed O Mogaji, Samuel N Ovia, Olanike O Oladipupo, Alice Y Kehinde, Fatai O Oyediran, Moses Aderogba, Louise K Makau-Barasa","doi":"10.4269/ajtmh.24-0352","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0352","url":null,"abstract":"<p><p>Efforts to eliminate schistosomiasis in Africa have advanced, with most countries evaluating the impact of preventive chemotherapy (PC) on disease burden. WHO has recommended eight distinct methodologies for such assessment. We, therefore, investigated the sensitivity of three prominent methodologies-sentinel, cluster, and practical, each varying in site selection, sampling approach, and data interpretation. We conducted a cross-sectional study among 2,093 children across 45 schools in Ese-Odo, Ile-Oluiji, and Irele local government areas (LGAs) of Ondo, Nigeria. Fresh stool and urine samples were processed using Kato-Katz and urine filtration techniques to estimate prevalence, which was compared with 2014 baseline estimates. Findings showed significant prevalence reductions in Ese-Odo from 1.3% (95% CI: 0.5-3.3) at baseline to 0.1% (95% CI: 0.01-0.95) at impact (d = -92.3%, P = 0.03) and in Ile-Oluiji from 58.0% (95% CI: 53.9-62.1) to 1.8% (95% CI: 0.9-3.3; d = -97%, P = 0.00). However, it increased from 3.0% (95% CI: 1.6-5.6) to 5.3% (95% CI: 3.8-7.3) in Irele (d = 66%, P = 0.13). Higher prevalence estimates were observed with the practical method compared with cluster and sentinel across the three LGAs: 0.3% versus 0.1% versus 0.0% in Ese-Odo, 5.8% versus 5.3% versus 5.4% in Irele, and 2.2% versus 1.8% versus 1.5% in Ile-Oluiji (all P >0.05). Sentinel and cluster methodologies suggest stopping PC, whereas the practical method suggests continued PC in Irele. Our findings demonstrate that practical assessment is a sensitive method for refining PC decisions.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447955","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":"Clinical and Demographic Features Associated with the Isolation of Ceftriaxone-Resistant Enterobacteriaceae in a Private Hospital in Kingston, Jamaica.","authors":"Matthew S Mendoza, Fredricka A Coombs, Hansel M Fletcher, Eugene W Liu","doi":"10.4269/ajtmh.24-0351","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0351","url":null,"abstract":"<p><p>Data on the burden of extended-spectrum β-lactamase producing Enterobacterales are limited in Jamaica. This study aims to identify factors associated with the isolation of ceftriaxone-resistant Enterobacterales in patients at a private hospital in Jamaica through a retrospective case-control study comparing patients with and without ceftriaxone-resistant Enterobacterales in 2021. The case subjects had at least one Enterobacterales isolate resistant to ceftriaxone, and the controls had at least one culture, all without cephalosporin resistance, including those without growth. The data extracted included antibiotics received, organism, sex, and age. Older age, male sex, and the isolation of Enterobacter species were independently associated with increased odds of ceftriaxone-resistant Enterobacterales on logistic regression. Age and male sex may be markers for past exposure to β-lactam antibiotics or nosocomial infection with ceftriaxone-resistant Enterobacterales and may have a greater influence on isolation of ceftriaxone-resistant Enterobacterales compared with the receipt of antibiotics in the past six months, with which no association was observed on final analysis.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447922","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":"Management of an Uncommon Snakebite Envenomation (Azemiops kharini).","authors":"Shuan-Zhu Guo, Shi-Ming Zhan, Shuo-Feng Zhuang, Jin Chen, Tian-Xing Li","doi":"10.4269/ajtmh.24-0587","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0587","url":null,"abstract":"<p><p>Envenomation and death resulting from snakebites represent a significant public health problem worldwide, posing a substantial threat to human lives. Azemiops kharini (white-headed Burmese viper) venom is a mixed toxin that usually causes swelling and pain, paresthesias, blood clotting disorders, cardiopulmonary arrest, and even multiple organ dysfunction syndrome. The patient exhibited symptoms of envenomation after an A. kharini snakebite, including decreased fibrinogen levels and finger stiffness. Management entailed the administration of a combination therapy consisting of multiple monovalent antivenoms along with Jidesheng snake pill. Finally, a favorable outcome was observed. We present a case of A. kharini snakebite envenomation managed at our medical facility for the benefit of fellow health care providers.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447951","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":"Rickettsial Pathogens in Dogs and Ticks During an Epidemic of Rocky Mountain Spotted Fever in Ensenada, Baja California, México.","authors":"Laura Backus, Francesca Rubino, Andrés M López-Pérez, Oscar E Zazueta, Javier Borboa, Alexa C Quintana, Will Probert, Jill K Hacker, Paola Gómez-Castellanos, Leslie C Inustroza-Sánchez, Claudia Herrera Olivas, Christopher D Paddock, Janet Foley","doi":"10.4269/ajtmh.24-0497","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0497","url":null,"abstract":"<p><p>A Rocky Mountain spotted fever (RMSF) epidemic has spread through the state of Baja California, Mexico over the last decade and a half, beginning in Mexicali, and subsequently to Tijuana and to Ensenada by 2018. In October of 2022, we surveyed dogs and homes in randomly selected Áreas Geoestadisticas Básicas (AGEBs) with and without reported human cases. Brown dog ticks (Rhipicephalus sanguineus sensu lato) were found on 33.9% of dogs and in the yards of 23.6% of homes. Homes from AGEBs with cases had over a 6-fold increased odds of ticks being present in the yard than AGEBs without reported cases. Both dogs that were permitted to roam and the presence of roaming dogs in the neighborhood were strongly associated with tick infestation of dogs and homes. No ticks or blood samples were polymerase chain reaction-positive for Rickettsia (R.) rickettsii, the causative agent of RMSF, although 54.6% of dogs were seropositive for spotted fever group rickettsiae, and 17.4% were seropositive for typhus group rickettsiae. R. massiliae and R. felis were detected in eight (1.3%) and 29 (4.8%) ticks, respectively; and R. felis was also detected in eight (4.6%) dog blood samples. Although the pathogenic potential of these other rickettsial species and their role in RMSF transmission remains unclear, our data on tick burdens in dogs and homes as risk factors for RMSF exposure provide further support to the pivotal need to reduce tick burdens and the numbers of roaming dogs to successfully manage the RMSF epidemic in northern Mexico.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447954","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":"The Performance of a Rapid Coronavirus Disease 2019 Antigen Test in Rural Gabon.","authors":"Saskia Dede Davi, Dearie Glory Okwu, Lillian Rene Endamne, Teite Rebecca Hildebrandt, Rella Zoleko-Manego, Ghyslain Mombo-Ngoma, Maradona Daouda Agbanrin, Rafiou Adamou, Ayola Akim Adegnika, Selidji Todagbe Agnandji, Michael Ramharter, Johannes Mischlinger","doi":"10.4269/ajtmh.24-0230","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0230","url":null,"abstract":"<p><p>Access to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing is limited in rural sub-Saharan Africa. We evaluated the performance of the Siemens CLINITEST® rapid coronavirus disease 2019 antigen test under real-life conditions during the pandemic in rural Gabon. From August 2021 to February 2022, 277 participants were tested in Sindara and Lambaréné, Gabon, via outpatient mobile services. Of these participants, 54.6% were female, with a median age of 29 years (interquartile range: 12-55). The test performance was analyzed for the main population and for SARS-CoV-2 infected sub-populations at both study sites (Lambaréné and Sindara). We further evaluated subpopulations with higher viral loads using a cycle threshold (Ct) value restricted to <35, 30, 25, and 20. Overall test sensitivity in the main population was 33.3% (95% CI: 23.6-44.3%), improving to 83.3% (95% CI: 35.9-99.6%) with a Ct value of <20. Specificity across all populations was 100% (190/190; 95% CI: 98.1-100%). The prevalence of polymerase chain reaction-defined SARS-CoV-2 was 31.4%. The positive predictive value was 100% (95% CI: 88.1-100%), and negative predictive value was 76.6% (95% CI: 70.8-81.7%). Sensitivity in Sindara was 71.4% (95% CI: 29-96.3%) and 30% (95% CI: 20.3-41.3%) in Lambaréné. The Siemens CLINITEST® demonstrated high specificity but low sensitivity overall. However, it exceeded the WHO-defined quality criteria of 80% in participants with high viral loads, making it a useful tool in resource-limited settings.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447964","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":"Analysis of the Evolutionary Relationship between Species of the New Triatoma pseudomaculata Subcomplex (Hemiptera, Triatominae) and Proposal for the Creation of the Triatoma costalimai Subcomplex.","authors":"Isabella da Silva Masarin, Jader de Oliveira, Yago Visinho Dos Reis, Amanda Ravazi, Fernanda Fernandez Madeira, Samanta Cristina Antoniassi Fernandes Tadini, Cleber Galvão, Maria Tercília Vilela de Azeredo-Oliveira, João Aristeu da Rosa, Kaio Cesar Chaboli Alevi","doi":"10.4269/ajtmh.23-0415","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0415","url":null,"abstract":"<p><p>Triatomines are insects of great importance for public health, as they are vectors of protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. The genus Triatoma is the most representative in number of species and one of the most important from an epidemiological point of view. The Triatoma pseudomaculata subcomplex (composed of the species Triatoma arthurneivai, T. pseudomaculata, and T. wygodzinskyi [from the old subcomplex Triatoma maculata] and Triatoma baratai, Triatoma costalimai, Triatoma deaneorum, Triatoma jatai, and Triatoma williami [from the old Triatoma matogrossensis subcomplex]) was recently proposed based on chromosomal data. Thus, considering that the experimental crossings helped with systematic questions about triatomines, we performed crosses between the species of the T. pseudomaculata subcomplex. Thus, we crossed T. pseudomaculata and Triatoma costalimai to assess the possible presence of interspecific genomic and reproductive compatibility. In addition, based on the molecular data available on GenBank, we performed a phylogenetic systematics study to assess the evolutionary relationship of the species of the T. pseudomaculata subcomplex. Experimental crosses did not result in hybrids, demonstrating that there is a prezygotic barrier established between these species. Based on the above, we confirmed the specific status of T. pseudomaculata and T. costalimai based on the biological species concept. Furthermore, the reproductive incompatibility associated with the phylogenetic systematic analyses demonstrate that T. costalimai does not belong to the T. pseudomaculata subcomplex. Thus, we suggest that the sister species T. costalimai and T. jatai should be grouped into a new subcomplex called T. costalimai.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447912","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":"A Honduran Prevalence Study on Soil-Transmitted Helminths Highlights Serological Antibodies to Tm-WAP49 as a Diagnostic Marker for Exposure to Human Trichuriasis.","authors":"Neima Briggs, Leroy Versteeg, Rojelio Mejia, Jeroen Pollet, Maria Jose Villar, Bin Zhan, Graeme Segal, Stephanie Novak, Patricia Lenihan, Paul Musgrave, Viviana Ellis, Carol Florencia Coello, K Jagannadha Sastry, Joe Craft, Peter J Hotez, Maria Elena Bottazzi","doi":"10.4269/ajtmh.24-0514","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0514","url":null,"abstract":"<p><p>Soil-transmitted helminth (STH) infections rank among the most prevalent communicable diseases of humans, yet detection of these parasites is mostly restricted to identifying active infection through fecal examinations. Currently, there are no commercial diagnostic tools to identify a prior whipworm or hookworm exposure, and the few serological assays for roundworm infection have not been well validated for crossreactivity or infections in humans. Such diagnostic restrictions limit the range of scientific and clinical questions that surround STH exposures and their implicated relationship to chronic diseases, such as autoimmunity, allergy, and cancer. The goal of this investigation was to evaluate the diagnostic potential of 13 STH recombinant proteins. As there are no gold standard tests to verify positive STH antisera, we used sera from active STH-infected individuals in Honduras (measured by quantitative real-time polymerase chain reaction of helminth DNA in stool) and compared antibody recognition by both ELISA and western blot with nonendemic control sera from age-matched individuals in the United States split into screening and validation cohorts. One recombinant protein, rTm-WAP49, shows potential as a whipworm diagnostic tool by receiver-operator characteristic analysis (area under the curve = 0.997, P <0.001) and indirect ELISA with sensitivity of 100% and specificity of 91% as defined by mean plus two SDs from the nonendemic screening cohort. We found discrepancies in serological recognition of previously tested STH antigens, highlighting the need to consider different technologies before down selection of a promising diagnostic candidate and screen multiple endemic populations before widely accepting an STH serological assay.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397774","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":"Assessment of Bleeding in Acute Febrile Illness with Thrombocytopenia Using Thromboelastography and Conventional Coagulation Parameters in the Emergency Department (ABATE): A Prospective Cohort Study.","authors":"Rachana Bhat, Nitin Gupta, Prithvishree Ravindra, Praveen Kumar Tirlangi, Ganesh V Mohan, Khalid Mohammad, Ankit Kumar Sahu, Ashwitha Bhat, Jayaraj Mymbilly Balakrishnan, Kavitha Saravu","doi":"10.4269/ajtmh.24-0560","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0560","url":null,"abstract":"<p><p>Acute febrile illnesses (AFIs) with thrombocytopenia, such as dengue, leptospirosis, and scrub typhus, are often associated with bleeding and present challenges in transfusion therapy during outbreaks. Conventional bleeding predictors, which involve platelet counts, do not assess clot strength or fibrinolysis defects and may lead to inappropriate or delayed transfusions. To predict bleeding, we aimed to create a scoring system using point-of-care thromboelastography (TEG) and other conventional coagulation parameters. In this prospective cohort study, patients with AFI and platelet counts <100,000/cu mm who presented to the emergency department were recruited, and samples were collected for conventional coagulation tests and TEG analysis at admission. Patients were monitored for 48 hours for bleeding events, blood product transfusions, and mortality within 7 days. Receiver operating characteristic curves were plotted for significant predictors identified in univariate analysis, and a scoring system was generated using stepwise logistic regression. Sixty-six patients were recruited, including 38 with dengue and 11 with leptospirosis. Nineteen patients experienced a bleeding event within 48 hours. Dyspnea and elevated aspartate transaminase levels were more prevalent among those who bled. Thromboelastography parameters (reaction time/maximum amplitude [R/MA]), prothrombin time, international normalized ratio (INR), and baseline platelet count were significant predictors of bleeding. A scoring system using R/MA, INR, and platelet count achieved an overall predictive accuracy of 83.3% for 48-hour bleeding, with a score ≥3 demonstrating a sensitivity of 68% and specificity of 77%. Thromboelastography in patients with dengue showed more significant coagulation abnormalities than in those with leptospirosis. Validation in larger, more homogeneous populations is necessary.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397820","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":"Lateral-Flow Antibody Detection Device for the Diagnosis of Human Fascioliasis Using Simulated Whole-Blood Samples.","authors":"Patcharaporn Boonroumkaew, Lakkhana Sadaow, Nongnapas Kanchanangkul, Rutchanee Rodpai, Oranuch Sanpool, Hiroshi Yamasaki, Pewpan M Intapan, Wanchai Maleewong","doi":"10.4269/ajtmh.24-0754","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0754","url":null,"abstract":"<p><p>Fascioliasis, which is caused by Fasciola hepatica and Fasciola gigantica (F. gigantica), is a public health problem worldwide. Stages infective to humans occur on aquatic plants and in water. The gold standard for diagnosing human infection depends on finding fluke eggs in stool samples. However, this method has low diagnostic sensitivity; eggs from other trematode species might be misidentified as those of Fasciola, and eggs are not voided in ectopic infections. Therefore, serological analysis can support the diagnosis of human fascioliasis. We evaluated whether a new fascioliasis immunochromatographic test kit, which detects specific IgG antibodies using F. gigantica excretory-secretory antigen, can be used for rapid diagnosis from whole blood. The kit (\"the fascioliasis whole-blood test kit\") was evaluated under laboratory conditions using 250 whole-blood samples (WBSs), of which 41 were from fascioliasis cases. Results based on simulated WBSs and the corresponding serum samples were compared and showed almost perfect agreement (percent agreement = 97.2%; kappa value = 0.9145). The diagnostic sensitivity and specificity of the test using simulated WBSs were 97.6% and 96.2%, respectively. Comparable values when serum samples were tested were 100.0% and 93.3%, respectively. This kit represents a significant advance because it does not require extensive training of personnel, is easy to use, and can support diagnosis at the bedside or in local and remote hospitals with limited facilities. The kit may also contribute significantly to epidemiological surveys.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397897","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":"Prognostic Models in Patients with Dengue: A Systematic Review.","authors":"Carlos Diaz-Arocutipa, María Chumbiauca, Percy Soto-Becerra","doi":"10.4269/ajtmh.24-0653","DOIUrl":"10.4269/ajtmh.24-0653","url":null,"abstract":"<p><p>There is uncertainty regarding the usefulness of predictive models for dengue prognosis. We performed a systematic review to identify and evaluate prognostic models in patients with dengue. We conducted a literature search in PubMed, Embase, and Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) up to May 24, 2023. We included case-control and cohort studies that developed or validated multivariable prognostic models related to severity, hospitalization, intensive care unit (ICU) admission, or mortality in patients of any age with a laboratory-based diagnosis of dengue. A narrative synthesis of the performance measures of the prognostic models evaluated in each study was performed. Of the 4,211 articles, a total of 35 studies reporting information on 43 prognostic models were included. Among these, 35 were developmental and 8 were for external validation. Most models were designed to predict severity (n = 30), followed by mortality (n = 10), hospitalization (n = 2), and ICU admission (n = 1). The reported C-statistic in the models ranged from 0.70 to 0.95 for severity, 0.83 to 0.99 for mortality, 0.87 for hospitalization, and 0.92 for ICU admission. Calibration measures were poorly reported in the vast majority of models. According to the Prediction Study Risk of Bias Assessment Tool, the risk of bias was considered high for all included models, and applicability was of low concern for most models. Our study identified multiple prognostic models, particularly for predicting severity and mortality in patients with dengue. Although most models demonstrated acceptable discriminative ability, calibration measures were poorly reported, and the overall methodological design was poor.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"898-908"},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397901","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}