PLoS Neglected Tropical Diseases[JOURNAL]
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200 papers
Burden and clinical impact of 'neglected' transfusion-transmitted infections in Cameroon: A systematic review and meta-analysis.
Malieuze Nanfah MD, Binam Nkot VM, Yop Kite MM … +9 more , Beack Bayengue SS, Tchamba GB, Tandja AG, Koloko BL, Ngo Malabo ET, Ekwe Priso JGLF, Embolo Enyegue EL, Koanga Mogtomo ML, Kojom Foko LP
PLoS Negl Trop Dis · 2026 May · PMID 42189856 · Full text
BACKGROUND: Blood supply is a public health challenge in African countries. In Cameroon, blood selection guidelines focus on four viral and bacterial pathogens (HIV, hepatitis B and C viruses, Treponema pallidum) associa...
BACKGROUND: Blood supply is a public health challenge in African countries. In Cameroon, blood selection guidelines focus on four viral and bacterial pathogens (HIV, hepatitis B and C viruses, Treponema pallidum) associated with transfusion-transmitted infections (TTIs). Other pathogens, often endemic (e.g., Plasmodium spp.), are not routinely screened in blood banks and are not included in blood safety guidelines or surveillance, despite their potential for transfusion transmission. MATERIALS AND METHODS: Here, we conducted a systematic review and meta-analysis of prevalence, determinants, and clinical impact of 'neglected' pathogens, defined as pathogens not included in national blood safety guidelines (e.g., filaria, dengue virus, Toxoplasma gondii), in blood banks. Additionally, we identified the most urgent challenges and proposed actionable solutions to guide blood safety guidelines in the country. RESULTS: A total of 18 studies, covering ~12,500 donations, were included, with the bulk coming from donors living in three regions (Littoral, Northwest, Centre). Plasmodium parasite (68.4%) was the major studied pathogen, even though an evident publication bias was found (p = 0.004). The other pathogens included dengue virus (5.3%), T. gondii (5.3%), and HTLV-1 (5.3%). The filarial parasite Loa loa was consistently accidentally found. Even though there is no evidence of SARS-CoV-2-associated TTIs till now, the pooled proportion of this virus was 17.7%. The pooled proportions of infection in blood donors were 16.6% for Plasmodium spp. and 0.5% for Loa loa. There is a paucity of clinical impact studies on these 'neglected' TTIs, and the available literature suggests impaired levels of immunoglobulin E and albumin. We identified urgent challenges, including awareness among healthcare providers and policymakers, diagnostic and logistical constraints, and low microbial density infections, associated with neglected pathogen-related blood safety. CONCLUSION: We opine that providing more epidemiological evidence is crucial to address the above-mentioned challenges for guiding and guaranteeing blood safety in Cameroon.
Bothrops jararaca snake venom: A reappraisal of its coagulant activity in humans, mice, and rats.
Torres AV, Penas Picon NT, Ferreira de Oliveira N … +5 more , Sachetto ATA, Thomazini CM, de Albuquerque CZ, Mattaraia VGM, Santoro ML
PLoS Negl Trop Dis · 2026 May · PMID 42189852 · Full text
BACKGROUND: Bothrops jararaca snake venom (BjV) contains toxins that both activate and inhibit blood coagulation and platelets, leading to consumption coagulopathy, thrombocytopenia, endothelial dysfunction, and secondar...
BACKGROUND: Bothrops jararaca snake venom (BjV) contains toxins that both activate and inhibit blood coagulation and platelets, leading to consumption coagulopathy, thrombocytopenia, endothelial dysfunction, and secondary fibrinolysis in human and animal victims of snakebite. Herein, we aimed to investigate the in vitro coagulant activity of BjV in human, mouse, and rat plasmas. METHODOLOGY/PRINCIPAL FINDINGS: The coagulant activity of BjV was evaluated using normal human plasma and plasmas deficient in coagulation factors II, V, VII, VIII, IX, or X; in mice, normal plasma as well as plasma from F8-/-, F9-/-, Vwf-/-, and pearl (Ap3b1-/-) strains were analyzed, in addition to normal plasma from Wistar rats. The contributions of calcium ions, phospholipids, and blood cells to BjV-induced coagulant activity were assessed. Pharmacological inhibitors were used to investigate the generation of factor Xa and/or thrombin, and their roles in the coagulant activity of BjV. Statistical analyses were performed to compare minimum coagulant dose (MCD) values and their corresponding clotting curves. Human and rat plasmas showed greater sensitivity to the coagulant activity of BjV than mouse plasmas. Calcium ions and phospholipids significantly enhanced the coagulant activity of BjV. Remarkably, both red blood cells and platelets in whole blood markedly potentiated the coagulant activity of BjV. Pre-incubation of plasma samples with rivaroxaban and/or dabigatran demonstrated that the coagulant activity of BjV in rat plasmas primarily depended on prothrombin activation, whereas in human and mouse plasmas it involved both thrombin-like enzymes and prothrombin activators. CONCLUSIONS/SIGNIFICANCE: This study reveals key differences in the coagulant activity of BjV in human and rodent plasmas, underscoring the need to considering these interspecies disparities when using animal models in comparative envenomation research.
Neglected rickettsial diseases in Southeast Asia: Twenty-five years of progress in surveillance, diagnostics, and clinical research.
Blacksell SD, Robinson MT, Saraswati K … +8 more , Perrone C, Batty EM, Wongsantichon J, Sonthayanon P, Wangrangsimakul T, Elliott I, Newton PN, Day NPJ
PLoS Negl Trop Dis · 2026 May · PMID 42189822 · Full text
BACKGROUND: Rickettsial diseases, including scrub typhus and murine typhus, are major yet persistently under-recognised causes of acute febrile illness in Southeast Asia. Limited diagnostic capacity, ecological complexit...
BACKGROUND: Rickettsial diseases, including scrub typhus and murine typhus, are major yet persistently under-recognised causes of acute febrile illness in Southeast Asia. Limited diagnostic capacity, ecological complexity, and non-specific clinical presentation have historically contributed to the underestimation of their burden. METHODS: We synthesised 25 years (2001-2025) of integrated epidemiological, clinical, diagnostic, molecular, ecological, and treatment research conducted across Southeast Asia. Evidence from prospective surveillance, hospital-based cohorts, seroepidemiology, molecular characterisation, in vitro isolation, genomic analyses, and randomised clinical trials was reviewed to identify convergent findings and policy-relevant lessons. FINDINGS: Rickettsial infections account for 10%-25% of hospitalised acute febrile illness cases in many endemic settings and are important causes of central nervous system infection, severe disease, and adverse pregnancy outcomes. Diagnostic advances include calibrating IFA and ELISA cut-offs, evaluating rapid diagnostic tests and LAMP assays, developing highly sensitive real-time PCR platforms, and genomic analyses revealing extensive strain diversity. Whole-genome sequencing and multilocus typing demonstrate high recombination and weak geographic structuring of the core genome despite antigenic heterogeneity. Randomised trials confirm doxycycline as first-line therapy for scrub typhus, while azithromycin shows inferior efficacy for murine typhus. Integrated One Health investigations have clarified ecological drivers and vector-host dynamics, and community engagement initiatives have improved awareness in high-risk populations. INTERPRETATION: Sustained regional investment has transformed rickettsial research from fragmented studies into an integrated surveillance, diagnostic, and translational research framework. This experience provides a transferable model for addressing neglected vector-borne diseases and strengthening febrile illness management in endemic settings. Continued support for laboratory capacity, genomic surveillance, and clinical research is essential to maintain progress and improve regional health system resilience.
The atypical dual-specificity protein phosphatase (DUSP)/kinatase of Leishmania infantum modulates infectivity, oxidative stress response and antimonial resistance.
Ribeiro JM, Fonseca GFD, Anbo MAK … +7 more , Costa KF, Oliveira ACS, Lopes KF, Cruz MGFML, Costa-Silva HM, Santi AMM, Murta SMF
PLoS Negl Trop Dis · 2026 May · PMID 42189819 · Full text
Dual-specificity protein phosphatases (DUSPs) are key modulators of mitogen-activated protein kinase (MAPK) signaling pathways that regulate cellular proliferation, differentiation, and stress adaptation. Although extens...
Dual-specificity protein phosphatases (DUSPs) are key modulators of mitogen-activated protein kinase (MAPK) signaling pathways that regulate cellular proliferation, differentiation, and stress adaptation. Although extensively characterized in higher eukaryotes, the functional roles of DUSPs in Leishmania remain poorly understood. In this study, we investigated the function of an atypical dual-specificity phosphatase/kinatase (LINF_340027100) in Leishmania infantum using CRISPR/Cas9-mediated genome editing. Repeated attempts to generate DUSP-null mutants were unsuccessful, and episomal complementation prior to chromosomal disruption did not permit deletion of the endogenous locus, suggesting that DUSP is essential for promastigote viability. To investigate DUSP function, we generated parasite lines with altered gene expression, including a heterozygous knockout (Li DUSP+/-) and an episomal overexpressor (Li WT + pIR1_SAT-DUSP). Modulation of DUSP expression resulted in pronounced alterations in parasite morphology, cell-cycle progression, differentiation, and intracellular proliferation in macrophages. The Li DUSP+/- line exhibited a twofold reduction in transcript abundance and maintained normal growth kinetics, but displayed elongated morphology, increased flagellar length, and a reduced G0/G1 population with concomitant S-phase accumulation. In addition, Li DUSP+/- parasites showed decreased tolerance to hydrogen peroxide, being 1.5- and 5.7-fold more sensitive in promastigote and intracellular amastigote forms, respectively. Conversely, the DUSP-overexpressing line exhibited a 2.3-fold increase in DUSP transcript levels, accompanied by modest impairment of promastigote proliferation, rounded morphology, altered cell-cycle distribution, and increased resistance to trivalent antimony, with 2.6- and 3.1-fold higher resistance observed in promastigote and intracellular amastigote forms, respectively. Both mutant lines showed reduced intracellular proliferation at 72 h post-infection. Transcript level analysis revealed altered expression of MAPK1, MAPK3, and MAPK10 in both promastigote and axenic amastigote-like forms, supporting a functional link between DUSP activity and MAPK signaling homeostasis. Together, these findings identify DUSP as a key regulator of parasite biology that integrates MAPK signaling with oxidative stress response, differentiation, and antimony susceptibility in L. infantum. This study provides the first functional characterization of this atypical DUSP/kinatase in Leishmania and highlights its potential as a target for therapeutic intervention.
Retraction: Tick-borne rickettsioses, neglected emerging diseases in rural senegal.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 May · PMID 42189775 · Full text
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The cross-city mobility patterns and incubation period of the early-stage chikungunya fever outbreak in Guangdong Province, China, in 2025.
Huang J, Huang J, Liang L … +15 more , Hu T, Zhao D, Zhang Y, Zhao Y, Jiang S, Wang G, Liu J, Zhuang Y, Zhang M, Huang J, Dong S, Huang X, Kang M, Liang W, Li Y
PLoS Negl Trop Dis · 2026 May · PMID 42172298 · Full text
BACKGROUND: Chikungunya fever (CF), an arthropod-borne disease caused by Chikungunya virus (CHIKV), is a serious public health threat globally. In July 2025, an outbreak occurred in Foshan City, Guangdong Province, China...
BACKGROUND: Chikungunya fever (CF), an arthropod-borne disease caused by Chikungunya virus (CHIKV), is a serious public health threat globally. In July 2025, an outbreak occurred in Foshan City, Guangdong Province, China. A large number of these cases involved cross-city movements, which complicated containment efforts and provided a unique opportunity to study transmission patterns and key epidemiological parameters. METHODS: We obtained information on 400 confirmed cases of CF with cross-city exposure histories reported across Guangdong Province in southern China by 21 August 2025. Demographic, clinical, and mobility data were mainly obtained from the National Notifiable Infectious Disease Reporting System and supplemented by epidemiological investigations. The incubation period was estimated using a parametric accelerated failure time model, with log-normal, gamma, Weibull, and Erlang distributions used to fit the model. Subgroup analysis was performed based on mobility patterns and exposure windows. PRINCIPAL FINDINGS: Significant demographic differences were observed compared with local Foshan cases: cross-city cases had higher proportions of males (58.3%), individuals within the age groups of 15-24, 25-34, and 35-44,and individuals with occupations of general staff/workers, business/service workers, and students. Fever (86.4%), arthralgia (79.3%), and rash (61.2%) were the most common symptoms. Mobility analysis revealed that Foshan and Guangzhou were the major sources of infection, with cases spreading mainly to cities within the Pearl River Delta and provinces such as Guangxi (43.3%) and Hunan (15.4%). The median incubation period was estimated to be 5.4 days (95% CI 5.0-5.7), with 2.5th and 97.5th percentiles of 2.5 days and 11.4 days, respectively. CONCLUSIONS: This study underscores the central role of population mobility in the spread of CHIKV and highlights distinct epidemiological characteristics of cross-city cases. The estimated median incubation period of 5.4 days provides important evidence for surveillance and response strategies during chikungunya outbreaks. Notably, students and migrant workers accounted for a higher proportion of cross-city cases, suggesting that highly mobile populations may contribute to inter-regional transmission. These findings highlight the importance of strengthened surveillance and coordination across regions for the prevention and control of future outbreaks in Guangdong and other high-risk areas in China.
The need for balanced dengue vaccine protection: Insights from Thai surveillance data on four serotypes.
Khosavanna RR, Iamsirithaworn S, Pinpaiboon S … +5 more , Phutthasophit K, Hunsawong T, Ko AI, Anderson KB, Buddhari D
PLoS Negl Trop Dis · 2026 May · PMID 42172202 · Full text
Dengue virus (DENV), comprising four distinct serotypes (DENV-1 to DENV-4), poses a major public health challenge in tropical regions. Infection with one serotype confers long-term immunity to that serotype alone, while...
Dengue virus (DENV), comprising four distinct serotypes (DENV-1 to DENV-4), poses a major public health challenge in tropical regions. Infection with one serotype confers long-term immunity to that serotype alone, while subsequent heterologous infections are associated with increased risk of severe disease, necessitating vaccines that induce durable, balanced immunity across all serotypes. However, achieving such balance immunity remains a central challenge for dengue vaccine development. Using passive surveillance data from Kamphaeng Phet, Thailand (2004-2022), we characterized long-term serotype circulation and contributions to clinical dengue burden in a hyperendemic setting. We observed sustained co-circulation of all four serotypes over nearly two decades, with periodic shifts in dominant serotype. Among 6,840 PCR-confirmed dengue cases, the majority of which were hospitalized, DENV-1 through DENV-4 accounted for 32.8%, 25.9%, 24.8%, and 16.5% of detected dengue cases, respectively. Compared with DENV-1, clinically-apparent DENV-2 and DENV-4 infections were more likely to represent secondary infections (odds ratio 4.94 and 5.24, respectively) and occurred at older ages, underscoring the context-dependent clinical expression of different serotypes. Together, these findings demonstrate that all four dengue serotypes contribute meaningfully to clinical disease burden in Thailand and caution against de-emphasizing individual serotypes based on transient epidemiologic patterns. These results reinforce the importance of tetravalent vaccine strategies alongside continued evaluation of vaccine performance in evolving epidemiologic settings.
Editorial Note: Detection of relapsing fever Borrelia spp., Bartonella spp. and Anaplasmataceae bacteria in argasid ticks in Algeria.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 May · PMID 42172191 · Full text
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Zoonotic leishmaniasis in China: Current status and challenges to elimination.
Manathunga T, Barrs V, Han Q … +5 more , Fang F, Mendoza-Roldan JA, Bezerra-Santos MA, Dantas-Torres F, Otranto D
PLoS Negl Trop Dis · 2026 May · PMID 42166495 · Full text
UNLABELLED: Leishmaniasis is expanding worldwide along with sand fly vectors. In China, particular challenges arise from its broad climatic and ecological gradients, the diversity of phlebotomine sand fly species, and nu...
UNLABELLED: Leishmaniasis is expanding worldwide along with sand fly vectors. In China, particular challenges arise from its broad climatic and ecological gradients, the diversity of phlebotomine sand fly species, and numerous potential mammalian and reptilian hosts. Two ecological types of visceral leishmaniasis (VL) are recognized: anthroponotic VL (AVL) caused by Leishmania donovani and zoonotic VL (ZVL) caused by Leishmania infantum, which is subdivided into mountain-type (MT-ZVL) where dogs are the main reservoir, and desert-type (DT-ZVL) with uncertain reservoirs. Over the last decade, VL has re-emerged in central and northern regions of China, with increasing MT-ZVL notifications and evidence of canine infections in geographical areas where transmission had not previously been reported. This review synthesizes three decades of literature on canine leishmaniasis (CanL) and its vectors in China, focusing on domestic and wild reservoirs in the maintenance of zoonotic VL. Molecular studies reveal substantial genetic heterogeneity within the L. donovani complex and frequent discordance between single-locus markers (e.g., ITS1, cytb) and higher-resolution approaches (MLST/MLMT). Leishmania infection in dogs is most common in western foci, with high detection rates ranging from 24.8% to 77.2%, especially in Gansu and Sichuan Provinces, where subclinical infections predominate. Also, evidence of co-circulating unclassified Leishmania lineages related to Sauroleishmania complicates diagnosis and surveillance. Vector ecology, including the endophilic/exophilic behavior of Phlebotomus chinensis and the role of P. sichuanensis at high altitudes, overlaps with environmental change, dog management, and increasing stray dog populations, thereby amplifying transmission risk. Based on available data, dog culling is ineffective for long-term control of CanL due to poor diagnostics, rapid replacement of culled dogs, and ecological complexity. Conversely, vector control and bite prevention, using topical pyrethroid repellents (collars, spot-on pipettes) and possibly oral isoxazolines, should be implemented in dogs as control measures after appropriate field evaluation. Key gaps include insufficient canine surveillance and validation of diagnostic tools, as well as incomplete characterization of wildlife reservoirs. Strengthened One Health surveillance, integrating genomics, vector studies, and reservoir investigations, is essential to guide targeted control and predict future spread. METHODS: The PubMed, Scopus, Google Scholar, and Web of Science databases were searched from 1950 to 2025 for peer-reviewed publications reporting the genetic diversity of Leishmania species, the epidemiology and prevalence of zoonotic VL and CanL, and trends in their spatial and temporal distribution in China for this narrative review. Three search strings were employed in these databases to; (1) identify reservoir host and sand fly vectors for leishmaniasis in China, (2) identify the epidemiology (risk factors, re-emergence, trends) and control and prevention of leishmaniasis in China, (3) identify the diversity of Leishmania species in China. The protocols for database searches are provided in the Supporting Information. The China National Knowledge Infrastructure database was additionally searched to obtain Leishmania prevalence data in animals. Data were extracted from articles published in English and Chinese. After removal of duplicates, abstracts of 865 articles were screened for relevance, from which 279 full-text articles were reviewed to extract relevant information. Articles were included for final review (n = 129) if they contained data on molecular and/or serological Leishmania infection-rate data in dogs, the genetic diversity of Leishmania species in China, computational trends in VL, reservoir hosts for Leishmania species and, sand fly vectors in China.
Estimating the potential impact of global research on neglected tropical diseases on population-level indicators of health access, sanitation, and research capacity.
Hernandez-Paez DA, Lozada-Martinez ID, Reyes-Duque JD … +1 more , Kalokoh S
PLoS Negl Trop Dis · 2026 May · PMID 42166491 · Full text
BACKGROUND: Neglected tropical diseases (NTDs) continue to affect over a billion people, disproportionately impacting low- and middle-income countries (LMICs). While scientific research on NTDs has expanded substantially...
BACKGROUND: Neglected tropical diseases (NTDs) continue to affect over a billion people, disproportionately impacting low- and middle-income countries (LMICs). While scientific research on NTDs has expanded substantially over the last two decades, it remains unclear whether this growth has translated into measurable improvements in population-level health, development, or research capacity. This study aimed to evaluate the potential impact of global NTDs research on population-level indicators related to health systems, socioeconomic conditions, and research and development. METHODS: We conducted a longitudinal analysis, integrating bibliometric data from 107,251 NTDs-related publications with country-level indicators from open-access global databases. Countries were stratified by World Bank income classification. Linear regressions, meta-analyses, and meta-regressions were used to examine associations and heterogeneity across indicators and income groups. RESULTS: NTDs research output was significantly associated with reduced out-of-pocket health expenditures and current health spending (as % of GDP) in LICs and LMICs, and with expansion of the NTD drug pipeline in LICs and HICs. Strongest and most consistent effects were observed in the WASH domain, particularly reductions in open defecation and sanitation-related mortality. However, research capacity gains were concentrated in HICs. CONCLUSIONS AND IMPLICATIONS: While NTDs research has yielded measurable benefits in selected domains and settings, its overall population-level impact remains uneven. Enhancing scientific coherence will require intentional alignment of research agendas with health system needs, equity-driven funding, and stronger translation mechanisms in resource-limited settings.
Climate change induced complex shifts in snake distributions expose people to snakebite and threaten biodiversity.
Pintor AFV, Kanankege KST, Turner M … +27 more , Abela B, de Castañeda RR, Moos B, Hasanein TA, Hedao P, Friar K, McKay A, Martín G, Wüster W, Whitaker R, Martínez-Freiría F, Jackson K, Chirio L, LeBreton M, Abdalhalee AM, Kuch U, Pandey DP, Zacharie CK, Barragan-Paladines ME, Arenas CY, Yousefi M, Malonza PK, Sasa M, Amr ZS, Achour H, Kafash A, Williams DJ
PLoS Negl Trop Dis · 2026 May · PMID 42166482 · Full text
Snakes play pivotal roles in many ecosystems. While some species, including medically important ones, are considered threatened by the IUCN, snakebite takes a heavy toll on rural agricultural populations in the developin...
Snakes play pivotal roles in many ecosystems. While some species, including medically important ones, are considered threatened by the IUCN, snakebite takes a heavy toll on rural agricultural populations in the developing world. Approximately 138,000 deaths and 400,000 disabilities result from snakebite annually and WHO has pledged to reduce the resulting health burden by 50% by 2030. Among a plethora of reasons for insufficient snakebite mitigation, one is limited explicit knowledge of how, where, and when humans and snakes interact, which limits the timely, accurate, and efficient deployment of resources. Here, we revise the list of medically important snakes based on recent taxonomic updates and use high-resolution data from a broad range of published and unpublished resources to compare expert-derived ranges with statistical geographical models of habitat suitability for all 508 most medically important snake species globally. Our study is the first to model every single medically important snake species including data deficient ones, at the highest resolution to date, and with the largest supporting occurrence dataset. We generate geographically explicit estimates of how much human and snake populations overlap (snake-human-overlap-index; SHOI), which is the most fundamental prerequisite for human-snake conflict to occur. Finally, we model the effects of climate change on snake distributions. We predict substantial, short- and long-term shifts in snake distributions, including range contractions for many threatened species and increased human exposure to species of major public health concern. In combination with other drivers of increased snake-human conflict, such as human behaviours and snake traits, our predictions can be used to decide where to stockpile which antivenom, how to ensure adequate capacity of individual health facilities, how to improve health care accessibility of remote at-risk communities, and where to focus conservation efforts for threatened snake species. Hence, we highlight the need for geographically targeted efforts to benefit both vulnerable human and snake populations, as part of a One-Health strategy.
Local heterogeneity in Lassa fever serology in rural Nigeria: Implications for vaccine trial site selection.
Simons D, Harden C, Imirzian N … +11 more , Thompson KET, Ifebueme NM, Eziechina S, Ignatius H, Marcus D, Aderibigbe F, Koninga JT, Meremikwu M, Moses L, Redding DW, Friant S
PLoS Negl Trop Dis · 2026 May · PMID 42166471 · Full text
INTRODUCTION: Lassa virus (LASV) causes significant morbidity in West Africa, yet vaccine trial planning is hampered by a lack of high-resolution, community-level seroprevalence data. We aimed to characterize the fine-sc...
INTRODUCTION: Lassa virus (LASV) causes significant morbidity in West Africa, yet vaccine trial planning is hampered by a lack of high-resolution, community-level seroprevalence data. We aimed to characterize the fine-scale spatial and demographic heterogeneity of LASV exposure in rural Nigeria to inform site selection strategies. METHODS: We conducted a cross-sectional serosurvey across nine villages in three Nigerian states (Benue, Ebonyi, and Cross River). We recruited 1,874 individuals and tested for LASV IgG using the highly specific Panadea LASV IgG ELISA. We employed Bayesian hierarchical models to estimate seroprevalence and investigated 21 pre-specified demographic, environmental, and behavioral risk factors for association with seropositivity. Village-specific transmission dynamics were explored using Bayesian generalized additive models for age-stratified seroprevalence. RESULTS: The overall model-based IgG seroprevalence was 3.2% (95% CrI: 2.5-4.0%). We observed marked fine-scale heterogeneity, with village-level estimates ranging from 0.8% to 6.5%. Age-seroprevalence curves suggested? divergent transmission dynamics, ranging from cumulative endemic exposure to recent focal outbreaks in younger cohorts. Likely constrained by low overall prevalence and high exposure ubiquity, univariable analyses detected no strong or consistent associations between seropositivity and the 21 pre-specified risk factors, including rodent consumption and agricultural practices. No significant village-wide spatial clustering of seropositive households was observed via Local Getis-Ord (Gi*). DISCUSSION: LASV exposure in rural Nigeria is characterized by low overall prevalence punctuated by significant hyper-local variation. The lack of consistent individual-level risk factors and the divergent age-exposure profiles suggest that risk may be influenced by stochastic, localized ecological drivers or obscured by the temporal misalignment of cross-sectional surveys. Vaccine trial site selection must move beyond regional incidence data to incorporate interdisciplinary, One Health metrics including high-resolution human serosurveillance and longitudinal reservoir monitoring to identify active transmission hotspots.
A multicenter hospital-based analysis of cystic Echinococcosis in Afghanistan: Filling a National data gap.
Borhani M, Mosawi SH, Li S … +13 more , Tuohetaerbaike B, Fathi S, Behrad MS, Fazli MS, Rahmani F, Mehrpoor AJ, Balokhil N, Hakimi T, Omar A, Jamali M, Azizi ZA, Wen H, Torgerson PR
PLoS Negl Trop Dis · 2026 May · PMID 42166457 · Full text
BACKGROUND: Cystic Echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus, is highly endemic in Afghanistan due to livestock-dependent livelihoods, poor sanitation, limited healthcare access,...
BACKGROUND: Cystic Echinococcosis (CE), a neglected zoonotic disease caused by Echinococcus granulosus, is highly endemic in Afghanistan due to livestock-dependent livelihoods, poor sanitation, limited healthcare access, and unregulated animal practices. Despite its substantial morbidity and economic burden, national surveillance and clinical data remain scarce. OBJECTIVE: This study aims to describe the clinical and demographic characteristics of surgically treated CE patients at five referral hospitals in Kabul, Afghanistan. The objective is to fill the gap of limited national-level data on CE, provide evidence for targeted clinical management, resource allocation, and inform the development of effective public health interventions to address this neglected disease. METHODOLOGY: This retrospective hospital based surgical case series analyzed 330 surgically treated CE patients admitted to five hospitals in Kabul (2021-2025). Data on demographics, geographic origin, affected organs, and clinical records were extracted from archived medical documents. Descriptive analysis prioritized epidemiological and clinical characterization. RESULTS: Patients (6-78 years) originated from 31 provinces, with Kabul (107 cases), Faryab (35), and Balkh (24) as top sources. No significant gender predominance was observed (52.12% male, 47.87% female). Lungs were the most affected organ (86.66%), followed by the liver (11.51%); 81.31% of patients <20 years had pulmonary CE. Most cases (45.45%) were recorded in 2025, reflecting improved record retrieval. DISCUSSION & CONCLUSION: CE persists as a major public health challenge in Afghanistan, driven by fragmented surveillance, inadequate prevention, and unequal treatment access. The high proportion of pulmonary CE and young patients highlights unique local epidemiological patterns. Addressing CE requires a multisectoral "One Health" approach integrating surveillance, community education, veterinary interventions, and expanded diagnostic/treatment capacity to break the poverty-disease cycle.
Parasite exosomes-derived circulating sja-miR-61 and sja-miR-7-5p as Novel biomarkers for the detection of Schistosoma japonicum infection using TaqMan real-time PCR.
Zhang XY, Li JP, Lu JL … +5 more , Mei CJ, Yang YY, Dong PP, Yu CX, Song LJ
PLoS Negl Trop Dis · 2026 May · PMID 42160352 · Full text
Schistosomiasis, a zoonotic parasitic disease caused by schistosome infection, remains a serious public health concern. However, diagnostic methods with both high sensitivity and specificity or early diagnosis for detect...
Schistosomiasis, a zoonotic parasitic disease caused by schistosome infection, remains a serious public health concern. However, diagnostic methods with both high sensitivity and specificity or early diagnosis for detecting schistosome infection are still lacking. This study aimed to evaluate the diagnostic potential of parasite-derived exosomes miRNAs in Schistosoma japonicum (S. japonicum) infection. Exosomes were isolated and purified from adult worms and eggs of S. japonicum using ultracentrifugation. Nine highly abundant miRNAs were identified in these exosomes through small RNA sequencing. TaqMan probe-based reverse transcription real-time PCR (RT-qPCR) revealed that serum levels of all nine parasite-derived miRNAs were significantly elevated in infected mice at different time points post-infection. Compared with healthy controls, infected patients exhibited significantly elevated serum levels of sja-miR-61 and sja-miR-7-5p. Receiver operating characteristic (ROC) analysis indicated that the area under the curve (AUC) values for serum sja-miR-61 and sja-miR-7-5p were 0.8750 and 0.8375, respectively, surpassing those of the other miRNAs examined in human serum. The sensitivity and specificity for detecting these miRNAs in human serum were 85.00% and 85.00% for sja-miR-61, and 70.00% and 80.00% for sja-miR-7-5p. When both miRNAs were detected in combination, sensitivity increased to 95.00% with a specificity of 75.00%. In mice, the sensitivity and specificity for detecting sja-miR-7-5p at 2 weeks post-infection were 73.33% and 86.67%, improving to 93.33% and 93.33% at 6 weeks. For sja-miR-61, sensitivity and specificity were 93.33% and 80.00% at 2 weeks, reaching 100.00% and 100.00% at 6 weeks. Serum levels of sja-miR-61 and sja-miR-7-5p dropped to undetectable levels two weeks after praziquantel treatment, underscoring their utility in monitoring treatment response. Furthermore, measurement of sja-miR-61 and sja-miR-7-5p in mice with varying infection intensities showed rising serum levels corresponding to increased worm burdens, with a minimum detection threshold equivalent to an infection with 5 cercariae, highlighting the high sensitivity of this approach for detecting low-level infections in mice. Collectively, the detection of these miRNAs in patient or mouse serum using TaqMan RT-qPCR exhibits good sensitivity and specificity, along with considerable value for early diagnosis and treatment monitoring. sja-miR-61 and sja-miR-7-5p represent promising biomarkers for the diagnosis of schistosomiasis japonica.
How rash and eschar came to clinical attention in scrub typhus and Japanese spotted fever.
Sando E, Yasuda I
PLoS Negl Trop Dis · 2026 May · PMID 42160320 · Full text
BACKGROUND: Early diagnosis of scrub typhus and Japanese spotted fever remains challenging because initial manifestations are often nonspecific. In endemic areas, nearly 30% of patients were not correctly diagnosed at th...
BACKGROUND: Early diagnosis of scrub typhus and Japanese spotted fever remains challenging because initial manifestations are often nonspecific. In endemic areas, nearly 30% of patients were not correctly diagnosed at the first visit to a participating site. Previous studies have mainly treated rash and eschar as present-or-absent findings. We examined how rash and eschar came to clinical attention in patients correctly diagnosed at the first visit to a participating site and in those diagnosed later. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed 217 patients with scrub typhus or Japanese spotted fever from three healthcare facilities in an endemic region of Japan. Because first-visit documentation was incomplete in many delayed-diagnosis cases, recognition-pattern variables were abstracted at the time the correct diagnosis was established. Among these patients, 156 (71.9%) were correctly diagnosed at the first visit to a participating site and 61 (28.1%) were diagnosed after one or more subsequent visits. In multivariable analysis, correct first-visit diagnosis was associated with rash reported as a chief complaint (adjusted odds ratio [aOR] 4.95, 95% confidence interval [CI] 2.07-11.84), rash elicited during history taking (aOR 5.86, 95% CI 2.80-12.27), eschar identified on physical examination (aOR 2.80, 95% CI 1.19-6.58), and eschar elicited during history taking, which was exclusively observed among patients diagnosed at the first visit to a participating site. Age 75 years or older was associated with lower odds of correct first-visit diagnosis (aOR 0.40, 95% CI 0.21-0.75). CONCLUSIONS/SIGNIFICANCE: In endemic settings, patients correctly diagnosed at the first visit to a participating site more often had rash and eschar brought to clinical attention in specific ways. Directed inquiry about skin symptoms and careful examination for eschar may help recognition in routine care.
Editorial Note: Multiple Pathogens Including Potential New Species in Tick Vectors in Côte d'Ivoire.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 May · PMID 42160282 · Full text
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Correction: Transcriptomic and ultrastructural responses to Amiodarone-Itraconazole in naturally benznidazole-resistant and -susceptible Trypanosoma cruzi strains.
Gutiérrez S, Ospina C, Cáceres T … +3 more , Patiño LH, Paniz-Mondolfi A, Ramírez JD
PLoS Negl Trop Dis · 2026 May · PMID 42160275 · Full text
[This corrects the article DOI: 10.1371/journal.pntd.0013916.].
[This corrects the article DOI: 10.1371/journal.pntd.0013916.].
Decision-making for indoor residual spraying in the post-elimination phase of visceral leishmaniasis in Nepal.
Banjara MR, Das ML, Joshi S … +7 more , Pant KR, Pyakurel UR, Dahal G, Kroeger A, Aseffa A, Halleux CM, Joshi AB
PLoS Negl Trop Dis · 2026 May · PMID 42149985 · Full text
BACKGROUND: The effectiveness of indoor residual spraying (IRS) during the post elimination phase of visceral leishmaniasis (VL) and when to stop its application is uncertain. This study investigated the relationship bet...
BACKGROUND: The effectiveness of indoor residual spraying (IRS) during the post elimination phase of visceral leishmaniasis (VL) and when to stop its application is uncertain. This study investigated the relationship between VL occurrence and frequency of IRS on vector density, infection rates, and insecticide susceptibility. METHODOLOGY/PRINCIPAL FINDINGS: Four villages in the Sarlahi district served as sentinel surveillance sites for sandfly density measurement and xeno-monitoring, selected based on VL endemicity levels of high, moderate, low and non-endemic (no reported cases in the past 10 years). A random sub-sample of households from each village was selected for sandfly surveillance. The sample size of 380 was determined to detect a 1% infection rate of sandflies with 95% confidence interval. Ecological and epidemiological data were collected and IRS activity data between 2012-2023 was analysed. Sandflies were collected using CDC light traps and mouth aspirators for 12 months from March 2023 to February 2024 and tested with PCR for kDNA of Leishmania donovani. Monthly density of female Phlebotomus argentipes sandflies varied across endemicity levels, with a peak in November, with fluctuations observed throughout the year. Village wise sandfly pools positivity with parasite DNA varied with level of endemicity (66.7% in high VL endemicity villages, 62.1% in moderate, 36.8% in low, and 26.3% in non-endemic villages). Overall, among the total 91 pools of sandflies tested, 50.5% were positive for parasite DNA. P. argentipes showed high susceptibility to insecticides alpha-cypermethrin, bendiocarb, deltamethrin, and malathion. There were differences in IRS applications with variations in coverage and frequency and programmatic factors across municipalities, with no IRS conducted in some villages. Occupational distribution varied across endemicity levels, and there were differences in sleeping habits during warm weather. Non-impregnated bed nets were available across all endemicity levels. CONCLUSIONS/SIGNIFICANCE: IRS should be continued in the villages based on surveillance of sandfly density and reports of VL cases in the post elimination phase of VL.
Bridging laboratory and field research: Method adjustments to blood feed field-derived Aedes aegypti.
Epelboin Y, Ortega-Lopez LD, Balthazar E … +4 more , Cornement A, Guidez A, Dusfour I, Gendrin M
PLoS Negl Trop Dis · 2026 May · PMID 42149974 · Full text
Reference strains of Aedes aegypti, reared over decades under laboratory conditions, are commonly used in research due to their consistency and ease of handling. While their use is relevant in terms of reproducibility be...
Reference strains of Aedes aegypti, reared over decades under laboratory conditions, are commonly used in research due to their consistency and ease of handling. While their use is relevant in terms of reproducibility between labs, complementary work on field-collected mosquitoes and their progeny is essential to capture biological and behavioral variations of natural populations. However, experimental set-ups optimized on reference strains are not always successful with field-derived mosquitoes; their lack of attraction to experimental blood meals is a recurrent issue. In this study, we evaluated methods to improve blood-feeding rate of field-derived mosquitoes from Cayenne (French Guiana), using the New Orleans reference strain as a control. We tested the impact of several blood-feeding systems for mosquitoes kept in a cage or in individual vials and adjusted starvation parameters. Individual mosquitoes offered a blood meal in lids of microtubes had the highest blood-feeding rate. For field-derived mosquitoes, starvation, or alternatively, provision of a 3% salt solution instead of the sugar solution, also consistently improved blood-feeding rate, with a minimal impact on survival. Our results may be helpful for establishment of new colonies, including in resource-limited settings, studies on fitness of field-derived mosquitoes and on experiments requiring individual level monitoring.
Approaches to quantifying acceptability of pharmaceutical interventions for neglected tropical diseases: A scoping review.
Duguay C, Ost K, Krentel A
PLoS Negl Trop Dis · 2026 May · PMID 42149972 · Full text
Measuring acceptability is important in the context of pharmaceutical and public health interventions, since it can have an impact on uptake - a factor that extends beyond the safety and efficacy of the intervention. Thi...
Measuring acceptability is important in the context of pharmaceutical and public health interventions, since it can have an impact on uptake - a factor that extends beyond the safety and efficacy of the intervention. This scoping review aimed to explore how the acceptability of pharmaceutical interventions for neglected tropical diseases has been quantitatively measured in the literature to inform advancement towards a standardized methodology. A systematic search across five databases identified 1340 articles, of which 40 met the inclusion criteria. Twenty articles (50%) were published in the last five years, between 2020 and 2025. Fourteen articles measured acceptability using multiple questions, with nine establishing a threshold for acceptability. Twenty-two articles assessed acceptability using a single question, while four articles reported measuring acceptability but did not provide details about their methodology. Notably, mass drug administration programs targeting preventive chemotherapy for neglected tropical diseases comprised most studies (18/40), yet these studies utilized 9 distinct approaches to measure acceptability, despite their similar implementation strategies. Nearly a third of the articles (13/40) stated that they measured acceptability, however their methodology revealed that they were measuring coverage (received treatment) and compliance (swallowed treatment). Given that acceptability is one of the seven considerations informing World Health Organization guideline recommendations, a standardized method to quantify this multifaceted attribute is essential. As more studies on acceptability are being published in recent years, the lack of standardization becomes increasingly concerning. This review underscores the urgent need for such methodologies to generate reliable, comparable data for research and policymaking.
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