PLoS Neglected Tropical Diseases[JOURNAL]
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200 papers
Epidemiological study of leptospiral interaction in bovine farms in rural areas of Colombia: A One Health approach.
Patiño-Gómez S, Naranjo-Vargas LF, Aguirre-Acevedo DC … +5 more , Aguirre-Ramírez NJ, Wunder EA, de Oliveira F, das Chagas-Xavier SC, Quintero-Vélez JC
PLoS Negl Trop Dis · 2026 May · PMID 42090421 · Full text
BACKGROUND: Leptospira are zoonotic agents with a complex transmission cycle that affects low-income and impoverished populations and causes significant economic losses in livestock. OBJECTIVE: To evaluate the interactio...
BACKGROUND: Leptospira are zoonotic agents with a complex transmission cycle that affects low-income and impoverished populations and causes significant economic losses in livestock. OBJECTIVE: To evaluate the interaction between people, animals, and the environment related to Leptospira infection in bovine farms in Urabá, Antioquia. METHODS: An exploratory cross-sectional study was conducted on cattle farms in Urabá, Antioquia. The proportion of pathogenic Leptospira infection in bovine and canine urine and environmental contamination in water and soil samples was estimated using molecular assays. Additionally, Leptospira seropositivity in humans, cattle, and canines was determined using the microagglutination test (MAT). Evaluation of composition characteristics of landscape was done and potential flooding areas were estimated. The domestic animals and human populations were characterized through descriptive analysis using productive and reproductive data and sociodemographic information, respectively. Then, associations between seropositivity/infection, antibody titers, Leptospira serogroups/species in cattle, canines, and humans, and productive, farms and landscape variables we explored using a mixed-data factor analysis. RESULTS: The proportion of seropositivity in cattle wa 76.9% (380/494). The most frequent serogroups on MAT were Mini, Tarassovi, Ballum, and Sejroe. In addition, molecular analysis indicated an infection rate of 4.0% (20/494) of the species L. borgpetersenii in cattle. Seropositivity in humans was 4.1% (3/73), with serogroups Icterohaemorrhagiae, Autumnalis, and Sejroe. Thirty-three percent (5/15) of dogs were seropositive for serogroups Canicola, Icterohaemorrhagiae, Ballum, and Autumnalis. The presence of L. tipperaryensis was detected in water and species L. weilii and L. cinconiae in soil. Evidence of high exposure to Leptospira was found in cattle. An association was also found between the serogroups circulating in humans and dogs (Autumnalis) and in humans and cattle (Sejroe), as well as forest fragmentation. CONCLUSIONS: The importance of addressing the epidemiology of Leptospira infection from a comprehensive One Health approach is highlighted.
Clonorchis sinensis excretory secretory products promote hepatic fibrosis through stimulating biliary epithelium to secrete IL-17A.
Liu T, Gao H, Wang N … +9 more , Wang W, Cao Z, Zhu H, Liu N, Gao H, Ji B, Liu T, Zhang F, Bai X
PLoS Negl Trop Dis · 2026 May · PMID 42085509 · Full text
Clonorchis sinensis (C. sinensis) infection causes serious pathological changes of hepatobiliary system such as hyperplasia of the biliary mucosa, inflammation and periductal fibrosis. The excretory-secretory products of...
Clonorchis sinensis (C. sinensis) infection causes serious pathological changes of hepatobiliary system such as hyperplasia of the biliary mucosa, inflammation and periductal fibrosis. The excretory-secretory products of C. sinensis (CsESPs) play critical roles in triggering inflammation and subsequent activation of hepatic stellate cells (HSCs). Yet, how CsESPs induce hepatic fibrosis through breaking the barrier of biliary epithelium remains unclear. Previous studies have confirmed that interleukin-17A (IL-17A) promoted fibrosis in some liver diseases. In the present study, the IL-17A levels in the serum of C. sinensis infected patients and healthy people were compared. C. sinensis infected mouse model was applied to discover the expression of IL-17A, especially its localization in the biliary epithelium. Cells and bile duct organoid models were established to evaluate the effect of CsESPs on the production of IL-17A by biliary epithelium and subsequent activation of HSCs. The results indicated that the levels of IL-17A were higher in the serum of patients and mice infected with C. sinensis than in the healthy people and control mice respectively. Infected mouse liver showed increased collagen deposition and marked hyperplasia of the intrahepatic bile duct with significant expression of IL-17A. CsESPs-stimulated human cholangiocarcinoma cells (RBE) displayed elevated proliferation ability and produced higher level of IL-17A. Supernatant of CsESPs-RBE cells activated human hepatic stellate cells (LX-2) with upregulated production of α-SMA and collagen I. Knocking down of IL-17A in RBE cells by lentivirus attenuated the expression of α-SMA and collagen I in LX-2 cells incubated with supernatants of CsESPs-stimulated RBE cells. Under stimulation of CsESPs, the bile duct organoids became swelled with thickened and deformable walls and prominent IL-17A signals. These findings suggest that CsESPs may activate HSCs through a new pathway of stimulating biliary epithelium to produce IL-17A.
Accuracy of AI-assisted diagnostic tools for Schistosoma haematobium: A systematic review and meta-analysis.
Desale S, Alemu G, Hailu T
PLoS Negl Trop Dis · 2026 May · PMID 42085501 · Full text
BACKGROUND: Urogenital schistosomiasis caused by Schistosoma haematobium remains endemic in sub-Saharan Africa. Diagnosis traditionally relies on urine microscopy to detect parasite eggs; however, its sensitivity decline...
BACKGROUND: Urogenital schistosomiasis caused by Schistosoma haematobium remains endemic in sub-Saharan Africa. Diagnosis traditionally relies on urine microscopy to detect parasite eggs; however, its sensitivity declines in low-intensity infections. Artificial intelligence (AI)-assisted image analysis offers a promising approach to automate egg detection and enhance diagnostic accuracy, but its performance compared with standard microscopy is not well established. METHODS: We conducted a systematic review following the PRISMA guidelines and checklist. Studies evaluating AI-assisted detection of S. haematobium compared with microscopy and/or molecular reference standards, published up to August 2025, were identified through searches in PubMed/MEDLINE, HINARI, Epistemonikos, Science Direct, Google Scholar and grey literature sources. Eligible studies were selected based on pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the QUADAS-2 tool. Heterogeneity among studies was evaluated using the Cochrane Q test and I² statistic. Data was analyzed using STATA version 14.1 and Review Manager version 5.4.1. RESULTS: Ten studies (15 datasets, 5,564 urine samples) conducted in sub-Saharan Africa met the inclusion criteria. AI-assisted tools demonstrated high diagnostic accuracy. The pooled sensitivity was 88% (95%CI 83%-91%) and pooled specificity was 89% (95% CI 83%-93%). The pooled diagnostic odds ratio was 54.00 (95% CI 30.41-95.88), indicating strong discrimination between infected and uninfected cases. The SROC curve yielded an AUC of 0.94 (95% CI 0.92-0.96), reflecting excellent overall accuracy. Heterogeneity across studies was high (I² = 100%), suggesting results varied by the specific AI platform and study context. CONCLUSION: AI-assisted microscopic diagnosis of S. haematobium achieved very good in this meta-analysis. These automated tools, whether smartphone-based or bench-top systems, showed promise for detecting infections and could help screen populations in endemic areas. With further validation in field settings and comparison to highly sensitive reference tests, AI diagnostic technology may become a valuable tool to improve case detection and support schistosomiasis control and elimination efforts.
Global, regional, and national disease burden of arthropod-borne diseases: Projections to 2030 based on the global burden of disease study 2021.
Li M, Yang Y, Xue C … +8 more , Zuo Q, Wang Y, Liu H, Pu Y, Shen Y, Wang X, Yin J, Cao J
PLoS Negl Trop Dis · 2026 May · PMID 42085455 · Full text
BACKGROUND: Arthropod-borne diseases (ABDs) represent an ongoing threat to global public health, affecting millions annually with viral, bacterial and parasitic infections worldwide. METHODS: Data on prevalence and disab...
BACKGROUND: Arthropod-borne diseases (ABDs) represent an ongoing threat to global public health, affecting millions annually with viral, bacterial and parasitic infections worldwide. METHODS: Data on prevalence and disability-adjusted life years (DALYs) for ABDs were obtained from the Global Burden of Disease (GBD) 2021 study. Based on DALYs, the nine ABDs were categorized into protozoan, helminthic, and viral diseases. Temporal trends were quantified using the average annual percentage change (AAPC) in age-standardized prevalence rates (ASPRs) and age-standardized DALY rates (ASDRs). Frontier analysis was applied to evaluate deviations from the expected disease burden according to sociodemographic index (SDI), and Bayesian age-period-cohort models were used to project future disease burdens through 2030. RESULTS: From 1990 to 2021, the global ASDR for ABDs declined from 1,219.26 to 884.16 per 100,000 population. Protozoiasis caused the most substantial burden (ASDR 819.83), followed by helminthiases and viral diseases. Although ASDRs declined across the three major disease categories overall, dengue fever exhibited a significant upward trend within the viral disease group (AAPC = 0.83%). Burdens remained concentrated in low and lower-middle SDI regions, though High-income Asia Pacific and Australasia experienced notable increases. Frontier analysis indicated that while parasitic burdens declined with rising SDI, viral disease patterns varied: dengue peaked at middle SDI, and Zika increased with SDI. Adolescents and young adults bore the greatest burden, with distinct sex-specific differences. Projections suggest that by 2030, ASPRs for malaria and African trypanosomiasis, as well as ASDRs for malaria, African trypanosomiasis, and leishmaniasis, will increase. CONCLUSIONS: Protozoan infections, particularly malaria, continue to dominate the burden of arthropod-borne diseases. Although the overall burden of viral diseases declined modestly, certain arboviral infections, including dengue, showed increasing trends. The distinct geographic concentration of these infections, coupled with the rising threat of arboviral diseases, underscores the urgent need for enhanced surveillance systems, expanded vaccination coverage, and strengthened global collaboration to mitigate future risks.
Diagnostic performance of a biotin-labeled 4D1 sandwich ELISA for serum antigen detection in talaromycosis.
Wei H, Amsri A, Thammasit P … +6 more , Pruksaphon K, Teng Y, Pu C, Huang Y, Nosanchuk JD, Youngchim S
PLoS Negl Trop Dis · 2026 May · PMID 42085450 · Full text
BACKGROUND: Talaromycosis, caused by the thermally dimorphic fungus Talaromyces marneffei, is a life-threatening opportunistic infection in individuals with advanced immunodeficiency, particularly people living with HIV...
BACKGROUND: Talaromycosis, caused by the thermally dimorphic fungus Talaromyces marneffei, is a life-threatening opportunistic infection in individuals with advanced immunodeficiency, particularly people living with HIV in endemic regions of Southeast Asia. Early diagnosis is essential to reduce morbidity and mortality; however, conventional diagnosis relies mainly on fungal culture, which is time-consuming and has limited sensitivity. METHODS: We developed and clinically evaluated a direct sandwich enzyme-linked immunosorbent assay (ELISA) using a biotin-labeled monoclonal antibody (4D1) for the detection of T. marneffei cytoplasmic yeast antigen in serum. The assay employed the same monoclonal antibody for both capture and detection in a double-recognition format. Analytical performance, cross-reactivity, and clinical diagnostic accuracy were systematically evaluated. RESULTS: No cross-reactivity was observed among the tested fungal antigens under the experimental conditions. The analytical limit of detection (LOD) in pooled human serum was 19.398 μg/mL. Clinical evaluation included 79 culture-confirmed talaromycosis cases and 381 non-talaromycosis controls. At an optimized optical density cut-off of 0.268, the assay demonstrated a sensitivity of 88.61% (95% confidence interval [CI] 79.47-94.66%) and a specificity of 96.06% (95% CI 93.59-97.78%). CONCLUSIONS: The biotin-labeled 4D1 sandwich ELISA provides a rapid and accurate diagnostic method with good concordance to culture and may support improved clinical diagnosis of talaromycosis. Its potential application for treatment monitoring requires further validation.
Retraction: Body lice of homeless people reveal the presence of several emerging bacterial pathogens in northern Algeria.
PLOS Neglected Tropical Diseases Editors
PLoS Negl Trop Dis · 2026 May · PMID 42085419 · Full text
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Sequential Organ Failure Assessment (SOFA) score and quick SOFA(qSOFA) predict 30-day mortality in patients with HIV-associated Talaromycosis: A multicenter retrospective cohort study.
Lang G, Ye S, Miao X … +6 more , Qin J, Xiang D, Wang M, Chen G, Su F, Xu L
PLoS Negl Trop Dis · 2026 May · PMID 42085388 · Full text
HIV-associated talaromycosis (HAT) is a severe fungal infection for which established severity assessment methods are lacking. The Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores were evaluated i...
HIV-associated talaromycosis (HAT) is a severe fungal infection for which established severity assessment methods are lacking. The Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores were evaluated in 464 patients with HAT to assess their associations with inflammatory markers, hospital stay, and 30-day mortality. SOFA scores were negatively correlated with blood culture positivity time (r = -0.470, P < 0.001) and positively correlated with IL-6, IL-10, and CRP (all P < 0.001). Patients with fungemia had higher SOFA scores (2.3 ± 2.4 vs. 1.2 ± 0.6, P < 0.001). Mortality increased with qSOFA scores: 8.9% (score 0), 16.5% (score 1), and 55.0% (score ≥2; P < 0.001). For SOFA, mortality was 4.5% (scores 0-1), 6.8% (2-3), 22.0% (4-5), 52.2% (6-7), and 85.7% (≥8; P < 0.001), repectively. Survivors' SOFA scores improved by day 7 (1.6 ± 1.6 to 1.0 ± 1.4, P < 0.001), while non-survivors worsened by day 7 (4.8 ± 3.4 to 5.1 ± 5.6, P = 0.027) compared to day 0. Among the surviving patients, the hospital stay days were 21.0 (14.0-27.0) for scores 0-1, 22.0 (16.0-29.0) for scores 2-3, 27.0 (20.3-43.5) for scores 4-6 and 29.0 (5.5-38.0) for scores ≥6 (P = 0.005). Multivariate analysis identified qSOFA [adjusted odds ratio (AOR):1.564, P = 0.018], SOFA [AOR:1.533, P = 0.001], and non-amphotericin B deoxycholate (non-AmBd) therapy [AOR:2.732, P = 0.026] were independent predictors of 30-day mortality. SOFA and qSOFA both predicted poor outcomes in patients with HAT. Early diagnosis and preemptive AmBd therapy should be prioritized for patients with HAT who had high SOFA/qSOFA scores.
Dual role of Japanese encephalitis virus fusion loop peptide antibodies in Zika virus infection.
Xi K, Zhang X, Li J … +14 more , Zhao Y, Xie X, Shen C, Zhang B, Zhu L, Xiao W, Wan C, Lin Y, Wang L, Liu Y, Wang Y, Yu J, Wu Q, Zhao W
PLoS Negl Trop Dis · 2026 May · PMID 42081585 · Full text
Zika virus (ZIKV) is a key member of the Flavivirus genus that has emerged as a major global public health concern. The fusion loop region (residues 98-110), located within domain II of the envelope protein, is highly co...
Zika virus (ZIKV) is a key member of the Flavivirus genus that has emerged as a major global public health concern. The fusion loop region (residues 98-110), located within domain II of the envelope protein, is highly conserved among flaviviruses, including ZIKV and Japanese encephalitis virus (JEV). However, the functional consequences of such conservation for cross-reactive immunity remains unclear. Here, we integrated bioinformatic analyses, functional assays in vitro and mouse models in vivo to systematically determine the effects of antibodies directed against the JEV fusion loop (FL) region on ZIKV infection. Sequence alignment and structural analysis revealed complete amino acid identity and almost identical three-dimensional conformations between the FL regions of the two viruses, providing a molecular basis for cross-reactivity. Antisera generated against the JEV FL region recognized ZIKV particles and displayed concentration-dependent bidirectional effects. Increased and decreased antibody levels respectively neutralized viral entry and replication, and facilitated infection via antibody-dependent enhancement (ADE). These effects were confirmed in vivo, in which high and low antibody doses reduced tissue pathology and improved survival, and increased viremia and exacerbated inflammatory responses, respectively. These findings highlight the importance of antibody concentration in determining whether cross-reactive responses to conserved structural elements engender neutralization or enhancement response. Our findings provide experimental evidence for assessing ZIKV susceptibility in JEV-vaccinated populations and offer structural insights for designing flavivirus vaccines that maximize protection while minimizing ADE risk. These findings further highlight potential pathogenic and clinical considerations for optimizing vaccine formulations to reduce cross-reactive enhancement risks.
Methods for estimating the burden of acute tropical infectious diseases: A scoping review.
Wang Q, Maude RJ, Day NPJ … +1 more , Sartorius B
PLoS Negl Trop Dis · 2026 May · PMID 42081584 · Full text
Acute infectious diseases, particularly lots of neglected tropical diseases (NTDs), pose significant public health challenges, especially in resource-limited settings where diagnostic and surveillance capacities are ofte...
Acute infectious diseases, particularly lots of neglected tropical diseases (NTDs), pose significant public health challenges, especially in resource-limited settings where diagnostic and surveillance capacities are often inadequate. This scoping review systematically explores methodologies for estimating the burden of acute infectious NTDs, focusing on metrics such as incidence, mortality, and disability-adjusted life years (DALYs). We identified 60 studies, predominantly on malaria and dengue, with a growing emphasis on advanced computational approaches like machine learning and Bayesian geospatial modeling. Key findings highlight the evolution from traditional surveillance-based methods to integrated frameworks incorporating environmental, demographic, and health system covariates. However, challenges persist, including data sparsity, underreporting, and methodological uncertainties. The review underscores the need for improved data integration, standardized frameworks, and interdisciplinary collaboration to enhance the accuracy and utility of burden estimates.
Modelling approaches for predicting the distribution of skin NTDs: A systematic review.
A Bushara M, Hassan R, Ahmed R … +4 more , Cano J, Davey G, Ganawa E, Simpson H
PLoS Negl Trop Dis · 2026 May · PMID 42081581 · Full text
BACKGROUND: Skin neglected tropical diseases (NTDs) such as cutaneous leishmaniasis, lymphatic filariasis, mycetoma, and podoconiosis affect millions in endemic regions, but are under-recorded despite causing significant...
BACKGROUND: Skin neglected tropical diseases (NTDs) such as cutaneous leishmaniasis, lymphatic filariasis, mycetoma, and podoconiosis affect millions in endemic regions, but are under-recorded despite causing significant burdens. Predictive modelling has been used to estimate the distribution and prevalence of some of these diseases, and predictions may be useful for identifying at-risk populations and guiding interventions. This review synthesises the literature on modelling approaches to predict skin NTD distributions, aiming to identify prevalent methodologies, evaluate their strengths and limitations, highlight research gaps, and provide recommendations for enhancing their utility. METHODS: We conducted a systematic literature review from three databases and included studies published from 2000-2024. Studies were included if they employed statistical models or machine learning algorithms to predict the distribution of skin NTDs. Two independent reviewers screened titles, abstracts, and full texts. Data extracted included disease, study region, source of epidemiological data, model types and predictors. RESULTS: From 2,870 retrieved records, 68 met the inclusion criteria. The most modelled skin NTDs were cutaneous leishmaniasis (n = 26) and lymphatic filariasis (n = 18). Geostatistical modelling was the most common approach, followed by ecological niche modelling, with MaxEnt and generalised linear models constituting the predominant model types. Common environmental covariates included climate, land cover and land use, elevation, and soil data. The types of epidemiological data varied, with many studies relying on passive surveillance and pseudoabsence data. The risk of bias was high among ecological niche models. CONCLUSIONS: Environmental and geostatistical models can inform targeted interventions for skin NTDs, aiding efficient resource allocation and public health planning. However, data limitations, especially the absence of true absence data, underreporting and variations in surveillance sensitivity, can reduce model accuracy and undermine decision-makers' confidence. Future studies should focus on incorporating information about case identification into modelling frameworks, including a broader spectrum of environmental and socio-economic determinants, and ensuring validation across diverse geographic regions.
Biomphalaria pfeifferi infected with Schistosoma spp. in Kakamega and Bungoma counties, western Kenya confirms autochthonous transmission of intestinal schistosomiasis.
Odiere MR, Kepha S, Kihara J … +9 more , Juma C, Kioko D, Wakesho F, Wanja DN, Muchangi M, Sempele I, Chami I, Matendechero SH, Omondi W
PLoS Negl Trop Dis · 2026 May · PMID 42081579 · Full text
BACKGROUND: Granular mapping conducted in Kakamega and Bungoma counties of western Kenya provided strong evidence of intestinal schistosomiasis among school-age children in this area. However, it was unclear whether the...
BACKGROUND: Granular mapping conducted in Kakamega and Bungoma counties of western Kenya provided strong evidence of intestinal schistosomiasis among school-age children in this area. However, it was unclear whether the observed infections were due to active transmission. To address this gap, a follow-up malacology survey was conducted to determine the presence of snail vectors and ascertain active transmission. METHODS: Nineteen Wards with ≥10% prevalence of Schistosoma mansoni were selected from Kakamega and Bungoma counties. From these Wards, 42 primary schools with the highest prevalence of S. mansoni were used to identify nearby water bodies with human-water contact activities for sampling snail vectors. Live snails were sampled by experienced collectors using a handheld dip-net scoop in standardized sampling frames for ~30 minutes at each water body. Snails were counted and identified to species-level based on shell morphology. Site locations sampled for snails were mapped using a geographical information system, and the type of water body recorded. All Biomphalaria and Bulinus snails were transported to the laboratory where they were screened for cercariae. Cercariae were identified to basic taxonomic groups using standard identification keys. The relative and mean abundance and prevalence of Schistosoma sp. infection in snails was determined. RESULTS: Out of 4,245 snails collected, 3,341 (78.7%, 95% CI: 77.5-79.9) were putatively identified as Biomphalaria pfeifferi, 88 (2.1%, 95% CI: 1.7-2.5) as Bulinus globosus, 664 (15.6%, 95% CI: 14.6-16.7) as Lymnaea natalensis and 152 (3.6%) as other species. B. pfeifferi were found in 36 out of the 42 primary school regions (85.7%), with the highest number (605 snails) recorded at Indangalasia in Lusheya-Lubinu Ward. A total of 87 (2.6%, 95% CI: 2.07-3.14) B. pfeifferi shed Schistosoma sp. cercariae. The mean abundance of B. pfeifferi was similar between streams (16 ± 35) and swamps/marshes (20 ± 31) (P = 0.356), but was higher compared to rivers (4 ± 10) (P = 0.005). CONCLUSIONS: The high abundance of B. pfeifferi coupled with the observation of field-caught snails shedding cercariae confirms autochthonous schistosomiasis transmission corroborating the reported human infections in Kakamega and Bungoma counties. Incorporation of focal snail control to complement chemotherapy will accelerate interruption of transmission in these areas.
Syndromic management of sexually transmitted infections in the Brazilian Amazon: A 10-year retrospective study.
Chaves Camilo AC, Pedrosa VL, Sardinha JC … +10 more , Costa SPD, Borges CL, Miranda AE, Bindá A, Leturiondo AL, Dos Santos Silva CG, Ferreira CO, Guerra MDGB, Talhari S, Talhari C
PLoS Negl Trop Dis · 2026 May · PMID 42081572 · Full text
BACKGROUND: The syndromic approach is a widely applied strategy for managing sexually transmitted infections (STIs) in settings where laboratory diagnostics are limited. This study aimed to describe temporal patterns in...
BACKGROUND: The syndromic approach is a widely applied strategy for managing sexually transmitted infections (STIs) in settings where laboratory diagnostics are limited. This study aimed to describe temporal patterns in syndromic STI diagnoses and identify factors independently associated with these diagnoses over a period of 10 years at a reference center in the state of Amazonas, Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective review was conducted using medical records from patients attending a reference center for STI care in Amazonas, Brazil, from 2014 to 2023. Sociodemographic, clinical, and behavioral data were analyzed. The syndromic classification followed World Health Organization guidelines and included vaginal discharge, cervical discharge, urethral discharge, genital ulcers, and genital warts. A total of 32,485 medical records were reviewed, with 14,931 (46.0%) syndromic diagnoses identified. The most frequent syndromes were genital warts (41.0%), urethral discharge (31.5%), genital ulcer (21.3%), cervical discharge (3.8%), and vaginal discharge (2.3%). In multivariate analysis, factors independently associated with receiving a syndromic diagnosis were age ≥ 30 years (OR = 1.16; 95% CI: 1.05-1.20), male sex (OR = 2.31; 95% CI: 1.75-2.45), single marital status (OR = 1.82; 95% CI: 1.43-2.21), irregular condom use (OR = 3.21; 95% CI: 2.46-3.60), and having two or more casual partners (OR = 3.42; 95% CI: 2.94-3.90). CONCLUSIONS/SIGNIFICANCE: Despite inherent limitations, the syndromic approach remains an essential strategy for STI control in resource-constrained contexts such as the Amazon. It facilitates prompt treatment and broadens access to care where laboratory confirmation is unavailable. Integrating syndromic and etiological approaches is vital to improve diagnostic accuracy, optimize antimicrobial use, and strengthen public health responses to STIs in the region.
Establishment and characterization of a Wolbachia (wAlbB)-infected Aedes aegypti line (Tw-Kao) for dengue control.
Yu HY, Chen BY, Chen YT … +13 more , Huang WK, Yang CH, Wu YC, Wan MH, Yeh WS, Goh FG, Hou X, Toh PK, Ng SH, Cai Y, Li JC, Chen CH, Liu WL
PLoS Negl Trop Dis · 2026 May · PMID 42081569 · Full text
Global trade and climate change are driving the geographic expansion of dengue vectors, contributing to the global spread of dengue. Conventional vector control measures have proven insufficient to prevent substantial di...
Global trade and climate change are driving the geographic expansion of dengue vectors, contributing to the global spread of dengue. Conventional vector control measures have proven insufficient to prevent substantial disease burdens, highlighting the need for innovative and sustainable strategies. The release of Wolbachia-infected mosquitoes offers a promising alternative for dengue suppression. Here, we developed a locally derived Ae. aegypti line carrying the wAlbB strain (wAlbB-Tw-Kao) and systematically evaluated its fitness, viral interference, and potential for vector population control. The strain was generated through embryonic microinjection of cytoplasm containing the intact wAlbB endosymbiont from field-collected Ae. albopictus in Kaohsiung, Taiwan, resulting in a stably infected mosquito line with 100% maternal transmission. Whole-genome sequencing confirmed a high similarity to the reference wAlbB genome. Cross-mating experiments demonstrated complete cytoplasmic incompatibility (CI, 0% egg hatch) when wAlbB-Tw-Kao males were mated with uninfected females. Antiviral assays against dengue virus serotype 2 (DENV-2) and Zika virus showed significant reductions in viral titers in the midgut, salivary glands, and saliva. In cage experiments, increasing release ratios of wAlbB-Tw-Kao males led to significant suppression of wild-type populations, achieving up to approximately 90% reduction in egg hatch. These findings demonstrate the successful development of a locally derived wAlbB-infected Ae. aegypti line with strong CI, stable maternal transmission, and effective DENV and ZIKV blocking. These properties provide a foundation for future field-relevant evaluation under both suppression and replacement deployment frameworks.
Incidence of acute pancreatitis among hospitalized patients with dengue: A systematic review and meta-analysis.
Chen Y, Shang M, Dou S … +5 more , Wang X, Ji H, Song X, Wang J, Liu Q
PLoS Negl Trop Dis · 2026 May · PMID 42081560 · Full text
BACKGROUND: Acute pancreatitis (AP) is an under-recognized but clinically relevant complication of dengue fever (DF), associated with rapid clinical deterioration and increased risk of mortality. However, the true incide...
BACKGROUND: Acute pancreatitis (AP) is an under-recognized but clinically relevant complication of dengue fever (DF), associated with rapid clinical deterioration and increased risk of mortality. However, the true incidence of this condition remains uncertain. METHODS: Following PRISMA 2020 guidelines, we systematically searched PubMed, Web of Science, Embase and China National Knowledge Infrastructure (CNKI) up to May 2025 for observational studies reporting AP among DF hospitalized patients. Eligible studies were identified according to predefined inclusion and exclusion criteria based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework. Two reviewers independently screened the literature and assessed study quality using the Newcastle-Ottawa Scale (NOS). Pooled incidence rates were estimated using random or common effect models depending on heterogeneity. RESULTS: Eight observational studies from five countries, comprising 1,078 hospitalized patients with DF, were included. Among them, 135 were diagnosed with AP. The pooled incidence of AP complicating DF was 12.4% (95% CI: 10.5-14.4%). Subgroup analysis suggested a higher incidence in studies with ≥100 participants compared to smaller cohorts (13.5% vs. 8.3%, P = 0.03). No evidence of significant publication bias was detected. CONCLUSION: DF-associated AP represents a clinically important complication, given the global burden of dengue and the potential severity of AP. Our findings underscore the importance of considering pancreatic enzyme testing, supplemented by imaging when clinically warranted, in dengue patients with persistent or severe abdominal symptoms and/or features of severe dengue. Large-scale, multicenter prospective studies are warranted to establish the true incidence and case-fatality risk, thereby informing evidence-based prevention and management strategies.
Chikungunya virus in dengue-suspected patients: Molecular evidence from the 2019 outbreak in Yangon, Myanmar.
Kapandji M, Lin H, Mutua MM … +16 more , Xu Q, Oshiro R, Oda Ibrahim CH, Pillay MT, Yamasato K, Nwe KM, Raekiansyah M, Dumre SP, Thant KZ, Aung WW, Khin AA, Thu HM, Urano T, Morita K, Takamatsu Y, Ngwe Tun MM
PLoS Negl Trop Dis · 2026 May · PMID 42081536 · Full text
BACKGROUND: Chikungunya virus (CHIKV) and dengue virus (DENV) frequently co-occur in Myanmar and present with overlapping symptoms, complicating diagnosis. During the 2019 dengue outbreak in Yangon, Myanmar, molecular da...
BACKGROUND: Chikungunya virus (CHIKV) and dengue virus (DENV) frequently co-occur in Myanmar and present with overlapping symptoms, complicating diagnosis. During the 2019 dengue outbreak in Yangon, Myanmar, molecular data on CHIKV were limited among dengue-suspected patients and there were no publicly available CHIKV genome sequences from Yangon in international databases. To address this gap and potential diagnostic overlap, we investigated the prevalence of CHIKV infection and described the genomic characteristics of detected strains. METHODS: Serum samples from 267 dengue-suspected patients collected in 2019 were screened for anti-CHIKV IgM and IgG by in-house ELISA and 211 samples with sufficient remaining volume were further analyzed by RT-qPCR, isolation of the virus, and whole-genome sequencing for mutation analysis. RESULTS: CHIKV antibodies were found in 24.7% (66/267) of samples (IgM 3.4%, IgG 21.3%), and viral RNA was detected in 10.9% (23/211) of samples. Fifteen viral isolates were successfully obtained (7.1% of those tested), including two co-detections with DENV-2 by RT-PCR. All isolates belonged to the East/Central/South African genotype, Indian Ocean Lineage (ECSA-IOL), and clustered with strains from Thailand, China, and Mandalay, Myanmar. Whole-genome analysis identified 33 non-synonymous mutations across nonstructural and structural proteins, including mutations previously reported in regional ECSA-IOL strains such as E1:K211E and E2:V264A, with 11 amino acid changes not previously reported in available Myanmar reference sequences. DISCUSSION: Serological and molecular findings indicate CHIKV circulation during the 2019 dengue outbreak in Yangon and highlight the limitations of single-target testing. Serological evidence indicate the presence of anti-CHIKV IgM and IgG antibodies, reflecting CHIKV exposure within the study population. Notably, all RNA-positive cases were seronegative for both IgM and IgG, a pattern consistent with the temporal dynamics of infection and the inherent constraints of serological detection in co-endemic settings. Molecular co-detection with DENV-2 and genomic findings highlight the potential value of multiplex diagnostic approaches in co-endemic settings. CONCLUSION: This study documents CHIKV detection and genomic characterization in dengue-suspected patients in Yangon and highlights the potential value of multiplex diagnostic approaches and continued genomic surveillance as broader public health considerations for arboviral detection in Myanmar.
AIDS patients with Talaromycosis Marneffei exhibit inflammatory activation and depletion in their peripheral blood monocytes.
Guo P, Yang Y, Chen X … +8 more , Li Q, Zhang H, Chen X, Xu F, Li Q, Ou J, Tang X, Li L
PLoS Negl Trop Dis · 2026 May · PMID 42081526 · Full text
OBJECTIVES: This study seeks to investigate the characteristics, dynamics, and association with disease progression of monocyte inflammation in patients with AIDS/Talaromycosis Marneffei (TSM). The findings are expected...
OBJECTIVES: This study seeks to investigate the characteristics, dynamics, and association with disease progression of monocyte inflammation in patients with AIDS/Talaromycosis Marneffei (TSM). The findings are expected to contribute to a deeper understanding of the disease's pathogenesis and prognostic factors, offering substantial potential for advancing diagnostic and therapeutic approaches and identifying new targets for immunotherapy. METHODS: We conducted a cross-sectional study to compare individuals with AIDS/TSM to those with AIDS/Pneumocystis Pneumonia(PCP), AIDS/tuberculosis(TB), uncomplicated AIDS, and healthy controls by analyzing the ratios and absolute values of peripheral blood mononuclear cells. Correlation analyses were employed to elucidate the relationship between monocyte levels and disease progression and prognosis. Flow cytometry and transcriptome sequencing were utilized to characterize the monocytes in patients with AIDS/TSM. Subsequently, a prospective study was undertaken on the TSM cohort to observe changes in monocyte numbers and proportions. RESULTS: We observed a significant reduction in both the number and proportion of these cells in TSM patients. This reduction was correlated with disease progression indicators such as platelet count (PLT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB). Furthermore, the baseline absolute monocyte count was found to be a significant predictor of mortality. Utilizing flow cytometry to analyze monocyte subpopulations, we found that the decrease in monocytes in TSM patients was characterized by an increase in classical monocytes and a decrease in intermediate and non-classical monocytes. Transcriptome sequencing data of monocytes revealed that those in TSM patients exhibited inflammatory activation, which was more pronounced in patients who succumbed to the disease. Subsequently, we conducted a prospective study on the TSM cohort and observed that antifungal treatment led to a gradual normalization of monocyte numbers and proportions. CONCLUSIONS: The peripheral blood monocytes of patients with AIDS and TSM exhibit a significant reduction, which correlates with disease progression and prognosis. Furthermore, these mononuclear cells demonstrate signs of inflammatory activation alongside a quantitative depletion.
Sire risk factors for vertical transmission of Leishmania infantum by the dam.
Duxbury KR, Richer LM, Petersen CA
PLoS Negl Trop Dis · 2026 May · PMID 42081512 · Full text
Leishmania (L.) infantum causes visceral leishmaniasis (VL) in humans across the Mediterranean basin and in Central and South America. VL is a zoonotic disease, with dogs as the predominant domestic reservoir. Traditiona...
Leishmania (L.) infantum causes visceral leishmaniasis (VL) in humans across the Mediterranean basin and in Central and South America. VL is a zoonotic disease, with dogs as the predominant domestic reservoir. Traditionally, this disease is transmitted via sand flies of the genus Phlebotomus or Lutzomyia as vectors. Case reports of transmission in non-endemic areas have increased, where transmission is predominantly vertical, sexual, or bloodborne. L. infantum has been shown to be enzootic in hunting hounds within the United States (U.S.), with no indication of vector borne transmission. In this population, there is very high risk of parasite spread if the dam's diagnostic status is positive. In comparison, very little is known about the risk if the sire not the dam is positive for L. infantum. This is a retrospective cohort study of 24 U.S. hunting hound sires' L. infantum exposure between 2013 and 2022 and the resultant evidence of infection in their 183 pups over that time. Offspring from sires who tested serologically positive for L. infantum during the year of birth had 1.59 times the risk of becoming diagnostically positive via serology or molecular detection for L. infantum during their lifetime (RR: 1.59 95% CI: 1.15-2.20 p-value: 0.0046) when compared to outcomes in pups from diagnostically negative sires. The basic reproductive number (R0) for the risk of the sire to indirectly transmit L. infantum to the pup within this cohort was 3.71. These results demonstrate the impact of sire's infection on transmission of L. infantum to offspring. There is a need for control efforts that address non-vectorial transmission from both parents. Control efforts targeting vector borne transmission of canine leishmaniosis in endemic countries are also needed.
The hydatid cyst fluid protein EgAgB8/1 demonstrates potent immunogenicity by eliciting robust humoral and cellular immune responses in mice.
Liu J, Xu J, Xu J … +8 more , Zhang J, Li Y, Huang W, Tian F, He X, Zhang T, Chen JH, Lu F
PLoS Negl Trop Dis · 2026 May · PMID 42081508 · Full text
BACKGROUND: Cystic echinococcosis (CE), a neglected zoonotic disease caused by the larval stage of Echinococcus granulosus, requires effective vaccine strategies for sustainable control. This study evaluated the immunoge...
BACKGROUND: Cystic echinococcosis (CE), a neglected zoonotic disease caused by the larval stage of Echinococcus granulosus, requires effective vaccine strategies for sustainable control. This study evaluated the immunogenic profiles of two antigenic targets: EgAgB8/1, a dominant immunogenic component of hydatid cyst fluid, and Eg-01883, a protoscolex-specific antigen identified through bioinformatic screening. METHODOLOGY/PRINCIPAL FINDINGS: E. granulosus strains were isolated from infected dogs for genomic DNA extraction. Recombinant proteins rEgAgB8/1 and rEg-01883 were expressed in E. coli, purified, and validated by SDS-PAGE and western blot. Initial protein microarray screening identified rEgAgB8/1 as exhibiting markedly higher immunoreactivity with cystic echinococcosis (CE) patient sera compared to the minimally reactive Eg-01883. Based on this finding, subsequent investigation focused on rEgAgB8/1 using a BALB/c mouse immunization model. The recombinant protein elicited potent humoral immunity, with antigen-specific IgG titers reaching 1:16,000, and stimulated significant lymphocyte proliferation. Immunized mouse sera specifically recognized native EgAgB8/1 in hydatid crude antigen preparations, confirming natural antigenicity. Flow cytometric analysis demonstrated that rEgAgB8/1 immunization significantly expanded splenic plasmablasts, memory B cells, and T follicular helper cells. Furthermore, it enhanced IFN-γ production in both CD4⁺ and CD8 ⁺ T cells while maintaining baseline IL-10 ⁺ T cell frequencies, and induced robust T cell memory responses. Statistical analyses were performed using Student's t-test for comparative evaluation. CONCLUSIONS: These findings establish rEgAgB8/1 as a highly immunogenic antigen capable of eliciting a cellular immune response characterized by dominant IFN-γ production without concomitant IL-10 elevation, alongside durable humoral responses in mice. The comprehensive immunogenicity profile supports further research into its immunological potential against cystic echinococcosis.
Field deployment of a mobile suitcase laboratory for Buruli ulcer diagnosis in Ghana.
Ahor HS, Boakyewaa Frimpong VN, Agbavor B … +7 more , Abass KM, Amofa G, Ofori E, El Wahed AA, Amoako YA, Phillips RO, Frimpong M
PLoS Negl Trop Dis · 2026 May · PMID 42081507 · Full text
Molecular diagnostics are the gold standard laboratory confirmation test for Buruli ulcer (BU), a severe necrotising skin disease caused by Mycobacterium ulcerans (M. ulcerans). However, current molecular tests are often...
Molecular diagnostics are the gold standard laboratory confirmation test for Buruli ulcer (BU), a severe necrotising skin disease caused by Mycobacterium ulcerans (M. ulcerans). However, current molecular tests are often performed outside endemic areas, which results in delayed diagnosis and increased patient management costs. To overcome these challenges and facilitate rapid diagnosis of clinically suspected BU lesions in affected communities, we developed a portable laboratory platform contained in two Pelican cases (each measuring 56 cm × 45.5 cm × 26.5 cm). We evaluated the feasibility of performing our earlier developed M. ulcerans Recombinase Polymerase Amplification (Mu-RPA) assay, along with a rapid DNA extraction method, using this mobile suitcase laboratory at BU clinics (BU-RPA mobile laboratory) in three endemic districts of Ghana. In the field, the entire process from sample collection to DNA extraction and amplification was completed in under one hour with this mobile setup. Among 39 PCR-confirmed BU cases, 32 (82%; 95% confidence interval [CI]: 67-91) were accurately identified by the BU-RPA mobile laboratory platform. All non-Buruli ulcer cases tested negative, resulting in a clinical specificity of 100% (95% CI: 90-100). Diagnostic performance varied by sample type: swabs demonstrated a sensitivity of 91%, whereas fine-needle aspirates (FNA) had a sensitivity of 69%. This mobile laboratory platform provides an effective workspace for the rapid, on-site diagnosis of BU, enabling timely results for healthcare providers at treatment centres. This mobile suitcase laboratory, together with its isothermal assays, presents a promising alternative to PCR for the swift diagnosis of suspected BU cases as well as other neglected tropical diseases in resource-limited settings.
Epidemiology and risk factors of soil-transmitted nematode-schistosome co-occurrence: An analysis of the global burden of disease study.
Wang R, Le B, Chen C … +4 more , Xia H, Fan X, Zhu C, He X
PLoS Negl Trop Dis · 2026 May · PMID 42081504 · Full text
OBJECTIVE: Soil-transmitted nematode (STN) infections and schistosomiasis frequently co-occur in endemic regions, imposing substantial combined health burdens. This study aimed to characterize the global co-occurrence pa...
OBJECTIVE: Soil-transmitted nematode (STN) infections and schistosomiasis frequently co-occur in endemic regions, imposing substantial combined health burdens. This study aimed to characterize the global co-occurrence patterns, long-term trajectories, and key risk factors of STN-schistosome co-occurrence using Global Burden of Disease (GBD) data. METHODS: We analyzed GBD 1990-2021 data from 69 countries and territories with available STN infections and schistosomiasis prevalence data. Co-occurrence patterns were classified into consistent, schistosomiasis-dominant, and STN infection-dominant regions based on global prevalence quartiles. Group-based trajectory modeling (GBTM) and similarity network clustering identified long-term evolutionary trajectories and epidemiological clusters. Negative binomial regression and population-attributable fraction (PAF) analysis quantified associations between 22 risk factors and disease burden. RESULTS: Global co-occurrence patterns remained stable over 32 years, with 68.1% of countries and territories showing concordant high or low burdens of both diseases. GBTM identified three distinct trajectories for each disease, with sub-Saharan Africa dominating high-burden groups. Similarity network clustering partitioned countries into six epidemiological clusters, ranging from persistently high co-burden to near-eliminated schistosomiasis with low STN prevalence. Key shared drivers included inadequate water, sanitation, and hygiene (WASH) factors, while nutritional deficiencies (iron deficiency, child growth failure) were specific risk factors for STN infections, particularly in co-endemic regions (PAF = 19.08% and 8.82%, respectively). Both high and low temperatures exerted protective effects against both infections. CONCLUSION: STN-schistosome co-occurrence exhibits distinct global epidemiological clusters with heterogeneous drivers. Integrated control strategies should combine WASH improvements, preventive chemotherapy, and targeted nutritional interventions, especially in co-endemic regions, to align with the WHO 2021-2030 Neglected Tropical Diseases Roadmap and accelerate elimination efforts.
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