Abstract Camel production plays a crucial role in supporting the livelihoods and food security of pastoral and agro-pastoral communities across Ethiopia, Kenya, Somalia, and Djibouti in the Horn of Africa. This review systematically synthesizes peer-reviewed studies and regional reports published between 2000 and 2026, identified through structured database searches and screened using defined inclusion criteria, to evaluate camel milk production systems, traditional utilization, physicochemical and nutritional quality, safety, and value chain dynamics across the region. Camel milk is widely consumed raw or fermented and serves as a key dietary resource. Traditional practices across the region involve spontaneous fermentation for product formation, the production of sour milk products and camel milk tea, and the incorporation of camel milk into various local dishes; however, systematic documentation of these practices remains limited. Compared with bovine and caprine milk, camel milk generally contains lower fat and lactose levels, higher vitamin C and mineral concentrations, and distinct protein characteristics, including lower κ-casein content and the absence of β-lactoglobulin, which influence digestibility and processing properties. Reported fat content ranges from approximately 2.5 to 4.5% and protein from 2.5 to 3.9%, while vitamin C levels substantially exceed those of bovine milk. These features confer nutritional advantages but also create technological challenges, such as weak coagulation and extended fermentation time. Despite increasing urban and cross-border demand, the sector remains constrained by feed shortages, limited veterinary services, inadequate processing facilities, informal marketing systems, and hygiene limitations that contribute to microbial contamination. Key gaps include a lack of harmonized quality standards, limited comparative data on milk composition and microbiological safety, weak cold-chain infrastructure, and poor value-chain coordination. Strengthened hygiene, standardized quality protocols, improved processing and cold-chain systems, and coordinated institutional support are essential to enhance commercialization, safety, and regional integration.
BACKGROUND:Shorter courses of primaquine and single-dose tafenoquine have potential to improve the prevention of recurrent Plasmodium vivax infections, but there are few data on their comparative effectiveness when provided unsupervised. We aimed to assess the effectiveness and safety of these new treatment options. METHODS:We conducted a multicentre, open-label, randomised, controlled, superiority trial in Ethiopia, Pakistan, Indonesia, and Cambodia. Adult patients (aged ≥18 years, or aged ≥16 years in Indonesia) with uncomplicated P vivax infection and glucose-6-phosphate dehydrogenase (G6PD) activity of 70% or greater were eligible for enrolment. Patients were treated with blood schizonticidal drugs (chloroquine in Ethiopia and Pakistan, dihydroartemisinin-piperaquine in Indonesia, and artesunate-pyronaridine in Cambodia) and randomly assigned (1:1:1) by an independent statistician using randomly permuted blocks of varying sizes to receive 7 days of unsupervised high-dose primaquine (total dose 7 mg/kg), single-dose tafenoquine (300 mg), or 14 days of low-dose primaquine (total dose 3·5 mg/kg). Randomisation was stratified by site. The primary endpoint, assessed in the modified intention-to-treat population (ie, patients who received allocated treatment, and were not lost to follow-up before day 15), was the cumulative incidence of any P vivax parasitaemia within 6 months compared between the primaquine groups, with the comparison of cumulative incidence between the tafenoquine group and the 14-day low-dose primaquine group a secondary endpoint. Key safety outcomes included the numbers of adverse and serious adverse events, including the number of gastrointestinal symptoms as well as the risk of anaemia. Safety outcomes were assessed in all patients who received any doses of study drug. The study is registered at ClinicalTrials.gov, NCT04411836, and is complete. FINDINGS:Between April 25, 2021 and Sept 13, 2024, 4850 patients were screened for eligibility, of whom 960 patients (672 [70·0%] were male and 288 [30·0%] were female) were enrolled and randomly assigned (320 patients per group). The modified intention-to-treat population of 295 patients allocated to the 7-day high-dose primaquine group, 305 patients allocated to the tafenoquine group, and 301 patients allocated to the 14-day low-dose primaquine group were considered at risk of P vivax recurrence from day 15 onwards. The cumulative incidence of P vivax recurrence at 6 months was 13·0% (97·55% CI 9·0-18·5) in the 7-day high-dose primaquine group and 18·5% (13·8-24·6) in the 14-day low-dose primaquine group (hazard ratio [HR] 0·66 [97·55% CI 0·40-1·09], p=0·063). The corresponding incidence in the tafenoquine group was 12·6% (97·55% CI 8·8-18·0), with an HR of 0·64 (97·55% CI 0·39-1·05, p=0·041) compared with the 14-day low-dose primaquine group. Of the adverse events occurring before day 42, 24 (42·9%) of 56 were considered drug related in the 7-day high-dose primaquine group, compared with 16 (22·2%) of 72 in the tafenoquine group and 13 (34·2%) of 38 in the 14-day low-dose primaquine group. Four serious adverse events occurred, of which two (gastrointestinal symptoms in two patients in the 7-day high-dose primaquine group) were considered probably related to study drug. One study drug unrelated death occurred in the 14-day low-dose primaquine group. INTERPRETATION:Both unsupervised 7-day high-dose primaquine and single-dose tafenoquine were well tolerated in patients with normal G6PD activity and they had a lower risk of P vivax recurrence compared with those in the 14-day low-dose primaquine group, albeit with uncertain magnitude. Our findings support the effectiveness and operational feasibility of shorter radical cure regimens across diverse malaria-endemic settings. FUNDING:National Health and Medical Research Council of Australia and Bill and Melinda Gates Foundation.
BACKGROUND:Extended-spectrum β-Lactamase and Carbapenemase-producing Enterobacterales cause severe infections and currently, they are spreading beyond hospitals and becoming a serious global health concern. They often colonize the gut silently, facilitating the transmission of resistant bacteria between patients and family members. OBJECTIVE:We sought investigate the prevalence and molecular characteristics of Extended-spectrum β-Lactamases-producing Enterobacterales (ESBL-PE), Carbapenem-resistant Enterobacterales (CRE), and factors associated there in among admitted adult patients and their family members at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS:A case-control study was conducted among 100 patients and their respective 100 family members from February 2023 to October 2023. Stool specimens were collected and processed using standard microbiological techniques. Antimicrobial susceptibility testing and ESBL production were determined using VITEK 2 system. Carbapenemase production was tested using modified carbapenem Inactivation method, and detection of resistance genes was performed by PCR. RESULT:Intestinal colonization with ESBL-PE was higher in patients (39.0%) than their respective family members (24.0%) (P = 0.028). Among patients, ESBL production was common in E. coli, 40.3% and K. pneumoniae, 34.7% than their family members 24.2% and 22.2%, respectively. Of the ESBL-PE isolates, 84.6% from patients and 100% from family members carried at least one ESBL encoding gene, with blaCTX-M being the predominant. Colonization with CRE and Carbapenemase-Producing Carbapenem-Resistant Enterobacterales was found to be 19.0% and 10.0%, respectively. These were identified only among patients, with blaNDM and blaOXA-48 are the most prevalent genes. Older age (>53 years) (P = 0.02) and previous ICU admission (P < 0.001) showed significant association with ESBL-PE colonization. CONCLUSION:ESBL-PE colonization was more prevalent in patients compared to their family members, with blaCTX-M identified as the most common gene. Exclusive detection of carbapenemase genes among patients, and the association of previous ICU admission with ESBL-PE colonization, highlights the need for targeted screening and strengthened infection prevention.
Uropathogenic Enterobacteriaceae with multidrug resistance (MDR) have become a significant threat to global healthcare systems in the treatment of urinary tract infections (UTIs). This present study aimed to evaluate the prevalence of MDR and Extended-Spectrum Beta-Lactamases (ESBL)-producing Enterobacteriaceae among patients suspected of having UTIs in the Southwest Shewa Zone of Ethiopia. A hospital-based cross-sectional study was conducted from January to March 2025. Midstream urine specimens were collected from 278 consecutive patients with urinary tract complaints, along with gathering comprehensive sociodemographic data. Enterobacteriaceae were isolated and identified using Gram staining and biochemical characteristics. Antibiotic susceptibility was determined using the Kirby-Bauer method on Mueller-Hinton agar. Logistic regression analysis was employed to identify factors linked to MDR-Enterobacteriaceae-related UTIs, considering a statistically significant P value of < 0.05. Among the 278 enrolled patients, Enterobacteriaceae were recovered from 16.9
Rapid and accurate detection of Salmonella is essential for improving food safety and reducing the burden of enteric infections, especially in low-resource settings. Aptamer-based diagnostic platforms offer a promising alternative to antibody-based methods, given their high specificity, stability, and low production cost. A DNA aptamer targeting Salmonella enterica was developed through Systematic Evolution of Ligands by Exponential Enrichment (SELEX) iterative rounds of selection. Target-binding efficiency was monitored by colorimetric and spectrophotometric binding tests. Silver nanoparticles (AgNPs) were synthesized and conjugated with candidate aptamers through direct adsorption. Dot blot colorimetric assays were performed by exposing aptamer-AgNP complexes to serial dilutions of Salmonella cultures ranging from 10² to 10⁸ CFU/mL. Aggregation was evaluated visually on nitrocellulose membranes and quantified by a UV-Vis spectrophotometer based on absorbance intensity and peak wavelength shifts. Controls included AgNPs alone and related non-target bacterial (Escherichia coli). Final aptamer pools were sequenced using Nextseq 550 Illumina platform to determine specific sequences and predict candidate secondary structures for future mass production. Aptamer selection showed progressive enrichment, with significant dot blot signal and aggregation from round 8, and strong binding after 12 rounds of SELEX. Upon exposure to Salmonella, aptamer-AgNP complexes exhibited a concentration-dependent aggregation response, with visual detection observed at bacterial concentrations of 105 CFU/mL and selective binding toward Salmonella compared to E. coli and spectrophotometrically quantifiable from 10⁵ CFU/mL. Peak absorbance increased from 0.31 AU for 10² CFU/mL target concentration to 1.73 AU with 10⁸ CFU/mL, and the wavelength shifted from 504 nm to 525 nm, indicating nanoparticle aggregation. No specific aggregation or spectral shifts were observed in control samples. The enriched aptamer candidates were identified and prioritized, exhibiting conserved secondary structures, including hairpins, multi-branched loops, and internal bulges, predicting to facilitate specific interactions with Salmonella outer membrane proteins or LPS-O antigen. This study demonstrates the diagnostic applicability of aptamer conjugated with AgNP colorimetric assays for sensitive and specific detection of Salmonella. Future work should focus on sequence-based chemical modifications to enhance aptamer immobilization and assay performance, thereby facilitating adaptation of the platform to lateral flow formats during mass production for point-of-care applications. IMPORTANCE:This study addresses a critical need for rapid, low-cost, and sensitive diagnostic tools for Salmonella detection, particularly in low-resource settings where conventional methods are often inaccessible or time-consuming. By developing an aptamer-based colorimetric assay using silver nanoparticles, the research offers a highly specific, sensitive, and affordable alternative to existing diagnostics. The use of DNA aptamers selected through Systematic Evolution of Ligands by Exponential Enrichment enables precise recognition of Salmonella surface markers, while the colorimetric readout allows for easy visual detection without the need for sophisticated instruments. The assay's sensitivity demonstrates its practical utility for early and field-level pathogen detection. Importantly, the incorporation of next-generation sequencing in aptamer characterization enhances the molecular understanding of aptamer-target interactions and supports future assay refinement for application in lateral flow assay. The findings support translating the platform into point-of-care formats, which help food safety monitoring and infectious disease control in developing regions.
