OBJECTIVES: To investigate the prevalence, genotype distribution, and associations of HR-HPV infection with cervical lesion grades among Chinese women aged 35-64 years. METHODS: A cross-sectional analysis was conducted u...OBJECTIVES: To investigate the prevalence, genotype distribution, and associations of HR-HPV infection with cervical lesion grades among Chinese women aged 35-64 years. METHODS: A cross-sectional analysis was conducted using data from women aged 35-64 years who participated in China's national cervical cancer screening program across 13 provinces in 2021. HR-HPV testing was performed at local laboratories using clinically validated assays approved in China, including pooled detection and genotype-specific platforms following standardized national protocols. Epidemiological characteristics were analyzed in 445,045 women, and genotype distribution was assessed in 113,149 women with available genotyping results. Group differences were assessed using chi-square tests, and factors associated with HR-HPV infection were further explored using multivariable logistic regression. RESULTS: The overall prevalence of HR-HPV infection was 10.42% (95% CI: 10.33-10.51). Significant regional variation was observed, with higher prevalence in Western China (11.48%; 95% CI: 11.30-11.66) and Central China (11.46%; 95% CI: 10.98-11.96), and lower prevalence in Northeastern China (9.12%; 95% CI: 8.89-9.36). HR-HPV prevalence increased with age, peaking in women aged 60-64 years (12.69%; 95% CI: 12.30-13.09). The most prevalent genotypes were HPV52 (2.36%), HPV16 (1.73%), and HPV58 (1.40%). Single infections predominated among HR-HPV positive women (87.91%). HPV16 was the most frequently detected genotype across all cervical lesion grades, while HPV52 (10.35%) and HPV58 (9.69%) accounted for a higher proportion of high-grade lesions than HPV18 (7.27%). CONCLUSION: HR-HPV infection remains prevalent among Chinese women, and these population-level findings may help inform age- and region-specific cervical cancer screening strategies and provide epidemiological evidence relevant to HPV vaccination planning.
OBJECTIVES: Neisseria meningitidis ST-4821 clonal complex (cc4821) has become the most prevalent in China, which can be divided into four sublineages globally, with the L44.4 sublineage incorporating all serogroup W (Men...OBJECTIVES: Neisseria meningitidis ST-4821 clonal complex (cc4821) has become the most prevalent in China, which can be divided into four sublineages globally, with the L44.4 sublineage incorporating all serogroup W (MenW) cc4821 isolates. We aimed to illustrate the capsular switching that generated MenW cc4821 isolates, focused on the origin and the universal capsular switching pattern. METHODS: The nucleotide sequences of capsular polysaccharide synthesis (cps) gene cluster were extracted from the genomes of cc4821 L44.4 sublineage in the Neisseria PubMLST Database and analyzed using MEGA software. The capsular switching of MenC to MenW was conducted via natural transformation, and the infectivity was evaluated through in vitro experiments. RESULTS: Phylogenetic analysis on cps of cc4821 L44.4 indicated that MenW, MenC, and MenB isolates could be clearly distinguished only in region A. Nm464 performed PacBio sequencing for origin analysis, which identified a potential donor strain (W: P1.18-1,3: F4-1: ST-22 [cc22]). C→W capsular switching was performed ex vivo, with recombinant sequences being highly conserved between cc4821 and cc11 MenW isolates. The transformant expressed a similar level of capsular polysaccharides to the donor strain but grew more slowly than the recipient strain. CONCLUSIONS: C→W capsular switching with a cc22 strain as the potential donor was identified in cc4821 isolates, which is a highly conserved pattern among MenW strains. A fitness cost was found in the capsular switching.
Respiratory syncytial virus (RSV) remains a health threat to young children worldwide. The host immune response plays a key role in disease following infection. Infection models advance our understanding of respiratory v...Respiratory syncytial virus (RSV) remains a health threat to young children worldwide. The host immune response plays a key role in disease following infection. Infection models advance our understanding of respiratory viruses, but individual models have gaps, which overlapping complementary systems can fill. We compared disease signatures in mice, adults and children; combining transcriptomic data collected from blood, nasal mucosa and lung biopsy following RSV infection. We identified both shared and species-specific pathways triggered by RSV. While systemic responses in children's blood were more similar to those in RSV-challenged adults, mucosal responses during primary infection in mice more closely resembled those in children. We identified an association between IL-17 pathways and RSV pathogenesis and with over-expression of the downstream effectors S100A8 and S100A9. Inhibiting these with the anti-inflammatory drug Paquinimod reduced disease. Here we demonstrate that integrating mouse and human transcriptomic data can identify novel targets to treat RSV disease.
BACKGROUND: A minority of Campylobacter infections cause severe morbidity, yet admission rates for patients requiring hospital-based treatment are poorly understood. Our study aimed to quantify the percentage of Campylob...BACKGROUND: A minority of Campylobacter infections cause severe morbidity, yet admission rates for patients requiring hospital-based treatment are poorly understood. Our study aimed to quantify the percentage of Campylobacter infections requiring hospitalisation and determine variation by patient subgroups. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review and meta-analyses of globally reported hospitalisation frequencies for Campylobacter infections. We performed a risk of bias assessment, followed by meta-analyses under the assumption of common parameters. Results were interpreted from the Quality Effects (QE) models in MetaXL and the heterogeneity of included studies assessed using chi-square tests. In addition to the primary meta-analysis for Campylobacter infections overall, we conducted subgroup analyses by Campylobacter species, demographic group, clinical group, antimicrobial resistance (AMR) status, start decade of cases and event type (sporadic or outbreak-associated). The study was registered with PROSPERO (CRD42023493466). FINDINGS: A total of 137 articles (containing 235 studies) published from 1979 to 2025 were eligible for meta-analysis. These publications contained 1,377,770 Campylobacter infections for 946 patient groups (data points), primarily from North America, Europe and Oceania. In the pooled analysis of hospitalisation frequencies for Campylobacter infections, 13.8% (95% CI 9.6-18.6) of individuals were hospitalised. Steady increases in hospitalisation frequency were observed over time. In a pooled analysis of data from three studies, species other than C. jejuni or C. coli were associated with a higher frequency of hospitalisation (27.3%; 95% CI 11.0-47.2). Pooled hospitalisation frequencies of males (6.4%; 95% CI 1.4-14.1) and females (6.8%; 95% CI 1.5-15.0) were similar, and patients aged ≥65 years (27.9%; 95% CI 13.5-45.0) and children <1 year old (15.6%; 95% CI 9.8-22.4) were hospitalised more often compared to other age groups. Patients with pre-existing conditions were at higher risk of hospitalisation (37.1%; 95% CI 13.4-64.2). Older age, comorbidities and infection with C. fetus were often associated with bacteraemia. Where bacteraemia was identified, most patients were hospitalised (89.5%; 95% CI 79.6-96.5). Hospitalisations were overrepresented amongst tetracycline-resistant Campylobacter infections (24.4% hospitalised; 95% CI 21.4-27.5). Cases associated with outbreaks were much less likely (4.2%; 95% CI 1.7-7.6) to be hospitalised compared to sporadic cases (16.1%; 95% CI 8.1-26.1). INTERPRETATION: While most patients with Campylobacter infections are not hospitalised, vulnerable groups such as the very young, older adults and those with comorbidities are more likely to be hospitalised. The increase in hospitalisation frequency over time reinforces the urgent need to address this burden by prioritising research and interventions targeting Campylobacter exposure in vulnerable populations.
Xi J, Jia X, Li S
… +26 more, Li X, Hu L, Xia H, Xu T, Xu Y, Yu Y, Hu F, Kang M, Sun Z, Ma L, Shan B, Ma X, Zou M, Li J, Hasi C, Liu Y, Guo D, Hu X, Liu Y, Jin Y, Ji P, Zhang L, Li Y, Xia Y, Liao K, Yang Q
OBJECTIVES: Community-acquired and hospital-acquired bloodstream infections (CA-BSI and HA-BSI) caused by Gram-negative bacteria (GNB) pose major clinical risks, but differences in their molecular epidemiology and progno...OBJECTIVES: Community-acquired and hospital-acquired bloodstream infections (CA-BSI and HA-BSI) caused by Gram-negative bacteria (GNB) pose major clinical risks, but differences in their molecular epidemiology and prognostic etiologic factors remain unclear. METHODS: A genomic epidemiology study analyzed 933 CA-BSI and 1001 HA-BSI isolates from 21 major Chinese teaching hospitals. We collected comprehensive clinical data and conducted molecular characterization, including sequence types, antibiotic resistance genes, virulence factors, and plasmid types, as well as clinical phenotypes of major pathogens. Multivariable Cox models were used to identify mortality predictors. RESULTS: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae complex were the predominant species in both CA-BSI and HA-BSI groups but exhibited distinct clinical and molecular characteristics between CA-BSI and HA-BSI. CA-BSI patients showed significantly higher inflammatory markers (CRP, PCT, WBC, and Neu%), while HA-BSI patients had significantly poorer prognosis including prolonged hospitalization, higher ICU admission rates and clinical deterioration or mortality. Genomic surveillance revealed a critical divergence: HA isolates were dominated by high-risk clones such as ST11 K. pneumoniae and ST2 A. baumannii, which were enriched in antimicrobial resistance genes, directly linking to worse outcomes. CA isolates, while more diverse, were characterized by specific lineages including ST131 E. coli (enriched with specific virulence genes: yersiniabactin, K1 capsule, and P fimbriae) and ST23 K. pneumoniae, which carried a significantly greater number of virulence genes. Multivariable analysis confirmed that mortality risk profiles are setting-specific, influenced by distinct combinations of patient comorbidities (including age, gender, agranulocytosis, and infection source) and bacterial genetic determinants (such as lacI or aadA2 for K. pneumoniae and aph(3')-Ia for A. baumannii). CONCLUSIONS: This first genomic epidemiological investigation of GNB-BSIs stratified by acquisition setting reveals a fundamental clinical and epidemiological divergence between CA- and HA-cases. The study underscores that tracking mortality-associated strains and genes is essential for improving clinical outcomes and advancing etiological knowledge.
OBJECTIVES: To evaluate the epidemiology and outcomes of candidaemia in hospitalised adults METHODS: A five-year (January 2015-December 2019) retrospective multi-site evaluation of candidaemia episodes in hospitalised ad...OBJECTIVES: To evaluate the epidemiology and outcomes of candidaemia in hospitalised adults METHODS: A five-year (January 2015-December 2019) retrospective multi-site evaluation of candidaemia episodes in hospitalised adults at three London hospitals to assess Candida species, infection source, antifungal resistance, management and mortality. RESULTS: 342 episodes of candidaemia in 333 patients were recorded. Common predisposing risk factors for candidaemia included vascular catheters, abdominal surgery, malignancy and diabetes. Candida albicans (36%), Candida glabrata/ Nakaseomyces glabratus (35%), and Candida parapsilosis (13%), were the most common causative species, with N. glabratus and C. parapsilosis associated with abdominal and line-related sources respectively. Fluconazole resistance was observed in 14% of isolates, while echinocandin resistance was rare (3%). Candida endocarditis and ocular candidiasis occurred in 5.2% and 2.6% of those assessed respectively; both were associated with persistent candidaemia (≥2 successive days). All-cause 30-day mortality was 32%. Age>60 years, liver disease, malignancy, non-removable source of candidaemia and lack of initial echinocandin therapy were independent baseline predictors of mortality. CONCLUSIONS: Candidaemia is a significant healthcare-associated infection with high mortality, particularly in ICU patients with difficult-to-clear foci. The rise of N. glabratus is concerning given its propensity for antifungal resistance. Future clinical and research priorities include better diagnostic tools and refinement of antifungal treatment strategies.
OBJECTIVES: The use of broadly neutralising antibodies (bNAb) to prevent HIV infection is under active investigation, including for the prevention of vertical HIV transmission. In neonates, an uncomplicated sampling meth...OBJECTIVES: The use of broadly neutralising antibodies (bNAb) to prevent HIV infection is under active investigation, including for the prevention of vertical HIV transmission. In neonates, an uncomplicated sampling method for blood collection is the use of dried blood spots (DBS). We aimed to validate the use of a combination of DBS with ELISA techniques to monitor bNAb concentrations, namely VRC07-523LS and CAP256V2LS, in neonates. METHODS: We evaluated the performance of various DBS elution protocols on spiked adult blood and next on spiked cord blood. The optimised method was validated on blood from infants injected with bNAbs. RESULTS: After selecting the best elution conditions, we reported good repeatability and reproducibility for both bNAbs in cord blood samples. The concordance study with infant receiving VRC07-523LS or CAP256V2LS samples showed that the values obtained from DBS eluates were closely aligned with those from plasma samples and when corrected by the haematocrit value, the number of outliers was 10.1% with a positive bias of 0.35 µg/mL for CAP256V2LS, and 5.0% with a positive bias of 3 µg/mL for VRC07-523LS. CONCLUSIONS: DBS microsampling allows accurate bNAb concentration measure in neonates, which will facilitate on-going paediatric clinical trials and possible subsequent monitoring in adults with home-sampling if deployed at scale.
Bain V, Silva-Avelar I, Correa-Silva S
… +16 more, Matsuo OM, Zheng Y, Rangel-Santos A, Gonçalves GS, de Toledo Fink T, Suguita P, Ferreira JCOA, Ferreira AEF, de Paula CSY, Astley C, Martins F, Carneiro-Sampaio M, Marques HHS, Silva CA, Palmeira P, Pereira MFB
Le Banner E, Le Moulec J, Kerjouan M
… +19 more, Grosbost V, Parrot A, Rondeau-Lutz M, Seguin VL, Lavigne C, Contis A, Mourguet M, Mohamed S, Jutant ÉM, Blivet S, Pradelli J, Espitia O, Chaussavoine L, Revuz S, Revest M, Tattevin P, Dupuis-Girod S, Guilhem A, Luque Paz D
OBJECTIVES: Patients with hereditary hemorrhagic telangiectasia (HHT) present increased risk of severe infections. Studies focusing on infections in HHT population are scarce. We aimed to assess characteristics and outco...OBJECTIVES: Patients with hereditary hemorrhagic telangiectasia (HHT) present increased risk of severe infections. Studies focusing on infections in HHT population are scarce. We aimed to assess characteristics and outcomes of infections in patients with HHT. METHODS: A retrospective study was conducted in a nationwide cohort of 4502 HHT patients. Patients with HHT hospitalized for infection across 16 referral centers in France between 2010 and 2024 were identified, and data were collected through a standardized questionnaire. RESULTS: We included 163 HHT patients (median age, 60 years [49-69], 52% male), who experienced a total of 249 bacterial infections. One third (n=53/163) experienced recurrent infections requiring hospitalization. Infections caused by Staphylococcus aureus were reported in 80 patients representing 107 episodes of infection. Brain abscesses were reported in 43 patients representing 51 episodes, often despite prior pulmonary arteriovenous malformations embolization (n=17/43). In multivariable analysis, factors associated with 1-year mortality (n=27/163, 17%) were age (aHR=1.06, 95%CI:1.01-1.16) and infective endocarditis (aHR=2.88, 95%CI:1.10-7.87). CONCLUSIONS: In this HHT cohort, severe infections were predominantly due to S. aureus, far ahead of brain abscesses caused by oral bacteria. Considering the high rate of recurrent infections, further studies focusing on prophylaxis strategies in HHT patients are needed.
Sun L, Fang M, Chen Y
… +20 more, Jiao W, Zou T, Long X, Wang Y, Jiang T, Bi J, Gao X, Li M, Duan L, Fan L, Qi Y, Wang M, Shi J, Zhang T, Xu Y, Tang Y, Wan C, Xu H, Zhu Y, Shen A
OBJECTIVES: Non-sputum based, child-friendly triage tests are urgently needed to achieve accurate diagnosis and monitoring of tuberculosis (TB) in children. We aimed to assess an Xpert MTB Host Response (MTB-HR) assay, w...OBJECTIVES: Non-sputum based, child-friendly triage tests are urgently needed to achieve accurate diagnosis and monitoring of tuberculosis (TB) in children. We aimed to assess an Xpert MTB Host Response (MTB-HR) assay, which provides a TB score based on the mRNA expression level of three host genes, for diagnosis and differentiation TB in children and adolescents. METHODS: The multicenter, prospective study was conducted in four provinces of China among children and adolescents who were admitted to hospitals for TB or latent tuberculosis infection (LTBI) screening. Subjects were included in the evaluation of Xpert-MTB-HR from February 2020 to December 2021. Baselines of TB scores were analyzed in healthy children and adolescents with various ages. Accuracy was evaluated in subjects with various TB status, including microbiological data, disease severity and age. RESULTS: Based on a composite clinical reference standard, among 780 patients enrolled, 403, 41, 109, and 227 were diagnosed as TB, LTBI, non-TB infectious diseases (DC) and healthy controls (HC), respectively. The mean TB scores decreased from 4 (IQR, 3·54-4·46) in infants to 0·91 (IQR, -0·23-2·04) in adolescents aged 17-18 years old. Using the composite clinical reference standard, the area under curves (AUCs) of the MTB-HR assay in discriminating ATB from HC, LTBI, and DC were 0·786 (95% CI, 0·749-0·823), 0·652 (95% CI, 0·559-0·744) and 0·771 (95% CI, 0·718-0·823), respectively.The optimal cutoff value was less than or equal to 2·675, resulting a sensitivity of 75·9% (95% CI, 67·0%-80·9%) and specificity of 70·5% (95%CI, 60·3%-76·7%) in TB diagnosis. The MTB-HR assay showed better auxiliary effect for diagnosis of ATB in children younger than five years of age (AUC, 0·885, 95% CI, 0·824-0·945, P=0·0006). The mean TB scores elevated at one month (P=0·0009) and three months (P=0·0061) after anti-TB treatment initiation. CONCLUSIONS: The MTB-HR assay showed potential for ATB diagnosis and treatment monitoring in children and adolescents, especially in ages under five years old.
OBJECTIVE: Evaluate long-term mortality and the role of causative pathogens in periprosthetic joint infection (PJI) following total hip arthroplasty (THA). METHODS: Retrospective nationwide cohort study of adults undergo...OBJECTIVE: Evaluate long-term mortality and the role of causative pathogens in periprosthetic joint infection (PJI) following total hip arthroplasty (THA). METHODS: Retrospective nationwide cohort study of adults undergoing THA (2012-2022) using data from the Swiss Joint Registry, Center for Infection Prevention and civil registry. Primary outcome was up to 10-year survival with or without PJI. Adjusted hazard ratios (aHR) were estimated via Gompertz regression, controlling for sex, age, BMI, and ASA. Pathogen-specific mortality hazard was analyzed. RESULTS: Of 215,678 patients, 89,709 met inclusion criteria (51.3% women; median age 69 years). PJI occurred in 745 (0.8%) patients, 2 752 (3.1%) underwent aseptic revision. PJI was associated with increased mortality (aHR 2.15; 95% CI, 1.79-2.57; p<0.001) compared to no PJI/revision, aseptic revisions were not (aHR 0.92; 95% CI, 0.80-1.06; p=0.27). Pathogens associated with increased mortality included Enterobacterales (aHR 3.17; 95% CI, 2.09-4.83, p<0.001), Staphylococcus aureus (aHR 2.32; 95% CI, 1.65-3.27; p<0.001), Cutibacterium acnes (aHR 2.31; 95% CI, 1.20-4.45; p=0.01), and coagulase-negative staphylococci (aHR 1.65; 95% CI, 1.16-2.35; p=0.006). Streptococcal infections showed no significant association (aHR 1.24; 95% CI, 0.62-2.49; p=0.54). CONCLUSION: PJI following THA was associated with an approximately twofold increase in long-term mortality hazard. C. acnes presented an unexpectedly high mortality hazard.
This study aimed to assess the association between bacterial loads as quantified by the BIOFIRE® Filmarray Pneumonia Plus Panel (FA-PP) and clinically significant bacterial cultures in different clinical settings, taking...This study aimed to assess the association between bacterial loads as quantified by the BIOFIRE® Filmarray Pneumonia Plus Panel (FA-PP) and clinically significant bacterial cultures in different clinical settings, taking into account the type of sample processed and the bacterial targets detected. A comprehensive search was conducted of the PubMed, EMBASE, and Web of Science databases up to November 2024. Pooled odds ratios (ORs) for binned values in genome copies/ml (gc/ml)(10, 10, 10, and ≥10) and their respective 95% confidence intervals (95% CI) are reported throughout the study. Heterogeneity across studies was assessed using the I statistic. Twenty-three observational studies comprising a total of 4581 patients and 5147 respiratory samples were finally included in the meta-analysis. Overall, pooled ORs for clinically significant culture results were 4.30 (95% CI, 2.53-7.31; P < 0.001) for ≥10 gc/ml, 1.33 (95% CI, 0.70-2.56; P=0.39) for 10, 0.42 (95% CI, 0.20-0.90; P=0.03) for 10, and 0.1 (95% CI, 0.07-0.37; P < 0.001) for 10 gc/ml. Subgroup analyses conducted according to the type of respiratory sample, bacterial target, and hospital admission ward yielded rather similar conclusions. The heterogeneity across studies was very high (I >80%). Our analyses suggested that values ≥10 gc/ml may be considered reliable indicators of clinically significant bacterial infection. Conversely, 10 gc/ml values likely reflect colonization. Intermediate values (10-10 gc/ml) pose a greater interpretative challenge. IMPORTANCE: The FA-PP assay has emerged as an ancillary tool for diagnosing lower respiratory tract infections and adjusting empirical antimicrobial therapies; consequently, it is being increasingly requested by clinicians. The current study fills a critical gap in the interpretation of quantitative data returned by the FA-PP for nosocomial bacterial targets. Assessment of the clinical relevance of FA-PP binned gc/ml values seems mandatory for clinical and therapeutic decision-making processes in patients with severe community-acquired or nosocomial pneumonia. Our analyses showed that values ≥10 gc/ml are consistently associated with a high probability of culture positivity, regardless of the respiratory sample type and the bacterial target considered. In contrast, values of 10 gc/ml likely reflect colonization. Our study emphasizes the need for well-designed and homogeneous studies to gauge the clinical relevance of intermediate FA-PP binned values (10 and 10 gc/ml).
BACKGROUND: Infections remain a leading cause of childhood mortality. Non-pharmaceutical interventions (NPI) implemented during COVID-19 pandemic altered the circulation of communicable pathogens. We aimed to assess how...BACKGROUND: Infections remain a leading cause of childhood mortality. Non-pharmaceutical interventions (NPI) implemented during COVID-19 pandemic altered the circulation of communicable pathogens. We aimed to assess how these changes affected paediatric infection-related mortality. METHODS: We conducted a population-based interrupted time-series analysis using national data from France and Switzerland (2015 to 2023), including deaths among individuals <18 years. Monthly infection-related mortality was analysed using quasi-Poisson regression models seasonally adjusted. Mortality rate ratios (MRR) were calculated to compare infection-related mortality among birth cohorts exposed to NPI or post-NPI periods versus pre-NPI cohorts. RESULTS: Among 32,619 paediatric deaths during the study period, 8272 were related to an infection. During the NPI period, infection-related mortality declined by 16% (95% CI: -23% to -7%), corresponding to an estimated reduction of 221 (95% CI: 90 to 371) deaths. Compared to pre-NPI birth cohorts, 2019 and 2020 cohorts had significantly lower infection-related MRR (0·80, 95% CI 0·66 to 0·98 and 0·80, 95% CI 0·65 to 0·98). CONCLUSION: The reduction in paediatric infection-related deaths during the NPI period underscores the ongoing burden of preventable paediatric mortality and suggests that targeted preventive strategies may sustainably reduce infection-related deaths beyond pandemic settings.
Leptospirosis is a globally prevalent zoonotic infection causing more than one million cases and nearly 60,000 deaths annually yet is often diagnosed late after organ dysfunction and other complications have arisen. Dela...Leptospirosis is a globally prevalent zoonotic infection causing more than one million cases and nearly 60,000 deaths annually yet is often diagnosed late after organ dysfunction and other complications have arisen. Delayed diagnosis leads to late initiation of antibiotics and other therapeutic interventions, at which point complications such as renal failure, jaundice, or pulmonary hemorrhage are more common and therapy is less effective. This review highlights the critical importance of early recognition and intervention, emphasizing the therapeutic window during the leptospiremic phase when antibiotics are most effective. We examine the limitations of current clinical and laboratory diagnostic methods, the evolving role of molecular and biomarker-based platforms, and the potential of integrated scoring systems for frontline triage. Evidence supporting early antibiotic therapy, supportive care strategies, and severity prediction tools is summarized. We propose a paradigm shift toward field-adaptable, point-of-care diagnostics and integrated care pathways to ensure earlier treatment, improved outcomes, and reduced global disease burden.
INTRODUCTION: Strongyloidiasis, caused by the soil-transmitted helminth Strongyloides stercoralis, remains a neglected public health issue in Australia, particularly among remote Aboriginal and Torres Strait Islander com...INTRODUCTION: Strongyloidiasis, caused by the soil-transmitted helminth Strongyloides stercoralis, remains a neglected public health issue in Australia, particularly among remote Aboriginal and Torres Strait Islander communities. This study aimed to map the spatial distribution of strongyloidiasis and investigate associated socioecological factors to identify high-risk areas and guide targeted interventions in Australia. METHODS: We used data from a previous nationwide pathology data survey conducted between 2012 and 2016, which included 81,131 individuals across 332 statistical area level 3 (SA3) regions in Australia. Socio-ecological and environmental variables were extracted from publicly available online sources to explore their relationship with strongyloidiasis. Spatial patterns were analysed using Global Moran's I and Getis-Ord statistic to identify clusters of high and low disease prevalence. Bayesian spatial modelling was applied to investigate whether socio-climatic factors explain the spatial distribution of strongyloidiasis in Australia. RESULTS: The predicted prevalence map showed substantial spatial heterogeneity of strongyloidiasis, with the highest prevalence identified in regions of the Northern Territory, northern Queensland, and northern Western Australia. Bayesian geospatial analysis indicated significant positive associations between strongyloidiasis prevalence and higher temperature (β: 0.080; 95% Credible Interval [CrI]: 0.043, 0.117) and higher soil pH (β: 0.231; 95% CrI: 0.038, 0.425). Conversely, a higher Socio-Economic Indexes for Areas (SEIFA) score, that is, areas with generally higher socio-economic status, was negatively associated with the strongyloidiasis prevalence (β: -0.107; 95% CrI: -0.179, -0.036). CONCLUSION: Our findings reveal significant geographical variation in strongyloidiasis prevalence across Australia, with high prevalence observed in northern Queensland, the Northern Territory, and northern Western Australia, where climatic factors, soil characteristics, and socioeconomic conditions can shape the spatial distribution of the disease. Geographically tailored strategies targeting high prevalence areas are essential for effective prevention and control.