{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:13:31Z","timestamp":1782454411738,"version":"3.54.5"},"reference-count":73,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:p>The COVID-19 pandemic, caused by SARS-CoV-2, have surpassed 5 million cases globally. Current models suggest that low- and middle-income countries (LMICs) will have a similar incidence but substantially lower mortality rate than high-income countries. However, malaria and neglected tropical diseases (NTDs) are prevalent in LMICs, and coinfections are likely. Both malaria and parasitic NTDs can alter immunologic responses to other infectious agents. Malaria can induce a cytokine storm and pro-coagulant state similar to that seen in severe COVID-19. Consequently, coinfections with malaria parasites and SARS-CoV-2 could result in substantially worse outcomes than mono-infections with either pathogen, and could shift the age pattern of severe COVID-19 to younger age-groups. Enhancing surveillance platforms could provide signals that indicate whether malaria, NTDs, and COVID-19 are syndemics (synergistic epidemics). Based on the prevalence of malaria and NTDs in specific localities, efforts to characterize COVID-19 in LMICs could be expanded by adding testing for malaria and NTDs. Such additional testing would allow the determination of the rates of coinfection and comparison of severity of outcomes by infection status, greatly improving the understanding of the epidemiology of COVID-19 in LMICs and potentially helping to mitigate its impact.<\/jats:p>","DOI":"10.4269\/ajtmh.20-0516","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T07:01:05Z","timestamp":1591081265000},"source":"Crossref","is-referenced-by-count":51,"title":["Malaria and Parasitic Neglected Tropical Diseases: Potential Syndemics with COVID-19?"],"prefix":"10.4269","author":[{"given":"Julie R.","family":"Gutman","sequence":"first","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi W.","family":"Lucchi","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Cantey","sequence":"additional","affiliation":[{"name":"2Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Steinhardt","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Samuels","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L.","family":"Kamb","sequence":"additional","affiliation":[{"name":"2Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan K.","family":"Kapella","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"},{"name":"3U.S. President\u2019s Malaria Initiative, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"McElroy","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatachalam","family":"Udhayakumar","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A.","family":"Lindblade","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","volume-title":"WHO Coronavirus Situation Report- 130","year":"2020"},{"key":"b2","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/S1473-3099(15)00061-4","article-title":"Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities","volume":"15","author":"Plucinski","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"b3","volume-title":"The Potential Impact of Health Service Disruptions on the Burden of Malaria: A Modelling Analysis for Countries in Sub-Saharan Africa","year":"2020"},{"key":"b4","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults","volume":"109","author":"Ludvigsson","year":"2020","journal-title":"Acta Paediatr"},{"key":"b5","volume-title":"Report 12: The Global Impact of COVID-19 and Strategies for Mitigation and Suppression","author":"Walker","year":"2020"},{"key":"b6","volume-title":"World Population Prospects 2019, Custom Data Acquired via Website","year":"2019"},{"key":"b7","volume-title":"Introduction to Syndemics: A Critical Systems Approach to Public and Community Health","author":"Singer","year":"2009"},{"key":"b8","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/ijc.28378","article-title":"Sickle cell trait is not associated with endemic Burkitt lymphoma: an ethnicity and malaria endemicity-matched case-control study suggests factors controlling EBV may serve as a predictive biomarker for this pediatric cancer","volume":"134","author":"Mulama","year":"2014","journal-title":"Int J Cancer"},{"key":"b9","first-page":"123","article-title":"Malaria and HIV coinfection in sub-Saharan Africa: prevalence, impact, and treatment strategies","volume":"9","author":"Kwenti","year":"2018","journal-title":"Res Rep Trop Med"},{"key":"b10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ijid.2015.11.006","article-title":"Impacts of neglected tropical disease on incidence and progression of HIV\/AIDS, tuberculosis, and malaria: scientific links","volume":"42","author":"Simon","year":"2016","journal-title":"Int J Infect Dis"},{"key":"b11","doi-asserted-by":"crossref","first-page":"e0006902","DOI":"10.1371\/journal.pntd.0006902","article-title":"Schistosomiasis is associated with incident HIV transmission and death in Zambia","volume":"12","author":"Wall","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"b12","doi-asserted-by":"crossref","first-page":"441","DOI":"10.3389\/fphys.2014.00441","article-title":"Malarial pathocoenosis: beneficial and deleterious interactions between malaria and other human diseases","volume":"5","author":"Faure","year":"2014","journal-title":"Front Physiol"},{"key":"b13","volume-title":"World Malaria Report 2019","year":"2019"},{"key":"b14","volume-title":"Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030","year":"2020"},{"key":"b15","volume-title":"Parasites","year":"2020"},{"key":"b16","volume-title":"Symptoms of Coronavirus","year":"2020"},{"key":"b17","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"b18","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"b19","doi-asserted-by":"crossref","first-page":"458","DOI":"10.15585\/mmwr.mm6915e3","article-title":"Hospitalizaiton rates and characteristics of patients hospitalized with laboratory-confirmed conronavirus disease 2019 - COVID-NET, 14 states, March 1\u201330, 2020","volume":"69","author":"Garg","year":"2020","journal-title":"Morb Mortal Wkly Rep"},{"key":"b20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.ijid.2020.03.020","article-title":"Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)","volume":"94","author":"Nishiura","year":"2020","journal-title":"Int J Infect Dis"},{"key":"b21","doi-asserted-by":"crossref","first-page":"2000180","DOI":"10.2807\/1560-7917.ES.2020.25.10.2000180","article-title":"Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess Cruise ship, Yokohama, Japan, 2020","volume":"25","author":"Mizumoto","year":"2020","journal-title":"Euro Surveill"},{"key":"b22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.15585\/mmwr.mm6913e1","article-title":"Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility\u2013King County, Washington, March 2020","volume":"69","author":"Kimball","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"b23","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.jinf.2020.03.037","article-title":"The pathogenesis and treatment of the \u2018Cytokine Storm\u2019 in COVID-19","volume":"80","author":"Ye","year":"2020","journal-title":"J Infect"},{"key":"b24","doi-asserted-by":"crossref","first-page":"4288","DOI":"10.4049\/jimmunol.169.8.4288","article-title":"IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha","volume":"169","author":"Liao","year":"2020","journal-title":"J Immunol"},{"key":"b25","doi-asserted-by":"crossref","DOI":"10.1001\/jama.2020.4683","article-title":"Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy","author":"Onder","year":"2020","journal-title":"JAMA"},{"key":"b26","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa415","article-title":"Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission","author":"Lighter","year":"2020","journal-title":"Clin Infect Dis"},{"key":"b27","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ijid.2020.03.017","article-title":"Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis","volume":"94","author":"Yang","year":"2020","journal-title":"Int J Infect Dis"},{"key":"b28","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1080\/21505594.2019.1708053","article-title":"Setting the stage: the initial immune response to blood-stage parasites","volume":"11","author":"Bucsan","year":"2020","journal-title":"Virulence"},{"key":"b29","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1086\/314548","article-title":"A low interleukin-10 tumor necrosis factor-alpha ratio is associated with malaria anemia in children residing in a holoendemic malaria region in western Kenya","volume":"179","author":"Othoro","year":"1999","journal-title":"J Infect Dis"},{"key":"b30","first-page":"113","article-title":"Distinct patterns of cytokine regulation in discrete clinical forms of Plasmodium falciparum malaria","volume":"11","author":"Akanmori","year":"2000","journal-title":"Eur Cytokine Netw"},{"key":"b31","doi-asserted-by":"crossref","first-page":"e00301","DOI":"10.1128\/IAI.00301-18","article-title":"Malaria parasite-mediated alteration of macrophage function and increased iron availability predispose to disseminated nontyphoidal Salmonella infection","volume":"86","author":"Lokken","year":"2018","journal-title":"Infect Immun"},{"key":"b32","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1038\/mi.2014.18","article-title":"The mucosal inflammatory response to non-typhoidal Salmonella in the intestine is blunted by IL-10 during concurrent malaria parasite infection","volume":"7","author":"Mooney","year":"2014","journal-title":"Mucosal Immunol"},{"key":"b33","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1093\/infdis\/jis591","article-title":"Influenza and malaria coinfection among young children in western Kenya, 2009\u20132011","volume":"206","author":"Thompson","year":"2012","journal-title":"J Infect Dis"},{"key":"b34","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1128\/CVI.00051-15","article-title":"Coinfection with blood-stage Plasmodium promotes systemic type I interferon production during pneumovirus infection but impairs inflammation and viral control in the lung","volume":"22","author":"Edwards","year":"2015","journal-title":"Clin Vaccine Immunol"},{"key":"b35","doi-asserted-by":"crossref","DOI":"10.1080\/1744666X.2020.1750954","article-title":"Immune-epidemiological parameters of the novel coronavirus - a perspective","author":"Saghazadeh","year":"2020","journal-title":"Expert Rev Clin Immunol"},{"key":"b36","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1586\/eri.13.45","article-title":"The silent threat: asymptomatic parasitemia and malaria transmission","volume":"11","author":"Lindblade","year":"2013","journal-title":"Expert Rev Anti Infect Ther"},{"key":"b37","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1378\/chest.11-2655","article-title":"Respiratory manifestations of malaria","volume":"142","author":"Taylor","year":"2012","journal-title":"Chest"},{"key":"b38","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3390\/v12040372","article-title":"Virology, epidemiology, pathogenesis, and control of COVID-19","volume":"12","author":"Jin","year":"2020","journal-title":"Viruses"},{"key":"b39","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.pt.2013.04.006","article-title":"Pathogenesis of malaria-associated acute respiratory distress syndrome","volume":"29","author":"Van den Steen","year":"2013","journal-title":"Trends Parasitol"},{"key":"b40","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"b41","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.trstmh.2005.09.021","article-title":"Standardized data collection for multi-center clinical studies of severe malaria in African children: establishing the SMAC network","volume":"100","author":"Taylor","year":"2006","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"b42","first-page":"30029","article-title":"Hemoglobin value may be decreased in patients with severe coronavirus disease 2019","volume":"S2531\u20131379","author":"Lippi","year":"2020","journal-title":"Hematol Transfus Cell Ther"},{"key":"b43","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1055\/s-0037-1614014","article-title":"Procoagulant activity of endothelial cells after infection with respiratory viruses","volume":"84","author":"Visseren","year":"2000","journal-title":"Thromb Haemost"},{"key":"b44","doi-asserted-by":"crossref","first-page":"104362","DOI":"10.1016\/j.jcv.2020.104362","article-title":"Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past","volume":"127","author":"Giannis","year":"2020","journal-title":"J Clin Virol"},{"key":"b45","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/jth.14768","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost"},{"key":"b46","article-title":"Incidence of thrombotic complications in critically ill ICU patients with COVID-19","author":"Klok","year":"2020","journal-title":"Thromb Res"},{"key":"b47","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1056\/NEJMc2009787","article-title":"Large-vessel stroke as a presenting feature of COVID-19 in the young","volume":"382","author":"Oxley","year":"2020","journal-title":"N Engl J Med"},{"key":"b48","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med"},{"key":"b49","article-title":"Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans","author":"Fox","year":"2020","journal-title":"Lancet"},{"key":"b50","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.cca.2020.03.022","article-title":"Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis","volume":"506","author":"Lippi","year":"2020","journal-title":"Clinica Chim Acta"},{"key":"b51","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.thromres.2013.09.030","article-title":"Coagulopathy in malaria","volume":"133","author":"Angchaisuksiri","year":"2014","journal-title":"Thromb Res"},{"key":"b52","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0163-4453(03)00130-0","article-title":"Cerebral venous and dural sinus thrombosis in severe falciparum malaria","volume":"48","author":"Krishnan","year":"2004","journal-title":"J Infect"},{"key":"b53","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4103\/1596-3519.126952","article-title":"Severe falciparum malaria associated with massive pulmonary embolism","volume":"13","author":"Musoke","year":"2014","journal-title":"Ann Afr Med"},{"key":"b54","first-page":"86","article-title":"Hemostatic alterations in malaria","volume":"24","author":"Srichaikul","year":"1993","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"b55","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.autrev.2014.10.004","article-title":"The mechanisms behind helminth\u2019s immunomodulation in autoimmunity","volume":"14","author":"Bashi","year":"2015","journal-title":"Autoimmun Rev"},{"key":"b56","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jaci.2016.07.007","article-title":"Regulation of the host immune system by helminth parasites","volume":"138","author":"Maizels","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"b57","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1017\/S003118200001698X","article-title":"Concomitant infections, parasites and immune responses","volume":"122","author":"Cox","year":"2001","journal-title":"Parasitology"},{"key":"b58","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.ijpara.2010.05.003","article-title":"Polyparasitism and its impact on the immune system","volume":"40","author":"Supali","year":"2010","journal-title":"Int J Parasitol"},{"key":"b59","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0140-6736(17)31612-4","article-title":"Chagas disease","volume":"391","author":"Perez-Molina","year":"2018","journal-title":"Lancet"},{"key":"b60","doi-asserted-by":"crossref","first-page":"e0004566","DOI":"10.1371\/journal.pntd.0004566","article-title":"Complexities and perplexities: a critical appraisal of the evidence for soil-transmitted helminth infection-related morbidity","volume":"10","author":"Campbell","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"b61","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12916-018-1177-5","article-title":"Complex interactions between malaria and malnutrition: a systematic literature review","volume":"16","author":"Das","year":"2018","journal-title":"BMC Med"},{"key":"b62","doi-asserted-by":"crossref","first-page":"e0004523","DOI":"10.1371\/journal.pntd.0004523","article-title":"Nutritional enteric failure: neglected tropical diseases and childhood stunting","volume":"10","author":"Tickell","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"b63","first-page":"1575","article-title":"Prealbumin: a marker for nutritional evaluation","volume":"65","author":"Beck","year":"2002","journal-title":"Am Fam Physician"},{"key":"b64","doi-asserted-by":"crossref","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China","author":"Wu","year":"2020","journal-title":"JAMA Intern Med"},{"key":"b65","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.it.2016.04.003","article-title":"Immune dysfunction as a cause and consequence of malnutrition","volume":"37","author":"Bourke","year":"2016","journal-title":"Trends Immunol"},{"key":"b66","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1371\/journal.pmed.0040115","article-title":"Malnutrition and infection: complex mechanisms and global impacts","volume":"4","author":"Schaible","year":"2007","journal-title":"PLoS Med"},{"key":"b67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/001946468602300102","article-title":"The 1918\u20131919 influenza pandemic\u2013the Indian experience","volume":"23","author":"Mills","year":"1986","journal-title":"Indian Econ Soc Hist Rev"},{"key":"b68","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1750-2659.2010.00138.x","article-title":"Population-based surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009","volume":"4","author":"Reyes","year":"2010","journal-title":"Influenza Other Respir Viruses"},{"key":"b69","volume-title":"Sustainable Development Goals: Indicator 2.1.1 - Prevalence of Undernourishment","year":"2020"},{"key":"b70","volume-title":"Age-dependent Effects in the Transmission and Control of COVID-19 Epidemics. Supplementary Information","author":"Davies","year":"2020"},{"key":"b71","volume-title":"The First Few X Cases and Contacts (FFX) Investigation Protocol for Coronavirus Disease 2019 (COVID-19)","year":"2020"},{"key":"b72","volume-title":"Operational Considerations for COVID-19 Surveillance Using GISRS","year":"2020"},{"key":"b73","volume-title":"Red Book: 2018 Report of the Committee on Infectious Diseases","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.20-0516\/article-10.4269-ajtmh.20-0516.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/aop\/article-10.4269-ajtmh.20-0516\/article-10.4269-ajtmh.20-0516.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T16:03:04Z","timestamp":1623081784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/aop\/article-10.4269-ajtmh.20-0516\/article-10.4269-ajtmh.20-0516.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,1]]},"references-count":73,"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-0516","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,1]]}}}