Background: Fleas transmit a variety of zoonotic agents whose epidemiology and public health risk remains poorly understood in sub-Saharan Africa, including Uganda particularly outside plague-endemic areas. Common flea-borne zoonotic agents include Rickettsia felis and Yersinia pestis.. Objectives: The study aimed at detecting and characterising flea-borne pathogens in peridomestic environments in Uganda. Methods: We collected fleas from domestic animals, chickens, rodents, and homestead environments; pooled them by species, collection time, and host species. A total of 172 pools were analyzed for Y. pestis Pla gene. Further, 62 pools were tested for Rickettsia species gltA, ompA, and htrA genes by PCR and Sanger sequencing. Results: Five flea species were identified: C. canis, C. felis, Echidnophaga gallinacea, Pulex irritans, and X. cheopis. Genus, Ctenocephalides, accounted for 84.8% of fleas collected, mostly found on dogs and goats. The flea species were found across all districts, year-round, with higher numbers collected in dry seasons than rainy seasons. Rattus rattus constituted 74% of rodents captured from human dwellings and was the only rodent species with fleas, where X. cheopis was the predominant species. All 172 pools were negative for Y. pestis. Rickettsia spp. was detected in 29/62 (46.8%) pools by the target genes. Of 25 htrA amplicons sequenced, 4% were identified as R. felis from C. canis, 92% were R. asembonensis from multiple flea species, and 4% were identified as Candidatus Rickettsia senegalensis. Conclusion:The survey identified high pool detection rate of Rickettsia spp. in fleas,suggestingrisk of human exposure and infection. This was the first report of Rickettsia spp. in E. gallinacea and detection of Candidatus R. senegalensis in Uganda.
Background: Dengue fever (DF) is endemic in Pakistan, posing health risks. Recent flooding in 2022 and strong monsoon rains in 2024 have increased the possibility of an epidemic. It is an infectious disease having potentially severe outcomes including thrombocytopenia.Discussion: Carica Papaya Leaf Extract (CPLE) has emerged as an off-label treatment option, showing promising results in increasing platelet counts and reducing hospital stays. However, a critical assessment of existing research reveals methodological flaws, hindering specific recommendations.Conclusion: This perspective advocates for comprehensive research to evaluate the risks and benefits of CPLE as a potential remedy for thrombocytopenia associated with dengue fever. A robust investigation will inform clinical practice and guide healthcare decisions, contributing to improved patient outcomes in dengue-endemic areas.
Background: Brucellosis remains a significant public health concern, especially in regions like the Mediterranean and Afghanistan. While its direct health effects are well-documented, its impact on quality of life is less explored.Objective: This study investigated the risk factors and quality of life effects of brucellosis in Herat, Afghanistan.Methods: Between October 2020 and February 2021, 155 participants were enrolled at Herat Regional Hospital and affiliated brucellosis laboratories. The sample included 75 individuals with confirmed brucellosis and 80 controls without a history of the disease. Data were collected using structured questionnaires, and quality of life was assessed with the SF-36. Statistical analyses included chi-square tests, logistic regression, and General Linear Model.Results: Key risk factors associated with brucellosis included marriage, lower education, contact with pets, infected family members, and using non-protected water (p < 0.05). Logistic regression confirmed increased odds of infection linked to these exposures. Quality of life assessments revealed significantly lower SF-36 scores among male patients across most components, with similar trends observed in female patients.Conclusion: Brucellosis significantly impacts quality of life, particularly among men, and is strongly linked to specific risk factors. Public health measures are essential to reduce infection rates and improve well-being in this region.
Background Infectious disease agents pose significant threats to humans, wildlife, and livestock, with rodents carrying a third of these agents, many linked to human diseases. However, the range of pathogens in rodents and the hotspots for disease remain poorly understood.Aim This study evaluated the prevalence of viral, bacterial, and parasitic pathogens in Mastomys natalensis rodents in riverine and non-riverine areas in selected districts in Zambia.Methods The study applied metagenomic next generation sequencing (mNGS). Tissues analysed included semen, foetal tissues, and blood-rich organs (liver, spleen, kidneys, and lungs). A multivariate logistic regression model explored the relationship between pathogen presence and host or ecological factors.Results A total of 182 rodents were captured, and 14 pathogens were detected in 10.4% of the samples (19/182). Detected organisms included zoonoses (Klebsiella michiganensis, Klebsiella pneumoniae, Salmonella enterica, and Bartonella elizabethae); Emerging zoonoses (Elizabethkingia miricola, Klebsiella variicola, Bartonella tribocorum, and Cardiovirus B); among others (Eimeria papillata etc). Riverine areas showed higher odds of pathogen presence (OR = 8.45; p < 0.001; 95% CI: 3.07–23.26).Conclusion These results suggest that M. natalensis harbours multiple infectious agents with zoonotic potential, and riverine regions may be key hotspots for rodent-borne pathogens in Zambia.
This article investigates the escalating occurrence of zoonotic diseases in Africa, attributing their spread to climate change and human activities. Africa’s unique combination of biodiversity, reliance on animal husbandry, and swift urbanization heightens its susceptibility. Climate change disrupts ecosystems and animal habitats, intensifying human-wildlife interactions. Urbanization, inadequate sanitation, and insufficient healthcare infrastructure further facilitate disease spread. Climate-induced displacement adds another layer of complexity. Mitigation strategies include improving surveillance systems, fostering early detection via point-of-care diagnostics and digital contact tracing, and investing in vaccines and therapeutics. Our purpose of this is to advocate for sustainable land use, robust community-level public health systems, international cooperation, and resource-sharing. We also emphasize the need for effective vector-control policies, dedicated research funding, and annual awareness, vaccination, and early detection campaigns in endemic regions.
Background Hepatitis E Virus is a major cause of acute and fulminant hepatitis, particularly in developing countries. While the virus is commonly spread through the fecal-oral route, numerous cases of transfusion transmitted Hepatitis E Virus (TT-HEV) have been reported, raising concerns about its transmission via blood transfusions, especially in industrialized countries. The high prevalence of antibodies and viremia among asymptomatic blood donors further heightens the risk of transfusion-related transmission. However, there is still debate about the best strategy to minimize TT-HEV.Objective The review was conducted to Summarize the literature on TT-HEV infection cases and the prevalence of HEV among blood donors.Methods The databases PubMed, Scopus, Web of Science, Embase, and CINAHL were searched for relevant studies from 2000 to 2022.Serological and molecular screening data of HEV in blood donors were used to gather prevalence and incidence rates.TT-HEV cases were reviewed by examining evidence of HEV infection before and after transfusion.Results A total of 121 manuscripts reports the prevalence and incidence of HEV among blood donors and cases of TT-HEV. Twenty-six articles reported confirmed cases of TT-HEV and 101 articles reported on HEV prevalence or incidence among blood donors.Conclusion TT-HEV transmission through blood products is a real concern, especially for immunocompromised patients.The risk and severity of infection could vary between immunocompetent and immunosuppressed patients.To increase transfusion safety, the evaluation recommends HEV screening protocols, especially in endemic region.
Background: Cattle colonised by the zoonotic pathogen verotoxin-producing Escherichia coli of serotype O157 (VTEC O157) can shed high levels of the pathogen in their faeces. A suggested key for controlling VTEC O157 is preventing colonisation of individuals.Aim: In this study the role of individual super-shedders and factors related to susceptibility and environmental exposure in the transmission of VTEC O157 among dairy calves are explored.Methods: The association between sex, age, pen hygiene, pen type and stocking density and colonisation of individual calves, established by recto-anal mucosal swabs, on farms where pathogenic VTEC O157 had been confirmed was investigated. In a follow-up sampling, the consistency of previously identified risk factors and the role of shedding pen mates was assessed by studying the risk of new/re-colonisation.Results: The results suggest an important role of stocking density that decreases with age, possibly due to increased resistance to colonisation following exposure. However, previous colonisation did not influence the risk of being colonised in the second sampling. Super-shedders (shedding >103 colony forming units/g faeces) significantly increased the risk of colonisation in peers (OR = 10, CI 4.2–52). In addition, environmental factors associated with survival of the bacteria, affected risk.Conclusion: The results confirm the suggested importance of super-shedders but also emphasises the importance of considering the combined exposure from peers and the environment.
Background: In the Netherlands, living in proximity to goat farms has been consistently associated with an increased incidence of community-acquired pneumonia (CAP). The cause remains largely unknown though airborne microbial agents could play a role.Objective: The aim of this study is to explore micro-organisms present in goats that can cause human pneumonia.Methods: An extensive literature review was conducted to identify all micro-organisms detected in goats that are associated with human pneumonia. Additionally, the identified micro-organisms were prioritized using a self-developed scoring system and expert opinion.Results: Through extensive literature review, 4309 references describing 302 different micro-organisms in goats or on goat farms were identified. Additional searches and reviews for human respiratory disease caused by each of these micro-organisms yielded a final list of 76 bacteria, 7 viruses, 7 fungi, and 6 protozoa. They were assigned scores based on pneumonia type, diagnosis of respiratory disease, patient immune status, and evidence strength. Based on these scores, the most likely potential causal micro-organisms included Moraxella spp. Chlamydia psittaci, Staphylococcus aureus, and Streptococcus pneumoniae. Subsequently, the list of micro-organisms was reviewed by external experts on their perceived likelihood of the organism causing this CAP.Conclusion: Results of this literature study can give insight into the possible causes of pneumonia. Nonetheless, no unambiguous conclusion on the actual cause of the increased CAP risk around goat farms can be drawn solely based on these results.
Background: Onchocerciasis infection is one of the neglected tropical diseases targeted for eradication by 2030. The disease is usually transmitted to humans through the bites of black flies. These black flies mostly breed near well-oxygenated fast-running water bodies. The disease is common in mostly remote agricultural villages near rivers and streams. Objective: In this study, a deterministic model describing the infection dynamics of human onchocerciasis disease with control measures is presented. Methods: We derived the model's reproductive number and used a stability theorem of a Metzler matrix to show that disease-free equilibrium is both locally and globally asymptotically stable whenever the reproductive number is less than one. Parameter contribution was conducted using sensitivity analysis. The model endemic equation is shown to be a cubic polynomial in the presence of infected immigrants and a quadratic form in their absence. Results: When the inflow of infected immigrants is null, the model endemic equation may admit a unique equilibrium if the reproductive number is greater than one, or admits multiple endemic equilibria if the reproductive number is less than unity. We carried out a sensitivity analysis to identify the significant parameters that contribute to onchocerciasis spread. Conclusion: Onchocerciasis disease can be eradicated if the importation of infected immigrants is properly monitored. The integration of the One Health concept in the public health system is key in tackling the emergence and spread of diseases.
Background:The pathogenic Leptospira is maintained in renal tubules of certain animals, mostly rodents, and excreted in the urine which can contaminate the environment. It is necessary to detect pathogenic Leptospira in environmental samples. Knowing the survival of Leptospira in the environment (water and soil) can provide an overview of where and how they can be transmitted to humans.Objective:Therefore, this study aimed to provide a systematic overview of pathogenic Leptospira presence in water and soil environment, the various species of pathogenic Leptospira that are harmful for human, and the ability to survive using a systematic review method.Methods:The search process used four databases: PubMed, Science Direct, Scopus, and ProQuest. Furthermore, the articles sought were published from 2000 to July 2021, and 38 were analysed.Results:The pathogenic Leptospira contamination in water was higher in urban areas, while soil samples were higher in rural areas. Various pathogenic Leptospira detected in the environment were L. alstonii, L. kmetyi, L. noguchii, and L. interrogans. Those pathogenic Leptospira can survive in water at 4-30°C and at pH < 7; in soil, it can survive at a humidity of < 20% and a pH < 6.Conclusion:Urban and rural areas have the same risk for leptospirosis disease because pathogenic Leptospira (P1).
Background: The interdisciplinary One Health (OH) approach recognizes that human, animal, and environmental health are all interconnected. Its ultimate goal is to promote optimal health for all through the exploration of these relationships. Antibiotic resistance (AR) is a public health challenge that has been primarily addressed within the context of human health and clinical settings. However, it has become increasingly evident that antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) that confer resistance are transmitted and circulated within humans, animals, and the environment. Therefore, to effectively address this issue, antibiotic resistance must also be considered an environmental and livestock/wildlife problem. Objective: This review was carried out to provide a broad overview of the existence of ARB and ARGs in One Health settings. Methods: Relevant studies that placed emphasis on ARB and ARGs were reviewed and key findings were accessed that illustrate the importance of One Health as a measure to tackle growing public and environmental threats. Results: In this review, we delve into the complex interplay of the three components of OH in relation to ARB and ARGs. Antibiotics used in animal husbandry and plants to promote growth, treat, and prevent infectious diseases lead to the development of antibiotic-resistant bacteria in animals. These bacteria are transmitted from animals to humans through food and environmental exposure. The environment plays a critical role in the circulation and persistence of antibiotic-resistant bacteria and genes, posing a significant threat to human and animal health. This article also highlights how ARGs are spread in the environment through the transfer of genetic material between bacteria. This transfer can occur naturally or through human activities such as the use of antibiotics in agriculture and waste management practices. Conclusion: It is important to integrate the One Health approach into the public health system to effectively tackle the emergence and spread of ARB and genes that code for resistance to different antibiotics.
ABSTRACTIntroduction: The use of steroids has been proposed as a pharmacological approach to treat the SARS-CoV-2 infection to improve outcomes. However, there are doubts about safety against the development of superinfections and their worse outcomes.Objective: To establish the relative frequency of superinfection associated with using steroids in patients with SARS-CoV-2 infection.Materials and methods: We conducted a systematic literature review and meta-analysis using PRISMA standards in 5 databases (PubMed/Scopus/Cochrane/EMBASE/Google Scholar). The search was carried out between February 2020 and May 2023. The search terms were ‘steroids’ or ‘superinfection’ ‘and’ followed by ‘SARS-CoV-2’ or ‘COVID-19’.Results: We found 77 studies, but only 10 with 3539 patients were included in the systematic review. All patients developed severe disease. The documented OR for superinfection through the meta-analysis was 1.437 (95% IC 0.869–2.378) with a p-value of 0.158 without showing a risk attributed to steroids and the development of superinfections. In the Funnel-plot analysis, no publication biases were found.Conclusion: No relationship was found between using steroids and superinfection in patients with SARS-CoV-2.
Introduction: Despite global evidence of chikungunya fever (CHIKF) in humans that is caused by chikungunya virus (CHIKV), little is known about the occurrence of CHIKF in Malawi. This study was conducted to determine the seroprevalence of CHIKF and to molecularly confirm the presence of CHIKV ribonucleic acid (RNA) among febrile outpatients seeking health care at Mzuzu Central Hospital in the Northern Region of Malawi. Methods: Enzyme-immunosorbent assay (ELISA) was used to detect the presence or absence of specific antibodies against CHIKV. Reversetranscription polymerase chain reaction (RT-PCR) was conducted on randomly selected anti-CHIKV IgM-positive samples to detect CHIKV RNA. Results: Out of 119 CHIKF suspected samples analyzed, 73 tested positive for anti-CHIKV IgM antibodies, with an overall seroprevalence of 61.3%. Most of the CHIKV infected individuals presented with joint pain, abdominal pain, vomiting and nose bleeding with seroprevalence of 45.2%, 41.1%, 16.4% and 12.3%, respectively. All the randomly selected samples that were positive for CHIKV anti-IgM by ELISAhad detectable CHIKV RNA by RT-PCR. Conclusion: The presence of anti-CHIKV IgM antibodies suggests the presence of recent CHIKV infection. We therefore recommend for the inclusion of CHIKF as the differential diagnosis in febrile ill patients in Mzuzu city, Malawi.
Arthropod-borne (arbo) viruses cause emerging diseases that affect the livelihoods of people around the world. They are linked to disease outbreaks resulting in high morbidity, mortality, and economic loss. In sub-Saharan Africa, numerous arbovirus outbreaks have been documented, but the circulation and magnitude of illness caused by these viruses during inter-epidemic periods remains unknown in many regions. In Rwanda, there is limited knowledge on the presence and distribution of arboviruses. This study aimed at determining the occurrence and distribution of selected arboviruses, i.e., chikungunya virus (CHIKV), o'nyong-nyong virus (ONNV), dengue virus (DENV), West Nile virus (WNV), Zika virus (ZIKV), Rift Valley fever virus (RVFV) and Crimean-Congo haemorrhagic fever virus (CCHFV), among febrile patients visiting health centres in Rwanda. A total of 2294 dry blood spots (DBS) were collected on filter papers during August 2019 - December 2020. Reverse-transcription polymerase chain reaction (RT-PCR) was performed on samples in pools of ten, using both quantitative (DENV, ZIKV, RVFV) and conventional PCR (CHIKV, ONNV, WNV, CCHFV) with virus specific primers, followed by sequencing. Demographic data and clinical manifestations of illness were analysed. ONNV infection was detected in 12 of 230 pools (5.2%) and ZIKV in three pools (1.3%). The other arboviruses were not detected. All ONNV cases were found in the Rwaniro health centre, while ZIKV infection was found among patients visiting the Kirinda and Zaza health centres. There was temporal variability in ONNV infections with most cases being recorded during the long dry season, while ZIKV infection occurred during both dry and wet seasons. Patients with ONNV were older and more were females. In conclusion, ONNV and ZIKV infection were detected in acute patients and can explain some of the feverish diseases in Rwanda.
Background: Changes in oral and hand hygiene behaviors have been reported during the COVID-19 pandemic in 2020 which may be associated with the incidence of the norovirus infection, a common cause of gastroenteritis. Objective: To estimate the trends of detection rates of norovirus gastroenteritis and associated factors before COVID-19 in 2015-2019 and during the COVID-19 in 2020 in Guangxi, China. Methods: A secondary analysis of Guangxi surveillance data of gastroenteritis patients was conducted. The detection rate in 2020 was predicted using an autoregressive integrated moving average modeland associated factors were analyzed using multiple logistic regression adjusted for interaction effects. Results: Of 7,903 gastroenteritis patients, the overall detection rate of norovirus gastroenteritis was 12.8%, (14.3% before and 6.1% during COVID-19). Detection rates gradually decreased from 2015 to 2020, of which the slope of predicted line was slightly flatter than the actual line. The odds ratios of detection were double to triple increase during COVID-19 in the younger age group and having food intake outside their homes. Tourist city, season, and types of food were independent associated factors. Conclusion: The detection rates were higher during the COVID-19 year among the population aged 45 years or less and those who consumed food outside their home.
During the pandemic outdoor activities were encouraged to mitigate transmission risk while providing safe spaces for social interactions. Human behaviour, which may favour or disfavour, contact rates between questing ticks and humans, is a key factor impacting tick-borne encephalitis (TBE) incidence. We analyzed annual and weekly TBE cases in Finland, Norway and Sweden from 2010 to 2021 to assess trend, seasonality, and discuss changes in human tick exposure imposed by COVID-19. We compared the pre-pandemic incidence (2010-2019) with the pandemic incidence (2020-2021) by fitting a generalized linear model (GLM) to incidence data. Pre-pandemic incidence was 1.0, 0.29 and 2.8 for Finland, Norway and Sweden, respectively, compared to incidence of 2.2, 1.0 and 3.9 during the pandemic years. However, there was an increasing trend for all countries across the whole study period. Therefore, we predicted the number of cases in 2020/2021 based on a model fitted to the annual cases in 2010-2019. The incidences during the pandemic were 1.3 times higher for Finland, 1.7 times higher for Norway and no difference for Sweden. When social restrictions were enforced to curb the spread of SARS-CoV-2 there were profound changes in outdoor recreational behavior. Future consideration of public health interventions that promote outdoor activities may increase exposure to vector-borne diseases.
This study aimed to evaluate the effect of COVID-19 outbreak on stroke admission by using a national database. A quasi-experimental, ecological study using the national database of Thailand was conducted. The study period was between January 2017 and August 2020 before and after COVID-19 outbreak starting from March 2020. Numbers of stroke admission were evaluated before and after the COVID-19 outbreak by an interrupted time series analysis for both pre- and post-COIVD-19 outbreak. There were 381,891 patients admitted throughout Thailand. Of those, 292,382 patients (76.56%) were admitted due to thrombotic stroke followed by hemorrhagic stroke (73,130 patients; 19.15%) and embolic stroke (16,379 patients; 4.29%). During pre-COVID-19 outbreak, all stroke subtypes had an increasing trend with a coefficient of 0.076 (p value < 0.001) for thrombotic stroke, 0.003 (p value < 0.001) for embolic stroke and 0.012 (p value = 0.025) for hemorrhagic stroke. The COVID-19 outbreak had significantly effect on reductions of incidence rates of thrombotic and hemorrhagic stroke with a coefficient of -2.412 (p value < 0.001) and -0.803 (p value = 0.023). The incidence rates of three stroke subtypes were increasing prior to the COVID-19 outbreak. The COVID-19 outbreak significantly impacts hospital admission rates of both thrombotic and hemorrhagic stroke subtypes.
The alpine ecosystems and communities of central Asia are currently undergoing large-scale ecological and socio-ecological changes likely to affect wildlife-livestock-human disease interactions and zoonosis transmission risk. However, relatively little is known about the prevalence of pathogens in this region. Between 2012 and 2015 we screened 142 rodents in Mongolia's Gobi desert for exposure to important zoonotic and livestock pathogens. Rodent seroprevalence to Leptospira spp. was >1/3 of tested animals, Toxoplasma gondii and Coxiella burnetii approximately 1/8 animals, and the hantaviruses being between 1/20 (Puumala-like hantavirus) and <1/100 (Seoul-like hantavirus). Gerbils trapped inside local dwellings were one of the species seropositive to Puumala-like hantavirus, suggesting a potential zoonotic transmission pathway. Seventeen genera of zoonotic bacteria were also detected in the faeces and ticks collected from these rodents, with one tick testing positive to Yersinia. Our study helps provide baseline patterns of disease prevalence needed to infer potential transmission between source and target populations in this region, and to help shift the focus of epidemiological research towards understanding disease transmission among species and proactive disease mitigation strategies within a broader One Health framework.
