Journal Description
Tropical Medicine and Infectious Disease
Tropical Medicine and Infectious Disease
is an international, scientific, peer-reviewed, open access journal of tropical medicine and infectious disease published monthly online by MDPI. It is the official journal of the Australasian College of Tropical Medicine (ACTM) and its Joint Faculties of Travel Medicine and Expedition and Wilderness Medicine.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Informit, and other databases.
- Journal Rank: JCR - Q1 (Tropical Medicine) / CiteScore - Q2 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.9 days after submission; acceptance to publication is undertaken in 4.8 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.8 (2023);
5-Year Impact Factor:
3.0 (2023)
Latest Articles
Incidence of Scrub Typhus According to Geographical and De-mographical Characteristic Changes in Chungcheong Region
Trop. Med. Infect. Dis. 2024, 9(7), 147; https://doi.org/10.3390/tropicalmed9070147 - 30 Jun 2024
Abstract
To determine the incidence trends of scrub typhus in the Chungcheong region, we analyzed the epidemiological survey information of 14,379 cases with scrub typhus reported to the integrated disease health management system of the Korea Centers for Disease Control and Prevention between 2012
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To determine the incidence trends of scrub typhus in the Chungcheong region, we analyzed the epidemiological survey information of 14,379 cases with scrub typhus reported to the integrated disease health management system of the Korea Centers for Disease Control and Prevention between 2012 and 2022 along with the demographic data collected from the Korean Statistics Information Service. Geographical analyses were performed to confirm the correlation between high-risk areas and the proportion of elderly people. The average age, proportion of elderly people, and changes in the agricultural population were statistically associated with incidence. Incidence of scrub typhus and agricultural population in the Chungcheong region has shown a decrease compared with that in 2012–2013. However, recent trends indicate a resurgence linked to increased outdoor activities with higher risks observed among older age groups. Additionally, advancing age correlates with a heightened probability of reinfection and additional infections with other febrile diseases. The incidence of scrub typhus in the Chungcheong region (2012–2022) is changing according to age group and route of infection, highlighting the need for revised prevention and promotion policies.
Full article
(This article belongs to the Special Issue Infectious Disease Prevention and Control: A One Health Approach)
Open AccessArticle
Clinical Prediction Rules for In-Hospital Mortality Outcome in Melioidosis Patients
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Sunee Chayangsu, Chusana Suankratay, Apichat Tantraworasin and Jiraporn Khorana
Trop. Med. Infect. Dis. 2024, 9(7), 146; https://doi.org/10.3390/tropicalmed9070146 - 28 Jun 2024
Abstract
Background: Melioidosis, a disease induced by Burkholderia pseudomallei, poses a significant health threat in tropical areas where it is endemic. Despite the availability of effective treatments, mortality rates remain notably elevated. Many risk factors are associated with mortality. This study aims to
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Background: Melioidosis, a disease induced by Burkholderia pseudomallei, poses a significant health threat in tropical areas where it is endemic. Despite the availability of effective treatments, mortality rates remain notably elevated. Many risk factors are associated with mortality. This study aims to develop a scoring system for predicting the in-hospital mortality from melioidosis using readily available clinical data. Methods: The data were collected from Surin Hospital, Surin, Thailand, during the period from April 2014 to March 2017. We included patients aged 15 years and above who had cultures that tested positive for Burkholderia pseudomallei. The clinical prediction rules were developed using significant risk factors from the multivariable analysis. Results: A total of 282 patients with melioidosis were included in this study. In the final analysis model, 251 patients were used for identifying the significant risk factors of in-hospital fatal melioidosis. Five factors were identified and used for developing the clinical prediction rules, and the factors were as follows: qSOFA ≥ 2 (odds ratio [OR] = 2.39, p= 0.025), abnormal chest X-ray findings (OR = 5.86, p < 0.001), creatinine ≥ 1.5 mg/dL (OR = 2.80, p = 0.004), aspartate aminotransferase ≥50 U/L (OR = 4.032, p < 0.001), and bicarbonate ≤ 20 mEq/L (OR = 2.96, p = 0.002). The prediction scores ranged from 0 to 7. Patients with high scores (4–7) exhibited a significantly elevated mortality rate exceeding 65.0% (likelihood ratio [LR+] 2.18, p < 0.001) compared to the low-risk group (scores 0–3) with a lower mortality rate (LR + 0.18, p < 0.001). The area under the receiver operating characteristic curve (AUC) was 0.84, indicating good model performance. Conclusions: This study presents a simple scoring system based on easily obtainable clinical parameters to predict in-hospital mortality in melioidosis patients. This tool may facilitate the early identification of high-risk patients who could benefit from more aggressive treatment strategies, potentially improving clinical decision-making and patient outcomes.
Full article
Open AccessArticle
Experimental Granulomatous Amebic Encephalitis Caused by Acanthamoeba castellanii
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Samuel da Luz Borges, Eberson da Silva de Macedo, Felipe Alexandre Vinagre da Silva, Brenda Jaqueline de Azevedo Ataíde, Nívia de Souza Franco Mendes, Adelaide da Conceição Fonseca Passos, Suellen Alessandra Soares de Moraes, Anderson Manoel Herculano, Karen Renata Herculano Matos Oliveira, Carlomagno Pacheco Bahia, Silvio Santana Dolabella and Evander de Jesus Oliveira Batista
Trop. Med. Infect. Dis. 2024, 9(7), 145; https://doi.org/10.3390/tropicalmed9070145 - 28 Jun 2024
Abstract
Acanthamoeba genus can affect humans with diseases such as granulomatous amebic encephalitis (GAE), a highly lethal neuroinfection. Several aspects of the disease still need to be elucidated. Animal models of GAE have advanced our knowledge of the disease. This work tested Wistar rats
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Acanthamoeba genus can affect humans with diseases such as granulomatous amebic encephalitis (GAE), a highly lethal neuroinfection. Several aspects of the disease still need to be elucidated. Animal models of GAE have advanced our knowledge of the disease. This work tested Wistar rats (Rattus norvegicus albinus) as an animal model of GAE. For this, 32 animals were infected with 1 × 106 A. castellanii trophozoites of the T4 genotype. Ameba recovery tests were carried out using agar plates, vascular extravasation assays, behavioral tests, and histopathological technique with H/E staining. Data were subjected to linear regression analysis, one-way ANOVA, and Tukey’s test, performed in the GraphPad Prism® 8.0 program, with a significance level of p < 0.05. The results revealed the efficiency of the model. Amebae were recovered from the liver, lungs, and brain of infected animals, and there were significant encephalic vascular extravasations and behavioral changes in these animals, but not in the control animals. However, not all infected animals showed positive histopathology for the analyzed organs. Nervous tissues were the least affected, demonstrating the role of the BBB in the defense of the CNS. Supported by the demonstrated evidence, we confirm the difficulties and the feasibilities of using rats as an animal model of GAE.
Full article
(This article belongs to the Special Issue Advances in Parasitic Neglected Tropical Diseases)
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Open AccessArticle
Challenges of Screening and Investigations of Contacts of Patients with Tuberculosis in Oyo and Osun States, Nigeria
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Aderonke Agbaje, Patrick Dakum, Olugbenga Daniel, Anyaike Chukwuma, Obioma Chijoke-Akaniro, Evaezi Okpokoro, Samuel Akingbesote, Christian Anyomi, Adekola Adekunle, Abiola Alege, Moroof Gbadamosi, Olutunde Babalola, Charles Mensah, Rupert Eneogu, Austin Ihesie and Ademola Adelekan
Trop. Med. Infect. Dis. 2024, 9(7), 144; https://doi.org/10.3390/tropicalmed9070144 - 28 Jun 2024
Abstract
Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of screening and investigation of contacts of patients with TB in Oyo and Osun State, Nigeria. This descriptive-qualitative
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Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of screening and investigation of contacts of patients with TB in Oyo and Osun State, Nigeria. This descriptive-qualitative study was conducted in eight Local Government Areas with high TB burdens. Twenty-four focus group discussions and 30 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents ages ranged from 17–85 years with a mean of 42.08 ± 14.9 years, and (4.0%) had a postgraduate degree. This study identified that the majority of TB contacts who tested negative for TB were unwilling to be placed on TB preventive therapy because of the belief that only a sick person should take drugs. Also, hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB was another existing gap reported in TB contact investigations. The findings emphasise the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.
Full article
(This article belongs to the Section Infectious Diseases)
Open AccessArticle
One Health Approach to Toxoplasmosis: Owner and Dog Seropositivity as Spatial Indicators of Risk Areas for Acquired, Gestational and Congenital Transmission
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Natacha Sohn-Hausner, Ricardo Guedes Correa, Louise Bach Kmetiuk, Evelyn Cristine da Silva, Gustavo Nunes de Moraes, Gabrielle dos Santos Rocha, Helio Langoni and Alexander Welker Biondo
Trop. Med. Infect. Dis. 2024, 9(7), 143; https://doi.org/10.3390/tropicalmed9070143 - 28 Jun 2024
Abstract
Background: Toxoplasmosis has been of public health concern due to direct associations with socioeconomic vulnerability and inadequate living conditions. Methods: Accordingly, the present study aimed to assess antibodies against T. gondii, historical reported toxoplasmosis cases and associated socio-environmental risk factors in Pinhais,
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Background: Toxoplasmosis has been of public health concern due to direct associations with socioeconomic vulnerability and inadequate living conditions. Methods: Accordingly, the present study aimed to assess antibodies against T. gondii, historical reported toxoplasmosis cases and associated socio-environmental risk factors in Pinhais, a full urban area of Curitiba, currently the eighth biggest metropolitan area of Brazil. Anti-Toxoplasma gondii antibodies were assessed by an indirect immunofluorescence reaction (RIFI). Owner and dog samples were also tested by IFAT to anti-Leishmania spp. and anti-Trypanosoma cruzi antibodies. Results: Overall, 20/135 (14.8%) persons and 13/133 (9.8%) dogs from 25 different households were considered seropositive to T. gondii. All samples were seronegative to Leishmania spp. and Trypanosoma cruzi. Conclusions: Although no significant covariates were found in the regression model, statistically associated risk factors in the bivariate analysis included no public water use (p = 0.016) and drinking raw milk (p = 0.041) for owners, and obesity (p = 0.028) and tick infestation (p = 0.03) for dogs. In addition, a spatial cluster of T. gondii seropositivity for both owners and their dogs overlapped the location of historic reported cases of human acquired, gestational and congenital toxoplasmosis. Finally, the results herein showed tick infestation as an indicator of socio-environmental risk for T. gondii exposure in the household environment, and dogs may be used as sentinels for human toxoplasmosis cases.
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(This article belongs to the Section One Health)
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Open AccessArticle
Evaluation of Bait Acceptance and Immune Response in Local Dogs during an Oral Rabies Vaccination Field Study in Morocco
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Nadia Aboulfidaa, Florence Cliquet, Emmanuelle Robardet, Sami Darkaoui, Marine Wasniewski, Christian Kaiser, Katharina Bobe, Ad Vos and Ouafaa Fassi Fihri
Trop. Med. Infect. Dis. 2024, 9(7), 142; https://doi.org/10.3390/tropicalmed9070142 - 26 Jun 2024
Abstract
The objective of this study was to evaluate the bait preference of three selected bait types by local dogs and the induced immunogenicity of the oral rabies vaccine strain SPBN GASGAS in Morocco. The vaccine strain, combined with different bait types, has been
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The objective of this study was to evaluate the bait preference of three selected bait types by local dogs and the induced immunogenicity of the oral rabies vaccine strain SPBN GASGAS in Morocco. The vaccine strain, combined with different bait types, has been tested in many different settings, but not yet in northern Africa. Overall, bait consumption and preference were similar in other studies using the same materials (bait type and sachet). The intestine bait had the highest acceptance rate (97.6%, 95%CI: 87.4–99.9), followed by the egg bait (83.0%, 95%CI: 69.2–92.4). Only 52% (95%CI: 37.4–66.3) of the dogs showed an interest in the fish meal bait. However, considering the successful release of the contents of the sachet (blue-dyed water) into the oral cavity, the egg bait (65.7%, 95%CI: 47.8–80.9) scored better than the intestine bait (51.7%, 95%CI: 32.5–70.6). The dogs selected for the immunogenicity study were offered the egg bait containing a sachet filled with SPBN GASGAS (3.0ml, 107.5 FFU/mL) or were given the same dose by direct oral administration (d.o.a.). In addition, several dogs were vaccinated by the parenteral route (s.c.) using a commercially available inactivated rabies vaccine. Unfortunately, due to the COVID-19 pandemic and subsequent travel restrictions, it was not possible to collect blood samples directly after vaccination. The blood samples were collected pre-vaccination and on five occasions between 450 and 1088 days post vaccination. The seroconversion rate, as determined for rabies-virus-neutralizing antibodies by the FAVN test, was significantly lower than that found for binding antibodies, as determined by ELISA, for all blood samples collected post vaccination. No treatment effect (bait, d.o.a., s.c.) could be seen in the seroconversion rate. At 15 months post vaccination, 84.2% of the dogs offered vaccine bait still tested sero-positive in ELISA. Only after 3 years was a clear drop in the seroconversion rate observed in all three treatment groups. This study confirms the long-term immunogenicity of the oral rabies vaccine SPBN GASGAS in dogs under field conditions.
Full article
(This article belongs to the Special Issue Treatment and Risk Assessment of Rabies)
Open AccessArticle
Consistency of Multi-Month Antiretroviral Therapy Dispensing and Association with Viral Load Coverage among Pediatric Clients Living with HIV in Mozambique
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Ivete Meque, Nicole Herrera, Michelle M. Gill, Rui Guilaze, Amancio Nhangave, Jaciara Mussá, Nilesh Bhatt, Mahoudo Bonou and Lauren Greenberg
Trop. Med. Infect. Dis. 2024, 9(7), 141; https://doi.org/10.3390/tropicalmed9070141 - 26 Jun 2024
Abstract
With the increase in uptake of multi-month antiretroviral therapy dispensing (MMD) for children, little is known about consistency of MMD receipt over time and its association with virological outcomes. This analysis aims to assess the uptake of 3-month MMD among children, consistent receipt
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With the increase in uptake of multi-month antiretroviral therapy dispensing (MMD) for children, little is known about consistency of MMD receipt over time and its association with virological outcomes. This analysis aims to assess the uptake of 3-month MMD among children, consistent receipt of MMD after uptake, and clinical outcomes following transition to MMD in 16 health facilities in Gaza and Inhambane Provinces. This is a secondary analysis involving children <15 years living with HIV with clinical visits during the period from September 2019 to August 2020. Of 4383 children, 82% ever received MMD (at least one pickup of a 3-month MMD supply) during the study period but only 40% received it consistently (defined as MMD at every visit during the study period). Consistent MMD was most common among older children and children without indications of clinical instability. Overall viral load (VL) coverage was 40% (733/1851). Consistent MMD was significantly associated with lower odds of having a VL (0.78, 95% CI: 0.64–0.95). In conclusion, while receipt of a multi-month supply was common particularly during the early days of the COVID-19 pandemic, only a minority of children received consistent MMD; however, there is a need to ensure children with fewer visits still receive timely VL monitoring.
Full article
(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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Open AccessArticle
Identification and Functional Implications of the E5 Oncogene Polymorphisms of Human Papillomavirus Type 16
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Antônio Humberto P. da Silva-Júnior, Ruany Cristyne de Oliveira Silva, Ana Pavla A. Diniz Gurgel, Marconi Rêgo Barros-Júnior, Kamylla Conceição Gomes Nascimento, Daffany Luana Santos, Lindomar J. Pena, Rita de Cássia Pereira Lima, Marcus Vinicius de Aragão Batista, Bárbara Simas Chagas and Antonio Carlos de Freitas
Trop. Med. Infect. Dis. 2024, 9(7), 140; https://doi.org/10.3390/tropicalmed9070140 - 26 Jun 2024
Abstract
The persistence of the human papillomavirus type 16 (HPV16) infection on the cervical epithelium contributes to the progression of cervical cancer. Studies have demonstrated that HPV16 genetic variants may be associated with different risks of developing cervical cancer. However, the E5 oncoprotein of
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The persistence of the human papillomavirus type 16 (HPV16) infection on the cervical epithelium contributes to the progression of cervical cancer. Studies have demonstrated that HPV16 genetic variants may be associated with different risks of developing cervical cancer. However, the E5 oncoprotein of HPV16, which is related to several cellular mechanisms in the initial phases of the infection and thus contributes to carcinogenesis, is still little studied. Here we investigate the HPV16 E5 oncogene variants to assess the effects of different mutations on the biological function of the E5 protein. We detected and analyzed the HPV16 E5 oncogene polymorphisms and their phylogenetic relationships. After that, we proposed a tertiary structure analysis of the protein variants, preferential codon usage, and functional activity of the HPV16 E5 protein. Intra-type variants were grouped in the lineages A and D using in silico analysis. The mutations in E5 were located in the T-cell epitopes region. We therefore analyzed the interference of the HPV16 E5 protein in the NF-kB pathway. Our results showed that the variants HPV16E5_49PE and HPV16E5_85PE did not increase the potential of the pathway activation capacity. This study provides additional knowledge about the mechanisms of dispersion of the HPV16 E5 variants, providing evidence that these variants may be relevant to the modulation of the NF-κB signaling pathway.
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(This article belongs to the Special Issue Molecular Epidemiology of Human Papillomavirus Infection)
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Investigating the Diagnostic and Therapeutic Potential of a T Cell Receptor (TCR)-like single Domain Antibody (sDAb)-Human IgG1 Antibody against Heat Shock Protein (HSP) 16KDa/HLA-A2 for Latent Tuberculosis
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Huaqiang Liu, Sylvia Annabel Dass, Matthew Tze Jian Wong, Venugopal Balakrishnan, Fazlina Nordin and Gee Jun Tye
Trop. Med. Infect. Dis. 2024, 9(7), 139; https://doi.org/10.3390/tropicalmed9070139 - 26 Jun 2024
Abstract
Heat shock protein 16-kDa (HSP 16-kDa) is essential for the survival of Mycobacterium tuberculosis (M. tuberculosis) during the latent period; hence, a peptide–MHC presentation of HSP 16-kDa could be a potential diagnostic and therapeutic target for latent tuberculosis (LTB). This study
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Heat shock protein 16-kDa (HSP 16-kDa) is essential for the survival of Mycobacterium tuberculosis (M. tuberculosis) during the latent period; hence, a peptide–MHC presentation of HSP 16-kDa could be a potential diagnostic and therapeutic target for latent tuberculosis (LTB). This study aimed to generate a TCR-like single-domain antibody (sDAb)-human IgG1 antibody and subsequently investigate its diagnostic and therapeutic potential in LTB, utilizing a model cell presenting the target peptide. A previously generated TCR-like sDAB that can bind to HSP 16-kDa was first fused to a human IgG1 Fc-receptor via a linker. The fusion product, sDAb-IgG1, was expressed with HEK293-F and was subsequently purified. Its diagnostic potential was investigated via cell-based ELISA utilizing MCF-7 cells peptide-pulsed with HSP 16-kDa peptides. Investigation into the antibody-dependent cell-mediated cytotoxicity (ADCC) of MCF-7 cells was also conducted to investigate its therapeutic potential. Finally, TCR-like sDAb-IgG1 was successfully produced transiently with HEK-293F and was purified using protein A chromatography. The generated antibody was tested using cell-based ELISA, which demonstrated the effective binding of the TCR-like sDAb-IgG1 to the 16-kDa peptide–MHC on the cell surface. The ADCC assay also showed that the antibody effectively mediated the ADCC of MCF-7 cells with the help of 16-kDa peptide–MHC. This allows us to hypothesize the possible utility of the said antibody for both diagnostics and therapeutics of latent tuberculosis after more investigations with clinical samples.
Full article
(This article belongs to the Special Issue The Epidemiology, Diagnosis and Treatment of Mycobacteria Infection (including TB and NTM))
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Open AccessArticle
Epidemiological Characteristics of Overseas-Imported Infectious Diseases Identified through Airport Health-Screening Measures: A Case Study on Fuzhou, China
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Hong Li, Yan Yang, Jiake Chen, Qingyu Li, Yifeng Chen, Yilin Zhang, Shaojian Cai, Meirong Zhan, Chuancheng Wu, Xinwu Lin and Jianjun Xiang
Trop. Med. Infect. Dis. 2024, 9(6), 138; https://doi.org/10.3390/tropicalmed9060138 - 20 Jun 2024
Abstract
Background: This study aimed to examine the epidemiological characteristics of imported infections and assess the effectiveness of border health screening in detecting imported diseases. Methods: We obtained infection data for 2016 to 2019 from the Fuzhou Changle International Airport Infection Reporting System. The
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Background: This study aimed to examine the epidemiological characteristics of imported infections and assess the effectiveness of border health screening in detecting imported diseases. Methods: We obtained infection data for 2016 to 2019 from the Fuzhou Changle International Airport Infection Reporting System. The demographic, temporal, and spatial characteristics of travel-related infections were analyzed using r×c contingency tables, the Cochran–Armitage trend test, and seasonal-trend decomposition using LOESS (STL). Detection rates were used as a proxy for the effectiveness of border health-screening measures. Results: Overall, 559 travel-related infections were identified during the study period, with 94.3% being imported infections. Airport health screening demonstrated an overall effectiveness of 23.7% in identifying travel-associated infections. Imported infections were predominantly identified in males, with 55.8% of cases occurring in individuals aged 20–49. The peak periods of infection importation were from January to February and from May to August. The infectious diseases identified were imported from 25 different countries and regions. All dengue fever cases were imported from Southeast Asia. Most notifiable infections (76.0%) were identified through fever screening at the airport. Conclusion: The increasing number of imported infections poses a growing challenge for public health systems. Multifaceted efforts including surveillance, vaccination, international collaboration, and public awareness are required to mitigate the importation and spread of infectious diseases from overseas sources.
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(This article belongs to the Special Issue Climate Change and Environmental Epidemiology of Infectious Diseases)
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Knowledge Gaps and Educational Opportunities in Congenital Toxoplasmosis: A Narrative Review of Brazilian and Global Perspectives
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David Richer Araujo Coelho, Rogerio Oliveira da Luz, Catiucia Soares Melegario, Willians Fernando Vieira and Lilian Maria Garcia Bahia-Oliveira
Trop. Med. Infect. Dis. 2024, 9(6), 137; https://doi.org/10.3390/tropicalmed9060137 - 20 Jun 2024
Abstract
Congenital toxoplasmosis is a parasitic disease caused by the transmission of the protozoan Toxoplasma gondii during pregnancy that can potentially cause severe consequences for the fetus or neonates. The disease disproportionately impacts the global population and is generally correlated with the Human Development
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Congenital toxoplasmosis is a parasitic disease caused by the transmission of the protozoan Toxoplasma gondii during pregnancy that can potentially cause severe consequences for the fetus or neonates. The disease disproportionately impacts the global population and is generally correlated with the Human Development Index. Despite its prevalence, there are knowledge gaps among pregnant women and healthcare providers regarding the prevention, diagnosis, and treatment of this condition. This narrative review aimed to examine the current state of knowledge of toxoplasmosis among both groups, with a focus on exploring the Brazilian and global perspectives and highlighting opportunities for enhancing education and communication. A search was conducted across five databases, and 60 studies were selected (23 in Brazil and 37 worldwide). Quantitative analysis revealed that general knowledge of toxoplasmosis among pregnant women is notably poor, with 66% of Brazilian women and 72% of women worldwide lacking sufficient understanding. Among those with some knowledge, the most recognized association is with cats (46% in Brazil and 38% worldwide), followed by raw or undercooked meat (27% in Brazil and 25% worldwide), and improperly sanitized vegetables or water (15% in Brazil and 21% worldwide). Similarly, gaps in knowledge were found among healthcare providers. Difficulty with IgG avidity test interpretation is higher in Brazil (43%) compared to worldwide (18%). The most recognized association is with cats (66% in Brazil and 74% worldwide), followed by raw or undercooked meat (49% in Brazil and 70% worldwide), and improperly sanitized vegetables or water (31% in Brazil and 32% worldwide). These findings emphasize the need for tailored local and global public health educational initiatives to enhance knowledge of toxoplasmosis among pregnant women and healthcare providers.
Full article
(This article belongs to the Special Issue Recent Advances in Toxoplasma gondii Infection and Toxoplasmosis)
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Open AccessArticle
Rapid Discriminative Identification of the Two Predominant Echinococcus Species from Canine Fecal Samples in the Tibetan Region of China by Loop-Mediated Isothermal Amplification–Lateral Flow Dipstick Assay
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Xinyue Lv, Jiajia Ai, Xiaojin Mo, Haojie Ding, Sofia Litchev, Entung Lu, Youhong Weng, Qing He, Quzhen Gongsang, Shijie Yang, Xiumin Ma, Jingzhong Li, Huasheng Pang, Shaohong Lu and Qingming Kong
Trop. Med. Infect. Dis. 2024, 9(6), 136; https://doi.org/10.3390/tropicalmed9060136 - 20 Jun 2024
Abstract
Echinococcosis poses a significant concern in the fields of public health and veterinary care as it can be transmitted between animals and humans. The primary endemic subtypes are cystic echinococcosis (CE) and alveolar echinococcosis (AE), which result from infestation by Echinococcus granulosus and
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Echinococcosis poses a significant concern in the fields of public health and veterinary care as it can be transmitted between animals and humans. The primary endemic subtypes are cystic echinococcosis (CE) and alveolar echinococcosis (AE), which result from infestation by Echinococcus granulosus and Echinococcus multilocularis, respectively. A prominent epidemic of echinococcosis greatly affects the Tibet Autonomous Region (TAR) in China. A new technique called the loop-mediated isothermal amplification–lateral flow dipstick (LAMP-LFD) test is introduced in this research to differentiate between E. granulosus and E. multilocularis using their repetitive genetic sequences. The test is characterized by its portable nature, simple operation, quick result production, high sensitivity, and low susceptibility to aerosol contamination. The LAMP-LFD method demonstrated an exceptional minimal detection limit, reaching levels as low as approximately 1 fg/μL (femtogram per microliter) of genomic DNA. The assay’s specificity was assessed, and no cross-reactivity was seen. A total of 982 dog fecal samples were collected from 54 counties in the TAR region between July 2021 and June 2022. The established method underwent validation using a commercially available ELISA kit. The agreement rate between the LAMP-LFD and ELISA methods was 97.25%, with a sensitivity of 96.05% and a specificity of 97.35%. The assay described in this study improves specificity by using a double-labeled probe, and it reduces the risk of false-positive results caused by aerosol contamination through the use of a sealed device. This makes it a suitable choice for quickly and accurately identifying the two main types of Echinococcus in field settings.
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(This article belongs to the Special Issue Echinococcosis: From Parasite–Host Interaction to Rapid Detection)
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Human Skin as an Ex Vivo Model for Maintaining Mycobacterium leprae and Leprosy Studies
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Natália Aparecida de Paula, Marcel Nani Leite, Daniele Ferreira de Faria Bertoluci, Cleverson Teixeira Soares, Patrícia Sammarco Rosa and Marco Andrey Cipriani Frade
Trop. Med. Infect. Dis. 2024, 9(6), 135; https://doi.org/10.3390/tropicalmed9060135 - 20 Jun 2024
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The in vitro cultivation of M. leprae has not been possible since it was described as causing leprosy, and the limitation of animal models for clinical aspects makes studies on leprosy and bacteria–human host interaction a challenge. Our aim was to standardize the
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The in vitro cultivation of M. leprae has not been possible since it was described as causing leprosy, and the limitation of animal models for clinical aspects makes studies on leprosy and bacteria–human host interaction a challenge. Our aim was to standardize the ex vivo skin model (hOSEC) to maintenance and study of M. leprae as an alternative animal model. Bacillary suspensions were inoculated into human skin explants and sustained in DMEM medium for 60 days. Explants were evaluated by RT-PCR-16SrRNA and cytokine gene expression. The viability and infectivity of bacilli recovered from explants (D28 and D60) were evaluated using the Shepard’s model. All explants were RT-PCR-16SrRNA positive. The viability and infectivity of recovered bacilli from explants, analyzed after 5 months of inoculation in mice, showed an average positivity of 31%, with the highest positivity in the D28 groups (80%). Furthermore, our work showed different patterns in cytokine gene expression (TGF-β, IL-10, IL-8, and TNF-α) in the presence of alive or dead bacilli. Although changes can be made to improve future experiments, our results have demonstrated that it is possible to use the hOSEC to maintain M. leprae for 60 days, interacting with the host system, an important step in the development of experimental models for studies on the biology of the bacillus, its interactions, and drug susceptibility.
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Open AccessArticle
Association between KSHV-Specific Humoral and T Cell Responses with Recurrence of HIV-Associated Kaposi Sarcoma
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Marie-Claire Mukasine, Gina Mulundu, Musonda Kawimbe, Keagan Mutale, Chibamba Mumba, Salum J. Lidenge and Owen Ngalamika
Trop. Med. Infect. Dis. 2024, 9(6), 134; https://doi.org/10.3390/tropicalmed9060134 - 18 Jun 2024
Abstract
Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining
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Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining whether KSHV-specific adaptive immune responses were associated with KS recurrence upon complete remission. We conducted a prospective cohort study. The primary outcome was the recurrence of HIV-associated KS. An immunofluorescence assay was used to determine anti-KSHV antibodies, an enzyme-linked immunospot was conducted for T cell responses, PCR was carried out to determine KSHV status, and flow cytometry was used for CD4 counting and immunophenotyping. KSHV detection in PBMCs was high and not associated with KS recurrence-free survival (p = 0.29). Anti-KSHV antibody titers were high and not associated with recurrence-free survival (p = 0.63). KSHV-specific T cell responses dropped from baseline levels among individuals with recurrence, but the drop was not statistically significant. Individuals experiencing KS recurrence had a significantly higher proportion of T cell subsets expressing PD1, while those with sustained remission had a significant increase in CD4 T cell counts from baseline levels during the follow-up period (p = 0.02). Anti-KSHV antibodies are not a good correlate of protection from KS recurrence. T cells in individuals experiencing KS recurrence hadhigh PD1 expression, while an increase in CD4 counts was associated with sustained KS remission.
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(This article belongs to the Special Issue Global Perspectives on Kaposi’s Sarcoma-Associated Herpesvirus Infection)
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Molecular Detection of Leishmania spp. and Blood Source of Female Sand Flies in the Parque Estadual do Rio Doce and Municipality of Timóteo, Minas Gerais, Brazil
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Cristian Ferreira de Souza, Carlos Alberto dos Santos, Paula Dias Bevilacqua, José Dilermando Andrade Filho and Reginaldo Peçanha Brazil
Trop. Med. Infect. Dis. 2024, 9(6), 133; https://doi.org/10.3390/tropicalmed9060133 - 13 Jun 2024
Abstract
Leishmaniasis is a group of diseases caused by protozoa of the genus Leishmania and is transmitted by the bite female sand fly. The present work is characterized as a descriptive study in two areas: a forest area located in the Parque Estadual do
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Leishmaniasis is a group of diseases caused by protozoa of the genus Leishmania and is transmitted by the bite female sand fly. The present work is characterized as a descriptive study in two areas: a forest area located in the Parque Estadual do Rio Doce, and another urban area located in the municipality of Timóteo-MG, with the objective of identifying the presence of Leishmania spp. and the blood source of the collected female sand flies. Part of the females were obtained from the Parque Estadual do Rio Doce, and part was collected using 19 ligth traps distributed in residences of Timóteo. For molecular studies of Leishmania spp. DNA, the ITS1 gene was used, and in the search for blood source, the CytB gene was used and positive samples were sequenced. The study demonstrated that there are at least three species of Leishmania circulating in the study areas: Leishmania (Viannia) braziliensis, Leishmania (Leishmania) amazonensis, and Leishmania (V.) guyanensis. Nyssomyia whitmani was the predominant sand fly species in the urban area of Timóteo with a positive diagnosis for the presence of Leishmania braziliensis DNA. We found the presence of blood from Gallus gallus (Chicken) and Sus scrofa (Pig) in sand flies. The present study demonstrates that Leishmania braziliensis is the main agent of cutaneous leishmaniasis in the study area, with the effective participation of Nyssomyia whitmani as the vector and both Gallus gallus and Sus scrofa acting as a food source for female sand flies, and helping maintaining the sand fly life.
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(This article belongs to the Special Issue Leishmaniasis: Vector-Host-Pathogen Interactions in Health and Disease)
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Impact of Neurological Complications on Long-Term Outcomes in Patients with Infective Endocarditis
by
Pedro Henrique Oliveira Murta Pinto, Isabela Galizzi Fae, Gustavo Brandão Oliveira, Roni Arley Silva Duque, Mauricio Vitor Machado Oliveira, Luan Salvador Machado Barbalho, André Oliveira Parreiras, Fernanda Alves Gelape, Fernanda Sophya Leite Cambraia, Guilherme Lelis Costa, Lucas Chaves Diamante, Renato Bráulio, Cláudio Léo Gelape, Andréa Teixeira-Carvalho, Teresa Cristina Abreu Ferrari and Maria Carmo Pereira Nunes
Trop. Med. Infect. Dis. 2024, 9(6), 132; https://doi.org/10.3390/tropicalmed9060132 - 13 Jun 2024
Abstract
Neurological complications are frequent during the active course of infective endocarditis (IE), and they are associated with high in-hospital mortality rates. However, limited data exist on the prognostic value of these complications for late outcomes. This study aimed to assess the long-term impact
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Neurological complications are frequent during the active course of infective endocarditis (IE), and they are associated with high in-hospital mortality rates. However, limited data exist on the prognostic value of these complications for late outcomes. This study aimed to assess the long-term impact of neurological complications in patients surviving an IE episode. A total of 263 consecutive IE patients admitted to a tertiary care center between 2007 and 2022 were prospectively included. Neurological complications at admission included transient ischemic attack (TIA), ischemic stroke, hemorrhagic stroke, intracerebral abscess, and meningitis. The primary outcome was a composite of overall mortality or heart valve surgery. Of the patients, 34.2% died in the hospital, leaving 173 survivors for long-term follow-up. Over a median of 3.5 years, 29 patients died, and 13 (9%) underwent cardiac surgery, resulting in an overall adverse event rate of 30%. Neurological complications independently predicted long-term adverse outcomes (hazard ratio (HR) 2.237; 95% CI 1.006–4.976), after adjusting for age, chronic kidney disease (CKD), and heart failure (HF) development. In an IE patient cohort, neurological complications at admission, which is a complication directly related to the IE process, were independent predictors of long-term outcomes.
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(This article belongs to the Special Issue Highlights in Infective Endocarditis)
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Risk Factors Associated with Loss to Follow-Up during Tuberculosis Treatment in the Sanatorium Hospital of Luanda, Angola
by
Domingos Vita, Maria Luisa Aznar, Joan Martínez-Campreciós, Debora Cristina Maindo Sebastiao Kansietoko and Israel Molina
Trop. Med. Infect. Dis. 2024, 9(6), 131; https://doi.org/10.3390/tropicalmed9060131 - 12 Jun 2024
Abstract
Background: Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable populations. Patients who are lost to follow-up (LTFU) after TB diagnosis still represent one of the biggest challenges to TB control. Method: In this prospective observational study,
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Background: Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable populations. Patients who are lost to follow-up (LTFU) after TB diagnosis still represent one of the biggest challenges to TB control. Method: In this prospective observational study, we aimed to identify and analyse the risk factors associated with LTFU among TB patients who started first-line TB treatment in the Sanatorium Hospital in Luanda. Result: A total of 113 patients with TB (non-multidrug resistant) were included between August 2018 and September 2019. Seventy-six (67.3%) patients were cured, 27 (23.9%) were LTFU, 5 (4.4%) died, 4 (3.5%) were transferred and 1 (0.9%) presented treatment failure. After excluding those who died, were transferred or failed treatment, we observed that severe TB at the time of diagnosis (OR 9.24, 95% CI 2.18–39.04) and food insecurity were significantly associated with LTFU (OR 5.96, 95% CI 1.66–21.41). Conclusions: The findings of our study can contribute to understanding the reasons for the LTFU of patients with TB and can guide policies and facilitate designing measures to allow better adherence and, therefore, greater treatment success.
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(This article belongs to the Section Infectious Diseases)
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Leprosy in Spain: A Descriptive Study of Admissions at Fontilles Sanatorium between 1909 and 2020
by
Cristina Juan, Lourdes Lledó, Miguel Torralba, José Ramón Gómez and Consuelo Giménez
Trop. Med. Infect. Dis. 2024, 9(6), 130; https://doi.org/10.3390/tropicalmed9060130 - 11 Jun 2024
Abstract
Background: The study aimed to characterize patients with leprosy admitted to Fontilles throughout the 20th and 21st centuries, focusing on differences across three periods (I, II, and III). It also explored variables linked to patient survival. Methods: This was a retrospective descriptive study
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Background: The study aimed to characterize patients with leprosy admitted to Fontilles throughout the 20th and 21st centuries, focusing on differences across three periods (I, II, and III). It also explored variables linked to patient survival. Methods: This was a retrospective descriptive study analyzing the medical records of Fontilles patients from 1909 to 2020. It assessed 26 clinical, sociodemographic, and temporal variables (n = 2652). Results: Most patients were male, single, multibacillary (MB), and farmers, from Andalusia and the Valencian Community. The origin of patients shifted over time towards being mostly foreign-born in period III. More than a half were previously admitted and had family members with leprosy. While leprosy reactions decreased over time, neurological symptoms were increasingly diagnosed. The age at onset, admission, and death increased progressively over time. The survival of patients with leprosy at Fontilles depended on the age at admission and the period. Conclusions: Improved knowledge, services, and awareness regarding leprosy led to increased age at onset and more favorable outcomes. The prolonged time between symptom onset and diagnosis indicates that leprosy is still a neglected disease. Although MB forms are more severe, leprosy classification did not significantly impact the survival rates of patients at Fontilles.
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(This article belongs to the Section Neglected and Emerging Tropical Diseases)
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Therapeutic Modulation of Arginase with nor-NOHA Alters Immune Responses in Experimental Mouse Models of Pulmonary Tuberculosis including in the Setting of Human Immunodeficiency Virus (HIV) Co-Infection
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Sadhana Chauhan, Rebecca J. Nusbaum, Matthew B. Huante, Alex J. Holloway, Mark A. Endsley, Benjamin B. Gelman, Joshua G. Lisinicchia and Janice J. Endsley
Trop. Med. Infect. Dis. 2024, 9(6), 129; https://doi.org/10.3390/tropicalmed9060129 - 6 Jun 2024
Abstract
L-arginine metabolism is strongly linked with immunity to mycobacteria, primarily through the antimicrobial activity of nitric oxide (NO). The potential to modulate tuberculosis (TB) outcomes through interventions that target L-arginine pathways are limited by an incomplete understanding of mechanisms and inadequate in vivo
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L-arginine metabolism is strongly linked with immunity to mycobacteria, primarily through the antimicrobial activity of nitric oxide (NO). The potential to modulate tuberculosis (TB) outcomes through interventions that target L-arginine pathways are limited by an incomplete understanding of mechanisms and inadequate in vivo modeling. These gaps in knowledge are compounded for HIV and Mtb co-infections, where activation of arginase-1 due to HIV infection may promote survival and replication of both Mtb and HIV. We utilized in vitro and in vivo systems to determine how arginase inhibition using Nω-hydroxy-nor-L-arginine (nor-NOHA) alters L-arginine pathway metabolism relative to immune responses and disease outcomes following Mtb infection. Treatment with nor-NOHA polarized murine macrophages (RAW 264.7) towards M1 phenotype, increased NO, and reduced Mtb in RAW macrophages. In Balb/c mice, nor-NOHA reduced pulmonary arginase and increased the antimicrobial metabolite spermine in association with a trend towards reduced Mtb CFU in lung. In humanized immune system (HIS) mice, HIV infection increased plasma arginase and heightened the pulmonary arginase response to Mtb. Treatment with nor-NOHA increased cytokine responses to Mtb and Mtb/HIV in lung tissue but did not significantly alter bacterial burden or viral load. Our results suggest that L-arginine pathway modulators may have potential as host-directed therapies to augment antibiotics in TB chemotherapy.
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(This article belongs to the Special Issue Ending Tuberculosis Epidemic: Current Status and Future Prospects)
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Are Pathogenic Leptospira Species Ubiquitous in Urban Recreational Parks in Sydney, Australia?
by
Xiao Lu, Mark E. Westman, Rachel Mizzi, Christine Griebsch, Jacqueline M. Norris, Cheryl Jenkins and Michael P. Ward
Trop. Med. Infect. Dis. 2024, 9(6), 128; https://doi.org/10.3390/tropicalmed9060128 - 6 Jun 2024
Abstract
Leptospirosis is a zoonotic disease caused by the spirochete bacteria Leptospira spp. From December 2017 to December 2023, a total of 34 canine leptospirosis cases were reported in urban Sydney, Australia. During the same spatio-temporal frame, one locally acquired human case was also
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Leptospirosis is a zoonotic disease caused by the spirochete bacteria Leptospira spp. From December 2017 to December 2023, a total of 34 canine leptospirosis cases were reported in urban Sydney, Australia. During the same spatio-temporal frame, one locally acquired human case was also reported. As it was hypothesised that human residents and companion dogs might both be exposed to pathogenic Leptospira in community green spaces in Sydney, an environmental survey was conducted from December 2023 to January 2024 to detect the presence of pathogenic Leptospira DNA in multipurpose, recreational public parks in the council areas of the Inner West and City of Sydney, Australia. A total of 75 environmental samples were collected from 20 public parks that were easily accessible by human and canine visitors. Quantitative PCR (qPCR) testing targeting pathogenic and intermediate Leptospira spp. was performed, and differences in detection of Leptospira spp. between dog-allowed and dog-prohibited areas were statistically examined. The global Moran’s Index was calculated to identify any spatial autocorrelation in the qPCR results. Pathogenic leptospires were detected in all 20 parks, either in water or soil samples (35/75 samples). Cycle threshold (Ct) values were slightly lower for water samples (Ct 28.52–39.10) compared to soil samples (Ct 33.78–39.77). The chi-squared test and Fisher’s exact test results were statistically non-significant (p > 0.05 for both water and soil samples), and there was no spatial autocorrelation detected in the qPCR results (p > 0.05 for both sample types). Although further research is now required, our preliminary results indicate the presence of pathogenic Leptospira DNA and its potential ubiquity in recreational parks in Sydney.
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(This article belongs to the Special Issue Neglected Zoonotic Diseases: Advances in Leptospirosis in Livestock and Companion Animals)
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