Authors: Abdol Sattar Pagheh, Adele Sadat Talebian, Tooran Nayeri, Ali Akbar Esmaeili, Fatemeh Rezaei, Eisa Nazar and Masood Ziaee
Abstract:
Background: Toxoplasma gondii (T. gondii) is the most successful obligate protozoan that can infect warm-blooded
vertebrate hosts. Some researchers suggest that the.....
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Authors: Abdol Sattar Pagheh, Adele Sadat Talebian, Tooran Nayeri, Ali Akbar Esmaeili, Fatemeh Rezaei, Eisa Nazar and Masood Ziaee
Background: Toxoplasma gondii (T. gondii) is the most successful obligate protozoan that can infect warm-blooded
vertebrate hosts. Some researchers suggest that the presence of Toxoplasma cysts in the brain can lead to mental
disorders. Bipolar disorder (BD) is one of the serious neuropsychiatric disorders. Several studies have shown a high
seroprevalence of T. gondii in bipolar patients. Therefore, this study aims to determine the prevalence of this infection
in patients with BD.
Methods: In this case-control study, anti-Toxoplasma immunoglobulin (Ig) G and IgM antibodies were measured
in serum samples from 115 patients with BD and 115 subjects without this disorder from the general population
using commercially available enzyme-linked immunosorbent assay. Demographic characteristics of the patient and
control groups, information about T. gondii infection and BD, and their potential risk factors were analyzed. We utilized
the Mann-Whitney U test for continuous variables, the chi-square test for categorical data, and multivariate logistic
regression to assess T. gondii infection and BD, with significance set at P < 0.05.
Results: Twenty-eight (24.34%) of 115 patients with BD and 10 (8.7%) of 115 controls had anti-T. gondii IgG
antibodies. IgM antibodies against T. gondii were not reported to be positive in any participants. Furthermore, there
was a statistically significant difference in the results [odds ratio (OR) = 2.89: 95% confidence interval (CI) = 1.08–7.73.
P = 0.03]. Within the study population, various factors were identified as significant risk factors for BD: sex (OR 8.10, 95%
CI 3.16–20.75), age 20–50 (OR 5.11, 95% CI 1.81–14.45), age over 50 (OR 19.54, 95% CI 4.02–94.89), education level (OR
0.24, 95% CI 0.09–0.60), working status (non-employment, OR 4.12, 95% CI 1.65–10.30), and income (middle, OR 0.29,
95% CI 0.10–0.89; high, OR 0.12, 95% CI 0.01–0.77), all with P-values less than 0.05. In addition, in the group of patients,
there was no statistically significant relationship between T. gondii infection with the type of bipolar disease (P = 0.93),
the severity of the disease (P = 0.61), and the history of suicide attempts (P = 0.63).
Conclusion: This study showed that toxoplasmosis is a risk factor for BD and increases the chance of developing
BD. However, more studies with a larger sample size are recommended to clarify the development pathways of this
disorder and provide new strategies for the prevention and treatment of this disease.
Clinical trial: Not applicable
How To Cite this Article
Pagheh, A.S., Talebian, A.S., Nayeri, T. et al. Association between latent toxoplasmosis and bipolar disorder: a case-control seroprevalence study. BMC Infect Dis25, 2 (2025). https://doi.org/10.1186/s12879-024-10405-0
Background: The challenge of dealing with isolated reactive treponemal chemiluminescence immunoassay (CIA)
results in clinical practice has prompted the development of a more efficient algorithm.....
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Background: The challenge of dealing with isolated reactive treponemal chemiluminescence immunoassay (CIA)
results in clinical practice has prompted the development of a more efficient algorithm for distinguishing true
infection from false reactivity in isolated CIA sera.
Methods: A prospective cohort study was conducted at Wuhan Tongji Hospital, involving 119,002 individuals
screened for syphilis using CIA from January 1, 2015, to January 6, 2017. Samples with reactive CIA results underwent
simultaneous testing with the T. pallidum passive particle agglutination assay (TPPA) and the rapid plasma reagin
test (RPR). Additionally, a subgroup of 189 individuals with differing TPPA statuses was selected for further analysis
using Western blotting (WB) and a modified TPPA assay (titer, 1:20). To identify the optimal serological approach for
distinguishing true from false reactivity in sera with isolated reactive CIAs (CIA+TPPA−RPR−), two distinct algorithms
were developed and evaluated. The first algorithm involved reflexively testing CIA+TPPA−RPR− sera with the modified
TPPA, followed by WB if nonreactive. The second algorithm began with WB, followed by the modified TPPA if
nonreactive or indeterminate.
Results: WB demonstrated lower sensitivity compared to TPPA, but it identified six syphilis cases among the 89
CIA+TPPA− samples. Both WB and modified TPPA exhibited a specificity of 100%. The two supplementary confirmatory
algorithms detected 12 additional syphilis cases, with the first algorithm being more cost-effective and labor-saving.
Conclusion A combination of a modified TPPA (titer, 1:20) and WB can serve as a reliable algorithm for distinguishing
true syphilis infection from false reactive signals in isolated reactive CIA sera.
Clinical trial number: Not applicable.
How To Cite this Article
Luo, X., Xiao, H., Lu, Y. et al. Modified TPPA combined with western blotting facilitates syphilis diagnosis in isolated reactive treponemal chemiluminescence immunoassay sera: a prospective cohort study. BMC Infect Dis 25, 6 (2025). https://doi.org/10.1186/s12879-024-10404-1
Background: Following interventions to eliminate trachoma in the Afar region of Ethiopia, our goal was to reassess
the prevalence of trachomatous trichiasis (TT) and.....
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Background: Following interventions to eliminate trachoma in the Afar region of Ethiopia, our goal was to reassess
the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation—follicular (TF) at the woreda level,
and to identify factors associated with the disease.
Methods: Cross-sectional community-based surveys were conducted in 26 trachoma-endemic woredas, employing
a standardized approach. Households were selected as the secondary sampling unit. Surveys involved interviews
with household heads, direct assessment of water, sanitation, and hygiene (WASH) access, and clinical examination of
eligible household members for trachomatous trichiasis (TT) and trachomatous inflammation—follicular (TF).
Result: Overall, 18 out of the 26 woredas (69%) achieved the World Health Organization-recommended threshold for
active trachoma elimination, with a prevalence of trachomatous inflammation—follicular (TF) below 5% in children
aged 1–9 years. Additionally, 14 woredas (54%) met the threshold for trachomatous trichiasis (TT) elimination, with a
prevalence of TT cases unknown to the health system below 0.2% in adults aged 15 years and older. However, access
to improved drinking water sources within a 30-minute trip was limited to only 17% of households, and merely 9%
had access to improved latrines. Addressing these WASH (Water, Sanitation, and Hygiene) challenges remains critical
for sustaining progress in trachoma control and achieving long-term public health improvements in the Afar region.
Conclusion: In seven woredas, further rounds of antibiotic mass drug administration are required, complemented by
initiatives to promote facial cleanliness and improve environmental conditions. Additionally, surgical campaigns for
trachomatous trichiasis (TT) are needed in 12 woredas. There is a critical need to enhance access to improved Water,
Sanitation, and Hygiene (WASH) facilities across all surveyed woredas to consolidate gains in trachoma control and
achieve sustained public health improvements.
How To Cite this Article
Gebreselassie, G., Negash, K., Woga, D. et al. Impact of trachoma elimination efforts in afar regional state, Ethiopia: survey findings from 26 evaluation units. BMC Infect Dis25, 5 (2025). https://doi.org/10.1186/s12879-024-10410-3
Authors: Abdurrazzaq Alege, Olayinka Rasheed Ibrahim, Rasheedat Mobolaji Ibraheem, Olajide Aladesua, Abubakar Sani Lugga, Yunusa Yusuf Yahaya, Abdallah Sanda and Bello Muhammed Suleiman
Abstract:
Background: Despite recurrent outbreaks of diphtheria in Nigeria, there is a lack of in-depth analysis of
hospitalization outcomes. Herein, we describe the sociodemographic, clinical, and.....
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Authors: Abdurrazzaq Alege, Olayinka Rasheed Ibrahim, Rasheedat Mobolaji Ibraheem, Olajide Aladesua, Abubakar Sani Lugga, Yunusa Yusuf Yahaya, Abdallah Sanda and Bello Muhammed Suleiman
Background: Despite recurrent outbreaks of diphtheria in Nigeria, there is a lack of in-depth analysis of
hospitalization outcomes. Herein, we describe the sociodemographic, clinical, and laboratory features associated with
hospitalization outcomes (defined as death or discharge) during the recent diphtheria outbreak in Nigeria.
Methods: This prospective observational study included 246 confirmed diphtheria cases managed in a dedicated
isolation ward of a health facility in northwestern Nigeria from July 1, 2023, to April 30, 2024. We analyzed clinical and
laboratory features, immunization status, and socio-demographics in relation to hospitalization deaths using SPSS
version 29.
Results: The median age (interquartile range) was 7.00 (4–10) years and 49.6% (122) were aged 5–10 years. Common
clinical features were fever (95.9%), sore throat (91.9%), painful swallowing (90.7%), pseudomembrane (93.1%), and
cervical-submandibular lymphadenopathy (91.5%). Most children were unvaccinated (158; 64.2%), 199 (80.9%)
received diphtheria antitoxin, and both were related to outcomes. Mortality rate was 23.5% (58/246). After adjusting
for confounders, predictors of hospitalization deaths were neck swelling with an adjusted odds ratio (AOR) of 9.80
(95% CI 1.68–56.47), abnormal respiratory findings (AOR, 149.99 [95% CI, 15.60–1442.02] ), hypoxemia (AOR, 37.79
[95% CI, 4.26–331.96] ), and elevated serum creatinine above 1.5 mg/dL (AOR 107.78, 95% CI, 7.94–1462.38).
Conclusions: Diphtheria is a significant burden in Nigeria, particularly among children. Neck swelling, hypoxemia,
abnormal respiratory findings, and impaired renal function were predictive of hospitalization death. Although
antitoxin and vaccination were related to outcomes, they did not predict hospitalization death.
How To Cite this Article
Alege, A., Ibrahim, O.R., Ibraheem, R.M. et al. Clinical presentation and predictors of hospital mortality of diphtheria in Nigeria, July 2023 to April 2024: a single-center study. BMC Infect Dis25, 8 (2025). https://doi.org/10.1186/s12879-024-10401-4
Authors: Abdurrazzaq Alege, Olayinka Rasheed Ibrahim, Rasheedat Mobolaji Ibraheem, Olajide Aladesua, Abubakar Sani Lugga, Yunusa Yusuf Yahaya, Abdallah Sanda and Bello Muhammed Suleiman
Account Details mentioned below: For Electronic Fund Transfer: (NEFT/RTGS)
Authors: Yuanchao Zhu, Lishuang Huang, Jingjing Zhang, Liang Liang and Pengfei Jin
Abstract:
Objectives: Drug-induced thrombocytopenia has been reported for numerous drugs. Vancomycin-induced
thrombocytopenia (VIT) is infrequently and often under-recognized. VIT can lead to the serious consequences of
some.....
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Authors: Yuanchao Zhu, Lishuang Huang, Jingjing Zhang, Liang Liang and Pengfei Jin
Objectives: Drug-induced thrombocytopenia has been reported for numerous drugs. Vancomycin-induced
thrombocytopenia (VIT) is infrequently and often under-recognized. VIT can lead to the serious consequences of
some life-threatening bleeding, especially in high-risk population. However, few studies have focused on VIT. This
study aimed to describe the occurrence and manifestation of VIT and evaluate its risk factors in real-world settings.
Methods: A retrospective case-control study of patients treated with intravenous vancomycin was conducted
between January 2018 and December 2023.
Results: Among the 1269 identified patients, the incidence of thrombocytopenia was 3.3% (42/1269) after a medium
of 9 days (range, 2 to 22) of the initiation of vancomycin therapy. Twenty-four patients experienced platelet recovery,
and all recovered after discontinuing vancomycin, with a mean duration of 9 days (range, 1 to 35) after vancomycin
cessation. The severity of thrombocytopenia varied among these patients, with 45.2% (19/42) experiencing Grade 3
to Grade 4 thrombocytopenia. Multivariate analysis indicated that risk factors for VIT were qSOFA score ≥ 2, underlying
renal diseases, duration of vancomycin therapy ≥ 8 days, PLT ≤ 150 × 109/L, and BUN ≥ 12 mmol/L. In the retrospective
cohort, among patients with 0–5 risk factors, the incidence rates of VIT were 0.2% (1/556), 1.6% (7/439), 5.8% (10/173),
14.9% (11/74), 42.1% (8/19), and 62.5% (5/8) respectively.
Conclusion: It is crucial for medical staff to remain vigilant and carefully observe any signs of potential bleeding
throughout vancomycin therapy, especially in those with more than 3 combined risk factors.
How To Cite this Article
Zhu, Y., Huang, L., Zhang, J. et al. Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study. BMC Infect Dis 25, 7 (2025). https://doi.org/10.1186/s12879-024-10393-1
Authors: Puhui Liu, Fangyuan Liu, Chunhui Wang, Aimin Mu, Chuanzhen Niu, Shihong Zhu and Ji Wang
Abstract:
Objective: This study develops a predictive model to evaluate mortality risk in severe fever with thrombocytopenia
syndrome (SFTS) patients in intensive care units (ICU) to improve.....
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Authors: Puhui Liu, Fangyuan Liu, Chunhui Wang, Aimin Mu, Chuanzhen Niu, Shihong Zhu and Ji Wang
Objective: This study develops a predictive model to evaluate mortality risk in severe fever with thrombocytopenia
syndrome (SFTS) patients in intensive care units (ICU) to improve the accuracy of prognosis and guide the
optimization of treatment strategies.
Methods: In this study, a retrospective analysis was conducted on severe SFTS patients admitted to the ICU between
July 2019 and October 2023. Patients were categorized into survival and mortality groups. Multivariate logistic
regression was performed to determine independent risk factors (IRFs) for mortality. In addition, the nomogram
model was constructed and its performance was assessed through ROC curves.
Results: The study comprised 218 severe SFTS patients. The mortality group showed significantly lower Glasgow
Coma Scale (GCS) scores, oxygenation indices, and higher levels of several serological markers, log10(virus loads), and
lactic acid. Multivariate analysis identified GCS score [odds ratio (OR) = 0.66, P < 0.001], log10(virus loads) [OR = 2.24,
P = 0.001], lactic acid [OR = 1.60, P = 0.01], and cystatin C [OR = 1.80, P = 0.049] as IRFs for mortality. A nomogram
incorporating these IRFs demonstrated excellent predictive accuracy (AUC = 0.92, 95% CI: 0.88–0.96), with a sensitivity
of 76% and a specificity of 91%. This model showed adequate fit and good clinical applicability.
Conclusion: The nomogram model, based on GCS score, log10(virus loads), lactic acid, and cystatin C, offers clinical
utility in predicting 28-day mortality for severe SFTS patients, though further validation is needed.
How To Cite this Article
Liu, P., Liu, F., Wang, C. et al. Intensive care unit-based mortality risk model construction for severe fever with thrombocytopenia syndrome patients: a retrospective study. BMC Infect Dis 25, 449 (2025). https://doi.org/10.1186/s12879-025-10828-3
Authors: Lelia H. Chaisson, Fred C. Semitala, Sandra Mwebe, Eileen P. Scully, Jane Katende, Lucy Asege, Martha Nakaye, Alfred O. Andama, Adithya Cattamanchi and Christina Yoon
Abstract:
Background: Systematic tuberculosis (TB) screening is recommended for all people with HIV (PWH) because of its
potential to improve TB outcomes through earlier diagnosis and treatment.....
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Authors: Lelia H. Chaisson, Fred C. Semitala, Sandra Mwebe, Eileen P. Scully, Jane Katende, Lucy Asege, Martha Nakaye, Alfred O. Andama, Adithya Cattamanchi and Christina Yoon
Background: Systematic tuberculosis (TB) screening is recommended for all people with HIV (PWH) because of its
potential to improve TB outcomes through earlier diagnosis and treatment initiation. As such, systematic screening
may be particularly important for men, who experience excess TB prevalence and mortality compared to women.
We assessed sex differences among PWH undergoing systematic TB screening, including TB prevalence and severity,
diagnostic accuracy of screening tools, and TB outcomes.
Methods: We enrolled and followed adults with HIV (CD4 ≤ 350 cells/µL) initiating antiretroviral therapy (ART) at
two HIV/AIDS clinics in Uganda from July 2013 to December 2016. All participants underwent TB screening and
sputum collection for TB testing (Xpert MTB/RIF [Xpert], culture). We evaluated diagnostic accuracy of four WHO-recommended TB screening strategies (symptom screen; C-reactive protiein [CRP]; symptom screen followed by CRP,
if symptomatic [symptoms + CRP]; Xpert) for culture-positive TB and compared TB prevalence, days-to-treatment
initiation, and 3-month mortality by sex.
Results: Of 1,549 participants, 727 (46.9%) were male and 236 (15.2%) had culture-positive TB. Compared to females,
males had lower pre-ART CD4 counts (median 139 vs. 183 cells/µL, p < 0.001), higher TB prevalence (20.5% vs. 10.6%,
p < 0.001), and higher mycobacterial load as measured by Xpert semi-quantitative grade (p = 0.03). Sensitivity was high
(≥ 89.8%) for all screening strategies except Xpert (Xpert sensitivity 57.2%) and did not differ by sex. Specificity varied
widely from 13.9% for symptom screen to 99.2% for Xpert, and was 5–15% lower for males than females for symptom
screen, CRP, and symptoms + CRP. Among PWH with culture-positive TB, median days-to-treatment initiation (2 vs. 4,
p = 0.13) and 3-month mortality (9.4% vs. 9.2%, p = 0.96) were similar for males and females.
Conclusions: Although ART-naïve males undergoing systematic screening had more advanced HIV and TB than
females, days-to-TB treatment initiation and early TB mortality were similar, suggesting that systematic TB screening
has the potential to reduce sex-based disparities in TB outcomes.
How To Cite this Article
Chaisson, L.H., Semitala, F.C., Mwebe, S. et al. Sex differences in systematic screening for tuberculosis among antiretroviral therapy naïve people with HIV in Kampala, Uganda. BMC Infect Dis25, 452 (2025). https://doi.org/10.1186/s12879-025-10835-4
Authors: Lelia H. Chaisson, Fred C. Semitala, Sandra Mwebe, Eileen P. Scully, Jane Katende, Lucy Asege, Martha Nakaye, Alfred O. Andama, Adithya Cattamanchi and Christina Yoon
Account Details mentioned below: For Electronic Fund Transfer: (NEFT/RTGS)
Authors: Simin Zhang, Zhipeng Xu, Zhan Wang, Xinru Fei, Zhongqi Li, Limei Zhu, Leonardo Martinez, Jianming Wang and Qiao Liu
Abstract:
Background: The treatment of people with tuberculosis necessitates the administration of both broad-spectrum
and narrow-spectrum antibiotics for a minimum duration of six months. Prolonged antibiotic therapy.....
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Authors: Simin Zhang, Zhipeng Xu, Zhan Wang, Xinru Fei, Zhongqi Li, Limei Zhu, Leonardo Martinez, Jianming Wang and Qiao Liu
Background: The treatment of people with tuberculosis necessitates the administration of both broad-spectrum
and narrow-spectrum antibiotics for a minimum duration of six months. Prolonged antibiotic therapy may result
in dysregulation of the gut microbiota, potentially influencing the onset and progression of tuberculosis. There
is a paucity of studies focus on the characteristics of gut microbiota changes at various time points during tuberculosis treatment. This study aims to elucidate the relationship between the composition of gut microbiota and their
stage within anti-tuberculosis therapy.
Methods: A multi-center, observational prospective cohort study was conducted at four designated hospitals
in Jiangsu Province in eastern China. The Gastrointestinal Symptom Rating Scale was employed to evaluate the gastrointestinal discomfort experienced during anti-tuberculosis treatment. Fecal samples were collected at baseline
before initiating anti-tuberculosis therapy and at the end of 2 months and 6 months during treatment. Total microbial genomic DNA was extracted and sequenced. Rarefaction curves and alpha diversity indices including observed
operational taxonomic units, Chao1 richness and Shannon index were calculated.
Results: From October 2020 to December 2022, a total of 204 people with tuberculosis were diagnosed. Among
these, 85 people with tuberculosis provided baseline, 2-month, and 6-month fecal samples. The average age
was 41.8 ± 15.193 years, with a gender ratio of 77 males to 8 females. Only 28.2% of the cohort reported being free
of gastrointestinal symptoms during anti-tuberculosis treatment. Anti-tuberculosis treatment significantly reduced
gut microbiota diversity, with a transient decrease in alpha diversity indices observed after two months. A higher
alpha diversity in baseline (Shannon index with mean ± standard deviation (SD) 2.92 ± 0.93 vs. 2.50 ± 0.84, P = 0.0014,
inverse Simpson’s index with 11.9 ± 8.66 vs. 7.87 ± 6.42, P = 0.0012), compared with people with tuberculosis
after 2 months of treatment. No significant differences were identified between 2 months of treatment and at the end
of treatment microbiota diversity (Shannon index 2.50 ± 0.84 vs 2.58 ± 0.81, P = 0.55, inverse Simpson’s index 7.87 ± 6.42
vs 11.90 ± 8.66, P = 0.43).
How To Cite this Article
Zhang, S., Xu, Z., Wang, Z. et al. Changes in gut microbiome following anti-tuberculosis treatment: a prospective cohort from eastern China. BMC Infect Dis 25, 453 (2025). https://doi.org/10.1186/s12879-025-10800-1
Authors: Junye Liu, Yan Yu, Wei Feng, Zhihao He, Mengfei Wang, Weikun Hou, Yannan Zhao, Yi Liu, Yuzhu Yan and Heping Zhao
Abstract:
Objective: Orthopedic wound infection is a difficult problem in the clinic. Accurate and rapid microbiological test
results are essential for case management, antibiotic therapy, and infection.....
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Authors: Junye Liu, Yan Yu, Wei Feng, Zhihao He, Mengfei Wang, Weikun Hou, Yannan Zhao, Yi Liu, Yuzhu Yan and Heping Zhao
Objective: Orthopedic wound infection is a difficult problem in the clinic. Accurate and rapid microbiological test
results are essential for case management, antibiotic therapy, and infection control.
Methods: We retrospectively evaluated 1285 specimens (puncture fluid, catheter, secretions, joint fluid, lavage fluid,
extraction fluid, blood culture, drainage fluid, cerebrospinal fluid, bone, prosthesis tissue, etc.) from 739 patients who
received orthopedic diagnosis and treatment, using routine conventional method (RCM)s as a reference method
to evaluate the performance of multiplex PCR combined with capillary electrophoresis (mPCR-CE) for detecting
pathogens and antibiotic resistance genes associated with bone infection.
Results: Among the 1285 samples analyzed, 1045 samples were consistent with the results of the RCM,
with an agreement rate of 81.32%. Among the 155 inconsistent results, 13 (1.01%) were mPCR-CE negative but RCM
positive, 142 (11.05%) was mPCR-CE positive but RCM negative. Compared with RCM, mPCR-CE demonstrated positive percentage and negative percentage agreement values of 65.37% and 98.35%, respectively. Moreover, the detection rate of multidrug-resistant bacteria by the mPCR-CE method was generally better than that by the RCM method.
The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) by the mPCR-CE method is relatively high.
The traditional drug-sensitive culture method is more inclined to detect extended-spectrum β-lactamases (ESBLs).
The mPCR-CE method has obvious advantages in terms of timeliness.
Conclusion: This study revealed that mPCR-CE is a new and effective diagnostic method that can significantly reduce
the identification time of bacterial identification and drug resistance, and has the potential to improve the management of orthopedic infections.
How To Cite this Article
Liu, J., Yu, Y., Feng, W. et al. Evaluation of the multiplex PCR combined with capillary electrophoresis technique for detecting pathogenic bacteria and antibiotic resistance genes in bone infections. BMC Infect Dis25, 454 (2025). https://doi.org/10.1186/s12879-025-10847-0
Purpose: This study aims to identify and rank the key risk factors associated with the Zika virus by leveraging a novel
multi-criteria decision-making (MCDM) framework based.....
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Purpose: This study aims to identify and rank the key risk factors associated with the Zika virus by leveraging a novel
multi-criteria decision-making (MCDM) framework based on type-2 heptagonal fuzzy sets. By integrating advanced
aggregation operators, the framework effectively addresses uncertainties in expert assessments and enhances
decision-making reliability.
Methods: A robust MCDM approach was developed using type-2 heptagonal fuzzy sets, which provide a more
nuanced representation of uncertainty compared to traditional fuzzy models. These sets were selected due to their
superior ability to handle vague, imprecise, and subjective expert judgments, common challenges in epidemiological
risk assessments. Arithmetic and geometric aggregation operators were employed to process fuzzy data effectively.
To ensure comprehensive and reliable rankings, the framework incorporated both outranking methods and distance-based approaches, specifically TOPSIS and WASPAS. A sensitivity analysis was conducted to validate the stability
of the rankings under varying conditions.
Results: The proposed framework identified Z3 (unprotected sexual activity) as the most critical risk factor
with a score of 0.6717, followed by Z8 (blood transfusions) at 0.5783, Z10 (pregnancy) at 0.5753, Z9 (mosquito bites)
at 0.4917, and Z7 (travel to endemic areas) at 0.4726. The rankings remained consistent across different MCDM methods (TOPSIS and WASPAS), demonstrating the robustness of the proposed approach. Pearson correlation analysis
confirmed a strong agreement between methods, with correlation coefficients, reinforcing the reliability of the model.
Conclusion: This study introduces an advanced decision-support system for healthcare professionals to systematically identify and prioritize Zika virus risk factors. By leveraging type-2 heptagonal fuzzy sets, the framework effectively
captures and processes uncertainty stemming from incomplete epidemiological data, imprecise expert assessments,
and subjective linguistic evaluations. The consistency of rankings across multiple MCDM methods, along with sensitivity analysis confirming their stability, demonstrates the model’s reliability. These findings provide a scientifically
grounded tool for improving risk analysis and strategic public health interventions.
How To Cite this Article
Sheela Rani, M., Dhanasekar, S. Application of type-2 heptagonal fuzzy sets with multiple operators in multi-criteria decision-making for identifying risk factors of Zika virus. BMC Infect Dis 25, 450 (2025). https://doi.org/10.1186/s12879-025-10741-9
Authors: Bibek Koirala, Aline Azar, Brianna Fountain, Melissa McGuirl, Shannon Stock, Marzena Galdzicka and Richard T. Ellison III
Abstract:
Background: Few studies have simultaneously examined the epidemiology and sex differences of diverse
community respiratory viruses, including human metapneumovirus (HMPV), over more than one season.
Authors: Bibek Koirala, Aline Azar, Brianna Fountain, Melissa McGuirl, Shannon Stock, Marzena Galdzicka and Richard T. Ellison III
Background: Few studies have simultaneously examined the epidemiology and sex differences of diverse
community respiratory viruses, including human metapneumovirus (HMPV), over more than one season.
Methods: Given that molecular testing for community respiratory viruses was widely performed on patients at
UMass Memorial Medical Center between January 2010 and December 2013, a retrospective study was conducted
to examine epidemiologic features of positive subjects. Initial testing was done with rapid influenza and respiratory
syncytial (RSV) virus antigen testing, with negative testing reflexed to a multiplex nucleic acid amplification platform
detecting nine respiratory viruses.
Results: Four thousand ninety-eight (50.6%) of 8092 patients tested positive for at least one virus. The majority
(75.3%) of individuals testing positive were inpatients. Rhinovirus/enterovirus was most frequently detected; influenza
A was more common in older adults and RSV incidence was highest among patients < 5 years of age. Pronounced
seasonality was seen with influenza viruses, RSV, HMPV, and parainfluenza 3 virus. Influenza A was significantly
more common in females (11.2% vs. 8.1%; p < 0.001), while parainfluenza 1 virus (2.0% vs. 1.2%; p < 0.01), rhinovirus/
enterovirus (23.4% vs. 19.9%; p < 0.001) and adenovirus (2.1% vs. 1.5%; p < 0.05) were significantly higher in males. Of
the ICU patients with HMPV, many (40.3%) were ≥ 65 years of age.
Conclusions: This pre-coronavirus disease 2019 (COVID-19) era study has one of the largest patient populations
evaluated for community respiratory virus infections. It confirms known epidemiology, seasonality, and coinfections,
and importantly shows a preponderance of influenza A infections among women, contrasting prior studies, which warrants further investigation. It also shows a high HMPV incidence in the ICU among the elderly, underscoring the
importance of testing in this population.
How To Cite this Article
Koirala, B., Azar, A., Fountain, B. et al. Pre-COVID-19 epidemiology of community respiratory viruses at a single US center reveals sex differences in influenza A and a higher ICU incidence of human metapneumovirus in the elderly population. BMC Infect Dis 25, 924 (2025). https://doi.org/10.1186/s12879-025-11307-5
Authors: Faramarz Koohsar, Roghiyeh Faridnia, Ogholniaz Jorjani, Mohammad Taher Hojjati, Ganesh Yadagiri, Ghasem Noshak, Hosein Tavakoli Pirzaman and Hamed Kalani
Abstract:
Background: Control and elimination programs for malaria in Iran have consistently faced significant challenges
due to various factors, including the presence of neighboring malaria-endemic countries.....
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Authors: Faramarz Koohsar, Roghiyeh Faridnia, Ogholniaz Jorjani, Mohammad Taher Hojjati, Ganesh Yadagiri, Ghasem Noshak, Hosein Tavakoli Pirzaman and Hamed Kalani
Background: Control and elimination programs for malaria in Iran have consistently faced significant challenges
due to various factors, including the presence of neighboring malaria-endemic countries such as Afghanistan and
Pakistan. In recent years, Golestan Province in northern Iran has recorded few cases of imported malaria, with a
sudden increase of 22 cases in 2023. This article provides an overview of the malaria situation in northern Iran, along
with a detailed report of these 22 cases.
Methods: The study population comprises all individuals exhibiting symptoms suspected of malaria (n = 445)
who were referred to the Malaria Diagnosis Center in Golestan Province, located in northeastern Iran, for diagnosis
between March 23, 2023, and December 23, 2023. A drop of peripheral blood, collected from a finger prick of each
patient, was utilized for Plasmodium falciparum/P. vivax antigen detection. Moreover, thin and thick smears were
prepared for each patient to investigate morphological characteristics and parasitemia percentage of the parasites.
Results: In total, 4.94% (22/445) of individuals with malaria-suspected symptoms were infected with Plasmodium
species. All 22 infected individuals were native to Golestan Province, and none had a previous history. The
mean ± standard error of mean (SEM) for the number of parasites/µL of blood sample was 16,029 ± 5,060 for P. vivax
and 105,460 ± 102,146 for P. falciparum. Among the patients, 77.27% (17/22) were infected with P. vivax, 18.18%
(4/22) were infected with P. falciparum, and 4.54% (1/22) were co-infected with both P. vivax and P. falciparum. In
the case of P. falciparum, 40% (1/5) of the samples presented the ring form, 60% (3/5) trophozoite form, and 20%
(1/5) gametocyte form. All patients demonstrated a positive response to the treatment, with a decrease in both the
number of parasites and the number of clinical symptoms over time.
Conclusions: This study discussed 22 cases of malaria diagnosed in 2023 in Golestan Province in northern Iran. Given
the presence of malaria vectors in this area and the observation of gametocytes in specimens from some patients, the
increase in reported malaria cases could be worrisome in terms of establishing local transmission in this area.
How To Cite this Article
Koohsar, F., Faridnia, R., Jorjani, O. et al. The resurgence of malaria in Northern Iran in 2023: a wake-up call. BMC Infect Dis25, 921 (2025). https://doi.org/10.1186/s12879-025-11266-x
Authors: Akil J. Williams, T’Shara P. Ali, Imani D. Griffith, Simone T. Jeremie, Shivani Mahabir, Chelsea A. Sudan, Kristof C. Stüven and Marsha A. Ivey
Abstract:
Background: To determine the prevalence and risk factors associated with STIs among adults 18 years or older
attending two STI clinics in Trinidad.
Methods: A cross-sectional study was.....
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Authors: Akil J. Williams, T’Shara P. Ali, Imani D. Griffith, Simone T. Jeremie, Shivani Mahabir, Chelsea A. Sudan, Kristof C. Stüven and Marsha A. Ivey
Background: To determine the prevalence and risk factors associated with STIs among adults 18 years or older
attending two STI clinics in Trinidad.
Methods: A cross-sectional study was conducted using a convenience sample of 250 persons, ≥ 18 years old, visiting
two STI testing sites. Interviewer-administered questionnaires collected data on participants’ socio-demographic
characteristics, self-reported STI history during the past 12 months, sexual orientation and behaviour, and substance
use. Descriptive statistics, Chi-Squared test and crude odds ratios were generated using STATA version 15.
Results: Of the 250 participants, most were 25–31 years old (27%, 68/250), female (53%, 132/250), single (68%,
170/250), Afro-Trinidadian (55%, 136/250), had secondary level education or lower (68%, 170/250), employed (55%,
138/250), heterosexual (90%, 224/250) and did not consume alcohol (39%, 95/250). More than half (51%, 127/250)
used condoms sometimes, and most did not use a condom during their last sexual encounter (76%, 178/233).
Self-reported STI prevalence was 28% (70/250), of which the most common STIs were gonorrhea (12%, 31/250),
herpes (6%, 15/250) and syphilis (5%, 13/250). There were significant gender differences between STI prevalence and
employment status, having multiple sexual partners and alcohol consumption (p < 0.05 each). The odds of reporting
an STI were higher among individuals with lower educational attainment (OR: 6.14, 95% CI: 2.66–14.16, p < 0.001), low
monthly household income (OR: 2.26, 95% CI: 1.08–4.71, p = 0.030) and non-heterosexual persons (OR: 2.93, 95% CI:
1.28–6.69, p = 0.010). However, being employed (OR: 0.36, 95% CI: 0.18–0.71, p = 0.003) or a student (OR: 0.19, 95% CI:
0.05–0.74, p = 0.017) was protective against STI. There were no observed associations reported for sexual behaviours
and substance use.
Conclusion: The prevalence of STIs was significant among adults attending an STI clinic. These findings highlight
the importance of targeted interventions addressing socio-demographic and behavioural factors in the prevention and control of STIs, particularly focusing on high-risk groups such as individuals with low education, low household
income and members of sexual minority groups.
How To Cite this Article
Williams, A.J., Ali, T.P., Griffith, I.D. et al. Prevalence and risk factors associated with sexually transmitted infections among adults attending an STI clinic in a small island developing state. BMC Infect Dis 25, 923 (2025). https://doi.org/10.1186/s12879-025-11297-4
Authors: Akil J. Williams, T’Shara P. Ali, Imani D. Griffith, Simone T. Jeremie, Shivani Mahabir, Chelsea A. Sudan, Kristof C. Stüven and Marsha A. Ivey
Account Details mentioned below: For Electronic Fund Transfer: (NEFT/RTGS)
Background: Hepatitis B virus (HBV) infection remains a significant global health challenge, particularly in regions
like China, where the prevalence of HBV carriers is high. We.....
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Background: Hepatitis B virus (HBV) infection remains a significant global health challenge, particularly in regions
like China, where the prevalence of HBV carriers is high. We report the dynamic serological and virological changes
in a chronic HBV patient who exhibited HBsAg loss and subsequent reversion, explore the complex molecular
mechanisms of atypical serological profile.
Case presentation: A 65-year-old male with a 40-year history of chronic HBV infection presented with hepatocellular
carcinoma (HCC). Over three years, the patient underwent multiple interventions, including transarterial
chemoembolization (TACE) and targeted therapies. Serial monitoring revealed a gradual decline in HBsAg levels,
leading to seronegativity, followed by HBsAg reversion two years later. HBV DNA levels were quantified at 1.45 × 10³
IU/mL during HBsAg seronegativity. Genetic analysis identified multiple mutations in the HBV S gene, potentially
altering HBsAg structure and antigenicity, contributing to the atypical serological profile.
Conclusions: This case underscores the complexity of HBV serological dynamics in the context of chronic infection
and cancer treatment. The observed HBsAg fluctuations highlight the need for vigilant monitoring and advanced
diagnostic techniques, such as HBV DNA testing, in patients with chronic HBV, particularly those undergoing
immunosuppressive therapies. The identified S gene mutations may explain the serological changes, emphasizing the
importance of genetic analysis in understanding HBV evolution and guiding clinical treatment.
How To Cite this Article
Wang, C., Lin, L. & Ding, D.P. Dynamic changes of chronic hepatitis B patient with loss of surface antigen: a case report. BMC Infect Dis25, 918 (2025). https://doi.org/10.1186/s12879-025-11337-z
Authors: Guihong Liu, Xin Zhang, Qian Cao, Tao Chen, Binbin Hu and Huashan Shi
Abstract:
Background: Typhoid and paratyphoid fever are common infectious diseases and remain a heavy burden, especially
in some low-income countries. Although the global burden has decreased over.....
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Authors: Guihong Liu, Xin Zhang, Qian Cao, Tao Chen, Binbin Hu and Huashan Shi
Background: Typhoid and paratyphoid fever are common infectious diseases and remain a heavy burden, especially
in some low-income countries. Although the global burden has decreased over the past three decades, an analysis of
the burden of typhoid and paratyphoid fever will help inform public health strategies.
Methods: This study is aimed to comprehensively evaluate the global, regional, and national burden of typhoid and
paratyphoid, and the temporal trends while exploring potential associations with socio-demographic development
over three decades (1990–2021). Data on typhoid and paratyphoid fever were analyzed using the Global Burden
of Disease (GBD) study in 2021. For this analysis, we calculated to demonstrate temporal trends in the incidence,
mortality, and disability adjusted life years (DALYs) of typhoid and paratyphoid fever from 1990 to 2021.
Results: From 1990 to 2021, both typhoid and paratyphoid fever showed declining trends globally and in different
socio-demographic index (SDI) regions, including incidence, mortality, and DALYs. For typhoid fever worldwide, new
cases decreased by 62.12%, with an EAPC of -3.92 (-4.14, -3.71); deaths decreased by 50.65%, EAPC − 2.83 (-2.99, -2.66),
and DALYs decreased by 52.30%, EAPC − 2.82 (-3.00, -2.64). For paratyphoid fever, new cases decreased by 73.15%,
with an EAPC of -4.77 (-5.29, -4.26); deaths decreased by 65.44%, EAPC − 3.74 (-4.24, -3.24), and DALYs decreased
by 68.42%, EAPC − 3.87 (-4.42, -3.31). For both typhoid and paratyphoid fever, children had the highest morbidity
and mortality rates; males had higher rates of incidence, mortality, and DALYs than females. However, among older
patients, the absolute number of new cases and DALYs was higher in women. The burden is concentrated in South
Asia, Southeast Asia, and Oceania, with only South Asia suffering severely from paratyphoid fever. Regarding typhoid
fever, the top three countries with the highest ASRs of incidence are Burkina Faso (328.48) (SDI: 0.285), Bangladesh
(303.14) (SDI: 0.492), and Papua New Guinea (299.45) (SDI: 418) which are in Western Sub-Saharan, South Asia, and
Oceania. The top three countries in terms of mortality and DALYs are Bhutan (5.61; 434.23) (SDI: 0.473), Bangladesh
(5.06; 382.38), and Burkina Faso (4.64; 352.57). Regarding paratyphoid fever, the top three countries with the highest
ASRs of mortality and DALYs are the same, including Pakistan (1.05; 72.66), India (0.75; 53.42), and Nepal (0.72; 50.65)
(SDI: 0.433), all of which are located in South Asia.
How To Cite this Article
Liu, G., Zhang, X., Cao, Q. et al. The global burden of typhoid and paratyphoid fever from 1990 to 2021 and the impact on prevention and control. BMC Infect Dis25, 919 (2025). https://doi.org/10.1186/s12879-025-11223-8
Authors: Sabrina J. Moyo, Joel Manyahi, Said Aboud, Kristine Mørch, Adam P. Roberts, Bjørn Blomberg and Nina Langeland
Abstract:
Objectives: Studies from Tanzania show rising prevalence of extended-spectrum β-lactamase (ESBL) amongst key
bacterial pathogens. We aimed to look at the clinical impact of bloodstream.....
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Authors: Sabrina J. Moyo, Joel Manyahi, Said Aboud, Kristine Mørch, Adam P. Roberts, Bjørn Blomberg and Nina Langeland
Objectives: Studies from Tanzania show rising prevalence of extended-spectrum β-lactamase (ESBL) amongst key
bacterial pathogens. We aimed to look at the clinical impact of bloodstream infections (BSI) caused by ESBL producing
Gram-negative bacteria (GNB). This study was carried out on hospitalised children aged less than five years from four
hospitals of the region of Dar es Salaam.
Methods: The study included 135 hospitalized children with BSI due to GNB which were screened for ESBL. Clinical
outcome i.e., death or discharge, was known for 130 children of which 12% (n = 15) died We used univariate and
multivariate regression analyses to compare the outcome i.e., in-hospital mortality and length of hospital stay of
inpatients with BSI caused by ESBL- producing GNB vs. outcome of inpatients with BSI caused by non ESBL producing
GNB.
Results: Of the 135 children, 69 (51%) and 66 (49%) had BSI due to ESBL and non-ESBL producers respectively. Of the
15 children who died, 73% had BSI due to Klebsiella pneumoniae or Escherichia coli. Mortality among children with
infections caused by ESBL and non-ESBL producers were 16% and 6%, respectively. After adjusting for differences
between groups regarding age, sex, and consciousness status on admission, infection with ESBL producing
bacteria was a significant predictor of mortality, OR = 29; 95% CI (1.5–540). Children infected with ESBL producing
GNB had longer duration of hospital stay, OR 3.2, 95% CI (1.3–7.8). Resistance towards antimicrobial agents other
than penicillin’s and cephalosporins was significantly higher among ESBL producers than non-ESBL producers e.g.
gentamicin (60/69, 87%) vs. (6/66, 9.1%), OR = 67; 95% CI (22.3-198.9) and ciprofloxacin (37/69, 54%) vs. (7/66, 10.6%),
OR = 8; 95%CI (3.9–24.3)
Conclusions: The rapidly increasing resistance to commonly used and affordable antibiotics increases the risk of
death and prolongs hospital stays in neonates in the study setting. These findings highlight the need for strengthened
infection prevention and control in community settings and appropriate antibiotic use to reduce the selection and
spread of ESBL-GNB in hospitals.
How To Cite this Article
Moyo, S.J., Manyahi, J., Aboud, S. et al. Extended-spectrum-β-lactamase-producing Gram-negative bacteria are associated with high mortality in children with bloodstream infections in Dar es Salaam, Tanzania. BMC Infect Dis 25, 1416 (2025). https://doi.org/10.1186/s12879-025-11629-4
Authors: Ayub Qamar, Liu Hui, Saeed Khan, Abdullah bin Khalid and Dongmei Hu
Abstract:
Objective: This study evaluates the leukocyte telomere length and its association with anti-HBsAg antibody titer
among the hepatitis-B recovered subjects of the Pakistani population.
Authors: Ayub Qamar, Liu Hui, Saeed Khan, Abdullah bin Khalid and Dongmei Hu
Objective: This study evaluates the leukocyte telomere length and its association with anti-HBsAg antibody titer
among the hepatitis-B recovered subjects of the Pakistani population.
Materials and methods: This was a retrospective cross-sectional study. In this study, 6414 subjects were screened
for quantitative HBV-DNA through qPCR. Six hundred and sixty-eight subjects had a history of chronic hepatitis-B
infection while at present they have no HBV-DNA in their blood samples. These subjects were screened for anti-HBsAg
antibody through ELISA technique. Among them, 77 subjects developed anti-HBsAg antibody against HBsAg antigen.
Of them, 61 subjects’ leukocyte telomere length was analyzed through qPCR. In addition, normal healthy control
subjects’ (n = 18) leukocyte telomere length was also performed.
Results: The leukocyte Telomere length of chronic Hepatitis-B recovered patients were compared with normal
healthy subjects. The mean and standard deviation of the peripheral blood leukocytes’ telomere length of the
Ct-values between patients and normal control subjects was 11.34 ± 4.12 and 14.79 ± 1.87, respectively. Similarly,
the Ct-values for single copy reference gene were 20.03 ± 1.06 and 20.69 ± 0.611 between the chronic Hepatitis-B
recovered patients and control subjects. A weak positive association was noted between anti-HBsAg antibody titer
with Target/Single copy reference (T/S) ratio and number of base pairs (r = 0.2). In addition, a decline in anti-HBsAg
antibody titer was observed with respect to the age of the subjects. There was no significant difference in number of
base pairs between the male and female recovered patients. A significant difference between HBV recovered patients
and normal control subjects was observed between the T/S ratio and number of base pairs (< 0.0001).
Conclusion: A marked difference in the T/S ratio and number of base pairs was observed between the hepatitis-B
recovered patients and normal control subjects. In chronic hepatitis-B recovered patients, the number of base pairs
on each chromosome end were significantly higher as compared with normal control subjects. A weak positive
correlation was noted between the T/S ratio and number of base pairs with anti-HBsAg antibody titer. This study shows that hepatitis-B recovered patients have maintained their higher telomere length as compared with the normal
control subjects
How To Cite this Article
Qamar, A., Hui, L., Khan, S. et al. Association of leukocyte telomere length with anti-HBsAg antibody titer in Hepatitis-B recovered patients from the Pakistani population. BMC Infect Dis25, 1414 (2025). https://doi.org/10.1186/s12879-025-11373-9
Authors: Jing Zheng, Ying Zhang, Jing Wang, Yijun Chen, Guangjun Zhu, Yufen Zheng, Haixi Yan, Jun Li and Bo Shen
Abstract:
Background: Patients with COVID-19 often produce multiple autoantibodies that impact immune function. This
study aimed to assess changes in immune status and correlation with SARS-CoV-2 infection by analyzing.....
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Authors: Jing Zheng, Ying Zhang, Jing Wang, Yijun Chen, Guangjun Zhu, Yufen Zheng, Haixi Yan, Jun Li and Bo Shen
Background: Patients with COVID-19 often produce multiple autoantibodies that impact immune function. This
study aimed to assess changes in immune status and correlation with SARS-CoV-2 infection by analyzing dynamic
shifts in patients’ antinuclear antibody (ANA) profiles.
Methods: A retrospective analysis was conducted on ANA data and clinical characteristics of 680 patients with novel
coronavirus pneumonia admitted to Taizhou Enze Medical Center (Group) between December 7, 2022, and January
31, 2023. The analysis covered three phases: early COVID-19 (within one year before admission, T1), COVID-19 phase
(during hospitalization, T2), and late COVID-19 (within one year after discharge, T3). ANA quantification was primarily
performed using indirect immunofluorescence, and the magnetic stripe immunofluorescence luminescence method
was employed to detect the ANA profile (ENA), including anti-dsDNA, nucleosome, Sm, SS-A/Ro52kD, SS-A/Ro60kD,
SS-B/La, PCNA, AMA M2, Scl-70, and Jo-1.
Results: During the T2 phase, 680 patients were analyzed. The positive rate of the ANA test was 35%. The proportion
of autoimmune diseases (AID) in ANA-positive patients was higher than in ANA-negative patients (22%vs.7%). The
ANA-positive group with AID showed higher ANA titers compared to the ANA-positive group without AID. During
the follow-up one year before and after SARS-CoV-2 infection, in the T1-T2 group, there were two cases of ANA
changing from negative to positive (one with AID, one without AID). The positive intensity of ANA increased by 15.6%
and decreased by 20%. In the T2-T3 group, the positive intensity of ANA increased by 3.3% and decreased by 33.3%.
Followed up of 7 patients with high ANA titers in T2 phase, among whom 5 cases did not support AID from the
perspective of diagnosis and medication, and 2 cases were diagnosed with SLE after being infected with SARS-CoV-2
Conclusions: SARS-CoV-2 infection induces overactivation of the immune system, significantly impacting patients
with autoimmune diseases. For patients without autoimmune diseases, ANA produced due to COVID-19 does not
persist. Some COVID-19 patients may trigger their own immune system response.
How To Cite this Article
Zheng, J., Zhang, Y., Wang, J. et al. Study on the dynamic changes in antinuclear antibody spectrum in SARS-CoV-2 infection: a retrospective analysis. BMC Infect Dis25, 1410 (2025). https://doi.org/10.1186/s12879-025-11848-9
Background: The HIV epidemic remains a significant public health concern among individuals aged 20–54 years.
However, comprehensive studies evaluating trends in HIV-related health burdens and associated.....
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Background: The HIV epidemic remains a significant public health concern among individuals aged 20–54 years.
However, comprehensive studies evaluating trends in HIV-related health burdens and associated behavioral risks in
China and the Western Pacific Region are limited.
Methods: This study utilizes data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to examine
HIV burden indicators—including the age specific rates (ASR) for prevalence (ASPR), incidence (ASIR), mortality (ASMR)
and DALYs (ASDR)—among individuals aged 20–54 years in China and the Western Pacific Region from 1990 to
2021. Long-term trends were analyzed using average annual percentage changes (AAPCs), while short-term trends
were assessed through annual percentage changes (APCs). Furthermore, trends in HIV-related DALYs associated with
behavioral risks were analyzed.
Results: In China, ASPR increased by 751.27% (AAPC = 7.19, 95%CI: 7.02–7.35), ASIR by 232.26% (AAPC = 3.8,
95%CI: 2.62–4.99), ASMR by 1535.29% (AAPC = 9.07, 95%CI: 8.51–9.63), and ASDR by 1379.27% (AAPC = 8.72,
95%CI: 8.22–9.23). In the Western Pacific Region, ASPR increased by 1101.91% (AAPC = 8.34, 95%CI: 8.2–8.47), ASIR
by 354.24% (AAPC = 4.68, 95%CI: 3.91–5.45), ASMR by 1241.67% (AAPC = 8.56, 95%CI: 8.05–9.08), and ASDR by
1135.86% (AAPC = 8.28, 95%CI: 7.83–8.73). Regarding the HIV-related DALYs rate attributable to behavioral risks, the
corresponding rate for unsafe sex, intimate partner violence, and drug use showed a significant increase from 1990 to
2021 in China and the Western Pacific Region (all AAPC > 0, p < 0.05). Notably, the HIV burden was consistently higher
in males than females in both regions, with most of gender disparities widening over time.
Conclusion: Despite significant progress in HIV/AIDS response, the burden remains substantial, with notable
gender differences. Strengthened international cooperation, targeted prevention strategies, and expanded access to
treatment are crucial to mitigating new HIV infections and improving health outcomes.
How To Cite this Article
Liu, H., Jing, Q., Meng, M. et al. Disease burden of HIV and its behavioral risks among adults aged 20–54 years in China and the Western Pacific Region from 1990 to 2021: an analysis based on the Global Burden of Disease Study 2021. BMC Infect Dis 25, 1412 (2025). https://doi.org/10.1186/s12879-025-11812-7
Authors: Lukas E. Brümmer, Theresa S. Ryckman, Sourya Shrestha, Florian M. Marx, William Worodria, Devasahayam J. Christopher, Grant Theron, Adithya Cattamanchi
Abstract:
Background: The costs, operational barriers, and sensitivity of available tools to confirm a TB diagnosis limit current
active case-finding (ACF) efforts for tuberculosis (TB). However,.....
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Authors: Lukas E. Brümmer, Theresa S. Ryckman, Sourya Shrestha, Florian M. Marx, William Worodria, Devasahayam J. Christopher, Grant Theron, Adithya Cattamanchi
Background: The costs, operational barriers, and sensitivity of available tools to confirm a TB diagnosis limit current
active case-finding (ACF) efforts for tuberculosis (TB). However, it is not well understood which of these limitations
have the greatest epidemiological relevance and might therefore warrant prioritization in confirmatory test
development.
Methods: To explore which features of the confirmatory testing step most influence the impact of ACF, we
developed a state-transition model of a one-time, community-based ACF campaign, with a fixed budget of one
million United States dollars for screening and confirmatory testing, assuming an adult target population with four
times the national prevalence of Uganda. We compared TB diagnoses, mortality, and transmission when conducting
ACF with a currently available confirmatory test (mirroring sputum-based Xpert Ultra) versus ACF with an improved
confirmatory test, i.e., (1) increased sensitivity (from 69% to 80%), (2) non-sputum specimen type (increasing specimen
availability from 93% to 100%), (3) immediate turn-around of test results at the point-of-care (increasing delivery of
positive results from 91% to 100%), or (4) reduced costs (from $20 to $10 per confirmatory test).
Results: In a simulated target population of 500,000 adults, 8,029 (1.6%; 95% uncertainty range [UR] 6,634-9,380)
had TB disease, and 1,136 (789-1,586) were projected to die of TB in the absence of ACF. Assuming current tests, ACF
could reach 149,811 (90,834 − 217,928; 30% of the target population) people under the allotted budget, connecting
1,151 (676-1,813) individuals with TB to treatment and averting 135 (64–249) deaths. Higher diagnostic sensitivity
most increased the number of people with TB who received treatment as a result of ACF (by 15% [5–27%]). However,
improvements that could benefit individuals regardless of their sputum bacillary load, such as reduced test costs,
achieved larger reductions in mortality (11% [4–36%]).
Conclusion: Due to greater detection of individuals with high bacillary load, making confirmatory tests for
community-based TB screening less expensive and more accessible may lead to greater population health benefits
than further increasing test sensitivity. Nonetheless, achieving large (> 20%) increases in the health impact of ACF will
require improvements to components of ACF other than the confirmatory diagnostic test.
How To Cite this Article
Brümmer, L.E., Ryckman, T.S., Shrestha, S. et al. Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: an epidemiological modeling analysis. BMC Infect Dis25, 1415 (2025). https://doi.org/10.1186/s12879-025-11905-3
Authors: Lukas E. Brümmer, Theresa S. Ryckman, Sourya Shrestha, Florian M. Marx, William Worodria, Devasahayam J. Christopher, Grant Theron, Adithya Cattamanchi
Account Details mentioned below: For Electronic Fund Transfer: (NEFT/RTGS)
Introduction: Carbapenem‑resistant gram‑negative bacilli are a worldwide concern because of high morbidity
and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate.....
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Introduction: Carbapenem‑resistant gram‑negative bacilli are a worldwide concern because of high morbidity
and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent
of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics
and antimicrobial susceptibility profiles of carbapenem‑resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022.
Methods: Ninety‑five clinical isolates of carbapenem non‑susceptible gram‑negative bacilli were collected from six
hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical
Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase
inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were
screened for the blaKPC,blaNDM, blaOXA‑48, blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened
for the blaOXA‑23, blaOXA‑58 and blaOXA‑24/40 genes.
Results: Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA‑48 genes
were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa,
and blaOXA‑24/40 predominated in A. baumannii. Most of the isolates showed co‑resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were
active against carbapenem‑resistant gram‑negative bacilli that produce serin‑carbapenemases.
Conclusion: The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase‑producing
K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified,
and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains
How To Cite this Article
Soria-Segarra, C., Soria-Segarra, C., Molina-Matute, M., Agreda-Orellana, I., Núñez-Quezada, T., Cevallos-Apolo, K., ... & Gutiérrez-Fernández, J. (2024). Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador. BMC Infectious Diseases, 24(1), 378.
Background: Highly active antiretroviral therapy (HAART) has been able to improve the immune system function and
survival of human immunodeficiency virus (HIV) patients. However, Patients coinfected.....
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Background: Highly active antiretroviral therapy (HAART) has been able to improve the immune system function and
survival of human immunodeficiency virus (HIV) patients. However, Patients coinfected with HIV and hepatitis B virus
(HBV) are more likely to develop end-stage liver disease (ESLD) than those infected with HBV alone. Consequently,
liver transplantation is often required for these patients. This study evaluates the outcomes of orthotopic liver
transplantation (OLT) of HIV-HBV coinfected patients in China.
Methods: We conducted a retrospective analysis on all HIV-HBV coinfected patients that underwent OLT from April
1, 2019 to December 31, 2021 and their outcomes were compared to all HBV monoinfected patients undergoing OLT
during the same period. Patient outcomes were determined, including cumulative survival, viral load, CD4 T-cell count
and postoperative complications.
Results: The median follow-up of HIV recipients was 36 months after OLT (interquartile range 12–39 months).
Almost all patients had stable CD4 T-cell count (> 200 copies/ul), undetectable HBV DNA levels, and undetectable
HIV RNA load during follow-up. The 1-, 2-, and 3-year posttransplant survival rates were 85.7% for the HIV group
(unchanged from 1 to 3 years) versus 82.2%, 81.2%, and 78.8% for the non-HIV group. Cumulative survival among
HIV-HBV coinfected recipients was not significantly different from the HBV monoinfected recipients (log-rank test
P = 0.692). The percentage of deaths attributed to infection was comparable between the HIV and non-HIV groups
(14.3% vs. 9.32%, P = 0.665). Post OLT, there was no significant difference in acute rejection, cytomegalovirus infection,
bacteremia, pulmonary infection, acute kidney injury, de novo tumor and vascular and biliary complications.
Conclusions: Liver transplantation in patients with HIV-HBV coinfection yields excellent outcomes in terms of
intermediate- or long-term survival rate and low incidence of postoperative complications in China. These findings
suggest that OLT is safe and feasible for HIV-HBV coinfected patients with ESLD.
Trial registration: Chinese Clinical Trial Registry (ChiCTR2300067631), registered 11 January 2023
How To Cite this Article
Tang, J., Weng, R., Fang, T., Zhang, K., Yan, X., Jin, X., ... & Zhao, D. (2024). Clinical outcomes of liver transplantation in human immunodeficiency virus/hepatitis B virus coinfected patients in China. BMC Infectious Diseases,24(1), 383.
Authors: Salvatore Rotundo, Maria Teresa Tassone, Nadia Marascio, Helen Linda Morrone, Simona Gigliotti, Angela Quirino, Alessandro Russo, Giovanni Matera, Enrico Maria Trecarichi and Carlo Tort
Abstract:
Background: Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that
mostly affects people living with HIV (PLWH), transplanted patients.....
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Authors: Salvatore Rotundo, Maria Teresa Tassone, Nadia Marascio, Helen Linda Morrone, Simona Gigliotti, Angela Quirino, Alessandro Russo, Giovanni Matera, Enrico Maria Trecarichi and Carlo Tort
Background: Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that
mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since
cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered
rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial
treatment in this population has not been previously investigated.
Methods: We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening
articles whose title included the keywords “bacillary” AND “angiomatosis” and included case reports about patients
not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their
duration.
Results: Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic
treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in
most cases macrolides and tetracyclines.
Conclusions: cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major
immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with
severity and extension of the disease can be useful to personalize the type of treatment and its duration.
How To Cite this Article
Rotundo, S., Tassone, M. T., Marascio, N., Morrone, H. L., Gigliotti, S., Quirino, A., ... & Torti, C. (2024). A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment. BMC Infectious Diseases, 24(1), 380.
Authors: Salvatore Rotundo, Maria Teresa Tassone, Nadia Marascio, Helen Linda Morrone, Simona Gigliotti, Angela Quirino, Alessandro Russo, Giovanni Matera, Enrico Maria Trecarichi and Carlo Tort
Account Details mentioned below: For Electronic Fund Transfer: (NEFT/RTGS)
Authors: Thibaut Vanbaelen, Sheeba Santhini Manoharan‑Basil and Chris Kenyon
Abstract:
There is considerable interest in the use of doxycycline post exposure prophylaxis (PEP) to reduce the incidence
of bacterial sexually transmitted infections (STIs). An important concern is.....
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Authors: Thibaut Vanbaelen, Sheeba Santhini Manoharan‑Basil and Chris Kenyon
There is considerable interest in the use of doxycycline post exposure prophylaxis (PEP) to reduce the incidence
of bacterial sexually transmitted infections (STIs). An important concern is that this could select for tetracycline
resistance in these STIs and other species. We searched PubMed and Google Scholar, (1948–2023) for randomized
controlled trials comparing tetracycline PEP with non‑tetracycline controls. The primary outcome was antimicrobial
resistance (AMR) to tetracyclines in all bacterial species with available data. Our search yielded 140 studies, of which
three met the inclusion criteria. Tetracycline PEP was associated with an increasedprevalence of tetracycline resistance in Neisseria gonorrhoeae, but this effect was not statistically significant (Pooled OR 2.3, 95% CI 0.9‑3.4). PEP had
a marked effect on the N. gonorrhoeae tetracycline MIC distribution in the one study where this was assessed. Prophylactic efficacy was 100% at low MICs and 0% at high MICs. In the one study where this was assessed, PEP resulted
in a significant increase in tetracycline resistance in commensal Neisseria species compared to the control group (OR
2.9, 95% CI 1.5‑5.5) but no significant effect on the prevalence of tetracycline resistance in Staphylococcus aureus. The
available evidence suggests that PEP with tetracyclines could be associated with selecting tetracycline resistance in N.
gonorrhoeae and commensal Neisseria species
How To Cite this Article
Rotundo, S., Tassone, M. T., Marascio, N., Morrone, H. L., Gigliotti, S., Quirino, A., ... & Torti, C. (2024). A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment. BMC Infectious Diseases, 24(1), 380.
Authors: Md. Feroz Kabir, Khin Nyein Yin, Mohammad Saffree Jeffree, Fatimah Binti Ahmedy, Muhamad Faizal Zainudin, Ohnmar Htwe, Sharmila Jahan, Md. Zahid Hossain, K. M. Amran Hossain
Abstract:
Background: Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL)
and induces disease burden.
Purpose The study.....
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Authors: Md. Feroz Kabir, Khin Nyein Yin, Mohammad Saffree Jeffree, Fatimah Binti Ahmedy, Muhamad Faizal Zainudin, Ohnmar Htwe, Sharmila Jahan, Md. Zahid Hossain, K. M. Amran Hossain
Background: Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL)
and induces disease burden.
Purpose The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL
and pain in LCS.
Methods: This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021
was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved
from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses
were conducted using IBM SPSS (Version 20.00).
Results: The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study
also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4–3.8), chest pain 2.4%
(95% CI; 1.8–3.1), joint pain 2.8% (95% CI; 2.2–2.3), headache 3.1% (95% CI; 2.4–3.8), and abdominal pain 0.3% (95%
CI; 0.01–0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life
across all domains of the WHOQOL-BREF (P < 0.001) compared to asymptomatic cases.
Conclusion: Three out of ten people with long COVID experience painful symptoms, which can significantly reduce
their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease
How To Cite this Article
Kabir, M. F., Yin, K. N., Jeffree, M. S., Ahmedy, F. B., Zainudin, M. F., Htwe, O., ... & Chakrovorty, S. K. (2024). Clinical presentation of post-COVID pain and its impact on quality of life in long COVID patients: a cross-sectional household survey of SARS-CoV-2 cases in Bangladesh. BMC Infectious Diseases, 24(1), 375.
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