Tropical Medicine Commons^™

Expert Recommendations To Strengthen Chikungunya Outbreak Surveillance And Reporting For Traveler Health Protection, Daniel C. Payne, Karoun H. Bagamian, Jeffery Goad, Nathan D. Grubaugh, Michael A. Johansson, Moritz U. G. Kraemer, Eyal Leshem, Francesca F. Norman, Alfonso J. Rodríguez-Morales, Henrik Salje, Stephen Thomas, Scott C. Weaver, Lindsey A. Laytner, Rebecca Sturgis, Suzanne K. Scheele, Davidson H. Hamer

Pharmacy Faculty Articles and Research

Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because …

Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai

Department of Medicine Faculty Papers

BACKGROUND: Facial Necrotizing Fasciitis (FNF) is a rare but aggressive, life-threatening infection involving the face's subcutaneous tissues and underlying musculature. It can rapidly progress to septic shock and multi-organ failure if not promptly recognized and treated. The clinical course, including severe pain, disproportionate tenderness, and systemic signs, is often the most crucial factor in diagnosis. While computed tomography (CT) can aid in identifying early signs such as soft tissue swelling and gas formation, clinical suspicion remains paramount and should not be delayed by reliance on imaging alone. Without early intervention, FNF may lead to devastating outcomes, including disfigurement, blindness, or …

Thrombocytopenia In Patients With Plasmodium Vivax In Colombia Is Associated With Anti-Phosphatidylserine Autoantibodies And Il-6, Ifnγ, Il-10 And Tgf-Β, María Camila Velasco-Pareja, Catalina Tovar-Acero, Miriam E. Cantero Guevara, Ana Rodriguez, Juan Rivera-Correa, María Fernanda Yasnot-Acosta

Publications and Research

Plasmodium vivax is the most widely distributed human protozoan in the world. It is a causative agent of malaria, with thrombocytopenia being a frequent complication. This study aimed to evaluate the effect of P. vivax infection on plasma cytokine/chemokine levels and anti-phosphatidylserine (anti-PS) autoantibodies, to explore their potential role in thrombocytopenia during P. vivax malaria in Córdoba, Colombia. We included patients with P. vivax malaria and thrombocytopenia (MT); patients with malaria without thrombocytopenia (M) and healthy controls (HC). Plasma cytokines/chemokines (IL-2, IL-4, IL-1β, TNF-α, IL-17A, IL-6, IL-10, IFNγ, IL-12p70, TGF-β1/IP-10, MCP-1, IL-8) were quantified. Evaluation of autoantibodies was performed by …

A Honduran Prevalence Study On Soil-Transmitted Helminths Highlights Serological Antibodies To Tm-Wap49 As A Diagnostic Marker For Exposure To Human Trichuriasis, Neima Briggs, Leroy Versteeg, Rojelio Mejia, Jeroen Pollet, Maria Jose Villar, Bin Zhan, Graeme Segal, Stephanie Novak, Patricia Lenihan, Paul Musgrave, Viviana Ellis, Carol Florencia Coello, K Jagannadha Sastry, Joe Craft, Peter J Hotez, Maria Elena Bottazzi

Faculty, Staff and Student Publications

Soil-transmitted helminth (STH) infections rank among the most prevalent communicable diseases of humans, yet detection of these parasites is mostly restricted to identifying active infection through fecal examinations. Currently, there are no commercial diagnostic tools to identify a prior whipworm or hookworm exposure, and the few serological assays for roundworm infection have not been well validated for crossreactivity or infections in humans. Such diagnostic restrictions limit the range of scientific and clinical questions that surround STH exposures and their implicated relationship to chronic diseases, such as autoimmunity, allergy, and cancer. The goal of this investigation was to evaluate the diagnostic …

Dengue Cases In Hanoi, Vietnam: Unseasonal Surge Foreshadows Increased Incidence That Demands Organized Preventive Action, Andrew W. Taylor-Robinson

Chulalongkorn Medical Journal

Letter to the Editor - Abstract not required.

Man With An Itchy Back, Katherine Schaffer, Nevin Adamski, Brittany Ambrose, Kathleen Anderson

Department of Emergency Medicine Faculty Publications

[First paragraph] A 61-year old man with no significant past medical history presented with painful bug bites on his lower back 1 day after a 1.5-week-long visit to Africa. He noticed bug bites on his lower back 3 days ago; since then, they have increased in size and become more painful. He was prescribed doxycycline at urgent care earlier that morning and had taken 1 dose. He is taking prophylactic medications for malaria and has had no fever at home. Vital signs, exquisitely tender papular lesions with a central punctum and surrounding erythema in the bilateral paralumbar regions.

Targeted Maternal Chagas Disease Screening Among Individuals Born In A Chagas-Endemic Country., Alvaro Proaño, Neil C Shah, Sneider A Gutierrez Guarnizo, Monica Miranda-Schaeubinger, Michael Z Levy, Robert H Gilman, Dustin D Flannery

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Chagas disease is a neglected tropical disease caused by the parasite Trypanosoma cruzi that affects 6 million people worldwide. In the United States, Chagas is estimated to affect 43 000 women of reproductive age. Pregnant persons with Chagas are at risk for congenital transmission to the newborn, which accounts for nearly a quarter of all new cases. In 2022, a US multidisciplinary expert working group4 developed recommendations for increased clinician-directed screening for Chagas. They concluded that women of reproductive age who were born in endemic countries should be tested due to vertical transmission risk. In 2024, Clark and Bern outlined …

Low Prevalence Of Soil Transmitted Helminth Infection In Ugandan Children Hospitalized With Severe Malaria, Drew Capone, Nuzrath Jahan, Ruth Namazzi, Robert Opoka, Chandy John

Paediatrics and Child Health, East Africa

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool …

Phenotypic Diversity Of Type Iii Secretion System Activity In Enteropathogenic Escherichia Coli Clinical Isolates, Carmen A Contreras, Tracy H Hazen, Carmen Guadarrama, Ramón Cervantes-Rivera, Theresa J Ochoa, Pablo Vinuesa, David A Rasko, Jose L Puente

Faculty, Staff and Student Publications

Introduction. Enteropathogenic Escherichia coli (EPEC) strains pose a significant threat as a leading cause of severe childhood diarrhoea in developing nations. EPEC pathogenicity relies on the type III secretion system (T3SS) encoded by the locus of enterocyte effacement (LEE), facilitating the secretion and translocation of bacterial effector proteins.

Gap Statement. While the regulatory roles of PerC (plasmid-encoded regulator) and GrlA (global regulator of LEE-activator) in ler expression and LEE gene activation are well-documented in the EPEC prototype strain E2348/69, understanding the variability in LEE gene expression control mechanisms among clinical EPEC isolates remains an area requiring further investigation.

Aim. This …

Concepts In Animal Parasitology, Scott L. Gardner, Sue Ann Gardner

Zea E-Books Collection

Note that this version of the textbook has been superceded by the one updated in 2026, available at the UNL Pressbooks site.

The hard copy version that is for sale at lulu.com is the old version.

"This is a textbook covering concepts in animal parasitology. It is meant to be used by students, teachers, professors, researchers, and members of the public who are interested in learning about animal parasite biology, systematics, taxonomy, zoogeography, and ecology. The primary intended audience is upper-level undergraduate or graduate university students who have knowledge of basic biology and, particularly, basic animal biology. (863 pages, …

From Heel To Toe: Investigating Plantar Fasciitis Causes, Diagnosis, And Treatment Strategies, Breanna Littlejohn

Undergraduate Honors Theses

This presentation informs plantar fasciitis patients. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The classic presentation is of sharp localized pain at the heel. In some cases, a heel spur may be found. This presentation explains how exercise can improve plantar fasciitis. Reviewing risk factors will help you identify and manage plantar fasciitis when undergoing treatment. Understanding plantar fasciitis is crucial as it is a common and painful condition affecting the bottom of the foot. This inflammation of the …

Projecting Temperature-Related Dengue Burden In The Philippines Under Various Socioeconomic Pathway Scenarios, Xerxes Seposo, Sary Valenzuela, Geminn Louis C. Apostol, Keith Alexius Wangkay, Percival Ethan Lao, Anna Beatrice Enriquez

Ateneo School of Medicine and Public Health Publications

Introduction

As climate change advances, the looming threat of dengue fever, intricately tied to rising temperatures, intensifies, posing a substantial and enduring public health challenge in the Philippines. This study aims to investigate the historical and projected excess dengue disease burden attributable to temperature to help inform climate change policies, and guide resource allocation for strategic climate change and dengue disease interventions.

Methods

The study utilized established temperature-dengue risk functions to estimate the historical dengue burden attributable to increased temperatures. Future projections were derived using Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathway (SSP) scenarios to estimate the …

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …

Socio-Economic Factors And Its Influence On The Association Between Temperature And Dengue Incidence In 61 Provinces Of The Philippines, 2010–2019, Xerxes Seposo, Sary Valenzuela, Geminn Louis Apostol

Ateneo School of Medicine and Public Health Publications

Background

Temperature has a significant impact on dengue incidence, however, changes on the temperature-dengue relationship across axes of socio-economic vulnerability is not well described. This study sought to determine the association between dengue and temperature in multiple locations in the Philippines and explore the effect modification by socio-economic factors.

Method

Nationwide dengue cases per province from 2010 to 2019 and data on temperature were obtained from the Philippines’ Department of Health–Epidemiological Bureau and ERA5-land, respectively. A generalized additive mixed model (GAMM) with a distributed lag non-linear model was utilized to examine the association between temperature and dengue inci-dence. We further …

Colonizing And Virulence Factors In Enterotoxigenic Escherichia Coli From Peru, Fulton P Rivera, Anicia Medina, Maribel Riveros, Theresa J Ochoa, Maria J Pons, Joaquim Ruiz

Faculty, Staff and Student Publications

Enterotoxigenic Escherichia coli (ETEC) ranks among the most relevant diarrheagenic pathogens. Efforts to design vaccines to fight ETEC have been focused on colonizing factors (CFs) and atypical virulence factors (AVF). An effective vaccine must account for differences in the regional prevalence of these CFs and AVFs to be truly effective in a given area. In the present study, the presence of 16 CFs and 9 AVFs, as well as the heat-stable (ST) variants (STh or STp), was established by polymerase chain reaction in 205 Peruvian ETEC isolates (120 from diarrhea cases and 85 from healthy controls). Ninety-nine (48.3%) isolates were …

Class 1 And 2 Integrons In Escherichia Coli Strains Isolated From Diarrhea And Bacteremia In Children Less Than 2 Years Of Age From Peru, Maribel Riveros, Maria J Pons, David Durand, Theresa J Ochoa, Joaquim Ruiz

Faculty, Staff and Student Publications

Class 1 and Class 2 integrons are mobilizable elements able to carry a variety of antibiotic resistance determinants. In the present study, Class 1 and 2 integrons present in 355 pathogenic Escherichia coli (285 diarrheagenic, of these 129 were enteropathogenic, 90 enteroaggregative, 66 enterotoxigenic, and 70 bacteremic) isolated from healthy and ill children under age 5 from periurban areas of Lima, Peru, were characterized. The presence of integrase 1 and 2 was established by polymerase chain reaction (PCR), and variable regions were grouped by PCR-restriction fragment length polymorphism and subsequent sequencing. Antimicrobial resistance was established by disk diffusion. Ninety-seven isolates …

Periprosthetic Knee Infection After Benign Tumor Excision Complicated By Carbapenem Resistant Enterobacteriaceae: A Case Report, Jennifer Adams, Daniel Habenicht, Duncan C. Ramsey

MEDI 9331 Scholarly Activities Clinical Years

Introduction

Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI.

Case presentation

We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem.

Discussion

CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE …

Regional Research-Practice-Policy Partnerships In Response To Climate-Related Disparities: Promoting Health Equity In The Pacific, Lawrence A. Palinkas, Meaghan O’Donnell, Susan Kemp, Jemaima Tiatia, Yvonette Duque, Michael Spencer, Rupa Basu, Kristine Idda Del Rosario, Kristin Diemer, Bonifacio Doma, David Forbes, Kari Gibson, Joshua Graff-Zivin, Bruce M. Harris, Nicola Hawley, Jill Johnston, Fay Lauraya, Nora Elizabeth F. Maniquiz, Jay Marlowe, Gordon C. Mccord, Imogen Nicholls, Smitha Rao, Angela Kim Saunders, Salvatore Sortino, Benjamin F. Springgate, David Takeuchi, Janette Ugsang, Vivien Villaverde

School of Medicine Faculty Publications

Although climate change poses a threat to health and well-being globally, a regional approach to addressing climate-related health equity may be more suitable, appropriate, and appealing to under-resourced communities and countries. In support of this argument, this commentary describes an approach by a network of researchers, practitioners, and policymakers dedicated to promoting climate-related health equity in Small Island Developing States and low- and middle-income countries in the Pacific. We identify three primary sets of needs related to developing a regional capacity to address physical and mental health disparities through research, training, and assistance in policy and practice implementation: (1) limited …

Rapid Assessment Of Opisthorchis Viverrini Igg Antibody In Serum: A Potential Diagnostic Biomarker To Predict Risk Of Cholangiocarcinoma In Regions Endemic For Opisthorchiasis., Rutchanee Rodpai, Vor Luvira, Lakkhana Sadaow, Wattana Sukeepaisarnjaroen, Amnat Kitkhuandee, Krisada Paonariang, Oranuch Sanpool, Wannaporn Ittiprasert, Victoria H. Mann, Pewpan M Intapan, Paul J. Brindley, Wanchai Maleewong

Microbiology, Immunology, and Tropical Medicine Faculty Publications

BACKGROUND: Opisthorchiasis is caused by an infection with fish-borne liver flukes of the genus Opisthorchis. Opisthorchiasis frequently leads to chronic inflammation in the biliary tract and is classified as a group 1 biological carcinogen by the International Agency for Research on Cancer: a definitive risk for cholangiocarcinoma (CCA).

METHODS: We used the rapid immunochromatographic test (ICT) to detect anti-Opisthorchis viverrini IgG and IgG4 subclass antibodies in sera of patients with CCA. The ICT kits were developed based on soluble antigens excreted and secreted by O. viverrini adult worms.

RESULTS: ICT indicated sera was positive for IgG and IgG4 antibodies, respectively, …

Chromosome-Level Genome Of Schistosoma Haematobium Underpins Genome-Wide Explorations Of Molecular Variation., Andreas J Stroehlein, Pasi K Korhonen, V Vern Lee, Stuart A Ralph, Margaret Mentink-Kane, Hong You, Donald P Mcmanus, Louis-Albert Tchuem Tchuenté, J Russell Stothard, Parwinder Kaur, Olga Dudchenko, Erez Lieberman Aiden, Bicheng Yang, Huanming Yang, Aidan M Emery, Bonnie L Webster, Paul J. Brindley, David Rollinson, Bill C H Chang, Robin B Gasser, Neil D Young

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Urogenital schistosomiasis is caused by the blood fluke Schistosoma haematobium and is one of the most neglected tropical diseases worldwide, afflicting > 100 million people. It is characterised by granulomata, fibrosis and calcification in urogenital tissues, and can lead to increased susceptibility to HIV/AIDS and squamous cell carcinoma of the bladder. To complement available treatment programs and break the transmission of disease, sound knowledge and understanding of the biology and ecology of S. haematobium is required. Hybridisation/introgression events and molecular variation among members of the S. haematobium-group might effect important biological and/or disease traits as well as the morbidity of disease …