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A pandemic can wreak havoc in supply chains, as witnessed in the COVID-19 context. As workers get infected, production level drops and demand from customers goes unfulfilled. Combining in a novel way an epidemic model with optimal control theory, our model provides a plant manager with the optimal level of prophylactic effort she needs to deploy over a planning horizon to protect the workforce from a pandemic in its early stage and so maintain production levels. Given the production planning problem, the effort in terms of prophylactic measures can be optimally determined in closed form, balancing worker protection against production requirements in a single step. The manager must initially implement the strictest measures before relaxing them in time. Three extensions are presented:, (1) determine the optimal period of time over which the prophylactic measures should be maintained; (2) determine the optimal effort in terms of prophylactic measures in the case of an endemic disease; and (3) assess the effect of a stochastic exogenous shock on the total number of infected. This research provides a production planning model that allows a decision-maker to mitigate the impact of worker absenteeism at the onset of a pandemic, thus improving supply chain resilience. [ABSTRACT FROM AUTHOR]

Heterophyiasis is a highly endemic disease in the Nile Delta, Egypt, where people consume raw or undercooked Oreochromis niloticus and Mugil cephalus. Birds and rats play a crucial role in fish-borne zoonotic trematode transmission since they serve as natural and experimental hosts. This study aimed to update the epidemiological information, morphological description, molecular identification and gene expression of two distinct heterophyid metacercariae in Giza, Wadi Al-Rayan, and Lake Manzala, Egypt, whereas various heterophyid infections could be expected. The present Centrocestus formosanus, Heterophyes heterophyes, and Heterophyes nocens with accession numbers OR947651.1, OR947700.1, and OR947719.1, respectively, matched with those recorded in the GenBank. Findings of the current investigation indicated that various cytokines like IL-1β, MHC-II, and TNF-α rapidly elevated in the infected pigeon's intestines. Additionally, the infection expanded due to the parasite's ejection from the host and the host's clinical affliction, which induced humoral immune responses. Interestingly, investigation of other trematode species is in extreme demand in terms of zoonoses. We suggest controlling snails, managing migratory birds, and examining and frying fishes to the point when the encysted metacercariae is destroyed. [ABSTRACT FROM AUTHOR]

Background: Paracoccidioidomycosis (PCM) and histoplasmosis are endemic fungal diseases in South America. Both can lead to lung involvement with fungal dissemination progressing to systemic and severe clinical manifestations, especially in immunosuppressed hosts. As the population of immunosuppressed individuals has been rising, a higher occurrence of fungal infections is predicted in this setting. This poses challenges regarding the differential diagnosis due to overlapping clinical and laboratorial findings, hampering the management of cases. Objectives: In this study, the authors discuss the occurrence of a false-positive Histoplasma urinary antigen detection in a kidney transplant recipient with acute PCM. Given the scarce information about this subject, a review on literature data is provided. Methods: A comprehensive literature search was conducted to investigate previous studies that found cross-reactivity between Histoplasma urinary antigen assays in human patients with confirmed diagnosis of PCM. Additionally, an update of PCM in transplant recipients is provided. Findings: The included studies reported 120 samples from patients with PCM tested for Histoplasma antigen, presenting an overall cross-reactivity of 51.67% and 17 cases of PCM in transplant recipients. CONCLUSIONS: The galactomannan urinary antigen developed to diagnose histoplasmosis can cross react with PCM, which may represent a concern in countries where both mycoses overlap. Author summary: Paracoccidioidomycosis (PCM) and histoplasmosis are severe fungal diseases occurring simultaneously in South America. They can cause similar clinical manifestations, especially in immunosuppressed hosts. This poses challenges regarding the differential diagnosis due to overlapping clinical and laboratorial findings, hampering the management of individual cases. In this study, the authors report the occurrence of a false-positive urinary test to detect histoplasmosis in a kidney transplant recipient with acute PCM. Given the scarce information about this subject, a review on literature data is provided. As conclusion, this study highlights the urinary test developed to diagnose histoplasmosis can cross react with PCM, which may represent a concern in countries where both mycoses overlap. [ABSTRACT FROM AUTHOR]

Goatpoxvirus (GTPV), sheeppoxvius (SPPV), and the Lumpy skin disease virus (LSDV) is a Capripoxvirus belonging to the family poxviridae. They can cause significant economic losses in countries where this disease are endemic. However, effective and convenient diagnostic tools against sera antibody are not readily available until now. Toward this goal, a polyclonal antibody competitive enzyme-linked immunosorbent assay (c-ELISA) of detecting serogroup-specific antibody is established based on major LSDV antigen A33. Serum samples (n = 605) were collected to optimize the c-ELISA from different areas. The cut-off value for the c-ELISA was estimate using percent inhibition (PI) values. The diagnostic performance of test including sensitivity (sn) and specificity (sp) were obtained by receiver operator characteristic (ROC) analysis. Among these analysis, > 57.61% PI value was accepted as cut-off of the c-ELISA, the diagnostic sn an diagnostic sp were reached to 96.4% and 98.5%, at > 95% confidence interval. These results show that the developed competitive ELISA is sensitive, specific, and reliable, which make it appropriate for serological investigation. [ABSTRACT FROM AUTHOR]

The 16th International Symposium on Schistosomiasis, held in Brazil, focused on disease control and elimination. Participants from 11 countries discussed various aspects of schistosomiasis, including the development of disease control tools and health education. The symposium featured keynote speeches, poster presentations, panel discussions, and abstract submissions. A Research Topic dedicated to the symposium aimed to disseminate selected studies presented during the event, covering topics such as diagnostic tests, host-parasite interactions, potential drug targets, and vaccine development. These studies contribute to the search for new strategies to combat schistosomiasis. The text also highlights the importance of education and diagnostic development in achieving the World Health Organization's guidelines for controlling and eliminating the disease. [Extracted from the article]

Leishmaniases are a group of neglected vector-borne infectious diseases that are among the six priority endemic diseases worldwide. Visceral leishmaniasis (VL) is the most severe clinical manifestation, characterized by systemic and chronic visceral involvement and high mortality in immunosuppressed and untreated patients. VL can be complicated into post-kala-azar dermal leishmaniasis (PKDL), and when dermatologic disorders occur simultaneously with active VL, an intermediate clinical form called para-kala-azar dermal leishmaniasis (para-KDL) occurs. This clinical form is of great epidemiological relevance, as humans act as a source of infection for vectorial transmission. In the Americas, Brazil is among the seven countries responsible for more than 90% of VL cases, though reports of PKDL and para-KDL are rare. This paper presents three cases of VL-HIV co-infection with Leishmania-containing skin lesions resembling para-kala-azar dermal leishmaniasis. The cases were investigated by the team from the Infectious Diseases Department of University Hospital (HUMAP/UFMS) in Mato Grosso do Sul, Brazil. The three patients exhibited skin lesions where amastigote forms of L. (L.) infantum were identified. All cases exhibited similar clinical manifestations of para-KDL, including fever, hepatosplenomegaly, pancytopenia, and disseminated skin lesions. The study described the prevalence of comorbidities, the incidence of VL relapse, and the therapeutic regimen in relation to the outcomes. The study underscores the importance of follow-up and secondary prophylaxis in patients with VL, which are essential for the efficacy of the treatment. Furthermore, the study provides insight into the potential epidemiological profile of para-KDL cases in Brazil, which contributes to the development of more efficient clinical management strategies for patients. Author summary: Visceral leishmaniasis (VL) is a neglected vector-borne infectious disease with a systemic and chronic involvement that is lethal when untreated. Para-kala-azar dermal leishmaniasis (para-KDL) is a complication of VL, in which the patient presents with dermatological and visceral manifestations simultaneously. Para-KDL cases are of significant epidemiological importance, as humans act as a source of infection in parasite transmission. In the Americas, Brazil accounts for over 90% of VL cases. Nevertheless, reports of para-KDL remain scarce. This paper presents three cases of VL-HIV co-infection with Leishmania-containing skin lesions resembling para-kala-azar dermal leishmaniasis. The three cases exhibit similarities in terms of signs and symptoms, diagnostic criteria for AIDS, and the presence of active VL with skin lesions. The study contributes to the understanding of the epidemiological profile of para-PKDL cases in Brazil. It highlights the significance of multidisciplinary follow-up and secondary prophylaxis for patients with VL and emphasizes the need for more effective clinical management strategies for these patients. [ABSTRACT FROM AUTHOR]

In Fiji, 90% of the population has access to basic sanitation; however, there are still persistent health risks from endemic faecal-oral diseases such as typhoid fever. There is a need to assess the contribution of existing sanitation facilities in the faecal pathogen transmission pathway. This study was conducted as part of a larger planetary health study across 29 rural communities within five river catchments. This specific research aimed to characterise latrine front-ends, both infrastructure and usage behaviour, and to assess the faecal contamination levels on various frequently contacted latrine surfaces in rural Fiji. A sanitation survey, along with observation and latrine swab sampling, was conducted in households over three phases: baseline (n = 311) (Aug–Dec 2019), endline (n = 262) (Jun–Sep 2022) and an in-depth front-end study (n = 12) (Oct–Nov 2022). Of 311 households, almost all had pedestal-type latrines, predominately cistern-flush (83%), followed by pour-flush (13%), and then hole-type (pit) latrines (4%). Washable latrine floors had significantly higher E. coli densities (6.7 × 102 CFU/25 cm2) compared to non-washable floors (1.3 × 102 CFU/25 cm2) (p = 0.05), despite washable floors indicating improved latrines. The in-depth front-end analysis found that moist latrine surfaces had significantly elevated E. coli densities (1.2 × 103 CFU/25 cm2) compared to the dry ones (14.3 CFU/25 cm2) (p < 0.001), highlighting the importance of maintaining dry latrine surfaces. Latrine floors and mid-walls were the most frequently contaminated surfaces, emphasising the need to clean and disinfect these surfaces. Only 46% of the households reported always using soap for handwashing after defecation, exacerbating the risk of transmitting faecal pathogens. This study highlights that latrine cleanliness and hygiene are as crucial as latrine infrastructures for the effective disruption of faecal pathogens transmission during latrine use. [ABSTRACT FROM AUTHOR]

Introduction: Dengue is a significant public health issue in the Urabá region, accounting for 37.5% of morbidity and 41.7% of mortality resulting from dengue in the department of Antioquia (Colombia) in 2018. Clinical Practice Guidelines (CPGs) are tools based on Evidence-Based Medicine, intended for medical personnel to bridge the gap between proven intervention efficacy and clinical decision-making. This study aims to identify barriers and facilitators in the implementation of CPGs for dengue patient care by healthcare officials in the municipalities of the banana axis in the Urabá region. Methodology: From a multifaceted approach to implementation research, a mixed method study that combines qualitative and quantitative approaches, was conducted during the years 2020 and 2021, using combined instruments to identify determinants (Guide Indicative Factors, Individual factors of health professionals, Patient factors, Professional interactions, Incentives and resources, Capacity for organizational change, and lastly Social, political, and legal factors) affecting adherence to the Comprehensive Clinical Care Guide for Patients with Dengue (GACIPD). Semi-structured interviews and focus groups with healthcare workers were conducted to assess determinants based on clinical experience. Questionnaires on determinants of GACIPD adherence, using an adapted version of the Chronic Disease Implementation Checklist (TICD), were also employed. Qualitative analysis of the interviews and focus groups used a concept-based coding framework. The questionnaire responses were analyzed using Likert scaling and frequency counts of determinants within and across domains. Participants included general practitioners, other health professionals, researchers, academics, and administrators. Results: There was a total of 103 participants in focus groups, 7 in semi-structured interviews, and 136 participants through questionnaires. Among the domains studied, the identification of barriers and facilitators emphasized institutional factors and individual factors. Organizational change capacity was identified as a major barrier, with only 3.6% of respondents indicating that their institution adjusted the prioritization of adequate care according to the guideline. The GACIPD domain received the highest facilitator rating, with 66.7% acceptance due to its practicality, simplicity, clarity, documentation, and ease of implementation, despite this, only 10% of professionals completely agree that their work is in accordance with the GACIPD. The determinant of patient factors was significant in the negative perception of adherence to GACIPD. Conclusions: Although barriers outweighed facilitators for GACIPD adherence, determinants for its use were generally positive, as most participants reported it as being a complete, documented, and easy-to-implement guide. The lack of knowledge of the guidelines impacting health professional's decision making was identified as a potentially modifiable barrier, and educational strategies could be implemented to overcome it. The region requires greater emphasis on the management of chronic health conditions, comorbidities, and coinfections of dengue with other endemic diseases. Author summary: Dengue is a significant public health issue in the Urabá, this region reported around 40% of morbidity and mortality for the disease in the department of Antioquia (Colombia) in 2018. Clinical Practice Guidelines are tools intended for medical personnel to bridge the gap between proven intervention efficacy and clinical decision-making. A study was conducted s to identify determinants affecting adherence to the Comprehensive Clinical Care Guide for Patients with Dengue. Focus groups, questionnaires, and interviews were used. Participants included general practitioners, other health professionals, researchers, academics, and administrators. The barrier most frequently identified by participants was organizational change capacity, however individual health professionals also identified a lack of interest in self-learning and knowledge of the guidelines. On the other hand, among facilitators, they identified the guideline's inherent characteristics. Although barriers outweighed facilitators for GACIPD adherence, determinants for its use were generally positive, as most participants reported it as being a complete, documented, and easy-to-implement guide. The lack of interest in self-learning and knowledge of the guidelines was identified as a potentially modifiable barrier and educational strategies could be implemented to overcome it. [ABSTRACT FROM AUTHOR]

Background: Malaria is a serious, fatal disease, and a high-risk determinant for human health globally. Children, pregnant women, and migrants are vulnerable groups for malaria infection in African regions. Recently, malaria is an endemic disease in Ethiopia. Objectives: This study aimed to determine the pooled prevalence of malaria and its determinant factors among the most vulnerable populations in Ethiopia. Methods: Electronic databases, including PubMed, Google Scholar, Web of Science, Semantic Scholar, and Scopus were used for searching articles published since the 2020 Gregorian calendar and onwards. All peer-reviewed Ethiopian journals, health institutions, and Universities were considered for article searching. A PRISMA flow chart and Endnote software were used for article screening, and to remove duplications, respectively. The modified version of the Newcastle–Ottawa Scale was used for potential risk of bias assessments. The heterogeneity among the included studies was evaluated using the indicator of heterogeneity (I2). Egger's test and funnel plot were used to examine the possible publication bias. A random-effects analysis was used to assess the pooled prevalence of malaria, and its determinant factors with a 95% CI. The screening process, data extraction, and quality assessment were done independently, and any disagreements were resolved through discussions. Results: A total of twelve studies were included in this study. The pooled malaria prevalence was 11.10% (95% CI: 6.10, 16.11). Stagnant water (AOR: 4.19, 95% CI: 2.47, 7.11), no insecticide-treated net utilization (AOR: 3.15, 95% CI: 1.73, 5.73), and staying outdoors at night (AOR: 5.19, 95% CI: 2.08, 12.94) were the pooled estimated statistically risk factors for malaria prevalence. Whereas, insecticide-treated bed net utilization (AOR: 1.59, 95% CI: 0.23, 10.95) reduces the risk of malaria infection. Conclusions: The pooled prevalence of malaria is high among vulnerable populations. Creating awareness regarding utilization of insecticide-treated bed nets, and draining stagnant water from the environment are possible interventions to reduce the prevalence of malaria. [ABSTRACT FROM AUTHOR]

Powassan virus is a tick-borne flavivirus that can cause severe neuroinvasive disease, with areas of endemicity in the Northeast and Midwest United States, Canada, and Russia. Diagnosis is challenging and relies on a high index of suspicion and choosing the right test based on duration of infection and the patient's immune status. This review covers laboratory testing for Powassan virus, including historical considerations, modern options, and methods being developed in the research space. [ABSTRACT FROM AUTHOR]

Foot-and-mouth disease (FMD) is a highly infectious and endemic disease in Lao PDR. However, surveillance is weak, and outbreaks are not routinely reported. To address this, serum samples were routinely collected from cattle and buffalo from provincial abattoirs between November 2021 and December 2022. A total of 2,663 serum samples were collected from large ruminants (n = 1,625 cattle; n = 1,038 buffalo) from 17 provinces. Samples were tested for specific antibodies directed against FMD non-structural protein (NSP) to determine the proportion of animals exposed to FMD virus. In addition to sampling from abattoirs, further independent data was collected to report clinical signs and outcomes from 94 districts in 12 northern provinces. These incident reports were recorded by district staff using a Google Form and summarised monthly in the National Animal Disease Reporting System. Information was collected on species, incident date, herd size, location and which clinical signs the animals presented. Overall, 46% of the tested animals returned a positive result using ID Screen® FMD NSP Competition ELISA. Results from serological testing were then compared with reported clinical signs from the same district. In districts reporting 'mouth problems' (regardless of other clinical signs) the median FMD seroprevalence was 49.7%, compared to 31.6% in districts not reporting mouth problems (p = 0.021). This finding suggests that reporting clinical cases of 'mouth problems' could be a potential predictor of FMD infection at a district level in cattle and buffalo in Lao PDR. Furthermore, in districts reporting 'fever', 'mouth problems', and 'nose/mouth secretions' together, the median FMD seroprevalence was 46.2%, compared to 24.4% in districts not reporting these signs (p = 0.033). In districts reporting 'mouth problems' and 'nose/mouth secretions' the median FMD seroprevalence was 49.4%, compared to 25.5% in districts not reporting these signs (p = 0.037). In districts reporting both 'fever' and 'mouth problems,' the median FMD seroprevalence was 46.4% compared to 25% in districts not reporting these signs (p = 0.017). Based on serological data generated by abattoir surveillance, this study identified clinical signs most predictive of FMD seroprevalence. These novel findings can be used to guide passive surveillance efforts in the future specifically in northern Laos and help support improved FMD surveillance more broadly in FMD endemic countries in Southeast Asia. [ABSTRACT FROM AUTHOR]

Background: Both dengue and Leptospira infections are endemic to tropical and subtropical regions, with their prevalence increasing in recent decades. Coinfection with these pathogens presents significant diagnostic challenges for clinicians due to overlapping clinical manifestations and laboratory findings. This case report aims to elucidate two clinical scenarios where the coinfection of dengue and leptospirosis complicates the disease course, creating a diagnostic conundrum. Case presentation: We present the clinical scenarios of two Bangladeshi males, aged 25 and 35 years, who were admitted to our hospital with acute febrile illness. The first patient exhibited hepatic and renal involvement, while the second presented with symptoms initially suggestive of meningoencephalitis. Both cases were initially managed under the presumption of dengue infection based on positive serology. However, further evaluation revealed coinfection with Leptospira, complicating the disease course. Both patients received appropriate treatment for dengue and antibacterial therapy for leptospirosis, ultimately resulting in their recovery. Conclusion: These case scenarios underscore the critical importance for clinicians in regions where dengue and Leptospira are endemic to consider both diseases when evaluating patients presenting with acute febrile illness. [ABSTRACT FROM AUTHOR]

Chagas disease, caused by Trypanosoma cruzi, affects millions of people globally and is associated with significant underdiagnosis and undertreatment. Current diagnostic algorithms face challenges in remote regions. We aimed to review the potential of rapid diagnostic tests (RDTs) for screening or diagnosing chronic Chagas disease in endemic areas. An expert panel representing scientific and academic institutions from the Americas convened with the aim of discussing the use of RDTs. The study employed the nominal group technique, gathering insights from diverse experts during a 3-day meeting. Panel discussions covered RDT application, research protocols, and regulatory mechanisms. The results indicate that RDTs play a crucial role in surveillance and screening, although limitations in sensitivity and specificity exist. The expert group recommends standardized protocols, emphasizes the importance of cost-effectiveness assessments, and highlights the need to consider geographic validation. Despite these challenges, RDTs present a promising avenue for improving Chagas disease diagnosis in resource-limited settings. Future research and a collaborative approach are deemed essential for effective implementation. Author summary: Chagas disease, caused by the Trypanosoma cruzi parasite, affects approximately 7 million people globally, with potential cardiac or digestive complications in 30% of cases. Underdiagnosis and undertreatment in Latin America result from its often-silent progression, emphasizing the need for early and accurate diagnosis. A meeting of representatives from scientific and academic institutions discussed the use of rapid diagnostic tests (RDTs) for chronic Chagas disease covering RDT application, research protocols, and regulatory mechanisms, emphasizing the important role of this tool in rapidly detecting T. cruzi-specific antibodies. RDTs offer breakthroughs for remote areas. Currently recommended for screening, experts suggest evaluating their expanded use for definitive individual diagnosis, emphasizing their portability, minimal blood requirement, and rapid results. Challenges, including variability in RDT sensitivity and specificity, call for further research and evidence-based recommendations. The expert group highlights the need for standardized diagnostic protocols, reviewing regulatory aspects, and advocating for updates to diagnostic lists and improved supply management. In conclusion, the expert meeting provided a roadmap for optimizing RDTs in chronic Chagas disease diagnosis, balancing potential benefits with existing challenges. The proposed generic protocol aims to guide multicenter studies, positioning RDTs as valuable tools in addressing this public health issue across the Americas. [ABSTRACT FROM AUTHOR]

Introduction: Query (Q) fever is a zoonosis caused by the bacterium Coxiella burnetii typically presenting as an influenza-like illness (ILI) with or without hepatitis. The infection may be missed by clinicians in settings of low endemicity, as the presentation is clinically not specific, and there are many more common differential diagnoses for ILI including SARS-CoV-2 infection. Methods: Residual serum samples were retrospectively tested for Phase 1 and 2 Q fever-specific IgM, IgG, IgA antibodies by indirect immunofluorescence and C. burnetii DNA by polymerase chain reaction. They had not been previously tested for Q fever, originating from undiagnosed patients with probable ILI, aged 10–70 years and living in regional New South Wales, Australia. The results were compared with contemperaneous data on acute Q fever diagnostic tests which had been performed based on clinicians requests from a geographically similar population. Results: Only one (0.2%) instance of missed acute Q fever was identified after testing samples from 542 eligible patients who had probable ILI between 2016–2023. Laboratory data showed that during the same period, 731 samples were tested for acute Q fever for clinician-initiated requests and of those 70 (9.6%) were positive. Probability of being diagnosed with Q fever after a clinician initiated request was similar regardless of the patients sex, age and the calendar year of sampling. Conclusion: In this sample, Q fever was most likely to be diagnosed via clinician requested testing rather than by testing of undiagnosed patients with an influenza like illness. Author summary: Q fever is a highly contagious infection presenting as an influenza-like illness or less commonly as acute hepatitis. Literature shows that there may be diagnostic delays in recognizing Q fever by primary care physicians if they are unfamiliar with the infection. We tested residual serum samples stored at NSW Health Pathology between 2016–2023 for Q fever, if that sample originated from a rural postcode in NSW and had been tested previously for an organism causing influenza like illnesses, but not Q fever. After testing 542 eligible samples only one case of missed acute Q fever was found. In the same period, from a similar population the same diagnostic laboratory received 731 requests for Q fever testing from which 70 were positive. Therefore, In this study the number of missed acute Q fever cases were clinically insignificant. [ABSTRACT FROM AUTHOR]

Introduction: During the pandemic, fear of contracting Covid led to a drop in patient numbers in almost all health services. After the declaration of Covid as an endemic disease, the occupancy rate of general hospitals in Yogyakarta was over 80 per cent in almost all cases. When the pandemic ends, nurses will struggle to juggle an increasing workload. High workloads can lead to burnout, affect mental and physical health, and reduce motivation and enjoyment in caring. The aim of this study is to determine the impact of post-pandemic nurse workload on the incidence of burnout. Materials and methods: A cross-sectional simple random sampling design was used in this study. The sample size was 101 nurses working in Kulon Progo, Sleman and Bantul district hospitals. Data were analysed using gamma test. Results: The results of the analysis show that the perceived workload is heavy for nurses both physically (75.44%), and psychologically (80.84%). In the incidence of burn out, data obtained as many as 51 (50.12%) nurses experienced emotional exhaustion in the severe category. In the depersonalisation aspect, 55 (54.50%) nurses experienced burnout in the moderate category. Similarly, in the decline in nurses’ self-efficacy, as many as 76 (75.29%) nurses experienced burnout in the moderate category. The results of bivariate tests using the Gamma correlation statistical test obtained the results of p value (0.007) < α (0.05), which indicates there is a significant relationship between workload and burnout that occurs in nurses. The results of the correlation test obtained a correlation coefficient value (r) of 0.844 with a positive relationship direction. Conclusion: There is a very strong correlation between workload and burnout experienced by nurses in the inpatient room. The positive direction of the relationship means that the higher the workload, the higher the incidence of burnout experienced by nurses in the inpatient room, after the Indonesian Government turned Covid 19 into an endemic. [ABSTRACT FROM AUTHOR]

Goat production in Lao People's Democratic Republic (Lao PDR) is a small but rapidly growing sector owing to strong export demand, primarily from Vietnam. Disease has been identified as one of the major constraints to goat production but there are limited data on causes and effective control strategies. The situation is exacerbated by a lack of veterinary and extension services in rural areas. Information on the major disease and clinical syndromes of goats and their causative agents is needed to develop local and national control strategies and to improve animal welfare. Zoonotic diseases involving goats are also potentially important in terms of live goat trade and public health, albeit research is lacking. This review summarises and evaluates the available published data on caprine diseases in Lao PDR and provides possible disease control strategies to improve goat production in Lao PDR. Surveys and observations suggest that lip and facial dermatitis, eye conditions and diarrhoea are the most common clinical syndromes affecting the health of Lao goats. These clinical syndromes can be considered as priorities for Lao goats. Serological surveys conducted in limited geographical areas of the country have identified moderate seroprevalence of foot and mouth disease (FMD) and low seroprevalence of bluetongue, peste des petits ruminants (PPR), brucellosis and Q fever in goats. Accordingly, the clinical signs associated with the latter diseases were not commonly reported. Trichostrongylus spp., Haemonchus contortus and coccidia are the main gastro-intestinal parasites identified among Lao goats. Despite these studies, an understanding of the causation of the most common clinical syndromes in Lao goats is still lacking, similar to the situation in many other parts of Southeast Asia. Studies to determine the causation of common clinical syndromes need to be conducted in Lao goats if progress is to be made on overcoming the disease constraint. Similarly, studies are also needed to evaluate interventions that have been introduced to limit the impact of these disease and clinical syndromes. They will likely require changes to goat management and nutrition, in addition to disease-specific interventions. Disease is one of the major issues affecting goat production in Lao PDR. Although only a limited number of studies have been published on diseases in Lao goats, a review of the available literature is desirable, given that goat production is rapidly expanding among smallholder farmers. This review article brings together the disease-related studies for a better understanding of health and production in Lao goats. This article belongs to the Collection Sustainable Animal Agriculture for Developing Countries 2023 [ABSTRACT FROM AUTHOR]

Hydatid disease is an endemic parasitic infection caused by the larval stages of the tapeworm Echinococcus. It is highly endemic in Kazakhstan, with both Echinococcus granulosus and Echinococcus multilocularis widely distributed throughout the country. Hydatid disease can affect almost any organ in the body, with the liver and lung being the most common sites, while cardiac involvement is rare. We report a case of a young female presenting with a 1-year history of stabbing precordial pain, shortness of breath, and weakness. She had a hydatid cyst involving the myocardium of the left ventricle and the left lobe of the liver. The patient underwent surgical resection and received albendazole medication as part of the treatment regimen. [ABSTRACT FROM AUTHOR]

Background and Aim: Brucellosis is a highly contagious, neglected zoonotic disease of major importance worldwide. The disease is endemic in many countries, burdening healthcare systems and the livestock industry and representing a persistent public health concern in these countries. Brucellosis is considered an important occupational hazard for livestock workers. Limited studies have investigated human brucellosis in Saudi Arabia. Therefore, this study aimed to estimate the prevalence of brucellosis among employees of high-risk brucellosis professions, including veterinarians, animal herders, and abattoir workers in Madinah, Saudi Arabia, and to determine the associated risk factors. Materials and Methods: A cross-sectional study was conducted in Madinah, Saudi Arabia, during the period of January-March 2023. Ninety blood samples were collected from individuals occupationally at risk of exposure to Brucella infections. Serum samples were examined for immunoglobulins (Ig)M and IgG antibodies against Brucella using an indirect enzyme-linked immunosorbent assay. Before sample collection, a predesigned online questionnaire was used to collect the participants' sociodemographic characteristics and the probable risk factors for human brucellosis. A Chi-square test was used to compare the differences among groups; p < 0.05 were considered statistically significant. Results: Among the 90 participants among the high-risk individuals, Brucella IgM and IgG seropositivity were found in 8 (8.8%) and 11 (12.12%) cases, respectively. IgM mono antibody positivity was observed in 4 (4.44%) and 7 (7.77%) of the study population who tested positive for IgG only. Dual positivity for IgM and IgG antibodies was observed in 4 (4.44%) participants. No significant association was determined between seropositivity and age, urbanicity, education, occupation, and duration of exposure (p > 0.05). Conclusion: Brucellosis is a high-risk occupational disease among workers with close contact with livestock. This study demonstrates that the seroprevalence of brucellosis among occupationally high-risk individuals in Madinah, Saudi Arabia, is relatively low compared to other countries in the region. Nevertheless, educational programs should be implemented to improve knowledge regarding brucellosis, particularly among high-risk individuals. [ABSTRACT FROM AUTHOR]

Background: Helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People's Democratic Republic (PDR). Schistosomiasis caused by Schistosoma mekongi is of public health concern on the islands of the Khong district. This study aimed to assess the impact of an Eco-Health/One-Health approach in combination with mass drug administration (MDA) to reduce these helminth infections. Methods: We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Khong district, Champasack province, Lao PDR, between April 2012 and March 2013. In each study village, 30–40 households were randomly selected. All members of selected households, who were at home during the study period were invited to participate in the study. A baseline study was conducted to assess helminth infections, knowledge attitudes and practices toward Schistosoma mekongi infection, behavior of open defecation and availability of latrine at home. After the baseline (T0), the Eco-Health/One-Health approach was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-Health/One-Health approach on helminth infections and compare intervention and control islands. Later in 2015, the Eco-Health/One-Health approach was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Frequency was used to describe the prevalence of helminth infections. Logistic regression was applied to associate the KAP (knowledge, attitudes, and practices and open defecation behavior) and the reduction of helminth infections between intervention and control islands. The reduction in prevalence pre- and post-intervention was associated using a McNemar test. A two-independent sample t-test was applied to compare the mean eggs per gram (EPG) of helminth infections between control and intervention islands. A paired t-test test was used to compare the mean EPG of stool samples before (baseline) and after (follow-up) interventions for the two islands separately. A P-value lower than 0.05 was considered statistically significant. Results: Eco-Health/One-Health approach appears to be associated with reduction in prevalence of S. mekongi by 9.0% [odds ratio (OR) = 0.49, P = 0.003] compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reduced O. viverrini infection by 20.3% (OR = 1.92, P < 0.001) and hookworm by 17.9% (OR = 0.71, P = 0.045), respectively. Annual parasitological assessments between 2012 and 2017 showed that the Eco-Health/One-Health approach, coupled with MDA, steadily reduced the prevalence of S. mekongi on the intervention island from 29.1% to 1.8% and on the control island from 28.4% to 3.1%, respectively. Conclusions: The study findings suggest that the Eco-Health/One-Health approach appears to be associated with a significant reduction in prevalence of S. mekongi and helminth co-infections, particularly hookworm and T. trichiura. Therefore, implementing the Eco-Health/One-Health approach in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030. [ABSTRACT FROM AUTHOR]

This article discusses the prevalence of female genital schistosomiasis (FGS) among long-term sub-Saharan African migrants in Europe. FGS is a condition characterized by gynecological signs and symptoms, such as menstrual disturbances and vulvovaginal discomfort, that can occur in women with urinary Schistosoma haematobium infection. The study found that African migrant women with a positive Schistosoma serology often experienced gynecological and urinary complaints, despite living in non-endemic European countries for many years. The findings suggest that chronic genitourinary schistosomiasis may be an underestimated condition in non-endemic countries, with significant implications for the sexual and reproductive health of migrant women. Further research is needed to develop a gold standard diagnostic and determine the appropriate treatment for chronic FGS. [Extracted from the article]

Chagas disease (CD) is a parasitic infection endemic in Latin America and also affects patients in Western countries due to migration flows. This has a significant impact on health services worldwide due to its high morbidity and mortality burden. This paper aims to share our experience at the National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, in Rome, Italy, where to date, a total of 47 patients—mainly Bolivian women—diagnosed with CD have received treatment with benznidazole, with all but one presenting with chronic disease. Most of the patients were recruited through the first extensive screening program held in 2014 at our Institute. About a quarter of our patients showed adverse effects to benznidazole, including a case of severe drug-induced liver injury, but 83% completed a full course of treatment. In addition to the description of our cohort, the paper reports a brief overview of the disease compiled through a review of the existing literature on CD in non-endemic countries. The growing prevalence of CD in Western countries highlights the importance of screening at-risk populations and urges public concern and medical awareness about this neglected tropical disease. There are still many unanswered questions that need to be addressed to develop a personalized approach in treating patients. [ABSTRACT FROM AUTHOR]

Currently, the emergence of the endemic Coronavirus disease (COVID‐19) situation still poses a serious threat to public health. However, it remains elusive about the role of fecal microbiota transplantation in treating COVID‐19. We performed a randomized, double‐blind, placebo‐controlled clinical trial enrolling a cohort of 40 COVID‐19 patients with mild‐moderate symptoms. Our results showed that fecal microbiota transplantation provided an amelioration in diarrhoea (p = 0.026) of digestive system and depression (p = 0.006) of neuropsychiatric‐related symptom in COVID‐19 patients, respectively. Meanwhile, we found that the number of patients with diarrhoea decreased from 19 to 0 on day 7 after fecal microbiota transplantation treatment, and it was statistically changed compared to the placebo group (p = 0.047). Of note, the serum concentration of aspartate aminotransferase‐to‐alanine aminotransferase ratio (AST/ALT, fecal microbiota transplantation, pre vs. post: 0.966 vs. 0.817), a biomarker for predicting long COVID‐19, was significantly reduced by fecal microbiota transplantation. In all, our study supports that fecal microbiota transplantation could be a novel therapeutic strategy for COVID‐19 patients with diarrhoea and depressive symptoms, which is potentially valuable in ameliorating long COVID‐19 symptoms. Author Summary: Although public attention towards the SARS‐CoV‐2 is decreasing, the emergence of new variants and the lingering aftermath of long COVID, which includes gastrointestinal and psychiatric symptoms, remains adverse effects on public health. Here, a randomized, double‐blind, placebo‐controlled clinical trial enrolling a cohort of 40 COVID‐19 patients with mild‐moderate symptoms was performed in our study. Our research revealed that fecal microbiota transplantation (FMT) led to alleviation in both diarrhea and depression symptoms among COVID‐19 patients. Additionally, the serum concentration of AST/ALT ratio, a biomarker for predicting long COVID‐19, showed a significant reduction following fecal microbiota transplantation. In conclusion, our research introduces an innovative treatment for COVID‐19 patients experiencing diarrhea and depressive symptoms, while is potentially valuable in ameliorating long COVID‐19 symptoms. [ABSTRACT FROM AUTHOR]

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Cholera, as an endemic disease around the world, has imposed great harmful effects on human health. In addition, from a microscopic viewpoint, the interference of random factors exists in the process of virus replication. However, there are few theoretical studies of viral infection models with biologically reasonable stochastic effects. This paper studied a stochastic cholera model used to describe transmission dynamics in China. In this paper, we adopted a special method to simulate the effect of environmental perturbations to the system instead of using linear functions of white noise, i.e., the transmission rate of environment to human was satisfied Ornstein-Uhlenbeck processes, which is a more practical and interesting. First, it was theoretically proved that the solution to the stochastic model is unique and global, with an ergodic stationary distribution. Moreover, by solving the corresponding Fokker-Planck equation and using our developed algebraic equation theory, we obtain the exact expression of probability density function around the quasi-equilibrium of the stochastic model. Finally, several numerical simulations are provided to confirm our analytical results. [ABSTRACT FROM AUTHOR]

Background: In countries where malaria is endemic, the use of rapid diagnostic tests(RDTs) has become routine, especially in rural settings. Such regions are characterised by often having other co-endemic infectious diseases, at high levels of prevalence. Aim: To illustrate the potential added-value of "sentinel" screening for patients presenting for a routine diagnostic test for malaria, at healthcare facilities in Uganda. Methods: We developed an economic model by combining two decision trees, one for malaria and a second for the co-endemic disease schistosomiasis. The integrated model was designed to inform policy strategies for the co-endemic disease in addition to malaria (i.e., whether to test opportunistically for schistosomiasis or use mass drug administration(MDA) as per usual practice).We performed the analysis on three comparators varying testing accuracy and costs. Results: Sentinel screening can provide added value to the testing of patients compared with the status quo: when schistosomiasis prevalence is high then MDA is preferential; if low prevalence, treating no one is preferred. If the disease has average levels of prevalence, then a strategy involving testing is preferred. Prevalence thresholds driving the dominant strategy are dependent upon the model parameters, which are highly context specific. At average levels of prevalence for schistosomiasis and malaria for Uganda, adding a sentinel screening was cost-effective when the accuracy of test was higher than current diagnostics and when economies of scope were generated(Expected value clinical Information = 0.65$ per DALY averted, 137.91$ per correct diagnoses).Protocols using diagnostics with current accuracy levels were preferred only for levels of MDA coverage below 75%. Conclusion: The importance of the epidemiological setting is crucial in determining the best cost-effective strategy for detecting endemic disease. Economies of scope can make sentinel screenings cost-effective strategies in specific contexts. Blanket thresholds recommended for MDA may not always be the preferred option for endemic diseases. Author summary: Malaria tests are commonly the default assessment when febrile patients arrive at clinics in low- and middle-income countries. This is due to the high prevalence of the disease coupled with the increased reliability and affordability of rapid diagnostic tests. While malaria and other prevalent diseases have received great attention in terms of international investments and local efforts over the years, other endemic diseases do not receive the same consideration in terms of testing capacity and, consequently, correct treatment. This study aims to provide a model to inform policymakers on the costs and benefits of carrying out an opportunistic screening for one (or potentially more) of these neglected tropical diseases (NTD), performed at the same time as a malaria diagnosis for febrile patients presenting at clinics. To achieve this, we developed a model to evaluate different healthcare protocols detecting malaria and schistosomiasis simultaneously, with input values referring to Uganda, as a case study. Schistosomiasis is an NTD and the main treatment strategy in endemic populations is mass drug administration (MDA). This study shows the added value of sentinel screening during a malaria diagnosis varying the level of prevalence of both malaria and schistosomiasis. [ABSTRACT FROM AUTHOR]

Malaria is a fever condition that results from Plasmodium parasites, which are transferred to humans by the attacks of infected female Anopheles mosquitos. The deterministic compartmental model was examined using stability theory of differential equations. The reproduction number was obtained to be asymptotically stable conditions for the disease-free, and the endemic equilibria were determined. More so, the qualitatively evaluated model incorporates time-dependent variable controls which was aimed at reducing the proliferation of malaria disease. The reproduction number R o was determined to be an asymptotically stable condition for disease free and endemic equilibria. In this paper, we used various schemes such as Runge–Kutta order 4 (RK-4) and non-standard finite difference (NSFD). All of the schemes produce different results, but the most appropriate scheme is NSFD. This is true for all step sizes. Various criteria are used in the NSFD scheme to assess the local and global stability of disease-free and endemic equilibrium points. The Routh–Hurwitz condition is used to validate the local stability and Lyapunov stability theorem is used to prove the global asymptotic stability. Global asymptotic stability is proven for the disease-free equilibrium when R 0 ≤ 1 . The endemic equilibrium is investigated for stability when R 0 ≥ 1 . All of the aforementioned schemes and their effects are also numerically demonstrated. The comparative analysis demonstrates that NSFD is superior in every way for the analysis of deterministic epidemic models. The theoretical effects and numerical simulations provided in this text may be used to predict the spread of infectious diseases. [ABSTRACT FROM AUTHOR]

Background: Plasmodium vivax is the main causative agent of malaria in Panama. However, the prevalence of asymptomatic infections in the different endemic regions remains unknown. Understanding the epidemiological behavior of asymptomatic infections is essential for the elimination of malaria. This study aimed to determine the prevalence of asymptomatic malarial infections in one of the main endemic regions of Panama using multiplex real-time reverse transcription RT-MqPCR. Methods: A cross-sectional study was conducted in three communities in the Guna Yala Comarca. A total of 551 thick blood smears and their respective samples on filter paper were collected from volunteers of different ages and sexes from June 20 to 25, 2016. Infections by the Plasmodium spp. were diagnosed using microscopy and RT-MqPCR. All statistical analyses were performed using the R software. Results: The average prevalence of asymptomatic infections by P. vivax in the three communities detected by RT-MqPCR was 9.3%, with Ukupa having the highest prevalence (13.4%), followed by Aidirgandi (11.1%) and Irgandi (3.3%). A total of 74 samples were diagnosed as asymptomatic infections using RT-MqPCR. Light microscopy (LM) detected that 17.6% (13/74) of the asymptomatic samples and 82.4% (61/74) were diagnosed as false negatives. A 100% correlation was observed between samples diagnosed using LM and RT-MqPCR. A total of 52.7% (39/74) of the asymptomatic patients were female and 85.1% (63/74) were registered between the ages of 1 and 21 years. Factors associated with asymptomatic infection were community (aOR = 0.38 (95% CI 0.17–0.83), p < 0.001) and age aOR = 0.98 (95% CI 0.97–1.00), p < 0.05); F = 5.38; p < 0.05). Conclusions: This study provides novel evidence of the considerable prevalence of asymptomatic P. vivax infections in the endemic region of Kuna Yala, representing a new challenge that requires immediate attention from the National Malaria Program. The results of this study provide essential information for the health authorities responsible for developing new policies. Furthermore, it will allow program administrators to reorient and design effective malaria control strategies that consider asymptomatic infections as a fundamental part of malaria control and move towards fulfilling their commitment to eliminate it. [ABSTRACT FROM AUTHOR]

Background: Dengue infection is a mosquito-borne, endemic viral disease, particularly in developing countries. Here, we report the results of the clinicodemographic, serologic profile and the monthly occurrence of a recent dengue fever outbreak in Puntland State (Somalia). Methodology: We analyzed the data of 956 dengue-suspected patients who were investigated using the rapid diagnostic testing (RDT) method for detecting NS1 (dengue virus non-structural protein) and IgM antibodies employing the SD Biosensor Dengue Dou NS Ag and IgM test kit (Germany) at the Puntland Public Health Referral Laboratory from November 21, 2022, to May 27, 2023. Results: We found that 118 cases were positive for dengue among the suspected patients enrolled in the present study. Of these cases, 76.2% were dengue NSI positive, 13.6% were dengue IgM positive, and 10.2% were both NSI and IgM positive. The number of females and males in the confirmed cases was equal, and most (48.3%) were aged 20 years or less. 43.1% of them lived in the Nugal region, particularly in Garowe. Clinically, fever was the most frequent symptom (88.9%). The cases peaked in December 2022 but dropped from January to March, with a slight rise in February, and then increased in April and May 2023. Conclusion: This study highlights the clinicodemographic characteristics, seroprevalence, and monthly occurrence of dengue in Puntland. We recommend improving vector control measures, enhancing case management, strengthening dengue surveillance, developing an early warning system, and conducting future studies to characterize the circulating strains. [ABSTRACT FROM AUTHOR]

Retrospective cohort studies in Cameroon found an association between Onchocerca volvulus microfilarial load in childhood (measured in 1991–1993) and risk of developing epilepsy later in life (measured in 2017). We parameterised and integrated this relationship (across children aged 3–15 years) into the previously published, stochastic transmission model, EPIONCHO-IBM, for Simulium damnosum sensu lato-transmitted onchocerciasis. We simulated 19 years (1998–2017) of annual ivermectin mass drug administration (MDA) reflecting coverage in the study area, and modelled epilepsy prevalence and incidence. Scenario-based simulations of 25 years of (annual and biannual) MDA in hyper- and holoendemic settings, with 65% and 80% therapeutic coverage, were also conducted. EPIONCHO-IBM predicted 7.6% epilepsy prevalence (compared to 8.2% in the Cameroon study) and incidence of 317 cases/100,000 person-years (compared to 350). In hyperendemic areas, 25 years of biannual MDA (80% coverage) eliminated onchocerciasis-associated epilepsy (OAE) and protected untreated under-fives from its development. Strengthening onchocerciasis programmes, implementing alternative strategies, and evaluating treatment for under-fives and school-age children are crucial to prevent OAE in highly-endemic settings. Onchocerciasis is a vector-borne disease endemic to parts of sub-Saharan Africa and associated with substantial morbidity including reports of onchocerciasis-associated epilepsy. Here, the authors use mathematical modelling to assess the impact of community-directed treatment with ivermectin on onchocerciasis-associated epilepsy. [ABSTRACT FROM AUTHOR]

Background: Paracoccidioidomycosis (PCM) is a systemic endemic fungal disease prevalent in Latin America. Previous studies revealed that host immunity against PCM is tightly regulated by several suppressive mechanisms mediated by tolerogenic plasmacytoid dendritic cells, the enzyme 2,3 indoleamine dioxygenase (IDO-1), regulatory T-cells (Tregs), and through the recruitment and activation of myeloid-derived suppressor cells (MDSCs). We have recently shown that Dectin-1, TLR2, and TLR4 signaling influence the IDO-1-mediated suppression caused by MDSCs. However, the contribution of these receptors in the production of important immunosuppressive molecules used by MDSCs has not yet been explored in pulmonary PCM. Methods: We evaluated the expression of PD-L1, IL-10, as well as nitrotyrosine by MDSCs after anti-Dectin-1, anti-TLR2, and anti-TLR4 antibody treatment followed by P. brasiliensis yeasts challenge in vitro. We also investigated the influence of PD-L1, IL-10, and nitrotyrosine in the suppressive activity of lung-infiltrating MDSCs of C57BL/6-WT, Dectin-1KO, TLR2KO, and TLR4KO mice after in vivo fungal infection. The suppressive activity of MDSCs was evaluated in cocultures of isolated MDSCs with activated T-cells. Results: A reduced expression of IL-10 and nitrotyrosine was observed after in vitro anti-Dectin-1 treatment of MDSCs challenged with fungal cells. This finding was further confirmed in vitro and in vivo by using Dectin-1KO mice. Furthermore, MDSCs derived from Dectin-1KO mice showed a significantly reduced immunosuppressive activity on the proliferation of CD4+ and CD8+ T lymphocytes. Blocking of TLR2 and TLR4 by mAbs and using MDSCs from TLR2KO and TLR4KO mice also reduced the production of suppressive molecules induced by fungal challenge. In vitro, MDSCs from TLR4KO mice presented a reduced suppressive capacity over the proliferation of CD4+ T-cells. Conclusion: We showed that the pathogen recognition receptors (PRRs) Dectin-1, TLR2, and TLR4 contribute to the suppressive activity of MDSCs by inducing the expression of several immunosuppressive molecules such as PD-L1, IL-10, and nitrotyrosine. This is the first demonstration of a complex network of PRRs signaling in the induction of several suppressive molecules by MDSCs and its contribution to the immunosuppressive mechanisms that control immunity and severity of pulmonary PCM. [ABSTRACT FROM AUTHOR]

Malaria, transmitted through the bite of a Plasmodium-infected Anopheles mosquito, remains a significant global health concern. This review examines the complex life cycle of Plasmodium, emphasizing the role of humans and mosquitoes in its transmission and proliferation. Malarial parasites are transmitted as sporozoites to the human body by biting an infected female Anopheles mosquito. These sporozoites then invade liver cells, multiply, and release merozoites, which infect red blood cells, perpetuating the cycle. As this cycle continues, the affected person starts experiencing the clinical symptoms of the disease. The current treatments for malaria, including chloroquine, artemisininbased combination therapy, and quinine, are discussed alongside the challenges of drug resistance and misdiagnosis. Although efforts have been made to develop a malarial vaccine, they have so far been unsuccessful. Additionally, the review explores the potential of medicinal plants as remedies for malaria, highlighting the efficacy of compounds derived from Artemisia annua, Cinchona species, and Helianthus annuus L., as well as exploration of plants and phytocompounds like cryptolepine, and isoliquiritigenin against drug-resistant Plasmodium species. Moreover, studies from Pakistan further highlight the diverse vegetal resources utilized in malaria treatment, emphasizing the need for further research into natural remedies. Despite the advantages of herbal medicines, including costeffectiveness, and fewer side effects; their limitations must be taken into account, including variations in potency and potential drug interactions. The review concludes by advocating for a balanced approach to malaria treatment and prevention, emphasizing the importance of early detection, accurate diagnosis, and integrated efforts to combat the disease in the endemic regions. [ABSTRACT FROM AUTHOR]

Regardless of microbial virulence (i.e., the global infection-fatality ratio), age generally drives the prevalence of death from infection in unvaccinated humans. Four mortality patterns are recognized: the common U- and L-shaped curves of endemic infections and the unique W- and J-shaped curves of pandemic infections. We suggest that these patterns result from different sets of human genetic and immunological determinants. In this model, it is the interplay between (1) monogenic genotypes affecting immunity to primary infection that preferentially manifest early in life and related genotypes or their phenocopies, including auto-antibodies, which manifest later in life and (2) the occurrence and persistence of adaptive, acquired immunity to primary or cross-reactive infections, which shapes the age-dependent pattern of human deaths from infection. We suggest that the U, L, W, and J age-dependent patterns of death from infection result from the interplay between (1) genotypes affecting immunity to primary infection, related genotypes, or their phenocopies later in life and (2) the occurrence and persistence of adaptive, acquired immunity to primary or cross-reactive infections. [ABSTRACT FROM AUTHOR]

African Swine Fever (ASF) is a reportable disease of swine that causes farreaching losses to affected countries and regions. Early detection is critically important to contain and mitigate the impact of ASF outbreaks, for which timely available data is essential. This research examines the potential use of Google Trends data as an early indicator of ASF outbreaks in Southeast Asia, focusing on the three largest swine producing countries, namely, Vietnam, the Philippines, and Thailand. Cross-correlation and Kullback-Leibler (KL) divergence indicators were used to evaluate the association between Google search trends and the number of ASF outbreaks reported. Our analysis indicate strong and moderate correlations between Google search trends and number of ASF outbreaks reported in Vietnam and the Philippines, respectively. In contrast, Thailand, the country of this group in which outbreaks were reported last, exhibits the weakest correlation (KL = 2.64), highlighting variations in public awareness and disease dynamics. These findings suggest that Google search trends are valuable for early detection of ASF. As the disease becomes endemic, integrating trends with other epidemiological data may support the design and implementation of surveillance strategies for transboundary animal diseases in Southeast Asia. [ABSTRACT FROM AUTHOR]

The human immunodeficiency virus (HIV) is an infection that mainly impacts CD4+ T cells inside the immune system, causing a gradual decline in immunological function. If untreated, this can lead to acquired immunodeficiency syndrome (AIDS), a disorder in which the body becomes extremely susceptible to opportunistic infections due to a severely compromised immune system. This paper presents a rigorous analysis of a mathematical model that describes the dynamics of HIV infectious disease transmission. There are some key outputs of the study presented. First, we derive the basic reproduction number (R0) which determines the threshold for disease persistence. Then, we analyze the stability of the disease-free and endemic equilibria. After that, we perform a sensitivity analysis to identify the key parameters that influence the dynamics of the system. The basic reproduction number (R0) is calculated using the next generation matrix approach. The stability of the disease-free and endemic equilibria is investigated to understand the long-term behavior of the model. A sensitivity analysis is conducted to determine which model parameters have the greatest impact on the spread of HIV. The model includes a class of nonlinear ordinary differential equations, and has both infection-free and endemic infection equilibrium points. The elasticity of R0 related to the model parameters is determined, and the local sensitivities between the model variables and parameters are numerically evaluated using non-normalization, half-normalization, and full-normalization techniques. The numerical results show that there are different sensitivities between model compartments and model parameters. The findings offer valuable insights for designing effective control strategies and optimizing interventions aimed at curbing the spread of HIV. [ABSTRACT FROM AUTHOR]

Typhus is a disease common to both humans and animals, transmitted by lice, ticks, or rats. The tick variant of this disease is more prevalent in colder regions such as Azerbaijan, where unsanitary living conditions and a local abundance of ticks may exist. Historically, typhus appeared in Azerbaijan as both a local and an epidemic disease, causing numerous casualties. During the Qajar period, no measures were taken to combat it, and typhus was somewhat managed as an endemic and local disease, with casualties kept to a minimum. However, with the onset of World War I on July 28, 1914, the typhus epidemic escalated due to a lack of sanitation and cleaning materials in the province of Azerbaijan, eventually. It became widespread in March 1917 alongside the triple threats of famine, cholera, and the Spanish flu. It left many casualties at the end of World War I in 1918. In this article, we will first state the global history of typhus and then delve into the history of endemic and local typhus in Azerbaijan during the Qajar period (1796-1925). Finally, we will explore the role of the typhus epidemic during World War I. We will analyze this in conjunction with other factors such as cholera, spatial influenza, severe famine, malnutrition, and food poverty, which played a significant role in the severity of the disease’s spread and the resulting fatalities among Iranians in Azerbaijan. [ABSTRACT FROM AUTHOR]

Tuberculosis is an infectious disease that involves any organ. However, the primary pituitary tuberculosis is an extremely rare disease. Intracranial tuberculomas account for 0.15-5% of intracranial space-occupying lesions, of which, pituitary as the primary site is unusual, and easily misdiagnosed as pituitary adenoma. In this setting, the late diagnosis can result in permanent endocrine dysfunction. We report the case of a 28-year-old woman who presented to the endocrinology department with complaints of progressively increasing headache for 1 month and double vision. On the clinical examination, the patient was conscious and oriented. The routine hematological and biochemical workup showed an increased erythrocyte sedimentation rate (ESR) and increased prolactin levels. MRI of Brain reveals Pituitary macroadenoma with impingement upon the optic chaisma, no other significant abnormality is detected in the brain. No other radiological and/or clinical clue that could elicit the suspicion of pulmonary or extrapulmonary lesions of tuberculosis was found. The Endoscopic Transnasal Transphenoidal Surgery was done. The histopathological examination of multiple irregular tissue from excised tumor was Granulomatous inflammation and the final diagnosis of pituitary tuberculoma was made. We report this rare case of pituitary lesion that may be included in the differential diagnosis of sellar lesions to avoid unnecessary surgical interventions, especially in regions where the disease is endemic. [ABSTRACT FROM AUTHOR]

Hantavirus and dengue virus infections lead to diseases causing economic and public health concerns. Acute hantavirus infections can lead to similar clinical haemorrhagic signs as other endemic diseases including dengue and leptospirosis. Using a retrospective case analysis of pregnant dengue and hantavirus disease patients with clinical reports and compatible clinical laboratory information during pregnancy, we report the first evidence of dengue and hantavirus infections and a case of dual dengue and hantavirus infection among pregnant women in the Caribbean. Laboratory testing by enzyme-linked immunosorbent assay (ELISA) and non-structural protein 1 (NS1) for DENV and for hantavirus infection pseudotype focus reduction neutralisation tests (pFRNT), ELISA and immunochromatographic (ICG) strips. Four pregnant cases with acute DENV infections were identified; however, only one out of the four cases (25%) had a detailed medical record to permit abstraction of clinical data. Six hantavirus infected pregnant cases were identified with gestation periods ranged from 36 to 39 weeks; none of the reported patients exhibited previous pregnancy complications prior to hospitalisation and infection. Acute liver damage was observed in three of the six cases (AST readings) who were subsequently diagnosed with hepatitis in pregnancy and variable clinical outcomes were observed with term and pre-term deliveries. Whilst hantavirus infection in pregnancy is rare, consideration should be given to differential diagnosis with fever, kidney involvement, liver involvement, haemorrhagic symptoms and thrombocytopenia in endemic areas with clinically similar diseases such as dengue and leptospirosis. First recorded case of hantavirus and dengue co-infection in a pregnant woman. First detailed report of clinical hantavirus infection in pregnant women in the Caribbean. First published report of clinical dengue infection in pregnant woman in the Caribbean. Possible complications of pregnancy following hantavirus infection. Pre-term birth and low birth weights. Clinical course of hantavirus infection in a Caribbean population. [ABSTRACT FROM AUTHOR]

Simple Summary: Chagas disease is endemic to the state of Texas in the United States but does not have consistent surveillance or reporting. We utilized multiple sampling sites and different species of triatomine to gain data on the blood meal sources found by DNA testing for the host and vector species identities. From domestic, peridomestic, and rural sites, we found a breadth of blood meal origins including mammals, chickens, and reptiles. Unique non-native taxa utilized for blood meals enabled us to also report on extensive foraging distances for the vectors. Understanding the diversity of blood meal sources and the distances the vectors travel between meals and daytime refuges are both important aspects for understanding the spread of this disease. The prevalence of Trypanosoma cruzi was assessed in 117 triatomine insects from central Texas. The qPCR-based results revealed T. cruzi in 59% of the insects (62 adults and eight nymphs), with overall prevalences of T. cruzi of 0% (0/9), 64% (11/17), 58% (10/17), 73% (30/41), and 57% (19/33) for the Bastrop, Caldwell, Gonzales, Guadalupe, and Hays counties, respectively. Analyses of 18S rRNA fragments confirmed T. cuzi in 81% of these samples. Vectors were identified as Triatoma gerstaeckeri (35% of which 65% were positive for T. cruzi), T. sanguisuga (21%, 43% positive), and Paratriatoma leticularia (0.3%, 100% positive). Food sources were recovered from 29% of the insects. Raccoons were 53% of the blood meals (83% positive for T. cruzi), while the remainder came from a variety of sources, including humans (33% positive), house geckos, Eastern woodrats, plain-bellied water snakes (50% positive), hispid cotton rats (0% positive), chickens (100% positive); Asian forest turtles, bison, and pigs (0% positive). The serendipitous detection of blood meal sources at known minimum distances from the collection of the vector insect enabled us to provide several instances where the insect foraging distance was greater than 400 m. These vector foraging distances are novel information that can assist in our understanding of the landscape dynamics for the spread of the pathogen. [ABSTRACT FROM AUTHOR]

Mpox (monkeypox) is a neglected tropical disease that has received increased attention since the multi-nation outbreak that began in 2022. The virus is endemic in West and Central Africa, where the Democratic Republic of the Congo (DRC) is the most affected country. Clade I monkeypox virus (MPXV) infection is endemic in the DRC and has an overall case fatality rate of 10.6% among children and adults. A study conducted in Sankuru Province, DRC, from 2007 to 2011 demonstrated that 75% of pregnant women with mpox had miscarriages or stillbirth. Further analysis of a stillborn fetus showed that MPXV could infect both the placenta and fetus, causing congenital infection. No additional cases of Clade I MPXV in pregnant women were reported until a new outbreak occurred in South Kivu Province during 2023 and 2024. Eight pregnant women having Clade I MPXV infection were identified, of whom four had either miscarriages or stillbirth, representing a 50% fetal mortality rate. These reports confirm previous data from the DRC that indicate the capability of Clade I MPXV to affect the fetus, causing congenital infection and fetal loss in a high percentage of cases. In this article, we review both past and new data from the DRC on the effects of Clade I MPXV during pregnancy and discuss the association of mpox with fetal loss. [ABSTRACT FROM AUTHOR]

Rift Valley fever (RVF) is a mosquito-borne zoonotic viral disease endemic to Africa and the Middle East. Live-attenuated RVF vaccines have been studied for both veterinary and human use due to their strong immunogenicity and cost-effective manufacturing. The live-attenuated MP-12 vaccine has been conditionally approved for veterinary use in the U.S.A., and next-generation live-attenuated RVF vaccine candidates are being actively researched. Assessing the virulence phenotype of vaccine seeds or lots is crucial for managing vaccine safety. Previously, preweaning 19-day-old outbred CD1 mice have been used to evaluate the MP-12 strain. This study aimed to characterize the relative virulence of three live-attenuated RVF vaccine strains in 19-day-old inbred C57BL/6 mice: the recombinant MP-12 (rMP-12), the RVax-1, and the ∆NSs-∆NSm-rZH501 strains. Although this mouse model did not show dose-dependent pathogenesis, mice that succumbed to the infection exhibited distinct brain pathology. Mice infected with ∆NSs-∆NSm-rZH501 showed an infiltration of inflammatory cells associated with infected neurons, and focal lesions formed around virus-infected cells. In contrast, mice infected with rMP-12 or RVax-1 showed a minimal association of inflammatory cells in the brain, yet the virus spread diffusely. The preweaning model is likely useful for evaluating host responses to attenuated RVFV strains, although further refinement may be necessary to quantitate the virulence among different RVFV strains or vaccine lots. [ABSTRACT FROM AUTHOR]

The current investigation examines the numerical performance of the fractional-order endemic disease model based on the direct spreading of cholera by applying the neuro-computing Bayesian regularization (BR) neural network process. The purpose is to present the numerical solutions of the fractional-order model, which provides more precise solutions as compared to the integer-order one. Real values based on the parameters can be obtained and one can achieve better results by utilizing these values. The mathematical form of the fractional direct spreading cholera disease is categorized as susceptible, infected, treatment, and recovered, which represents a nonlinear model. The construction of the dataset is performed through the implicit Runge–Kutta method, which is used to lessen the mean square error by taking 74% of the data for training, while 8% is used for both validation and testing. Twenty-two neurons and the log-sigmoid fitness function in the hidden layer are used in the stochastic neural network process. The optimization of BR is performed in order to solve the direct spreading cholera disease problem. The accuracy of the stochastic process is authenticated through the valuation of the outputs, whereas the negligible calculated absolute error values demonstrate the approach's correctness. Furthermore, the statistical operator performance establishes the reliability of the proposed scheme. [ABSTRACT FROM AUTHOR]

Simple Summary: Dengue is an endemic disease in Sri Lanka causing frequent cyclical epidemics. Aedes albopictus is a dengue vector mosquito which is widely spread in many parts of the country. The Sterile Insect Technique (SIT) is a novel dengue vector control approach to be integrated with the currently available vector control methods. A series of Mark–Release–Recapture (MRR) experiments were conducted in Sri Lanka against Ae. albopictus using gamma-ray-sterilized males to evaluate the field performance of the sterilized males and estimate the wild mosquito population size to be used for future SIT trials. Results obtained from this study can be used for planning future pilot field trials in Sri Lanka. Dengue is an important mosquito-borne disease in Sri Lanka. The Sterile Insect Technique (SIT) is an environment-friendly and novel method that can suppress dengue vector mosquitoes in Sri Lanka. This study aimed to evaluate the field performance of sterile males and the density of wild male Aedes albopictus (Skuse) using a Mark–Release–Recapture (MRR) assay. Laboratory-colonized male pupae were exposed to 50 Gy gamma using a Co60 source. Sterile males (approx. 10,000) marked with fluorescent dust were released weekly for 4 consecutive weeks (January–February 2021) in a geographically isolated 30 ha site in Gampaha. Results show sterile males could disperse up to 543.8 m with a mean distance of 255.1 ± 44.6 m and survive up to 6 days with a mean life expectancy of 3.55 ± 2.32 days. A high field mating competitiveness of sterile males based on a Fried value of 0.47 ± 0.007 and significant induced sterility in the wild eggs in the second generation were found. The mean wild male mosquito population density was 163 males/ha. The data generated will be useful for designing future trials in Sri Lanka and other countries with similar situations. [ABSTRACT FROM AUTHOR]

At 3 severe infection cohort sites in Uganda, Orientia seropositivity was common. We identified 4 seroconversion cases and 1 PCR-positive case. These results provide serologic and molecular support for Orientia spp. circulating in sub-Saharan Africa, possibly expanding its endemic range. Orientia infections could cause severe illness and hospitalizations in this region. [ABSTRACT FROM AUTHOR]

The impact of co-infections with Theileria ovis and Anaplasma ovis on caprine health is very limited knowledge and is rarely documented in the literature. Türkiye is endemic for tick-borne diseases (TBDs), posing a risk of co-infections in goats. To evaluate the impact of single and co-infection with T. ovis and A. ovis on caprine health, four groups of goats were examined: healthy goats, goats infected with T. ovis, goats infected with A. ovis and goats co-infected with both species. Sera from blood samples was tested for oxidant/antioxidant markers [malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST)], cytokines [interleukins (IL)-6, IL-1, tumor necrosis factor-α (TNF-α)], DNA damage [8- hydroxy-2'-deoxyguanosine (8-OHdG)] and trace minerals [(copper (Cu), zinc (Zn), manganese (Mn), selenium (Se)]. MDA, 8-OHdG, TNF-α, IL-1 and IL-6 levels, CAT and GST enzyme activities were found to be significantly increased in both Theileria ovis and Anaplasma ovis single- and co-infections (P<0.05). In goats, single and co-infected with A. ovis showed a statistically significant increase in SOD enzyme activity compared to goats infected only with T. ovis (P<0.05). In goats co-infected with A. ovis and T. ovis, considerable decrease in GPx enzyme activity were observed (P<0.05). Zn and Se levels in single infected with A. ovis indicated a significant decrease. Also, Cu, Zn, and Se levels in co-infected animals decreased significantly (P<0.05). Significant increase in lipid peroxidation and antioxidant enzyme activity in goats with single and double infections indicates impaired erythrocyte membrane integrity due to oxidative stress. Moreover, increased proinflammatory cytokine concentrations in all groups indicate that a high degree of systemic inflammation is induced during parasitaemia. [ABSTRACT FROM AUTHOR]

Dengue fever is a viral disease that results in numerous fatalities and considerable financial burden. Although vaccines have been developed to treat it, some countries still have endemic cases of the disease. To manage the transmission of the disease in these areas, we create a new model that includes an alert compartment to analyze the dynamics of dengue using a fractional‐order approach. We conduct a qualitative analysis of the model and use the Pontryagin principle to develop and study an optimal control problem. Since there is no definitive treatment for dengue, it is essential to prioritize measures that control or prevent the transmission of the disease. We consider control measures, including prevention efforts, insecticides, educational campaigns, and treatment for humans. We can analyze their impact on the transmission dynamics through numerical simulations. We compare our model to an existing one in two ways: with alert and without alert. We analyze the memory effect and validate the results by interpreting parameters on the reproduction number. Our results indicate that individual control measures are insufficient to eliminate the disease, and a combination of all control measures with timely alerts to the population is necessary. [ABSTRACT FROM AUTHOR]

With the gradual emphasis on health by people, the research on the pathogenesis of endemic diseases has become increasingly in-depth. Through analyzing the environmental selenium characteristics and conducting a comparative study in typical areas of Chinese loess and black soil in this paper, it is concluded that the environmental selenium in the two regions has different characteristics. The soil in the loess area has the characteristics of high alkalinity, low selenium, and relatively high selenium availability, and the crops are selenium-deficient, while the soil in the black soil area has the characteristics of high organic matter, low selenium availability, and relatively high selenium in crops. The research concluded that the environmental occurrence mechanism of Keshan disease in the loess area and the black soil area is different. Keshan disease can be induced in both low-selenium and sufficient-selenium environments, and environmental selenium should be one of the inducing factors of Keshan disease. This research provides a reference for predicting the areas where Keshan disease occurs and for disease prevention, and it can also serve in the prevention and control of endemic diseases. [ABSTRACT FROM AUTHOR]

Background Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. Methods Twenty years (2001–2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). Results Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0–4 y (28.7%) and 20–39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001–2010), cases were concentrated in the Metropolitan region, and in the second decade (2011–2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. Conclusions Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion. [ABSTRACT FROM AUTHOR]

Simple Summary: Brucellosis is a disease that is commonly found in Turkey among both humans and animals. It causes significant economic losses in the livestock industry and is of great public health concern. This study focused on analyzing the genetic makeup of Brucella isolates from Turkey using a core-genome single-nucleotide polymorphism (cgSNP) analysis. This analysis showed potential links between the Turkish isolates and those from neighboring countries and other parts of the world. This highlights the importance of implementing strict measures to control the spread of brucellosis throughout the country. Brucellosis is a disease caused by the Brucella (B.) species. It is a zoonotic disease that affects farm animals and causes economic losses in many countries worldwide. Brucella has the ability to persist in the environment and infect the host at low doses. Thus, it is more important to trace brucellosis outbreaks, identify their sources of infection, and interrupt their transmission. Some countries already have initial data, but most of these data are based on a Multiple-Locus Variable-Number Tandem-Repeat Analysis (MLVA), which is completely unsuitable for studying the Brucella genome. Since brucellosis is an endemic disease in Turkey, this study aimed to examine the genome of Turkish Brucella isolates collected between 2018 and 2020, except for one isolate, which was from 2012. A total of 28 strains of B. melitensis (n = 15) and B. abortus (n = 13) were analyzed using a core-genome single-nucleotide polymorphism (cgSNP) analysis. A potential connection between the Turkish isolates and entries from Sweden, Israel, Syria, Austria, and India for B. melitensis was detected. For B. abortus, there may be potential associations with entries from China. This explains the tight ties found between Brucella strains from neighboring countries and isolates from Turkey. Therefore, it is recommended that strict measures be taken and the possible effects of uncontrolled animal introduction are emphasized. [ABSTRACT FROM AUTHOR]

To assess the temporal and spatial dynamics of chikungunya incidence and its association with social vulnerability indicators in Brazil, an ecological and population-based study was conducted herein, with confirmed cases of chikungunya and based on clinical and clinical–epidemiological criteria from 2017 to 2023. Data were obtained from the Notifiable Diseases Information System and social vulnerability indicators were extracted from the official platform of the United Nations Development Program and the Social Vulnerability Atlas. Temporal, spatial, and global spatial regression models were employed. The temporal trend showed that in 2017, the incidence increased by 1.9%, and this trend decreased from 2020 to 2021 (−0.93%). The spatial distribution showed heterogeneity and positive spatial autocorrelation (I: 0.71; p < 0.001) in chikungunya cases in Brazil. Also, the high-risk areas for the disease were concentrated in the northeast and north regions. The social vulnerability indicators associated with the outcome were those related to income, education, and housing conditions. Our analyses demonstrate that chikungunya continues to be a serious health concern in Brazil, but specially in the northeast and north regions. Lastly, mapping risk areas can provide evidence for the development of public health strategies and disease control in endemic regions. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition even in some endemic areas. Schistosomal appendicitis, an incidentally discovered appendicitis associated with schistosomiasis histological findings, affects young males predominantly. Timely diagnosis and treatment, including appendectomy and anti-helminthic therapy, are crucial. Case report: A 24-year-old Sudanese male patient presented with abdominal pain. Diagnosed with acute appendicitis, he underwent appendectomy, revealing appendix inflammation with Schistosoma ova in histopathology. Abdominal ultrasound detected no complications. Weakly positive Schistosoma serology was noted, but stool and urine analysis showed no infection evidence. Prescribed praziquantel, patient had 3-year post-op follow-up without complications. Conclusions: This case report underscores the significance of including schistosomiasis in the differential diagnosis of appendicitis, particularly in regions where the disease is endemic. It underscores the necessity of histopathological evaluations for accurate diagnosis, emphasizing the potential implications for clinical practice in similar settings. [ABSTRACT FROM AUTHOR]