Although several studies have estimated gestational syphilis (GS) incidence in several countries, underreporting correction is rarely considered. This study aimed to estimate the level of under-registration and correct the GS incidence rates in the 557 Brazilian microregions.Brazilian GS notifications between 2007 and 2018 were obtained from the SINAN-Syphilis system. A cluster analysis was performed to group microregions according to the quality of GS notification. A Bayesian hierarchical Poisson regression model was applied to estimate the reporting probabilities among the clusters and to correct the associated incidence rates.We estimate that 45,196  GS cases were underreported in Brazil from 2007 to 2018, representing a coverage of 87.12%  of registered cases, where HPD stands for the Bayesian highest posterior density credible interval. Underreporting levels differ across the country, with microregions in North and Northeast regions presenting the highest percentage of missed cases. After underreporting correction, Brazil’s estimated GS incidence rate increased from 8.74 to 10.02 per 1000 live births in the same period.Our findings highlight disparities in the registration level and incidence rate of GS in Brazil, reflecting regional heterogeneity in the quality of syphilis surveillance, access to prenatal care, and childbirth assistance services. This study provides robust evidence to enhance national surveillance systems, guide specific policies for GS detection disease control, and potentially mitigate the harmful consequences of mother-to-child transmission. The methodology might be applied in other regions to correct disease underreporting.10.13039/501100003593National Council for Scientific and Technological Development; The Bill Melinda Gates Foundation and 10.13039/100010269Wellcome Trust. The World Health Organization (WHO) estimates that syphilis infection affects one million pregnancies yearly worldwide, with important consequences for pregnant women and newborns. Untreated gestational syphilis (GS) has been linked to a significantly higher incidence of stillbirth, neonatal death, prematurity, and low birth weight. Notifying GS is compulsory for all WHO member countries; it is mandatory to communicate all cases to health authorities and investigate them. However, the lack of quality in the case detection and data recording processes may contribute to under-registration of GS cases on the health information systems, which underestimates the real magnitude of the disease, especially in middle-income countries such as Brazil.We searched PubMed/Medline, EMBASE, and LILACS using the search strategy (“underreporting of syphilis” OR “syphilis underreporting” OR “under-registration of syphilis” OR “under-registration”) AND (“Pregnant women”) AND (Brazil) seeking for studies on under-registration of GS across Brazil until July 2023. We supplemented the literature review with internet searches (Google scholar and Semantic scholar), analysis of references in identified papers, and the authors’ own knowledge. We found 6 studies focusing on small to medium-sized Brazilian cities, which indicated: 13.74% of GS under-registration between 2010 and 2013 in the west of São Paulo State; 6.5% of GS notification in Montes Claros city, Minas Gerais State, between 2007 and 2013; 50% more cases of congenital syphilis than GS cases from 2009 to 2015 in Londrina, Paraná State; and 46% of GS underreporting in a special indigenous sanitary district in Mato Grosso State. None of these studies covered the whole country and they do not considered factors associated with underreported cases of GS or even provided corrected estimation of GS incidence. Based on such literature review, the modeling of syphilis under-registration is also rare worldwide since none study was found on this regard.This is the first study to map the quality of GS notifications at the national, regional, and small area levels in a large country such as Brazil, emphasizing that GS detection and incidence are related to socio-economic conditions and access to health services such as deprivation level and adequate prenatal care. States and microregions in the Brazilian North and Northeast regions presented the highest GS underreporting cases. Health managers and policymakers could easily use our methodology to amplify national syphilis surveillance and estimate the real incidence of GS. Also, the statistical modeling strategy may be used as a reference for application in other middle-income countries.Taken together, modeling results from this national-level study on GS burden in Brazil, along with findings from other local surveys, suggest that GS remains a significant public health problem, highlighting the need for improved surveillance. Our research reveals important differences in underreporting of GS cases across Brazilian regions, as well as the association of syphilis surveillance quality with socioeconomic conditions and access to healthcare. This underscores the urgent need to enhance syphilis surveillance and case notification within the healthcare system, particularly in the country's poorest region. Furthermore, correcting GS incidence at different area levels could provide a better understanding of the epidemiological profile and help estimate the social, economic, and health burdens associated with the disease nationwide. Additionally, our findings offer valuable insights for policymakers to enhance planning and take action to reduce the burden of GS, thereby contributing to the reduction of mother-to-child transmission and adverse effects during childbirth.Treponema pallidum, first identified in 1905.Syphilis is a sexually transmitted infection caused by ,Data from 2016 shows that over 900,000 pregnant women were diagnosed with syphilis worldwide, resulting in more than 350,000 adverse outcomes, from which over 200,000 were stillbirths or neonatal deaths.Despite the mandatory registration of gestational syphilis and the notable increase in notifications in recent years, underreporting GS cases is still a problem in Brazil.15Accurate reporting of GS cases allows policymakers to design control policies and helps to reduce its consequences for pregnant individuals and their offspring. Although Brazil and other countries recognize the importance of improving the quality of syphilis detection and notification during pregnancy,We conducted a cross-sectional ecological study design, considering GS cases notified in Brazil between 2007 and 2018. Brazil, a continental country, divided into 27 states and five macroregions , comprising 557 microregions, which are defined as contiguous aggregations of the 5570 Brazilian municipalities.Sistema de Informação de Agravos de Notificação) using data received from the Brazilian Ministry of Health in 2019. In Brazil, it is mandatory for healthcare professionals to register GS cases through SINAN-Syphilis, where they complete a form including personal, socioeconomic, and gestational information of the patient at the time of diagnosis.This study used administrative non-identified data available from public Brazilian databases. The outcome variable, the count of GS cases, was extracted from the Notifiable Diseases Information System ,The most important and attractive feature of this modeling strategy is that, to attain identifiability, it only requires an informative prior distribution for parameter By varying the number of clusters K and the prior distribution for parameter It worth mentioning that, for each microregion, provided that Not applicable. All analyses used de-identified and publicly available data.The study’s funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.From January 2007 to December 2018, 305,758 GS cases were registered in Brazil corresponding to a GS incidence rate of 8.74 per 1000 live births. GS incidence rates vary across the Brazilian territory , where tTo correct for GS underreporting, we performed a sensitivity analysis by applying the Bayesian model with 12 different specifications, which are related to the combinations between the number of clusters (K) and the prior distribution elicited to parameter γ1 . Accordiγ1 . All thea priori, the proportion of underreported GS cases in the best data quality cluster is 1%, on average  of SINAN-Syphilis at state level are shown on Our study estimates that around 13% of the notifications of gestational syphilis were not registered in SINAN-Syphilis between 2007 and 2018 in Brazil. The underreporting pattern differs between regions, states and microregions: a higher percentage of underreporting of GS cases was found in the North and Northeast regions, while, in general, in the Southeast region, the observed and corrected cases of GS were similar, considering that the lowest percentage of underreported GS cases were found in the microregions of such region. The lowest estimated coverage of GS cases was found in Roraima State (in North region), while the highest was found in São Paulo (in Southeast region). These different patterns highlight that reporting quality may be related to socio-economic and access to health care services.To the best of our knowledge, this is the first study mapping the underreporting of GS across the country and estimating the real burden of the disease in all Brazilian microregions and states. A small-scale surveillance study in Minas Gerais State found that only 6.5% of identified GS cases were reported in SINAN-Syphilis between 2007 and 2013.T. pallidum among pregnant women should be requested, at least, at the first prenatal care visit, in the beginning of the third trimester of gestational period, and at the moment of childbirth.,,,,We highlight the role of inequalities in access to health services and GS cases detection. Despite the expansion of prenatal coverage in Brazil in the last decade and improvements in actions to reduce GS, the quality of prenatal services is still low in many Brazilian cities, particularly in the North and Northeast regions.,,,,,,,,Besides, the access to syphilis tests during the gestational period and the reporting of cases have been directly associated with highest municipal Human Development Index (HDI), most of them located in the Southeast and South region of Brazil.,,,The increasing incidence of GS represents a growing concern for health professionals and public health in Brazil,Previne Brasil, a public policy that will transfer financial resources to municipalities based on their health indicators, such as the proportion of pregnant with at least six prenatal care visits and tested for syphilis.The study is a first attempt to estimate the underreporting of GS in Brazil and correct incidence rates for the whole country, which could help to address the country’s gap of knowledge regarding GS notification. We provide robust subsidies to Brazilian health authorities to better increase surveillance for GS across the country, highlighting municipalities where improvements in surveillance and case reporting should be prioritized. Our results could allow policymakers and stakeholders to improve policy and action to reduce GS, and, therefore, contribute to reducing mother-to-child transmission and the adverse effects on birth outcomes related to congenital syphilis. Also, it could be used by the Brazilian Ministry of Health in planning the Despite the relevance of our results, the study presented some limitations. First, the percentages of underreported cases were calculated for the entire study period, not allowing for analysis of possible improvements or setbacks in the quality of information over time. Second, the model imposes the same reporting probability for areas within the same data quality cluster. However, we found this is the best methodology to be applied, given the restricted type of prior information we have available on underreporting of GS in Brazil.Brazilian microregions and states in the North and Northeast regions presented the highest values of underreporting of GS, which directly affects the knowledge of the epidemiological profile and the estimation of the social, economic, and health burdens associated with the disease. Conversely, microregions and states in the Southern region presented the lowest values of underreported cases. This scenario highlights the regional disparities in the incidence rate of GS and the quality of prenatal care in the Brazilian context, as well as emphasizes the need to improve the quality of information registered in SINAN-Syphilis, considering the importance of disease surveillance across the country. Furthermore, strategies to prevent, control, and maintain the surveillance of GS based only on the data made available in the national health information system without correcting for underreported cases can lead to misguided actions and health policies, particularly related to health finance and the distribution of human resources across the regions.This study provides robust evidence that can be used to enhance national surveillance system and particularly specific policies for GS detection, early treatment and disease control, based in prior information and using a statistical methodology that could be applied by health manager of many countries.G.L.O., M.Y.I. and A.J.F.F. conceptualized this study and contributed to its design.G.L.O. conducted the statistical analysis.G.L.O., M.Y.I., A.J.F.F., C.A.S.S.T., R.A., R.F., R.L., M.P., E.S.P., and A.M.C. contributed to the result analysis and interpretation.G.L.O., M.Y.I., A.J.F.F., C.A.S.S.T., I.O.S and M.A.S performed literature review.G.L.O. and A.J.F.F. formatted tables, figures and wrote the first draft.M.Y.I. and M.L.B acquired the data, funding and coordinated the study.G.L.O., A.J.F.F., C.A.S.S.T. and M.Y.I. have accessed and verified the underlying data.G.L.O., A.J.F.F., E.S.P., M.Y.I. and M.L.B were responsible for the decision to submit the manuscript.All authors have access to all the data reported in the study, wrote the manuscript and approved the final version.http://portalsinan.saude.gov.br/sinan-net. Additionally, all data collected for the study and posterior results are available from the corresponding author upon reasonable request.The GS data are publicly available from the Brazilian National Notifiable Diseases Information System (SINAN) at The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.The abstract translated to Portuguese was submitted by the authors and we reproduce it as supplied. It has not been peer reviewed. Our editorial processes have only been applied to the original abstract in English, which should serve as a reference for this manuscript.We declare no competing interests.


Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Parvimonas micra in periodontitis pocket samples collected from young, <35 years, and old, >35-year-old patients, YP and OP, respectively. The results from the analyses of a total of 3447 subgingival plaque samples analyzed for clinical diagnosis purposes by cultivation regarding the proportions of these species were collected from a database and elucidated. The prevalence of A. actinomycetemcomitans was found to be more than twice as high  in samples from the younger (42.2%) than the older group (20.4%) (p < 0.001). The prevalence of P. micra was significantly lower in samples from the younger age group  (p < 0.001), whereas P. gingivalis was similarly distributed  in the two age groups (p = 0.006). A similar pattern was noticed for A. actinomycetemcomitans and P. gingivalis when high proportions (>50%) of the samples of these bacterial species were elucidated. In contrast, the proportion of samples containing >50% with P. micra was lower compared with the two other bacterial species. Furthermore, it was noted that the proportion of samples from old patients containing A. actinomycetemcomitans in combination with P. micra was almost three times higher than in samples when P. micra was replaced by P. gingivalis. In conclusion, A.actinomycetemcomitans showed an increased presence and proportion in samples from young patients compared with the old patients, while P. gingivalis was similarly distributed in the two age groups. P. micra showed an increased presence and proportion in samples from old patients compared with the young patients.The aim of this study was to compare data about the prevalence and proportions of the bacterial species  Aggregatibacter actinomycetemcomitans [Porphyromonas gingivalis [Parvimonas micra (earlier Peptostreptococcus micros and Micromonas micra) has also been studied [A. actinomycetemcomitans is associated with aggressive forms of the periodontitis (grade C) affecting adolescents and young adults, P. gingivalis and P. micra are mainly associated with chronic, slow progressing forms of the disease that occur later in life [Periodontitis is a multifactorial disease characterized by microbial-induced inflammatory destruction of the periodontal (tooth-supporting) tissues . Oral hycomitans  and the ngivalis . The gra studied . While A in life .A. actinomycetemcomitans activates and kills immune cells by different mechanisms [A. actinomycetemcomitans carrying the cageE gene was found to produce increased levels of this toxin [P. gingivalis produces gingipains, which dysregulate a number of normally tightly controlled pathways [P. micra activates those gingipains and also produces high amounts of hydrogen sulfide [The association of these bacterial species to disease may be, at least partly, due to a carriage of different virulence factors . The leuchanisms . Individchanisms ,14. Receis toxin . P. gingpathways . P. micr sulfide ,18.Rising age is an important host-related factor that influences the microbial ecology of the oral cavity. Subsequent changes in the oral microbial community over time may become detrimental for the oral and systemic health of an older (aging) individual ,20,21.A. actinomycetemcomitans in dental plaque collected for routine clinical laboratory analysis, the clinical diagnosis of the patients was not homogeneously reported in the patient information attached to the referral to the laboratory for microbiological diagnostics. Thus, the classification of the patients was digitomized only and was based on the old definition of early onset periodontitis, which distinguished patients ≤35 years versus those >35 years of age [When studying factors associated with the initiation and progression of periodontitis, the clinical parameters collected from the patients are crucial factors. However, when we recently pooled together 15 years (2000–2014) of long data from our database to investigate the presence of s of age .A. actinomycetemcomitans in samples from patients <35 years compared to those of the in the samples from patients >35 years. Our hypothesis is that the presence of A. actinomycetemcomitans bacteria is gradually replaced by the obligate anaerobic bacterial species as the patient ages, and the microecology of the periodontal is modified to anoxic conditions.That study showed an increased prevalence and proportion of A. actinomycetemcomitans and of the obligate anaerobes P. gingivalis and P. micra in subgingival plaque samples sent by external referral for routine diagnostic analysis. The clinical diagnosis of the patients was not considered, although the data was age-stratified in a binary manner (≤35 years and >35 years).Therefore, in this report, we aimed to compare and summarize clinical microbiological registry data on the presence of the capnophilic The study was performed at the Dental School, Umeå University, Sweden, and includes samples which were received from the undergraduate or/and specialist clinics of the dental school and from external clinics. Collected samples were microbiologically analyzed at the Clinical Oral Microbiology laboratory of the Dental School for periodontal routine diagnostic purposes over a period of 15 years. We underline that this study is a summary of data obtained from analyses of clinical samples sent to the clinical laboratory for identification and characterization. No sample has been originally taken for research purposes, and the data cannot be traced to any of the sampled individuals. In addition, no clinical data from the patients were included. From the database results from all analyzed subgingival plaque samples, a total of 3447, collected from 1505 unique patients (range 9–92 years), were used. Among these, 1087 samples were collected from patients ≤ 35 years, young patients , whereas 2360 samples were collected from patients >35 years, old patients . Based on these data, this study was carried out according to the aim.2, 5% CO2, 85% N2). The colonies of P. gingivalis and P. micra colonies were macroscopically identified as being black pigmented and showing a positive BAPNA test, while P. micra colonies were identified as having a white smooth or rough morphology, surrounded by a halo [A. actinomycetemomitans, the sample were spread on trypticase–bacitracin–vancomycin (TBV) plates and incubated for three days under aerobic condition in the presence of 5% CO2, following macroscopic identification. The colonies of A. actinomycetemcomitans were identified as having a starlike structure and showing a positive catalase test [The samples were routinely produced by using paper points and transported in a viable anaerobic medium (VMGAIII) to the clinical laboratory and handled as described previously . Brieflyy a halo ,24. For ase test . Since uA. actinomycetemcomitans are different parameters, in this report, we presented these parameters in relation to each other. The concentration values of the bacterium of each sample were like the proportion values collected from the database.Since the proportion and concentration of Chi-square tests were used to identify significant differences in the distribution of the individuals and samples positive for the analyzed bacterial species in relation to the age group. The differences in the proportions of the bacterium in patients from the two age groups were calculated with the Mann–Whitney test.A. actinomycetemcomitans was detected in 27% of the dental plaque samples from the individuals and the same proportion (27%) was positive for P. gingivalis. Conversely, P. micra was about twice as prevalent (49%) compared to the other two species  in individuals from the younger than the older group (p < 0.001)  (p < 0.001), whereas P. gingivalis was slightly lower distributed  in the younger age group (p = 0.047)  in samples from the younger than the older group (p < 0.001)  (p < 0.001), whereas P. gingivalis was similarly distributed  in the two age groups (p = 0.006)  A. The pr= 0.047) A. When t= 0.047) B. The pr< 0.001) A. The pr= 0.006) B.A. actinomycetemcomitans (0.1–25%) were observed in the older group, whereas this species was more dominant in proportions >25% in the younger group (p < 0.001). When the two other bacterial species were considered individually, the proportions of P. gingivalis were similarly distributed in the two age groups (p = 0.547), while P. micra were more dominant in the older age group (p = 0.001)  . P. gingge group .P. gingivalis and P. micra, their co-existence was further investigated according to the distribution of A. actinomycetemcomitans in the samples , the proportions of P. gingivalis remained unchanged, with increasing A. actinomycetemcomitans proportions. Instead, P. micra proportions co-increased with ascending proportions of A. actinomycetmcomitans but declined when the latter exceeded 50% (Due to the difference in the proportion dynamics between  samples . Subgingectively A. When Aeded 50% B.A. actinomycetemcomitans was around two times higher than the samples containing A. actinomycetemcomitans in combination with the other bacterial species. Among the OP samples, the opposite was observed, i.e., the proportion of samples containing only A. actinomycetemcomitans was about two times lower than the samples containing A. actinomycetemcomitans in combination with the other bacterial species. Furthermore, it was noted that the proportion OP samples containing A. actinomycetemcomitans in combination with P. micra was almost three times higher than in samples when P. micra was replaced by P. gingivalis.In a polymicrobial infection site the bacterial species may affect each other. To obtain an overview of co-colonization, the presence of the bacterial species was presented alone and in different combination . Among tA. actinomycetemcomitans in the individual samples were compared, no overall relation could be observed, neither for the samples collected from young patients nor from old patients. (When the proportion and concentration of atients. A,B. HoweA. actinomycetemcomitans is shown in younger rather than older adults, whereas the reverse was the case for P. micra, and there was no differences in the prevalence of P. gingivalis between age groups. Our findings converge with earlier findings demonstrating that the prevalence of A. actinomycetemcomitans decreases with age but diverge in that the prevalence of P. gingivalis by increases with age [P. gingivalis in dental plaque, we did not find variations between the two age groups. Of note, in a cohort of, on average, 68-year-old patients, P. gingivalis has been subgingivally detected with higher frequency in periodontitis than health, but with no statistically significant differences in the bacterial counts [The present study examined the dynamics of three well-established periodontal pathogens in the subgingival dental plaque of younger and older individuals. Aging is indeed a physiological process and is accompanied by natural changes in the composition of the oral microbiota . In the with age ,27,28. Wl counts .A. actinomycetemcomitans, the current and earlier findings clearly agree that it is found in greater proportions in the subgingival dental plaque of younger individuals [A. actinomycetemcomitans showed higher concentrations in subgingival samples compared with other genotypes of this bacterium [In the case of ividuals ,23,26,27acterium . In addiacterium .P. micra is somehow less studied in the literature. We hereby show that P. micra is twice as prevent in subgingival plaque in the older compared to the younger population, whereas the proportions of this species in subgingival plaque do not vary according to the age grouping. While we have not identified studies reporting the subgingival prevalence of P. micra according to age grouping, there is evidence that the subgingival proportion of this species does not vary with age, but rather with periodontal heath status [P. micra was subgingivally detected at higher numbers in active compared to stable periodontitis [Tannerella forythus and Prevotella intermedius [The case of h status ,31. Of idontitis ,33. Simiermedius .A. actinomycetemcomitans and P. gingivalis or P. micra in subgingival plaque. The gradual decrease in the proportions of the latter two species with increasing proportions of A. actinomycetemcomitans in the younger patient group converges with microbial clustering observations, implying that inherent factors promote the coexistence of P. gingivalis with P. micra, but not with A. actinomycetemcomitans [P. micra and P. gingivalis may be a such factor, on the biochemical level [P. micra-induced activation of gingipains [A. actinomycetemcomitans and P. gingivalis [A. actinomycetemcomitans does not affect the proportions of P. gingivalis, but there is a positive interrelationship with P. micra instead.In this study we also observed altered dynamics between the proportions of comitans . Hydrogeal level . Anotherngipains . Furtherngivalis ,37. HoweThe introduction of PCR-based quantification of periodontitis-associated bacterial species has in many aspects facilitated the work. However, quantification of the total amount of bacteria using PCR-based methods encounters problem , which iA. actiniomycetemcomitans in the samples. This further indicates that a high proportion of the bacterium in a sample does not necessarily mean that the sample contains a high concentration of the bacterium, or vice versa.In this study it is shown that there is no or a weak association between proportion and concentration of cage E carriers of A. actinomycetemcomitans [Clinical laboratory diagnostics is today recommended as the relevant treatment for aggressive or refractory forms of periodontitis. In addition, to analyze the samples for presence/proportions of periodontitis-associated bacterial species, it would be beneficial to screen the samples for the presence of JP2- and comitans ,40. Carrcomitans ,14,41.A. actinomycetemcomitans, P. gingivalis and P. micra, alone and in combination with each other among young and old patients, this could be inferred to ecological interdependencies between these species in the subgingival milieu, under the factor of aging. However, there is no concrete biological evidence at present to support this hypothesis.Based on the findings in this study of A limitation of this study is the lack of clinical parameters; however, a sample from a periodontal pocket sent for microbial analysis is indicative for a diagnosis of periodontitis.A. actinomycetemcomutans compared with samples from old patients, while P. gingivalis was similarly distributed in the two age groups. P. micra showed an increased presence and proportion in samples from old patients compared with the young patients.Periodontal plaque samples from young patients showed an increased presence and proportion of


Hyalomma are of concern, as these ticks are believed to be vectors of many pathogens responsible for human and animal diseases. However, we have observed that for many pathogens there are no vector competence experiments, and that the level of evidence provided by the scientific literature is often not sufficient to validate the transmission of a specific pathogen by a specific Hyalomma species. We therefore carried out a bibliographical study to collate the validation evidence for the transmission of parasitic, viral, or bacterial pathogens by Hyalomma spp. ticks. Our results show that there are very few validated cases of pathogen transmission by Hyalomma tick species.Current and likely future changes in the geographic distribution of ticks belonging to the genus  Borrelia burgdorferi sensu lato ”  with the Boolean operator “AND” in the PubMed and Scopus databases without date restriction. The literature search was conducted in English. We retained peer-reviewed research articles and reviews (not including conference proceedings) and book sections. Screening was conducted first on titles, then on abstracts, and finally on the full text when available. After reading the entire articles, the ones that were eliminated corresponded to those that did not have available data or no original data. The number of references found in each of the two databases is shown in Numerous pathogens—parasitic, viral, or bacterial—have been reported in the scientific literature as transmitted or potentially transmitted by ticks of the genus Hyalomma. The synthesis of these studies, with an attributed level of evidence of vectorial transmission, is reported in H. dromedarii, H. impeltatum, H. marginatum, H. rufipes, and H. truncatum.Crimean–Congo Hemorrhagic Fever Virus (CCHFv) by H. dromedarii.African Horse Sickness virus by H. truncatum.Venezuelan equine encephalitis virus by Theileria annulata by H. anatolicum, H. dromedarii, H. excavatum, H. lusitanicum, and H. scupense.Theileria equi by H. anatolicum and H. excavatum.Theileria lestoquardi by H. anatolicum.Theileria ovis by H. anatolicum.Babesia occultans by H. rufipes.Coxiella burnetii by H. aegyptium.Anaplasma marginale by H. excavatum.Rickettsia aeschlimannii by H. marginatum and H. rufipes.In conclusion, we observed that there are many missing pathogen vector competence experiments, and that the level of evidence provided by the scientific literature is often not sufficient to validate the existence of vectorial transmission. We conclude that the pathogen/tick associations for which transmission from an infected host to an initially healthy host via tick bite has been experimentally validated are the following:


The Marburg virus disease (MVD) is caused by a rare RNA virus that can result in severe hemorrhagic fever in humans and other primates. The disease was first discovered in 1967 in Marburg Frankfurt in Germany and since then, sporadic cases have been reported in southeastern Africa. The Egyptian fruit bat is considered a reservoir for the virus, which can be transmitted through direct contact with infected bat or monkey tissue, bodily fluids, or contaminated objects. The Marburg virus disease shares clinical features with the Ebola virus disease, and there are no widely accepted vaccines or antiviral medications to treat it. The article provides an overview of Marburg virus (MARV) outbreaks in Africa, including the most recent outbreaks in Guinea, Ghana, Equatorial Guinea, and Tanzania. The authors discuss the recent outbreaks and the implications of the spread of MARV to Africa’s healthcare systems. The authors also present key recommendations for both multicountry and global preparedness efforts in order to better prevent and respond to future MARV outbreaks and other viruses with an epidemic potential. The MARV consists of five strains and is classified as a biosafety level 4 agent due to its high fatality rate, direct person transmission, and lack of vaccines. Under an electron microscope, Marburg virion show pleomorphism, containing genomic RNA, large L protein, nucleoprotein, and virion proteins 30 and 35 within a lipoprotein unit membrane envelope. The virus has a stable infectivity at room temperature and its genome consists of linear, nonsegmented, negative-sense, single stranded RNA with a single overlapping region (VP30/VP24) with a length ranging from 800 to 14 000 nm3. MARV has seven structural proteins and elicits different antibodies compared to the Ebola virus. Although less well-known, MARV remains a significant viral pathogen1. In 1967, the virus was discovered during outbreaks of hemorrhagic fever in Marburg and Frankfurt in Germany, and in Yugoslavia and Belgrade. The outbreaks resulted in 31 cases and seven deaths. The virus was transmitted to individuals who were working with imported African green monkeys or their tissues4. Over the course of the years, MARV has been reported sporadically and isolated among residents and travelers in southeastern Africa. There have been several reported cases of MARV between 1998 and 2000 among young male workers in Durban, South Africa, and the Democratic Republic of Congo (DRC)5.The Marburg virus disease (MVD) is a severe and rare hemorrhagic fever caused by a unique RNA virus called the Marburg virus (MARV), which can affect both humans and nonhuman primates. MARV, a member of the Filoviridae family shares similarities with the Ebola virusRousettus aegyptiacusʼ is believed to be a reservoir for MARV, as several bat species are often hosts for the filovirus family according to previous research studies6. The virus can be transmitted directly from bats or monkeys to humans or from human to human through various routes including direct contact with infected bat shedding or monkey tissue, bodily fluids like blood, stool, urine, sweat, breast milk, or amniotic fluids, contaminated medical instruments or objects, and sexual contact with a recently recovered person with no active symptoms7. MARV has a similar pathogenesis to the Ebola virus and clinical features resembling tropical diseases. Its incubation period ranges from 2 to 21 days and it initially presents with fever, headache, muscle aches, and a rash7.The Egyptian fruit bat ʻ8 and periodic outbreaks in Central Africa. There were occurrences in Uganda in 2012 and 2014. The WHO stated that the possibility of a MARV outbreak spreading is high at the national level but low at the global level1. Currently, WHO is assisting the Ministry of Health of all affected country in enhancing various response pillars such as surveillance at entry points, laboratory capabilities, case management, risk communication, infection prevention, control, and community engagement4. In response to the emergence of the MARV in Africa, the CDC has issued travel advisories of varying levels 1 and 2 for affected countries but does not currently recommend international travel or trade restrictions. These precautionary alerts are influenced and justified by past experiences with comparable events9. MARV shares several clinical features and transmissibility comparable to the Ebola virus, requiring similar infection prevention and control measures including safe burials. Following the recent outbreaks of MARV in Ghana, Tanzania, and Equatorial Guinea, respectively, there is an increase of burden of this viral disease in Africa11. However, less is known about MARV maybe due to the absence of a recent large-scale outbreak like the West Africa Ebola outbreak10. This highlights the importance to address the challenges posed by MARV and infectious diseases in the African region. A better understanding of the factors that contribute to disease outbreaks, as well as the development of effective prevention and control strategies will significantly contribute to tackling the infection12. Therefore, our paper seeks to succinctly discuss the most recent outbreaks and implications of MARV in the African region, as well as provide key recommendations for both multinational and global preparedness to better manage, curb, and prevent unforeseen epidemics in the African continent.MARV continues to be a global health concern, with a case-fatality ratio of over 88%13. Visitors to the Sinoia Caves, which were known to have insectivorous bats, developed symptoms after 8–9 days, leading to suspicion of bats or their discharge as a potential source of infection14. From 1975 to 1985, only a few cases of MVD were reported in Africa. Prior to 1998, MARV was not believed to be as fatal as the Ebola virus. However, this perception changed after two significant outbreaks occurred in the Democratic Republic of Congo between 1998 and 2000, and the first-ever outbreak in Angola between 2004 and 200515. Uganda experienced four epidemics in the year 2007, 2012, 2014, and 2017, each with an incident fatality percentage ranging from 27 to 100%11, while between the year 1998 and 2000, the Republic of Congo reported a total of 154 cases of MVD, resulting in 128 deaths and a case-fatality rate of 83%16.The MARV has been responsible for many outbreaks since it was first discovered in 1967, with the majority of these outbreaks occurring in Africa. In 1975, the second outbreak of MVD occurred in Zimbabwe, marking the first-ever recorded outbreak of the disease in Africa18. This was followed by another outbreak in Ghana in 2022, reported as the country’s first-ever case of MARV, which resulted in the death of one male adult and the 14-month-old child by June 202218. In early 2023, Equatorial Guinea and Tanzania experienced an outbreak of MARV, which was the first of its kind. In mid-February 2023, Equatorial Guinea confirmed its first-ever outbreak of MVD after conducting preliminary tests on samples from the eastern province of the country. The outbreak resulted in at least 11 deaths as at 11 April 2023 from 14 laboratory confirmed cases of which the majority of the cases were reported among females20. In Tanzania, the first outbreak was declared by the Ministry of Health on 21 March 2023 in the Bukoba district of northwestern Kagera region. The outbreak has resulted in eight confirmed cases and five deaths as of 4 April 2023, including a healthcare worker with a case-fatality rate of 63%. The remaining three patients are currently receiving treatment at designated treatment centers21. According to the WHO, the average case-fatality rate of MVD is 50%. However, the fatality rates in the past have varied between 24 and 88% due to differences in virus strains and the management of cases22  recently developed cAd3-Marburg, an experimental vaccine for MARV. This cAd3 vaccine platform has demonstrated safety in previous clinical trials with Ebola and Sudan virus vaccines developed by the VRC39.The treatment of Marburg disease is currently supportive. Treatment in the hospital can be provided to patients, focusing on fluid and electrolyte balance, oxygenation, blood pressure, blood replacement, and treatment of co-infections4. Environmental factors including population density and mobility, healthcare infrastructure, outbreak preparedness and response capabilities, disease surveillance, public health measures, and cultural practices and burial rituals are some of the reasons for differences in cases and deaths of MVD among African countries14. African healthcare systems should be prepared and ready to efficiently tackle MVD cases in already affected and yet affected countries by investing in their healthcare system, and implementing early and coordinated measures40. Active disease surveillance should be massively expanded through investments in health systems to identify cases, track contacts and communities at risk, and reduce the risks of transmission to others, while appropriate infection prevention and control measures are taken to safeguard them and their contacts25, by establishing isolation centers, mobile laboratories, and a trained rapid response team41. Moreover, adopting the one-health concept and fostering collaboration would enhance Africa’s surveillance system and emergency response capabilities to effectively address MVD1. Collaboration with government and international partners, along with adequate funding will facilitate a swift and effective response41. There is also a need for coordinated countermeasures to strengthen the surveillance system and enable international and local contact tracing of individuals who show signs of MARV during travel or upon their return16. To avoid misconceptions and stigmatization that could impede contact tracing, cross-border public health education campaigns on MARV should also be carried out urgently and on a large-scale in all Africa16. To prepare for the possibility of both multinational and global outbreak of MARV, it is crucial to improve the training of frontline healthcare workers in the areas of timely and accurate diagnosis, effective care and management of patients with MARV40. Mental health and psychosocial support by professional counselors should also be offered to survivors of MVD41.After the recent outbreak of MARV in Tanzania in March, 2023, the WHO warns that the risk of MARV is high in Africa as it continues to spread to densely populated areas, with a 90% mortality rate. At the global level, it has been stated that it is unlikely to result in a global pandemic40. Regulations on appropriate measures to prevent MVD such as avoiding contact with reservoir animals, ensuring thorough cooking of animal products, maintaining good hand hygiene, WHO developed guidelines for safe management and burial practices as well as options for cremation should be established in all African countries with protocols for strict adherence17. Only trained healthcare providers equipped with personal protective equipment should be allowed to handle potentially infected patients with Filovirus infection to prevent breaches in protocol and ensure proper care. To minimize the risk of transmission, disposable supplies should always be used for patients with Marburg infection, and the use of sharp objects should be minimized. Handling human remains should be limited, while autopsies are avoided as much as possible. It is expedient to inform state and local authorities about Marburg deaths and contaminated items, and human remains should be handled according to their guidance42. Once recovered from Marburg or any other Filoviruses, individuals are typically immune and noninfectious to others. However, Ebola can be present in semen for up to 3 months postrecovery, necessitating abstinence from sexual activity, including oral sex, for at least 3 months and mothers in the recovery phase should refrain from breastfeeding for at least 15 days as the virus has been found in breast milk during this period (Ebola Disease)43. The WHO’s country-specific recommendations should be utilized to curb MVD in areas where it is prevalent, and collaboration between the government and stakeholders is necessary to swiftly contain MARV outbreaks especially during co-morbidities currently experienced to avoid collapsing of the already fragile healthcare systems17. Investing in research and development is crucial for finding curative measures against the MARV. This involves supporting studies on antiviral drugs, vaccines, and innovative treatments tailored to MARV infection2. Collaborating with local and international research institutions can advance treatment strategies and deepen understanding of the virus44 as well as conducting clinical trials to evaluate the safety and effectiveness of potential therapies is essential for identifying effective interventions for MARV in Africa39.Establishing epidemiology, community involvement, and comprehensive surveillance initiatives, particularly in the impacted region of the continent, is of utmost importanceThe study briefly mentions recent MARV outbreaks in Guinea, Ghana, Equatorial Guinea, and Tanzania. However, as there is limited data, this article did not provide detailed information on the causes, extent, or impact of these outbreaks of each affected country, limiting the understanding of their implications. Also, the study mentions the absence of widely accepted vaccines or antiviral medications for MVD and gave a brief summary of the ongoing efforts but does not delve into these efforts or potential strategies for prevention and control. Exploring current research and initiatives in this area would enhance the completeness of the study.44.MVD is a severe hemorrhagic fever caused by the MARV, which is transmitted directly from bats or monkeys to humans or from human to human, and is able to affect both humans and nonhuman primates. Several countries in the African region have experienced a series of MARV outbreaks in the past few years. Recently, West African countries have reported their first-ever outbreaks of MARV. The possibility of future outbreaks in other African countries is high, considering the rapid increase in emerging zoonotic diseases on the continent. These outbreaks have put additional pressure on healthcare systems in Africa being adversely impacted, affecting the overall quality of life. There is an urgent need to deploy a multifaceted health system strengthening approach for the prevention and curative of MARV, and better respond to its future outbreaks and other viruses with an epidemic potential in AfricaEthical clearance was not required because we did not deal with human or animal data.None.None.O.J.O., E.M., N.O.O., H.A.O., A.A.F., O.B., O.G., J.J.L., and D.E.L.P. III: conceptualization; O.J.O., E.M., N.O.O., O.G., J.J.L., and D.E.L.P. III: methodology; H.A.O., J.J.L., O.J.O., E.M., and O.B.: validation; O.J.O., E.M., N.O.O., O.B., H.A.O., A.A.F., O.G., and D.E.L.P. III: investigation; N.O.O., E.M., J.J.L., O.B.: resources; O.J.O., E.M., A.A.F., H.A.O., J.J.L., and D.E.L.P. III: data curation; O.J.O., E.M., N.O.O., H.A.O., A.A.F., O.B., O.G., J.J.L., and D.E.L.P III: writing – original draft; O.J.O., E.M., N.O.O., H.A.O., A.A.F., O.B., O.G., J.J.L., and D.E.L.P. III: writing – review and editing; O.J.O., E.M., N.O.O., J.J.L., O.B., H.A.O., A.A.F.: visualization; O.J.O., E.M., N.O.O., O.G., J.J.L., D.E.L.P. III: supervision.The authors declare no conflicts of interest.Name of the registry: not applicable.Unique identifying number or registration ID: not applicable.Hyperlink to your specific registration (must be publicly accessible and will be checked): not applicable.Okesanya Olalekan John.None.None.


The diversity of studies carried out in connection with personalized and precision medicine was clearly emphasized during these international conferences, as also observed in the 20 papers of this Special Issue. The most represented topics concern brain diseases, cancers, lungs obstruction, muscles, and skeletal diseases. Other specific topics include the intestinal microbiome or COVID-19, emerging methods for imaging and using radiotherapy, and a promising new class of therapeutic molecules known as dendrimers. This Special Issue, “Personalized and Precision Medicine 2022” (Alzheimer’s disease is the most prevalent brain disease and can take several clinical presentations. The article by V. Bessi et al.  comparesSpastic-type cerebral palsy is a brain disease that induces a complex neuromuscular disorder, involving altered skeletal muscle microanatomy and growth. The paper by R.E. Akins et al.  focuses Orthopedic surgeries are frequently followed by inpatient rehabilitation. The paper by D. Rak et al.  posed thFour papers in this Special Issue are based on cancer, which is one of the leading causes of death. The paper by K.Y. Arga and R. Sinha et al.  exploresTwo papers from the same group focus on the treatment of bladder cancers. The first of the two, by A. Sherif et al. , uses a The review by S. Boussios et al.  focuses Klebsiella pneumoniae bloodstream infection are analyzed in the paper by M.-C. Lu et al. [Besides the COVID-19 virus, various other obstructive lung diseases are known. The paper by P. Steiropoulos et al.  evaluateu et al. . No effeAkkermansia spp., which may have beneficial effects on inflammation and metabolism, continued to increase in a subset of participants, even beyond the supplementation period.For instance, miscellaneous topics concern the prediction of hepatotoxicity in azathioprine-treated patients with auto-immune diseases. The paper by W.T. Hung et al.  studies Two different physical techniques are presented. The clinical applications of ultra-high-frequency ultrasound are proposed by D. Berritto et al.  for the Finally, an emerging family of macromolecules with potential therapeutic properties, known as dendrimers, are reviewed by A.-M. Caminade , with emOverall, the twenty papers in this Special Issue constitute an impressionist overview of the state-of-the-art research in the field of personalized and precision medicine, with some perspectives on the future of this topic.


With the global burden of chronic liver disease (CLD) on the rise, especially due to the rise in obesity and metabolic syndrome, a third-world country like Nepal faces a different problem. With alcohol intake being rooted in Nepalese culture, alcoholic liver disease (ALD) is the most common cause of CLD in our society.This is a retrospective observational study conducted in the inpatient ward of the Department of Gastroenterology at the University in Nepal. Ethical approval was taken from the Institutional Review Committee, and a structured questionnaire format was used to record the data retrospectively using admission log books and admission sheets. Demographic data regarding age, sex, and address were collected, while the form of decompensation during presentation was used as a source of clinical data. For statistical analysis, see SPSS 21  was used.A male-to-female ratio of 2:1 was found, with ALD the most common cause of CLD in admitted patients. Similarly, the majority of patients were admitted due to ascites, which was compounded by spontaneous bacterial peritonitis. 93.60% of patients admitted with CLD had a deranged prothrombin time, while only about a third of patients had elevated aspartate aminotransferase and/or alanine aminotransferase.The large burden of ALD highlights the importance of awareness programs at the community level, which have been neglected till date. HighlightsAlcoholic liver disease contributes to an overwhelming burden of chronic liver disease patients admitted in Nepal.Ascites with spontaneous bacterial peritonitis is the most common form of decompensation for which a patient is admitted.Awareness programs need to be implemented at the community level to address this issue.et al.,The global burden of chronic liver disease (CLD) is on the rise. Based on data from the Global Burden of Disease study, the age-standardized incidence rate of CLD and cirrhosis was 20.7 per 100 000 in 2015, a 13% increase from 20002 077/078].This study was conducted retrospectively at TUTH, located in Maharajgunj, Kathmandu. This center was chosen for study because of its high patient flow. Ethical approval for conducting the study was taken from the Institutional Review Board (IRB) of TUTH, IOM .Ethical approval was obtained from the research ethics committee of the Institutional Review Committee (IRC) of Institute of Medicine (IOM) [Ref: 164 (6-11) EWritten informed consent was obtained from the patient for the publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.No funding was received for the study.Authors have no conflict of interest to declare.A.K.S., A.S., and S.S. wrote the original manuscript, reviewed, and edited the original manuscript. A.K.S., A.S., S.S., and A.B. reviewed and edited the original manuscript.1. Name of the registry: Research Registry.2. Unique identifying number or registration ID: researchregistry8369.3. Hyperlink to your specific registration (must be publicly accessible and will be checked): Register Now – Research RegistryDr Anish Kumar Shrestha.Not commissioned, externally peer-reviewed.


Mentha longifolia is a valuable medicinal and aromatic plant that belongs to Lamiaceae family. This study looked at the antibacterial effects of M. longifolia essential oil and pulegone in edible coatings made of chitosan and alginate on the growth of Staphylococcus aureus, Listeria monocytogenes, and Escherichia coli in cheese. For this purpose, first fresh mint plant was collected from the cold region of Jiroft in Kerman province. Plant samples were dried in the shade at ambient temperature, and essential oil was prepared using Clevenger. The essential oil was analyzed by gas chromatography using mass spectrometric (GC/MS) detection. The major composition of M. longifolia oil was pulegone (26.07%), piperitone oxide (19.72%), and piperitone (11.88%). The results showed that adding M. longifolia essential oils and pulegone to edible coatings significantly reduced the growth of bacteria during storage. The bacterial population decreased by increasing the concentration of chitosan, M. longifolia, and pulegone in edible coatings. When the effects of pulegone and M. longifolia essential oils on bacteria were compared, it was found that pulegone had a stronger effect on bacterial population reduction. Coating treatments showed more antibacterial activity on E. coli than other bacteria. In general, the results of this research showed that alginate and chitosan coatings along with M. longifolia essential oil and its active ingredient pulegone had antibacterial effects against S. aureus, L. monocytogenes, and E. coli in cheese. E. coli, S. aureus, L. monocytogenes, etc. E. coli is part of the natural intestinal flora of all warm-blooded animals. The presence of this bacterium in water and food is accepted as an indicator of fecal contamination and the possible presence of dominant pathogens [S. aureus is the third cause of foodborne diseases in the world. This bacterium exists in the mammary ducts of cows suffering from mastitis and enters the milk during milking, and the use of this milk in the production of traditional cheese causes its contamination. Food intoxication with S. aureus occurs as a result of consuming enterotoxin-contaminated food, and it can remain in cheese for a long time [L. monocytogenes is a facultative intracellular pathogenic organism to humans and animals. This is the cause of listeriosis infection in humans and animals. Symptoms of the disease in humans include abortion, encephalitis, meningitis, and septicemia  [Contaminated milk and dairy products are one of the important sources of infections and food intoxication in humans. One of the causes of contamination of dairy products is their suitable conditions for the growth of many microorganisms. In cheese, depending on the preparation stages and ripening condition, there is a possibility of contamination with various spoilage and disease-causing bacteria, including athogens . S. aureong time . L. mono system) . Traditi system) .Lamiaceae, have not only antimicrobial but also antioxidant properties compared to other families [Today, people turn to herbal medicines for various reasons, including the high cost of chemical drugs and their side effects. Numerous studies have been conducted to find natural compounds with biological activities derived from plant, animal, and microbial resources because, on the one hand, common chemical drugs used to treat infectious diseases are becoming increasingly ineffective against microorganisms, and, on the other hand, consumers are becoming more aware of the negative effects of chemical and synthetic food preservatives . Medicinfamilies .Lamiaceae is a family of plants that includes Mentha longifolia. In temperate areas of central and southern Europe, southwest Asia, and Australia, it primarily grows wild in wet environments beside rivers and other waterways [Lamiaceae are cyclohexanes and aromatic, and pulegone as the main constituent of M. longifolia oils has a specific aroma ranging from intense to spicy and vinegar. The main constituents of M. longifolia essential oil are different in various studies. In several studies, the major constituents were pulegone, cineole, linalool, menthol, carvone, piperthone, thymol, beta-caryophyllene, etc. These compounds have antimicrobial properties [aterways ,13. Reseoperties ,15.M. longifolia essential oil had a great inhibitory effect on L. monocytogenes, Klebsiella pneumoniae, fungi and yeasts, and E. coli was the least sensitive [M. longifolia from different regions of Lorestan province in Iran exhibited high inhibitory effect against Pseudomonas aeruginosa, S. aureus, and E. coli [In a study, it was found that ensitive . It has  E. coli .Marocystis pyrifera. Alginates are considered emulsifiers, stabilizers, and thickeners [Edible coatings as a consumable layer have adhesive, antioxidant, and antibacterial properties. By covering the surface of the product, these coatings prevent the reduction of moisture and the penetration of oxygen, and improve the appearance of the product . Many orickeners . When a ickeners .M. longifolia essential oil and pulegone to edible coatings made of alginate and chitosan would affect the growth of S. aureus, L. monocytogenes, and E. coli in cheese.Because chitosan is effective at preventing the growth of Gram-positive and Gram-negative bacteria, yeasts, and molds, it is used as an edible film and coating. Chitosan has natural antioxidant and antimicrobial properties that are affected by its concentration and molecular weight . Due to M. longifolia essential oil compounds were identified using GC/MS. M. longifolia essential oil, which comprised 97.8% of the total essential oil. The main compounds of the essential oil are pulegone (26.07%), piperitone oxide (19.72%), piperitone (11.88%), 1,8-cineole (8.21%), cis-piperitone oxide (6.35%), and borneol (5.96%). As M. longifolia essential oil is mainly composed of monoterpene compounds .The E. coli, S. aureus, and L. monocytogenes are presented in Descriptive statistics related to chitosan, pulegone, and essential oil in E. coli population in cheese reduced when storage period, chitosan concentration, and essential oil levels were increased. At the conclusion of the storage time, the lowest number of bacteria related to the treatment contained 10% chitosan and 150 ppm peppermint essential oil. On all days of storage, the control showed the greatest level of bacterial population.According to Pearson’s correlation coefficients are presented in E. coli bacteria in cheese decreased. As the storage period increased, the population of E. coli in cheese samples coated with pulegone and chitosan decreased. On the first and 20th days of storage, increasing the amount of chitosan from 5 to 10% in the coatings did not have a significant effect on the bacterial population. At the conclusion of the storage time, the control and treatment coated with 10% chitosan and 50 ppm pulegone had the greatest and lowest populations of bacteria, respectively.The results of Pearson’s correlation coefficients are presented in S. aureus in cheese reduced with longer storage times in all treatments. At the conclusion of the storage time, the lowest number of bacteria related to the treatment contained 10% chitosan and 150 ppm essential oil. The treatment coated with 5% chitosan without essential oil had the most bacteria population, but there was no significant difference between this treatment, control and the treatment coated with 10% chitosan without essential oil (p > 0.05). By increasing the amount of essential oil and chitosan in the coatings, the population of S. aureus in the cheese samples decreased.According to Pearson’s correlation coefficients are presented in S. aureus bacteria in cheese decreased. At the conclusion of the storage time, the smallest and the largest of the bacterial count were observed in the treatment coated with 10% chitosan and 50 ppm pulegone and the control, respectively. Increasing the storage period led to a decrease in the bacterial population in all treatments.The results of Pearson’s correlation coefficients are presented in L. monocytogenes in cheese decreased by increasing the storage period in all treatments. At the end of the storage time, the highest amount of bacterial count was observed in the control, which had no significant difference with the treatment coated with 10% chitosan without essential oil. By increasing the essential oil concentration in the coatings, the number of L. monocytogenes decreased. Increasing the concentration of chitosan also led to a decrease in the bacterial population.The results of Pearson’s correlation coefficients are presented in p> 0.05). Over the course of all storage times, the control treatment had the highest bacterial count. On the first and 20th day, at 5% and 10% chitosan concentrations, increasing the amount of pulegone in the coatings did not have a significant effect on the bacterial population. On the 30th day, in the concentration of 10% chitosan, increasing the pulegone concentration from 10 to 50 ppm did not have a significant effect on the number of L. monocytogenes.Pearson’s correlation coefficients are presented in S. aureus ATCC 29213, and L. monocytogenes ATCC 19,115 ; E. coli O157 ATCC 43,895 ; Sodium alginate ; chitosan with a deacetylation level of greater than 75% ; Tryptic Soy Broth (TSB); Baird parker agar; Sorbitol-MacConkey agar; Palcam Listeria-Selective agar culture media ; and pulegone active ingredient .Materials used in the study were M. longifolia was taken in May 2021 from a cold area of Jiroft City. The aerial part of this plant was dried in the shade and ambient temperature. After drying, the plant was ground. About 100 g of dried sample was placed in 400 mL distilled water and submitted to hydrodistillation for 3 h using a Clevenger-type apparatus [M. longifolia was 1%(v/w), and it was colorless. Gas chromatography  equipped with a mass spectrometer (GC-MS) was used to determine the chemical composition of M. longifolia essential oil. Compounds were separated on HP-5 MS capillary column . A sample of 1.0 μL was injected in the split mode with split ratio 1:100. Helium was used as a carrier gas at a flow rate of 1.0 mL/min. The injection temperature was 230 °C. Compounds were further identified and authenticated using their complete mass fragmentation data compared to the NIST02.L and WILEY7n.L mass spectral libraries and published mass spectra and, wherever possible, by coinjection with authentic standards [After the scientific confirmation of the species by plant science experts at University of Jiroft Herbarium, pparatus . The yietandards .Lactic cheese samples were prepared at Pegah Dairy Company of Jiroft. The steps were as follows:First, raw milk was standardized (the amount of fat (3%) and dry matter (15%) was adjusted). Then the milk temperature rose to 96 °C. A mixture of sour yogurt and vinegar was added to the hot stirring milk until the milk was completely coagulated. The clot was cut, drained, and poured into plastic molds, and within 5 h, the molds were returned to complete dehydration. Cheese pieces were placed in salt solution 16%) at 5 °C, and after 72 h, the relevant tests  were performed on them % at 5 °C.M. longifolia essential oil  as well as different concentrations of pulegone . The samples were then placed in an incubator  under controlled temperature and humidity (about 12 °C and relative humidity of 85%) for approximately 8 h until the coatings were dry [The cheese samples were cut into cubes  and coated by immersion method, during which the samples were immersed in the coating mixtures for 1 min until all surfaces of the cheese samples were completely covered with the coating material. Coating mixtures were sodium alginate solution (25%) with concentrations of 0, 5, and 10% chitosan and different concentrations of were dry .M. longifolia essential oil and pulegone in the coatings, and a sensory evaluation test was also performed. The maximum concentration of M. longifolia essential oil and pulegone was determined according to the results obtained from the sensory evaluation. By increasing the concentration more than 150 ppm for M. longifolia essential oil and 50 ppm for pulegone, the flavor and taste scores decreased. In this way, the studied concentrations were determined for essential oil and pulegone.In the pre-test, we used higher concentrations of S. aureus, L. monocytogenes, and E. coli O157) into the cheese texture, bacterial suspensions containing 105 CFU/g were injected into 8 points of cheese samples with a sterile syringe. After that, the samples were placed in polypropylene containers and kept at 5 °C [To inoculate the bacteria  was used with the Statistix ver. 10 software to see whether there were any significant differences between the results. Differences at M. longifolia essential oil , and pulegone  on the growth of E. coli, S. aureus, and L. monocytogenes in cheese was examined during three storage times. In general, by increasing the storage period (30 days) in all treatments, the number of bacteria in the cheese decreased. This decrease was more pronounced in treatments with increasing concentrations of chitosan, essential oil, and pulegone. The effect of the studied treatments on reducing the growth of E. coli was greater than the other two bacteria. In general, the pulegone active ingredient was more effective in reducing the growth of bacteria than the M. longifolia essential oil.Cheese is a ready-to-eat food product that is not subjected to any other treatment to ensure its safety before consumption. Contamination of cheese with foodborne pathogens may occur in several stages . Therefore, information on the main sources of pathogens and the mechanisms by which they infect the dairy chain is needed if contamination of any cheese is to be prevented . The useM. longifolia essential oil, and the pulegone active component. Evaluation of the antimicrobial effects of M. longifolia essential oil against E. coli, S. aureus, and Candida albicans showed that the pulegone and 1,8-cineole compounds are important in this regard [M. longifolia essential oil has been found to have strong antibacterial properties against a variety of bacteria, including Staphylococcus, Pseudomonas, Bacillus, and E. coli, as well as some fungal strains including Aspergillus, Fusarium, and Penicillium [Studies have demonstrated the antibacterial properties of chitosan, s regard . In our s regard . M. longicillium .M. longifolia essential oil against several foodborne pathogens, pulegone, 1,8-cineole, and menthofuran were the most prevalent constituents of essential oils. Their results also showed that the most sensitive bacterium to M. longifolia essential oil was E. coli, which is consistent with our results. In another study, it was found that M. longifolia from the mint family had antibacterial properties on Staphylococcus and Listeria species. The results of this study similarly confirm the results of our study [S. aureus and Salmonella typhimurium were investigated, and the results showed that 1,8-cineole has a stronger antibacterial effect on Gram-positive bacteria than Gram-negative bacteria, while pulegone has a higher antibacterial effect on Gram-negative bacteria [It has been reported that one of the key characteristics of essential oils and active substances is the hydrophobic property, which led to the change and destruction of the cell membrane structure and their greater permeability. This is concerning the action of these substances and their compounds in the death of pathogenic bacteria. The result is that the majority of the ions and other essential components of the cell leak out, which ultimately causes the bacterium’s death . It willur study . Studiesur study . In one bacteria , which iM. longifolia essential oil and pulegone as the effective ingredient and the main composition of M. longifolia essential oil, it was found that this substance had more antibacterial properties than the complete essential oil in much lower concentrations. Pulegone is a monoterpene ketone found in the leaves and flowers of several members of the mint family [S. aureus, S. typhimurium, and E. coli [Comparing the results of t family . Terpenet family . Based o E. coli .Streptococcus equi subsp. equi were investigated [The antibacterial effects of trans-cinnamaldehyde, 1,8-cineole, and pulegone against stigated . AccordiDissolving in the cytoplasmic membrane and interfering with the protein structure of the enzyme and destroying the microorganism;Interruption in activities related to succinate and reactions related to NADH;Disturbing electron transfer in the respiratory chain;Creating a break in oxidative phosphorylation.In general, the antimicrobial activity of essential oils is expressed by several mechanisms:The lipophilic property of essential oils can explain its increased membrane permeability or destruction due to the activity of enzymes in the cell membrane such as protein kinase .Lactobacillus rahmnosu and Enterococcus faecium, all antimicrobial agents’ MIC and MBC against E. coli and S. aureus were extremely low.Chitosan’s polycationic composition is thought to be the source of its antibacterial properties. The protonated amino group in chitosan interacts electrostatically with the negative residues on cellular surfaces to achieve antibacterial activity . With inL. monocytogenes on the surface of ready-to-eat roast beef was examined. Results showed that L. monocytogenes on the surface of roast beef may be controlled by chitosan coatings. In [In some studies ,53,54, tings. In , the effM. longifolia essential oil and the active ingredient of pulegone on the growth of some pathogenic bacteria in lactic cheese was investigated. The results generally demonstrated that the population of investigated microorganisms decreased by increasing the concentration of chitosan, M. longifolia, and pulegone in edible coatings. When the effects of pulegone and M. longifolia essential oils on bacteria were compared, it was found that pulegone had a stronger impact on bacterial population reduction. Coating treatments showed more antibacterial activity on E. coli than other bacteria. From this study, it can be concluded that chitosan coating along with M. longifolia essential oil and its active ingredient pulegone had antibacterial effects against S. aureus, L. monocytogenes, and E. coli in cheese. As a result, it can be utilized as a strong and natural food preservative.In this research, the impact of edible coatings of alginate and chitosan along with


Orientia tsutsugamushi and Rickettsia typhi, respectively. Numerous studies have been undertaken on rickettsial illnesses in humans and animals, including arthropod vectors, in Thailand. However, the reports on the seroprevalence of antibodies to O. tsutsugamushi and R. typhi in buffaloes is extremely rare. Thus, this study aimed to estimate the seroprevalence of both rickettsial infections in water buffaloes  in Phatthalung Province, southern Thailand.Scrub typhus and murine typhus are globally distributed zoonoses caused by the intracellular Gram-negative bacteria O. tsutsugamushi and R. typhi using an indirect immunofluorescence assay.From February to March 2023, a total of 156 serum samples were collected from 156 water buffaloes on 29 farms in Phatthalung province. The sera were screened for antibodies against O. tsutsugamushi and R. typhi in individual water buffaloes was 4.49%  and 3.85% (95% CI: 1.77%–8.14%), respectively, whereas 31% (9/29) of the herds had buffaloes with antibodies. The number of buffaloes with scrub typhus infection and ectoparasite infestation was statistically significant . Intriguingly, the prevalence of scrub typhus antibodies in buffaloes that were not infested with ectoparasites was much higher than those that were.The seroprevalence of antibodies against O. tsutsugamushi and R. typhi antibodies in water buffalo sera in Southern Thailand. Two serum samples showed a high antibody titer against O. tsutsugamushi. Seroprevalence mainly occurred in non-ectoparasite-infested buffaloes, especially for O. tsutsugamushi antibodies. At the herd level, one-third of the studied farms showed seroprevalence. Additional research on the occurrence of these pathogens in vectors and in other animal reservoirs is necessary.This is the first report of  Orientia tsutsugamushi and Rickettsia typhi, respectively. Both are neglected tropical zoonoses that are major causes of febrile illness worldwide , no risk factors related to R. typhi seropositivity were identified.O. tsutsugamushi and R. typhi for each water buffalo farm are presented in O. tsutsugamushi, while five farms (17.24%) had at least one water buffalo with antibodies against R. typhi. In total, there were 13 seropositive buffaloes among the 29 farms. Farms 27 and 29 both had one buffalo with antibodies against both antigens.The antibody titers against O. tsutsugamushi and R. typhi in water buffaloes. Most O. tsutsugamushi seroepidemiological research has involved small ruminants [R. typhi have been conducted on domestic ruminants [O. tsutsugamushi and R. typhi in water buffaloes in Southern Thailand was found to be slightly low. However, the seropositivity of cattle in Japan was 9.6% [et al. [This is the first investigation of the prevalence of antibodies to uminants , 19 and uminants . In addiuminants . The seruminants . In our was 9.6% , higher  [et al.  found a  [et al. .O. tsutsugamushi in the group of buffaloes with ectoparasite infestation (p < 0.05), this factor appeared to be unrelated to the seroprevalence of O. tsutsugamushi antibodies in water buffaloes. In contrast, a Sudanese study by Eisawi et al. [et al. [Since we detected low antibody prevalence against i et al.  discover [et al. , we wereO. tsutsugamushi transmission between hosts [Xenopsylla cheopis) was identified as a significant vector species of R. typhi [et al. [et al. [Rickettsia spp. to humans. In Thailand, ticks and lice were the most frequent ectoparasites found in water buffalo. Unfortunately, we could only collect lice from the buffaloes and we were unable to detect both pathogens in the lice. Additional epidemiological research is required to fully understand the role that ectoparasites or arthropods, like lice and ticks, play as reservoirs in that area.In Thailand, water buffaloes are used for traditional culture and agricultural activities. Therefore, there is a potential for an insect-borne disease, such as scrub or murine typhus, to spread to humans. Trombiculid mites have been identified as possible vectors for en hosts , and theR. typhi . In addi [et al.  and Gala [et al.  indicateO. tsutsugamushi-seropositive water buffaloes, especially those that were ectoparasite-free at the time of blood collection. The ectoparasite-free water buffaloes had a higher rate of seropositivity than the ectoparasite-infested water buffaloes. Studies on the risk factors associated with seroprevalence have mostly been conducted on cattle and humans who work with cattle or buffaloes [O. tsutsugamushi [O. tsutsugamushi-infected ectoparasites might have moved from one host to another or to the surrounding environment at the time of sampling, which would result in seropositivity in ectoparasite-free water buffaloes. Our investigation on the risk factors associated with buffaloes showing seropositivity for O. tsutsugamushi and R. typhi was lacking and requires further study. Importantly, ectoparasites in the environment should be investigated in future studies.In this study, only ectoparasite infestation was a risk factor for uffaloes , 25. It ugamushi . RegardiO. tsutsugamushi and R. typhi antibody seroprevalence in water buffaloes from Southern Thailand. Antibodies to O. tsutsugamushi and R. typhi were detected in 4.49% and 3.85% of serum samples, respectively. The seroprevalence of antibodies against these antigens was significant among non-ectoparasite-infested buffaloes. At the herd level, the rate of seroprevalence was 31%. There were 13 seropositive buffaloes among 29 farms, with each farm having buffaloes positive for O. tsutsugamushi or R. typhi antibodies. To comprehend the hazards of this disease under the One Health concept, additional epidemiological research on the prevalence of rickettsial infection among water buffaloes, associated workers, and ectoparasites is required.This is the first study on DP and SB: Conceived and designed the study. SB, PS, NC, KK, and YM: Conducted the literature review and prepared tables. DP, SB, PS, NC, and KK: Drafted the manuscript. PS, SB, and YM: Critically revised the manuscript. DP: Conducted the laboratory tests. PS: Conducted statistical analysis. KK: Collected the samples. All authors have read, reviewed, and approved the final manuscript.


Laelia has restricted geographic distribution, with species in Brazil and Mexico. However, in molecular studies, the Brazilian species have not been included despite remarkably similar floral structures in both Mexican and Brazilian groups of species. The main objective of the present study is to analyze vegetative structural characters of 12 species of Laelia in Mexico to find similarities to recognize them as a taxonomic group and their relationship with possible ecological adaptations. This work supports the proposal to recognize 12 species of Laelias from Mexico as a taxonomic group (except for the new species recognized as Laelia dawsonii J. Anderson), since a strong similarity was found, translated by 90% of structural characters shared by the Mexican Laelias, given the relationship between the structural characters and the altitudinal distribution in which the groups of Mexican Laelias species are found. We propose that Laelias of Mexico be recognized as a taxonomic group and their structural characteristics allow for better understanding of adaptation of species to their environment.The Laeliinae Subtribe (Epidendroideae-Orchidaceae) is exclusively Neotropical, composed of 43 genera and 1466 species, presenting great floral and vegetative diversity. The genus  The Orchidaceae family is one of the most diverse plant groups, with around 30,000 species known worldwide ,2. OrchiLaelia, then it is proposed to recognize the Laelias of Mexico as a consolidated taxonomic group. The purpose of the present investigation is whether the Laelias of Mexico can be distinguished from the closely related genera Broughtonia and Cattleya based on structural characters.Anatomy, or the study of the shape and internal structure of plant tissues and organs, is a classic source of data used in plant taxonomy. These data are especially useful for phylogenetic relationships by suggesting homologies and contextualizing evolutionary polarity . CurrentLaelia, structural characters  were analyzed for 15 Laeliinae species: 12 species of orchids that represent the genus Laelia in Mexico, Broughtonia (one species) and Cattleya (two species) that are genera closely related to Laelia [Laelia dawsonii has just been recognized as a distinct species from L. anceps [To understand the similarity relationships between the Mexican species of o Laelia , as compo Laelia . Further. anceps  and was . anceps .Dermal Tissue. Adaxial cuticle generally striated, except in L. rubescens and L. halbingeriana, which is smooth; adaxial cuticle thickness from 5 to 11 μm (<12 μm); except from L. rubescens, which is >12 μm, abaxial cuticle thickness 5–14 μm. Adaxial epidermal cells distributed in rows in L. gouldiana, L. rubescens and L. halbingeriana, the rest of the species with alternately distributed cells, the abaxial epidermal cells are in rows. Adaxial and abaxial epidermal cells are generally isodiametric polygonal in shape, except L. eyermaniana, L. rubescens and L. superbiens, where they are elongated polygonal. Area of adaxial epidermal cells <5000 μm2, cells abaxial from 801 to 1400 μm2, with the exception of L. aurea, where it is from 600 to 800 μm2. Stomata only in the abaxial epidermis, distributed in rows, except in L. albida and L. autumnalis, L. furfuracea, L. superbiens and L. halbingeriana, which is alternate, trichomes present at the margins of the adaxial surface, denoted by the permanence of basal cells, except in L. albida, L. crawshayana, L. eyermaniana and L. halbingeriana. Papillae present in the abaxial epidermis, except in L. albida, L. eyermaniana, L. furfuracea and L. halbingeriana, the papillae are epidermal, except in L. anceps and L. speciosa, where they are cuticular. The length of the guard cells is 30 to 40 μm, except in L. superbiens, which is larger than 45 μm. The development of the cuticular ridges is light in L. albida, L. anceps, L. eyermaniana and L. halbingeriana and deep in the rest of the species. The substomatal chamber is conspicuous, with the exception of L. aurea, L. rubescens and L. halbingeriana, which is inconspicuous. Stomata are generally semi-sunken, with the exception of that in L. autumnalis, L. eyermaniana, L. furfuracea and L. speciosa that are at the level of the epidermis and in L. aurea that are sunk. Stomatal index from 2 to 6. Height of adaxial epidermal cells 18–24 μm, except in L. albida, L. anceps, L. autumnalis, L. furfuracea and L. gouldiana ranging from 24 to 30 μm. Cell width adaxial epidermal 23–27 μm in L. anceps and L. crawshayana, 28–31 μm in L. aurea and in L. furfuracea, L. speciosa and L. superbiens, it Is 32–35 μm. Height of abaxial epidermal cells less than 30 μm as in Laelia furfuracea. Width of abaxial epidermal cells 25–37 μm as in L. aurea, except in L. speciosa which is 38 to 41 μm. Fundamental tissue. Hypodermis. Present in the leaf of all species, located both on the adaxial surface as abaxial, with the exception of L. speciosa which only occurs in the adaxial surface. Species with both hypodermises have a stratum in its abaxial hypodermis, the adaxial hypodermis generally presents one layer, with the exception of that in L. superbiens, which has two layers. Cell shape of the adaxial hypodermis is oblong except for L. rubescens, which presents cells with an elongated polygonal shape, and L. speciosa with polygonal cells isodiametric. Shape of cells of hypodermis abaxial, polygonal isodiametric except in the case of L. anceps, L. superbiens and L. halbingeriana, which are oblongs, and L. Rubescens that presents cells with a polygonal shape perpendicularly elongated. Thick cell walls in the adaxial hypodermis, except in L. crawshayana and L. rubescens, which are thin. In the hypodermis abaxial the walls are in some species thick and in others thin. The type of wall in both the adaxial and abaxial hypodermis is cellulosic, except in L. superbiens and L. halbingeriana, which is lignified. The distribution of the layers of the adaxial hypodermis is continuous for all species, while the distribution in the abaxial hypodermis is continuous only in some species, with the exception of that in L. crawshayana, L. aurea, L. anceps, L. eyermaniana and L. speciosa, which is discontinuous. On the other hand, in the basal region, the presence of hypodermis was found in all species. The location is on both surfaces , with the exception of L. eyermaniana, where it is abaxial only. There is one layer of the adaxial hypodermis, with the exception of L. superbiens and L. crawshayana, which have two or more layers. In the case of the abaxial hypodermis, there is only one layer for all species. Mesophyll with a thickness from 500 to 2500 μm, with L. superbiens being the species with the highest thickness (2500 μm). Heterogeneous mesophyll , except in L. autumnalis, L. gouldiana, L. rubescens and L. superbiens, which is homogeneous. The proportion of palisade parenchyma was generally 0 to 0.4, with the exception of that in L. albida, L. anceps and L. aurea, which is from 0.41 to 0.8, and in L. rubescens, L. superbiens and L. halbingeriana, which was 0.81 to 1. The presence of secondary thickenings was found only in the species L. aurea and L. superbiens. Water cells are absent in all species. Presence of calcium oxalate crystals with the exception of L. albida, L. anceps, L. aurea, L. autumnalis and L. eyermaniana. The shape of these crystals is mainly raphides. The ubication of the crystals is mainly in the center of the mesophyll. In the case of the basal region, the mesophyll is heterogeneous , with exception of the species that present a homogeneous mesophyll: L. anceps, L. autumnalis, L. eyermaniana, L. gouldiana and L. rubescens. The basal region also presents air spaces in the mesophyll, with the exception of L. crawshayana, L. furfuracea, L. speciosa, L. superbiens and L. halbingeriana. Extravascular fibers are found in the middle region in all species, the location is generally both abaxial and adaxial, with the exception of L. rubescens which has extravascular fibers present throughout the mesophyll. There are one to four layers of adaxial extravascular fiber bundles, with exception of L. rubescens and L. superbiens, which have four to five layers, make abaxial extravascular fibers of two to four layers, with the exception of L. aurea and L. furfuracea, which have four to six layers, and L. rubescens, which has six to nine layers. Extravascular fiber wall thickness of 2.5 μm, except for the species L. aurea, L. gouldiana, L. superbiens and L. halbingeriana with a wall thickness of 5 μm. Extravascular fibers with presence of stegmata. Central zone. In the central zone of the leaves, the presence of bulliform cells was found, with the exception of L. anceps, L. aurea, L. eyermaniana, L. gouldiana and L. halbingeriana. Species with bulliform cells have two to four strata. In a cross section, the leaves of the Mexican species of the genus Laelia present the projected central zone; this projection can be observed generally in convex shape, with the exception of that in L. anceps, L. aurea, L. rubescens and L. superbiens, which is keeled. Most species have a vascular bundle in the central zone. Regarding the presence of extravascular fiber bundles in the central zone, they were evident in all the species and generally had 2 to 4 strata. Vascular tissue. Four types of vascular bundles were found, except for L. crawshayana, L. superbiens and L. halbingeriana presenting three types and L. rubescens with five types of vascular bundles. In the blade, there are generally two layers of vascular bundles as in the case of L. albida, with the exception of L. eyermaniana and L. superbiens with one layer, and L. rubescens with three layers. Across the lamina there are 30 to 90 vascular bundles, with the exception of L. superbiens that presents more than 90 vascular bundles.In particular, the characters evaluated were 11 quantitative anatomical characters with 30 repeated measurements per species. The summary of descriptive statistics for these characters, such as the mean (M) and the standard deviation (SD) are concentrated in The CDA result showed that the first three canonical functions contributed 90% of the variation . The eigLaelia superbiens and the genus Cattleya displayed a very thick mesophyll (1501 to 2000 µm), while on the left side were the Laelia species L. crawshayana, L. eyermaniana, L. gouldiana and L. furfuracea, with lower thickness of the mesophyll (500 to 1000 µm). This quantitative anatomical character showed variations within the Mexican Laelias species   it was f species .Cattleya had a smaller area of abaxial epidermal cells (600 to 800 µm2) compared to those of L. crawshayana, L. eyermaniana, L. gouldiana, L. furfuracea, L. speciosa and L. anceps , and at the upper end of the axis, the Mexican species of the genus Laelia with a smaller abaxial cuticle , the two species of . anceps   and Cattleya species (red)  as a grouping algorithm, separating the group of Laelias (pink) from the es (red) . It was Laelia anceps, L. albida, L. autumnalis, L. eyermaniana, L. furfuracea, L. gouldiana and L. speciosa, share the following anatomical characters: striated cuticular surface, conspicuous substomatal chamber, thick cells walls of adaxial hypodermis, distribution of continuous adaxial hypodermis strata, absence of cells with secondary thickenings in the mesophyll and four types of vascular bundles in the mesophyll  (High-mountain Laelias (2000–3000 m asl), which include the species  lamina) . The mor lamina) .Laelia aurea and L. rubescens species. They are similar in the following anatomical characters: epidermal papillae present in the abaxial epidermis of leaves, deep development of cuticular edges of the stoma, inconspicuous substomatal chamber, cellulosic cell wall in the abaxial hypodermis of leaves, presence of secondary thickenings in the mesophyll and hypodermis of the basal region of a stratum and air spaces present in the basal region of the leaf. Interesting morphological characters that can be highlighted for lowland orchids are: chartaceous leathery leaves and pseudobulbs with a discoid shape and more wrinkled, a leaf in each pseudobulb, an exclusively pubescent lip, a lip throat with a brown spot, scale-shaped floral bracts, and a stigmatic surface that is not hidden by the rostellum.At the other extreme are the orchids at low altitudinal distribution (500 m asl), which include Cattleya, in the case of C. mossiae, which is found at altitudes of 800 to 2000 meters asl, and for C. purpurata 500 meters asl, anatomical characters were identified that can be functional for distinguishing them from the genus Laelia, such as: stomatal index (>7), rough cuticle, oblong adaxial and abaxial epidermal cell shape. The morphological characters in both Cattleya species are leaves with proportions greater than 7.41 cm.Regarding the species of the analyzed genus Laelia in Mexico. The importance of the results obtained lies in the fact that the present research work shows that the Laelias of México share several structural attributes by which its species can be recognized as a taxonomic group.Here we present a study where anatomical and morphological characters were integrated to analyze the similarity relationships and the altitudinal distribution present in the species of the genus Previous studies mention the relevance of the taxonomic relationships that exist between some species of the Laeliinae Subtribe based on their vegetative and floral morphology . Stern aLaelia in México, which inhabit more xeric environments, have thicker cuticles as a mechanism of tolerance to drought, as has been reported for other orchid species belonging to xeromorphic environments [This work is the first contribution on the relationship that exists between the thickness of the cuticle and the environment in the Mexican Laelias species. Particularly the species of the genus ronments .L. eyermaniana, L. rubescens and L. superbiens have elongated polygonal cells, and adaxial and abaxial epidermal cells are distributed alternately. In species such as L. gouldiana, L. rubescens and L. halbingeriana, the distribution is in rows.In general, for the species of the Laeliinae subtribe, the shape of the cells in the epidermis is polygonal isodiametric, and their distribution is in rows . In the Laelia from other species. For example, in the case of Cattleya purpurata, the area of the adaxial epidermal cells is >5000 µm2. In Mexican Laelias, the adaxial epidermal cell area is <5000 µm2, while abaxial cell area is 801 to 1400 µm2, except for L. aurea, where it is 600 to 800 µm2. The area of the abaxial epidermal cells in both species of the genus Cattleya is smaller than in all the Mexican Laelias species with a value of 600 to 800 µm2.One of the characters that is not considered in previous studies but quantitatively analyzed in our study was the area of the abaxial and adaxial epidermal cells. In the Mexican Laelias, it was found that the area of the epidermal cells is a character that helps differentiate the Mexican species of the genus L. superbiens being the species in this study with the greatest thickness. Furthermore, the type of mesophyll is also heterogeneous, except for L. autumnalis, L. gouldiana, L. rubescens and L. superbiens, where it is homogeneous.For the Mexican Laelias species, the thickness of the mesophyll was quantitatively measured, and it was found to range from 500 to 2500 µm, with Laelia aurea and L. rubescens are naturally exposed to a water deficit and are the only species with cells with secondary thickenings in the mesophyll. Baker reports the presence of secondary thickenings in the mesophyll as a common character in several species within the Laeliinae subtribe [Laelia, since only two species display them; nevertheless, they were also found in the species of Broughtonia and Cattleya, confirming its presence in several species within the Laeliinae subtribe [subtribe . Pridgeosubtribe ,16. It hsubtribe . It is wsubtribe .L. crawshayana, L. halbingeriana and L. superbiens, which have three types, and species from more xeric environments such as L. rubescens that have up to five types of vascular bundles. There are two vascular bundle strata in the lamina, except for L. eyermaniana and L. superbiens with one stratum and L. rubescens with three strata. Throughout the lamina there are 30 to 90 vascular bundles, except in L. superbiens, which has more than 90 vascular bundles.Regarding vascular tissue, it has been reported that vascular bundles confer efficient water transport to the plant, necessary to respond to short periods of water availability . The MexL. rubescens, which has oblong-elliptical leaves up to 18 cm long and 4 cm wide [L. rubescens that inhabits lowlands and has a high tolerance to drought [Laelia species that live in the high mountains have fewer vascular bundles, more elongated and narrower leaves, as well as a less thick mesophyll in contrast to the low-altitude Mexican Laelias.It is noteworthy that in this work it was found that species from more xeric environments have a greater number of vascular bundles in the mesophyll, have shorter leaves and are wider. Such is the case of  cm wide . In addi drought , exhibitLaelia albida, L. anceps, L. aurea, L. autumnalis and L. eyermaniana. The shape of these crystals is raphides and druse crystals; however, they are scarce, and their location is in the center of the mesophyll . These preparations belong to the collection of the Research Support Laboratory of the IB-UNAM Botanical Garden and were collected by the AMO Herbarium located in Mexico City. Measurements of the anatomical parameters were obtained with the Image-J program. We selected characters important for identification of the subtribe Laeliinae [The anatomical characters  were anaaeliinae . Regardiaeliinae .The morphological characters include vegetative traits related to rhizomes, pseudobulbs, leaf, plus reproductive characters such as arrangement of inflorescence, flowers, floral bracts, the season of flowering, the column, ovary, petals, pollinia, viscidium and rostellum , based oThe foliar anatomy of the Laelias from Mexico was described, including the qualitative and quantitative characters of the demic, fundamental and vascular tissues. Likewise, we presented the evaluation of quantitative anatomical characters of the group.The values corresponding to the mean, standard deviation, and the values (minimum and maximum) of the 11 quantitative anatomical characters of the species in this work were obtained. A matrix was made with these 11 continuous quantitative anatomical characters, each with 30 repetitions  for eachDescriptive statistics were performed for the 11 continuous quantitative anatomical characters. Subsequently, a test of normality (Shapiro–Wilk) and homoscedasticity of the variances (Levene’s test) were performed. A one-way analysis of variance (ANOVA) was applied to each character with 15 species as levels. These analyses and box plots for each character were prepared with R-Studio 3.6.2 .In total, 107 morphological and anatomical characters were examined. The data matrix was elaborated from these structural characters to know the similarity relationships between the taxa from a cluster analysis. The character states of the quantitative anatomical characters were coded from a post hoc analysis with Dunnett’s test. The cluster analysis was developed with the total of the structural characters from the NTSYS-PC program (v.2.1), for which a mixed data matrix was generated including the quantitative characters and the qualitative characters encoded as binary or multistate. On other hand, a similarity matrix, obtained through the taxonomic distance coefficient and the average linkage (UPGMA), was used as the grouping algorithm of the NTSYS-PC program (v.2.1).