Tick-borne diseases at the crossroads of the Middle East and central Europe
Bibliographic record
Abstract
OBJECTIVES: The Balkan Peninsula, acting as a crossroad between central Europe and the Middle East, presents diverse ecosystems supporting various tick species capable of transmitting TBDs. This study focuses on Serbia and North Macedonia, both endemic for TBDs, aiming to investigate human-biting ticks' prevalence, TBD prevalence, and major TBPs in blood samples. PATIENTS AND METHODS: This prospective observational study was conducted in 2022 at two medical centers, involving 45 patients from Novi Sad, Serbia, and 17 patients from Skopje, North Macedonia. All participants had either a tick still attached or had had one removed within the preceding 48 h. The study consisted in clinical evaluations of patients and testing of patient samples and ticks for tick-borne pathogens using a High-Throughput pathogen detection system based on microfluidic real-time PCR. In addition, the study assessed the genetic diversity of the identified pathogens. RESULTS: Ixodes ricinus was the most prevalent tick species, with varying infestation rates across various body parts. Tick species and feeding times differed between Novi Sad and Skopje. TBPs were prevalent, with Rickettsia spp. dominant in Skopje and a mix including Rickettsia aeschlimannii, Rickettsia monacensis, Anaplasma phagocytophilum, and Borrelia afzelii in Novi Sad. Subclinical bacteremia occurred in 8.06% of cases, mostly involving Anaplasma spp. Clinical manifestations, primarily local hypersensitivity reactions, were observed in six patients. Phylogenetic analysis confirmed R. aeschlimannii and R. monacensis identity, highlighting genetic differences in gltA gene sequences. CONCLUSIONS: This study sheds light on the prevalence and diversity of TBPs in tick-infested individuals from Serbia and North Macedonia, contributing valuable insights into the epidemiology of TBDs in the Balkan region.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".