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Background Leptospirosis is a zoonotic disease that can be transmitted by contact with the urine of infected mammals. Rodents play a mayor role in the transmission of leptospires to humans. The province of Santa Fe reports the greatest number of cases in Argentina. Yet, in this region, there are still knowledge gaps regarding the diversity of rodent species that may be hosts of pathogenic leptospires. The aims of this study were to evaluate the presence of leptospiral antibodies in rodents from three riverside communities of Santa Fe, and to identify factors associated with leptospiral infection. Methodology/Principal findings Each community was divided into three environmental settings based on the level of human disturbance, and sampled during two springs (Sep-Oct 2014 and 2015) and one autumn (Mar-Apr 2015). Serum samples of captured sigmodontine and murine rodents were tested for leptospiral antibodies by enzyme-linked immunosorbent assay (ELISA), and microagglutination test (MAT) was used to assess the infecting serovar in seropositive individuals. Factors influencing seropositivity were analyzed using logistic regression models. We caught 119 rodents, of which 101 serums were suitable for analysis. Most frequently trapped species were Scapteromys aquaticus, Akodon azarae and Oligoryzomys spp., with seroprevalences of 41.3%, 42.9% and 55% respectively. Seropositivity was higher in individuals with an average body condition score and in those that were sexually mature, but in the latter the differences were marginally significant. Conclusions/Significance Our results suggest that native rodents may be playing a role in the environmental circulation of pathogenic leptospires and provide relevant information for public health policies in the area., Author summary Rodents are considered as the main reservoirs of pathogenic leptospires, which can cause leptospirosis, a disease that can be severe for both humans and domestic animals. Multiple socio-environmental factors have been found to influence the risk of leptospirosis, and many mammal species can play a role in the transmission of the bacteria. The purpose of this study was to investigate the local conditions and rodent fauna that may influence the risk of leptospirosis in communities located in the floodplains of the Parana river, near Santa Fe, Argentina. We conducted a survey of antibodies against leptospires in rodents from the center, border, and outside of three riverside settlements. We observed a relatively high seroprevalence among captured individuals (42%). Animals with an intermediate body condition were more likely to be seropositive. In most sites, native rodents were dominant over introduced rats and mice and lived close to human dwellings. Given the socio-environmental conditions observed in these settlements and the high frequency of floods that affect them, the presence of potentially infected rodents provide ample opportunities for leptospirosis to affect these communities.

Background The burden of scrub typhus in endemic areas is poorly understood. This study aimed at estimating the proportion of hospitalisations and outpatient visits for undifferentiated fever in the community that may be attributable to scrub typhus. Methodology and principal findings The study was a retrospective cohort with a nested case-control study conducted in the South Indian state of Tamil Nadu. We conducted house-to-house screening in 48 villages (42965 people, 11964 households) to identify hospitalised or outpatient cases due to undifferentiated fever during the preceding scrub typhus season. We used scrub typhus IgG to determine past infection. We calculated adjusted odds ratios for the association between IgG positivity and case status. Odds ratios were used to estimate population attributable fractions (PAF) indicating the proportion of hospitalised and outpatient fever cases attributable to scrub typhus. We identified 58 cases of hospitalisation and 236 outpatient treatments. 562 people were enrolled as control group to estimate the background IgG sero-prevalence. IgG prevalence was 20.3% in controls, 26.3% in outpatient cases and 43.1% in hospitalised cases. The PAFs suggested that 29.5% of hospitalisations and 6.1% of outpatient cases may have been due to scrub typhus. In villages with a high IgG prevalence (defined as ≥15% among controls), the corresponding PAFs were 43.4% for hospitalisations and 5.6% for outpatients. The estimated annual incidence of scrub typhus was 0.8/1000 people (0.3/1000 in low, and 1.3/1000 in high prevalence villages). Evidence for recall error suggested that the true incidences may be about twice as high as these figures. Conclusions The study suggests scrub typhus as an important cause for febrile hospitalisations in the community. The results confirm the adequacy of empirical treatment for scrub typhus in hospitalised cases with undifferentiated fever. Since scrub typhus may be rare among stable outpatients, the use of empirical treatment remains doubtful in these., Author summary Scrub typhus is an important cause of fever in many Asian countries, including China, India, Vietnam and Japan. It is caused by the intra-cellular bacteria Orientia tsutsugamushi and is transmitted to humans by mite larvae (chiggers) which attach to the skin of the host. Scrub typhus is potentially life-threatening but treatable with relatively cheap antibiotics such as doxycycline. The incidence of scrub typhus in the community is not known as most studies were done at hospitals and health posts lacking a clearly defined source-population for patients seeking health care for fever. In this study, the proportion of fever cases due to scrub typhus and the incidence of the infection were estimated by retrospective case identification in a population of 42000 people living in 48 villages in the South Indian state of Tamil Nadu. We found that about 30% to 40% of hospitalisations for undifferentiated fever may be due to scrub typhus. In contrast, scrub typhus accounted for only about 5% of outpatient fever cases. Our findings confirm the need for large population-based cohort studies to better understand the epidemiology of scrub typhus in endemic settings.

Background Aedes mosquitoes severely affect the health and wellbeing of human populations by transmitting infectious diseases. In French Polynesia, Aedes aegypti is the main vector of dengue, chikungunya and Zika, and Aedes polynesiensis the primary vector of Bancroftian filariasis and a secondary vector of arboviruses. Tools for assessing the risk of disease transmission or for measuring the efficacy of vector control programmes are scarce. A promising approach to quantify the human-vector contact relies on the detection and the quantification of antibodies directed against mosquito salivary proteins. Methodology/Principal findings An ELISA test was developed to detect and quantify the presence of immunoglobulin G (IgG) directed against proteins from salivary gland extracts (SGE) of Ae. aegypti and Ae. polynesiensis in human populations exposed to either species, through a cross-sectional study. In Tahiti and Moorea islands where Ae. aegypti and Ae. polynesiensis are present, the test revealed that 98% and 68% of individuals have developed IgG directed against Ae. aegypti and Ae. polynesiensis SGE, respectively. By comparison, ELISA tests conducted on a cohort of people from metropolitan France, not exposed to these Aedes mosquitoes, indicated that 97% of individuals had no IgG directed against SGE of either mosquito species. The analysis of additional cohorts representing different entomological Aedes contexts showed no ELISA IgG cross-reactivity between Ae. aegypti and Ae. polynesiensis SGE. Conclusions/Significance The IgG response to salivary gland extracts seems to be a valid and specific biomarker of human exposure to the bites of Ae. aegypti and Ae. polynesiensis. This new immuno-epidemiological tool will enhance our understanding of people exposure to mosquito bites, facilitate the identification of areas where disease transmission risk is high and permit to evaluate the efficacy of novel vector control strategies in Pacific islands and other tropical settings., Author summary In Pacific islands like in most tropical regions, Aedes mosquitoes affect the health of human populations by transmitting diseases like dengue, chikungunya, Zika and filariasis. The biting nuisance of Aedes mosquitoes also impacts local tourism, affecting the sustainability of island economies. Mosquito saliva is injected during the biting process, and the response triggered by the human immune system to proteins contained in mosquito saliva was shown to be a relevant biomarker of exposure to mosquito bites. Using this approach, we have developed an immuno-epidemiological tool to investigate the exposure of people to the bites of Aedes aegypti and Aedes polynesiensis, two significant mosquito vectors of infectious diseases in French Polynesia and other island countries and territories in the Pacific. This novel tool proved specific and reliable. It will improve the assessment of disease transmission risk and be useful for measuring the efficacy of both conventional and innovative vector control strategies.

Background Following one to five years of antibiotic mass drug administration (MDA) for the elimination of trachoma as a public health problem, programmes must conduct impact surveys to inform decisions on whether MDA is still needed. These decisions are currently based on the prevalence of trachomatous inflammation—follicular (TF), which, after MDA, correlates poorly with prevalence of ocular Chlamydia trachomatis infection. Methodology/Principal findings Impact surveys in six evaluation units (EUs) of Malawi were used as a platform to explore associations between the prevalence of TF, ocular C. trachomatis infection and anti-Pgp3 antibodies one year after the third annual round of MDA. Participants were examined for trachoma using the World Health Organization simplified grading system. Ocular swabs and dried blood spots (DBS) were collected from children aged 1–9 years. Swabs were tested for C. trachomatis DNA using GeneXpert. DBS were assayed for anti-Pgp3 antibodies using ELISA. EU-level prevalence of TF in children aged 1–9 years ranged from 4.7% (95% CI 3.4–6.3) to 7.2% (95% CI 5.8–8.9). Prevalence of C. trachomatis infection in children ranged from 0.1% (95% CI 0.0–0.6) to 0.7% (95% CI 0.3–1.3) while Pgp3 seroprevalence ranged from 6.9% (95% CI 5.4–8.6) to 12.0% (95% CI 10.1–14.0) and increased with age. Conclusions/Significance Based on current global policy, the prevalence of TF indicates that a further year of antibiotic MDA is warranted in four of six EUs yet the very low levels of infection cast doubt on the universal applicability of TF-based cut-offs for antibiotic MDA. Pgp3 seroprevalence was similar to that reported following MDA in other settings that have reached the elimination target however the predictive value of any particular level of seropositivity with respect to risk of subsequent infection recrudescence is, as yet, unknown., Author summary Trachoma, caused by ocular infection with the bacterium Chlamydia trachomatis, is treated at the population level with mass drug administration (MDA) of azithromycin, a broad-spectrum antibiotic. Decisions to stop MDA are subsequently made following impact surveys designed to determine the prevalence of trachoma in children aged 1–9 years. However, clinical signs of trachoma can persist in treated communities even in the absence of active C. trachomatis infection, potentially leading to continued MDA that may be unnecessary. In this study, we use the platform provided by six impact surveys to compare prevalence of clinical signs of trachoma in children with prevalence of C. trachomatis infection and anti-C. trachomatis antibodies. Based on current policy, prevalence of clinical signs of trachoma in four of six evaluation units surveyed indicated further MDA is warranted. However, tests for C. trachomatis DNA indicate extremely low levels of infection making the need for further MDA unclear. Prevalence of anti-C. trachomatis antibodies were similar to that found in other low prevalence settings, however the significance of such levels, and of levels of current C. trachomatis infection, with regard to the risk of reinfection are, as yet, unknown.

Background Dengue is a febrile illness transmitted by mosquitoes, causing disease across the tropical and sub-tropical world. Antibody prevalence data and serotype distributions describe population-level risk and inform public health decision-making. Methodology/Principal findings In this cross-sectional study we used data from a pediatric dengue seroprevalence study to describe historical dengue serotype circulation, according to age and geographic location. A sub-sample of 780 dengue IgG-positive sera, collected from 30 sites across urban Indonesia in 2014, were tested by the plaque reduction neutralization test (PRNT) to measure the prevalence and concentration of serotype-specific neutralizing antibodies according to subject age and geography. PRNT results were obtained from 776 subjects with mean age of 9.6 years. 765 (98.6%) neutralized one or more dengue serotype at a threshold of >10 (1/dil). Multitypic profiles were observed in 50.9% of the samples; a proportion which increased to 63.1% in subjects aged 15–18 years. Amongst monotypic samples, the highest proportion was reactive against DENV-2, followed by DENV-1, and DENV-3, with some variation across the country. DENV-4 was the least common serotype. The highest anti-dengue antibody titers were recorded against DENV-2, and increased with age to a geometric mean of 516.5 [1/dil] in the oldest age group. Conclusions/Significance We found that all four dengue serotypes have been widely circulating in most of urban Indonesia, and more than half of children had already been exposed to >1 dengue serotype, demonstrating intense transmission often associated with more severe clinical episodes. These data will help inform policymakers and highlight the importance of dengue surveillance, prevention and control., Author summary Dengue is a febrile illness transmitted by mosquitoes, causing disease across the tropical and sub-tropical world. Antibody prevalence data and serotype distribution describe population-level risk and inform public health decision-making. We present data from a dengue seroprevalence study in children in Indonesia; circulation of the four dengue serotypes (DENV-1, -2, -3, -4) was assessed, by age and location. Samples collected from 30 urban Indonesian sites were tested using the plaque reduction neutralization test (PRNT), which enabled us to measure prevalence and concentration of antibodies specific to dengue virus serotypes. Results were obtained from 776 subjects (mean age: 9.6 years). 765 (98.6%) neutralized ≥1 dengue serotype; the highest proportion was reactive against DENV-2, followed by DENV-1, and DENV-3, with some variation across the country. Reaction to multiple serotypes was observed in 50.9% of samples. The highest anti-dengue antibody titers were recorded against DENV-2, and increased with age. The fact that all four dengue serotypes have been widely circulating in urban Indonesia, and more than half of children had been exposed to >1 dengue serotype, shows intense transmission, often associated with more severe clinical episodes. These data will help inform policymakers and highlight the importance of dengue surveillance, prevention and control.