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Abstract Backgrounds The non-indigenous tropical infectious diseases that occur in the non-tropics arise from personnel communication between locals and visitors. Many of these infectious diseases involve oral complications. It is very important for practitioners to manage such cases based on a clear understanding of the association between tropical infectious diseases and oral health. In this study, we summarize the oral complications related to tropical infectious diseases and investigate the understanding of infectious disease practitioners in relation to the association between these conditions. In addition, we provide supportive advice to facilitate the oral management of tropical infectious diseases. Methods First, we investigate the oral complications related to tropical infectious diseases by performing an appropriate literature search. Then, we analyzed the understanding of 207 Chinese practitioners specializing in infectious diseases in relation to the association between these two conditions by applying a bespoke online questionnaire. Results Analysis revealed that the Chinese practitioners had very poor attitudes and knowledge relating to the association between tropical infectious diseases and oral health. Different backgrounds had no significant impact on the understanding of Chinese practitioners with regards to the association between tropical infectious diseases and oral health. Conclusion Many oral complications are related to tropical infectious diseases. The understanding of Chinese practitioners with regards to the association between infectious disease and oral health was very inadequate. It is essential to promote publicity and education relating to infectious tropical diseases and oral health.

This document is an editorial published in the journal Frontiers in Cellular & Infection Microbiology. The editorial discusses the use of stem cell technologies in the study of tropical infectious diseases. The authors highlight the challenges in studying these diseases and the potential of stem cell technologies to overcome these challenges. They provide examples of how stem cell technologies have been applied to the study of malaria and Chagas disease, and they discuss the potential of these technologies in studying other parasites such as Toxoplasma gondii and helminths. The authors emphasize the importance of stem cell-based approaches in understanding and finding new avenues for prevention and treatment of these diseases. [Extracted from the article]

Backgrounds: The non-indigenous tropical infectious diseases that occur in the non-tropics arise from personnel communication between locals and visitors. Many of these infectious diseases involve oral complications. It is very important for practitioners to manage such cases based on a clear understanding of the association between tropical infectious diseases and oral health. In this study, we summarize the oral complications related to tropical infectious diseases and investigate the understanding of infectious disease practitioners in relation to the association between these conditions. In addition, we provide supportive advice to facilitate the oral management of tropical infectious diseases. Methods: First, we investigate the oral complications related to tropical infectious diseases by performing an appropriate literature search. Then, we analyzed the understanding of 207 Chinese practitioners specializing in infectious diseases in relation to the association between these two conditions by applying a bespoke online questionnaire. Results: Analysis revealed that the Chinese practitioners had very poor attitudes and knowledge relating to the association between tropical infectious diseases and oral health. Different backgrounds had no significant impact on the understanding of Chinese practitioners with regards to the association between tropical infectious diseases and oral health. Conclusion: Many oral complications are related to tropical infectious diseases. The understanding of Chinese practitioners with regards to the association between infectious disease and oral health was very inadequate. It is essential to promote publicity and education relating to infectious tropical diseases and oral health. [ABSTRACT FROM AUTHOR]

Abstract Background With the increasing exchange of domestic and international personnel, local infections of tropical infectious diseases are continuing in tropics and imported infections are emerging in non-tropics, some of which are accompanied by oral manifestations. Therefore, it is essential for dental professionals to identify the related oral manifestations, who are working for domestic medical service, international medical assistance, peace-keeping medical service or medical support of international joint military exercises. This study aims to investigate the attitude and knowledge of Chinese dental professionals on tropical infectious diseases and oral health, and to explore the difference between different genders, education backgrounds, professional identities, professional titles and tropics working experience. Methods Network questionnaire was used to evaluate the knowledge and attitude of 236 Chinese dental professionals towards tropical infectious diseases and oral health. Results The scores of the participants on tropical infectious diseases and oral health were quite low. Although working experience in the tropics partially affected the understanding, there was no difference between different genders, education backgrounds, professional identities and professional titles. Conclusion The understanding of dental professionals on tropical infectious diseases and oral health was insufficient. It is necessary to improve the clinical education and management specified with tropical infectious diseases and oral health.

Background: With the increasing exchange of domestic and international personnel, local infections of tropical infectious diseases are continuing in tropics and imported infections are emerging in non-tropics, some of which are accompanied by oral manifestations. Therefore, it is essential for dental professionals to identify the related oral manifestations, who are working for domestic medical service, international medical assistance, peace-keeping medical service or medical support of international joint military exercises. This study aims to investigate the attitude and knowledge of Chinese dental professionals on tropical infectious diseases and oral health, and to explore the difference between different genders, education backgrounds, professional identities, professional titles and tropics working experience. Methods: Network questionnaire was used to evaluate the knowledge and attitude of 236 Chinese dental professionals towards tropical infectious diseases and oral health. Results: The scores of the participants on tropical infectious diseases and oral health were quite low. Although working experience in the tropics partially affected the understanding, there was no difference between different genders, education backgrounds, professional identities and professional titles. Conclusion: The understanding of dental professionals on tropical infectious diseases and oral health was insufficient. It is necessary to improve the clinical education and management specified with tropical infectious diseases and oral health. [ABSTRACT FROM AUTHOR]

The recombinant, modified leucine-rich repeat protein rhKU_Sej_LRR_2271 has been suggested as a candidate for leptospiral vaccine development since it was predicted to be a transmembrane protein containing leucine-rich repeat motifs and immunogenic epitopes. The immunogenic epitopes showed binding affinities with lower IC50 values than peptides of known antigenic proteins, e.g., LipL32. Moreover, this protein was immunoreactive with hyperimmune sera against several serovars. In this study, we aimed to develop a lateral flow strip test using the rhKU_Sej_LRR_2271 protein for the detection of anti-leptospiral IgG in dogs. The lateral flow assay was performed with 184 dog plasma samples and evaluated with a culture method, 16S ribosomal RNA gene (rss) analysis real-time PCR, and LipL32 ELISA. The culture method failed to detect leptospires in the dog blood samples. Six of nine symptomatic dogs gave positive results with the real-time PCR assay. The lateral flow assay and LipL32 ELISA gave positive results with 59 and 50 dogs, respectively. The sensitivity, specificity, and accuracy of the rhKU_Sej_LRR_2271 lateral flow strip test were 70.00, 82.09, and 78.80%, respectively, when compared with LipL32 ELISA. There was a significant association between the LipL32 ELISA and the rhKU_Sej_LRR_2271 lateral flow assay. The rhKU_Sej_LRR_2271 lateral flow strip test has therefore demonstrated a good potential to detect anti-leptospiral IgG in dogs.

Leucine-rich repeat (LRR) proteins are advocated for being assessed in vaccine development. Leptospiral LRR proteins were identified recently in silico from the genome of Leptospira borgpetersenii serogroup Sejroe, the seroprevalence of leptospiral infections of cattle in Thailand. Two LRR recombinant proteins, rKU_Sej_LRR_2012M (2012) and rhKU_Sej_LRR_2271 (2271), containing predicted immunogenic epitopes, were investigated for their cross-protective efficacies in an acute leptospirosis model with heterologous Leptospira serovar Pomona, though, strains from serogroup Sejroe are host-adapted to bovine, leading to chronic disease. Since serovar Pomona is frequently reported as seropositive in cattle, buffaloes, pigs, and dogs in Thailand and causes acute and severe leptospirosis in cattle by incidental infection, the serogroup Sejroe LRR proteins were evaluated for their cross-protective immunity. The protective efficacies were 37.5%, 50.0%, and 75.0% based on the survival rate for the control, 2012, and 2271 groups, respectively. Sera from 2012-immunized hamsters showed weak bactericidal action compared to sera from 2271-immunized hamsters (p < 0.05). Therefore, bacterial tissue clearances, inflammatory responses, and humoral and cell-mediated immune (HMI and CMI) responses were evaluated only in 2271-immunized hamsters challenged with virulent L. interrogans serovar Pomona. The 2271 protein induced prompt humoral immune responses (p < 0.05) and leptospiral tissue clearance, reducing tissue inflammation in immunized hamsters. In addition, protein 2271 and its immunogenic peptides stimulated splenocyte lymphoproliferation and stimulated both HMI and CMI responses by activating Th1 and Th2 cytokine gene expression in vaccinated hamsters. Our data suggest that the immunogenic potential renders rhKU_Sej_LRR_2271 protein a promising candidate for the development of a novel cross-protective vaccine against animal leptospirosis.

Domestic and stray dogs can be frequently infected by Leptospira, and thus may represent a source for transmission of this zoonotic disease in Thailand. Here, we have used peptides derived from a recombinant leucine-rich repeat (LRR) protein of Leptospira, rKU_Sej_LRR_2012M, for the development of an indirect enzyme-linked immunosorbent assay (ELISA) aimed at detecting antibodies against Leptospira interrogans, L. borgpetersenii, and L. biflexa, the three major seroprevalences in Thai dogs. The rKU_Sej_LRR_2012M protein is recognized by hyperimmune sera against several leptospiral serovars. The epitope peptides of the rKU_Sej_LRR_2012M showed binding affinities with lower IC50 values than peptides of known antigenic protein LipL32. Four peptides, 2012-3T, 2012-4B, 2012-5B and pool 2012-B, were specifically recognized by rabbit hyperimmune sera against nine serovars from three Leptospira spp. The indirect peptide-based ELISAs with these four peptides were evaluated with the LipL32 ELISA by using a receiver–operator curve (ROC) analysis. All peptides had an area under the curve of ROC (AUC) greater than 0.8, and the sum of sensitivity and specificity for each peptide was greater than 1.5. The degree of agreement of 2012-3T and pool 2012-B and 2012-4B and 2012-5B peptides were in moderate-to-good levels with kappa values of 0.41–0.60 and 0.61–0.80, when compared with LipL32, respectively. This finding would suggest an excellent capability of the 2012-4B and 2012-5B peptide-based ELISAs assay for the diagnosis of canine leptospiral infections.

Piroplasmic parasites such as Theileria and Babesia commonly infect important livestock animals, leading to economic losses in the livestock industry. These parasites are primarily transmitted by ticks found infesting livestock animals. In Malaysia, livestock diseases caused by tick-borne pathogens are still under-studied, even though tick infestations are common in many livestock farms. Here, we molecularly detect a Theileria sp. from Haemaphysalis bispinosa ticks infesting goats in a privately-owned farm in Perak, peninsular Malaysia. PCR was performed on the DNA extracted from ticks to determine the presence of piroplasms. Three ticks were found PCR-positive for piroplasms. Sequence analyses of partial 18S rRNA gene sequences revealed the presence of a Theileria species at 100% identity to Theileria luwenshuni. Our findings suggest the presence of T. luwenshuni, a highly pathogenic Theileria sp. to sheep and goats, in the small ruminant industry in Malaysia. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) is seen in critically ill patients. Its etiological spectrum in India is expected to be different from that seen in western countries due to the high prevalence of tropical infections. Aim: To study the epidemiological profile of ARDS patients. Setting: A tertiary care hospital in Karnataka, India. Materials and Methods: Retrospective analysis of 150 out of the 169 ARDS patients diagnosed during 2010–2012. Data collected included the clinical features and severity scoring parameters. Results: The mean age of the study population was 42.92 ± 13.91 years. The causes of ARDS included pneumonia (n = 35, 23.3%), scrub typhus (n = 33, 22%), leptospirosis (n = 11, 7.3%), malaria (n = 6, 4%), influenza (H1N1) (n = 10, 6.7%), pulmonary tuberculosis (n = 2, 1.3%), dengue (n = 1, 0.7%), abdominal sepsis (n = 16, 10.7%), skin infection (n = 3, 2%), unknown cause of sepsis (n = 18, 12%), and nonseptic causes (n = 15, 10%). A total of 77 (51.3%) patients survived, 66 (44%) expired, and 7 (4.7%) were discharged against medical advice (AMA). Preexisting comorbidities (46) were present in 13 survivors, 19 nonsurvivors, and four discharged AMA. History of surgery prior to the onset of ARDS was present in one survivor, 13 nonsurvivors, and one discharge AMA. Mean Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Sequential Organ Failure Assessment scores in survivors were 9.06 ± 4.3, 49.22 ± 14, and 6.43 ± 2.5 and in nonsurvivors 21.11 ± 7, 86.45 ± 23.5, and 10.6 ± 10, respectively. Conclusion: The most common cause of ARDS in our study was pneumonia, but a large percentage of cases were due to the tropical infections. Preexisting comorbidity, surgery prior to the onset of ARDS, higher severity scores, and organ failure scores were more frequently observed among nonsurvivors than survivors.

Background. Early prediction of severe dengue could significantly assist patient triage and case management. Methods. We prospectively investigated 7563 children with ≤3 days of fever recruited in the outpatient departments of 6 hospitals in southern Vietnam between 2010 and 2013. The primary endpoint of interest was severe dengue (2009 World Health Organization Guidelines), and predefined risk variables were collected at the time of enrollment to enable prognostic model development. Results. The analysis population comprised 7544 patients, of whom 2060 (27.3%) had laboratory-confirmed dengue; nested among these were 117 (1.5%) severe cases. In the multivariate logistic model, a history of vomiting, lower platelet count, elevated aspartate aminotransferase (AST) level, positivity in the nonstructural protein 1 (NS1) rapid test, and viremia magnitude were all independently associated with severe dengue. The final prognostic model (Early Severe Dengue Identifier [ESDI]) included history of vomiting, platelet count, AST level. and NS1 rapid test status. Conclusions. The ESDI had acceptable performance features (area under the curve = 0.95, sensitivity 87% (95% confidence interval [CI], 80%-92%), specificity 88% (95% CI, 87%-89%), positive predictive value 10% (95% CI, 9%-12%), and negative predictive value of 99% (95% CI, 98%-100%) in the population of all 7563 enrolled children. A score chart, for routine clinical use, was derived from the prognostic model and could improve triage and management of children presenting with fever in dengue-endemic areas. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) is seen in critically ill patients. Its etiological spectrum in India is expected to be different from that seen in western countries due to the high prevalence of tropical infections. Aim: To study the epidemiological profile of ARDS patients. Setting: A tertiary care hospital in Karnataka, India. Materials and Methods: Retrospective analysis of 150 out of the 169 ARDS patients diagnosed during 2010–2012. Data collected included the clinical features and severity scoring parameters. Results: The mean age of the study population was 42.92 ± 13.91 years. The causes of ARDS included pneumonia (n = 35, 23.3%), scrub typhus (n = 33, 22%), leptospirosis (n = 11, 7.3%), malaria (n = 6, 4%), influenza (H1N1) (n = 10, 6.7%), pulmonary tuberculosis (n = 2, 1.3%), dengue (n = 1, 0.7%), abdominal sepsis (n = 16, 10.7%), skin infection (n = 3, 2%), unknown cause of sepsis (n = 18, 12%), and nonseptic causes (n = 15, 10%). A total of 77 (51.3%) patients survived, 66 (44%) expired, and 7 (4.7%) were discharged against medical advice (AMA). Preexisting comorbidities (46) were present in 13 survivors, 19 nonsurvivors, and four discharged AMA. History of surgery prior to the onset of ARDS was present in one survivor, 13 nonsurvivors, and one discharge AMA. Mean Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Sequential Organ Failure Assessment scores in survivors were 9.06 ± 4.3, 49.22 ± 14, and 6.43 ± 2.5 and in nonsurvivors 21.11 ± 7, 86.45 ± 23.5, and 10.6 ± 10, respectively. Conclusion: The most common cause of ARDS in our study was pneumonia, but a large percentage of cases were due to the tropical infections. Preexisting comorbidity, surgery prior to the onset of ARDS, higher severity scores, and organ failure scores were more frequently observed among nonsurvivors than survivors. [ABSTRACT FROM AUTHOR]

The successful management of disseminated Nocardia infection is not well described in medical literature. Immunocompetent individuals presenting with complicated and widespread Nocardia infection is an uncommon phenomenon. We describe an interesting case of a large Nocardia abscess in the brain in an immunocompetent patient that was aspirated. The patient clinically improved and was discharged home on a prolonged course of intravenous antibiotics and close outpatient follow-up. He successfully finished the antibiotic therapy for one year, and repeat imaging studies suggested the resolution of the abscess. With this case, we also intend to do a brief literature analysis about the management of brain abscess caused by Nocardia species., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Anwar et al.)

Tropical infectious diseases (IDs) remain a rare complication in transplant recipients even in tropical settings, but this topic has become increasingly important during the last decade due to multiple factors. Interestingly, non-tropical countries report most of the experiences with tropical diseases. The reported experience from non-endemic regions, however, does not always reflect the experience of endemic areas. Most of the guidelines and recommendations in the literature may not be applicable in tropical settings due to logistical difficulties, cost, and lack of proven benefit. In addition, certain post-transplant prevention measures, as prophylaxis and reducing exposure risk, are not feasible. Nonetheless, risk assessment and post-transplant management of tropical IDs in tropical areas should not be neglected, and clinicians need to have a higher clinical awareness for tropical ID occurring in this population. Herein, we review the more significant tropical ID in transplant patients, focusing on relevant experience reported by tropical settings. [ABSTRACT FROM AUTHOR]

Mumps is an acute viral illness occurring in children and young adults transmitted via droplets. It is a vaccine-preventable illness caused by the mumps virus, an RNA (ribonucleic acid) virus belonging to theParamyxoviridaefamily. It typically presents with fever, parotitis, epididymo-orchitis, oophoritis, meningitis, encephalitis, pancreatitis and arthritis. Although viremia with multiorgan involvement is known to be commonly seen in mumps, there have been no reported cases of splenic abscess in a case of mumps. Here we present the case of a 16-year-old girl with unknown vaccination history who presented with fever, rash, bilateral parotid swelling, myocarditis, pneumonitis with pleural effusion and shock. Enzyme-linked immunosorbent assay (ELISA) for mumps Immunoglobulin M (IgM) antibody was positive (ratio: 7.26, reference: 1.10). She was managed conservatively with parenteral antibiotics, oxygen, inotropic support and bronchodilators. As she complained of abdominal pain in the left hypochondrium on the 13th day since onset of symptoms, ultrasound scan of abdomen was done which showed a hypoechoic lesion with internal echoes in the inferior pole of spleen (2.9 cm x 2.2 cm) suggestive of splenic abscess. Computed tomography (CT) of abdomen confirmed similar findings. The splenic abscess completely regressed with parenteral antibiotics. Therefore, one must suspect splenic abscess in a case of mumps when the presentation includes abdominal pain and tenderness so that appropriate treatment may be provided for the best outcome for the patient., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Muralitharan et al.)

Background and objective Dengue fever (DF) and its complications - dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) - are major public health problems in Southeast Asia. Predicting the development of DHF and DSS using hematological parameters and ultrasonic signs of vascular leakage will help in reducing morbidity and mortality associated with these diseases. Hence, this study aimed to test the association of platelets and packed cell volume (PCV) on day one (D1) of admission with gallbladder wall thickness (GWT) and ascites, which herald the onset of DHF and DSS. Methods The electronic health records of 52 pediatric patients admitted during a mini-outbreak were analyzed to assess platelets and PCV on D1, laboratory and ultrasonography findings, and outcomes. Correlations between D1 hematological parameters and GWT and ascites were tested. Results There was a positive correlation between GWT of more than 5 mm and ascites. However, there was no significant correlation of platelets and PCV on D1 with either GWT or ascites and consequently DHF or DSS. All the patients responded to fluid, blood, and supportive therapy. There were no mortalities. Conclusion Patients who develop GWT after DF are at an increased risk of developing ascites that deteriorate to DHF and DSS. D1 platelets and PCV are not reliable indicators for predicting the progression or worsening of the disease in the pediatric population., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Uthraraj et al.)

Leptospirosis is a zoonotic infection most commonly occurring in tropical regions through contact with water or soil contaminated with animal urine. In New York, approximately one to three cases occur annually, the majority occurring through workplace exposure to animal reservoirs. In cases of the more severe presentation of leptospirosis, Weil's disease, it is important to identify the infection promptly to allow for early antibiotic initiation as well as early initiation of daily dialysis in cases in which it is necessary. We present a case of Weil's disease in a 64-year-old male with presumed exposure through his combined workplace and residential environment. The resolution of symptoms occurred through a combination of hemodialysis, doxycycline, and meropenem antibiotic treatment. We also discuss the barriers to diagnosis, including the non-specific presentation of leptospirosis, the limitation of access to testing centers, and the limitations to antibody testing within the first week of symptom presentation due to low antibody levels., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Shaban et al.)

South and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. In addition to hospital-acquired acute kidney injury in tertiary care centers, these countries face a large preventable burden of community-acquired acute kidney injury secondary to tropical infectious diseases or animal venoms, affecting previously healthy young individuals. This article reviews the epidemiology, clinical picture, prevention, risk factors, and pathophysiology of acute kidney injury associated with tropical diseases (malaria, dengue, leptospirosis, scrub typhus, and yellow fever) and animal venom (snakes, bees, caterpillars, spiders, and scorpions) in tropical regions of Asia and Latin America, and discusses the potential future challenges due to emerging issues., (Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Abstract: The number of transplant recipients with tropical infectious diseases is growing due to increasing international travel and the rising number of transplants taking place in the tropics and subtropics. With increases in population migration, the prevalence of individuals infected with geographically restricted organisms also rises. There are three potential categories of tropical infections in transplant patients: (1) donor-related infections transmitted by the graft or through transfusion of blood products; (2) reactivation or recrudescence of latent infections in the donor recipient; and (3) de novo acquisition of infection in the post-transplant period through the traditional route of infection. We present an overall discussion of the association of parasitic (protozoa and helminths) and non-parasitic (viral, bacterial, and fungal) tropical infectious diseases and solid-organ and hematopoietic transplantation. We also suggest potential screening guidelines for some of these tropical infections. [Copyright &y& Elsevier]