Tropical Medicine and Infectious Disease

18 pages, 632 KiB

Open AccessReview

Using a Syndemics Perspective to (Re)Conceptualize Vulnerability during the COVID-19 Pandemic: A Scoping Review

by Yisel Hernandez Barrios, Dennis Perez Chacon, Yosiel Molina Gomez, Charlotte Gryseels, Kristien Verdonck, Koen Peeters Grietens and Claudia Nieto-Sanchez

Trop. Med. Infect. Dis. 2024, 9(8), 189; https://doi.org/10.3390/tropicalmed9080189 - 22 Aug 2024

Viewed by 824

Abstract

Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to [...] Read more.

Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to better understand how this theoretical framework helped to define, operationalize, and tackle issues of vulnerability during the COVID-19 pandemic. Original research, reviews, and opinion pieces elaborating on syndemics, vulnerability, and COVID-19, published between December 2019 and October 2022 and available from PubMed, were eligible. We analyzed 40 records and identified three framings of syndemics operating during this period: (1) interactions between COVID-19, diseases/health conditions, and specific social factors; (2) interactions between COVID-19 and social determinants of health; and (3) impacts of COVID-19 on specific populations. Emerging conceptualizations described vulnerability to COVID-19 as a systemic issue, explained the impact of COVID-19 control measures on increased vulnerability, and presented COVID-19 as a syndemic on its own. However, this theory’s potential for deepening our understanding of vulnerability during this pandemic was constrained by superficial explorations of the interactions between biomedical and social spheres, and insufficient theoretical and methodological support from the social sciences. Full article

(This article belongs to the Special Issue An Update on Syndemics)

► Show Figures

Figure 1

16 pages, 2061 KiB

Open AccessEditor’s ChoiceStudy Protocol

A Generalizable Prioritization Protocol for Climate-Sensitive Zoonotic Diseases

by Adam C. Castonguay, Sukanta Chowdhury, Ireen Sultana Shanta, Bente Schrijver, Remco Schrijver, Shiyong Wang and Ricardo J. Soares Magalhães

Trop. Med. Infect. Dis. 2024, 9(8), 188; https://doi.org/10.3390/tropicalmed9080188 - 21 Aug 2024

Viewed by 1114

Abstract

Emerging and re-emerging zoonotic diseases pose a significant threat to global health and economic security. This threat is further aggravated by amplifying drivers of change, including climate hazards and landscape alterations induced by climate change. Given the complex relationships between climate change and [...] Read more.

Emerging and re-emerging zoonotic diseases pose a significant threat to global health and economic security. This threat is further aggravated by amplifying drivers of change, including climate hazards and landscape alterations induced by climate change. Given the complex relationships between climate change and zoonotic disease health outcomes, a structured decision-making process is required to effectively identify pathogens of greatest concern to prioritize prevention and surveillance efforts. Here, we describe a workshop-based expert elicitation process in six steps to prioritize climate-sensitive zoonoses based on a structured approach to defining criteria for climate sensitivity. Fuzzy analytical hierarchy process methodology is used to analyze data provided by experts across human, animal, and environmental health sectors accounting for uncertainties at different stages of the prioritization process. We also present a new interactive expert elicitation interface that facilitates data collection and real-time visualization of prioritization results. The novel approach presented in this paper offers a generalized platform for prioritizing climate-sensitive zoonoses at a national or regional level. This allows for a structured decision-making support process when allocating limited financial and personnel resources to enhance preparedness and response to zoonotic diseases amplified by climate change. Full article

(This article belongs to the Section One Health)

► Show Figures

Figure 1

8 pages, 546 KiB

Open AccessCase Report

Concomitant Parenchymal, Subarachnoid, and Ventricular Neurocysticercosis in Rome, Italy: A Case Report with a 4-Year Follow-Up

by Maria Letizia Giancola, Shalom Haggiag, Angela Corpolongo, Alessandro Stasolla, Andrea Mariano, Agazio Menniti, Paolo Campioni, Barbara Bartolini, Pierluigi Galizia, Antonella Vulcano, Carla Fontana, Claudio Gasperini, Elise O’Connell, Hector H. Garcia, Theodore E. Nash and Emanuele Nicastri

Trop. Med. Infect. Dis. 2024, 9(8), 187; https://doi.org/10.3390/tropicalmed9080187 - 21 Aug 2024

Viewed by 911

Abstract

Neurocysticercosis (NCC) is caused by the larval stage of Taenia solium. This parasitic disease is endemic in many areas of the world and is emerging in Europe. NCC can affect different brain regions, but simultaneous involvement of the parenchymal, subarachnoid, and ventricular [...] Read more.

Neurocysticercosis (NCC) is caused by the larval stage of Taenia solium. This parasitic disease is endemic in many areas of the world and is emerging in Europe. NCC can affect different brain regions, but simultaneous involvement of the parenchymal, subarachnoid, and ventricular regions is rare. We report the case of a 39-year-old woman from Honduras, resident in Rome for 10 years, who presented to the Emergency Department complaining of headaches, transient hemianopsia, and bilateral papilledema. MRI showed a concomitant parenchymal, subarachnoid, and ventricular involvement in the brain. T. solium IgG antibodies were detected in the blood. The etiological diagnosis of NCC was obtained by identifying T. solium in cerebrospinal fluid using Next Generation Sequencing. Endoscopic neurosurgery with the placement of a ventricular shunt and medical long-term anti-parasitic treatment with a cumulative number of 463 days of albendazole and 80 days of praziquantel were performed. A successful 4-year follow-up is reported. NCC is one of the most common parasitic infections of the human CNS, but it is still a neglected tropical disease and is considered to be an emerging disease in Europe. Its diagnosis and clinical management remain a challenge, especially for European clinicians. Full article

(This article belongs to the Section Neglected and Emerging Tropical Diseases)

► Show Figures

Figure 1

7 pages, 875 KiB

Open AccessCase Report

Bartonella Neuroretinitis with Initial Seronegativity and an Absent Macular Star: A Case Report and Literature Review

by Jason Timothy Pan, Dayna Wei Wei Yong and Hazel Anne Lin

Trop. Med. Infect. Dis. 2024, 9(8), 186; https://doi.org/10.3390/tropicalmed9080186 - 20 Aug 2024

Cited by 1 | Viewed by 797

Abstract

Cat-scratch disease (CSD) is an infectious disease caused by Bartonella henselae, presenting with fever and lymphadenopathy following contact with felines. The ocular manifestations include neuroretinitis, characterised by optic nerve swelling and a macular star. Case Presentation: We discuss a case of neuroretinitis [...] Read more.

Cat-scratch disease (CSD) is an infectious disease caused by Bartonella henselae, presenting with fever and lymphadenopathy following contact with felines. The ocular manifestations include neuroretinitis, characterised by optic nerve swelling and a macular star. Case Presentation: We discuss a case of neuroretinitis that presented atypically, without a macular star. There was an initial suspicion of Bartonella, but the serology was negative. Our patient was eventually empirically treated for infective neuroretinitis based on a positive contact history (recently scratched by one of his three pet cats). There was progression to a macular star upon serial dilated fundus examination, and the repeated serology one week after symptom onset showed rising titres, supporting a diagnosis of CSD. Conclusions: A judicious review of systems, repeat assays, serial dilated fundus examination, and early ophthalmic evaluation are useful in cases of suspected neuroretinitis, remaining an important differential in the evaluation of sudden-onset painless vision loss and unilateral disc swelling. Full article

► Show Figures

Figure 1

22 pages, 1338 KiB

Open AccessEditor’s ChoiceReview

Best Practices in the Management of Clostridioides difficile Infection in Developing Nations

by Rafael Mendo-Lopez, Carolyn D. Alonso and Javier A. Villafuerte-Gálvez

Trop. Med. Infect. Dis. 2024, 9(8), 185; https://doi.org/10.3390/tropicalmed9080185 - 19 Aug 2024

Viewed by 1298

Abstract

Clostridioides difficile infection (CDI) is a well-known cause of hospital-acquired infectious diarrhea in developed countries, though it has not been a top priority in the healthcare policies of developing countries. In the last decade, several studies have reported a wide range of CDI [...] Read more.

Clostridioides difficile infection (CDI) is a well-known cause of hospital-acquired infectious diarrhea in developed countries, though it has not been a top priority in the healthcare policies of developing countries. In the last decade, several studies have reported a wide range of CDI rates between 1.3% and 96% in developing nations, raising the concern that this could represent a healthcare threat for these nations. This review defines developing countries as those with a human development index (HDI) below 0.8. We aim to report the available literature on CDI epidemiology, diagnostics, management, and prevention in developing countries. We identify limitations for CDI diagnosis and management, such as limited access to CDI tests and unavailable oral vancomycin formulation, and identify opportunities to enhance CDI care, such as increased molecular test capabilities and creative solutions for CDI. We also discuss infection prevention strategies, including antimicrobial stewardship programs and opportunities emerging from the COVID-19 pandemic, which could impact CDI care. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

21 pages, 1463 KiB

Open AccessArticle

Repurposing Insecticides for Mosquito Control: Evaluating Spiromesifen, a Lipid Synthesis Inhibitor against Aedes aegypti (L.)

by Daniela Cerda-Apresa, Selene M. Gutierrez-Rodriguez, Jesus A. Davila-Barboza, Beatriz Lopez-Monroy, Iram P. Rodriguez-Sanchez, Karla L. Saavedra-Rodriguez and Adriana E. Flores

Trop. Med. Infect. Dis. 2024, 9(8), 184; https://doi.org/10.3390/tropicalmed9080184 - 18 Aug 2024

Viewed by 887

Abstract

The growing resistance of Aedes aegypti (L.) to conventional insecticides presents a major challenge in arbovirus control, necessitating the exploration of alternative insecticidal chemistries. Spiromesifen, derived from spirocyclic tetronic acids, is widely used against agricultural pests and is crucial in resistance management due [...] Read more.

The growing resistance of Aedes aegypti (L.) to conventional insecticides presents a major challenge in arbovirus control, necessitating the exploration of alternative insecticidal chemistries. Spiromesifen, derived from spirocyclic tetronic acids, is widely used against agricultural pests and is crucial in resistance management due to its unique lipid synthesis inhibition. This study evaluates the insecticidal activity of spiromesifen against temephos-resistant Ae. aegypti populations, focusing on larval body weight, volume, biochemical composition, and adult female reproductive potential. Spiromesifen demonstrated effective larvicidal activity, significantly reducing adult emergence. Resistance to spiromesifen was not observed, with resistance ratios (RR₅₀, RR₉₀) ranging from 0.36- to 3.31-fold. Larvae exposed to LC₅₀ showed significant reductions in body weight and volume, and reduced carbohydrate, lipid, and protein contents. Enhanced catalase activity and malondialdehyde levels indicated increased oxidative stress and lipid peroxidation, highlighting its effects on lipid metabolism. Spiromesifen also exhibited sterilizing effects, significantly reducing fecundity and fertility in adult females, thereby impacting Ae. aegypti reproductive capacity. These findings highlight the potential of spiromesifen as a component of integrated vector management strategies, especially in regions with prevalent insecticide resistance in Ae. aegypti, serving as an effective larvicide and impacting adult reproductive outcomes. Full article

(This article belongs to the Special Issue Mosquito-Borne Diseases: Intervention Strategies Used to Control Mosquito Populations and Reduce Disease Transmission)

► Show Figures

Figure 1

24 pages, 2732 KiB

Open AccessArticle

‘The Lost Peace’: Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia

by Rosalind McCollum, Carrie Barrett, Georgina Zawolo, Rachel Johnstone, Tiawanlyn G. Godwin-Akpan, Hannah Berrian, Shahreen Chowdhury, Jerry Kollie, Karsor Kollie, Emerson Rogers, Colleen Parker, Maneesh Phillip, Lucas Sempe, Maaike Seekles, John Solunta Smith, Wede Seekey, Anna Wickenden, Zeela Zaizay, Sally Theobald and Laura Dean

Trop. Med. Infect. Dis. 2024, 9(8), 183; https://doi.org/10.3390/tropicalmed9080183 - 17 Aug 2024

Viewed by 1192

Abstract

Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by [...] Read more.

Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by further assessing and contextualising the syndemic relationship between NTDs (particularly their associated disability) and mental distress in Liberia. Participatory qualitative methods, including body mapping (56 participants), social mapping (28 participants), and in-depth interviews (12) provided space for persons affected by NTDs to narrate their experiences. Simultaneously, 201 surveys explored experiences of common mental health conditions among persons affected by skin NTDs. An intersectionality approach was applied within the analysis for both qualitative and quantitative methods informed by Meyer’s minority stress model, adapted for NTDs. Qualitative data was analysed thematically and gender-disaggregated, univariable and multivariable analyses were applied to survey data for the outcome measures depression (PHQ-9) and anxiety (GAD-7). Disability was associated with higher levels of depression and anxiety (p < 0.001). An interaction between disability and being a women increased incidence risk ratio of depression (p < 0.001). In alignment with qualitative findings, persons affected experienced additional generalised (financial concerns), external (experience of stigma) and internal (experience of pain and physical symptoms) minority stressors, to varying degrees, which contributed towards their mental distress, and mental health conditions. These findings were used to co-develop a syndemic-informed person-centred health system response to address the suffering associated with NTDs and mental distress, including a focus on strengthening relationships between formal and informal community health actors and the broader health system. Full article

(This article belongs to the Special Issue An Update on Syndemics)

► Show Figures

Figure 1

9 pages, 267 KiB

Open AccessEditor’s ChoiceArticle

Global Dynamics of Gastrointestinal Colonisations and Antimicrobial Resistance: Insights from International Travellers to Low- and Middle-Income Countries

by Laura Seijas-Pereda, David Carmena, Carlos Rescalvo-Casas, Marcos Hernando-Gozalo, Laura Prieto-Pérez, Juan Cuadros-González and Ramón Pérez-Tanoira

Trop. Med. Infect. Dis. 2024, 9(8), 182; https://doi.org/10.3390/tropicalmed9080182 - 17 Aug 2024

Viewed by 654

Abstract

Gastrointestinal microorganism resistance and dissemination are increasing, partly due to international travel. This study investigated gastrointestinal colonisations and the acquisition of antimicrobial resistance (AMR) genes among international travellers moving between Spain and low- and middle-income countries (Peru and Ethiopia). We analysed 102 stool [...] Read more.

Gastrointestinal microorganism resistance and dissemination are increasing, partly due to international travel. This study investigated gastrointestinal colonisations and the acquisition of antimicrobial resistance (AMR) genes among international travellers moving between Spain and low- and middle-income countries (Peru and Ethiopia). We analysed 102 stool samples from 51 volunteers collected before and after travel, revealing significantly higher rates of colonisation by both bacteria and protists upon return. Diarrhoeagenic strains of E. coli were the most notable microorganism detected using RT-PCR with the Seegene Allplex™ Gastrointestinal Panel Assays. A striking prevalence of β-lactamase resistance genes, particularly the TEM gene, was observed both before and after travel. No significant differences in AMR genes were found between the different locations. These findings highlight the need for rigorous surveillance and preventive strategies, as travel does not significantly impact AMR gene acquisition but does affect microbial colonisations. This study provides valuable insights into the intersection of gastrointestinal microorganism acquisition and AMR in international travellers, underscoring the need for targeted interventions and increased awareness. Full article

(This article belongs to the Special Issue Contemporary Migrant Health, 2nd Edition)

13 pages, 1301 KiB

Open AccessArticle

The Content Validity of an Instrument That Measures Health-Seeking Behavior for Tuberculosis among People Living with HIV in India

by Ankeeta Menona Jacob, Jeni Jacob, Wim Peersman and Avinash K. Shetty

Trop. Med. Infect. Dis. 2024, 9(8), 181; https://doi.org/10.3390/tropicalmed9080181 - 16 Aug 2024

Viewed by 806

Abstract

Determinants of health-seeking behavior among people living with HIV (PLHIV) are important. This study aims to develop and assess the content validity of an instrument that measures health-seeking behavior for tuberculosis among PLHIV in India. An instrument was developed using deductive methods and [...] Read more.

Determinants of health-seeking behavior among people living with HIV (PLHIV) are important. This study aims to develop and assess the content validity of an instrument that measures health-seeking behavior for tuberculosis among PLHIV in India. An instrument was developed using deductive methods and the Modified Andersen’s Behavioral Model of Health Services (BMHS). We identified three domains using the BMHS. Ten subject experts validated the tool between June 2022 and August 2022. Lawshe’s Content Validity Ratios (CVRs) and Scale Content Validity Indices (CVIs) were computed. The items with CVR and CVI values ≥0.62 were considered for the final tool. The health-seeking behavior among PLHIV, based on the BMHS, identified knowledge regarding TB (domain 1), healthcare accessibility and factors leading to delay in treatment-seeking behavior (domain 2), and client satisfaction regarding diagnostic and treatment-seeking behavior (domain 3). Content Validity Ratios (CVRs) of all the items related to domains 1 and 2 were ≥0.62. The Scale Content Validity Indices (for relevance), i.e., S-CVI (average) and S-CVI (proportional relevance), were ≥0.62 for all domains. The items with CVR and CVI values ≥0.62 in the domains were accepted in the final tool, which contained 69 items. Full article

(This article belongs to the Section Infectious Diseases)

► Show Figures

Figure 1

11 pages, 6487 KiB

Open AccessArticle

Comparative Genomics Revealing the Genomic Characteristics of Klebsiella variicola Clinical Isolates in China

by Fang Yang, Fei-Yi Liu and Yi-Ming Zhong

Trop. Med. Infect. Dis. 2024, 9(8), 180; https://doi.org/10.3390/tropicalmed9080180 - 16 Aug 2024

Viewed by 917

Abstract

Klebsiella variicola is an opportunistic pathogen often misidentified as Klebsiella pneumoniae, leading to misdiagnoses and inappropriate treatment in clinical settings. The genetic and molecular characteristics of clinically isolated K. variicola remain largely unexplored. We aim to fill this knowledge gap by examining [...] Read more.

Klebsiella variicola is an opportunistic pathogen often misidentified as Klebsiella pneumoniae, leading to misdiagnoses and inappropriate treatment in clinical settings. The genetic and molecular characteristics of clinically isolated K. variicola remain largely unexplored. We aim to fill this knowledge gap by examining the genomic properties of and evolutionary relationships between clinical isolates of K. variicola. The genomic data of 70 K. variicola strains were analyzed using whole-genome sequencing. A phylogenetic tree was generated based on the gene sequences from these K. variicola strains and public databases. Among the K. variicola strains, the drug resistance genes with the highest carrying rates were beta-lactamase and aminoglycoside. Locally isolated strains had a higher detection rate for virulence genes than those in public databases, with yersiniabactin genes being the most prevalent. The K locus types and MLST subtypes of the strains exhibited a dispersed distribution, with O3/O3a being the predominant subtype within the O category. In total, 28 isolates carried both IncFIB(K)_Kpn3 and IncFII_pKP91 replicons. This study underscores the importance of developing more effective diagnostic tools and therapeutic strategies for K. variicola infections. The continued surveillance and monitoring of K. variicola strains is essential for understanding the epidemiology of infections and informing public health strategies. Full article

► Show Figures

Figure 1

13 pages, 11823 KiB

Open AccessArticle

Pre-Exposure Prophylaxis to Prevent Hematophagous Bat-Mediated Rabies Outbreaks in Remote Amazon Communities: Lessons from a Pilot for Public Health Policy

by Felipe Rocha, Alexander Vargas, Elke Maria Nogueira de Abreu, Julio Cesar Augusto Pompei, Marco Antonio Natal Vigilato, Daniel Magalhães Lima, Raphael Schneider Vianna, Ottorino Cosivi, Sergio E. Recuenco, Wagner Augusto Costa, Luciana Hardt, Karin Correa Scheffer Ferreira, Rene dos Santos Cunha Neto, Luciana Botelho Chaves, Andrea de Cassia Rodrigues da Silva, Alberto Lopes Begot, Jorge Alberto Azevedo Andrade, Weber Marcos, Silene Manrique Rocha, Francisco Edilson Ferreira Lima Junior and Marcelo Yoshito Wada Show full author list Hide full author list

Trop. Med. Infect. Dis. 2024, 9(8), 179; https://doi.org/10.3390/tropicalmed9080179 - 14 Aug 2024

Viewed by 1776

Abstract

In 2018, an outbreak of human rabies caused by the hematophagous bat Desmodus rotundus hit the Brazilian Amazon Basin community of Melgaço, Brazil, resulting in the death of 10 people, 9 of them children. The incidence of rabies has been on the rise [...] Read more.

In 2018, an outbreak of human rabies caused by the hematophagous bat Desmodus rotundus hit the Brazilian Amazon Basin community of Melgaço, Brazil, resulting in the death of 10 people, 9 of them children. The incidence of rabies has been on the rise among populations in conditions of vulnerability in this ecosystem due to human expansion into sylvatic environments and limited access to public health services. To address this issue, in September 2019, a collaborative effort from national, local, and international institutions promoted and executed a pilot for pre-exposure prophylaxis of a population in high-risk areas for hematophagous bat-mediated rabies. This measure is usually only implemented in response to outbreaks. The pilot was conducted in Portel, in a nearby location to the previous outbreak, with the use of fluvial transportation, and 2987 individuals in 411 dwellings were successfully vaccinated. It established a methodology for pre-exposure prophylaxis for populations in conditions of vulnerability, identifying logistics and costs, as well as characterizing the target riverine population regarding risk factors associated with bites by hematophagous bats. This approach offers a proactive measure to prevent future outbreaks and provides valuable insights into how to address the issue of rabies in remote and difficult-to-reach areas. Full article

(This article belongs to the Special Issue Treatment and Risk Assessment of Rabies)

► Show Figures

Figure 1

19 pages, 1546 KiB

Open AccessReview

Lassa Fever: Critical Review and Prospects for Control

by Marianne E. Besson, Michel Pépin and Pierre-Alexandre Metral

Trop. Med. Infect. Dis. 2024, 9(8), 178; https://doi.org/10.3390/tropicalmed9080178 - 14 Aug 2024

Viewed by 1936

Abstract

Lassa Fever is a deadly viral haemorrhagic disease, causing annually several hundreds of deaths in West Africa. This zoonotic disease is primarily transmitted to humans by rodents of the genus Mastomys, even though other rodents reportedly carry the Lassa virus, while secondary [...] Read more.

Lassa Fever is a deadly viral haemorrhagic disease, causing annually several hundreds of deaths in West Africa. This zoonotic disease is primarily transmitted to humans by rodents of the genus Mastomys, even though other rodents reportedly carry the Lassa virus, while secondary interhuman transmission accounts for approximately 20% of cases. Although this disease has been endemic in rural zones of Nigeria, Sierra Leone, Liberfia, and Guinea for hundreds of years, it is also characterised by epidemic outbreaks in the dry season, responsible for heavy death tolls. No licensed vaccine or satisfying treatment is currently available. Disease management is hindered by the incomplete knowledge of the epidemiology and distribution of the disease, resulting from an inadequate health and surveillance system. Additional scientific constraints such as the genetic diversity of the virus and the lack of understanding of the mechanisms of immune protection complexify the development of a vaccine. The intricate socio-economic context in the affected regions, and the lack of monetary incentive for drug development, allow the disease to persist in some of West Africa’s poorest communities. The increase in the number of reported cases and in the fatality rate, the expansion of the endemic area, as well as the threat Lassa Fever represents internationally should urge the global community to work on the disease control and prevention. The disease control requires collaborative research for medical countermeasures and tailored public health policies. Lassa Fever, created by the interconnection between animals, humans, and ecosystems, and embedded in an intricate social context, should be addressed with a ‘One Health’ approach. This article provides an overview of Lassa Fever, focusing on Nigeria, and discusses the perspectives for the control of disease. Full article

(This article belongs to the Section Neglected and Emerging Tropical Diseases)

► Show Figures

Figure 1

10 pages, 961 KiB

Open AccessEditor’s ChoiceReview

Insights into the State of the Art of Urogenital Schistosomiasis with a Focus on Infertility

by Rafaella P. Marques, Waqas Ahmad, Raquel Soares, Katia C. Oliveira and Monica C. Botelho

Trop. Med. Infect. Dis. 2024, 9(8), 177; https://doi.org/10.3390/tropicalmed9080177 - 10 Aug 2024

Viewed by 968

Abstract

Schistosomiasis is a neglected tropical disease that affects developing countries worldwide and is caused by several species of parasites from the Schistosoma genus. Chronic infection is characterized by the formation of granulomas around the parasite eggs, the leading cause of pathology. The hepatosplenic [...] Read more.

Schistosomiasis is a neglected tropical disease that affects developing countries worldwide and is caused by several species of parasites from the Schistosoma genus. Chronic infection is characterized by the formation of granulomas around the parasite eggs, the leading cause of pathology. The hepatosplenic clinical form is one of the most common, but urogenital schistosomiasis is another relevant clinical presentation responsible for infertility in men and women. Inflammatory response, anatomical deformations, and endocrine/biochemical changes are involved in the development of infertility. Schistosome parasites can synthesize catechol estrogen-like molecules and affect the sexual hormone balance in their host. Here, we review many aspects of the pathology of urogenital schistosomiasis, specifically infertility, and point to the biochemical and endocrinal elements that must be investigated in the future. Full article

(This article belongs to the Special Issue Advances in Parasitic Neglected Tropical Diseases)

► Show Figures

Figure 1

14 pages, 246 KiB

Open AccessArticle

An Overview of the Management of Drug-Resistant Tuberculosis in Six French-Speaking African Countries from 2018 to 2022

by Gisèle Badoum, Abdoul R. Ouédraogo, Attannon A. Fiogbé, Albert Kuate Kuate, Alphazazi Soumana, Yacine Mar Diop, Mohammed F. Dogo, Olivia B. Mbitikon, Adjima Combary, Gildas Agodokpessi, Dissou Affolabi, Annie Bisso, Dona R. Atimbada, Sonia Menon and Kobto G. Koura

Trop. Med. Infect. Dis. 2024, 9(8), 176; https://doi.org/10.3390/tropicalmed9080176 - 9 Aug 2024

Viewed by 1060

Abstract

Drug-resistant tuberculosis (DR-TB) poses a significant public health challenge, particularly in resource-limited settings. The prevalence and management of DR-TB in African countries require comprehensive strategies to improve patient outcomes and control the spread of the disease. Aggregated routine data (from 2018 to 2022) [...] Read more.

Drug-resistant tuberculosis (DR-TB) poses a significant public health challenge, particularly in resource-limited settings. The prevalence and management of DR-TB in African countries require comprehensive strategies to improve patient outcomes and control the spread of the disease. Aggregated routine data (from 2018 to 2022) on multidrug-resistant TB (MDR-TB) were collected from the National TB Programs (NTPs) from all six countries. The diagnostic capacity for MDR-TB was globally insufficient. The system for collecting and transporting samples was sometimes inoperative. A total of 2353 cases of MDR-TB were reported, with 86.4% receiving treatment. The gap between the expected number of MDR-TB cases and the number reported per country varied from 51.5% to 88.0%, depending on the year. Fifty-two extensively drug-resistant (XDR) TB cases received treatment regimens over five years, with variations across countries. All patients received free follow-up examinations, nutritional and financial support for travel expenses to the outpatient care and treatment centers. The MDR-TB treatment success rates for all regimens between 2018 and 2021 ranged from 44.4 to 90.9%, varying by country and year. The information system relied on primary tools, reporting tools, and digital solutions. Progress has been made in MDR-TB management; however, challenges persist, necessitating resources to enhance access to rapid molecular screening tests. Full article

(This article belongs to the Special Issue The Epidemiology, Diagnosis and Treatment of Mycobacteria Infection (including TB and NTM))

12 pages, 2863 KiB

Open AccessReview

Receptor Tyrosine Kinase Signaling Involves Echinococcus–Host Intercommunication: A Potential Therapeutic Target in Hepatic Echinococcosis

by Haijun Gao, Zhuoma Bianba, Xiaojin Mo, Wei Hu, Zheng Feng, Fangye Zhou and Ting Zhang

Trop. Med. Infect. Dis. 2024, 9(8), 175; https://doi.org/10.3390/tropicalmed9080175 - 7 Aug 2024

Viewed by 962

Abstract

Echinococcosis, one of the most serious and life-threatening parasitic forms of zoonosis worldwide, is caused by the larvae of Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis). Various drugs are being applied clinically to treat zoonosis; however, their [...] Read more.

Echinococcosis, one of the most serious and life-threatening parasitic forms of zoonosis worldwide, is caused by the larvae of Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis). Various drugs are being applied clinically to treat zoonosis; however, their therapeutic efficacy remains a great challenge, especially with albendazole as the preferred drug of choice. Receptor tyrosine kinase (RTK) signaling controls normal cellular proliferation, differentiation, and metabolism in humans and mammals, which are intermediate hosts of E. granulosus and E. multilocularis. Disruption of RTK signaling can cause various forms of carcinogenesis and exacerbate the progression of certain forms of parasitic disease. As a result, a significant number of studies on tyrosine kinase inhibitors (TKIs) have been conducted for the treatment of cancer and parasitic infection, with some TKIs already approved for clinical use for cancer. Notably, RTK signaling has been identified in the parasites E. granulosus and E. multilocularis; however, the mechanisms of RTK signaling response in Echinococcus–host intercommunication are not fully understood. Thus, understanding the RTK signaling response in Echinococcus–host intercommunication and the potential effect of RTK signaling is crucial for identifying new drug targets for echinococcosis. The present review illustrates that RTK signaling in the host is over-activated following infection by E. granulosus or E. multilocularis and can further facilitate the development of metacestodes in vitro. In addition, some TKIs exert strong parasitostatic effects on E. granulosus or E. multilocularis, both in vitro and/or in vivo, through downregulation of RTK signaling molecules. The summarized findings suggest that RTK signaling may be a promising drug target and that TKIs could be potential anti-Echinococcus drugs warranting further research. Full article

(This article belongs to the Section Neglected and Emerging Tropical Diseases)

► Show Figures

Figure 1

13 pages, 1327 KiB

Open AccessArticle

Reduced Gut Bacterial Diversity in Early Life Predicts Feeding Intolerance in Preterm Neonates

by Maria Di Chiara, Alessandro Lazzaro, Daniela Scribano, Maria Trancassini, Valeria Pietropaolo, Michele Sonnessa, Chiara De Luca, Rita Prota, Elisa Onestà, Gianluigi Laccetta and Gianluca Terrin

Trop. Med. Infect. Dis. 2024, 9(8), 174; https://doi.org/10.3390/tropicalmed9080174 - 6 Aug 2024

Viewed by 768

Abstract

Microbiota plays a crucial role in intestinal maturation in preterm newborns. The clinical manifestation of the immaturity of the gastro-intestinal tract is called feeding intolerance (FI). This condition may resolve spontaneously or dramatically evolve into necrotizing enterocolitis. One of the most challenging tasks [...] Read more.

Microbiota plays a crucial role in intestinal maturation in preterm newborns. The clinical manifestation of the immaturity of the gastro-intestinal tract is called feeding intolerance (FI). This condition may resolve spontaneously or dramatically evolve into necrotizing enterocolitis. One of the most challenging tasks for the neonatologist is to identify those neonates that will develop the disease early in order to adequately provide nutrition to these patients, from the very first hours of life. A close interplay between the maturity of the gastro-intestinal tract and gut microbiota has been described; however, in preterm neonates, this relationship is still undefined. We analyzed the bacterial composition of stool samples, collected early in life, from 30 preterm newborns classified as intolerant or tolerant according to the degree of readiness of the gastro-intestinal tract to receive enteral nutrition. The Pielou evenness index was significantly increased in intolerant compared with tolerant newborns. Data corrected for confounding variables confirmed that the occurrence of gut maturation was independently influenced by Pielou evenness at birth. A lower bacterial diversity very early in life is associated with improved feeding tolerance in preterm newborns. The abundance analysis showed that neonates not ready to receive enteral nutrition for feeding intolerance show, after birth, an increased abundance of Proteobacteria, Lachnospiracae, Enterobacter and Acinetobacter. We can argue that those are the taxa that prevent the establishment of pioneer bacteria. A lower alpha-diversity, in the first days of life, may facilitate the seeding of beneficial pioneer bacteria that, in turn, drive healthy microbial colonization during neonatal life. Full article

(This article belongs to the Special Issue Microbial Infections and Antimicrobial Use in Neonates and Infants)

► Show Figures

Figure 1

9 pages, 276 KiB

Open AccessArticle

Household Location (Urban, Peri-Urban and Rural Settlements) as an Associated Risk Factor for Toxoplasmosis during Pregnancy in Southeastern Brazil

by Maria Linda Ferreira Lima, Ana Maria Anthônia Ferreira Lima Simão de Sousa, Lucimara Lopes Marques, Isabella Braghin Ferreira, Rogério Giuffrida, Louise Bach Kmetiuk, Alexander Welker Biondo and Vamilton Alvares Santarém

Trop. Med. Infect. Dis. 2024, 9(8), 173; https://doi.org/10.3390/tropicalmed9080173 - 1 Aug 2024

Viewed by 849

Abstract

Background: Brazil has a high prevalence of toxoplasmosis. However, there is a gap in comparing seroprevalence for Toxoplasma gondii across different environments, particularly among pregnant residents of rural and urban areas. Methods: The prevalence of IgG and IgM for T. gondii was compared [...] Read more.

Background: Brazil has a high prevalence of toxoplasmosis. However, there is a gap in comparing seroprevalence for Toxoplasma gondii across different environments, particularly among pregnant residents of rural and urban areas. Methods: The prevalence of IgG and IgM for T. gondii was compared among pregnant residents of the urban, peri-urban, and rural settlement areas in a municipality in southeastern Brazil. Information regarding age and area of residence was compiled from January 2015 to December 2022. Logistic regression analysis was used to assess the age and area of residence as risk factors. Results: A total of 1614 examinations were recorded, revealing 54.0% seropositivity, which was highest in the rural settlement (61.1%), followed by the peri-urban area (55.9%), and lowest in the urban area (49.2%). Conclusions: The high prevalence of IgG and presence of IgM in pregnant residents of rural, peri-urban, and urban areas highlights the significance of the results obtained for strengthening maternal health programs aimed at preventing toxoplasmosis, regardless of their residence. Full article

23 pages, 1606 KiB

Open AccessArticle

Addressing the Syndemic Relationship between Lymphatic Filariasis and Mental Distress in Malawi: The Potential of Enhanced Self-Care

by Carrie Barrett, John Chiphwanya, Dorothy E. Matipula, Janet Douglass, Louise A. Kelly-Hope and Laura Dean

Trop. Med. Infect. Dis. 2024, 9(8), 172; https://doi.org/10.3390/tropicalmed9080172 - 31 Jul 2024

Cited by 1 | Viewed by 1231

Abstract

Lymphatic filariasis (LF) causes disfiguring and disabling lymphoedema, which can lead to mental distress and requires life-long self-care treatment. This study applies syndemic theory to understand the biosocial relationship between LF and mental distress in Malawi. Using in-depth qualitative methods, we critically evaluate [...] Read more.

Lymphatic filariasis (LF) causes disfiguring and disabling lymphoedema, which can lead to mental distress and requires life-long self-care treatment. This study applies syndemic theory to understand the biosocial relationship between LF and mental distress in Malawi. Using in-depth qualitative methods, we critically evaluate experiences of mental distress and LF through 21 life-history interviews, to narrate experiences from the perspective of persons affected by LF, and to understand how enhanced self-care (ESC) for lymphoedema management disrupts the syndemic relationship. Complementary key informant interviews with Ministry of Health LF programme staff were conducted to further understand intervention and health system delivery. All interviews were recorded, transcribed, and translated, and then subject to thematic analysis. Our findings suggest that for persons affected by LF in Malawi, before being trained in ESC, absent referral pathways, inequalities in healthcare provision or available treatment, and limited knowledge of the condition (LF) drove the syndemic of LF and mental distress. Distress was often exacerbated by stigma and social exclusion, and shaped by intersections of gender, generation, poverty, and extreme climate conditions. We argue that addressing the syndemic suffering associated with LF and mental distress through interventions which center the needs of persons affected is critical in effective and equitable LF care delivery. Full article

(This article belongs to the Special Issue An Update on Syndemics)

► Show Figures

Figure 1

10 pages, 278 KiB

Open AccessEditor’s ChoiceArticle

Presence of Intestinal Parasites in Patients with Chronic Non-Communicable Diseases in Masaya (Nicaragua)

by Carla Muñoz-Antoli, Aleyda Pavón, Jacklyn Comas, Rafael Toledo and José Guillermo Esteban

Trop. Med. Infect. Dis. 2024, 9(8), 171; https://doi.org/10.3390/tropicalmed9080171 - 30 Jul 2024

Viewed by 887

Abstract

Aims: A cross-sectional study was conducted in Masaya (Nicaragua) to estimate the prevalence of intestinal parasite (IP) infections in patients with non-communicable diseases (NCDs) and to determine the associations between the types of NCDs and patients’ epidemiological characteristics of infection. Methods: A total [...] Read more.

Aims: A cross-sectional study was conducted in Masaya (Nicaragua) to estimate the prevalence of intestinal parasite (IP) infections in patients with non-communicable diseases (NCDs) and to determine the associations between the types of NCDs and patients’ epidemiological characteristics of infection. Methods: A total of 157 preserved faecal samples were examined (direct wet mount, formalin/ethyl acetate concentration and modified Ziehl–Neelsen technique). Microscopically positive faecal sample identification was completed by conducting a molecular study. Results: The total prevalence of IP was 52% in NCD patients. Diabetic patients presented an IP prevalence of 42%. Blastocystis presented the highest prevalence (42%). A molecular analysis of Giardia intestinalis (prevalence of 1.3%) revealed 100% of sub-assemblage BIII and the Entamoeba complex (5%) was identified as E. dispar. Blastocystis ST1 appeared in 44% of those suffering from diabetes and ST3 in 66% of those suffering from hypertension, while ST2 only appeared in those suffering with several NCDs simultaneously. In diabetic patients, the risk of infection is associated with having pets (p = 0.021) and land-floor houses. The risk of infection appears to be statistically related (p = 0.019) in those with several NCDs having received a previous helminthic deworming treatment. Conclusions: Coordinated public health activities for IP and NCD screening and diagnosis are crucial to their successful control programmes. Full article

(This article belongs to the Section Infectious Diseases)

12 pages, 235 KiB

Open AccessArticle

Awareness, Intention to Use Pre-Exposure Prophylaxis, and Factors Associated with Awareness among Men Who Have Sex with Men in the Republic of Korea

by Sarang Jang and Aeree Sohn

Trop. Med. Infect. Dis. 2024, 9(8), 170; https://doi.org/10.3390/tropicalmed9080170 - 25 Jul 2024

Viewed by 725

Abstract

This study assessed pre-exposure prophylaxis (PrEP) awareness, knowledge, and attitudes in a sample of 1389 men who have sex with men (MSM). Using a self-report survey, we measured PrEP knowledge mean scores, attitudes toward PrEP, and awareness rates to identify the key influences [...] Read more.

This study assessed pre-exposure prophylaxis (PrEP) awareness, knowledge, and attitudes in a sample of 1389 men who have sex with men (MSM). Using a self-report survey, we measured PrEP knowledge mean scores, attitudes toward PrEP, and awareness rates to identify the key influences on PrEP uptake. PrEP awareness among participants was 66.3%, with 33.7% having never heard of PrEP. Approximately 4.5% had previous experience with PrEP but were not current users, while only 2.7% reported that they were currently taking it. Logistic regression analysis revealed that the significant predictors of PrEP awareness were educational attainment, marital status, prior HIV testing knowledge, and attitudes toward PrEP. Several demographic factors were not significant predictors of intention to use PrEP; however, using the internet to meet partners, number of partners, HIV testing, positive attitudes, and reduced perceived barriers played a critical role in shaping PrEP use intentions. These findings highlight the critical role of targeted educational strategies and tailored public health messaging in enhancing the awareness and intention to use PrEP among MSM. Full article

(This article belongs to the Special Issue HIV Testing, Prevention and Care Interventions)

13 pages, 1755 KiB

Open AccessArticle

Human Defensin 5 Inhibits Plasmodium yoelii Development in Anopheles stephensi by Promoting Innate Immune Response

by Tingting Liu, Jing Wang, Xin Li, Shasha Yu, Dan Zheng, Zhilong Liu, Xuesen Yang and Ying Wang

Trop. Med. Infect. Dis. 2024, 9(8), 169; https://doi.org/10.3390/tropicalmed9080169 - 25 Jul 2024

Viewed by 810

Abstract

Malaria poses a serious threat to human health. Existing vector-based interventions have shortcomings, such as environmental pollution, strong resistance to chemical insecticides, and the slow effects of biological insecticides. Therefore, the need to develop novel strategies for controlling malaria, such as reducing mosquito [...] Read more.

Malaria poses a serious threat to human health. Existing vector-based interventions have shortcomings, such as environmental pollution, strong resistance to chemical insecticides, and the slow effects of biological insecticides. Therefore, the need to develop novel strategies for controlling malaria, such as reducing mosquito vector competence, is escalating. Human defensin 5 (HD5) has broad-spectrum antimicrobial activity. To determine its effect on Plasmodium development in mosquitoes, HD5 was injected into Anopheles stephensi at various time points. The infection density of Plasmodium yoelii in An. stephensi was substantially reduced by HD5 treatment administered 24 h prior to infection or 6, 12, or 24 h post-infection (hpi). We found that HD5 treatment upregulated the expression of the innate immune effectors TEP1, MyD88, and Rel1 at 24 and 72 hpi. Furthermore, the RNA interference of MyD88, a key upstream molecule in the Toll signaling pathway, decreased the HD5-induced resistance of mosquitoes against Plasmodium infection. These results suggest that HD5 microinjection inhibits the development of malaria parasites in An. stephensi by activating the Toll signaling pathway. Full article

(This article belongs to the Special Issue Epidemiology, Detection and Treatment of Malaria)

► Show Figures

Figure 1

13 pages, 2095 KiB

Open AccessArticle

Molecular Characterization of Leptospira Species among Patients with Acute Undifferentiated Febrile Illness from the Municipality of Villeta, Colombia

by Carlos Ramiro Silva-Ramos, J. Manuel Matiz-González, Juliana Gil-Mora, Heidy-C. Martínez Díaz, Álvaro A. Faccini-Martínez, Claudia Cuervo, Peter C. Melby, Patricia V. Aguilar, Miguel M. Cabada, Juan David Rodas and Marylin Hidalgo

Trop. Med. Infect. Dis. 2024, 9(8), 168; https://doi.org/10.3390/tropicalmed9080168 - 25 Jul 2024

Viewed by 1144

Abstract

Leptospira is a bacterial genus that includes several pathogenic species related to leptospirosis. In Colombia, leptospirosis is a mandatorily reported disease, widely distributed across the country. In the Villeta municipality, leptospirosis has been identified as an important cause of febrile illness; however, to [...] Read more.

Leptospira is a bacterial genus that includes several pathogenic species related to leptospirosis. In Colombia, leptospirosis is a mandatorily reported disease, widely distributed across the country. In the Villeta municipality, leptospirosis has been identified as an important cause of febrile illness; however, to date, no studies have been performed to identify the circulating species. A genus-specific qualitative qPCR was performed on DNA extracted from febrile patients’ acute-phase whole-blood samples targeting a fragment of the rrs gene. Positive qPCR samples were further amplified for the adk, icdA, LipL32, LipL41, rrs, and secY genes through conventional PCR for sequencing. All high-quality obtained sequences were further assessed through concatenated phylogenetic analysis. A total of 25% (14/56) of febrile patients’ acute blood samples were positive for Leptospira spp. High-quality sequences were obtained for only five genes, and analysis through concatenated phylogeny identified that all sequences clustered within the P1/pathogenic clade; some of them formed a robustly supported clade with Leptospira santarosai, and others were closely related with other Leptospira species but exhibited considerable genetic divergence. We describe the presence of pathogenic Leptospira species among febrile patients from the Villeta municipality and identify L. santarosai and other Leptospira species as causative agents of leptospirosis in the region. Full article

(This article belongs to the Section Neglected and Emerging Tropical Diseases)

► Show Figures

Figure 1

12 pages, 208 KiB

Open AccessArticle

Using a Knowledge and Awareness Survey to Engage and Inform a Community-Based Tuberculosis Intervention among Nomads in Adamawa State, Nigeria

by Stephen John, Suraj Abdulkarim, Thandi Katlholo, Caoimhe Smyth, Hunpiya Basason, Md. Toufiq Rahman and Jacob Creswell

Trop. Med. Infect. Dis. 2024, 9(8), 167; https://doi.org/10.3390/tropicalmed9080167 - 23 Jul 2024

Viewed by 1074

Abstract

Background: Nomadic populations are frequently isolated and vulnerable to diseases including tuberculosis (TB) and human immunodeficiency virus (HIV) due to limited access to health-related information and services, poverty, and social exclusion. We designed and implemented community-driven and -based outreach for TB and HIV [...] Read more.

Background: Nomadic populations are frequently isolated and vulnerable to diseases including tuberculosis (TB) and human immunodeficiency virus (HIV) due to limited access to health-related information and services, poverty, and social exclusion. We designed and implemented community-driven and -based outreach for TB and HIV based on the results of a TB knowledge, attitude, and practices (KAP) survey in Adamawa, Nigeria. Methods: We conducted a cross-sectional study on KAP among nomads using an adapted WHO survey. A TB and HIV community-level active case-finding intervention among nomadic populations was planned and delivered based on the KAP survey results. Results: Among 81 respondents, 26 (32.1%) knew what caused TB. More than 60% reported no health facilities in their community. Radio and healthcare workers were primary sources of information on health. Using community input, we developed and broadcasted radio jingles to sensitize people to TB services. Outreach initiatives led to the verbal screening of 61,891 individuals and 306 were diagnosed with TB. Additionally, 4489 people underwent HIV testing, and 69 were HIV-positive, all of whom were linked to treatment. Conclusions: The results of KAP surveys can inform the design of evidence-based TB and HIV community-driven and -based case-finding interventions in rural Nigeria among nomadic populations. Full article

(This article belongs to the Special Issue New Insights in Screening and Preventive Treatment for Tuberculosis)

Journal Menu

Journal Browser

Trop. Med. Infect. Dis., Volume 9, Issue 8 (August 2024) – 23 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI