PLoS Neglected Tropical Diseases[JOURNAL]
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200 papers
Clinical and epidemiological characteristics of leptospirosis in patients under and over 5 years of age in primary health centers in the Peruvian Amazon, 2022-2024.
Davila-Philipps SV, Vasquez Hassinger T, Vela-Tello KK … +7 more , Carrasco-Celi JI, Rios-Alava YN, Vasquez-Lechuga JL, Parimango-Alvarez MH, Marin-Lizarraga J, Ramirez-García EA, Zevallos K
PLoS Negl Trop Dis · 2026 Jun · PMID 42348663 · Full text
BACKGROUND: Leptospirosis is an emerging zoonotic disease with high incidence in tropical regions such as the Peruvian Amazon. Although it affects individuals of all ages, knowledge about its clinical and epidemiological...
BACKGROUND: Leptospirosis is an emerging zoonotic disease with high incidence in tropical regions such as the Peruvian Amazon. Although it affects individuals of all ages, knowledge about its clinical and epidemiological profile in children under 5 years remains limited. In this age group, leptospirosis may present with nonspecific manifestations, which may hinder timely recognition in primary care. METHODOLOGY: We conducted a retrospective cross-sectional study using secondary data from medical records and epidemiological forms of MAT-confirmed leptospirosis cases evaluated between 2022 and 2024 at four primary health care centers in Belén, Loreto, Peru. A total of 2,325 patients with clinical suspicion of leptospirosis were evaluated during the study period, of whom 400 MAT-confirmed cases with sufficient information for analysis were included. Comparisons between patients under 5 years and those aged 5 years or older were exploratory. RESULTS: Among the 400 confirmed cases, 28 occurred in children under 5 years. In this age group, the most frequently recorded symptoms were malaise (78.6%) and fever (71.4%). Half of the children under 5 years lived in flood-prone areas, and 46.4% were evaluated within the first 3 days after symptom onset. Compared with older patients, children under 5 years more often showed nonspecific symptom profiles, whereas headaches and chills were less frequently recorded. Nutritional classification and selected symptom patterns also differed between age groups, although these comparisons were exploratory and based on a small pediatric sample. CONCLUSION: In this series of MAT-confirmed leptospirosis cases managed at the primary health care centers, children under 5 years commonly presented with nonspecific symptoms such as malaise and fever. In an endemic Amazonian setting where multiple febrile illnesses coexist, this pattern may hinder early recognition. These findings support the need to strengthen clinical suspicion, diagnostic capacity, and epidemiological surveillance for pediatric leptospirosis in primary care. Further studies with larger pediatric samples are needed to better characterize age-related differences in presentation.
Assessing the sustainability of Rwanda's mass drug administration program for schistosomiasis and soil-transmitted helminthiasis: A mixed-methods application of the program sustainability assessment tool.
Mazimpaka C, Hamer DH, Ruberanziza E … +6 more , Lane KJ, Nshimiyimana L, Mbonigaba JB, Mbituyumuremyi A, Thea DM, Wirtz VJ
PLoS Negl Trop Dis · 2026 Jun · PMID 42348604 · Full text
BACKGROUND: Mass drug administration (MDA) is a key strategy for controlling schistosomiasis and soil-transmitted helminthiasis in low-resource settings. Assessing its long-term sustainability is important for maintainin...
BACKGROUND: Mass drug administration (MDA) is a key strategy for controlling schistosomiasis and soil-transmitted helminthiasis in low-resource settings. Assessing its long-term sustainability is important for maintaining and expanding disease control achievements. This study examined the sustainability capacity of Rwanda's MDA program using the Program Sustainability Assessment Tool (PSAT). METHODOLOGY: A mixed-methods approach was used. Twenty-one key informants, including government officials, donors, and local stakeholders, participated in qualitative interviews, and 16 of them also completed the PSAT quantitative survey. Qualitative data were thematically analyzed, while quantitative findings from the survey were used to calculate domain-specific and overall sustainability scores. FINDINGS: The overall Rwanda MDA program sustainability score was 3.75 out of 5. Partnerships scored the highest at 4.1, with qualitative data emphasizing strong collaboration among government agencies, international organizations, and community stakeholders. Political support and program evaluation both received a score of 3.9, with qualitative data emphasizing good policy alignment, but some issues with data accuracy. Funding stability was the weakest domain, scoring 3.3, and qualitative data highlighted reliance on external donors. Strategic planning scored 3.5, with qualitative data highlighting limited development of long-term financial strategies and the absence of a dedicated sustainability plan. CONCLUSION: This assessment revealed a moderate sustainability capacity for the MDA program, characterized by strong political support, active partnerships, and promising adaptations, including the expansion of treatment coverage to adults. However, dependence on donor funding, staffing shortages, and data management issues continue to pose a risk to the program's sustainability. Improving domestic resource allocation, investing in human resources, and strengthening data systems could enhance the program's capacity for sustainability.
Seasonal dynamic modeling for real-time prediction of human brucellosis epidemiological trends in Gansu, Guangdong and Sichuan Provinces, China.
Lou P, Huang Y, Yang J … +4 more , Chen N, Zhao F, Xu J, Wang K
PLoS Negl Trop Dis · 2026 Jun · PMID 42348580 · Full text
OBJECTIVES: Construct a seasonal dynamic model that captures the transmission characteristics of brucellosis in Gansu, Guangdong and Sichuan provinces of China, in order to fit and predict the epidemic trends of new huma...
OBJECTIVES: Construct a seasonal dynamic model that captures the transmission characteristics of brucellosis in Gansu, Guangdong and Sichuan provinces of China, in order to fit and predict the epidemic trends of new human brucellosis, and further formulate scientific and targeted prevention and control strategies. METHODS: Based on the number of new human brucellosis cases reported by the Centers for Disease Control and Prevention in Gansu, Guangdong and Sichuan provinces from 2021 to 2024, a seasonal SEIV dynamic model of brucellosis transmission between sheep/cattle and humans was constructed, with parameters estimated by using the nonlinear least squares method and the Markov Chain Monte Carlo method. The model fitted the epidemic trends of new human brucellosis and estimated the basic reproduction number R0. Through parameter sensitivity analysis, effective prevention and control measures can be proposed. RESULTS: The established seasonal SEIV dynamic model can well fit the number of new human brucellosis cases and cumulative new human brucellosis cases in Gansu, Guangdong and Sichuan provinces, respectively. The calculated mean absolute percentage error (MAPE) values were approximately 20% and 6%, respectively, indicating a good agreement between the fitted and actual values. It is projected that Gansu and Sichuan provinces will reach peak values of 146,310 and 157,903 cases in July and May 2038, respectively, followed by a gradual declines toward a stable state. The epidemic in Guangdong province will reach a relatively stable, sustained prevalence by 2038. The estimated basic reproduction number R0 for brucellosis transmission in Gansu, Guangdong and Sichuan provinces were 2.2510 (95%CI: 2.2160 - 2.2859), 2.7937 (95%CI: 2.7592 - 2.8283) and 2.9499 (95%CI: 2.9007 - 2.9992), respectively. These findings indicate that brucellosis will continue to spread under the current prevention and control measures. Finally, sensitivity analyses of the number of new human brucellosis cases and R0 were conducted based on specific parameters, it is demonstrated that increasing the culling rate of infected sheep/cattle, raising the vaccination rate of susceptible sheep/cattle, and reducing the immune loss rate of vaccinated sheep/cattle can effectively suppress the spread of brucellosis. CONCLUSION: The constructed seasonal SEIV dynamic model can accurately simulates the epidemic trends of new human brucellosis cases in Gansu, Guangdong and Sichuan provinces, quantitatively proposes effective prevention and control measures, and lay a theoretical foundation for combating the spread of brucellosis.
Toxoplasmosis meets the World Health Organization criteria for a neglected tropical disease.
Furtado JM, Belfort R, Bodaghi B … +14 more , Chee SP, de-la-Torre A, Dorokhova O, Khairallah M, Mahendradas P, Nsiangani-Lusambo N, Pleyer U, Resnikoff S, Seeber F, Taylor HR, Thorne JE, Vasconcelos-Santos DV, Yeh S, Smith JR
PLoS Negl Trop Dis · 2026 Jun · PMID 42348543 · Full text
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Non-typhoidal Salmonella co-infect and complicate Plasmodium falciparum malaria in children under-five: A prospective cohort study on clinical presentation and outcome in Kisantu district hospital, DR Congo.
Tack B, Vita D, Mbuyamba J … +17 more , Nketo J, Ntangu E, Phoba MF, Luyindula A, Nkoji G, Vuvu H, Heroes AS, Im J, Tadesse BT, Siribie M, Jeon HJ, Marks F, Hardy L, Vlieghe E, Toelen J, Jacobs J, Lunguya O
PLoS Negl Trop Dis · 2026 Jun · PMID 42341028 · Full text
INTRODUCTION: Non-typhoidal Salmonella (NTS) bloodstream infections complicate Plasmodium falciparum (Pf) malaria infections in children under-five, but bacterial co-infections are often missed due to absence of microbio...
INTRODUCTION: Non-typhoidal Salmonella (NTS) bloodstream infections complicate Plasmodium falciparum (Pf) malaria infections in children under-five, but bacterial co-infections are often missed due to absence of microbiological diagnosis. We compared signs/symptoms and outcome of NTS bloodstream infection, severe Pf malaria and NTS-Pf malaria co-infections. METHODS: In an area with high, stable Pf malaria transmission (Kongo Central, DR Congo), children (>28 days- <5 years) admitted to hospital with severe febrile illness were enrolled during 18 months (NCT04473768/NCT04850677). Data (in-hospital and 1-month post-discharge) were prospectively collected. RESULTS: NTS bloodstream infections and severe Pf malaria were diagnosed in 12% (331/2682) and 52% (1389/2682) of enrolled children, respectively. NTS-Pf co-infections occurred in 10% (264/2682) of enrolled children, i.e., Pf malaria co-infected 80% (264/330) of NTS bloodstream infections and NTS co-infected 6% (78/1389) of severe Pf malaria. In children with recent Pf malaria (i.e., HRP2-antigen persistence with negative microscopy), NTS occurred in 32% (173/545), making recent malaria a major risk factor for NTS (OR=5.85, p < 0.001). Compared to severe Pf malaria, age under-two (OR=2.19), > 3 days of fever (OR=3.28) and acute malnutrition (OR=2.20-3.48) were risk factors for NTS (p < 0.001) and NTS cases more often had hypoglycemia, grunting, hepato-/splenomegaly, jaundice or altered consciousness, but overall clinical presentation was not discriminative. In-hospital NTS case fatality was high (24% versus 3% in severe Pf malaria), occurred within 2 days of admission in 64% of deaths, and was preceded by general danger/sepsis signs. NTS cases had slower fever resolution, more frequent in-hospital fever recurrence, longer hospital stays, and more post-discharge deaths (n = 4) than severe Pf malaria cases. CONCLUSION: NTS and Pf malaria frequently co-infected children under-five. Severe Pf malaria and NTS bloodstream infections could not be distinguished clinically, but fatality rates were higher in NTS. Low thresholds for empirical NTS antibiotics and early danger sign recognition triggering sepsis care might improve outcome.
Encephalomyocarditis virus (EMCV): An overlooked threat to primates.
Amona I, Kumakamba C, Labarrere C … +3 more , Davoust B, Fenollar F, Mediannikov O
PLoS Negl Trop Dis · 2026 Jun · PMID 42335074 · Full text
Many emerging zoonotic viruses pose major risks to animal and human health, with most recent epidemics of viral origin. This review focuses on encephalomyocarditis virus (EMCV), a member of the Picornaviridae family and...
Many emerging zoonotic viruses pose major risks to animal and human health, with most recent epidemics of viral origin. This review focuses on encephalomyocarditis virus (EMCV), a member of the Picornaviridae family and the Cardiovirus genus with significant but largely underrecognized zoonotic potential. While EMCV has not yet caused major public health crises, its broad host range and rodent reservoir suggest a wider ecological impact. It is typically detected only during high-fatality outbreaks, particularly in domestic animals and non-human primates (NHPs), which are among the most vulnerable hosts. Multiple fatal outbreaks in captive and semi-captive NHPs have been documented. Human infections appear rare, yet the prevalence of antibodies suggests widespread exposure. EMCV remains largely absent from diagnostic panels and its epidemiology is poorly understood. We argue that EMCV warrants much closer attention due to its ability to cause severe disease in NHPs and its potential risk to humans. This review synthesizes current knowledge on the biology, epidemiology, pathogenicity, diagnosis, and prevention of EMCV in primates.
Epidemiological characteristics and importation patterns of imported dengue fever in southwest border regions of China.
Hao J, Shen Y, Xu H … +10 more , Guo F, Ren D, Ma T, Song S, Song R, Treenate N, Zhen Q, Wang Z, Shui T, Yan X
PLoS Negl Trop Dis · 2026 Jun · PMID 42330091 · Full text
Dengue fever is a global public health issue of international concern. The southwestern border regions of China (Yunnan Province) are an important gateway for imported dengue fever cases in China. This study aims to inve...
Dengue fever is a global public health issue of international concern. The southwestern border regions of China (Yunnan Province) are an important gateway for imported dengue fever cases in China. This study aims to investigate the importation patterns of imported dengue cases in Yunnan Province to support global dengue prevention efforts. This study examined imported dengue cases in Southwestern border regions of China, comparing actual and predicted cases via a counterfactual model under COVID-19 measures. Social network analysis was used to identify the importation pattern. From 2012 to 2023, 6,205 imported dengue cases were reported, making up 20.2%. The main sources were Southeast Asian countries: Myanmar (86.6%), Laos (5.8%), and Cambodia (4.9%). During the COVID-19 pandemic, imported cases dropped dramatically when borders closed, with predicted case counts being approximately 16.2-fold, 315.3-fold, and 12.3-fold higher than observed counts from 2020 to 2022, respectively, reflecting the sharp reduction in cross-border mobility during this period. In 2023, observed cases exceeded predictions by 45.0%. The cumulative social network identified three transmission communities centered around Kunming and Xishuangbanna in China, and Myanmar. The community centered in Myanmar had a bridging closeness centrality of 3.67, mainly connecting to Chinese border cities like Dehong (3.7) and Lincang (3.7). The Xishuangbanna community had a centrality of 3.4, primarily linking to Laos (3.4). The Kunming community had the highest centrality at 4.4, connecting mainly to non-border countries including Thailand (4.0), Cambodia (4.3) and Malaysia (2.8). Imported dengue cases in China's southwest border regions exhibit a dual-center pattern: land-border cases cluster in cities adjacent to Myanmar and Laos, while air-border cases concentrate in Kunming. Future efforts should enhance port monitoring and cross-border cooperation.
The nuclear basket nucleoporin MLP1 is required to maintain nuclear integrity, and mitotic fidelity in Trypanosoma brucei.
Yagoubat A, Crobu L, Stanojcic S … +7 more , Kuk N, Sarrazin A, Blanchard MP, Bastien P, Lévêque MF, Berry L, Sterkers Y
PLoS Negl Trop Dis · 2026 Jun · PMID 42330037 · Full text
Trypanosoma brucei, a divergent eukaryote parasite, is responsible for neglected tropical diseases in humans and animals, specifically sleeping sickness or human African trypanosomiasis and nagana. Beyond its scientific...
Trypanosoma brucei, a divergent eukaryote parasite, is responsible for neglected tropical diseases in humans and animals, specifically sleeping sickness or human African trypanosomiasis and nagana. Beyond its scientific significance, a comprehensive understanding of its biology has substantial medical and economical implications. Nuclear pore complexes (NPCs) are large multiprotein channels embedded in the nuclear envelope that regulate nucleocytoplasmic transport. In addition to this critical function, NPCs are involved in essential nuclear processes such as chromosome segregation, transcription, and cytokinesis. This study demonstrates that Myosin-like protein-1 (MLP1) localizes to the nuclear basket of NPCs in T. brucei. Silencing of TbMLP1 by RNA interference in T. brucei procyclic cells resulted in severe growth, significant impairment of messenger RNA export, disorganization of nuclear structure, and marked genomic instability. Flow cytometry and fluorescence in situ hybridization (FISH) analyses revealed abnormal DNA content and a reduction in disomic cells, alongside an increase in monosomic, trisomic, and polysomic cells, indicating intolerable aneuploidy detrimental to cell viability. Together, these findings demonstrate that TbMLP1 links NPC function to multiple key cellular pathways. This research provides new insights into the mechanisms that maintain nuclear architecture, preserve nuclear envelope morphology, ensure genome stability, and faithful chromosome segregation, and support appropriat kinetochore distribution and mitotic spindle organization.
An Immune system for the city: A cluster-randomized trial of a new paradigm for surveillance and control of disease vectors.
Levy MZ, Tamayo LD, Condori-Pino CE … +3 more , Arevalo-Nieto C, Castillo-Neyra R, Paz-Soldan VA
PLoS Negl Trop Dis · 2026 Jun · PMID 42330036 · Full text
Vector-borne pathogens continue to emerge, kill and harm humans with unrelenting regularity. Conventional strategies for controlling insect vectors grew out of the military; communication is hierarchical, responses unila...
Vector-borne pathogens continue to emerge, kill and harm humans with unrelenting regularity. Conventional strategies for controlling insect vectors grew out of the military; communication is hierarchical, responses unilateral, and regulation predetermined. We developed an alternative approach, modeled after the adaptive immune system, and compared the approaches through a cluster-randomized trial in the context of an ongoing urban Chagas disease vector control campaign in Arequipa, Peru. Clusters consisted of pre-defined geographic jurisdictions of health facilities, and averaged 2,271 households. Thirty clusters were assigned to the immune arm, and thirty to the conventional arm, balancing on antecedents related to the probability of vector infestation. Following delays, the trial initiated in October 2021. We report here early results from a pre-planned interim analysis scheduled for March 2023. In the immune arm 23 infested households were discovered and confirmed in 10 separate foci; in the conventional arm only 5 infested households were discovered and confirmed, and all were from the same focus. The immune approach was adaptive, and more effort was expended upon confirmation of an infestation (1085.2 person days in the immune arm vs 864.2 in the conventional; Rate ratio 23/1085.2:5/864.2 = 3.66 [1.49 - 10.60], p-value = 0.0038). Vector surveillance approaches modeled after the immune system are a potentially more effective alternative to conventional approaches, especially to control vector borne diseases in cities and other complex environments.
Paucibacillary leprosy presenting as fibular neuropathy: A case of autochthonous zoonotic exposure in endemic Florida.
Ruffing K
PLoS Negl Trop Dis · 2026 Jun · PMID 42330030 · Full text
We report a case of paucibacillary leprosy presenting as fibular neuropathy in a patient from Florida, an area with documented autochthonous transmission of Mycobacterium leprae. The patient exhibited neuropathic symptom...
We report a case of paucibacillary leprosy presenting as fibular neuropathy in a patient from Florida, an area with documented autochthonous transmission of Mycobacterium leprae. The patient exhibited neuropathic symptoms and a characteristic skin lesion, ultimately confirmed by biopsy with histopathological findings consistent with paucibacillary Hansen's disease, with negative Fite-Faraco staining and negative M. leprae PCR. The patient reported no travel history to internationally endemic areas; zoonotic exposure through frequent contact with armadillo-inhabited soil was identified as the most probable source of infection. This case underscores the importance of thorough physical examination and consideration of autochthonous zoonotic exposure in regions with documented environmental transmission.
Social marginalisation, environmental degradation and Toxoplasma gondii exposure in urban informal settlements in Brazil.
Eyre MT, Wang JY, Carneiro IO … +21 more , Reis RB, Wunder EA, Júnior NN, Ribeiro GS, Souza FN, Santana JO, Delight EA, Felzemburgh RDM, Santana FS, Mohr S, Melendez AXTO, Queiroz A, Santos AC, Cruz JS, Owens M, Martorelli Di Genova B, Reis MG, Muñoz-Zanzi C, Diggle PJ, Costa F, Ko AI
PLoS Negl Trop Dis · 2026 Jun · PMID 42330015 · Full text
Toxoplasma gondii infection poses a substantial global health burden, yet transmission pathways and population susceptibility in urban informal settlements remain poorly characterised, particularly for women of childbear...
Toxoplasma gondii infection poses a substantial global health burden, yet transmission pathways and population susceptibility in urban informal settlements remain poorly characterised, particularly for women of childbearing age. We analysed archived samples from a cross-sectional serosurvey of 728 children and adolescents aged 4-18 years living in a marginalised urban community in Salvador, Brazil, to characterise exposure patterns and identify demographic, socioeconomic, behavioural, household, and environmental factors associated with seropositivity and to assess spatial heterogeneity in exposure risk. Overall seroprevalence was 49%, increasing with age and higher in males than females; Bayesian serocatalytic models estimated sex-specific forces of infection of 0.078 for males and 0.050 for females, with approximately half of female participants still susceptible upon reaching childbearing age, highlighting the risk of congenital toxoplasmosis. In regression analyses, seropositivity was associated with male sex, lower household income, cat ownership, and residence at lower elevation, greater distance from the main road, and reported contact with sewer water. Notably, most seropositive participants (77.3%) did not live in households with cats. Geostatistical modelling demonstrated fine-scale spatial heterogeneity, with clustered hotspots exceeding 50-60% predicted prevalence. Adjustment for measured covariates attenuated but did not eliminate spatial clustering, indicating residual fine-scale spatial structure consistent with unmeasured environmental processes operating beyond individual households, alongside additional unstructured variation that may reflect household-level or peridomestic differences not captured by the measured covariates. Together, these findings provide evidence consistent with an important role for household and peridomestic environmental exposure pathways in T. gondii transmission in informal settlements, extending beyond households with domestic cats and shaped by social marginalisation and environmental vulnerability.
Snakes and snakebites in the munduruku cosmology and medicine, central Brazilian Amazonia.
Dias GR, Lavareda GRD, Gomes TA … +11 more , Silva GRDD, Melo GS, Almeida MC, Silva MLD, Oliveira UG, Wen FH, Sachett J, Farias AS, Murta F, Machado VA, Monteiro W
PLoS Negl Trop Dis · 2026 Jun · PMID 42330010 · Full text
Snakebite envenoming is a major public health problem in the Amazon, disproportionately affecting Indigenous populations with high incidence and mortality rates. Efforts to decentralize antivenom treatment to remote area...
Snakebite envenoming is a major public health problem in the Amazon, disproportionately affecting Indigenous populations with high incidence and mortality rates. Efforts to decentralize antivenom treatment to remote areas require not only logistical adaptations, but also a deeper understanding of Indigenous medical systems to enable culturally appropriate care. This study aimed to construct an explanatory model of snakebites from the perspective of the Munduruku people, an Indigenous group in the Central Brazilian Amazon. We conducted a qualitative study based on in-depth interviews with nineteen traditional healers. Our methodological orientation follows the Amerindian perspectivism theory. Data was sorted into five relevant categories: 1) Participants' identities; 2) Snakes and snakebites; 3) Course of sickness; and 4) Therapeutic resources in the Munduruku medicine. Munduruku healers interpret snakebites as events involving both natural and supernatural dimensions, integrating bodily, social, and spiritual factors. Snakes are perceived as intentional beings, and envenomation may result not only from physical encounters but also from sorcery or transgression of social norms; perceived severity is shaped by the type of snake, adherence to dietary and sexual restrictions, and spiritual causality. Therapeutic practices predominantly involve topical preparations, rituals, and symbolic interventions embedded within broader relational and cosmological frameworks. Despite these distinct explanatory models, most participants recognized the importance of biomedical care, particularly for severe cases, and did not oppose referral to hospital-based treatment, while Indigenous healing practices remain central throughout the therapeutic itinerary. Improving snakebite outcomes in the Amazon requires intercultural health strategies that integrate biomedical and Indigenous systems, with symmetrical partnerships with Indigenous healers being essential to ensure timely access to antivenom while respecting local knowledge and practices.
Amebiasis as a neglected tropical disease: Current knowledge gaps and future directions.
Shirley DA, Jayarathne S, Warren CA … +1 more , Moonah S
PLoS Negl Trop Dis · 2026 Jun · PMID 42329967 · Full text
Entamoeba histolytica is a protozoan parasite that causes amebic colitis, a leading cause of severe diarrheal disease worldwide, and amebic liver abscess, the most common extraintestinal manifestation of infection. The d...
Entamoeba histolytica is a protozoan parasite that causes amebic colitis, a leading cause of severe diarrheal disease worldwide, and amebic liver abscess, the most common extraintestinal manifestation of infection. The disease burden is highest in resource-limited settings but remains clinically important in travelers and men who have sex with men in non-endemic regions. Although most infections are asymptomatic, severe and fulminant disease is associated with high mortality, particularly among individuals exposed to corticosteroids or other forms of immunosuppression. The increasing use of molecular diagnostic tools has improved understanding of the epidemiology of E. histolytica and enabled distinction from morphologically identical but nonpathogenic Entamoeba species; however, these diagnostics remain underutilized in many endemic settings due to cost and infrastructure limitations. Treatment options remain limited, with nitroimidazoles constituting the only drug class available for symptomatic invasive disease, leaving few alternatives for patients who cannot tolerate therapy or in the event of emerging resistance. Despite advances in understanding parasite pathogenesis and the application of high-throughput technologies, no licensed vaccine exists, and progress toward vaccine development has been minimal. These persistent gaps highlight the need to reprioritize amebiasis as a neglected tropical disease and to accelerate investment in diagnostics, therapeutics, and preventive strategies.
Survey on the current status of rabies post-exposure prophylaxis clinics construction and the surveillance of rabies-exposed individuals in China, 2022.
Ren Q, Mu D, Zhai HR … +8 more , Li SH, Zhou SJ, Chen JY, Luo A, Zheng YL, Yin WW, Zhang YP, Chen QL
PLoS Negl Trop Dis · 2026 Jun · PMID 42329891 · Full text
BACKGROUND: Rabies continues to pose a significant public health challenge in China. To offer a scientific foundation for formulating rabies prevention and control strategies, this study conducted a national survey to co...
BACKGROUND: Rabies continues to pose a significant public health challenge in China. To offer a scientific foundation for formulating rabies prevention and control strategies, this study conducted a national survey to comprehend the current status of rabies post-exposure prophylaxis (PEP) clinics construction and the surveillance of rabies-exposed individuals in China. METHODS: The Chinese Center for Disease Control and Prevention (CCDC) developed a national rabies prevention and control questionnaire, and conducted a survey across 31 provinces in Mainland China. The questionnaire was completed by the person in charge of rabies prevention and control in each provincial disease prevention and control institution. RESULTS: By the end of 2022, 24,304 PEP clinics were reported in Mainland China. The number of PEP clinics per capita in China is 1.75 per 100,000. Nationwide, 47% of PEP clinics were capable of handling category III exposures. A total of 10,770,543 PEP clinic visits were reported. East China reported the highest number of rabies exposures (4,022,265). Among category III exposures, only 35% reported using rabies immunoglobulin (RIG). 97% of rabies exposures were attacked by dogs or cats. In South China, exposures caused by cats were nearly as frequent as those caused by dogs (47% and 48% respectively). CONCLUSIONS: The distribution of PEP clinics across China is uneven. This pattern appears broadly consistent with the historical geographic distribution of rabies risk, which may reflect a risk-informed allocation of resources. We recommended implementing tiered prevention and control strategies, with emphasis on enhancing the stockpile of RIG, dogs and cats population management, and health education in regions with higher rabies exposure risks. In provinces with a high incidence of rabies outbreaks, it is essential to actively advocate for the inclusion of rabies vaccines and RIG in the reimbursement scope of the New Rural Cooperative Medical Insurance Scheme, and raise the reimbursement rate and limit. The "One Health" approach should be adopted, including mandatory immunization and surveillance management systems for dogs and cats.
Editorial note: Sunbathing, a possible risk factor of murine typhus infection in Greece.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 Jun · PMID 42329837 · Full text
Abstract loading — click title to view on PubMed.
Inhibition of Toxoplasma gondii proliferation by dimethyl itaconate: Evidence from in vitro and in vivo studies.
Zhao J, Bao L, Chen H … +11 more , Zhao T, Tang D, Sun Y, Zuo Y, Shang J, Liu Y, Zhou X, Zhao M, Yang X, Zhang L, Zhao G
PLoS Negl Trop Dis · 2026 Jun · PMID 42313860 · Full text
Toxoplasma gondii (T. gondii) is an obligate intracellular parasite capable of infecting more than 350 species, including humans, livestock, and wildlife. However, available clinical drugs for toxoplasmosis not only caus...
Toxoplasma gondii (T. gondii) is an obligate intracellular parasite capable of infecting more than 350 species, including humans, livestock, and wildlife. However, available clinical drugs for toxoplasmosis not only cause severe adverse effects but also demonstrate reduced therapeutic efficacy due to the emergence of drug-resistant strains, highlighting the urgent need for novel therapeutic interventions. This study aimed to evaluate the activity of dimethyl itaconate (DI) against T. gondii both in vitro and in vivo and to elucidate its underlying mechanism of action. The in vitro antiparasitic effects of DI were comprehensively investigated using transmission electron microscopy (TEM), plaque assays, quantitative PCR (qPCR), mitochondrial functional assays, ELISA, and transcriptomic profiling. In vivo evaluations were conducted in T. gondii-infected mouse models to assess survival rates, parasite loads, histopathological changes, and oxidative stress modulation. The results revealed that DI-treated tachyzoites exhibited marked organelle disruption, loss of membrane integrity, and activation of autophagy. Plaque assays combined with qPCR analysis consistently demonstrated a dose-dependent suppression of T. gondii proliferation. Notably, DI induced mitochondrial dysfunction, characterized by reduced mitochondrial membrane potential, ATP depletion, and a concomitant increase in reactive oxygen species (ROS) levels, consistent with the transcriptomic profiling data. This mechanistic evidence suggests that DI exerts its inhibitory effects on T. gondii tachyzoites primarily by disrupting the parasite's energy metabolism pathways. In vivo, DI administration increased survival rates, partially alleviated histopathological damage, significantly reduced parasite loads in target organs, and mitigated oxidative stress and inflammatory responses. Overall, DI exhibits promising anti-T. gondii activity both in vitro and in vivo, suggesting its potential as a candidate compound for the treatment of toxoplasmosis.
The health and economic burden of podoconiosis in East Africa: A systematic review and meta-analysis of health outcomes with narrative synthesis of economic evidence.
Hitimana N, Anagnostopoulou V, Bremner S … +5 more , Uwimana NU, Hounsome N, Rugema L, Mutesa L, Semrau M
PLoS Negl Trop Dis · 2026 Jun · PMID 42308246 · Full text
BACKGROUND: Podoconiosis is a neglected tropical disease (NTD) causing chronic lower limb lymphoedema through prolonged barefoot exposure to irritant volcanic soils. Despite affecting an estimated 4 million people global...
BACKGROUND: Podoconiosis is a neglected tropical disease (NTD) causing chronic lower limb lymphoedema through prolonged barefoot exposure to irritant volcanic soils. Despite affecting an estimated 4 million people globally, podoconiosis remains absent from the Global Burden of Disease study and severely under-researched relative to its impact. East Africa carries the greatest regional burden, yet no comprehensive synthesis of prevalence, disability-adjusted life years (DALYs), or economic burden data exists for the region. This systematic review and meta-analysis aimed to address this gap by synthesising available evidence on the prevalence and health and economic burden of podoconiosis across East Africa. METHODS: We conducted a systematic search of PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, EconLit, WHO AFROLIB, and Google Scholar for studies published in English between 2011 and 2023. Studies reporting population-based podoconiosis prevalence, DALYs, or economic burden data from East African countries as defined by the UN M49 geoscheme were eligible for inclusion. Grey literature was also searched, including reports, ministry of health documents, and conference proceedings both in English and French, to capture evidence not indexed in academic databases. The search was updated in March 2026 to ensure the most current evidence was captured. Quality assessment was performed using the Newcastle-Ottawa Scale. Prevalence data were pooled using a random-effects model with the DerSimonian-Laird estimator and Freeman-Tukey double arcsine transformation. Subgroup analyses were conducted by country, sample size, and geographic scope. RESULTS: Fourteen studies met the inclusion criteria, comprising 10 from Ethiopia, 2 from Kenya, and 1 each from Uganda and Rwanda, collectively examining 1,720,437 individuals. The overall pooled prevalence was 1.19 (95% CI: 1.14-1.25) on the transformed scale, with extreme heterogeneity (I² = 99.0%). The Ethiopia-specific pooled prevalence was 4.52% (95% CI: 3.92-5.16%), compared to 0.20% (95% CI: 0.10-0.33%) for the non-Ethiopian subgroup, a more than 20-fold difference. A consistent inverse relationship between sample size and observed prevalence was identified across all analyses, reflecting the systematic tendency of smaller studies to target confirmed endemic foci while larger surveys captured broader populations. Only one study Deribe et al. (2020), reported DALY and economic burden estimates, confined to Ethiopia, estimating 172,073 DALYs annually and a total economic burden of US$213.2 million per year. CONCLUSION: Podoconiosis imposes a substantial but profoundly under-quantified burden across East Africa, with disease intensity disproportionately concentrated in Ethiopian highland communities. The near-complete absence of DALY and economic burden data outside Ethiopia represents a critical evidence gap. Standardised nationally representative surveys, expansion of burden modelling beyond Ethiopia, and advocacy for inclusion of podoconiosis in the Global Burden of Disease study are urgently needed to support evidence-based policy and resource prioritisation across the region. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews with the registration number: CRD42023432640.
Epidemiology, seroprevalence, and circulation of Chikungunya virus in Southern Africa (SADC region): A systematic review.
Lamula S, Ramatsitsi N, Buwa-Komoreng L
PLoS Negl Trop Dis · 2026 Jun · PMID 42302086 · Full text
Chikungunya virus (CHIKV) is an emerging arbovirus that causes major morbidity in tropical regions, but its epidemiology in Southern Africa is poorly defined. This study compiles research on CHIKV circulation, clinical c...
Chikungunya virus (CHIKV) is an emerging arbovirus that causes major morbidity in tropical regions, but its epidemiology in Southern Africa is poorly defined. This study compiles research on CHIKV circulation, clinical characteristics, and surveillance strategies in the region, specifically in the Southern African Developing Community (SADC) block. A systematic search of peer-reviewed publications published between January 2012 and October 2025 that reported CHIKV detection, seroprevalence, or clinical symptoms in eight Southern African countries was conducted. Eligible studies included human studies, outbreak investigations, population-based surveys, diagnostic evaluations, and case reports. Whilst, zoonotic studies, animal studies, letters to editors, comments, and studies not clearly define in terms of country, number participants and method of investigation were considered ineligible. Twenty studies met inclusion criteria, representing data from Madagascar, Mozambique, the Democratic Republic of the Congo (DRC), Angola, Tanzania, Malawi, South Africa (SA), and Mauritius. CHIKV circulation was confirmed in both urban and rural settings, often co-occurring with dengue, Zika, and Rift Valley fever viruses. Seroprevalence estimates varied widely, from sporadic detection in Angola to sustained immunoglobulin G (IgG) positivity in Madagascar and Tanzania, indicating ongoing endemic transmission. Women of reproductive and working age were disproportionately affected. Clinical presentations were dominated by acute febrile illness with arthralgia, though severe neurological outcomes and long-term rheumatologic sequelae were reported. Diagnostic practices relied primarily on serology, with molecular confirmation limited to outbreak contexts. Vector surveillance detected CHIKV in mosquitoes even in the absence of human cases. CHIKV is a common virus in Southern Africa that is not well known. Effective response and early detection depend on strengthened integrated surveillance that combines entomological, molecular, and serological approaches. The findings highlight the necessity of investigating the long-term effects of Chikungunya infection and conducting coordinated regional monitoring.
Post-market surveillance of albendazole tablet brands in Kenya: Implications for deworming programs and clinical outcomes.
Yator EK, Njogu PM
PLoS Negl Trop Dis · 2026 Jun · PMID 42302068 · Full text
BACKGROUND: Albendazole is a broad-spectrum anthelminthic extensively used in clinical settings and national deworming programs. It is the cornerstone of the preventive chemotherapy for soil-transmitted helminthiases pre...
BACKGROUND: Albendazole is a broad-spectrum anthelminthic extensively used in clinical settings and national deworming programs. It is the cornerstone of the preventive chemotherapy for soil-transmitted helminthiases prevalent in low-resource settings. The high proliferation of albendazole generic products, with poor post-market surveillance capacity in the low- and middle-income countries, poses dire risk of substandard and falsified medicines, which may predispose patients to treatment failures, adverse drug reactions, morbidity, and mortality, with consequent loss of public confidence in healthcare systems. OBJECTIVE: This study aimed to determine the quality and pharmaceutical equivalence of albendazole 400 mg tablet brands marketed in Nairobi, Kenya. EXPERIMENTAL: A cross-sectional analytical study was conducted on seven albendazole 400 mg tablet brands purchased from pharmacy outlets in Nairobi. Tests for identity, friability, hardness, disintegration, assay, uniformity of weight, and dissolution were conducted as specified in the United States, British and International Pharmacopoeias. Dissolution profiles of generic albendazole tablet brands and the innovator brand (Zentel) were compared using model independent fit factors f1 and f2, and the dissolution efficiency (DE). Data was captured and analyzed using Microsoft Excel 2021, and reported as means, relative standard deviations, and percentages. RESULTS: All the seven albendazole 400 mg tablet brands complied with compendial specifications for identity, friability, hardness, assay, and uniformity of weight. However, two brands (EK5 and EK6) did not comply with the disintegration test and consequently demonstrated extremely poor dissolution, having released <6% of labelled albendazole content at 60 minutes with DE < 5%. Only two brands (EK4 and EK2) exhibited dissolution profiles that approximated the innovator brand (f2 > 50, f1 < 10) and could be used interchangeably, while the other two (EK3 and EK7) had intermediate drug release. CONCLUSION: While all tested albendazole 400 mg tablet brands complied with basic pharmacopoeial specifications for quality, dissolution testing revealed significant nonequivalence, with only three (42.86%) of the seven brands being pharmaceutically equivalent. Poor dissolution of majority (57.14%) of albendazole tablet brands portends therapeutic insufficiency and development of drug resistance, reinforcing the need for stringent post-market surveillance to safeguard public health.
Retraction: Effectiveness of carbon dioxide cryotherapy for the treatment of cutaneous leishmaniasis: Systematic review and meta-analysis.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 Jun · PMID 42301982 · Full text
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