PLoS Neglected Tropical Diseases[JOURNAL]
Sun
200 papers
Interaction effects of physicochemical factors on the growth of Burkholderia pseudomallei in soil microcosms.
Chaianunporn K, Wang-Ngarm S, Chareonsudjai P … +2 more , Chareonsudjai S, Chaianunporn T
PLoS Negl Trop Dis · 2026 May · PMID 42149956 · Full text
BACKGROUND: Burkholderia pseudomallei (B. pseudomallei), the causative agent of melioidosis, inhabits diverse ecological niches such as soil, surface water, and rhizospheres. Soil serves as its primary reservoir. Underst...
BACKGROUND: Burkholderia pseudomallei (B. pseudomallei), the causative agent of melioidosis, inhabits diverse ecological niches such as soil, surface water, and rhizospheres. Soil serves as its primary reservoir. Understanding the ecological niche of B. pseudomallei in soil is crucial for developing strategies to reduce bacterial presence. Therefore, this study investigated the interaction effects of soil parameters, namely pH, salinity, temperature, moisture content, carbon to nitrogen (C/N) ratio, and iron content, on B. pseudomallei proliferation through factorial soil microcosm experiments. METHODOLOGY/PRINCIPAL FINDINGS: The experiments comprised three sets: (1) pH and salinity, (2) C/N ratio and salinity, and (3) iron content and salinity under varying temperature and moisture levels. Polynomial regression models demonstrated that all tested factors significantly influenced B. pseudomallei abundance, exhibiting linear, quadratic, cubic, and multi-way interactions. Optimal growth conditions varied with environmental context: B. pseudomallei growth peaked around pH 5 in the absence of salinity, whereas increased temperature and moisture expanded salinity tolerance (up to 0.61% at 35 °C and 75% moisture). The effect of C/N ratio on B. pseudomallei growth was moisture-dependent. The growth rate increased as the optimal C/N ratio rose from approximately 14 to 18 under 25 and 75% moisture, respectively, while elevated salinity consistently suppressed B. pseudomallei growth. Iron demonstrated contrasting effects depending on moisture; B. pseudomallei growth declined with increasing iron content at low-to-moderate moisture (25 and 50%) but was enhanced at high moisture (75%), with optimal iron content reaching 268.18 mg/kg at 35 °C. CONCLUSIONS/SIGNIFICANCE: These findings highlight that B. pseudomallei proliferation is governed by multifactorial interactions among soil physicochemical parameters. Understanding these interactions may support the development of environmental management strategies to reduce B. pseudomallei persistence in soil.
Effectiveness of community engagement in snakebite prevention and proper first aid practices: A community trial in rural Bangladesh.
Faiz MA, Farheen C, Rashid R … +12 more , Jahan F, Abu Sayeed A, Ghose A, Amin MR, Rahman ASMM, Rahaman FMA, Howlader C, Khan S, Chowdhury N, Debi GR, Rahman MS, Rahman AKMF
PLoS Negl Trop Dis · 2026 May · PMID 42149946 · Full text
BACKGROUND: Snakebite is a neglected tropical disease with significant public health implications, especially in rural Bangladesh. Studies to identify an effective community-based intervention to address this underapprec...
BACKGROUND: Snakebite is a neglected tropical disease with significant public health implications, especially in rural Bangladesh. Studies to identify an effective community-based intervention to address this underappreciated problem are scarce. This study evaluates the effectiveness of community engagement and enhanced health literacy for snakebite prevention and increased appropriate first aid practices utilizing existing health care system in rural communities of Bangladesh. METHODOLOGY AND PRINCIPAL FINDING: This quasi experimental study was conducted in two rural sub-districts of Bangladesh. Educational sessions, visual aids, and culturally tailored community engagement activities were implemented in intervention area. Baseline and endline surveys were conducted to evaluate the effectiveness of the intervention in terms of outcome on preventive measures, first aid knowledge, and practices by the community people. In the intervention area, preventive knowledge improved modestly from 9.2% to 12% (OR: 1.38, 95% CI: 1.09-1.74), and first aid knowledge rose from 50% to 73% (OR: 2.62, 95% CI: 2.25-3.06). Positive practices increased significantly from 18% to 22% (OR: 1.24, 95% CI: 1.04-1.49). The incidence rate of snakebite increased by 10.6% in the control area while it dropped by 43.4% in the intervention area (from 294.4 to 166.5 per 100,000). CONCLUSION: The incidence of snakebite was significantly decreased by community-based initiatives that improved the knowledge and practice of community people. Tailored education, community engagement, and culturally sensitive strategies were key to success. However, gaps in sustaining positive practices highlight the need for ongoing support. These findings provide a replicable model for addressing snakebite challenges in resource-limited settings.
Characterization of the first complete genome sequence of yellow fever virus (YFV) in Sierra Leone: Implications for public health.
Sandi JD, Brock-Fisher TM, Kallon TMPS … +17 more , Paye MF, Fofanah IU, Nosamiefan D, Kamara MS, Teh AJ, Turay A, Wilkason C, Baudi I, Tomkins-Tinch C, I'Anson C, Stachler E, Pekar JE, Ozonoff A, Park D, Happi C, Sabeti PC, Grant DS
PLoS Negl Trop Dis · 2026 May · PMID 42149940 · Full text
Yellow fever virus (YFV), a mosquito-borne orthoflavivirus that causes severe hemorrhagic disease, is endemic in parts of South America and Africa, yet genomic data from Sierra Leone is lacking despite ongoing case-based...
Yellow fever virus (YFV), a mosquito-borne orthoflavivirus that causes severe hemorrhagic disease, is endemic in parts of South America and Africa, yet genomic data from Sierra Leone is lacking despite ongoing case-based surveillance. Using hybrid-capture metagenomic sequencing, we generated a complete 10,611 nt YFV genome (98% coverage) from an adult male patient who reported to the Kailahun Government Hospital with fever and muscle pain. Phylogenetic analysis assigned the genome to the West African II genotype via the YFV Nextstrain build. The Sierra Leone genome showed 57 substitutions, three of which were non-synonymous (NS2B: N79S, NS3: V515I, and NS5 (RdRp domain): A643V), relative to its most recent common ancestor with other genomes from Senegal and the Netherlands. Bayesian phylogenetics estimated the time to the most recent common ancestor with these genomes as January 14, 2001 (95% HPD: December 17, 1987 - April 28, 2009), potentially indicative of long-standing transmission within West Africa that has not been genomically characterized, rather than specific localization to Sierra Leone. Together, these findings underscore the need for expanded genomic surveillance to monitor YFV spread and evolution.
Host-virus association databases as tools for understanding viral spillover at varying scales.
Lindsley IC, Juman MM, Seifert SN … +4 more , Gibb R, Albery GF, Jephcott F, Restif O
PLoS Negl Trop Dis · 2026 May · PMID 42149938 · Full text
Large host-virus association databases are increasingly used to explore broad questions in disease ecology, particularly around host range, pathogen diversity, and the potential for spillover. While these databases have...
Large host-virus association databases are increasingly used to explore broad questions in disease ecology, particularly around host range, pathogen diversity, and the potential for spillover. While these databases have been instrumental in large-scale synthesis of host-pathogen biogeography and zoonotic risk, their potential role in addressing fine-scale questions about pathogen prevalence, maintenance, and transmission dynamics remains underexplored. In this study, we build on previous efforts to assess how different types of data, including both entries in databases and the original studies they draw from, can support targeted research on zoonotic spillover. We selected two zoonotic diseases, Ebola virus disease and Lassa fever, which are characterised by recurrent spillover events and outbreaks in sub-Saharan Africa. We searched the VIRION database for entries corresponding to the respective viral taxa, the genus Orthoebolavirus and the species Mammarenavirus lassaense, and used these entries as case studies. We evaluated the extent to which databases capture crucial contextual metadata, such as spatial and temporal resolution, negative results, and measures of viral load. Guided by a conceptual framework of factors that lead to spillover, we demonstrate that while host-virus databases are valuable for addressing high-level patterns, fine-scale investigations of spillover require specific studies with detailed epidemiological data. Our study adds to a growing body of literature offering practical recommendations for database users and managers and highlights how these tools can be used as starting points in spillover research.
A systematic review comparing the performance of alternative blackfly (Simulium) trapping methods against the standard human landing catch (HLC) for onchocerciasis surveillance.
Kyomuhangi I, Mustafa A, Hawkes FM
PLoS Negl Trop Dis · 2026 May · PMID 42149935 · Full text
Despite decades of control efforts, onchocerciasis remains a major public health concern in Africa, the Americas, and Yemen. Human Landing Catch (HLC) is the primary method for collecting blackflies and is central to sur...
Despite decades of control efforts, onchocerciasis remains a major public health concern in Africa, the Americas, and Yemen. Human Landing Catch (HLC) is the primary method for collecting blackflies and is central to surveillance. However, HLC raises ethical concerns due to collectors' exposure to painful and potentially infectious bites and faces operational challenges in areas of very low or high transmission. Consequently, several alternative blackfly trapping methods have been investigated, but no comprehensive synthesis comparing their effectiveness against standard HLC across studies has been conducted. Therefore, we performed a systematic review comparing the performance of alternative blackfly traps with standard HLC. A systematic review (PROSPERO registration number: CRD420261294895) of literature published in Scopus, PubMed, and Web of Science up to December 2025 was supplemented by an expert-provided reference list. From 166 records, 62 were screened, and 13 studies (comprising 79 comparisons with standard HLC) met inclusion criteria. Alternative traps included light traps, Bellec traps, tent traps baited with humans or cows, Esperanza Window Traps, Host Decoy Traps, electric nets, and modified HLC. Most comparisons (75.9%) found alternative traps to be less effective than standard HLC, with statistical analyses often supporting these differences, although nearly half lacked formal significance testing. Variation in study design-including trap placement, rotation, and trapping duration-and inconsistent reporting of key variables such as season, habitat, and species limited direct comparisons. Some studies indicated that increasing trap density or deployment duration of Esperanza Window Traps could improve effectiveness. While HLC remains the most effective method, its ethical and operational limitations highlight the need for reliable alternatives. Most existing traps underperform relative to HLC, but modifications based on deeper understanding of blackfly behaviour and ecology could improve performance. Future research should focus on standardizing trap evaluation methods, exploring species-specific behaviours, and assessing scalability to develop ethical, scalable tools for onchocerciasis surveillance.
Systematic review of health risk assessment in Africa's bushmeat trade: Are there any risks assessed?
Amougou CV, Missoup AD, Tindo M … +1 more , Gaubert P
PLoS Negl Trop Dis · 2026 May · PMID 42149918 · Full text
BACKGROUND: The bushmeat trade in tropical Africa represents a major route for zoonotic disease emergence. Yet, the extent to which health risks have been quantitatively assessed remains unclear. Therefore, our study aim...
BACKGROUND: The bushmeat trade in tropical Africa represents a major route for zoonotic disease emergence. Yet, the extent to which health risks have been quantitatively assessed remains unclear. Therefore, our study aimed at systematically reviewing health risk assessments conducted in the African bushmeat trade, and identifying methodological patterns and research gaps. METHODOLOGY/PRINCIPAL FINDINGS: Following PRISMA guidelines, we searched Web of Science and Google Scholar (to November 2024) using multilingual Boolean queries. Eligible studies included any research assessing health, zoonotic, or food-borne risks in bushmeat supply chains across Africa. Two co-authors independently cross-validated c. 23% of extracted data. Descriptive statistics and generalized linear models were used to explore publication patterns and predictors of research output. From 449 records finally identified, 129 met inclusion criteria. Ethnobiological and public health surveillance approaches dominated (41.1% each), while epidemiological studies were scarce. Most publications appeared after 2017, mainly from Cameroon, Nigeria, and the Democratic Republic of Congo, with epidemic occurrence significantly predicting national research output. Interviews were the most frequent method (44.8%), while pathogen detection occurred in 40.3% of studies, identifying 66 confirmed human pathogens (23 viruses, 19 bacteria, 24 parasites). More than 88% of studies did not report survey effort, and none implemented a formal quantitative health risk assessment. CONCLUSIONS/SIGNIFICANCE: Quantitative health risk assessment in the African bushmeat trade remains unattainable due to scarce data on pathogen prevalence, exposure, and host-pathogen interactions. Only formal recognition and state-regulated management of the trade-incorporating molecular surveillance, host-pathogen ecological data, and supply-chain mapping within a One Health framework-will enable reliable risk quantification.
Dengue vaccine acceptability in Peru: A mixed-methods study in two dengue-endemic Peruvian cities.
Cañari-Casaño JL, Ortega EB, Vizcarra AS … +7 more , Camizan-Castro R, Ríos López EJ, Córdova López JJ, Hidalgo C, Moyano LM, Morrison AC, Paz-Soldan VA
PLoS Negl Trop Dis · 2026 May · PMID 42149914 · Full text
INTRODUCTION: Dengue poses a major public health challenge in Peru, with Piura and Iquitos experiencing recurrent outbreaks and limited control options. A dengue vaccine could complement current vector control strategies...
INTRODUCTION: Dengue poses a major public health challenge in Peru, with Piura and Iquitos experiencing recurrent outbreaks and limited control options. A dengue vaccine could complement current vector control strategies and reduce transmission, yet community perceptions and barriers to uptake in pre-implementation settings remain poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: Our mixed-methods study design was conducted in Piura and Iquitos, guided by the 5C's Framework of Vaccine Hesitancy. Sixteen focus group discussions (n = 147) explored acceptability and concerns regarding a hypothetical future dengue vaccine; a subsequent survey (n = 883) quantified vaccine acceptability. Dengue vaccine acceptability was operationalized using a theory-driven, multi-item outcome contrasting individuals willing to vaccinate ("acceptors") with those unsure about accepting vaccination ("unsure"). Multivariable logistic regression examined factors associated with vaccine uncertainty. RESULTS: Using the multi-item, theory-driven classification, most (81.9%) survey participants were classified as "acceptors", 14.5% were "unsure", and 3.6% would refuse all vaccines ("refusers"). Qualitative findings underscored the need for clear information on efficacy, eligibility, and side effects, provided by trusted health professionals. In multivariable analysis, compared to acceptors, the "unsures" had more negative views towards COVID-19 vaccination (OR 2.17), higher technical or higher education (OR 3.33), and reduced confidence due to the rapid COVID-19 vaccine development (OR 2.17). The "unsures" also expressed less trust in vaccine benefits (OR 0.25), less willingness to pay for a dengue vaccine (OR 0.40), and lower knowledge of dengue transmission (OR 0.45) compared to the acceptors. CONCLUSIONS: Although most participants expressed willingness to receive a future dengue vaccine, vaccine uncertainty was primarily shaped by factors related to confidence, convenience, and communication. Mistrust in vaccines in general or residual mistrust linked to COVID-19 vaccination experiences, and concerns about vaccine development may hinder acceptance. Tailored communication, engaging trusted local leaders, and ensuring easy access are critical for successful dengue vaccination campaigns in these endemic regions.
Spatiotemporal trends of neglected tropical disease hospitalizations in Ecuador over 25-years from 2000 to 2024.
Aldaz-Barreno C, Romero-Sandoval N, Gualán M … +6 more , Álvarez P, Zurita-Loma D, Dávila Rosero G, Martin M, Cooper PJ, Unit on the Social and Environmental Determinants of Health Inequalities (SEDHI)
PLoS Negl Trop Dis · 2026 May · PMID 42149910 · Full text
BACKGROUND: The World Health Organization identifies 21 neglected tropical diseases (NTDs) affecting millions globally. While their population burden is well recognised, less is known about the long-term trends in severe...
BACKGROUND: The World Health Organization identifies 21 neglected tropical diseases (NTDs) affecting millions globally. While their population burden is well recognised, less is known about the long-term trends in severe NTD-related morbidity requiring hospitalization. We analysed national trends and geographic patterns of hospitalizations attributed to NTDs in Ecuador between 2000 and 2024. METHODS: We analysed hospital discharge data from Ecuador's national registry over a 25-year period. Age-standardized hospitalization rates were estimated, and temporal trends were assessed using Joinpoint regression for the 5 most frequent NTDs. Standardized morbidity ratios (SMRs) were estimated for these NTDs for census years (2001, 2010 and 2022) to explore relative changes in hospitalization rates over time and by geography. RESULTS: A total of 179,439 hospital discharges were attributed to NTDs, representing 0.7% of all hospitalizations. The five most frequent NTDs accounted for 97.1% of hospitalizations: dengue and chikungunya (62.4%), snakebite envenoming (20.1%), soil-transmitted helminthiases (8.7%), taeniasis and cysticercosis (3.9%), and scabies and other ectoparasitoses (2.0%). Only 0.4% of hospitalizations resulted in death. Hospitalizations were more frequent in males (54%) and younger populations (median 19 years, Q1 9 - Q3 37). Overall hospitalizations rates increased over time, driven primarily by arboviral infections, while non-arboviral NTDs showed declining trends: snakebite (from 2014, annual percent change -7.81%, 95% CI -11.27, -5.69, P = 0.006), soil-transmitted helminths (from 2000, -5.62%, 95% CI -6.56, -4.68, P < 0.001), and taeniasis and cysticercosis (from 2003, -10.42%, 95% CI -14.50, -9.68, P = 0.002). Relative morbidity caused by NTDs was consistently greater in Coastal and Amazon provinces, with shifts over time across regions, although taeniasis and cysticercosis morbidity remained greatest in southern Andean Provinces. CONCLUSION: Over 25 years in Ecuador, hospitalizations attributed to several non-arboviral NTDs declined, while arboviral infections increasingly contributed to severe NTD-related morbidity. These findings reflect trends in the most severe clinical manifestations requiring inpatient care and highlight persistent geographic inequalities, particularly in the Amazon region. Strengthening surveillance, prevention, and equitable access to timely diagnosis and care will be essential to reduce severe NTD morbidity and support progress towards national and global NTD elimination and control targets.
Strengthening frontline capacity for skin neglected tropical diseases: Findings from a global survey.
Anwar S, Freeman EE, Geutjes R … +6 more , Fenenga C, Pathak P, Dagne DA, Gabrielli AF, Fuller LC, Ruiz Postigo JA
PLoS Negl Trop Dis · 2026 May · PMID 42149907 · Full text
BACKGROUND: Skin-related neglected tropical diseases (skin NTDs) remain a major source of morbidity in resource-limited settings. These conditions include Buruli ulcer, chromoblastomycosis and other deep mycoses, cutaneo...
BACKGROUND: Skin-related neglected tropical diseases (skin NTDs) remain a major source of morbidity in resource-limited settings. These conditions include Buruli ulcer, chromoblastomycosis and other deep mycoses, cutaneous leishmaniasis, post-kala-azar dermal leishmaniasis, leprosy, lymphatic filariasis, mycetoma, noma, onchocerciasis, scabies, tungiasis, and yaws. Recent efforts have focused on developing training materials to help frontline health workers diagnose and treat skin NTDs. However, little is known about how these materials are perceived and utilized in endemic regions. We performed a global online survey to identify gaps and establish priorities for future training resource development. METHODS: We conducted a cross-sectional, anonymous online survey to assess training needs for skin NTDs. The survey was disseminated by the World Health Organization's Global Neglected Tropical Diseases Programme via the WHO website, targeted email distribution to NTD professionals, and outreach on LinkedIn. Respondents identified skin NTDs most urgently requiring improved training resources in their settings and reported on priority topics, target audiences, languages, formats, and barriers to access. RESULTS: A total of 308 participants from 48 countries completed the survey during the one-month response period. The three most frequently reported skin NTDs in need of additional training resources were leprosy (64.6%), scabies (60.7%), and lymphatic filariasis (55.6%). Early detection and diagnosis were the most prioritized training topics (86.0%). Most respondents preferred English-language resources (62.7%), with printed manuals and guidelines identified as the most useful format (70.1%). The most commonly reported barrier was limited availability of up-to-date materials (75.3%). CONCLUSIONS: We highlight persistent gaps in the accessibility of training materials for skin NTDs. While many high-quality resources exist, their dissemination, adaptation, and translation remain limited. Respondent-identified priorities provide a framework to enhance training resources, strengthen the capacity of frontline healthcare workers, and ultimately advance global skin NTD control, elimination, and eradication goals.
Nationwide larval mosquito sampling in Cambodian households: Vector species in anthropogenic breeding sites.
Doeurk B, Kasai S, Maquart PO … +1 more , Boyer S
PLoS Negl Trop Dis · 2026 May · PMID 42149905 · Full text
Vector control remains a key strategy in reducing mosquito-borne disease transmission. Understanding mosquito species distribution, diversity, and breeding habitat ecology is crucial for effective surveillance and to def...
Vector control remains a key strategy in reducing mosquito-borne disease transmission. Understanding mosquito species distribution, diversity, and breeding habitat ecology is crucial for effective surveillance and to define targeted vector control interventions. We conducted a study to understand the diversity and habitat preferences of mosquito larvae across Cambodia during the rainy season from July to September 2024. Mosquito larvae were collected from a variety of breeding habitats located around households across all 25 provinces. The national sampling was conducted once during the rainy season in urban (city) and rural (village) areas within each province. Collected larvae were reared to adult emergence in the insectarium for morphological identification, further confirmed with molecular techniques. We found 37 mosquito species in the households, of which 12 are vectors of pathogens such as dengue and Japanese encephalitis viruses, and Plasmodium species, representing 93% of all collected mosquitoes. Larvae were predominantly found in anthropized artificial breeding habitats, accounting for 98% of all larvae collected. Notably, the two primary dengue vectors, Aedes aegypti and Ae. albopictus, were recorded from all 52 sampling locations. In addition, our study identified the presence of Aedes vittatus in 12 provinces, a new confirmed vector of dengue in Cambodia. We also recorded eight Japanese encephalitis vectors, with at least one species from all sampling sites. There were no statistically significant differences in larval mosquito biodiversity (relative abundance, number of species, Shannon and Simpson diversity indices) between cities and villages, with 15 species occurring in both environments, representing 41% of the species and 99% of all mosquitoes collected. The widespread and predominant presence of dengue and Japanese encephalitis vectors in every household confirms the endemic circulation of these diseases in Cambodia.
Correction: Establishing an external quality assurance scheme for the detection of Orientia tsutsugamushi IgM in clinical samples: Strengthening quality control of scrub typhus diagnosis in Indian laboratories.
Ratchagadasse VR, Vasudevan D, Philomenadin FS … +5 more , Sivakumar H, Devanathan N, Kaur H, Mukhopadhyay L, Dhodapkar R
PLoS Negl Trop Dis · 2026 May · PMID 42149842 · Full text
[This corrects the article DOI: 10.1371/journal.pntd.0014007.].
[This corrects the article DOI: 10.1371/journal.pntd.0014007.].
Mycetoma.
Hoekstra M, Lattwein KR, van de Sande WWJ
PLoS Negl Trop Dis · 2026 May · PMID 42139367 · Full text
The Neglected Tropical Disease mycetoma is a chronic, progressive infectious disease characterized by large tumor-like masses in subcutaneous tissues. It is endemic in rural areas of low- and middle-income countries, whe...
The Neglected Tropical Disease mycetoma is a chronic, progressive infectious disease characterized by large tumor-like masses in subcutaneous tissues. It is endemic in rural areas of low- and middle-income countries, where it can lead to extensive health and socioeconomic burdens for the patient and their family. It is especially prevalent among male farmers. The disease can be caused by both bacteria and fungi, referred to as actinomycetoma and eumycetoma, respectively. Inoculation occurs when a skin breach allows the pathogen to enter the subcutaneous tissue. The pathogen can form grains, which make the disease more resistant to host defense and antimicrobial treatments. This review summarizes the current knowledge on the historical background and epidemiology of mycetoma, the characteristics of its causative agents, underlying pathophysiology, diagnostic approaches, available treatment strategies, preventive measures, and future prospects for disease management and research. Although the recognition of mycetoma as both a neglected tropical disease and a fungal priority pathogen has increased awareness and research interest, large knowledge gaps remain.
Natural history and impact of Giardia lamblia on child growth attainment and associated pathway-specific biomarkers in a Nicaraguan birth cohort.
Gutiérrez L, Vielot NA, Reyes Y … +10 more , Herrera R, Toval-Ruiz C, Mora J, Arndt MB, Barney R, Choy RKM, Bucardo F, Vilchez S, Becker-Dreps S, Bartelt LA
PLoS Negl Trop Dis · 2026 May · PMID 42139304 · Full text
BACKGROUND: Giardia lamblia (Giardia) is one of the most common intestinal parasitic infections globally, with an estimated 280 million symptomatic infections annually. In children from low- and middle-income countries (...
BACKGROUND: Giardia lamblia (Giardia) is one of the most common intestinal parasitic infections globally, with an estimated 280 million symptomatic infections annually. In children from low- and middle-income countries (LMICs), Giardia is highly prevalent and has been associated with loss of intestinal barrier function, nutrient-metabolic dysregulation, and linear growth impairment, but specific mechanisms linking Giardia to these outcomes remain poorly understood. METHODS AND RESULTS: We used data and samples from a subset of 76 children in a longitudinal birth cohort in Nicaragua to evaluate the natural history and geospatial distribution of Giardia infections, child growth outcomes (weight-for-age [WAZ] and length-for-age [LAZ] z scores), and relationships with established biomarkers of inflammation, intestinal damage, and growth-signaling. During the first 36 months of life, we tested 2,305 stools (1,903 surveillance stools and 402 diarrheal stools) for Giardia by qPCR. The incidence of Giardia-positive stools was 59.6 per 100 child-years. Any detection of Giardia was associated with a reduction in LAZ at 36 months of life (β:-0.16, P = 0.042). This effect increased when considering persistent or recurrent Giardia detections (β:-0.26, P=<0.001) as well as living in a high-density Giardia detection area (β:-0.44, P=<0.001). Among intestinal markers, Giardia was associated with lower median fecal neopterin (a marker of chronic intestinal T cell activation) at 24 and 36 months of age. Among serum systemic biomarkers measured at 24 months, Giardia detections were associated with indicators of intestinal epithelial cell damage (higher median Intestinal Fatty Acid Binding Protein (P = 0.002) and Anti-FliC IgA (P = 0.033), and reduced growth-signaling hormone (lower median Insulin-like Growth Factor (IGF-1) (P = 0.005). CONCLUSION: Giardia detection was negatively associated with linear growth in an exposure-dependent manner. Simultaneously, Giardia was associated with diminished serum growth-signaling hormones. Patterns of serum and fecal intestinal biomarkers suggest that Giardia-mediated epithelial disruption is dissociated from markers of intestinal inflammation.
PvGTSeq and PvCRiSP: Two amplicon-based targeted sequencing panels for Plasmodium vivax.
Manrique-Valverde PC, Hasund CM, Kelley KA … +18 more , Amaya-Romero JE, Arévalo-Herrera M, Brosula R, Calzada JE, Chenet SM, Corredor V, Early AM, Fontecha G, Forero-Peña DA, Herrera S, Lana JT, Laws M, Niles-Robin R, Obaldia N, Santamaria AM, Schwabl P, Auburn S, Neafsey DE
PLoS Negl Trop Dis · 2026 May · PMID 42133746 · Full text
Plasmodium vivax is the main cause of malaria outside of sub-Saharan Africa, and in many settings it presents significant challenges to malaria elimination efforts. Despite some control successes in the Americas, regiona...
Plasmodium vivax is the main cause of malaria outside of sub-Saharan Africa, and in many settings it presents significant challenges to malaria elimination efforts. Despite some control successes in the Americas, regional annual case counts of malaria have increased by over 25% between 2014 and 2023, largely driven by P. vivax. Genomic surveillance can play a key role in understanding the extent to which disease persistence represents indigenous transmission as opposed to introduction of new strains through migration, and whether specific variants evade control measures. Efforts to make P. vivax genomic surveillance more cost-effective have led to the development of targeted sequencing-based methods, which strike a varying balance between assay sensitivity and breadth/informativeness. We introduce two new highly sensitive multiplexed amplicon sequencing panels for P. vivax: PvGTSeq and PvCRiSP. PvGTSeq requires selective whole-genome amplification (sWGA) and contains 249 amplicons-36 for antimalarial resistance and 213 for population structure-optimized for Latin America but applicable to all continents. PvCRiSP features four highly polymorphic amplicons that operate without sWGA and is designed to estimate complexity of infection (COI), identify instances of clonal transmission, and characterize recurrent episodes. Both panels use a single multiplex PCR with non-proprietary reagents, achieve ≥75% amplicon recovery at parasitemias as low as five parasites/μL, and PvCRiSP remains effective with low quality DNA. PvGTSeq showed high sequencing accuracy (error rate 3.85e-4% - 2.87e-3%), and both panels efficiently detected alleles from minority clones in simulated polyclonal infections. We validated both panels with samples from Colombia, Guyana, Honduras, Panama, and Venezuela, and performed in-silico assessments using data from 16 countries worldwide, confirming that these two panels have high power to discriminate samples and assign global geographic origin to imported cases. These panels will therefore be useful tools for P. vivax molecular surveillance in diverse geographic settings.
Antigenic divergence of cobra short-chain α-neurotoxins: Implications for regional antivenom effectiveness in Southeast Asia.
Tan CH, Palasuberniam P, Pernee LL … +1 more , Tan KY
PLoS Negl Trop Dis · 2026 May · PMID 42133734 · Full text
Short-chain α-neurotoxins (SNTXs) are the principal neurotoxic components in several Asiatic cobras, including Naja atra, Naja philippinensis, and Naja samarensis. Although structurally conserved, SNTXs exhibit marked an...
Short-chain α-neurotoxins (SNTXs) are the principal neurotoxic components in several Asiatic cobras, including Naja atra, Naja philippinensis, and Naja samarensis. Although structurally conserved, SNTXs exhibit marked antigenic variation that can limit the effectiveness of regional antivenoms used for snakebite envenoming in Asia. Here, we evaluated the immunoreactivity of the Philippine Cobra Antivenom (PCAV) and three regional products-Naja kaouthia Monovalent Antivenom (NkMAV), Neuro Bivalent Antivenom (NBAV), and Indonesian SABU-against a panel of cobra venoms and purified α-neurotoxins. PCAV bound strongly to homologous N. philippinensis SNTX but showed significantly lower cross-reactivity with SNTXs from Naja kaouthia, Naja sputatrix, and N. atra, and minimal recognition of marine elapid SNTXs and long-chain α-neurotoxins (LNTXs) of Monocled Cobra as well as King Cobra. Conversely, NkMAV and NBAV recognized mainland Asian SNTXs more broadly but reacted poorly with the Philippine cobra toxin. These differences were statistically significant in multiple comparisons versus the homologous venom control. Hierarchical clustering of normalized immunoreactivity delineated two major SNTX antigenic subtypes corresponding to Philippine versus continental Asian lineages. Peptide sequence analysis unmasked two distinct loop-II motifs (28WWS-TII37 and 28RWR-YRT37) associated with these divergent immunotypes. Phylogenetic reconstruction suggests that the Philippine cobras retain an ancestral-like SNTX motif, while Sundaic and East Asian cobras have diversified to employ another major SNTX form. Epitope prediction further revealed differences in surface exposure and accessibility, which helps explain the limited cross-neutralization among antivenoms. These findings demonstrate a clear antigenic dichotomy among Asian cobra SNTXs, which underlies species-specific antivenom effectiveness and highlights the need to incorporate representative SNTX variants into immunogen formulations to improve regional antivenom coverage.
Human resource challenges in leprosy control: A cross-sectional study in southwest border area of China.
Song R, Shen Y, Guo F … +13 more , Zhen Q, Kou S, Zha S, Yu X, Li Z, Song S, Hao J, Zhang Y, Wang Y, Ma T, Shui T, Yan X, Zhao W
PLoS Negl Trop Dis · 2026 May · PMID 42133733 · Full text
BACKGROUND: Leprosy remains a neglected tropical disease and major global public health challenge, particularly in developing countries with severe healthcare workforce shortages hindering control. The southwestern borde...
BACKGROUND: Leprosy remains a neglected tropical disease and major global public health challenge, particularly in developing countries with severe healthcare workforce shortages hindering control. The southwestern border, represented by Yunnan Province, is a core endemic area. A comprehensive assessment of its leprosy workforce is critical for achieving elimination. METHODS/RESULTS: In October 2024, a cross-sectional census survey evaluated 423 Leprosy prevention and control personnel across all 129 counties in Yunnan Province, China. These counties were categorized into high (I), moderate (II), and low (III) endemicity areas based on their leprosy burden. Distinct workforce patterns emerged among 423 personnel, Category I areas exhibited the highest proportion of personnel aged 30-39 years (37.5%), along with the continuing education participation (78.5%), the highest full-time employment rate (52.5%), and strongest prescription protocol awareness (72.5%). Category II areas featured the oldest personnel profile (35.0% aged ≥50 years),with a moderate positive correlation between age and years of service (r = 0.58), highest continuing education participation (78.8%). In contrast, Category III areas had the highest proportion under 30 years (20.5%), and highest proportion of personnel with Bachelor's degrees or higher (69.9%) lowest full-time employment rate (38.4%), highest compensation dissatisfaction (38.4% "below average"), and lowest intention to leave (8.2%). Pervasive workforce aging existed (at least 30% of personnel ≥50 years in Category II and III) and widespread technical gaps (>75% Category III areas lacked essential lab skills). Part-time staffing was common (47.5%-61.6% across categories). Despite over >90% of personnel in these three categories rated their compensation as "average or below", compensation and career challenges were most acute in Categories I and II. CONCLUSIONS: The Yunnan leprosy workforce shows strengths, notably high continuing education participation (78.5%) and balanced clinical/preventive staffing. However, it faces significant challenges, workforce aging, shortage of highly qualified personnel, and limited lab capacity. Urgent intervention measures are needed to revitalize the workforce, enhance training, and strategically allocate resources to expedite the achievement of leprosy elimination.
Cost-effectiveness of soil-transmitted helminthiasis intervention programmes: A scoping review.
Odhiambo M, Wuresah I, Chepchieng G … +5 more , Kubal N, Krolewiecki A, Mwandawiro C, Brooks A, Okoyo C
PLoS Negl Trop Dis · 2026 May · PMID 42127165 · Full text
BACKGROUND: Soil-transmitted helminthiases (STH) infect over 1.5 billion people worldwide, causing serious health issues, especially among women of reproductive age and school-age children. Mass drug administration (MDA)...
BACKGROUND: Soil-transmitted helminthiases (STH) infect over 1.5 billion people worldwide, causing serious health issues, especially among women of reproductive age and school-age children. Mass drug administration (MDA) using albendazole or mebendazole is the main method of control. However, high reinfection rates and limited integration with water, sanitation, and hygiene (WASH) and routine primary health care programs make the effectiveness of long-term control and elimination challenging. METHODS: This scoping review aimed to systematically map and summarize cost-effectiveness evidence for STH control and elimination efforts. Following Arksey and O'Malley's framework and Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines, we identified 22 studies published from 1993 to 2025 through PubMed and Google Scholar. PRINCIPAL FINDINGS: Most studies focused on MDA intervention with school or community-based delivery platforms. School-based delivery costs ranged from $0.03 to $0.76 per child, and community-wide delivery costs ranged from $0.27 to $1.74 per individual. Community-wide programs were estimated to have greater impact and cost-effectiveness in high-prevalence areas, costing $28 to $198 per disability-adjusted life year averted. Programs that delivered multiple disease interventions (integrated programs) showed the highest economic returns, primarily due to shared delivery platforms and reduced operational costs. The main factors influencing cost-effectiveness included treatment coverage, baseline prevalence, and delivery costs. Evidence gaps for cost-effectiveness still exist for preschool-aged children and integration with WASH. CONCLUSION: This scoping review showed that context affects the cost-effectiveness of STH intervention programs. Community-wide and integrated MDA strategies offered more economic value than school-based delivery in areas with high prevalence.
Evolutionary trends of plague research from 2016 to 2025: A bibliometric analysis.
Niu Y, Zhang Y, Zhou S … +5 more , Liu G, Chen Y, Yuan Y, Du G, Liu J
PLoS Negl Trop Dis · 2026 May · PMID 42127162 · Full text
BACKGROUND: Plague is a severe zoonotic disease caused by Yersinia pestis, a pathogen characterized by high infectivity and mortality rates. Historically, three global pandemics have inflicted heavy disasters on human so...
BACKGROUND: Plague is a severe zoonotic disease caused by Yersinia pestis, a pathogen characterized by high infectivity and mortality rates. Historically, three global pandemics have inflicted heavy disasters on human society. Despite improvements in control measures and the application of antibiotics, plague has been somewhat controlled; however, since the beginning of the 21st century, plague outbreaks have continued to occur in regions with a high burden of neglected tropical diseases (NTDs) in Africa, the Americas, and Asia. In recent years, the rapid development of technologies such as molecular biology, immunology, and bioinformatics has propelled significant advancements in plague diagnostics, vaccine development, and transmission mechanisms. However, there has been a lack of systematic quantitative analysis of the distribution characteristics, evolving hotspots, and frontier trends of plague research, which makes it challenging to provide comprehensive scientific support for research and control decision-making. METHODS: Search for relevant literatures on plague that were published in the Web of Science Core Collection and PubMed database from January 1, 2016 to November 12, 2025.Bibliometric methods were adopted, and software including COOC 20.6, VOSviewer 1.6.20, and Anaconda were used to analyze the publication trend, distribution of institutions, national cooperation network, keyword co-occurrence clustering, and the annual variation trends. RESULTS: A total of 1994 documents were finally included. The annual number of publications showed an overall fluctuating upward trend, with a significant growth rate from 2020 to 2021 (annual growth rate of 10.44%). Core research institutions included the U. S. Centers for Disease Control and Prevention and Beijing Institute of Microbiology and Epidemiology. The United States, China, France and Madagascar were the main core countries for cooperation. Keyword co-occurrence clustering identified five major research fields, which were plague vaccine development and immune mechanism, ecology and vector control, historical epidemiology and public health, epidemiology and transmission chain, and plague-related infectious diseases and biosafety. The research trends analysis showed that from 2016 to 2020, the plague research mainly focused on keywords such as "Rodents" "Epidemiological Survey" "Human Plague" and "Fleas". From 2021 to 2025, "Phylogenetic Analysis," "Public Health," and "Madagascar" newly entered the top 20 keyword list; the frequencies of "Black Death" and "Infectious Disease" increased significantly, while the frequencies of "Plague Vaccine" and "Prairie Dogs" remained relatively stable. CONCLUSIONS: Over the past decade, remarkable achievements have been made in plague research. Interdisciplinary integration and technological innovation have continued to deepen. However, global collaboration remains insufficiently developed. In the future, it is necessary to foster broader cross-regional cooperation, accelerate the research, development and translation of vaccines and diagnostic technologies, integrate multiple technologies to construct a precise prevention and control system. and enhance the global collaborative prevention and control capabilities of plague.
Safety and pharmacokinetics of GSK3494245, a highly selective Leishmaniasis kinetoplastid proteasome inhibitor for the treatment of visceral leishmaniasis: A Phase 1, randomized, single ascending dose escalation study in healthy participants.
Moodley M, Kostapanos M, Iavarone L … +9 more , Bracher M, Lavezzi SM, Davy M, Singh P, Bhat R, Wong D, Sharma H, Tan LK, Miles TJ
PLoS Negl Trop Dis · 2026 May · PMID 42127151 · Full text
BACKGROUND: Visceral leishmaniasis (VL) is a neglected tropical disease caused by kinetoplastid parasites. If left untreated, VL has a case fatality >90%, making treatment essential for patient survival. Existing therapi...
BACKGROUND: Visceral leishmaniasis (VL) is a neglected tropical disease caused by kinetoplastid parasites. If left untreated, VL has a case fatality >90%, making treatment essential for patient survival. Existing therapies have several limitations that impact treatment outcomes, including toxicity, requirement for parenteral administration, long treatment duration, and development of parasite resistance, driving the need for newer therapies. This Phase 1 first-time-in-human study evaluated the tolerability, safety, and pharmacokinetics (PK) of GSK3494245, a novel highly selective Leishmania kinetoplastid proteasome inhibitor. METHODOLOGY: This was a randomized, double-blind, placebo-controlled, single ascending dose study evaluating the oral administration of GSK3494245 in healthy participants aged 18 to ≤55 years (NCT04504435). The study was conducted at a single center in the United Kingdom between October 2020 and January 2024. FINDINGS: GSK3494245 had an acceptable safety profile following administration of single doses of up to 240 mg in healthy male participants. All adverse events (AEs) were considered resolved or recovered, with most AEs being of mild or moderate severity. One serious AE of mild tachycardia was reported. The increase in exposure was slightly more than dose-proportional and approximately proportional under fasted and fed conditions, respectively. The median time to reach the maximum plasma concentration (Cmax) ranged from 0.50 to 1.79 hours, and the geometric mean of the elimination half-life ranged from 1.04 to 2.27 hours. Two participants met the Cmax stopping criterion. CONCLUSION: GSK3494245 showed an acceptable safety profile over the dose range studied. However, based on its observed PK profile, GSK3494245 is unlikely to achieve the effective dose while ensuring safe exposure within the once- or twice-daily monotherapy target product profile recommended by the Drugs for Neglected Diseases initiative. CLINICAL TRIAL REGISTRATION: NCT Number (www.clinicaltrials.gov): NCT04504435 EudraCT, CTIS: 2019-004492-39.
Molecular detection and genetic characterisation of a large flood-borne outbreak of human leptospirosis in Jakarta, Indonesia: A retrospective analysis of surveillance data.
Nelwan EJ, Anggraini YW, Zanjabila S … +9 more , Setiawan B, Suhartiningsih Suhartiningsih, Handayani FD, Jeny Jeny, Erlina L, Fadilah F, Baird JK, Hamers RL, Suwarti S
PLoS Negl Trop Dis · 2026 May · PMID 42127150 · Full text
Recurring outbreaks of leptospirosis in flood-prone areas caused by heavy rainfall pose a major public health concern, particularly in megacities such as Jakarta, Indonesia. From December 2019 through February 2020, Jaka...
Recurring outbreaks of leptospirosis in flood-prone areas caused by heavy rainfall pose a major public health concern, particularly in megacities such as Jakarta, Indonesia. From December 2019 through February 2020, Jakarta experienced a large leptospirosis outbreak due to extensive flooding following extreme monsoonal rainfall. We conducted a comprehensive retrospective analysis of the outbreak based on complete surveillance data from all five districts and 42 of 44 subdistricts in Jakarta. A total of 282 cases (97 suspected, 153 probable, and 32 confirmed) were reported in West (n = 162), South (n = 64), East (n = 30), North (n = 14) and Central (n = 12) Jakarta. Cases were predominantly adult males exposed to floodwaters. Of 241 cases tested, 164 (68.0%) had a positive IgM-based rapid diagnostic test (RDT). Of 118 cases tested with TaqMan RT-PCR targeting lipL32, 32 (27.1%) were positive. Of 95 cases tested with both assays, the combined detection rate was 74.7% (71/95); of whom 27 were positive by both RDT and RT-PCR. RT-PCR identified 5 additional RDT-negative cases, all of whom had fever <7 days. We sequenced 42 archived blood samples using Multi Locus Sequence Typing (MLST) and identified Leptospira interrogans and L. borgpeterseni as the predominant species. The findings emphasise the importance of rapid and early laboratory-based diagnosis during leptospirosis outbreaks in flood-prone urban areas, to better target public health interventions. Climate-resilient urban planning is critical for vulnerable megacities in low-resource settings, where complex environmental and infrastructural challenges are compounded by the effects of a changing climate.
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