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Only about 20% of HCWs in each country said their health facility had the medicines needed to treat snakebites, with antivenom available in 0-34% of facilities across the sectors and countries, and snakebites were not systematically recorded. This research shows that an integrative approach through policies to increase resource allocation for health system strengthening, including community education, HCW training, and improved access to snakebite treatment, is needed. Part of this approach should include regulations that ensure antivenoms available in health facilities meet quality control standards and that snakebites are accommodated into routine reporting systems to assess progress.Japanese encephalitis (JE) is a vaccine-preventable, mosquito-borne disease. learn more Substantial progress with JE control in Asia has been made during the past decade, with most endemic countries now having JE vaccination programs, commonly using live attenuated SA14-14-2 JE vaccine (CD-JEV). If a child develops encephalitis during the weeks to months following CD-JEV vaccination and anti-JE virus IgM (JE IgM) antibody is detected in serum, the question arises if this is JE virus infection indicating vaccine failure, or persistent JE IgM antibody postvaccination. To better understand JE IgM seropositivity following vaccination, sera from 268 children from a previous CD-JEV study were tested by two different JE IgM assays to determine JE IgM antibody frequency on days 28, 180, and 365 postvaccination. With the CDC JE IgM antibody capture ELISA (MAC-ELISA), 110 children (41%) had JE IgM positive or equivocal results on their day 28 sample, and eight (3%) and two (1%) had positive or equivocal results on day 180 and day 365 samples, respectively. With the Inbios JE Detect™ MAC-ELISA, 118 (44%) children had positive or equivocal results on day 28 sample, and three (1%) and one (0.4%) had positive or equivocal results on day 180 and day 365 samples, respectively. Our results indicate that more than 40% children vaccinated with CD-JEV can have JE IgM antibodies in their serum at 1 month postvaccination but JE IgM antibody is rare by 6 months. These data will help healthcare workers assess the likelihood that JE IgM antibodies in the serum of a child with encephalitis after vaccination are vaccine related.Malaria elimination strategies are designed to more effectively identify and treat infected individuals to interrupt transmission. One strategy, reactive screen-and-treat, starts with passive detection of symptomatic cases at health facilities. Individuals residing within the index case and neighboring households are screened with a malaria rapid diagnostic test (RDT) and treated if positive. However, it is unclear to what extent this strategy is effective in reducing transmission. Reactive screen-and-treat was implemented in Choma district, Southern Province, Zambia, in 2013, in which residents of the index case and neighboring households within 140 m were screened with an RDT. From March 2016 to July 2018, the screening radius was extended to 250-m, and additional follow-up visits at 30 and 90 days were added to evaluate the strategy. Plasmodium falciparum parasite prevalence was measured using an RDT and by quantitative PCR (qPCR). A 24-single nucleotide polymorphism molecular bar-code assay was used to genotype parasites. Eighty-four index case households with 676 residents were enrolled between March 2016 and March 2018. Within each season, parasite prevalence declined significantly in index households at the 30-day visit and remained low at the 90-day visit. However, parasite prevalence was not reduced to zero. Infections identified by qPCR persisted between study visits and were not identified by RDT. Parasites identified within the same household were most genetically related; however, overall parasite relatedness was low and similar across time and space. Thus, despite implementation of a reactive screen-and-treat program, parasitemia was not eliminated, and persisted in targeted households for at least 3 months.Talaromyces marneffei (T. marneffei), formerly Penicillium marneffei, is a dimorphic fungus prevalent in Southeast Asia that can cause severe systemic infection, especially in immunocompromised patients. There are few reports about the use of posaconazole in T. marneffei infection. Here, we present a case of pulmonary T. marneffei infection in a renal transplant recipient. The patient responded rapidly to oral posaconazole administration but experienced serum creatinine fluctuation because of the interaction between posaconazole and immunosuppressants. Seven months after adjusting the dose of immunosuppressants, the patient recovered completely. Posaconazole is a potentially promising therapy for T. marneffei infection, but it should be administered under close monitoring.Cutaneous leishmaniasis (CL) can present with various skin lesions ranging from a single ulcer to diffuse multiple nodules. Here, we present a case of a 67-year-old man with a large erythematous well-defined indurated plaque over the left face for a duration of 4 months. A slit skin smear was performed, and it was stained with Giemsa stain which showed multiple amastigotes confirming the diagnosis of CL. Oral miltefosine was started at a dose of 150 mg/day but had to be stopped after 20 days as the patient developed diarrhea, bipedal edema, and renal impairment. This case emphasizes an uncommon variant of CL and the role of systemic treatment with oral miltefosine and its associated adverse effects.Lassa fever remains endemic in parts of West Africa and continues to pose as a quiescent threat globally. We described the background on Lassa fever, factors contributing to its emergence and spread, preventive measures, and potential solutions. This review provides a holistic and comprehensive source for academicians, clinicians, researchers, policymakers, infectious disease epidemiologists, virologists, and other stakeholders.Access to safe water and basic sanitation and hygiene facilities (WASH) are important for childhood health globally. However, inequalities in WASH access persist, and local governments need to better understand the potential impact of scaling up WASH services on childhood health. Using 2011 Peru Demographic and Health Survey data as a case study, we applied a modified substitution estimator approach to assess the impact of scaling up access (20-100%) to WASH on diarrhea prevalence among children less then 5 years. The modified substitution estimator approach can help identify population subgroups or areas where WASH interventions and sustained implementation could be most beneficial and reduce existing disparities. Using findings from a recent meta-analysis and computing bootstrapped estimates and 95% CIs, we examined inequalities in the effect of WASH on self-reported diarrhea by urbanicity, maternal education level, household wealth, and district of residence. Increasing access (100% change) to improved water sources, sanitation, and hygiene facilities reduced population-level prevalence of childhood diarrhea by 8.