BMC Infectious Diseases最新文献

{"title":"Impact of COVID-19 control measures on influenza positivity among patients with acute respiratory infections, 2018-2023: an interrupted time series analysis.","authors":"Wei Chen, Huabin Wang, Xianlin Ten, Miao Fu, Meili Lin, Xiaoping Xu, Yongjun Ma","doi":"10.1186/s12879-025-11279-6","DOIUrl":"10.1186/s12879-025-11279-6","url":null,"abstract":"<p><strong>Background: </strong>After experiencing the global COVID-19 pandemic, whether there have been new changes in the epidemiological characteristics of influenza has become a topic of great concern. This study aims to investigate the impact of implementation and lifting of COVID-19 control measures on influenza positivity among patients with acute respiratory infections (ARI) from 2018 to 2023.</p><p><strong>Methods: </strong>The data were collected from January 2018 to December 2023 in two designated sentinel hospitals in Jinhua. We performed an interrupted time series analysis (ITSA) using a beta regression model and a generalized additive model (GAM), adopting a two-model cross-validation strategy to assess the effect of two major interventions on influenza positivity: the COVID-19 control measures implemented in early 2020 and lifted at the end of 2022. We also analyzed influenza epidemiological characteristics and seasonality before, during, and after the pandemic.</p><p><strong>Results: </strong>A total of 98,244 cases were included in this study, and the overall influenza positivity rate was 39.34%. Females and the 6-17-year age group had higher positivity rates. Before the pandemic, influenza primarily showed a winter peak pattern, whereas during the pandemic, the positivity rate declined significantly with no distinct peak. After the pandemic ended, an unusual dual-peak pattern emerged. The interrupted time series analysis revealed that, following the implementation of non-pharmaceutical interventions (NPIs) in early 2020, influenza positivity immediately decreased significantly in the beta regression model (β = -1.75, p = 0.003). After the lifting of measures in late 2022, a marginally lagged increasing trend was observed in the beta regression model (β = 0.14, p = 0.096) and a significant increasing trend was found in the GAM model (edf = 7.00, p < 0.001). Seasonal effects differed between the models: the beta regression model exhibited significant annual seasonal fluctuations (sin12 = 0.67, p < 0.001), while the GAM model did not exhibit a significant association independent of the time trend.</p><p><strong>Conclusion: </strong>COVID-19 and its control measures substantially reduced influenza positivity rates; however, once these measures were lifted, influenza activity resurged, and its seasonal epidemic pattern changed. The intensity of influenza appeared to exceed pre-pandemic levels, underscoring the importance of NPIs in controlling respiratory infectious diseases. Strengthened surveillance and optimized strategies remain necessary to mitigate the threat of influenza in the post-pandemic era.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"925"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-COVID-19 epidemiology of community respiratory viruses at a single US center reveals sex differences in influenza A and a higher ICU incidence of human metapneumovirus in the elderly population.","authors":"Bibek Koirala, Aline Azar, Brianna Fountain, Melissa McGuirl, Shannon Stock, Marzena Galdzicka, Richard T Ellison","doi":"10.1186/s12879-025-11307-5","DOIUrl":"10.1186/s12879-025-11307-5","url":null,"abstract":"<p><strong>Background: </strong>Few studies have simultaneously examined the epidemiology and sex differences of diverse community respiratory viruses, including human metapneumovirus (HMPV), over more than one season.</p><p><strong>Methods: </strong>Given that molecular testing for community respiratory viruses was widely performed on patients at UMass Memorial Medical Center between January 2010 and December 2013, a retrospective study was conducted to examine epidemiologic features of positive subjects. Initial testing was done with rapid influenza and respiratory syncytial (RSV) virus antigen testing, with negative testing reflexed to a multiplex nucleic acid amplification platform detecting nine respiratory viruses.</p><p><strong>Results: </strong>Four thousand ninety-eight (50.6%) of 8092 patients tested positive for at least one virus. The majority (75.3%) of individuals testing positive were inpatients. Rhinovirus/enterovirus was most frequently detected; influenza A was more common in older adults and RSV incidence was highest among patients < 5 years of age. Pronounced seasonality was seen with influenza viruses, RSV, HMPV, and parainfluenza 3 virus. Influenza A was significantly more common in females (11.2% vs. 8.1%; p < 0.001), while parainfluenza 1 virus (2.0% vs. 1.2%; p < 0.01), rhinovirus/enterovirus (23.4% vs. 19.9%; p < 0.001) and adenovirus (2.1% vs. 1.5%; p < 0.05) were significantly higher in males. Of the ICU patients with HMPV, many (40.3%) were ≥ 65 years of age.</p><p><strong>Conclusions: </strong>This pre-coronavirus disease 2019 (COVID-19) era study has one of the largest patient populations evaluated for community respiratory virus infections. It confirms known epidemiology, seasonality, and coinfections, and importantly shows a preponderance of influenza A infections among women, contrasting prior studies, which warrants further investigation. It also shows a high HMPV incidence in the ICU among the elderly, underscoring the importance of testing in this population.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"924"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic arthritis score (SAS) - a novel clinical prediction model for the probability of septic arthritis in the adult native knee.","authors":"Jonas Tverring, Amelia Johansson, Omid Bornaei, Adam Lantz, Oskar Ljungquist","doi":"10.1186/s12879-025-11306-6","DOIUrl":"10.1186/s12879-025-11306-6","url":null,"abstract":"<p><strong>Background: </strong>Patients presenting with an acutely painful swollen joint represent a diagnostic challenge. We aimed to develop a clinical prediction model for septic arthritis (SA) in the adult native knee.</p><p><strong>Methods: </strong>We screened all synovial cultures in south Sweden in 2020 and 2021. We included cultures taken in the emergency department from adults' native knees where SA was considered a differential diagnosis based on medical chart review. We developed a prediction model using logistic regression and performed internal validation using bootstrapping. We present a nomogram and an online calculator ( http://sascore.org ) for individual risk estimation, net benefit compared to usual care and treatment threshold recommendations.</p><p><strong>Results: </strong>A total of 668 patients were included from 2996 screened synovial cultures. The final septic arthritis score (SAS) included four variables: synovial-to-serum glucose quotient, synovial white blood cell count, abnormal synovial fluid appearance on visual inspection, and triage priority according to Rapid Emergency Triage and Treatment System (RETTS) vital signs. SAS had an optimism-adjusted area under the receiver operating characteristics curve of 0.971 (95% bootstrap confidence interval: 0.957 to 0.987). Clinicians provided empirical intravenous antibiotics to 47 out of 51 patients with a final diagnosis of SA and to 244 out of 617 patients without SA (92% sensitivity, 60% specificity). SAS had 92% sensitivity and 92% specificity at 10% probability for SA treatment threshold and 100% sensitivity and 79% specificity at 2% treatment threshold.</p><p><strong>Conclusion: </strong>The use of SAS would theoretically avoid 50-82% of unnecessary empirical antibiotics as compared to usual care in our cohort with retained or improved identification of actual septic arthritis of the native knee. External validation is warranted before clinical use.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"926"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors associated with sexually transmitted infections among adults attending an STI clinic in a small island developing state.","authors":"Akil J Williams, T'Shara P Ali, Imani D Griffith, Simone T Jeremie, Shivani Mahabir, Chelsea A Sudan, Kristof C Stüven, Marsha A Ivey","doi":"10.1186/s12879-025-11297-4","DOIUrl":"10.1186/s12879-025-11297-4","url":null,"abstract":"<p><strong>Background: </strong>To determine the prevalence and risk factors associated with STIs among adults 18 years or older attending two STI clinics in Trinidad.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a convenience sample of 250 persons, ≥ 18 years old, visiting two STI testing sites. Interviewer-administered questionnaires collected data on participants' socio-demographic characteristics, self-reported STI history during the past 12 months, sexual orientation and behaviour, and substance use. Descriptive statistics, Chi-Squared test and crude odds ratios were generated using STATA version 15.</p><p><strong>Results: </strong>Of the 250 participants, most were 25-31 years old (27%, 68/250), female (53%, 132/250), single (68%, 170/250), Afro-Trinidadian (55%, 136/250), had secondary level education or lower (68%, 170/250), employed (55%, 138/250), heterosexual (90%, 224/250) and did not consume alcohol (39%, 95/250). More than half (51%, 127/250) used condoms sometimes, and most did not use a condom during their last sexual encounter (76%, 178/233). Self-reported STI prevalence was 28% (70/250), of which the most common STIs were gonorrhea (12%, 31/250), herpes (6%, 15/250) and syphilis (5%, 13/250). There were significant gender differences between STI prevalence and employment status, having multiple sexual partners and alcohol consumption (p < 0.05 each). The odds of reporting an STI were higher among individuals with lower educational attainment (OR: 6.14, 95% CI: 2.66-14.16, p < 0.001), low monthly household income (OR: 2.26, 95% CI: 1.08-4.71, p = 0.030) and non-heterosexual persons (OR: 2.93, 95% CI: 1.28-6.69, p = 0.010). However, being employed (OR: 0.36, 95% CI: 0.18-0.71, p = 0.003) or a student (OR: 0.19, 95% CI: 0.05-0.74, p = 0.017) was protective against STI. There were no observed associations reported for sexual behaviours and substance use.</p><p><strong>Conclusion: </strong>The prevalence of STIs was significant among adults attending an STI clinic. These findings highlight the importance of targeted interventions addressing socio-demographic and behavioural factors in the prevention and control of STIs, particularly focusing on high-risk groups such as individuals with low education, low household income and members of sexual minority groups.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"923"},"PeriodicalIF":3.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High daily dose Short COurse PrimaquinE after G6PD testing for the radical cure of Plasmodium vivax malaria in Indonesia and Papua New Guinea: the SCOPE implementation study protocol.","authors":"","doi":"10.1186/s12879-025-11109-9","DOIUrl":"10.1186/s12879-025-11109-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Plasmodium vivax malaria remains an important threat to the public in the Asia Pacific region. Preventing P. vivax relapses is crucial for reducing morbidity from malaria and ultimately controlling and eliminating this species. Primaquine is the only widely available drug with antirelapse activity against dormant stages of P. vivax. Its widespread use in clinical practice is limited by its potential to cause severe haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The primary aims of this staged, binational, multicentre, before-and-after implementation study are to determine the safety, feasibility, and cost-effectiveness of a revised package of case management interventions for improved P. vivax radical cure. The interventions include: i) pre-treatment testing of patients for G6PD deficiency using a semi-quantitative point-of-care device from SDBiosensor (ROK); ii) prescription of high dose primaquine (7mg/kg total dose) either over 7 days for G6PD normal patients (≥ 70% activity) or 14 days for intermediate patients (30- &lt; 70% activity), or lower dose weekly primaquine over 8 weeks for deficient patients (&lt; 30% activity); iii) improved patient education processes; iv) routine community-based review on day 3 (and day 7 for Stage 1) and v) enhanced malariometric surveillance and community pharmacovigilance. Stage 1 of the study (800 patients) will be implemented at 4 community clinics across Indonesia and Papua New Guinea (PNG) and will focus on analysis of treatment safety. If safety of the intervention is confirmed during Stage 1, the study will proceed to Stage 2, in which patient recruitment will be expanded to 10 clinics across Indonesia and PNG, and the feasibility of the similar intervention package will be assessed, but with a single community-based review on day 3. Stage 2 will run for 12 months and recruit approximately 11,410 patients. Mixed methods analyses of Stage 2 data will focus on the operational feasibility and cost-effectiveness of the revised case management package, with effectiveness determined through analysis of individual-level risk of P. vivax recurrence and population-level changes in incidence (with comparison to the pre-implementation period). Feasibility will be assessed via qualitative observations, in-depth interviews and focus groups of health care workers and participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The intervention package will provide critical information on the safety, feasibility and cost-effectiveness of achieving radical cure with G6PD testing prior to high dose primaquine treatment and community-based follow-up. The study results will inform national malaria programs aiming to eliminate P. vivax in Indonesia and PNG by 2030.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The study was registered on clinicaltrials.gov for Indonesia: NCT05879224 on the 18th May 2023 and PNG: NCT05874271 on the 16th May 2023.&lt;/","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"922"},"PeriodicalIF":3.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic changes of chronic hepatitis B patient with loss of surface antigen: a case report.","authors":"Chong Wang, Lin Lin, Da Peng Ding","doi":"10.1186/s12879-025-11337-z","DOIUrl":"10.1186/s12879-025-11337-z","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection remains a significant global health challenge, particularly in regions like China, where the prevalence of HBV carriers is high. We report the dynamic serological and virological changes in a chronic HBV patient who exhibited HBsAg loss and subsequent reversion, explore the complex molecular mechanisms of atypical serological profile.</p><p><strong>Case presentation: </strong>A 65-year-old male with a 40-year history of chronic HBV infection presented with hepatocellular carcinoma (HCC). Over three years, the patient underwent multiple interventions, including transarterial chemoembolization (TACE) and targeted therapies. Serial monitoring revealed a gradual decline in HBsAg levels, leading to seronegativity, followed by HBsAg reversion two years later. HBV DNA levels were quantified at 1.45 × 10³ IU/mL during HBsAg seronegativity. Genetic analysis identified multiple mutations in the HBV S gene, potentially altering HBsAg structure and antigenicity, contributing to the atypical serological profile.</p><p><strong>Conclusions: </strong>This case underscores the complexity of HBV serological dynamics in the context of chronic infection and cancer treatment. The observed HBsAg fluctuations highlight the need for vigilant monitoring and advanced diagnostic techniques, such as HBV DNA testing, in patients with chronic HBV, particularly those undergoing immunosuppressive therapies. The identified S gene mutations may explain the serological changes, emphasizing the importance of genetic analysis in understanding HBV evolution and guiding clinical treatment.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"918"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of immune recovery in people living with HIV who initiated antiretroviral therapy as late presenters.","authors":"Sandra Pinto-Cardoso, Monserrat Chávez-Torres, Mariana López-Filloy, Santiago Ávila-Ríos, Karla Romero-Mora, Amy Peralta-Prado","doi":"10.1186/s12879-025-11318-2","DOIUrl":"10.1186/s12879-025-11318-2","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"917"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of typhoid and paratyphoid fever from 1990 to 2021 and the impact on prevention and control.","authors":"Guihong Liu, Xin Zhang, Qian Cao, Tao Chen, Binbin Hu, Huashan Shi","doi":"10.1186/s12879-025-11223-8","DOIUrl":"10.1186/s12879-025-11223-8","url":null,"abstract":"<p><strong>Background: </strong>Typhoid and paratyphoid fever are common infectious diseases and remain a heavy burden, especially in some low-income countries. Although the global burden has decreased over the past three decades, an analysis of the burden of typhoid and paratyphoid fever will help inform public health strategies.</p><p><strong>Methods: </strong>This study is aimed to comprehensively evaluate the global, regional, and national burden of typhoid and paratyphoid, and the temporal trends while exploring potential associations with socio-demographic development over three decades (1990-2021). Data on typhoid and paratyphoid fever were analyzed using the Global Burden of Disease (GBD) study in 2021. For this analysis, we calculated to demonstrate temporal trends in the incidence, mortality, and disability adjusted life years (DALYs) of typhoid and paratyphoid fever from 1990 to 2021.</p><p><strong>Results: </strong>From 1990 to 2021, both typhoid and paratyphoid fever showed declining trends globally and in different socio-demographic index (SDI) regions, including incidence, mortality, and DALYs. For typhoid fever worldwide, new cases decreased by 62.12%, with an EAPC of -3.92 (-4.14, -3.71); deaths decreased by 50.65%, EAPC - 2.83 (-2.99, -2.66), and DALYs decreased by 52.30%, EAPC - 2.82 (-3.00, -2.64). For paratyphoid fever, new cases decreased by 73.15%, with an EAPC of -4.77 (-5.29, -4.26); deaths decreased by 65.44%, EAPC - 3.74 (-4.24, -3.24), and DALYs decreased by 68.42%, EAPC - 3.87 (-4.42, -3.31). For both typhoid and paratyphoid fever, children had the highest morbidity and mortality rates; males had higher rates of incidence, mortality, and DALYs than females. However, among older patients, the absolute number of new cases and DALYs was higher in women. The burden is concentrated in South Asia, Southeast Asia, and Oceania, with only South Asia suffering severely from paratyphoid fever. Regarding typhoid fever, the top three countries with the highest ASRs of incidence are Burkina Faso (328.48) (SDI: 0.285), Bangladesh (303.14) (SDI: 0.492), and Papua New Guinea (299.45) (SDI: 418) which are in Western Sub-Saharan, South Asia, and Oceania. The top three countries in terms of mortality and DALYs are Bhutan (5.61; 434.23) (SDI: 0.473), Bangladesh (5.06; 382.38), and Burkina Faso (4.64; 352.57). Regarding paratyphoid fever, the top three countries with the highest ASRs of mortality and DALYs are the same, including Pakistan (1.05; 72.66), India (0.75; 53.42), and Nepal (0.72; 50.65) (SDI: 0.433), all of which are located in South Asia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"919"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting.","authors":"Cynthia Ahimbisibwe, Richard Kwizera, Jane Frances Ndyetukira, Olivie Carolyne Namujju, Alisat Sadiq, Mucunguzi Atukunda, Caleb P Skipper, David R Boulware, David B Meya","doi":"10.1186/s12879-025-11319-1","DOIUrl":"10.1186/s12879-025-11319-1","url":null,"abstract":"<p><strong>Background: </strong>Besides the commonly used intravenous formulations of amphotericin B, an oral nanocrystal amphotericin B (MAT2203) formulation is being evaluated for efficacy to treat invasive fungal infections. This new experimental oral formulation has not been used before.</p><p><strong>Methods: </strong>Herein, we describe our experiences with using oral amphotericin B for management of patients with HIV-associated cryptococcal meningitis in Uganda from a research nurse perspective.</p><p><strong>Results: </strong>We found oral amphotericin B a better alternative to intravenous amphotericin B deoxycholate due to less toxicity, mostly limited to gastrointestinal-related toxicities only. We clinically observed no drug reactions like rigors, phlebitis, and less vomiting among patients on oral amphotericin B as compared to those on intravenous amphotericin B deoxycholate. Subjectively, meningitis symptoms of patients on oral amphotericin B seemed to overall clinically improve more rapidly compared to those receiving intravenous amphotericin B deoxycholate. Few adverse events were observed. A novel challenge with oral amphotericin was difficulty in monitoring adherence for the night doses in the absence of the healthcare providers.</p><p><strong>Conclusions: </strong>Oral amphotericin B was generally safe and well tolerated. However, it requires some training for the nurse, patient and care takers for better administration, adherence and treatment outcomes.</p><p><strong>Trial registration: </strong>This was observational sub-study that was nested under the EnACT trial. The EnACT trial was registered prospectively. ClincalTrials.gov: NCT04031833; Registration date: July 24, 2019; Last verified: March 31, 2023.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"920"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The resurgence of malaria in Northern Iran in 2023: a wake-up call.","authors":"Faramarz Koohsar, Roghiyeh Faridnia, Ogholniaz Jorjani, Mohammad Taher Hojjati, Ganesh Yadagiri, Ghasem Noshak, Hosein Tavakoli Pirzaman, Hamed Kalani","doi":"10.1186/s12879-025-11266-x","DOIUrl":"10.1186/s12879-025-11266-x","url":null,"abstract":"<p><strong>Background: </strong>Control and elimination programs for malaria in Iran have consistently faced significant challenges due to various factors, including the presence of neighboring malaria-endemic countries such as Afghanistan and Pakistan. In recent years, Golestan Province in northern Iran has recorded few cases of imported malaria, with a sudden increase of 22 cases in 2023. This article provides an overview of the malaria situation in northern Iran, along with a detailed report of these 22 cases.</p><p><strong>Methods: </strong>The study population comprises all individuals exhibiting symptoms suspected of malaria (n = 445) who were referred to the Malaria Diagnosis Center in Golestan Province, located in northeastern Iran, for diagnosis between March 23, 2023, and December 23, 2023. A drop of peripheral blood, collected from a finger prick of each patient, was utilized for Plasmodium falciparum/P. vivax antigen detection. Moreover, thin and thick smears were prepared for each patient to investigate morphological characteristics and parasitemia percentage of the parasites.</p><p><strong>Results: </strong>In total, 4.94% (22/445) of individuals with malaria-suspected symptoms were infected with Plasmodium species. All 22 infected individuals were native to Golestan Province, and none had a previous history. The mean ± standard error of mean (SEM) for the number of parasites/µL of blood sample was 16,029 ± 5,060 for P. vivax and 105,460 ± 102,146 for P. falciparum. Among the patients, 77.27% (17/22) were infected with P. vivax, 18.18% (4/22) were infected with P. falciparum, and 4.54% (1/22) were co-infected with both P. vivax and P. falciparum. In the case of P. falciparum, 40% (1/5) of the samples presented the ring form, 60% (3/5) trophozoite form, and 20% (1/5) gametocyte form. All patients demonstrated a positive response to the treatment, with a decrease in both the number of parasites and the number of clinical symptoms over time.</p><p><strong>Conclusions: </strong>This study discussed 22 cases of malaria diagnosed in 2023 in Golestan Province in northern Iran. Given the presence of malaria vectors in this area and the observation of gametocytes in specimens from some patients, the increase in reported malaria cases could be worrisome in terms of establishing local transmission in this area.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"921"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}