{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:54:02Z","timestamp":1790704442673,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI137395"],"award-info":[{"award-number":["R01AI137395"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21AI152260"],"award-info":[{"award-number":["R21AI152260"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AI134990"],"award-info":[{"award-number":["K24AI134990"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Asymptomatic malaria carriers often harbor low parasite densities missed by rapid diagnostic tests (RDTs), yet they contribute to transmission. Direct skin feeding (DSF) assays can sensitively measure their infectiousness to mosquitoes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To characterize human-to-mosquito transmission from the asymptomatic reservoir in Bagamoyo, Tanzania, DSFs were performed in persons &amp;gt;5 years of age positive for Plasmodium falciparum by RDT or real-time PCR. Fifty colony-reared Anopheles gambiae were fed on the posterior calves. Successful mosquito infection was defined as \u22651 oocyst-positive mosquito midgut among 25 dissected eight days postskin feeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 491 participants with median parasite density of 5.1\u2005parasites\/\u03bcL who underwent DSF, 22% were infectious to mosquitoes. RDT-positive participants infected roughly twice as many mosquitoes compared to RDT-negative\/PCR-positive persons. However, up to 21% of infectious carriers were PCR-negative at the time of skin feeding, after screening PCR-positive a few days earlier. Overall, 9.1% (342\/3741) of mosquitoes fed on infectious carriers were parasite-positive at dissection. Half of infectious individuals infected a single mosquito, while the top 16 transmitters (3% of those undergoing DSF) cumulatively infected 57% of infected mosquitoes. RDT-positive school-age children (6\u201315\u2005years), 27% of the DSF cohort, contributed to 58% of infected mosquitoes. Unexpectedly, mosquito midguts from 39 DSFs (44% of oocyst-positive feeds analyzed) tested positive for Plasmodium ovale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parasites circulating at the limit of PCR detection commonly infect mosquitoes. However, a small proportion of highly infectious carriers contribute disproportionately to transmission, offering potential for targeted interventions. P. ovale was frequently co-transmitted with P. falciparum to mosquitoes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf634","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:15:29Z","timestamp":1765458929000},"page":"924-933","source":"Crossref","is-referenced-by-count":1,"title":["Uneven\n                    <i>Plasmodium falciparum<\/i>\n                    Transmission and Cryptic\n                    <i>ovale<\/i>\n                    Transmission From the Asymptomatic Reservoir in Bagamoyo, Tanzania"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4516-723X","authenticated-orcid":false,"given":"Jessica T","family":"Lin","sequence":"first","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]},{"name":"Department of Microbiology and Immunology, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick K","family":"Mathias","sequence":"additional","affiliation":[{"name":"Florida Medical Entomology Laboratory, Institute of Food and Agricultural Sciences, University of Florida , Vero Beach, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7361-1847","authenticated-orcid":false,"given":"Guozheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwajabu","family":"Loya","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith S","family":"Muller","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Basham","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Nyasembe","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kano","family":"Amagai","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaack","family":"Rutha","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7539-4562","authenticated-orcid":false,"given":"Claudia","family":"Gaither","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Immunology and Emerging Pathogens Institute, College of Veterinary Medicine, University of Florida , Gainesville, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwanaidi","family":"Nyange","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srijana B","family":"Chhetri","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Swinehart","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2638-1775","authenticated-orcid":false,"given":"Feng-Chang","family":"Lin","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhoel R","family":"Dinglasan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Immunology and Emerging Pathogens Institute, College of Veterinary Medicine, University of Florida , Gainesville, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-0850","authenticated-orcid":false,"given":"Jonathan J","family":"Juliano","sequence":"additional","affiliation":[{"name":"Institute of Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina ,","place":["USA"]},{"name":"Department of Infectious Diseases and Immunology and Emerging Pathogens Institute, College of Veterinary Medicine, University of Florida , Gainesville, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Tarimo","sequence":"additional","affiliation":[{"name":"Vector Immunity and Transmission Biology Unit, Department of Environmental Health and Ecological Sciences, Ifakara Health Institute-Bagamoyo Office , Bagamoyo ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billy","family":"Ngasala","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"key":"2026051419573219300_jiaf634-B1","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1016\/S1473-3099(21)00072-4","article-title":"Sources of persistent malaria transmission in a setting with effective malaria control in eastern Uganda: a longitudinal, observational cohort study","volume":"21","author":"Andolina","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2026051419573219300_jiaf634-B2","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/cid\/cix1123","article-title":"The relative contribution of symptomatic and asymptomatic Plasmodium vivax and Plasmodium falciparum infections to the infectious reservoir in a low-endemic setting in Ethiopia","volume":"66","author":"Tadesse","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2026051419573219300_jiaf634-B3","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1038\/s41467-021-21269-2","article-title":"Genotyping cognate Plasmodium falciparum in humans and mosquitoes to estimate onward transmission of asymptomatic infections","volume":"12","author":"Sumner","year":"2021","journal-title":"Nat Commun"},{"key":"2026051419573219300_jiaf634-B4","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1038\/s41467-021-22573-7","article-title":"Higher gametocyte production and mosquito infectivity in chronic compared to incident Plasmodium falciparum infections","volume":"12","author":"Barry","year":"2021","journal-title":"Nat Commun"},{"key":"2026051419573219300_jiaf634-B5","doi-asserted-by":"crossref","first-page":"7072","DOI":"10.1038\/s41598-023-33657-3","article-title":"Plasmodium falciparum gametocyte carriage in longitudinally monitored incident infections is associated with duration of infection and human host factors","volume":"13","author":"Andolina","year":"2023","journal-title":"Sci Rep"},{"key":"2026051419573219300_jiaf634-B6","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1093\/infdis\/jiac169","article-title":"Asymptomatic school-aged children are important drivers of malaria transmission in a high endemicity setting in Uganda","volume":"226","author":"Rek","year":"2022","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B7","doi-asserted-by":"crossref","first-page":"4626","DOI":"10.1038\/s41467-024-49080-9","article-title":"Plasmodium falciparum infection in humans and mosquitoes influence natural Anopheline biting behavior and transmission","volume":"15","author":"Markwalter","year":"2024","journal-title":"Nat Commun"},{"key":"2026051419573219300_jiaf634-B8","doi-asserted-by":"crossref","first-page":"5863","DOI":"10.1016\/j.vaccine.2016.10.027","article-title":"Utilizing direct skin feeding assays for development of vaccines that interrupt malaria transmission: a systematic review of methods and case study","volume":"34","author":"Brickley","year":"2016","journal-title":"Vaccine"},{"key":"2026051419573219300_jiaf634-B9","doi-asserted-by":"crossref","first-page":"e42821","DOI":"10.1371\/journal.pone.0042821","article-title":"Mosquito feeding assays to determine the infectiousness of naturally infected Plasmodium falciparum gametocyte carriers","volume":"7","author":"Bousema","year":"2012","journal-title":"PLoS One"},{"key":"2026051419573219300_jiaf634-B10","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/nature15535","article-title":"The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015","volume":"526","author":"Bhatt","year":"2015","journal-title":"Nature"},{"key":"2026051419573219300_jiaf634-B11","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1093\/infdis\/jiae276","article-title":"Micro-heterogeneity of transmission shapes submicroscopic malaria carriage in coastal Tanzania","volume":"230","author":"Rapp","year":"2024","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B12","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.4269\/ajtmh.20-1233","article-title":"Direct comparison of standard and ultrasensitive PCR for the detection of plasmodium falciparum from dried blood spots in Bagamoyo, Tanzania","volume":"104","author":"Markwalter","year":"2021","journal-title":"Am J Trop Med Hyg"},{"key":"2026051419573219300_jiaf634-B13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13071-022-05181-2","article-title":"Seasonality and transmissibility of Plasmodium ovale in Bagamoyo District, Tanzania","volume":"15","author":"Tarimo","year":"2022","journal-title":"Parasit Vectors"},{"key":"2026051419573219300_jiaf634-B14","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1093\/infdis\/jiaa478","article-title":"Under the radar: epidemiology of Plasmodium ovale in the Democratic Republic of the Congo","volume":"223","author":"Mitchell","year":"2021","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B15","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.3201\/eid2906.221016","article-title":"Similar prevalence of Plasmodium falciparum and non\u2013P. falciparum malaria infections among schoolchildren, Tanzania","volume":"29","author":"Sendor","year":"2023","journal-title":"Emerg Infect Dis"},{"key":"2026051419573219300_jiaf634-B16","doi-asserted-by":"crossref","first-page":"e76316","DOI":"10.1371\/journal.pone.0076316","article-title":"Strategies for detection of Plasmodium species gametocytes","volume":"8","author":"Wampfler","year":"2013","journal-title":"PLoS One"},{"key":"2026051419573219300_jiaf634-B17","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s12936-017-1863-3","article-title":"Multiplex, DNase-free one-step reverse transcription PCR for Plasmodium 18S rRNA and spliced gametocyte-specific mRNAs","volume":"16","author":"Hanron","year":"2017","journal-title":"Malar J"},{"key":"2026051419573219300_jiaf634-B18","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1093\/infdis\/jiz420","article-title":"qRT-PCR versus IFA-based quantification of male and female gametocytes in low-density Plasmodium falciparum infections and their relevance for transmission","volume":"221","author":"Gruenberg","year":"2020","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B19","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1186\/s12936-020-03291-9","article-title":"Assays for quantification of male and female gametocytes in human blood by qRT-PCR in the absence of pure sex-specific gametocyte standards","volume":"19","author":"Wang","year":"2020","journal-title":"Malar J"},{"key":"2026051419573219300_jiaf634-B20","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0166-6851(93)90077-B","article-title":"High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction","volume":"61","author":"Snounou","year":"1993","journal-title":"Mol Biochem Parasitol"},{"key":"2026051419573219300_jiaf634-B21","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/s12936-019-2922-8","article-title":"Is that a real oocyst? Insectary establishment and identification of Plasmodium falciparum oocysts in midguts of Anopheles mosquitoes fed on infected human blood in Tororo, Uganda","volume":"18","author":"Musiime","year":"2019","journal-title":"Malar J"},{"key":"2026051419573219300_jiaf634-B22","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/infdis\/jix237","article-title":"A molecular assay to quantify male and female Plasmodium falciparum gametocytes: results from 2 randomized controlled trials using primaquine for gametocyte clearance","volume":"216","author":"Stone","year":"2017","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B23","doi-asserted-by":"crossref","first-page":"e1001788","DOI":"10.1371\/journal.pmed.1001788","article-title":"Ultra-sensitive detection of Plasmodium falciparum by amplification of multi-copy subtelomeric targets","volume":"12","author":"Hofmann","year":"2015","journal-title":"PLoS Med"},{"key":"2026051419573219300_jiaf634-B24","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1038\/s41467-017-01270-4","article-title":"Examining the human infectious reservoir for Plasmodium falciparum malaria in areas of differing transmission intensity","volume":"8","author":"Gon\u00e7alves","year":"2017","journal-title":"Nat Commun"},{"key":"2026051419573219300_jiaf634-B25","doi-asserted-by":"crossref","first-page":"107010","DOI":"10.1016\/j.ijid.2024.107010","article-title":"Dynamics of asymptomatic Plasmodium falciparum and Plasmodium vivax infections and their infectiousness to mosquitoes in a low transmission setting of Ethiopia: a longitudinal observational study","volume":"143","author":"Hailemeskel","year":"2024","journal-title":"Int J Infect Dis"},{"key":"2026051419573219300_jiaf634-B26","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/s13071-023-05761-w","article-title":"Malaria rapid diagnostic tests reliably detect asymptomatic Plasmodium falciparum infections in school-aged children that are infectious to mosquitoes","volume":"16","author":"Hofer","year":"2023","journal-title":"Parasit Vectors"},{"key":"2026051419573219300_jiaf634-B27","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1093\/infdis\/jiz680","article-title":"Plasmodium falciparum gametocyte density and infectivity in peripheral blood and skin tissue of naturally infected parasite carriers in Burkina Faso","volume":"223","author":"Meibalan","year":"2021","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B28","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1186\/s12936-017-1978-6","article-title":"Do the venous blood samples replicate malaria parasite densities found in capillary blood? A field study performed in naturally-infected asymptomatic children in Cameroon","volume":"16","author":"Sandeu","year":"2017","journal-title":"Malar J"},{"key":"2026051419573219300_jiaf634-B29","doi-asserted-by":"crossref","first-page":"246","DOI":"10.3389\/fmicb.2020.00246","article-title":"Uptake of Plasmodium falciparum gametocytes during mosquito bloodmeal by direct and membrane feeding","volume":"11","author":"Talman","year":"2020","journal-title":"Front Microbiol"},{"key":"2026051419573219300_jiaf634-B30","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1186\/s12936-016-1538-5","article-title":"A computational lens for sexual-stage transmission, reproduction, fitness and kinetics in Plasmodium falciparum","volume":"15","author":"Lawniczak","year":"2016","journal-title":"Malar J"},{"key":"2026051419573219300_jiaf634-B31","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1093\/infdis\/jiaf498","article-title":"Seasonal variation and interspecies dynamics among Plasmodium falciparum and ovale species in Bagamoyo, Tanzania","volume":"233","author":"Carey-Ewend","year":"2026","journal-title":"J Infect Dis"},{"key":"2026051419573219300_jiaf634-B32","doi-asserted-by":"crossref","first-page":"e0007414","DOI":"10.1371\/journal.pntd.0007414","article-title":"Persistent transmission of Plasmodium malariae and Plasmodium ovale species in an area of declining Plasmodium falciparum transmission in eastern Tanzania","volume":"13","author":"Yman","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"key":"2026051419573219300_jiaf634-B33","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/0035-9203(52)90076-X","article-title":"A study of human malaria oocysts as an aid to species diagnosis","volume":"46","author":"Shute","year":"1952","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026051419573219300_jiaf634-B34","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12936-023-04541-2","article-title":"Genotyping of Anopheles mosquito blood meals reveals nonrandom human host selection: implications for human-to-mosquito Plasmodium falciparum transmission","volume":"22","author":"Mbewe","year":"2023","journal-title":"Malar J"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaf634\/65858442\/jiaf634.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/233\/5\/924\/65858442\/jiaf634.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/233\/5\/924\/65858442\/jiaf634.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:57:40Z","timestamp":1778803060000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/233\/5\/924\/8378431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,13]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,12,13]]},"published-print":{"date-parts":[[2026,5,15]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaf634","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,15]]},"published":{"date-parts":[[2025,12,13]]}}}