Socioeconomic disadvantage may influence the chronic hepatitis B (CHB) care continuum and the stage at which clinically relevant liver disease is recognised. However, evidence linking both individual- and area-level socioeconomic disadvantage to histologically assessed liver fibrosis in CHB remains limited. We examined whether socioeconomic disadvantage at the individual and area levels was associated with liver fibrosis severity in adults with CHB in Türkiye. In this nationwide multicentre observational study, adults with CHB who underwent liver biopsy in routine care between 1 January 2019 and 31 December 2024 across 24 centres in Türkiye were screened. Clinical and histopathological data were obtained retrospectively from medical records, while socioeconomic data were collected after biopsy through structured face-to-face interviews. Fibrosis was staged using the Ishak system. Individual socioeconomic indicators and province-level categories of the socioeconomic development index (SEDI) were examined. The primary analysis used ordinal logistic regression. Supportive analyses included multivariable logistic regression, 1:1 propensity score matching with conditional logistic regression, overlap weighting, likelihood-ratio tests for interaction, chi-square or Fisher’s exact tests, Kruskal–Wallis tests, and Wilcoxon rank-sum tests, with Benjamini–Hochberg adjustment for post-hoc comparisons. The analytic cohort included 956 adults, of whom 53.7
Tuberculosis (TB) and HIV co-infection remains a major public health challenge in resource-limited settings. Liangshan Yi Autonomous Prefecture in Southwest China bears a dual high burden of HIV and TB. This study aimed to analyze the epidemiological trends of HIV-TB co-infection in Liangshan from 2019 to 2024 and to inform integrated prevention strategies. A retrospective analysis was conducted on 3367 HIV-TB co-infected cases extracted from the National HIV/AIDS and TB surveillance systems. Records were linked via unique identifiers. Descriptive statistics and chi-square tests for trend assessed incidence trends, demographics, transmission routes, treatment outcomes, and drug resistance. From 2019 to 2024, HIV-TB incidence declined from 12.26 to 8.76 per 100,000 (χ2trend = 40.459, P < 0.001), driven by high-burden counties and populations under 45 years (all P < 0.001). Patients were predominantly young males (61.10
Abstract Background Echinococcosis, a severe zoonotic parasitic disease, imposes a significant health burden in western China, primarily as alveolar (AE) and cystic (CE) forms caused by Echinococcus multilocularis ( Em ) and E. granulosus sensu lato ( Egsl ), respectively. Its transmission, tied to a complex host cycle, is strongly influenced by climatic factors. This study aimed to model the ecological niches of these parasites, validate predictions with epidemiological data, and project the impact of climate change on future transmission risk geography. Methods Utilizing location data of 1247 human cases diagnosed in western China from 1981 to 2016, obtained from the National Echinococcosis Control Program, and contemporary climate data, we developed optimized Maximum Entropy (MaxEnt) models. This involved defining an appropriate spatial resolution, screening 19 bioclimatic variables to select key predictors (7 for Em , 6 for Egsl ), and identifying optimal model parameters. Model performance was evaluated using the Area Under the Curve (AUC) and AUC of 10% Receiver Operating Characteristic (AUCpROC) curve, and validity was assessed via correlation with county-level incidence. Future habitat suitability was projected for multiple periods (2011–2100) under three climate scenarios (SSP-126, SSP-370, SSP-585) generated by 5 global climate models. Results The models demonstrated high predictive accuracy (AUC > 0.92; AUCpROC: 0.084 for Em , 0.070 for Egsl ) and a significant positive correlation with incidence ( ρ > 0.6, P < 0.0001). Em and Egsl exhibited distinct climatic niches: Em prefers cool, stable climates with moderate summer moisture, while Egsl spreads in areas with dry-cold winters, warm-humid summers, and moderate seasonality. Future projections reveal a spatially heterogeneous reshaping of risk. While overall suitability increases, Em 's suitable area is projected to shift toward higher altitudes (e.g., expanding in Qinghai and Xizang but contracting in Ningxia and Gansu). In contrast, Egsl shows widespread outward expansion from current endemic margins, particularly across the Tibetan Plateau. Qinghai and Xizang are identified as key expansion hotspots for both Em and Egsl . Conclusion The findings confirm distinct ecological drivers for the suitability of Em and Egsl , and indicate that climate change will potentially shift the endemic areas of AE and expand those of CE in western China. This underscores the necessity for forward-looking, spatially targeted surveillance and control strategies, informed by a One Health approach, to mitigate the evolving burden of echinococcosis.
Much work remains to achieve the sustainable development goals for improved sanitation access for all. Subsidised sanitation interventions are often criticised due to the possibility of the infrastructure being neglected or culturally inappropriate for target communities. The BALatrine intervention is a novel approach consisting of a community-wide subsidised recipient-aided installation of an improved latrine with septic tank (‘BALatrine’) and education package. This study aimed to investigate the long-term usage and cultural acceptability of the BALatrine project four to six years following its implementation in a main trial. We conducted a cross-sectional follow-up study in September 2022 of 88 households who received BALatrines in two villages between 2016 and 2017. Quantitative and qualitative interviews with the household head and members were conducted to understand BALatrine usage and perceptions. Descriptive statistics were used to tabulate interview responses. The BALatrines were still in excellent condition with 89
Abstract Background Mosquitoes transmit diverse pathogens, some of which cause mosquito-borne diseases (MBDs). Climate and socioeconomic changes, such as temperature fluctuations, altered rainfall patterns, and urbanization, may affect the distributions of key vectors, particularly Aedes and Anopheles , and increase the health burden of MBDs. West Africa is a historically high-endemic region for MBDs, including malaria and dengue. However, existing studies in this region remain limited in scope, making comprehensive, high-resolution spatial mapping of vectors and pathogens inadequate. This study aimed to map the distributions of mosquitoes and mosquito-associated pathogens and identify potentially suitable areas for key mosquito species in West Africa, thereby supporting regional surveillance and control efforts. Methods We conducted a scoping review of English-language studies in PubMed, Web of Science, Embase, and Scopus through 7 March 2023. From eligible studies, relevant online databases, and GenBank, we extracted records of mosquito species, mosquito-associated pathogens, and human infections documented by outbreaks, pathogen isolation, molecular detection, or serology. Geographic records were standardized to WGS84 and mapped in ArcGIS 10.7. Potential distributions of key mosquito species were modeled in Maxent 3.4.1 using 24 climatic, topographic, population, land-cover, and related variables. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC). Results We compiled 19,578 occurrence records for 302 mosquito species in 16 genera and 598 records for 124 mosquito-associated pathogens from 22 families; 20 pathogens were reported to infect humans. Aedes , Anopheles and Culex occurred in all 16 countries, and Anopheles harbored the most pathogen species ( n = 55). DENV was detected in mosquitoes in five countries but human infections were reported in 13. Models for nine key mosquito species yielded AUC values of 0.763–0.912. Land cover contributed more than 10% to six models, and suitable habitats were predicted in Cape Verde for five species without occurrence records in the country. Conclusions We established a geospatial database of mosquitoes and their associated pathogens in West Africa. Current records remain incomplete and unevenly distributed, with gaps in key vector occurrence and limited mosquito-based detection of viral and parasitic pathogens relative to human infection evidence. Ecological niche modeling suggests that suitable habitats of some important mosquito species may extend beyond their reported ranges. These findings can guide targeted field surveys and coordinated mosquito–pathogen surveillance in under-sampled areas of West Africa.
Abstract Background Liver fibrosis caused by Schistosoma japonicum may continue to progress even following successful praziquantel chemotherapy. Although liver biopsy remains the gold standard for diagnosis of liver fibrosis, its invasiveness limits clinical applications. Conventional non-invasive indices, such as aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) index, often show suboptimal performance in schistosomiasis-related cases. This study aimed to develop and validate a machine learning (ML)-based model using epidemiological and laboratory data to identify liver fibrosis in individuals with prior S. japonicum infection, as a step toward precision management. Methods Data were obtained from the Jiangsu S. japonicum Infection Cohort (Jiangsu Province, China), involving 6158 participants with a documented history of infection who completed follow-up assessments during 2021–2022. Modeling variables were selected using LASSO regression and variance inflation factor analysis. Five ML models (k-nearest neighbor, logistic regression, support vector machine, decision tree, and extreme gradient boosting (XGBoost)) were evaluated. Model performance was compared against APRI and FIB-4 using the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and shapley additive explanations (SHAP) for interpretability. Results In the validation set, the XGBoost model demonstrated the highest diagnostic performance with an AUC of 0.854 (95% confidence interval ( CI): 0.826–0.881), outperforming other ML models (AUC range: 0.609–0.776). This was significantly superior to FIB-4 (AUC = 0.514) and APRI (AUC = 0.516) ( P < 0.001). DCA confirmed that the XGBoost model provided a substantial clinical net benefit across a broad range of threshold probabilities. According to Shapley additive explanations analysis, variables such as alcohol intake (mean SHAP value = 0.401), gamma-glutamyl transferase (0.295), and triglycerides (0.292) were the most influential predictors of liver fibrosis risk. Conclusions The XGBoost-based model offers a robust, non-invasive tool for identifying liver fibrosis in individuals with prior S. japonicum infection, with alcohol intake, gamma-glutamyl transferase, and triglycerides identified as the critical predictors. By outperforming traditional indices and leveraging routinely available data, this model represents a promising advancement toward precision management of individuals with prior S. japonicum infection, offering a scalable approach for early intervention, risk‑stratified assessment, and monitoring of hepatic morbidity in post‑transmission settings.
Abstract Background Uzbekistan faces a substantial burden of hepatitis B and D virus (HBV and HDV) infections despite implementing universal hepatitis B vaccination in 1998. Regional variation in disease distribution and contemporary transmission dynamics remain inadequately characterized. Our objective was to evaluate the geographically stratified prevalence of HBV and HDV, while also identifying the key risk factors fueling transmission within the adult population of Uzbekistan. Methods We conducted a nationwide cross-sectional study of 10,552 adults across seven regions of Uzbekistan from July 2022 to June 2024. Participants were selected using stratified random sampling from a parent cohort of 1,048,575 individuals. Serological testing included hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), anti-HDV antibodies, and viral RNA detection. Multivariate logistic regression identified independent risk factors for HBV and HDV infections. Results Overall HBsAg prevalence was 4.7% (95% CI : 4.3–5.1%), with substantial geographic heterogeneity ranging from 3.2% in Tashkent to 6.3% in Bukhara. Among HBsAg-positive individuals, 68.1% had detectable HBV DNA and 12.7% had HDV superinfection. HDV RNA prevalence among HBV DNA-positive individuals ranged from 2.5% to 23.7% across regions. Age-cohort analysis demonstrated vaccination program impact, with older unvaccinated adults bearing disproportionate disease burden. Female sex associated with 31% lower odds of chronic HBsAg carriage. Married status, healthcare-associated exposures, and body piercings correlated with increased anti-HBc positivity. Remarkably, sharing personal hygiene items showed striking HDV-specific association (a O R 2.34, 95% CI : 1.16–4.74; P = 0.02) but no association with HBV markers, suggesting distinct transmission pathways for HDV superinfection. Conclusions Persistent HBV burden with notable regional clustering and HDV superinfection necessitates targeted interventions. The identification of personal hygiene item sharing as a specific HDV transmission route provides an actionable household-level prevention target. Intensified screening and treatment of unvaccinated adults remain critical for hepatitis elimination efforts.
Abstract Background Emerging Plasmodium falciparum resistance to artemisinin derivatives, mediated principally by mutations in the Pfkelch13 propeller domain, is reshaping the antimalarial therapeutic landscape across sub-Saharan Africa and the Greater Mekong subregion. Concurrently, whole-plant Artemisia annua herbal tea has re-emerged in malaria-endemic settings, prompting renewed scrutiny of its phytochemical matrix and its clinical performance relative to artemisinin-based combination therapy. The present systematic review synthesises the contemporary evidence on the efficacy and safety of Artemisia annua herbal tea against P. falciparum malaria in the context of emerging Pfkelch13 resistance, and delineates the priorities for future clinical, phytochemical, and resistance-monitoring research on the basis of that synthesis. Methods A PRISMA-2020-compliant systematic review was conducted across six databases for the period January 2000 to December 2025. Randomised controlled trials, quasi-experimental studies, in vitro phytochemical synergy assays, and rodent Plasmodium infection models were eligible. Two reviewers screened, extracted, and quality-rated the studies independently (Cohen’s κ =0.83) using RoB 2.0, Newcastle–Ottawa, and the RITAM stacking criteria. A qualitative narrative synthesis with GRADE-style confidence rating across twelve outcomes was performed. Results Thirty studies were retained. Mechanistically, whole-plant A. annua delivers over forty co-extracted phytochemicals that act through multiple, partly redundant antimalarial targets. Chou–Talalay combination indices below 1 were documented for artemisinin co-administered with luteolin (Combination index, CI = 0.36), quercetin (CI = 0.42), and casticin (CI = 0.58) at a 1:3 molar ratio, and whole-plant IC 50 values were 3–5 × lower than those of equivalent-concentration purified artemisinin on 3D7, chloroquine-resistant, and multidrug-resistant strains. In Pfkelch13-mutant rodent P. falciparum lines, stable resistance to whole-plant therapy emerged three times more slowly than to equivalent-dose purified dihydroartemisinin. Clinically, retained randomised trials demonstrated rapid initial parasite clearance within 72 h—Mueller day-7 cure 74% vs 91% (quinine); Blanke day-7 cure 7/10 vs 7/9 and day-28 cure 1/9 (11.1%); Magalhães first-day parasitaemia-negative at ~ 175 mg cumulative artemisinin— but day-28 parasitological cure rates of A. annua monotherapy fell consistently below the 95.5–98.6% artemisinin-based combination therapy (ACT) benchmark band wherever directly reported [Blanke 1/9 (11.1%) vs sulfadoxine–pyrimethamine 3/8 (37.5%); Magalhães 0/7 sustained cure]. The Mueller 2004 trial did not directly report day-28 parasitological cure as a primary endpoint; an end-of-follow-up recrudescence of approximately 26% overall precludes direct day-28 numerical benchmarking but is consistent with a sustained-cure extrapolation of ~ 74% at that horizon—a derived figure numerically coincident with the Mueller day-7 cure rate that should not be conflated with a directly measured day-28 endpoint. Adverse events were predominantly mild (bitter taste, transient GI discomfort), with no serious events recorded in any retained study; safety data for children under five, pregnant or lactating women, and patients with hepatic or renal co-morbidity remain critically insufficient. Conclusions Whole-plant A. annua herbal tea achieves reproducible early parasitological clearance and preserves the multi-target pharmacological substrate whose pre-clinical resistance-modulation profile (three-fold slower resistance emergence in Pfkelch13-mutant murine lines) is biologically coherent with a Pfkelch13-modulating effect, although this effect has not yet been clinically reproduced in Pfkelch13-endemic African settings. The ≥ 84-percentage-point day-28 cure-rate gap between directly-reported A. annua monotherapy and the African ACT benchmark band frames the present-day clinical use of A. annua infusion as a complementary or adjourning intervention rather than a replacement for ACT. This positioning is preserved while Pfkelch13-stratified randomised trials, vulnerable-population safety studies, and population-scale molecular resistance surveillance are designed and executed.
Anthrax remains a life-threatening zoonotic disease in resource-limited settings. Adsorbed anthrax vaccine (AVA, BioThrax) is the only United States-authorized preexposure prophylaxis for high-risk Bacillus anthracis exposure. Although AVA safety has been described, depression-related adverse events (AEs) remain insufficiently characterized. This study evaluated real-world depression-related safety signals associated with AVA and anthrax-related antibacterial agents. AVA-related AE reports were extracted from the Vaccine Adverse Event Reporting System (VAERS), and depression-related AE reports for seven anthrax-related antibacterial agents were retrieved from the FDA Adverse Event Reporting System (FAERS). AEs were coded using Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analyses were performed using four standard signal-detection methods, with sensitivity analysis excluding concurrent vaccination. Seven complementary machine learning algorithms, covering regression, tree-based, boosting, kernel, instance-based, and probabilistic methods, explored predictors, with Shapley Additive Explanation (SHAP) for interpretation. Time-to-onset, clinical priority, and exploratory transcriptomic signatures were also assessed. In VAERS, 9446 AVA-related AE reports were identified, including 180 depression-related cases [total depression population n = 180, ROR 5.02 (95
Evidence increasingly shows close, bidirectional links between infectious diseases (IDs) and non-communicable diseases (NCDs). However, research, health policy, and prevention practices still largely address them in separate frameworks. This scoping review summarises the current evidence on the interconnections between IDs and NCDs and explores integrated strategies for their prevention and management. This scoping review systematically searched PubMed, Web of Science, and Scopus for English-language systematic reviews and meta-analyses published between Jan 1, 2000, and April 20, 2026. Two reviewers independently screened eligible studies and extracted effect estimates for associations between IDs and NCDs. Evidence was grouped into two themes: associations between infectious agents and cancer, and the effects of NCDs on susceptibility to or severity of IDs. From 5799 records identified, 41 meta-analyses or systematic reviews met the inclusion criteria. The included reviews showed associations between pathogen infections and specific cancers, including hepatitis B and C virus infections with liver cancer, human papillomavirus infection with cervical cancer, and Helicobacter pylori infection with gastric cancer. IDs were also associated with an increased risk or burden of NCDs, as illustrated by the association between tuberculosis and chronic obstructive pulmonary disease. Conversely, NCDs could affect susceptibility to and outcomes of IDs; patients with diabetes or cardiovascular disease had higher risks of severe disease or adverse outcomes following tuberculosis, influenza, or COVID-19 infection. IDs and NCDs can interact through shared mechanisms, overlapping risk factors, and bidirectional pathways, underscoring the need for integrated strategies that combine prevention, early detection, treatment, and long-term management. At the public health level, this calls for health policies and financing mechanisms to move beyond disease-specific silos towards systemic frameworks that support integrated prevention and control, coordinated management, and cross-sectoral action.
Eosinophilic meningitis due to Angiostrongylus cantonensis (AC) is an emerging parasitic disease worldwide but remains endemic in the Pacific region. In New Caledonia, sporadic cases occur each year, and the route of transmission is often unclear. In January 2023, an unusual cluster of three cases occurred in a village on Lifou Island following week-long community festivities, leading to an epidemiological investigation to determine the outbreak scope, the source of contamination, and inform public health interventions. We conducted a retrospective epidemiological and environmental investigation in one month after the suspected exposure. Cases were defined according to international criteria and classified as confirmed, probable, or suspected. Clinical data, attendance at the festivities and food exposures were collected from medical records and interviews. Environmental observations focused on potential contamination sources in food preparation areas. Serological analyses were performed in symptomatic and asymptomatic exposed individuals. Descriptive statistics were used to summarize demographic, clinical, and exposure characteristics. Nineteen cases were identified, including three confirmed and sixteen suspected cases; no probable cases were identified. Headache was the predominant symptom, often associated with vomiting or paresthesias. All cases attended festivities on December 27, 2022 suggesting a common exposure during that day. The median incubation period was 3 weeks (IQR: 2–4). Two exposure hypotheses were identified: beverages diluted with rainwater and contamination of blended fruit juice. Environmental investigations revealed rats and gastropods around rainwater reservoirs and food preparation areas, including on utensils left to dry outdoors. No AC DNA was detected in water samples. Serology for AC was positive in all confirmed cases (3/3), in 13 of 14 tested suspected cases, and in all ten exposed asymptomatic individuals tested 9 months after the outbreak. This investigation highlights the diagnostic and epidemiological challenges of neuroangiostrongyliasis in endemic areas, where mild presentations often remain unconfirmed and where the value of serological testing is limited by the lack of baseline seroprevalence data. The findings support the hypothesis of accidental incorporation of a heavily infected gastropod into blended fruit juice during preparation, potentially facilitated by open-air kitchen practices in rural Pacific settings.
Climate change is accelerating the circulation of the chikungunya virus (CHIKV), posing a significant threat to both endemic areas and immunologically naive temperate regions. This study aims to synthesize empirical climatic drivers, future transmission projections, and global adaptation strategies to evaluate current evidence and identify key research gaps. This scoping review completed protocol registration on the Open Science Framework prior to literature retrieval, with systematic searches conducted across PubMed, Web of Science, Scopus and EBSCOhost to collect all relevant English peer-reviewed papers published between Jan 1, 2000 and Nov 1, 2025. Multi-level screening filtered out unqualified literature, and unified datasets related to epidemiological parameters, predictive models and adaptation measures were extracted from 104 eligible studies. The results indicate that: (1) Current evidence reveals post-2014 research favors Europe and South America, disproportionately focusing on temperature (n = 38) and precipitation (n = 32). CHIKV transmission exhibits a non-linear thermal optimum (23–30 °C) and a 1-to-4-week lag following extreme precipitation. (2) Future projections (n = 24) consistently indicate transboundary vector expansion into higher latitudes and altitudes. (3) Regarding adaptation strategies, we conceptualized a three-tiered intervention framework. However, a stark socioeconomic-climatic gap emerged: while 43
Abstract Background Scrub typhus is a vector-borne infectious disease that is a major public health concern in Republic of Korea. Environmental factors are associated with disease transmission. However, comprehensive predictive models incorporating multiple environmental determinants while accounting for spatial and temporal correlations remain limited. This study aimed to characterize the spatiotemporal patterns of scrub typhus incidence and develop a Bayesian spatiotemporal prediction model incorporating multiple environmental covariates across 229 administrative units in the Republic of Korea from 2015 to 2024. Methods We developed a comprehensive analytical framework using national surveillance data from 229 administrative units collected from January 2015 to December 2024. Seasonal-trend decomposition, hotspot analysis, and negative binomial regression were employed to characterize spatiotemporal patterns to inform the Bayesian spatiotemporal modelling framework. Bayesian prediction modelling using an Integrated Nested Laplace Approximation was implemented to analyse environmental covariates, including temperature, relative humidity, normalized difference vegetation index (NDVI), elevation, and cropland ratio, while accounting for spatial clustering and temporal autocorrelation. Results Spatiotemporal analyses revealed distinct seasonal dynamics, with November incidence rates 91-fold higher than those in February [incidence rate ratio (IRR): 91.00, 95% confidence interval ( CI ) 66.50–125.00], and significant geographic clustering in southern provinces. The Bayesian model identified significant positive associations between disease risk and temperature [IRR: 1.02 per 1 °C, 95% credible interval (CrI): 1.01–1.04], NDVI (IRR: 1.07 per 0.1-unit, 95% CrI: 1.03–1.11), and elevation (IRR: 1.32 per 100 m, 95% CrI: 1.15–1.51). Relative humidity showed contrasting effects depending on the lag period, with protective effects at a 1-month lag (IRR: 0.96, 95% CrI: 0.93–0.999) but increased risk at a 2-month lag (IRR: 1.16, 95% CrI: 1.12–1.21). Conclusions This comprehensive framework successfully captured spatiotemporal disease patterns and provided quantitative risk assessment capabilities for evidence-based public health planning and targeted preventive strategies.
Malaria remains a leading cause of morbidity and mortality among children under five in Uganda. Despite national control efforts, significant disparities and inequalities in prevalence persist across regions, residences, and mean socio-economic status. This study examines the socio-demographic factors and wealth-related inequalities associated with malaria among children under five in Uganda. A secondary analysis of data from the Uganda Malaria Indicator Survey (UMIS) 2018–2019 was conducted. A sample of 4,600 children with malaria test results was included in the study. The distribution of malaria prevalence across socio-demographic factors was analysed using cross-tabulations and a chi-squared test. Malaria-related inequalities were measured using equity plots and the concentration index (CIX). A multilevel logistic regression model was used to examine the relationship between malaria prevalence and associated factors. The results are presented as adjusted odds ratios (aORs) with 95
BACKGROUND:Worldwide, anemia in children under-five is a major public health issue, particularly in sub-Saharan Africa. Sub-Saharan Africa also has the highest burden of malaria. This study aimed to develop an ensemble machine learning model to estimate anemia burden and potential predictors in under-five children in malaria-endemic sub-Saharan African countries. METHOD:A cross-sectional study was conducted using Demographic and Health Survey data from sub-Saharan African countries. Samples were selected through a two-stage stratified cluster sampling method. Data analysis was performed using Python 3.8, with a total weighted sample of 21,249. The dataset was split into 80% for training and 20% for testing and validation purposes. To address class imbalance, a hybrid data balancing approach combining SMOTE (Synthetic Minority Over-sampling Technique) and Tomek Links was applied. Four machine learning algorithms were developed and evaluated using standard performance metrics. Recursive Feature Elimination with a Random Forest classifier was used to identify potential predictors of anemia among children under five living in malaria-endemic SSA countries. RESULT:In this study, XGBoost showed the best performance, achieving an accuracy of 83.69%, a precision of 85.81%, and an F1 score of 83.19%. Additionally, XGBoost attained the highest ROC AUC of 90.1 and Precision Recall AUC of 90.0. According to Recursive Feature Elimination with a Random Forest classifier, region, birth order, child age, wealth index, and number of mosquito nets were identified as the associated factors of anemia among under-five children in malaria-endemic SSA countries. CONCLUSION:To reduce anemia among under-five children in malaria-endemic regions of sub-Saharan Africa, interventions should prioritize implementing geographically targeted programs, focus on younger children and those with high birth orders by integrating anemia screening into routine check-ups. In addition, enhancing economic support for low-income families and distributing and educating families on the proper use of mosquito nets are essential.
Arthropod including ticks, fleas, and lice have been found to be infected with Rickettsia massiliae, a pathogenic member of spotted fever group, causing rickettsiosis. This comprehensive scoping review summarize the known facts about its transmission, diagnostic-methods, phylogenetic position, human-case-reports, preventive-measures, and distribution in Palearctic and Oriental regions. Three main steps were followed to compile this study: explanation of objective(s), identification of relevant literature, and retrieval of data determined by inclusion and exclusion criteria. Various databases, including Science Direct, Web of Science, PubMed, Scopus, Cochrane, and Google Scholar were screened for relevant literature. Our objectives were to collect data regarding transmission method(s) of R. massiliae, identification-assay(s), phylogenetic position, clinical-reports globally, and distribution via possible vectors host animals surviving in Palearctic and Oriental regions. Descriptive analysis has been conducted to plot the frequency graphs of reported numbers in different countries and hosts. Findings presented that R. massiliae have been found across Palearctic and Oriental regions in 5 tick genera (Rhipicephalus, Hyalomma, Haemaphysalis, Ixodes, Amblyomma, and Dermacentor), 1 of louse (Haematopinus), 1 of sheep ked (Melophagus), and 1 of flea (Archaeopsylla), although their role as a vector(s) is still unknown. Dogs, sheep, cattle, and goats were recorded as epidemiologically important host animals for infected arthropods in 30, 23, 17, and 16 different studies, highlighting their role in its possible transmission. Additionally, Rh. sanguineus sensu lato (s.l) and Rh. turanicus were reported to infest the aforementioned animals, which is also being recognized as potential vector for its transmission. Highest number of R. massiliae reports (10) from different animals and vectors were recorded in China. Italy was recorded with highest (3) clinical cases of humans to-date. Moreover, transmission methods like transovarial via Rh. turanicus and horizontal/artificial-feeding via Rh. sanguineus s.l. and various diagnostic methods for R. massiliae have been documented. R. massiliae has been widely documented throughout Palearctic and Oriental regions, with human cases reported in about six countries. Rh. sanguineus and Rh. turanicus stands out the potential vectors, while further investigation into the implications of diverse range of arthropods in epidemiology of this bacterium.
Lifelong daily antiretroviral therapy (ART) effectively suppresses human immunodeficiency virus type 1 (HIV-1) replication but does not eradicate the virus, underscoring the urgent need for long-acting antivirals and functional cure strategies. Broadly neutralizing antibodies (bNAbs) have emerged as a promising approach for achieving durable HIV-1 remission. In this systematic review, we summarize recent advances in the development of bNAbs for HIV-1 treatment. We searched PubMed, Embase, and Web of Science for clinical trials published up to March 22, 2026. We included data evaluating intravenously administered bNAbs, with or without concomitant conventional ART, and comparing them with placebo, ART or no intervention. These data were used to evaluate the pharmacokinetics, antiviral efficacy, resistance profiles, immunologic effects, and safety of intravenously administered bNAbs. LS-modified bNAbs extended half-life by 2- to 5-fold relative to their parental counterparts (e.g., VRC01LS: 71 vs 15 days), although viremia reduced half-life by 20–40
Angiostrongyliasis, a food-borne parasitic disease caused by Angiostrongylus cantonensis, is characterized by eosinophilic meningitis or meningoencephalitis, leading to serious central nervous system damage. Current diagnostic methods lack specificity or sensitivity, and the pathogenesis is complex and incompletely understood. This study aimed to comprehensively characterize the dynamic alterations in the gut microbiota and host metabolism in both suitable (rats) and non-suitable (mice) hosts following A. cantonensis infection and to identify potential metabolic biomarkers for early diagnosis. Female BALB/c mice and Sprague Dawley rats (n = 10/group) were infected with 30 or 100 third-stage larvae, respectively. Serum, urine, feces, and brain samples were collected longitudinally. Gut microbiota was analyzed via 16S rRNA gene sequencing and metagenomics. Host metabolism was profiled using untargeted and targeted metabolomics via ultraperformance liquid chromatography-quadrupoles/time of flight-mass spectrometry. Statistical analyses included Wilcoxon rank sum test, linear discriminant effect size analysis, Spearman correlation analysis, orthogonal partial least squares-discriminatory analysis, and receiver operating characteristic curve analysis. Infection induced significant, host-specific gut microbiota dysbiosis. In infected hosts, Firmicutes decreased (P < 0.05) while Bacteroidetes increased (P < 0.05). A main difference in gut flora structure between infected hosts was observed in Prevotellaceae, which increased significantly in mice (P < 0.05) but decreased in rats (P < 0.05). Metagenomics revealed enhanced carbohydrate metabolism and fatty acid biosynthesis in gut microbes of infected mice, whereas up-regulated amino acid and vitamin metabolism were also observed in infected rats. Infection caused pronounced disruptions in host lipid and bile acid (BA) metabolism, changes in various BA types were closely related to alterations in specific bacterial genera (P < 0.05). Several metabolites, including phosphatidylcholine (16:0/18:1), 2-phenyl acetic acid, 2-octenoylglycine, lysophosphatidylcholine (18:2), O-glucuronide, and 2-carboxylic acid, were identified as potential early diagnostic biomarkers in the mouse model. A. cantonensis infection causes profound host-specific dysregulation of the gut microbiome and metabolome, with severe disturbances in Firmicutes, Bacteroidetes, lipid and BA metabolism being central features. These alterations highlight the critical role of the host-gut microbiota-metabolite axis in pathogenesis and offer novel insights for developing diagnostic and therapeutic strategies.
Abstract Background The Special Programme for Research and Training in Tropical Diseases (TDR), co-sponsored by World Health Organization, United Nations Children’s Fund, United Nations Development Programme, and the World Bank, launched the Clinical Research and Development Fellowship (CRDF) in 1999 to strengthen clinical research capacity in low- and middle-income countries (LMICs). Despite sustained investment, evidence on the longer-term scientific outcomes of such programmes remains limited. This study evaluated the scientific outcomes of the CRDF programme (1999–2021) using bibliometric analysis of fellows’ peer-reviewed publications before and after their fellowship. Methods A retrospective bibliometric analysis was conducted on peer-reviewed publications authored by CRDF fellows from 1999 through 2021. Publication data were retrieved from Open Researcher and Contributor ID profiles and verified using PubMed, Google search, and Google scholar. A retrospective bibliometric analysis was conducted using descriptive and comparative statistical methods to evaluate publication productivity, authorship position, journal quality metrics, collaboration patterns, disease focus, and research themes before and after fellowship participation. Analyses were conducted using R statistical software. Scientific outcome of the fellowship was judged based on the evolution of collaboration network, journal metrics, and seniority in authorship. Results Among 128 fellows, 76 had verifiable publications, contributing a total of 1821 peer-reviewed articles. Publications were predominantly produced after fellowship participation (1309; 71.9%), compared with 512 pre-fellowship publications. Median publications per fellow increased from 5 [interquartile range (IQR): 2–10] before the fellowship to 14 (IQR: 8–28). The proportion of first-author publications declined (30.7–19.2%), while last-author publications increased (8.0–11.0%), suggesting progression toward senior research roles. Journal quality improved, with publications in Q1 journals increasing from 66.6 to 71.3%, and the median impact factor rising from 2.8 (IQR: 1.9–3.9) to 3.4 (IQR: 2.6–4.9). North–South collaborations increased substantially after the fellowship, while South–South collaborations grew modestly. Conclusions Participation in the CRDF programme was associated with a visible increase in research productivity, publication quality, and international collaboration among fellows. Research output aligned closely with infectious diseases of poverty and evolving global health priorities. While the collaboration network expanded, leadership as gauged by the evolution of authorship position remained constrained, highlighting the need for continued investment in research leadership development. Bibliometric analysis offers a useful approach for examining longer-term scientific outcomes of capacity-strengthening initiatives, while recognizing its limitations in capturing broader policy and societal impacts.
Dermatophytosis is commonly caused by anthropophilic or zoophilic fungi. Although factors related to the disease onset have been identified, it is unclear whether these factors influence disease prevalence differently depending on the fungus’s ecological niche. Our study aimed to determine the epidemiological characteristics of dermatophytosis caused by anthropophilic versus zoophilic agents. We conducted a retrospective descriptive study (1976–2015) including confirmed cases of dermatophytosis diagnosed by positive mycological cultures in patients treated at the Institute of Tropical Medicine “Daniel Alcides Carrion”—National University of San Marcos, Lima, Peru. Demographic and microbiological data were collected. We used the Chi-square test to evaluate differences in the prevalence of anthropophilic and zoophilic dermatophytosis across the variables of interest. A total of 4961 cases of dermatophytosis were diagnosed. Anthropophilic dermatophytosis was most prevalent in adults, primarily due to Trichophyton rubrum (92.19
