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 - Q2 (Parasitology) / CiteScore - Q2 (General Immunology and Microbiology)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.4 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the second half of 2023).
- 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:
2.9 (2022);
5-Year Impact Factor:
3.1 (2022)
Latest Articles
Stop in Time: How to Reduce Unnecessary Antibiotics in Newborns with Late-Onset Sepsis in Neonatal Intensive Care
Trop. Med. Infect. Dis. 2024, 9(3), 63; https://doi.org/10.3390/tropicalmed9030063 - 19 Mar 2024
Abstract
The fear of missing sepsis episodes in neonates frequently leads to indiscriminate use of antibiotics, and prescription program optimization is suggested for reducing this inappropriate usage. While different authors have studied how to reduce antibiotic overprescription in the case of early onset sepsis
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The fear of missing sepsis episodes in neonates frequently leads to indiscriminate use of antibiotics, and prescription program optimization is suggested for reducing this inappropriate usage. While different authors have studied how to reduce antibiotic overprescription in the case of early onset sepsis episodes, with different approaches being available, less is known about late-onset sepsis episodes. Biomarkers (such as C-reactive protein, procalcitonin, interleukin-6 and 8, and presepsin) can play a crucial role in the prompt diagnosis of late-onset sepsis, but their role in antimicrobial stewardship should be further studied, given that different factors can influence their levels and newborns can be subjected to prolonged therapy if their levels are expected to return to zero. To date, procalcitonin has the best evidence of performance in this sense, as extrapolated from research on early onset cases, but more studies and protocols for biomarker-guided antibiotic stewardship are needed. Blood cultures (BCs) are considered the gold standard for the diagnosis of sepsis: positive BC rates in neonatal sepsis workups have been reported as low, implying that the majority of treated neonates may receive unneeded drugs. New identification methods can increase the accuracy of BCs and guide antibiotic de-escalation. To date, after 36–48 h, if BCs are negative and the baby is clinically stable, antibiotics should be stopped. In this narrative review, we provide a summary of current knowledge on the optimum approach to reduce antibiotic pressure in late-onset sepsis in neonates.
Full article
(This article belongs to the Special Issue Microbial Infections and Antimicrobial Use in Neonates and Infants)
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Open AccessCorrection
Correction: Yu et al. Inhibiting Liver Autophagy and Promoting Hepatocyte Apoptosis by Schistosoma japonicum Infection. Trop. Med. Infect. Dis. 2024, 9, 42
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Zhihao Yu, Tingting Jiang, Fangfang Xu, Jing Zhang, Yuan Hu and Jianping Cao
Trop. Med. Infect. Dis. 2024, 9(3), 62; https://doi.org/10.3390/tropicalmed9030062 - 18 Mar 2024
Abstract
In the published publication [...]
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Open AccessArticle
A Longitudinal Study in Tunisia to Assess the Anti-RBD IgG and IgA Responses Induced by Three Different COVID-19 Vaccine Platforms
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Wafa Ben Hamouda, Mariem Hanachi, Sonia Ben Hamouda, Wafa Kammoun Rebai, Adel Gharbi, Amor Baccouche, Jihene Bettaieb, Oussema Souiai, Mohamed Ridha Barbouche, Koussay Dellagi, Melika Ben Ahmed and Chaouki Benabdessalem
Trop. Med. Infect. Dis. 2024, 9(3), 61; https://doi.org/10.3390/tropicalmed9030061 - 13 Mar 2024
Abstract
Background: Vaccination constitutes the best strategy against COVID-19. In Tunisia, seven vaccines standing for the three main platforms, namely RNA, viral vector, and inactivated vaccines, have been used to vaccinate the population at a large scale. This study aimed to assess, in our
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Background: Vaccination constitutes the best strategy against COVID-19. In Tunisia, seven vaccines standing for the three main platforms, namely RNA, viral vector, and inactivated vaccines, have been used to vaccinate the population at a large scale. This study aimed to assess, in our setting, the kinetics of vaccine-induced anti-RBD IgG and IgA antibody responses. Methods: Using in-house developed and validated ELISA assays, we measured anti-RBD IgG and IgA serum antibodies in 186 vaccinated workers at the Institut Pasteur de Tunis over 12 months. Results: We showed that RNA vaccines were the most immunogenic vaccines, as compared to alum-adjuvanted inactivated and viral-vector vaccines, either in SARS-CoV-2-naïve or in SARS-CoV-2-experienced individuals. In addition to the IgG antibodies, the vaccination elicited RBD-specific IgAs. Vaccinated individuals with prior SARS-CoV-2 infection exhibited more robust IgG and IgA antibody responses, as compared to SARS-CoV-2-naïve individuals. Conclusions: After following up for 12 months post-immunization, we concluded that the hierarchy between the platforms for anti-RBD antibody-titer dynamics was RNA vaccines, followed by viral-vector and alum-adjuvanted inactivated vaccines.
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(This article belongs to the Special Issue COVID-19 Variants, Vaccines and New Waves)
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Potential Way to Develop Dengue Virus Detection in Aedes Larvae as an Alternative for Dengue Active Surveillance: A Literature Review
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Yenny Rachmawati, Savira Ekawardhani, Nisa Fauziah, Lia Faridah and Kozo Watanabe
Trop. Med. Infect. Dis. 2024, 9(3), 60; https://doi.org/10.3390/tropicalmed9030060 - 11 Mar 2024
Abstract
The burden of dengue has emerged as a serious public health issue due to its impact on morbidity, mortality, and economic burden. Existing surveillance systems are inadequate to provide the necessary data for the prompt and efficient control of dengue. Passive surveillance of
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The burden of dengue has emerged as a serious public health issue due to its impact on morbidity, mortality, and economic burden. Existing surveillance systems are inadequate to provide the necessary data for the prompt and efficient control of dengue. Passive surveillance of dengue cases may lead to underreporting and delayed mitigation responses. Improved dengue control program requires sensitive and proactive methods for early detection of dengue. We collected and reviewed existing research articles worldwide on detecting dengue virus in Aedes species larvae. Searches were conducted in PUBMED and Google Scholar, including all the studies published in English and Bahasa Indonesia. Twenty-nine studies were included in this review in terms of assay used, positivity rate, and dengue serotype detected. The presence of dengue virus in immature mosquitoes was mostly detected using reverse transcription PCR (RT-PCR) in pooled larvae. In one study, dengue virus was detected in larvae from laboratory-infected mosquitoes using enzyme-linked immunosorbent assay (ELISA). The positivity rate of dengue virus detection ranged from 0 to 50% in field-caught larvae. Although various methods can detect the dengue virus, further research encourages the use of low-cost and less laborious methods for active surveillance of dengue in larvae.
Full article
(This article belongs to the Special Issue Emerging Diseases/Viruses Prevention: Control, Surveillance, and One Health–2nd Edition)
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Open AccessArticle
Sustaining the Continued Effectiveness of an Antimicrobial Stewardship Program in Preterm Infants
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Tommaso Zini, Francesca Miselli, Chiara D’Esposito, Lucia Fidanza, Riccardo Cuoghi Costantini, Lucia Corso, Sofia Mazzotti, Cecilia Rossi, Eugenio Spaggiari, Katia Rossi, Licia Lugli, Luca Bedetti and Alberto Berardi
Trop. Med. Infect. Dis. 2024, 9(3), 59; https://doi.org/10.3390/tropicalmed9030059 - 07 Mar 2024
Abstract
Background: There are wide variations in antibiotic use in neonatal intensive care units (NICUs). Limited data are available on antimicrobial stewardship (AS) programs and long-term maintenance of AS interventions in preterm very-low-birth-weight (VLBW) infants. Methods: We extended a single-centre observational study carried out
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Background: There are wide variations in antibiotic use in neonatal intensive care units (NICUs). Limited data are available on antimicrobial stewardship (AS) programs and long-term maintenance of AS interventions in preterm very-low-birth-weight (VLBW) infants. Methods: We extended a single-centre observational study carried out in an Italian NICU. Three periods were compared: I. “baseline” (2011–2012), II. “intervention” (2016–2017), and III. “maintenance” (2020–2021). Intensive training of medical and nursing staff on AS occurred between periods I and II. AS protocols and algorithms were maintained and implemented between periods II and III. Results: There were 111, 119, and 100 VLBW infants in periods I, II, and III, respectively. In the “intervention period”, there was a reduction in antibiotic use, reported as days of antibiotic therapy per 1000 patient days (215 vs. 302, p < 0.01). In the “maintenance period”, the number of culture-proven sepsis increased. Nevertheless, antibiotic exposure of uninfected VLBW infants was lower, while no sepsis-related deaths occurred. Our restriction was mostly directed at shortening antibiotic regimens with a policy of 48 h rule-out sepsis (median days of early empiric antibiotics: 6 vs. 3 vs. 2 in periods I, II, and III, respectively, p < 0.001). Moreover, antibiotics administered for so-called culture-negative sepsis were reduced (22% vs. 11% vs. 6%, p = 0.002), especially in infants with a birth weight between 1000 and 1499 g. Conclusions: AS is feasible in preterm VLBW infants, and antibiotic use can be safely reduced. AS interventions, namely, the shortening of antibiotic courses in uninfected infants, can be sustained over time with periodic clinical audits and daily discussion of antimicrobial therapies among staff members.
Full article
(This article belongs to the Special Issue Microbial Infections and Antimicrobial Use in Neonates and Infants)
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Open AccessArticle
Single-Dose Rifampicin Leprosy Chemoprophylaxis for Household Contacts in Kiribati: An Audit of a Combined Retrospective and Prospective Approach
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Patrick O. Campbell, Temea Bauro, Erei Rimon, Eretii Timeon, Caitlin Bland, Nabura Ioteba, Nicholas M. Douglas, Arturo Cunanan and Stephen T. Chambers
Trop. Med. Infect. Dis. 2024, 9(3), 58; https://doi.org/10.3390/tropicalmed9030058 - 01 Mar 2024
Abstract
Kiribati is a Pacific Island nation with a widely dispersed population and one of the highest rates of leprosy worldwide. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) of leprosy contacts has reduced new case detection rates in controlled trials. In 2018, an SDR-PEP programme was
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Kiribati is a Pacific Island nation with a widely dispersed population and one of the highest rates of leprosy worldwide. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) of leprosy contacts has reduced new case detection rates in controlled trials. In 2018, an SDR-PEP programme was introduced in Kiribati that included screening and chemoprophylaxis of household contacts of leprosy cases retrospectively (2010–2017) and prospectively (2018–2022). We conducted a retrospective audit to determine the comprehensiveness, timeliness and feasibility of the SDR-PEP programme. Overall, 13,641 household contacts were identified (9791 in the retrospective and 3850 in the prospective cohort). In the retrospective cohort, 1044 (11%) contacts were absent, 403 (4%) were ineligible for SDR, and 42 new cases were detected (0.4%) Overall, SDR coverage was 84.7%. In the prospective cohort, 164 (4%) contacts were absent, 251 (7%) were ineligible for SDR, and 23 new cases were diagnosed (0.6%). Overall, SDR coverage was 88.1%. Across both cohorts, there were 23 SDR refusals. The median time to SDR administration was 220 days (IQR 162–468) and 120 days (IQR 36–283) for the retrospective and prospective cohorts, respectively. SDR was readily accepted in both cohorts. The new case detection rate (0.5%) is consistent with that in other studies. Overall SDR coverage in both the retrospective and prospective phases met programmatic expectations.
Full article
(This article belongs to the Special Issue Leprosy: Stop Transmission and Prevent Disease)
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Vaccine Hesitancy, Knowledge, and COVID-19 Vaccination in a Sample of Italian and Albanian Healthcare Students Attending an University in Albania
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Ersilia Buonomo, Fabian Cenko, Gaia Piunno, Daniele Di Giovanni, Enkeleda Gjini, Bora Kërpi, Mariachiara Carestia, Stefania Moramarco, Cristiana Ferrari and Luca Coppeta
Trop. Med. Infect. Dis. 2024, 9(3), 57; https://doi.org/10.3390/tropicalmed9030057 - 29 Feb 2024
Abstract
Background: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable
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Background: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable source of vaccine-related information for patients. Special attention must therefore be paid to medical students, who are the future HCWs. Methods: We conducted a cross-sectional study (November 2022–January 2023) on all the Albanian and Italian students attending medical science courses at the Catholic University “Our Lady of Good Counsel” (Tirane, Albania) to investigate VH and the factors contributing to it (using the Vaccination Attitude Examination Scale-VAX), including COVID-19 vaccination. Vaccine knowledge was assessed using the Zingg and Siegrist Scale. Students were asked to voluntarily answer an anonymous questionnaire. Results: 689 questionnaires were collected (58.8% Albanians, 72.3% female; 70.4% aged 20–25 years; 70.4% attending the Medicine and Surgery course). Generally, students showed low VH, especially Italians (p < 0.001); however, some hesitancy was observed regarding the potential long-term effects of vaccines, especially among Albanians (p < 0.05). The results also showed a significant difference in vaccine knowledge scores between different course years (χ2 = 90.058; df = 40; p = < 0.001) and different degree courses (χ2 = 89.932; df = 40; p = < 0.001). With regard to COVID-19 vaccination, being of Albanian origin significantly increases the risk of not being vaccinated (OR = 7.215; 95%CI 3.816–13.640, p < 0.001), highlighting possible differences in vaccine coverage and policy between the two countries. Conclusion: Vaccine hesitancy should be addressed at early stages during medical sciences courses, in order to protect future healthcare workers, to preserve essential health services, and reduce the risk of further pandemics.
Full article
(This article belongs to the Section Infectious Diseases)
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Open AccessArticle
Operational Differences between Product Development Partnership, Pharmaceutical Industry, and Investigator Initiated Clinical Trials
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Eric I Nebie, Peter van Eeuwijk, Hélène N. Sawadogo, Elisabeth Reus, Jürg Utzinger and Christian Burri
Trop. Med. Infect. Dis. 2024, 9(3), 56; https://doi.org/10.3390/tropicalmed9030056 - 29 Feb 2024
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Medicine development is a lengthy endeavour. Increasing regulatory stringency and trial complexity might lead to reduced efficiency, dwindled output, and elevated costs. However, alternative models are possible. We compared the operational differences between pharmaceutical industry sponsored trials, product development partnership trials, and investigator-initiated
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Medicine development is a lengthy endeavour. Increasing regulatory stringency and trial complexity might lead to reduced efficiency, dwindled output, and elevated costs. However, alternative models are possible. We compared the operational differences between pharmaceutical industry sponsored trials, product development partnership trials, and investigator-initiated trials to identify key drivers of inefficiency in clinical research. We conducted an exploratory mixed-methods study with stakeholders, including clinical trial sponsors, contract research organisations, and investigators. The qualitative component included 40 semi-structured interviews, document reviews of 12 studies and observations through work shadowing in research institutions in Burkina Faso, Mali, and Switzerland. The findings were triangulated with an online survey polling clinical research professionals. The operational differences were grouped under five categories: (i) trial start-up differences including governance and management structure; (ii) study complexity; (iii) site structural and organisational differences; (iv) study conduct, quality approaches, and standard operating procedures; and (v) site capacity strengthening and collaboration. Early involvement of sites in the planning and tailored quality approaches were considered critical for clinical operations performance. Differences between the types of trials reviewed pertained to planning, operational complexities, quality approaches, and support to the sites. Integration of quality-by-design components has the potential to alleviate unnecessary process burden.
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What Does a KAP Survey Reveal about the Awareness Regarding Leishmaniasis among the Community of an Endemic Area in Sri Lanka?
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Mayumi Manamperi, P. Kandegedara, G. I. C. L. De Zoysa, J. M. A. I. K. Jayamanna, E. G. Perera and N. D. Asha Dilrukshi Wijegunawardana
Trop. Med. Infect. Dis. 2024, 9(3), 55; https://doi.org/10.3390/tropicalmed9030055 - 28 Feb 2024
Abstract
Leishmaniasis is one of the neglected tropical diseases. Studies show that the poor knowledge about epidemiological aspects of leishmaniasis within communities causes the collapse of existing disease control programs. Therefore, the present study focuses on a detailed survey of the existing awareness among
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Leishmaniasis is one of the neglected tropical diseases. Studies show that the poor knowledge about epidemiological aspects of leishmaniasis within communities causes the collapse of existing disease control programs. Therefore, the present study focuses on a detailed survey of the existing awareness among the threatened population in the Medawachchiya Public Health Inspector’s (PHI) Area in the Anuradhapura District, Sri Lanka, aiming to assist the health staff to organize community-based vector control programs effectively in the future. Assessment of the awareness of residents of two hundred and seventy households (n = 270) from 10 Grama Niladhari Divisions (GNDs) was carried out by using a structured questionnaire. Among 143 females and 134 males, only 75.1% had knowledge about the disease, 5.8% (n = 16) of the participants knew only about the vector, and 28.9% (n = 80) knew about control methods. The study showed a considerable lack of awareness about the disease among the studied population. The study found that age and education levels had significant impacts on knowledge, attitudes, and practices. However, factors like gender, marital status, occupation, income, and expenses did not show significant correlations. The present study suggests huge scope for greater achievements in community-related vector control methods by implementing a continuous educational program.
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(This article belongs to the Special Issue Community Engagement and Neglected Tropical Diseases (NTDs))
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Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019−2021
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Pedro Plans-Rubió, Sofia Godoy, Diana Toledo, Angela Domínguez, Joan Caylà, Ignasi Parron, Joan Pau Millet and Pere Godoy
Trop. Med. Infect. Dis. 2024, 9(3), 54; https://doi.org/10.3390/tropicalmed9030054 - 27 Feb 2024
Abstract
The aim of this study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection for new cases of pulmonary TB cases reported in Catalonia in 2019–2021. All contacts aged 18 years or older with
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The aim of this study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection for new cases of pulmonary TB cases reported in Catalonia in 2019–2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables; a p < 0.05 was considered statistically significant. Multiple logistic regression analysis was used to detect the independent factors associated with TB preventive treatment non-adherence; a p < 0.05 was considered statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: “exposure at school or workplace” (aOR = 3.34), “exposure to an index case without laboratory confirmation of TB” (aOR = 2.07), “immigrant contact” (aOR = 1.81), “male gender” (aOR = 1.75) and “exposure duration < 6 h per week or sporadic” (aOR = 1.60. By contrast, the factor “short-term TB preventive treatment regimen” (aOR = 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.
Full article
(This article belongs to the Special Issue New Insights in Screening and Preventive Treatment for Tuberculosis)
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Open AccessArticle
Integrated Strategies for Aedes aegypti Control Applied to Individual Houses: An Approach to Mitigate Vectorial Arbovirus Transmission
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Danielle Cristina Tenório Varjal de Melo, Eloína Maria de Mendonça Santos, Morgana Nascimento Xavier, Josimara do Nascimento, Victor Araújo Barbosa, André Luiz de Sá Oliveira, Marcos Vinícius Meiado, Maria Alice Varjal de Melo-Santos, Marcelo Henrique Santos Paiva, Gabriel da Luz Wallau and Cláudia Maria Fontes de Oliveira
Trop. Med. Infect. Dis. 2024, 9(3), 53; https://doi.org/10.3390/tropicalmed9030053 - 24 Feb 2024
Abstract
Aedes aegypti and Culex quinquefasciatus mosquitoes are vectors of different arboviruses that cause a large burden of disease in humans worldwide. A key step towards reducing the impact of arboviruses on humans can be achieved through integrated mosquito surveillance and control approaches. We
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Aedes aegypti and Culex quinquefasciatus mosquitoes are vectors of different arboviruses that cause a large burden of disease in humans worldwide. A key step towards reducing the impact of arboviruses on humans can be achieved through integrated mosquito surveillance and control approaches. We carried out an integrated approach of mosquito surveillance and control actions to reduce populations of these insects along with a viral surveillance in a neighborhood of Recife (Northeastern Brazil) with high mosquito densities and arbovirus transmission. The actions were carried out in 40 different houses in the Nova Descoberta neighborhood. The area was divided into two groups, the control group using tools to monitor the mosquito density (1 OVT; 1 Double BR-ovt; monthly capture of alates) and the experimental group with control actions using surveillance tools in an intensified way (2 OVTs; 2 Double BR-ovts; fortnightly capture of alates; toxic baits). We evaluated the study’s impact on the mosquito density via the Egg Density (ED) and Adult Density (AD) over a period of 12 cycles of 28 days each. The collected adult mosquitoes were processed via RT-qPCR for DENV, CHIKV and ZIKV and, subsequently, the Minimum Infection Rate (MIR) was calculated. After 12 cycles, we observed a 91% and 99% reduction in Aedes ED and AD in the monitored properties, as well as a 76% reduction in the AD of Cx. quinquefasciatus in the same properties. Moreover, we detected circulating arboviruses (DENV and ZIKV) in 19.52% of captured adult mosquitoes. We show that enhancing entomological surveillance tools can aid in the early detection of possible risk areas based on vector mosquito population numbers. Additionally, the detection of important arboviruses such as ZIKV and DENV raises awareness and allows for a better selection of risk areas and silent virus spread. It offers supplementary information for guiding emergency mosquito control measures in the target area. The goal is to minimize human–vector interactions and, subsequently, to lower the risk of transmitting circulating arboviruses.
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(This article belongs to the Special Issue Emerging Topics in Arbovirus Vectors)
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Ecology and Infection Status of Sand Flies in Rural and Urban Cutaneous Leishmaniasis Endemic Areas in Northwest Ethiopia
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Wondmeneh Jemberie, Abebe Animut, Sisay Dugassa, Araya Gebresilassie, Roma Melkamu, Esayas Aklilu, Mulugeta Aemero, Johan van Griensven and Myrthe Pareyn
Trop. Med. Infect. Dis. 2024, 9(3), 52; https://doi.org/10.3390/tropicalmed9030052 - 23 Feb 2024
Abstract
Cutaneous leishmaniasis (CL) caused by Leishmania aethiopica is transmitted by Phlebotomus longipes in northern Ethiopia. No studies have been conducted to investigate the transmission dynamics of CL, despite its high endemicity in both rural and urban settings. Evidence on the ecology and behavior
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Cutaneous leishmaniasis (CL) caused by Leishmania aethiopica is transmitted by Phlebotomus longipes in northern Ethiopia. No studies have been conducted to investigate the transmission dynamics of CL, despite its high endemicity in both rural and urban settings. Evidence on the ecology and behavior of the vector from this area are required to develop integrated disease control strategies. Sand flies were collected in the dry and wet seasons in 2021 in CL-endemic rural Gindmeteaye and urban Addis-Alem in northwest Ethiopia. Trapping was performed with sticky and Centers for Disease Control and Prevention (CDC) light traps in three habitats, including inside patients’ houses, peridomestic areasand in caves/rocky areas. Sand flies were morphologically identified to species level. Female Phlebotomus species were categorized according to blood feeding status and tested by spliced-leader (SL-) ribonucleic acid (RNA) polymerase chain reaction (PCR) to screen for Leishmania infection. Of 1161 sand flies, the majority (77%) were P. longipes, six (0.5%) were P. orientalis and the remaining were Sergentomyia. The abundance of the 430 female P. longipes was significantly linked to seasonality (p < 0.001), with the majority in the dry season occurring in the outdoor rocky (37%) and peridomestic (34%) sites, while, in the wet season, most (62%) were captured indoors. This seasonality was more pronounced in rural Gindmeteaye, where housing construction is poor. The number of blood-fed and gravid P. longipes was significantly higher in the wet (31%; 22%), compared to the dry season (13%; 8%), and their proportion was highest indoors. Eighteen (4%) female P. longipes were Leishmania positive, with highest infection prevalence in caves (7% compared to 3% indoors, p = 0.022), and in the dry season (6%, p < 0.001). Phlebotomus orientalis specimens were all captured in May in rural Gindmeteaye, five indoors and one in a peridomestic site. Further research should be conducted to investigate the absolute contribution of humans and indoor transmission to the transmission cycle of CL. Inhabitants of endemic villages should be made aware that evening outdoor activities near caves may increase their exposure to infectious sand flies. Whether P. orientalis can breed and become infected at high altitudes should be further studied.
Full article
(This article belongs to the Special Issue Leishmaniasis: Vector-Host-Pathogen Interactions in Health and Disease)
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Open AccessArticle
Training and Active Case Detection to Prevent Leprosy: Effect on Knowledge, Attitude and Skills of Health Workers on Early Diagnosis of Leprosy in a Leprosy Hotspot District in Ethiopia
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Ephrem Mamo, Dareskedar Tsehay, Seid Hassen, Solomon Getahun, Addis Mengiste, Beletshachew Tadesse, Tesfaye Tadesse, Mengestu Legesse and Kidist Bobosha
Trop. Med. Infect. Dis. 2024, 9(3), 51; https://doi.org/10.3390/tropicalmed9030051 - 23 Feb 2024
Abstract
Background: Despite all of the efforts, leprosy continues to affect hundreds of thousands of people every year, including children, showing the ongoing transmission of the disease within the population. The transmission of leprosy can be interrupted through an integrated approach that includes active
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Background: Despite all of the efforts, leprosy continues to affect hundreds of thousands of people every year, including children, showing the ongoing transmission of the disease within the population. The transmission of leprosy can be interrupted through an integrated approach that includes active case-finding, contact tracing and capacity building of health workers. Methods: A cross-sectional study design was used to assess the knowledge, attitudes and skills of health workers in the screening and diagnosis of leprosy. One hundred and eighty-one and eighty-eight health care workers participated in the pre-and post-assessment surveys, respectively. Data were collected through interviews and an observational checklist. Frequency tables and graphs were used to describe the study variables, and statistical significance between pre- and post-assessment surveys was declared at p-value < 0.5. Result: The percentages of healthcare workers with good knowledge, positive attitudes and skills were 61.2%, 55.6% and 51.7% in the pre-assessment survey and 77.3%, 56.3% and 75.0%, respectively, in the post-assessment survey. There was a significant improvement in the knowledge and skill scores of participants in the post-assessment survey (p < 0.01). During the campaign, 3780 index contacts were screened; 570 (15.1%) were diagnosed with skin diseases, and 17 new leprosy cases were diagnosed (case detection rate of 45 per 10,000 contacts). Conclusion: Training improved the knowledge and skills of healthcare workers, and a large number of skin diseases were detected through mass screening and active case findings. Providing training for frontline healthcare workers contributed to the detection of more cases and facilitated early detection of leprosy cases.
Full article
(This article belongs to the Section Infectious Diseases)
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Open AccessBrief Report
Spike S2 Subunit: Possible Target for Detecting Novel SARS-CoV-2 Variants with Multiple Mutations
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Teerada Ponpinit, Yutthana Joyjinda, Weenassarin Ampoot, Siriporn Yomrat, Phatthamon Virojanapirom, Chanida Ruchisrisarod, Abhinbhen W. Saraya, Pasin Hemachudha and Thiravat Hemachudha
Trop. Med. Infect. Dis. 2024, 9(2), 50; https://doi.org/10.3390/tropicalmed9020050 - 15 Feb 2024
Abstract
Novel SARS-CoV-2 variants have multiple mutations that may impact molecular diagnostics. The markedly conserved S2 subunit may be utilized to detect new variants. A comparison of 694 specimens (2019–2022) in Thailand using a commercial RT-PCR kit and the kit in combination with S2
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Novel SARS-CoV-2 variants have multiple mutations that may impact molecular diagnostics. The markedly conserved S2 subunit may be utilized to detect new variants. A comparison of 694 specimens (2019–2022) in Thailand using a commercial RT-PCR kit and the kit in combination with S2 primers and a probe was performed. Delayed amplification in ORF1ab was detected in one BA.4 omicron, whereas no amplification problem was encountered in the S2 target. There were no statistically significant differences in mean Ct value between the target genes (E, N, ORF1ab, and S2) and no significant differences in mean Ct value between the reagents. Furthermore, 230,821 nucleotide sequences submitted by 20 representative counties in each region (Jan–Oct 2022) have been checked for mutations in S2 primers and probe using PrimerChecker; there is a very low chance of encountering performance problems. The S2 primers and probe are still bound to the top five currently circulating variants in all countries and Thailand without mismatch recognition (Jun–Nov 2023). This study shows the possible benefits of detecting S2 in combination with simultaneously detecting three genes in a kit without affecting the Ct value of each target. The S2 subunit may be a promising target for the detection of SARS-CoV-2 variants with multiple mutations.
Full article
(This article belongs to the Special Issue Emerging Diseases/Viruses Prevention: Control, Surveillance, and One Health–2nd Edition)
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Human Cytomegalovirus (HCMV) Genetic Diversity, Drug Resistance Testing and Prevalence of the Resistance Mutations: A Literature Review
by
Ivana Grgic and Lana Gorenec
Trop. Med. Infect. Dis. 2024, 9(2), 49; https://doi.org/10.3390/tropicalmed9020049 - 15 Feb 2024
Abstract
Human cytomegalovirus (HCMV) is a pathogen with high prevalence in the general population that is responsible for high morbidity and mortality in immunocompromised individuals and newborns, while remaining mainly asymptomatic in healthy individuals. The HCMV genome is 236,000 nucleotides long and encodes approximately
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Human cytomegalovirus (HCMV) is a pathogen with high prevalence in the general population that is responsible for high morbidity and mortality in immunocompromised individuals and newborns, while remaining mainly asymptomatic in healthy individuals. The HCMV genome is 236,000 nucleotides long and encodes approximately 200 genes in more than 170 open reading frames, with the highest rate of genetic polymorphisms occurring in the envelope glycoproteins. HCMV infection is treated with antiviral drugs such as ganciclovir, valganciclovir, cidofovir, foscarnet, letermovir and maribavir targeting viral enzymes, DNA polymerase, kinase and the terminase complex. One of the obstacles to successful therapy is the emergence of drug resistance, which can be tested phenotypically or by genotyping using Sanger sequencing, which is a widely available but less sensitive method, or next-generation sequencing performed in samples with a lower viral load to detect minority variants, those representing approximately 1% of the population. The prevalence of drug resistance depends on the population tested, as well as the drug, and ranges from no mutations detected to up to almost 50%. A high prevalence of resistance emphasizes the importance of testing the patient whenever resistance is suspected, which requires the development of more sensitive and rapid tests while also highlighting the need for alternative therapeutic targets, strategies and the development of an effective vaccine.
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(This article belongs to the Special Issue Genetic Diversity of Viruses: From Source Tracing to Treatment Tailoring)
Open AccessArticle
Determinants of Immunovirological Response among Children and Adolescents Living with HIV-1 in the Central Region of Cameroon
by
Rodolphe Steven Dobseu Soudebto, Joseph Fokam, Nelly Kamgaing, Nadine Fainguem, Ezechiel Ngoufack Jagni Semengue, Michel Carlos Tommo Tchouaket, Rachel Kamgaing, Aubin Nanfack, Yagai Bouba, Junie Yimga, Collins Chenwi Ambe, Hyacinthe Gouissi, Jeremiah Efakika Gabisa, Krystel Nnomo Zam, Alex Durand Nka, Samuel Martin Sosso, Gregory-Edie Halle-Ekane, Marie-Claire Okomo and Alexis Ndjolo
Trop. Med. Infect. Dis. 2024, 9(2), 48; https://doi.org/10.3390/tropicalmed9020048 - 14 Feb 2024
Abstract
About 90% of new HIV-1 infections in children occur in sub-Saharan Africa, where treatment monitoring remains suboptimal. We sought to ascertain factors associated with immunovirological responses among an ART-experienced paediatric population in Cameroon. A laboratory-based and analytical study was conducted from January 2017
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About 90% of new HIV-1 infections in children occur in sub-Saharan Africa, where treatment monitoring remains suboptimal. We sought to ascertain factors associated with immunovirological responses among an ART-experienced paediatric population in Cameroon. A laboratory-based and analytical study was conducted from January 2017 throughout December 2020 wherein plasma viral load (PVL) analyses and CD4 cell counts were performed. Viral suppression (VS) was defined as PVL < 1000 copies/mL and immunological failure (IF) as CD4 < 500 cells/µL for participants ≤5 years and CD4 < 250 cells/µL for those >5 years; p < 0.05 was considered statistically significant. Overall, 272 participants were enrolled (median age: 13 [9–15.5] years; 54% males); median ART duration 7 [3–10] years. Globally, VS was achieved in 54.41%. VS was 56.96% in urban versus 40.48% in rural areas (p = 0.04). IF was 22.43%, with 15.79% among participants ≤5 years and 22.92% among those >5 years (p = 0.66). IF was 20.43% in urban versus 33.33% in rural areas (p = 0.10). Following ART, IF was 25.82% on first-line (non-nucleoside reverse transcriptase inhibitors; NNRTI-based) versus 10.17% on second-line (protease inhibitor-based) regimens (p = 0.01). Interestingly, IF was 7.43% among virally suppressed versus 40.32% among virally unsuppressed participants (p < 0.0001). A low VS indicates major challenges in achieving AIDS’ elimination in this paediatric population, especially in rural settings and poor immune statuses. Scaling up NNRTI-sparing regimens alongside close monitoring would ensure optimal therapeutic outcomes.
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(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
Open AccessCase Report
Unusual Localization of AIDS-Related Kaposi’s Sarcoma in a Heterosexual Male during the COVID-19 Pandemic: A Case Report
by
Manuela Arbune, Monica-Daniela Padurariu-Covit, Carmen Tiutiuca, Raul Mihailov, Elena Niculet, Anca-Adriana Arbune and Alin-Laurentiu Tatu
Trop. Med. Infect. Dis. 2024, 9(2), 47; https://doi.org/10.3390/tropicalmed9020047 - 13 Feb 2024
Abstract
Kaposi’s sarcoma is an AIDS-defining illness and remains the most frequent tumor arising in HIV-infected patients with multifactorial etiology. We present a case of a 30-year-old Caucasian male with an 18-year history of HIV infection. The patient was presented with a one-week history
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Kaposi’s sarcoma is an AIDS-defining illness and remains the most frequent tumor arising in HIV-infected patients with multifactorial etiology. We present a case of a 30-year-old Caucasian male with an 18-year history of HIV infection. The patient was presented with a one-week history of fever, non-productive cough, and skin lesions. There was an associated weakness and weight loss in a duration of 6 months. Clinical examination showed fever, generalized lymphadenopathy, lower limb edema, ascites, and violaceous cutaneous eruption comprising patches, plaques, and nodules. He also had a red nodule on the left conjunctiva, as well as on his oral mucosa. His CD4+ count was below 10/mm3 and ARN-HIV viral load was above 100,000 c/mL, in relation to the antiretroviral failure after five drug regimens. The role of co-infections in oncogenesis and the course of Kaposi’s sarcoma were considered in recent studies. Delayed diagnosis of Kaposi’s sarcoma in the present case resulted in a negative impact for this patient during the COVID-19 pandemic.
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(This article belongs to the Special Issue Living with HIV: Support, Care, and Treatment for Vulnerable Populations)
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Open AccessEditor’s ChoiceArticle
Genomic and Phylogenetic Characterisation of SARS-CoV-2 Genomes Isolated in Patients from Lambayeque Region, Peru
by
Sergio Luis Aguilar-Martinez, Gustavo Adolfo Sandoval-Peña, José Arturo Molina-Mora, Pablo Tsukayama-Cisneros, Cristian Díaz-Vélez, Franklin Rómulo Aguilar-Gamboa, D. Katterine Bonilla-Aldana and Alfonso J. Rodriguez-Morales
Trop. Med. Infect. Dis. 2024, 9(2), 46; https://doi.org/10.3390/tropicalmed9020046 - 11 Feb 2024
Abstract
Objective: this study aims to identify and characterise genomic and phylogenetically isolated SARS-CoV-2 viral isolates in patients from Lambayeque, Peru. Methods: Nasopharyngeal swabs were taken from patients from the Almanzor Aguinaga Asenjo Hospital, Chiclayo, Lambayeque, Peru, which had been considered mild, moderate, and
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Objective: this study aims to identify and characterise genomic and phylogenetically isolated SARS-CoV-2 viral isolates in patients from Lambayeque, Peru. Methods: Nasopharyngeal swabs were taken from patients from the Almanzor Aguinaga Asenjo Hospital, Chiclayo, Lambayeque, Peru, which had been considered mild, moderate, and severe cases of COVID-19. Patients had to have tested positive for COVID-19, using a positive RT-PCR for SARS-CoV-2. Subsequently, the SARS-CoV-2 complete viral genome sequencing was carried out using Illumina MiSeq®. The sequences obtained from the sequence were analysed in Nextclade V1.10.0 to assign the corresponding clades, identify mutations in the SARS-CoV-2 genes and perform quality control of the sequences obtained. All sequences were aligned using MAFFT v7.471. The SARS-CoV-2 isolate Wuhan NC 045512.2 was used as a reference sequence to analyse mutations at the amino acid level. The construction of the phylogenetic tree model was achieved with IQ-TREE v1.6.12. Results: It was determined that during the period from December 2020 to January 2021, the lineages s C.14, C.33, B.1.1.485, B.1.1, B.1.1.1, and B.1.111 circulated, with lineage C.14 being the most predominant at 76.7% (n = 23/30). These lineages were classified in clade 20D mainly and also within clades 20B and 20A. On the contrary, the variants found in the second batch of samples of the period from September to October 2021 were Delta (72.7%), Gamma (13.6%), Mu (4.6%), and Lambda (9.1%), distributed between clades 20J, 21G, 21H, 21J, and 21I. Conclusions: This study reveals updated information on the viral genomics of SARS-CoV-2 in the Lambayeque region, Peru, which is crucial to understanding the origins and dispersion of the virus and provides information on viral pathogenicity, transmission and epidemiology.
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(This article belongs to the Special Issue COVID-19 Variants, Vaccines and New Waves)
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Open AccessArticle
Epidemiology of Dengue in Argentina during the 2010/11 to 2019/20 Seasons: A Contribution to the Burden of Disease
by
Solana Rapaport, Mariana Mauriño, María Alejandra Morales, Cintia Fabbri, Victoria Luppo, María Pía Buyayisqui, Teresa Varela, Carlos Giovacchini and Analía Urueña
Trop. Med. Infect. Dis. 2024, 9(2), 45; https://doi.org/10.3390/tropicalmed9020045 - 10 Feb 2024
Abstract
Background: Dengue is an important public health problem in Argentina, as in many other countries. We reviewed and updated information on the dengue disease burden in Argentina over a 10-year period. Methods: We conducted a retrospective descriptive study from 2010 to 2020 based
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Background: Dengue is an important public health problem in Argentina, as in many other countries. We reviewed and updated information on the dengue disease burden in Argentina over a 10-year period. Methods: We conducted a retrospective descriptive study from 2010 to 2020 based on data from the National Health Surveillance System. The main outcomes included dengue cases, incidence rates, deaths, and serotype distribution by season, age group, and region. Results: A total of 109,998 confirmed cases of dengue were reported. Seasonality stands out, prevailing during summer and autumn. Two main outbreaks (seasons 2015/16 and 2019/20), with increasing magnitude, were observed. The 2019/20 season showed the highest number of cases (58,731) and incidence rate (135/100,000). The Northeast region had the highest number of cases and incidence rate. In 2020, for the first time, autochthonous cases were registered in the Cuyo region. The only region with no autochthonous cases was the South. Adolescents and young adults showed the highest incidence rate. The case fatality rate for the period was 0.05%. Four serotypes circulated, but the predominant one was DEN-1 (78%). Conclusions: Dengue has been expanding temporally and spatially. Although the DEN-1 serotype widely predominated, the increasing circulation of other serotypes raises concerns regarding re-exposure and the severity of future cases. Understanding epidemiological trends is key to defining public prevention and control policies.
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(This article belongs to the Special Issue Advances in Prevention, Surveillance, and Control of Diseases Transmitted by Aedes Mosquitoes)
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Serological Comparison of Native Antigen ELISAs with Rapid ICT Test Kits for the Diagnosis of Human Alveolar and Cystic Echinococcosis in China
by
Shu-Kun Yang, Wei Zhang, Na Zhu, Donald P. McManus, Darren J. Gray, Archie C. A. Clements, Angela M. Cadavid Restrepo, Gail M. Williams, Ting Zhang, Guo-Rong Ma, Yan-Hui Yang and Yu-Rong Yang
Trop. Med. Infect. Dis. 2024, 9(2), 44; https://doi.org/10.3390/tropicalmed9020044 - 07 Feb 2024
Abstract
Background: The aim of this study was to compare the diagnostic performance of native antigen ELISAs and ADAMU-AE/CE commercial ICT test kits in subjects either exposed to Echinococcus infection or with clinically diagnosed alveolar (AE) or cystic (CE) echinococcosis. Methods: A total of
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Background: The aim of this study was to compare the diagnostic performance of native antigen ELISAs and ADAMU-AE/CE commercial ICT test kits in subjects either exposed to Echinococcus infection or with clinically diagnosed alveolar (AE) or cystic (CE) echinococcosis. Methods: A total of 370 subjects with a previous clinical confirmation of CE or AE from northwestern China were recruited. Serum samples were also obtained from 3923 children/teenagers during a community survey. All sera were tested using native antigen ELISAs. The ADAMU-AE/CE test kits were subsequently used for the serology of the 370 clinically confirmed individuals and of 251 children/teenagers that were ELISA antibody-positive for both Echinococcus species but ultrasound-negative during baseline survey. An analysis of the association between the serological tests and ultrasound classification was carried out amongst 89 AE and 164 CE cases. A Kappa consistency analysis was undertaken to compare the diagnostic performance of the native antigen ELISAs and the ADAMU kits and the ultrasound imaging results. The χ² test was also used for a comparison of the different seropositivity rates between the groups. Findings: There was poor consistency (Kappa = 0.26 and 0.28 for AE and CE respectively) between the native antigen ELISAs and the ADAMU kits for the diagnosis of AE and CE among the cases and the surveyed children/teenagers, but a relatively good consistency (Kappa = 0.63) between the ADAMU-AE kit and ultrasound observations for the AE cases. Additionally, of the 251 teenagers co-positive for both AE and CE antibodies by the native antigen ELISAs, only one was found positive by the ADAMU-AE kit, verified as a new AE case on subsequent ultrasound follow-up. The remainder (N = 250) were negative by serology using the ADAMU-AE/CE kits and by ultrasound examination. The two native antigen ELISAs did not discriminate well between cases of clinically diagnosed AE and CE. In contrast, ADAMU-AE and ADAMU-CE commercial ICT test kits readily differentiated cases of AE from CE with specificities of 99% for AE and 100% for CE. Conclusions: The ADAMU-AE/CE kits proved reliable, accurate, and amenable diagnostic tools in the clinical setting for confirmation of suspected AE/CE cases. The native antigen ELISAs tests can provide useful information on the level of human exposure to Echinococcus infection.
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(This article belongs to the Special Issue Echinococcosis: From Parasite–Host Interaction to Rapid Detection)
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