Tropical diseases: definition, geographic distribution, transmission, and classification

Central nervous system infections in the tropics

PURPOSE OF REVIEW

Emerging and re-emerging central nervous system (CNS) infections are a major public health concern in the tropics. The reasons for this are myriad; climate change, rainfall, deforestation, increased vector density combined with poverty, poor sanitation and hygiene. This review focuses on pathogens, which have emerged and re-emerged, with the potential for significant morbidity and mortality.

RECENT FINDINGS

In recent years, multiple acute encephalitis outbreaks have been caused by Nipah virus, which carries a high case fatality. Arboviral infections, predominantly dengue, chikungunya and Zika are re-emerging increasingly especially in urban areas due to changing human habitats, vector behaviour and viral evolution. Scrub typhus, another vector borne disease caused by the bacterium Orientia tsutsugamushi , is being established as a leading cause of CNS infections in the tropics.

SUMMARY

A syndromic and epidemiological approach to CNS infections in the tropics is essential to plan appropriate diagnostic tests and management. Rapid diagnostic tests facilitate early diagnosis and thus help prompt initiation and focusing of therapy to prevent adverse outcomes. Vector control, cautious urbanization and deforestation, and reducing disturbance of ecosystems can help prevent spread of vector-borne diseases. Regional diagnostic and treatment approaches and specific vaccines are required to avert morbidity and mortality.

Artificial intelligence for the optimal management of community-acquired pneumonia

PURPOSE OF REVIEW

This timely review explores the integration of artificial intelligence (AI) into community-acquired pneumonia (CAP) management, emphasizing its relevance in predicting the risk of hospitalization. With CAP remaining a global public health concern, the review highlights the need for efficient and reliable AI tools to optimize resource allocation and improve patient outcomes.

RECENT FINDINGS

Challenges in CAP management delve into the application of AI in predicting CAP-related hospitalization risks, and complications, and mortality. The integration of AI-based risk scores in managing CAP has the potential to enhance the accuracy of predicting patients at higher risk, facilitating timely intervention and resource allocation. Moreover, AI algorithms reduce variability associated with subjective clinical judgment, promoting consistency in decision-making, and provide real-time risk assessments, aiding in the dynamic management of patients with CAP.

SUMMARY

The development and implementation of AI-tools for hospitalization in CAP represent a transformative approach to improving patient outcomes. The integration of AI into healthcare has the potential to revolutionize the way we identify and manage individuals at risk of severe outcomes, ultimately leading to more efficient resource utilization and better overall patient care.

Knowledge, Attitudes, and Practices Regarding Tropical Diseases among Nursing Students: A Comparative Cross-Sectional Study

This study aimed to compare bachelor nursing students' knowledge, attitudes, and practices (KAP) regarding tropical diseases. This cross-sectional study was conducted with 128 participants who were recruited using stratified random sampling and completed a sociodemographics questionnaire and KAP questionnaire concerning tropical diseases. Descriptive statistics were used to present the data, and inferential statistics, including one-way analysis of variance and Mann-Whitney U tests, were calculated to identify potential differences between variables. The study found nursing students who took the tropical nursing courses had better knowledge and attitudes regarding preventing tropical diseases than those who did not. Participants who took the tropical nursing courses had a significantly higher median knowledge score of 22 with an interquartile range (IQR) of 2 (P <0.001) and a median attitude score of 31 (IQR: 6, P = 0.02) compared with those who did not take it. However, there were no significant differences between the two groups in practice regarding tropical diseases (P = 0.20). In conclusion, students who take tropical nursing courses may improve their knowledge and attitudes toward tropical diseases, but the two groups in this study did not significantly differ in practice, possibly because of self-reported practices rather than direct observation. This study highlights the potential of accurate digital information to provide credible resources in enhancing nursing students' KAP concerning tropical diseases.

Examining the Relationships between the Incidence of Infectious Diseases and Mood Disorders: An Analysis of Data from the Global Burden of Disease Studies, 1990-2019

Mood disorders are among the commonest mental disorders worldwide. Epidemiological and clinical evidence suggests that there are close links between infectious diseases and mood disorders, but the strength and direction of these association remain largely unknown. Theoretical models have attempted to explain this link based on evolutionary or immune-related factors, but these have not been empirically verified. The current study examined cross-sectional and longitudinal associations between the incidence of infectious diseases and mood disorders, while correcting for climate and economic factors, based on data from the Global Burden of Disease Studies, 1990-2019. It was found that major depressive disorder was positively associated with lower respiratory infections, while bipolar disorder was positively associated with upper respiratory infections and negatively associated with enteric and tropical infections, both cross-sectionally and over a period of 30 years. These results suggest that a complex, bidirectional relationship exists between these disorders. This relationship may be mediated through the immune system as well as through the gut-brain and lung-brain axes. Understanding the mechanisms that link these groups of disorders could lead to advances in the prevention and treatment of both.

A Systematic Review of Applications of Machine Learning and Other Soft Computing Techniques for the Diagnosis of Tropical Diseases

This systematic literature aims to identify soft computing techniques currently utilized in diagnosing tropical febrile diseases and explore the data characteristics and features used for diagnoses, algorithm accuracy, and the limitations of current studies. The goal of this study is therefore centralized around determining the extent to which soft computing techniques have positively impacted the quality of physician care and their effectiveness in tropical disease diagnosis. The study has used PRISMA guidelines to identify paper selection and inclusion/exclusion criteria. It was determined that the highest frequency of articles utilized ensemble techniques for classification, prediction, analysis, diagnosis, etc., over single machine learning techniques, followed by neural networks. The results identified dengue fever as the most studied disease, followed by malaria and tuberculosis. It was also revealed that accuracy was the most common metric utilized to evaluate the predictive capability of a classification mode. The information presented within these studies benefits frontline healthcare workers who could depend on soft computing techniques for accurate diagnoses of tropical diseases. Although our research shows an increasing interest in using machine learning techniques for diagnosing tropical diseases, there still needs to be more studies. Hence, recommendations and directions for future research are proposed.

How Molecularly Imprinted Polymers can be Used for Diagnostic and Treatment of Tropical Diseases?

Molecularly imprinted polymers (MIPs) have been widely used in nanomedicine in the last few years. However, their use for diagnostic and treatment of tropical diseases is limited. Through this review, we aim to illustrate how MIPs were used to detect tropical disease and we show that they are not exploited enough in treatment. We finally show how MIPs could be used in the future in the treatment of tropical disease.

Methodological Appraisal of Literature Concerning the Analysis of Genetic Variants or Protein Levels of Complement Components on Susceptibility to Infection by Trypanosomatids: A Systematic Review

Background

Trypanosomatids are protozoa responsible for a wide range of diseases, with emphasis on Chagas Disease (CD) and Leishmaniasis, which are in the list of most relevant Neglected Tropical Diseases (NTD) according to World Health Organization (WHO). During the infectious process, immune system is immediately activated, and parasites can invade nucleated cells through a broad diversity of receptors. The complement system − through classical, alternative and lectin pathways − plays a role in the first line of defense against these pathogens, acting in opsonization, phagocytosis and lysis of parasites. Genetic modifications in complement genes, such as Single Nucleotide Polymorphisms (SNPs), can influence host susceptibility to these parasites and modulate protein expression.

Methods

In March and April 2021, a literature search was conducted at the PubMed and Google Scholar databases and the reference lists obtained were verified. After applying the inclusion and exclusion criteria, the selected studies were evaluated and scored according to eleven established criteria regarding their thematic approach and design, aiming at the good quality of publications.

Results

Twelve papers were included in this systematic review: seven investigating CD and five focusing on Leishmaniasis. Most articles presented gene and protein approaches, careful determination of experimental groups, and adequate choice of experimental techniques, although several of them were not up-to-date. Ten studies explored the association of polymorphisms and haplotypes with disease progression, with emphasis on lectin complement pathway genes. Decreased and increased patient serum protein levels were associated with susceptibility to CD and Visceral Leishmaniasis, respectively.

Conclusion

This systematic review shows the influence of genetic alterations in complement genes on the progression of several infectious diseases, with a focus on conditions caused by trypanosomatids, and contributes suggestions and evidence to improve experimental design in future research proposals.

Natural-Product-Based Solutions for Tropical Infectious Diseases

About half of the world's population and 80% of the world's biodiversity can be found in the tropics. Many diseases are specific to the tropics, with at least 41 diseases caused by endemic bacteria, viruses, parasites, and fungi. Such diseases are of increasing concern, as the geographic range of tropical diseases is expanding due to climate change, urbanization, change in agricultural practices, deforestation, and loss of biodiversity. While traditional medicines have been used for centuries in the treatment of tropical diseases, the active natural compounds within these medicines remain largely unknown. In this review, we describe infectious diseases specific to the tropics, including their causative pathogens, modes of transmission, recent major outbreaks, and geographic locations. We further review current treatments for these tropical diseases, carefully consider the biodiscovery potential of the tropical biome, and discuss a range of technologies being used for drug development from natural resources. We provide a list of natural products with antimicrobial activity, detailing the source organisms and their effectiveness as treatment. We discuss how technological advancements, such as next-generation sequencing, are driving high-throughput natural product screening pipelines to identify compounds with therapeutic properties. This review demonstrates the impact natural products from the vast tropical biome have in the treatment of tropical infectious diseases and how high-throughput technical capacity will accelerate this discovery process.

Critical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine

Tropical disease results in a great burden of critical illness. The same life-saving and supportive therapies to maintain vital organ functions that comprise critical care are required by these patients as for all other diseases. In low income countries, the little available data points towards high mortality rates and big challenges in the provision of critical care. Improving critical care in low income countries requires a focus on hospital design, training, triage, monitoring & treatment modifications, the basic principles of critical care, hygiene and the involvement of multi-disciplinary teams. As a large proportion of critical illness from tropical disease is in low income countries, the impact and reductions in mortality rates of improved critical care in such settings could be substantial.

Viral hemorrhagic fever in the tropics: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine

Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses namely Arenaviruses, Filoviruses, Bunyaviruses, and Flaviviruses. Humans are not the natural reservoir for any of these organisms and acquire the disease through vectors from animal reservoirs. In some conditions human to human transmission is possible increasing the risk to healthy individuals in the vicinity, more so to Health Care Workers (HCW). The pathogenesis of VHF, though poorly understood, varies according to the viruses involved. The resultant microvascular damage leads to increased vascular permeability, organ dysfunction and even death. The management is generally supportive but antiviral agents are of benefit in certain circumstances.