Introduction:
Bushbuckridge subdistrict, located in the northeastern lowveld of South Africa, lies within the country’s malaria-endemic belt and borders Kruger National Park, as well as being near Mozambique and Eswatini. Despite significant progress toward malaria elimination, the area remains vulnerable to residual and cross-border transmission. Understanding local Anopheles vector dynamics and insecticide susceptibility is therefore essential for sustaining malaria control. This study assessed Anopheles species diversity and insecticide susceptibility to inform entomological surveillance priorities aligned with the WHO Entomological Surveillance Planning Tool (ESPT).

Methods:
Larval Anopheles mosquitoes were collected from natural habitats between June 2022 and April 2024 and reared to adulthood. Adult males and females underwent WHO tube bioassays with deltamethrin (0.05%), DDT (4%), and pirimiphos-methyl (0.25%). Species were identified using morphological keys and PCR assays.

Results:
A total of 4454 adults emerged (45.1% males, 54.9% females), representing 18 taxa, including primary, secondary, and non-vector species, highlighting ecological complexity. Anopheles pretoriensis was most abundant (33.4%), followed by An. quadriannulatus (20.7%) and An. rufipes (20.0%). The primary malaria vector An. arabiensis represented 7.1%, demonstrating its persistence in residual transmission areas and the need for targeted control. Two specimens indicated potential hybridisation between An. arabiensis and An. quadriannulatus. PCR identification failed in 3% of An. gambiae complex and 16% of An. funestus group specimens. Bioassays showed high susceptibility overall, but An. funestus group males exposed to DDT had 94.6% mortality, suggesting possible resistance.

Conclusions:
This study highlights a diverse Anopheles community in a residual transmission setting. While susceptibility remains high, emerging resistance and hybridisation underscore the need for continued species-specific, ESPT-informed surveillance to guide adaptive malaria vector control strategies.

Introduction: Brucellosis, caused by Brucella spp., is a globally prevalent zoonotic disease and a significant cause of febrile illness, yet it often remains underdiagnosed. This study assessed brucellosis seroprevalence in a rural South African community and examined associated exposure factors among livestock-owning and non-livestock households.

Methods: A cross-sectional random cluster household survey was conducted in 2022–2023 in uMkhanyakude District, KwaZulu-Natal Province, South Africa. Household interviews were conducted, and serum samples from 688 participants were tested for anti‑Brucella IgG antibodies using a commercial ELISA. Risk factors for seropositivity were assessed using Fisher’s Exact test, with p<0.2 considered significant.

Results: Overall, human Brucella seroprevalence was 4.4% (30/688; 95% CI: 3.0–6.3%) after adjusting for household clustering. Participants had a median age of 36 years (IQR: 25–53; range: 12–95); 98% identified as Black African and 59% were female. Poultry ownership was common (74% kept chickens), while 12% kept cattle, 16% goats, and 39% both bovids. Univariable analysis showed higher seropositivity among males (7.9% vs. 2.0%; p<0.001), participants older than 36 years (6.3% vs. 2.4%; p=0.09), and those with primary-level or no schooling (6.9% vs. 3.0%; p=0.106). A strong association was observed with household cattle or goat ownership (6.4% vs. 0.4%; p<0.001), whereas associations with livestock slaughter (p=0.151) and abortions (p=0.19) were weaker. Behavioural factors associated with increased seropositivity included consumption of unboiled/raw milk (p=0.097) or fermented milk (p=0.077), eating animals found dead (p=0.059), and frequent hunting of antelopes, small mammals, or birds (p=0.085). No associations were found with the consumption of undercooked meat, employment status or sector, chicken ownership, or keeping cats/dogs as pets (stratified by bovid ownership). Multivariable analysis will be presented.

Conclusions: Brucellosis seroprevalence was associated with multiple demographic and behavioural factors, particularly sex, age and contact with cattle or goats. Strengthening livestock control measures, together with targeted awareness campaigns for high-risk groups, may reduce human Brucella exposure.

Introduction: Taeniosis is a parasitic disease caused by the adult stage of the zoonotic cestode, Taenia spp. Humans become infected by eating raw/undercooked beef or pork contaminated with Taenia saginata or T. solium cysticerci, respectively. Taenia infections can result in serious diseases such as neurocysticercosis and lead to major economic losses through the downgrading of cysticerci-infected meat. Although taeniosis is a major risk factor for cysticercosis, there are currently few reports on the prevalence of taeniosis in South Africa. Accordingly, this research aims to determine the prevalence of taeniosis in Mpumalanga Province using morphological and molecular techniques.

Methods: Routine laboratory-submitted stool samples originating from adults were obtained from a private pathology laboratory. Samples were examined for the presence of tapeworm proglottids macroscopically, and the detection of taeniid ova was performed by examining wet mounts of the stool samples using microscopy. Species identification was carried out by injecting adult tapeworm proglottids with Indian ink to highlight morphological differences.

Results: Out of 221 stool samples tested thus far, a 2.26% prevalence of taeniosis has been recorded, with positive samples originating from Nkangala and Ehlanzeni districts of the province. Proglottids observed in the positive samples were all identified to be from T. saginata. The preliminary results from this study correlate with published findings in KwaZulu-Natal and the Eastern Cape, with prevalence ranging between 0.78% and 3.8%. Molecular techniques are yet to be conducted to confirm the prevalence of taeniosis in Mpumalanga Province.

Conclusion: South African cases of taeniosis are not mandatorily reportable, despite the clinical and consequential economic impact when livestock become infected. There is a need for targeted public health interventions, improved food safety measures, and enhanced surveillance strategies to mitigate the burden of taeniosis in endemic regions such as South Africa.

Introduction:

Mpox in PLHIV is associated with severe outcomes, particularly when co-infected with opportunistic pathogens, such as Mycobacterium tuberculosis (MTB).

Aim: We describe three cases of severe mpox in PLHIV, each with CD4 counts under 200 cells/mm3 and laboratory-confirmed disseminated tuberculosis.

Methods:

A retrospective review of three hospitalized patients with mpox and HIV who were also found to have disseminated tuberculosis. The clinical course, management, and outcomes were summarized.

Results:

Case 1: A 44-year-old man with newly diagnosed HIV presented after 14 days of illness with disseminated necrotizing mpox and sepsis, along with severe immunosuppression (CD4 <200 cells/mm3). Urine LF-LAM confirmed disseminated TB, and blood culture confirmed Staphylococcus aureus bacteremia. Despite oxygen supplementation and broad-spectrum antibiotics, he died within three days of admission, prior to starting anti-tuberculosis or antiretroviral therapy.

Case 2: A 22-year-old woman with perinatally acquired HIV, virally suppressed on ART, presented after 8 days of illness with nodulopustular and severe genital mpox. Disseminated TB was confirmed via urine LF-LAM. She was started on anti-tuberculosis therapy, continued her ART, improved clinically, and was discharged after 10 days.

Case 3: A 28-year-old woman with HIV who had stopped ART for over a year presented with two weeks of widespread nodulopustular lesions. Initially misdiagnosed as disseminated herpes, she was restarted on ART. She became unconscious and died shortly after starting ART, raising concerns for unmasking IRIS.

Conclusion:

Mpox in PLHIV with severe immunosuppression is associated with high morbidity and mortality, especially when combined with disseminated TB and delayed ART initiation or reinitiation. Early recognition, integrated HIV/TB/mpox assessment, and careful timing of ART are crucial in high-burden settings to improve clinical outcomes.

Background:
Spinal hydatidosis is a rare manifestation of cystic echinococcosis caused by Echinococcus granulosus, endemic in Peru and other regions of South America, the Mediterranean, Africa, and Asia. Vertebral involvement accounts for 0.5–2% of cases and is associated with high morbidity, neurological compromise, and frequent recurrence.

Case Presentation:
A 28-year-old woman from Huacho, Peru, with prior T12 hydatid cyst surgery presented with six months of progressive dorsal pain, lower limb paresthesias, urinary retention, and worsening paraparesis. Examination showed paraparesis (MRC 3+/5, left predominance), hyperreflexia, a sensory level at T10, and partial sphincter dysfunction.

MRI revealed a multiloculated cystic lesion at T12 with vertebral body lysis and >50% canal compromise. CT demonstrated ≈80% destruction of the T12 vertebral body with dorsolumbar instability. After one week of albendazole (400 mg twice daily), she underwent T12 corpectomy, cyst excision, decompression, and reconstruction with a titanium mesh cage and T11–L1 fixation. Intraoperative rupture occurred; hypertonic saline irrigation was applied. Histopathology confirmed echinococcosis.

Postoperatively, she completed a 4-month rehabilitation program, achieving recovery of sphincter control and motor improvement to 4/5. At discharge, she could walk short distances with a walker and required partial assistance.

At 12 months post-surgery, she remained stable, with no radiological recurrence. She ambulated with minimal assistance and had functional urinary continence, with mild residual weakness.

Conclusion:
Recurrent spinal hydatidosis requires aggressive surgical resection and prolonged antihelminthic therapy. Multicystic lesions increase the risk of rupture and recurrence. Early diagnosis, radical excision, stabilization, and close follow-up are essential to optimize neurological outcomes.

Visceral leishmaniasis is a neglected zoonotic disease in Brazil, occurring predominantly in tropical and subtropical areas. It is a chronic disease with systemic involvement, associated with high morbidity and mortality. Analyzing the epidemiological behavior of this disease is essential for planning effective prevention and control strategies.

This was a retrospective ecological study based on secondary data obtained from the Department of Informatics of the Brazilian Unified Health System (DATASUS). Records of cases and deaths due to visceral leishmaniasis in Brazil from 2015 to 2025 were analyzed. The variables evaluated included year of occurrence, geographic region, sex, and age group. A descriptive analysis was performed to assess temporal and regional distribution.

During the study period, a total of 28,553 cases and 2,295 deaths due to visceral leishmaniasis were recorded in Brazil. The highest frequencies of cases and deaths were observed in the Northeast and Southeast regions. Males and individuals aged 20 to 39 years were the most affected. A variable temporal pattern was observed, with periods of increased mortality in certain regions of the country.

Therefore, visceral leishmaniasis, as a neglected disease, represents a major public health challenge in Brazil, with significant regional and demographic inequalities. The findings highlight the need to strengthen epidemiological surveillance, promote early diagnosis, and implement public policies targeted at areas with the highest disease burden.

This clinical case report describes the complex management of autoimmune hepatitis (AIH), a chronic inflammatory liver disease of idiopathic origin that can progress to cirrhosis or liver failure if not diagnosed and treated promptly. In tropical regions, infections such as dengue may worsen the course of liver diseases. We report the case of a 48-year-old woman with a history of mammary tuberculosis, type 2 diabetes, confirmed dengue infection, fever, and intermittent use of herbal infusions. She presented with dark urine, acholia, jaundice, and right upper quadrant pain lasting 17 days. Laboratory tests showed elevated liver enzymes, coagulation abnormalities, positive antinuclear antibodies (ANA), and abdominal imaging findings consistent with chronic liver disease and cirrhosis. Despite corticosteroid treatment, she progressed to fulminant hepatic failure and passed away . AIH was considered the main contributing factor, given its higher prevalence in women and its interaction with triggers such as viral infections. Dengue, particularly serotypes DENV1 and DENV3, has high liver tropism and may cause anything from asymptomatic transaminase elevation to fulminant liver failure. The diagnosis of AIH relies on serology and clinical criteria; in this case, only ANA with a speckled pattern was detected, and specific autoantibodies like anti-LC1 could not be tested due to resource limitations. Initial treatment was based on corticosteroids. An integrated diagnostic approach, including liver biopsy, is essential, as is health education to raise awareness of AIH as a potential cause of liver failure in patients with recent viral infections.

Introduction

Intestinal parasitic infections remain a public health concern in Sri Lanka, where contaminated green leafy vegetables are an important transmission route. This study assessed intestinal parasite prevalence in fresh green leafy vegetables across all nine provinces of Sri Lanka and examined variations in parasitic contamination according to the site of collection in different geographical locations.

Methods

A cross-sectional study was conducted from October 1 to November 30, 2025, during the Second Inter-Monsoon (SIM) season across all nine provinces of Sri Lanka. Ninety open markets were included, with ten per province. Five fresh green leafy vegetable types consumed either raw, steamed, or half-cooked namely; Centella asiatica (Gotukola, [n=84]), Alternanthera sessilis (Mukunuwenna, [n=86]), Ipomoea aquatica (Kankun, [n=83]), Trianthema portulacastrum (Sarana, [n=52]), and Amaranthus viridis (Thampala, [n=44]) were selected. Approximately 50g of each sample was processed with a Tween 20 (5%) wash followed by overnight sedimentation, and centrifugation (2000×g, 15 min). Microscopic examination of parasites was performed on both the supernatant and sediment of each sample.

Results

The overall parasitic contamination was 22.6% (n=79). A. sessilis recorded the highest prevalence (24/86; 27.9%), while I. aquatica exhibited the lowest (10/83; 12.1%). Medically important parasites, including protozoans (Balantidium coli, Cystoisospora belli, coccidian oocysts morphologically consistent with Toxoplasma gondii) and helminths (Ascaris spp., Hymenolepis spp., Strongyloides spp., Capillaria spp., Toxocara spp., hookworm and taeniid eggs) were detected. Strongyloides spp. was the most prevalent parasite (31/349; 8.9%). No statistically significant differences were observed in the distribution of parasitic species across vegetable types or in prevalence across provinces (P > 0.05).

Conclusions

This study confirms uniform parasitic contamination of fresh green leafy vegetables across all nine provinces of Sri Lanka, regardless of vegetable type or geographical location during the Second Inter-Monsoon season.

Introduction

Mosquito host-seeking behavior is a key driver of malaria transmission, yet the biological factors underlying variation in human attractiveness remain unclear. Physiological states such as pregnancy and menstrual cycle have been proposed to increase of human odor variability and modify attractiveness to mosquitoes, but evidence remains inconsistent. These assumptions have raised concerns about variability in female odor cues limiting the inclution of women in research and the generalizability of findings. To address this gap, we investigated whether sex and menstrual cycle consistently influence human body odor and attractiveness to Anopheles gambiae, a primary malaria vector.

Methods

We conducted two longitudinal studies in which body odor samples were repeatedly collected from women at three menstrual cycle phases across up to four cycles, and from men at matched intervals. Skin volatile profiles were analyzed using gas chromatography, and mosquito attraction was assessed using a uniport olfactometer assay with worn nylon sleeves and socks.

Results

Mosquito attraction did not differ between male and female participants at any timepoint. Attraction levels and volatile profiles remained stable within individuals across repeated measurements. Individual-level differences explained most of the variation observed in both mosquito attraction and odor chemistry, accounting for up to 64% of the variance in foot volatiles and 59% in arm volatiles. In contrast, sex and menstrual cycle phases showed only marginal effects.

Conclusion

Our findings refine and challenge assumptions from prior studies by demonstrating no consistent effect of sex or menstrual cycle phase on mosquito attraction. Instead, stable, individual specific odor signatures were the primary determinants of both volatile composition and attractiveness to Anopheles gambiae. These results highlight the intrinsic stability of human body odor and emphasize the importance of interindividual variation, rather than sex‑related physiology, in shaping host attractiveness.

This mixed-method cross-sectional study was conducted in 2024 to assess the burden and determinants of schistosomiasis in snails, cattle, and humans. Snail habitats were mapped using Quantum GIS and sampled using purposive and simple random sampling. Snails were collected, identified, and examined for schistosomes via cercariae shedding and microscopy. A structured questionnaire was administered. Urine and stool samples were collected using cluster and systematic random sampling, and analyzed by means of microscopy. Cattle postmortem inspection was performed using convenience sampling. Data entry, descriptive statistics, Chi-square test, binary logistic regression analysis, and Pearson correlation were performed using SPSS at P <0.05. Out of the 385 snails, Bulinus globosus snails (n=362, 94.0%) were more abundant than Bulinus pfeifferi (n=14, 4.0%) and Bulinus africanus (n=9, 2.0%). Only Bulinus globosus (n=104) snails were shedding Cercariae, registering a 27.01% infection rate. Of the samples, 168/406 were positive for urinary schistosomiasis, registering 45.81% prevalence. In addition, 13/180 stool samples were positive for bovine schistosomiasis, registering 7.22% prevalence. All postmortem samples were negative for bovine schistosomes. Gender, age, occupation, history of Mass Drug Administration (MDA), use of PPE, and water source were associated with urinary schistosomiasis (P<0.005). Respondents who did not receive Praziquantel (COR= 2.481, 95%, CI: 1.020- 6.031) were 2.48 times more at risk of schistosomiasis. Lack of PPE usage (COR= 0.524, 95%, CI: 0.309-0.889), open water source (COR= 0.455, 95%, CI: 0.181-1.143), and men (COR=0.467, 95%, CI: 0.299-0.730) had reduced odds of being infected than their counterparts. We recommended MDA for residents and livestock, vector control, and health education.