Trop. Med. Infect. Dis., Volume 9, Issue 12 (December 2024) – 26 articles

The occurrence of hepatitis E virus (HEV) in patients with Schistosomiasis mansoni (SM) is still poorly understood in Brazil. The objective of this study was to estimate the seroprevalence of anti-HEV IgG in patients with SM and its association with the periportal fibrosis (PPF), assessed by serum markers and ultrasound criteria. This cross-sectional study was carried out in an endemic area in Pernambuco, Brazil, with schistosomal patients who underwent coproscopic survey. Anti-HEV antibody IgG were evaluated by using ELISA (Euroimmun^®, Lübeck, Germmany). In positive cases, HEV-RNA was tested by using real-time PCR. Among the 286 patients (60.8% women; 56% 18–44 years), 116 (40.6%) had advanced PPF (Niamey pattern D/E/F). Anti-HEV IgG was positive in 15 (5.24%), and all were HEV-RNA negative. Anti-HEV IgG was more frequent in patients with an advanced PPF (D/E/F) pattern (p = 0.034) and those with the largest spleen diameter (p = 0.039). In this study, the occurrence of anti-HEV IgG in patients with SM was higher than described in the same region and more frequent among patients with evidence of advanced liver fibrosis. Full article

Malaria remains a significant public health problem in India. Although temperature influences Anopheline mosquito feeding intervals, population density, and longevity, the reproductive potential of the Plasmodium parasite and rainfall influence the availability of larval habitats, and evidence to correlate the impact of climatic factors on the incidence of malaria is sparse. Understanding the influence of climatic factors on malaria transmission will help us predict the future spread and intensification of the disease. The present study aimed to determine the impact of temporal trend of climatic factors such as annual average maximum, minimum, mean temperature, and rainfall on the annual incidence of malaria cases in India for a period of 61 years from 1961 to 2021 and relative humidity for a period of 41 years from 1981 to 2021. Two different analyses were performed. In the first analysis, the annual incidence of malaria and meteorological parameters such as annual maximum, minimum, and mean temperature, annual rainfall, and relative humidity were plotted separately in the graph to see if the temporal trend of climatic factors had any coherence or influence over the annual incidence of malaria cases. In the second analysis, a scatter plot was used to determine the relationship of the incidence of malaria in response to associated climatic factors. The incidence of malaria per million population was also calculated. In the first analysis, the annual malaria cases showed a negative correlation of varying degrees with relative humidity, minimum, maximum, and mean temperature, except rainfall, which showed a positive correlation. In the second analysis, the scatter plot showed that the rainfall had a positive correlation with malaria cases, and the rest of the climatic factors, such as temperature and humidity, had negative correlations of varying degrees. Out of the total 61 years studied, in 29 years, malaria cases increased more than 1000 square root counts when the minimum temperature was at 18–19 °C; counts also increased over a period of 33 years when the maximum temperature was 30–31 °C, over 37 years when the mean temperature was 24–25 °C, over 20 years when the rainfall was in the range of 100–120, and over a period of 29 years when the relative humidity was at 55–65%. While the rainfall showed a strong positive correlation with the annual incidence of malaria cases, the temperature and relative humidity showed negative correlations of various degrees. The increasing temperature may push the boundaries of malaria towards higher altitude and northern sub-tropical areas from the southern peninsular region. Although scanty rainfall reduces the transmission, increases in the same would increase the malaria incidence in India. Full article

PAVON has developed a malaria microscopy competency training scheme to augment competency in malaria microscopy. Here, data accrued from training activities between 2020 and 2023 in Botswana are presented. Three trainings were done for 37 central and peripheral level technicians for a two-week period. The scheme consisted of basic theory on Plasmodium parasites, malaria epidemiology and diagnosis. The practicals focused on standard slide preparation, staining, parasite detection, speciation and counting. Scores were assessed by the Wilcoxon signed rank test. Participants who excelled joined the WHO External Competency Assessment for Malaria Microscopy (ECAMM). The median competency scores for the three trainings were detection: 100 (IQR = 94–100), 100 (IQR = 94–100) and 92 (IQR = 92–100), respectively, from pre-test scores of 40 (IQR = 27–54), 44 (IQR = 32–52) and 20 (IQR = 10–40) (z = 2.937, p < 0.003, z = 3.110, p = 0.002 and (z = 2.251, p = 0.024), respectively. Speciation: 93 (IQR = 86–96), 81 (IQR = 73–96) and 88, (IQR = 88–100) from pre-test scores of 50 (IQR = 30–50), 36 (IQR = 20–45) and 17 (IQR = 17–50) (z = 2.936, p < 0.003, z = 3.152, p = 0.002 and z = 3.237, p = 0.001). The competency scores achieved in the ECAMM were 98/98 and 97/98 for sensitivity and specificity pre- and post-tests detection. The training was effective in raising the competency skills of participants and is open to NMPs (National Malaria Programs) for critical capacity building. Full article

Kaposi sarcoma-associated herpes virus (KSHV), also known as human herpes virus 8 (HHV-8), is the primary etiologic cause of Kaposi sarcoma (KS) and KSHV Inflammatory Cytokine Syndrome (KICS). Patients with KICS demonstrate symptoms of systemic inflammation, high KSHV viral load, elevation of inflammatory markers, and increased mortality. Management requires rapid diagnosis, treatment of underlying HIV, direct treatment of KS, and addressing the hyperimmune response. While a case definition based on clinical presentation, imaging findings, laboratory values, KSHV viral load, and lymph-node biopsy has been proposed, some of the required investigations are frequently unavailable in resource-constrained settings. Due to these challenges, KICS likely remains underdiagnosed and undertreated in these settings. We report a case of a 19-year-old woman living with HIV, and intermittent adherence to her ART, who presented with hypotension and acute hypoxemic respiratory failure. She was found to have high KSHV and HIV viral loads, low CD4 count, anemia, thrombocytopenia, hypoalbuminemia, and elevated inflammatory markers. On bedside ultrasound, she was found to have bilateral pleural effusions, ascites, an enlarged spleen, and hyperechoic splenic lesions. The diagnosis of KICS was made based on this constellation of findings. Weighing the risk and benefits of steroid administration in KS patients, the patient was successfully treated by the continuation of ART and the initiation of paclitaxel chemotherapy and steroids. We propose an adapted case definition relevant to the resource-constrained context. Due to the dual burden of KSHV and HIV in sub-Saharan Africa, additional cases of KICS are likely, and this syndrome will contribute to the burden of early mortality in newly diagnosed HIV patients. Addressing the diagnostic and therapeutic challenges of KICS must be a part of the overall management of the HIV pandemic. Full article

Objective: Staphylococcus aureus (SA), including methicillin-resistant strains (MRSAs), is a major cause of skin and soft tissue infections (SSTIs) in military populations. This study investigated SSTI incidence and SA carriage in a military training site over 16 weeks using a prospective observational cohort design. Methods: Two training cohorts provided pre- and post-training self-collected swabs for bacterial carriage, and environmental swabs from accommodations, personal items, and training facilities. Hygiene awareness and practices were assessed through questionnaires. Bacteria were identified using culture, mass spectrometry (MALDI-TOF), and genomic sequencing. Results: Nasal carriage of SA increased from 19% to 49% by the end of training. SSTIs requiring treatment occurred in 16% of participants. Steam cleaning reduced but did not eliminate SA on personal bed linen. Additionally, 40% of participants had poor knowledge of antibacterial cleaning practices and wound management. Conclusions: Increased SA carriage was linked to human-to-human transmission in close-quarter military training environments. Implications for Public Health: Improved personal hygiene training, wound management education, and monitored cleaning protocols are essential to mitigate SSTI risks in communal military training environments. Full article

Agricultural pesticides may play a crucial role in the selection of resistance in field populations of mosquito vectors. This study aimed to determine the susceptibility level of An. gambiae s.l. to pyrethroids and neonicotinoids in vegetable farms in northern Benin, in West Africa, and the underlying insecticide resistance mechanisms. A survey on agricultural practices was carried out on 85 market gardeners chosen randomly in Malanville and Parakou. Anopheles gambiae s.l. larvae were collected, reared to adult stages, and identified to species level. Susceptibility was tested with impregnated papers (WHO bioassays) or CDC bottles according to the insecticides. Synergists (PBO, DEM, and DEF) were used to screen resistance mechanisms. Allelic frequencies of the kdr (L1014F), kdr (L1014S), N1575Y, and ace-1R G119S mutations were determined in mosquitoes using Taqman PCR. Fertilizers and pesticides were the agrochemicals most used with a rate of 97.78% and 100%, respectively, in Malanville and Parakou. Anopheles coluzzii was the predominant species in Malanville, while An. gambiae was the only species found in Parakou. Bioassays revealed a high resistance of An. gambiae s.l. to pyrethroids and DDT, while a susceptibility to bendiocarb, pyrimiphos-methyl, malathion, and clothianidin was recorded. Resistance to acetamiprid was suspected in mosquitoes from both localities. A lower resistance level was observed when mosquitoes were pre-treated with synergists, then exposed to insecticides. The kdr L1014F mutation was observed in both locations at moderate frequencies (0.50 in Malanville and 0.55 in Parakou). The allelic frequencies of N1575Y and G119S were low in both study sites. This study confirmed the resistance of An. gambiae s.l. to insecticides used in agriculture and public health. It reveals a susceptibility of vectors to bendiocarb, pyrimiphos-methyl, malathion, and clothianidin, thus indicating that these insecticides can be used as an alternative in Benin to control malaria vectors. Full article

Key populations are particularly vulnerable to human immunodeficiency virus (HIV) infection. Nearly half of Tajikistan’s gross domestic product (GDP) originates from labor migrant transfers. While not officially designated as a key population, over 300,000 migrants return to Tajikistan every year at increased risk for HIV due to absence or interruption of treatment, change in risky behaviors, and other factors. We analyzed cross-sectional data from the national registry system operated by the Tajikistan Ministry of Health and Social Protection of individuals (n = 10,700) who had been diagnosed with HIV from 1 January 2010 to 30 May 2023. Individual HIV cases resided in five regions: Districts of Republican Subordination (DRS), Dushanbe (Tajikistan’s capital city), Gorno-Badakhshan Autonomous Oblast (GBAO), Khatlon, and Sughd. We developed logistic regression models to investigate the relationships between key population status and demographic characteristics. GBAO has the largest proportion of labor migrants (49.59%), which is much larger than that of the other regions (<32%). In contrast to other key populations, there was a larger proportion of HIV cases in rural areas that were labor migrants (23.25%) in comparison to urban areas (16.05%). In multivariable analysis, the odds of being a labor migrant were 6.248 (95% CI: 4.811, 8.113), 2.691 (95% CI: 2.275, 3.184), and 1.388 (95% CI: 1.155, 1.668) times larger if a case was residing in GBAO, Sughd, or DRS, compared to Dushanbe, respectively. Our research contributes to the field by proposing to expand the definition of key population to include labor migrants in Central Asia who should be emphasized as a vulnerable population at high risk of HIV. We encourage policy action to provide designated HIV funding for labor migrants, increase international attention, and promote potential modifications of national regulations and/or laws regarding prevention and treatment of HIV among non-citizen populations. Full article

Recently malaria and micronutrient deficiencies have become a major worldwide public health problem, particularly in Africa and other endemic countries with children under 5 years old being the most vulnerable. Apart from nutritional problems that cause micronutrient deficiencies, studies have also reported that parasitic infections like malaria can affect the levels of micronutrients. Thus, this research was aimed at assessing the serum levels of micronutrient biomarkers and their association with malaria infection in children under 5 years old in the Buea Health District. Method: This cross-sectional study recruited 80 participants from February to April 2024. The micronutrient biomarkers levels were measured using a Q-7plex Human Micronutrient Measurement Kit. Results: There were changes in serum micronutrient biomarkers levels between malaria infected and healthy children. Ferritin was higher in sick children (23.53 μg/L ± 7.75) than in healthy children (19.07 μg/L ± 3.87), significantly (p < 0.002). The same trend was observed with the soluble transferrin receptor being higher (p < 0.049) in sick children (3.74 mg/L ± 1.92) compared to healthy ones (3.08 mg/L ± 0.64). In addition, the levels of retinol-binding protein 4 and thyroglobulin levels were not significantly different between the sick and healthy children. Therefore, this study revealed that malaria causes alterations in the serum levels of micronutrient biomarkers and consequently affects micronutrient levels in children below the age of 5 in the Buea Health District. Full article

Phlebotomus pedifer is a vector of Leishmania aethiopica, the causative agent of cutaneous leishmaniasis. This study assessed the abundance and distribution of P. pedifer in different habitats and human houses situated at varying distances from hyrax (reservoir host) dwellings, in Wolaita Zone, southern Ethiopia. Sandflies were collected from January 2020 to December 2021 using CDC light traps, sticky paper traps, and locally made emergence traps. Sampling was performed in human houses, peri-domestic areas, farmlands, and hyrax dwellings. Houses 200 m and 400 m from hyrax dwellings were selected to study whether distance affects indoor sandfly abundance. A total of 2485 sandflies were captured, with P. pedifer accounting for 86.1% of the catch and Sergentomyia spp. comprising the remaining 13.9%. The abundance of P. pedifer was highest in human houses (72.3%) and lowest in farmlands (4.0%). Temperature showed a positive correlation with sandfly abundance (r = 0.434, p = 0.000), while rainfall (r = −0.424, p = 0.001) and humidity (r = −0.381, p = 0.001) were negatively correlated with abundance. Houses near hyrax dwellings had significantly higher P. pedifer abundance compared to those further away. Soil-emergence trapping yielded only a few P. pedifer specimens, primarily from hyrax dwellings. The findings highlight the increased presence of P. pedifer indoors, particularly in houses close to hyrax habitats, emphasizing the need for targeted indoor vector control strategies to mitigate the risk of cutaneous leishmaniasis transmission. Full article

Providing tuberculosis preventive treatment (TPT) to close contacts of persons with TB is a core strategy recommended by WHO for the prevention and control of TB. Nigeria rolled out the 3-month Isoniazid-Rifampicin (3HR) shorter regimen TPT as a pilot for use among eligible adult and child contacts. This study assesses acceptance and completion rates of 3HR TPT among contacts and determines the perspectives of healthcare workers (HCWs) and contacts on acceptance and completion of 3HR TPT in Nigeria. In this cross-sectional descriptive study using mixed methods, records of TPT-eligible clients were retrospectively reviewed, while 18 purposely selected HCWs and 18 contacts on 3HR were interviewed. Of the 30,012 eligible contacts, 12,040 (40.1%) were initiated on TPT. Among these, 8213 (68%) were enrolled on 3HR, and 6972 (84.7%) of them completed treatment. Perceived facilitators include belief in its effectiveness, training among HCWs, and a good understanding of TPT from HCW counseling sessions. Barriers reported were linked to stockouts, misconceptions about side effects, non-disclosures, and disincentive follow-up strategies. The acceptance and completion rate for 3HR TPT was good. Scaling up 3HR TPT will require redesigning policies towards addressing identified barriers and utilizing interventions linked to capabilities, opportunities, and motivations among contacts of TB patients and HCWs. Full article

Snakes responsible for bites are rarely identified, resulting in a loss of information about snakebites from venomous species whose venom effects are poorly understood. A prospective clinical study including patients bitten by a snake was conducted in Cameroon between 2019 and 2021 to evaluate the efficacy and tolerability of a marketed polyvalent antivenom. Clinical presentation during the first 3 days of hospitalization was recorded following a standardized protocol. This ancillary study aimed to assess the frequency of bites by the different species encountered in Cameroon and to describe the symptoms of bites by formally identified species. Of the 447 patients included in the study, 159 (35.6%) brought the snake that caused the bite that was identified by a specialist. Out of these, 8 specimens could not be identified due to poor condition, 19 were non-venomous species, and 95 belonged to Echis romani—formerly E. ocellatus—species. The remaining 37 specimens included 2 Atheris squamigera, 12 Atractaspis spp., 2 Bitis arietans, 11 Causus maculatus, 1 Dendroaspis jamesoni, 1 Naja haje, 1 N. katiensis, 5 N. melanoleuca complex, and 2 N. nigricollis. Symptoms, severity of envenomation, and post-treatment course are described. Symptoms and severity of bites are consistent with cases described in the literature, but some specific features are highlighted. Full article

Hepatitis B remains a major public health issue in Vietnam. Mandatory reporting to the national electronic communicable disease surveillance system (eCDS) has been required since July 2016. We conducted an evaluation of the hepatitis B surveillance system in Ninh Binh, the province with the highest reported burden of hepatitis B in Northern Vietnam, between 2017 and 2022. Using the CDC’s guidelines for evaluating public health surveillance systems, we assessed four key attributes: simplicity, timeliness, data quality, and acceptability. This retrospective evaluation included document reviews, analysis of hepatitis B data, and in-depth interviews with provincial-level healthcare staff involved in the reporting of hepatitis B cases. The results showed that the eCDS improved reporting frequency, provided more detailed case information, and enhanced data accessibility compared to the previous paper-based system. However, the system faced several challenges, including unclear objectives, difficulties in distinguishing acute from chronic cases, insufficient training for staff, lack of supervision for data quality, and technical software issues. Despite these challenges, stakeholders found the system acceptable but emphasized the need for improvements, including revising the system’s objectives, automating case classification, enhancing training, securing funding for maintenance, and implementing regular data review processes. Full article

Trachoma recrudescence is a serious concern for trachoma control programs. Programs define recrudescence as the return of trachomatous inflammation-follicular (TF) prevalence above elimination threshold (≥5%) on district-level trachoma surveillance surveys (TSSs). This study aimed to determine potential correlates of trachoma recrudescence within a historically highly endemic region. Between 2015 and 2021, population-based TSSs were conducted in 51 districts of Amhara, Ethiopia. District estimates were calculated accounting for multistage design; logistic regression was used to estimate the association of key correlates with recrudescence at the district level. Among the 51 districts, 17 (33%) were recrudescent. Correlates of recrudescence included indicators of historic trachoma burden, such as higher trachomatous inflammation-intense (TI) prevalence (odds ratio [OR]: 2.6, CI: 1.4–5.3) and higher Chlamydia trachomatis (Ct) infection prevalence (OR: 2.9, CI: 1.1–9.9) at the first recorded impact survey. The increased prevalence of children with clean faces (OR: 0.4, CI: 0.21–1.0) and the increased prevalence of travel time to a water source ≤ 30 min (OR: 0.5, CI: 0.2–1.1) at the TSS were associated with a protective effect from recrudescence. Data on historical trachoma burden as well as current water and sanitation conditions may help programs predict where recrudescence is more likely to occur and thus help programs sustain elimination as a public health problem. Full article

Although every youth in pediatric/adolescent HIV care will need to transition to adult-oriented care, there are no existing evidence-based interventions to optimize health through this process. Healthcare transition poses a persistent challenge to the health of youth living with HIV, which may result in gaps in care engagement, medication adherence, and viral suppression. Our process evaluation of iTransition, a multilevel mobile health (mHealth) intervention, included iterative interviews with youth, providers, and Transition Champions. These data, along with team meeting notes, highlight the important role the intervention plays in addressing healthcare transition-related challenges, positioning it to fill a critical gap for both youth and providers. It also highlights important individual (e.g., competing priorities of youth and providers), clinical (e.g., electronic health record integration), and contextual (e.g., clinical policies during COVID-19 pandemic) challenges to intervention reach and implementation. More work is needed to refine interventions to support care continuity for youth living with HIV as they transition to adult-oriented care. Full article

Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how community-driven initiatives have successfully improved leprosy awareness, reduced stigma, and fostered early case detection and treatment adherence. The importance of culturally sensitive, inclusive approaches in health education and stigma reduction campaigns is highlighted, emphasizing the potential for community engagement to enhance national leprosy programs and contribute to the World Health Organization’s Zero Leprosy Strategy. By examining these examples, this article illustrates how integrating community participation into leprosy control and elimination programs can drive sustainable outcomes for achieving Zero Leprosy, even in resource-limited settings. Full article

To assess the burden of food-borne trematodiases in China from 1990 to 2021 and project the burden through 2035, data were captured from the Global Burden of Disease Study (GBD) 2021 datasets. The estimated prevalent food-borne trematodiase cases were 33.32 million (95% uncertainty interval (UI): 29.25–38.35 million) in China in 2021, contributing to 768,297.4 disability-adjusted life years (DALYs) (95% UI: 383,882.8–1,367,826.1). The number of prevalent cases and DALYs declined by 9.02% and 18.11%, and a downward decline was seen in age-standardized prevalence and DALY rates (estimated annual percentage change: −0.96% and −1.21%, respectively). A higher prevalence and DALY rates were observed among males than females, and the middle-aged group bore the highest burden, while the older population showed the most rapid increase in prevalent cases and DALY numbers. Projected DALY counts and rates remain stable through 2035 using the Bayesian age–period–cohort (BAPC) model. These findings demonstrate a decline in the burden of food-borne trematodiases in China from 1990 to 2021; however, the prevalence remained high, which contributed considerably to disability and premature death. Continued control efforts and targeted interventions are essential to further reducing the burden of food-borne trematodiases in China. Full article

Over the past 27 years, three major global TB control strategies have been implemented, and it is important at this stage to evaluate their impact on tuberculosis (TB) case notification rates (CNRs). This study, therefore, analyzed TB CNR trends from 1995 to 2022 across 208 countries and islands, using data from the WHO Global TB Programme database. Countries were classified by income level and population size based on World Bank criteria. The analysis revealed significant disparities in TB CNRs across income groups: Low-income, lower-middle-income, and upper-middle-income countries consistently reported higher CNRs compared to high-income countries. Regional analysis further demonstrated notable variations influenced by both economic and geographical factors. These findings reaffirm the strong link between TB and poverty, underscoring the need for a holistic approach to combat the disease. Efforts must extend beyond enhancing health care access and delivery to addressing the social determinants that drive TB transmission and progression. Full article

Schistosomiasis is caused by infection with trematode flukes of the genus Schistosoma. More than 700 million people worldwide are estimated to be susceptible to infection. In sub-Saharan Africa, schistosomiasis is the second most widespread neglected tropical disease after malaria. This retrospective investigation evaluated the incidence and impacts of schistosomiasis on communities across three major districts of the Eastern Cape province in South Africa using a cross-sectional retrospective observational analysis of secondary data from patients with microscopically confirmed schistosomiasis between 2019 and 2020. This study focused upon both rural and semi-urban areas, including Bizana, Butterworth, Centane, Elliotdale, Flagstaff, Idutywa, Lusikisiki, Libode, Mqanduli, Port St. Johns, Willowvale, and Mthatha. Data were obtained from three districts—Alfred Nzo, Amatole, and OR Tambo—covering both rural and semi-urban regions. This study included patients of all ages who submitted urine samples for schistosomiasis testing in the specified districts. A simple random sampling method was used to select 337 clinical records from the National Health Laboratory Service (NHLS) of Mthatha. Hospital records from the NHLS Microbiology Department of Mthatha were analyzed. St Barnabas Laboratory had the highest frequency of cases (34.1%), followed by Greenville Depot (17.8%) and Willowvale Laboratory (11.3%). Most cases were in the 10–19 age group (63.4%), followed by those under 10 years of age (24.9%). Male patients constituted 76.4% of the cases, while female patients accounted for 23.6%. Viable ova were observed in 98.2% of the samples. This study highlights a significant prevalence of schistosomiasis in the Eastern Cape province, with a higher incidence in rural areas and among males aged 10–19. These findings underscore the need for targeted public health interventions and continuous monitoring to control and prevent schistosomiasis in this region. Full article

Sickle cell disease (SCD) is a prevalent inherited blood disorder, particularly affecting populations in Africa. This review examined the disease’s burden, its diverse clinical presentations, and the challenges associated with its management in African settings. Africa bears a significant burden of SCD, with prevalence varying across countries and age groups. Newborn screening programs have highlighted the high prevalence of SCD at birth, emphasizing the need for early diagnosis and intervention. The clinical manifestations of SCD in Africa are multifaceted, encompassing acute complications like vaso-occlusive crises, acute chest syndrome, and stroke, as well as chronic complications such as organ damage and leg ulcers. Biological factors, including fetal hemoglobin levels, and demographic factors, like age and sex, influence disease severity and outcomes. The management of SCD in Africa faces numerous challenges. Limited access to resources, including diagnostic tools, medications, and trained healthcare professionals, hinders optimal care. The high cost of advanced therapies further restricts patient access. Cultural stigma and a lack of awareness create additional barriers to effective management. To address these challenges, early diagnosis through newborn screening programs and point-of-care testing is crucial. Comprehensive care models, including hydroxyurea therapy, pain management, and patient education, are essential for improving outcomes. Collaboration with international networks and leveraging local resources can enhance the sustainability of SCD programs. In conclusion, SCD significantly impacts African populations. Overcoming the challenges associated with its management requires addressing resource limitations, affordability issues, and cultural barriers. Early diagnosis, comprehensive care models, and ongoing research focused on affordability and accessibility are crucial for improving the lives of individuals living with SCD in Africa. Full article

Background: Studies of infective endocarditis (IE) are generally limited to institutions, underlining the need for more comprehensive epidemiological research. Objective: The aim of this study was to determine the mortality profile of IE-related deaths and related causes in Brazil at the national level and across regions. Method: We conducted a population-based study using data from the country’s mortality information system for the period 2000 to 2019. We identified IE-related deaths and related causes based on the ICD-10 codes. Cluster analysis was performed to determine the relationship between the variables. Results: There were 52,055 IE-related deaths during the study period. Deaths occurred predominantly among men and people aged between 60 and 79 years. The Southeast accounted for the largest proportion of deaths. The most frequent ICD-10 chapter mentioned in relation to IE-related deaths was diseases of the circulatory system. We identified three distinctive profiles: 1—an age of 80 years and over and women, where the most frequent chapters were endocrine, circulatory and metabolic diseases and the South and Southeast accounted for the largest proportion of deaths; 2—an age between 30 and 79 years and men, where the most frequent chapters were infectious and genitourinary diseases and the South and Southeast accounted for the largest proportion of deaths; and 3—an age between 0 and 29 years without any difference between sexes, where the most frequent chapter was diseases of the respiratory system and the North, Northeast and Midwest accounted for the largest proportion of deaths. Conclusions: The findings of the cluster analysis revealed distinctive IE-related mortality profiles, indicating regional differences. Full article

This study analyzed the trend and factors associated with medical–surgical complications in patients discharged from leprosy multidrug therapy at the Centre Hospitalier Régional Spécialisé (CHRS), in Macenta, Republic of Guinea. This was a retro 2012 (n = 54) and 2013 (n = 35) and then a slight decrease between 2014 (n = 34) and 2017 (n = 26). From 2019 (n = 18) to 2021 (n = 1), a significant d spective study using routine secondary data from 2012 to 2021. The most represented age group ranged from 25 to 59 years (73.8%), with a male predominance of 72.6%. Farmers represented 60.7% of the patients, 74.5% of the patients had plantar wounds, and 48.8% resided in the N’zerekore region. A trend analysis showed an overall significant decrease in the number of patients with complications between ecline was found. In the patients with leprosy reactions, there was a reduction in numbers from 48 in 2012 to 2 in 2014, with a predominance in men. There were significant associations between region, plantar perforation disease (p = 0.013), and physical disability (p = 0.029) and between year and leprosy reaction after the cure (p < 0.001). In summary, there was a high proportion of patients with plantar ulcers, which predominantly affected farmers, and a significant proportion with leprosy reactions and physical disabilities. Community awareness around leprosy and capacity building of the providers in terms of appropriate management may contribute to improving patients’ quality of life. Full article

Interactions between parasites and hosts are not fully understood, though the dynamic pattern of infection and reinfection in humans varies with different demographic variables and behavioral changes. A community-based non-equivalent control group post-test-only design, an aspect of quasi-experimental design (QED), was carried out between March 2019 and February 2020. For the extraction of data from respondents, structural questionnaires were filled. Their CD4 count and viral load from the database of the National Health Laboratory Services, Mthatha were recorded. The method applied for the identification of intestinal parasites was a direct examination of the stool and the use of concentration methods. The post-test analysis showed that the intervention sites that received THEdS (Treatment, Health education, and Sanitation) bundle had a cure proportion of 60% and a re-infection proportion of 40%. The post-test results on control sites (treatment-only group) showed that the cure proportion was 51.4% and the re-infection proportion was 48.6%. The viral load significantly reduced from 377 to 44 copies/mL with a significant increment in CD4 count from 244 to 573 (cells µL) and (p-value) = 0.002. The combination of THEdS is an effective measure to reduce infection and reinfection of intestinal parasites. The THEdS bundle is a sustainable control and prevention method for the control of helminthes and protozoan associated with unsanitary environment and poor personal hygiene among immune-compromised individuals like HIV/AIDS patients. Full article

Tuberculosis (TB) is a global health challenge associated with considerable levels of illness and mortality worldwide. The development of innovative therapeutic strategies is crucial to combat the rise of drug-resistant TB strains. DNA Gyrase A (GyrA) and serine/threonine protein kinase (PknB) are promising targets for new TB medications. This study employed techniques such as similarity searches, molecular docking analyses, machine learning (ML)-driven absolute binding-free energy calculations, and molecular dynamics (MD) simulations to find potential drug candidates. By combining ligand- and structure-based methods with ML principles and MD simulations, a novel strategy was proposed for identifying small molecules. Drugs with structural similarities to existing TB therapies were assessed for their binding affinity to GyrA and PknB through various docking approaches and ML-based predictions. A detailed analysis identified six promising compounds for each target, such as DB00199, DB01220, DB06827, DB11753, DB14631, and DB14703 for GyrA; and DB00547, DB00615, DB06827, DB14644, DB11753, and DB14703 for PknB. Notably, DB11753 and DB14703 show significant potential for both targets. Furthermore, MD simulations’ statistical metrics confirm the drug–target complexes’ stability, with MM-GBSA analyses underscoring their strong binding affinity, indicating their promise for TB treatment even though they were not initially designed for this disease. Full article

Marginalized groups in Manitoba, Canada, especially females and people who inject drugs, are overrepresented in new HIV diagnoses and disproportionately affected by HIV and structural disadvantages. Informed by syndemic theory, our aim was to understand people living with HIV’s (PLHIV) gendered and intersecting barriers and facilitators across the cascade of HIV care before and during the COVID-19 pandemic. This study was co-designed and co-led alongside people with lived experience and a research advisory committee. We employed semi-structured interviews with thirty-two participants and three questionnaires. Interviews were audio-recorded, transcribed, and coded, and descriptive statistics were performed on the first two questionnaires. Qualitative data analysis used thematic analysis and focused on identifying categories (individual, healthcare, and social/structural) related to the barriers and facilitators to HIV care. A total of 32 PLHIV completed this study and over 70% of females and 50% of males reported severe and moderate sexual abuse among other traumatic childhood experiences. Barriers to accessing or continuing in the cascade of HIV care included navigating the initial shock of receiving an HIV diagnosis, mental health challenges and inaccessible supports, substance use, violence (including intimate partner), internalized and enacted compounded stigma related to houselessness and substance use, discrimination by primary care service providers and social networks, lack of preventative and social supports, lack of accessible housing, and programmatic issues. COVID-19 increased mental health problems and disrupted relationships with HIV service providers and peers living with HIV. Facilitators to HIV care included stopping substance use, caring service providers particularly during HIV diagnosis, welcoming healthcare environments, social opportunities and integrated supports, and supportive social networks. Women, men, and non-binary PLHIV experience interconnected factors complicating their experiences with HIV care. Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research and appropriately serve PLHIV. Full article

The COVID-19 pandemic has underscored the pivotal role of vaccines in mitigating the devastating impact of the virus. In Thailand, the vaccination campaign against SARS-CoV-2 began on 28 February 2021, initially prioritizing healthcare professionals before expanding into a nationwide effort on 7 June 2021. This study employs a mathematical model of COVID-19 transmission with vaccination to analyze the impact of Thailand’s COVID-19 vaccination program from 1 March 2021 to 31 December 2022. We specifically assess the potential loss of lives and occurrence of severe infections across various age groups in a hypothetical scenario where vaccines were not administered. By fitting our model with officially reported COVID-19 death data, our analysis reveals that vaccination efforts prevented a total of 300,234 deaths (95% confidence interval: 295,938–304,349) and averted 1.60 million severe COVID-19 infections (95% confidence interval: 1.54–1.65 million). Notably, the elderly population over 80 years old benefited the most from vaccination, with an estimated 84,518 lives saved, constituting 4.28% of this age group. Furthermore, individuals aged between 70 and 74 years experienced the highest reduction in severe infections, with vaccination potentially preventing 8.35% of this age bracket from developing severe COVID-19. Full article

Leptospirosis is a widespread disease throughout the world, presenting in severe clinical forms in dogs. The pathogenicity of the different serovars in field infections is not fully documented, and clinical diagnosis is often limited to a combination of serological tests and molecular analyses. The latter, although a fundamental tool, cannot identify the infecting strain without further analysis. This study reports the use of various indirect (microscopic agglutination test, MAT) and direct (microbiological culture, real-time PCR) laboratory techniques, followed by typing protocols (Multi-locus Sequence Typing (MLST), Multiple Loci Variable number tandem repeat Analysis (MLVA), serotyping) that allowed for the identification of the Leptospira serovar Australis in a symptomatic and previously vaccinated dog (vaccine containing heterologous strains). This study reports long-term clinical follow-up (0–640 days) and describes the possible role of the infection in the development of chronic renal failure. This study aims to highlight how a combination of different techniques can be useful to better characterise the environmental circulation of zoonotic agents. Therefore, the identification and isolation of circulating L. strains would facilitate the updating of epidemiological data, enhance the knowledge of pathogenicity and long-term clinical effects, and provide a valuable resource for improving the efficacy of a specific serovar vaccination. Full article