American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Assessment of Health Status and Creation of a Registry of Potential Research Participants Aged 1.5 to 50 Years on Bioko Island, Equatorial Guinea.","authors":"María Silvia Angué López Mikue, Said Abdallah Jongo, Vicente Urbano Nsue Ndong Nchama, Ali Hamad Said, Ali Mtoro, Gertrudis Owono Bidjimi, Marta Alene Owono, Escolastica Raquel Mansogo Maye, Martin Eká Ondo Mangue, Genaro Nsue Nguema Okomo, Beltrán Ekua Ntutumu Pasialo, Dolores Mbang Ondo Mandumbi, Fortunata Lobede Mochomuemue, Juan Carlos Momo Besaha, Raul Chuquiyauri, Kamaka R Kassim, Ali Mohamed Ali, Ummi Abdul Kibondo, Thabit Athuman, Carlos Cortez Falla, Jeremías Nzamio Mba Eyono, Jordan Michael Smith, Guillermo A García, José Raso, Elizabeth Nyakarungu, Maxmillian Mpina, Claudia Daubenberger, Mathilde Riloha Rivas, Tobias Schindler, Laurence Lemiale, B Kim Lee Sim, Marcel Tanner, L W Preston Church, Peter F Billingsley, Stephen L Hoffman, Thomas L Richie, Salim Abdulla","doi":"10.4269/ajtmh.24-0143","DOIUrl":"10.4269/ajtmh.24-0143","url":null,"abstract":"<p><p>A malaria control program established in 2004 on Bioko Island, Equatorial Guinea, achieved significant reductions in malaria prevalence; however, progress subsequently stalled, leading to a proposal to develop and implement a highly effective malaria vaccine to increase impact. After conducting clinical trials of Sanaria® (Rockville, MD) Plasmodium falciparum (P. falciparum) sporozite vaccines against P. falciparum malaria, which demonstrated safety and efficacy, a larger phase 3 trial was planned to support vaccine licensure for specific target populations and eventual island-wide malaria elimination. The Equatorial Guinea Pilot Study for Recruitment, Screening and Participant Registry (EGRESPAR) assessed the health status of the target population and generated a registry of eligible children and adults. Households in areas with malaria prevalence ≥15% were randomly selected, aiming to register 2,100 healthy Equatoguineans divided equally into age groups of 1.5-9, 10-17, and 18-50 years. A total of 6,493 individuals from 1,807 households, who considered themselves or their children to be healthy, completed questionnaires; 2,021 were screened using phase 3 enrollment criteria, 643 were excluded, and 1,378 were entered into the registry. Among those screened, 13.6% had Plasmodium, 1.8% had Loa loa, 4.8% had hepatitis B, 0.5% had hepatitis C, and 2.1% had HIV. Adults were twice as likely to have clinically relevant medical conditions, such as obesity, hypertension, or diabetes, meeting exclusion criteria compared to children. In conclusion, there was a significant prevalence of infections and chronic medical conditions among Bioko Island residents who considered themselves or their children to be healthy and interested in clinical research participation, particularly in adults. The EGRESPAR successfully generated a registry to support the initiation of a large-scale phase 3 vaccine trial.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707890","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 Day in the Life of a Ugandan Healthcare Provider: Managing Neonatal Tetanus.","authors":"Kaitlyn M Pereira, Edrin Jjuuko","doi":"10.4269/ajtmh.24-0774","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0774","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810212","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":"Blood-Meal Hosts of the Enzootic Vector of Eastern Equine Encephalomyelitis Virus, Culiseta melanura, in Michigan, United States.","authors":"John B Keven, Edward D Walker","doi":"10.4269/ajtmh.24-0637","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0637","url":null,"abstract":"<p><p>Eastern equine encephalomyelitis virus (EEEV) is endemic in Michigan, showing an upsurge in human cases and in infections of white-tailed deer, horses, and other animals in the past decade (2010-2020). However, blood-host associations of the enzootic mosquito vector Culiseta melanura in the Great Lakes region are poorly known compared with other better-studied regions. Vertebrate sources of blood meals of Cs. melanura collected from resting boxes were determined through sequencing of the mitochondrial cytochrome B gene generated from polymerase chain reaction. Thirty-six unique avian species were detected in the samples, and 42% of the blood meals originated from only two species (American robin and northern cardinal). This result shows that although the Cs. melanura population investigated here used a wide range of avian hosts, American robin and northern cardinal are the main hosts in southwestern Michigan.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810290","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":"Development of Carbapenem Resistance While on Antibiotic Therapy in a Patient with Melioidosis.","authors":"Matthew Chung Yi Koh, Alicia Ang, Jinghao Nicholas Ngiam, David Michael Allen, Brenda Sze Peng Ang","doi":"10.4269/ajtmh.24-0819","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0819","url":null,"abstract":"<p><p>We present a case of a 46-year-old male with disseminated melioidosis. He initially presented with primary bacteremia but eventually developed a recrudescent infection characterized by meningo-rhombencephalitis, as well as pulmonary and splenic abscesses. This was attributed to the emergence of carbapenem resistance, which developed while he was receiving parenteral antibiotic therapy. The patient eventually improved after switching his antibiotics to a combination of ceftazidime and trimethoprim-sulfamethoxazole. The development of carbapenem resistance in Burkholderia pseudomallei during therapy is rare but may be attributed to mutations resulting in the overexpression of efflux pumps. Combination therapy may play a role in such cases by limiting the emergence of antibiotic resistance.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810298","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 Water Quality among Handwashing and Drinking Water Stations in Schools in Belize, 2022.","authors":"Anh N Ly, Alexandra Kossik, Ary Sosa, Uriel Sosa, Dian Maheia, Yolanda Gongora, Russell Manzanero, Francis Morey, Melissa Diaz-Musa, Dennis Nichols, Adrianna Maliga, Kelsey McDavid, Christina Craig, Gerhaldine Morazan, Matthew Lozier, Kristy O Murray","doi":"10.4269/ajtmh.24-0125","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0125","url":null,"abstract":"<p><p>Water quality assessments are critical for ensuring timely responses to water-related concerns, particularly in low-resource areas with limited water, sanitation, and hygiene (WASH) infrastructure. In collaboration with the Belize Ministry of Health and Wellness and the Ministry of Education, Culture, Science and Technology, we conducted a survey on WASH infrastructure and resources among 221 schools. We identified 65 schools across all six districts of Belize for water quality testing. Among these 65 schools, 83% had at least one water sample that did not meet the WHO's recommended free chlorine residual level for drinking water. Additionally, coliforms and Escherichia coli were detected in at least one drinking or handwashing water sample from 43 (66%) and 14 (22%) schools, respectively. These findings underscore the importance of routine water quality testing in schools to inform timely public health responses.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810286","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":"Manual Single-Lumen Alternating Microbatch Dialysis to Deplete Stored Blood Potassium: A Potential Use for Children with Severe Malaria-Associated Acute Kidney Injury.","authors":"Rebecca Coriolan, Apaara Chawla, Jolyn Morgan, Amanda Snyder, James Rose, Giovanni Ceschia, Gianna Zangri, Andrea L Conroy, Anthony Batte, Stuart L Goldstein, Denise C Hasson","doi":"10.4269/ajtmh.24-0756","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0756","url":null,"abstract":"<p><p>Acute kidney injury (AKI) remains a common cause of preventable death in low-resource settings because of cost and lack of dialysis access. AKI occurs in 24-59% of children with severe malaria, and when severe malaria-associated acute kidney injury (SM-AKI) is complicated by hyperkalemia, mortality approaches 40%. Treatment of these children with severe anemia becomes challenging as packed red blood cells (pRBCs) have high potassium (K+) loads. We describe a protocol using the novel manual single-lumen alternating microbatch (mSLAMB) dialysis system to deplete pRBCs of K+, hypothesizing that this system can decrease K+ >80% in 20 minutes. Herein, we ran pRBC aliquots through the mSLAMB system using diffusive clearance. Three cycles were completed in each of four experiments. K+ was measured at baseline and after every cycle to calculate K+ reduction. Active ultrafiltration was performed to control net volumes, assessed as percentage of blood volume reduction and hematocrit rise. We reduced K+ in pRBC aliquots by a median of 93.2% (interquartile range [IQR], 89.9-95.1) in a median of 20.5 minutes (IQR, 17.8-23.1) per experiment. Greatest median K+ reduction occurred in cycle 1 (80.9%; IQR, 80.8-80.9), with minimal additional clearance achieved by cycle 3. Median hematocrit rise at experiment conclusion was 2.5% (IQR, 1.8-3.3). We conclude that mSLAMB dialysis consistently and effectively removed >80% of K+ from pRBCs in just over 20 minutes and facilitated volume control. Further studies are assessing transfusion risks in children with SM-AKI and hyperkalemia as this technique may allow for safer resuscitation.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810325","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":"Age-Specific Seroprevalence of Measles, Mumps, and Rubella IgG across All Age Groups in Chonburi Province, Thailand after the Coronavirus Disease 2019 Pandemic.","authors":"Nasamon Wanlapakorn, Preeyaporn Vichaiwattana, Thanunrat Thongmee, Jira Chansaenroj, Yong Poovorawan","doi":"10.4269/ajtmh.25-0005","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0005","url":null,"abstract":"<p><p>Thailand's Expanded Program on Immunization revised the timing of the second measles, mumps, and rubella (MMR) vaccine dose to 2.5 years in 2014 and later to 1.5 years in 2020. These adjustments can temporarily reduce vaccine coverage as the population transitions to the new schedules. Combined with disruptions caused by the coronavirus disease 2019 (COVID-19) pandemic, these changes may have adversely affected vaccine uptake and overall population immunity. This study aimed to evaluate the age-specific seroprevalence of anti-measles, anti-mumps, and anti-rubella IgG in individuals across all age groups in Chonburi province, Thailand, following the COVID-19 pandemic. Between October 2022 and January 2023, 650 participants from Chonburi were included and categorized into nine age groups: <5, 5-10, 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, and >70 years. The levels of antibodies were analyzed using commercial ELISA kits. Overall, 77.5%, 55.1%, and 84.1% were seropositive for MMR antibodies, respectively. Adolescents aged 11-20 years had the lowest seropositivity rates for measles (47.0%) and mumps (27.6%), followed by young adults aged 21-30 years. Rubella seropositivity rates were similarly low in these groups. This study highlights immunity gaps for measles in adolescents and young adults. To address this gap and support ongoing measles elimination efforts, targeted interventions, such as supplementary immunization activities with a booster dose of measles-containing vaccines for this age group, are recommended to prevent the potential resurgence of measles in the near future.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972997","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":"Conventional DNA Extraction Followed by Real-Time PCR Had Higher Sensitivity for Detection of Mycobacterium Tuberculosis in Clinical Samples Compared to Standard Methods.","authors":"Angel Sebastian Rodriguez-Pazmiño, Bernardo Castro-Rodríguez, Greta Esther Cardenas-Franco, Greta Franco-Sotomayor, Elsy Carvajal, Joselyn Calderon, Darwin Santiago Paredes, Heidy Buenaño-Morales, Manuel González, Lina Macero, Rita García, Solon Alberto Orlando, Miguel Angel Garcia-Bereguiain","doi":"10.4269/ajtmh.24-0797","DOIUrl":"10.4269/ajtmh.24-0797","url":null,"abstract":"<p><p>The Mycobacterium tuberculosis complex (MTBC), the causative agent of tuberculosis (TB), remains a significant global health challenge, with an estimated 10.8 million cases diagnosed and 1.25 million deaths in 2023, according to the WHO. In this context, enhancing TB case detection using more sensitive diagnostic methods is essential. Here, we compared the performance of two commercial real-time polymerase chain reaction (PCR) kits with the reference standards of smear microscopy, culture, and Gene Xpert. By analyzing 402 clinical specimens, we found that conventional DNA extraction, followed by real-time PCR, using either of the two commercial kits provided the highest sensitivity for detecting MTBC. Positivity values of 48.98-60.07% and 50.34-53.24% were obtained with the commercial kits \"VIASURE MTBC + non tuberculous mycobacterias (NTM) Real-Time PCR Detection Kit\" (Certest, Spain) and \"ANYPLEX™ MTB/NTM Real-Time Detection Kit\" (Seegene, South Korea), respectively. In contrast, the reference standards yielded positivity values of 14.75% (smear microscopy), 32.65% (culture), and 28.95% (GeneXpert assay). These alternative methods should be considered as valuable tools to strengthen TB control and prevention strategy.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762695","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":"Fluid Resuscitation in Pediatric Cerebral Malaria: Insights from the FEAST Trial and Further Evidence from Malawi.","authors":"Elizabeth C George, Kathryn Maitland","doi":"10.4269/ajtmh.25-0132","DOIUrl":"10.4269/ajtmh.25-0132","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762743","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":"Development and Internal Validation of a Risk Assessment Tool to Identify Neonates at Risk for 60-Day Hospital Readmission in Dar es Salaam, Tanzania, and Monrovia, Liberia.","authors":"Rodrick R Kisenge, Evance Godfrey, Readon C Ideh, Julia Kamara, Ye-Jeung Coleman-Nekar, Abraham Samma, Hussein K Manji, Christopher R Sudfeld, Adrianna Westbrook, Michelle Niescierenko, Claudia R Morris, Cynthia G Whitney, Robert F Breiman, Christopher P Duggan, Karim P Manji, Chris A Rees","doi":"10.4269/ajtmh.24-0648","DOIUrl":"10.4269/ajtmh.24-0648","url":null,"abstract":"<p><p>Hospital readmissions among neonates are common and may reflect ongoing illness. We conducted a prospective observational cohort study of neonates discharged from two hospitals, one in Dar es Salaam, Tanzania, and one in Monrovia, Liberia, to develop and internally validate a risk assessment tool to identify neonates at risk for unplanned readmission within 60 days of discharge. One hundred and fifteen candidate variables were collected. The outcome of unplanned readmission was identified through phone calls to caregivers. We constructed a multivariable logistic regression model with best subset selection to identify the optimal combination of variables to identify neonates at risk for readmission. We used bootstrap validation with 500 repetitions to internally validate the tool. Of the 2,344 neonates discharged, 98.5% were enrolled and had 60-day outcomes. Of these, 3.6% were readmitted within 60 days of discharge, with 41.7% of readmissions occurring within 14 days of discharge. The risk assessment tool included eight variables that were predictive of readmissions. Neonates who had documented abnormal posturing during hospital admission (adjusted odds ratio [aOR] 7.29, 95% CI 1.51-35.12), hydrocephalus (aOR 7.52, 95% CI 1.21-46.95), and low birth weight (aOR 3.16, 95% CI 1.69-5.92) had the greatest risk of readmission. The overall discriminatory value of the risk assessment tool was 0.77 (95% CI 0.76-0.79). The risk assessment tool demonstrated excellent calibration for predicting readmissions at low scores. However, this tool requires external validation before it can be used in sub-Saharan Africa to direct resources for follow-up of high-risk neonates.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762721","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}