Ribotyping is a molecular typing approach based on ribosomal RNA (rRNA) gene sequences for the identification and characterization of bacterial strains. This review aims to evaluate the effectiveness of ribotyping in the identification of infectious bacteria in animal-derived foods and veterinary samples. A narrative literature review was conducted using major scientific databases, including PubMed, Scopus, Google Scholar, and Web of Science, covering studies published to 2025. Relevant articles were selected based on their focus on ribotyping methodologies (e.g., RFLP-, PCR-, and automated ribotyping) and their applications in food safety, veterinary microbiology, and zoonotic disease investigations. The findings indicate that ribotyping has been widely applied for epidemiological investigations, source tracking, and characterization of foodborne and zoonotic pathogens. These approaches have contributed to understanding bacterial diversity and monitoring antibiotic resistance patterns in animal populations and related food products. However, compared with high-resolution molecular techniques such as whole genome sequencing (WGS), ribotyping demonstrates lower discriminatory power and limited resolution for fine-scale epidemiological analysis. Despite these limitations, ribotyping remains a useful, accessible, and cost-effective tool in certain laboratory and surveillance settings, particularly where advanced genomic technologies are not readily available. Overall, integrating ribotyping with newer genomic approaches can enhance the monitoring and control of infectious bacteria, thereby supporting animal health, food safety, and public health outcomes.
Vertical transmission of sexually transmitted infections remains a public health concern, particularly in socially vulnerable settings. Although Brazil has achieved the elimination of mother-to-child transmission of HIV, syphilis during pregnancy continues to pose significant challenges, especially in the northern region. This cross-sectional study aimed to estimate the prevalence of HIV and syphilis and identify associated factors among pregnant women receiving prenatal care in Belém, Pará, Brazil. Between April and June 2021, 398 pregnant women were interviewed using a structured clinical-epidemiological questionnaire and underwent laboratory testing. HIV diagnosis was established using fourth-generation serological assays with immunoblot confirmation, and syphilis diagnosis was based on nontreponemal testing followed by treponemal confirmation. Descriptive analyses were performed, followed by bivariate analyses using Fisher's exact test, chi-square test with Monte Carlo simulation, and Mann-Whitney U test, and Poisson regression with robust variance was applied to estimate prevalence ratios for syphilis. The prevalence of syphilis was 6.36%, and HIV prevalence was 1.01%. Psychoactive substance use was the only variable independently associated with syphilis positivity, while other sociodemographic and behavioral factors showed descriptive trends without statistical significance, and no significant associations were observed for HIV infection. These findings indicate that persistent social and behavioral vulnerabilities, particularly psychoactive substance use, contribute to ongoing syphilis transmission during pregnancy, underscoring the importance of integrating substance use screening, targeted counseling, and harm-reduction strategies into prenatal care to advance efforts toward eliminating vertical transmission of sexually transmitted infections.
Background:Malaria remains a major cause of morbidity and mortality worldwide, with over 263 million cases and 597,000 deaths estimated in 2023, of which 94% occurred in Sub-Saharan Africa. Despite this heavy burden, several low- and middle-income countries have recently succeeded in eliminating local malaria transmission. Objective:This article describes and synthesises malaria elimination experiences in Suriname, Timor-Leste and Georgia, all three certified malaria-free by the World Health Organization in 2025, to identify strategic lessons and contextual factors that may inform elimination efforts in malaria-endemic countries, including those in Sub-Saharan Africa. Methodology:A structured narrative review was conducted using official reports from WHO, the Global Fund and PAHO; national public health documents; and peer-reviewed articles indexed in PubMed, Scopus and Google Scholar between 2012 and 2025. Search terms included 'malaria elimination,' 'malaria-free certification,' 'Suriname malaria,' 'Timor-Leste malaria' and 'Georgia malaria.' Inclusion criteria required relevance to elimination strategies, publication in English or French and availability in full text. Grey literature from WHO, PAHO and the Global Fund was systematically included. Results:The three countries share several common determinants of success: strong and sustained political commitment, robust epidemiological surveillance systems, active community mobilisation and consistent financial support. Strategies were adapted to context: involvement of indigenous communities and cross-border control in the Amazon basin (Suriname), universal coverage and extensive partner support in a postconflict setting (Timor-Leste) and institutional resilience and postelimination vigilance in a context of political transition (Georgia). Conclusion:These experiences demonstrate that malaria elimination is achievable even in resource-limited or fragile contexts, provided interventions are tailored to the local setting and supported by coherent governance. Key lessons for malaria-endemic countries include strengthening community-based surveillance, cross-border cooperation, community education and securing sustainable financing. The risk of reintroduction remains real, and postelimination vigilance is essential.
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease in which host-related factors contributing to disease susceptibility and clinical outcomes remain incompletely understood. We aimed to evaluate the impact of ABO and Rh blood groups on susceptibility and prognosis in patients with CCHF and to investigate their relationship with epidemiological characteristics in a large real-world cohort. This retrospective study included 1143 adult patients with PCR-confirmed CCHF who were followed at our center between April 2015 and September 2024. ABO and Rh blood groups were determined using the Hitachi ElecSys 2010 Rack system, and hematological, biochemical, and coagulation parameters were evaluated simultaneously with CCHF PCR testing at hospital admission. Clinical outcomes, viral load, epidemiological characteristics, disease severity according to the Severity Grading Score (SGS), and laboratory findings were compared among blood groups. In addition, multivariable logistic regression analysis was performed to identify independent predictors of in-hospital mortality. Of the 1143 patients, 732 (64.0%) were male and 411 (36.0%) were female; 548 patients had blood group A, 353 group O, 154 group B, and 88 group AB. Overall in-hospital mortality was 8.5% (97/1143). No significant differences were observed among ABO or Rh blood groups regarding in-hospital mortality, intensive care unit (ICU) requirement, viral load, or reported tick exposure. Although no deaths or ICU admissions occurred in the AB Rh-negative subgroup, this subgroup comprised only 13 patients. Significant differences were identified only in amylase and lipase levels among blood groups, whereas SGS, ferritin, interleukin-6, and other laboratory parameters were comparable. In the multivariate analysis, ABO and Rh blood groups were also not independently associated with in-hospital mortality. These findings suggest that ABO and Rh blood groups are not associated with clinically meaningful differences in disease severity or prognosis in patients with CCHF. Further multicenter prospective studies are warranted to validate these findings.
Dengue virus (DENV), a mosquito-borne arbovirus, remains a critical global health concern, causing approximately 390 million infections annually. Dengue fever poses significant challenges to healthcare systems in endemic regions like Pakistan due to the presence of four established serotypes (DENV-1-DENV-4) and the potential emergence of a fifth serotype (DENV-5). The current study aimed to investigate molecular characteristics of DENV-1 isolates from Peshawar, Pakistan, focusing on serotyping, genetic variability in the CprM junction region, and identification of potential antiviral phytochemicals. A total of 45 patient samples were screened, with the highest infection rate (49%) observed among individuals aged 20-40 years. Phylogenetic analysis revealed that six isolates clustered within the DENV-1 clade and grouped closely related to isolates from China, India, Bangladesh, and Pakistan, suggesting a regional evolution and potentially cross-border transmission. The prominent amino acid substitutions were Q47H, G48E, P49H, K51 E/N, L52 M, and M57I, which may influence viral structure, immune evasion, and antigenic properties. To address the lack of effective antivirals, a library of 60 phytochemicals was screened. Nine compounds demonstrated favorable ADMET profiles and high binding affinity (docking scores < -100) with the CprM region. Silydianin exhibited the strongest interaction (-159.81), indicating promising inhibitory potential. This integrative molecular and computational approach enhances our understanding of circulating DENV-1 strains and highlights plant-derived compounds as candidates for future antiviral development, pending in vitro validation.
Background:Human brucellosis (HB) is a climate-sensitive zoonotic disease whose transmission is influenced by complex interactions among climatic, environmental, livestock, and human behavioral factors. Although the Middle East is a major climate change hotspot and remains highly endemic for HB, evidence regarding climate-brucellosis relationships has not previously been systematically synthesized. This review aimed to evaluate the influence of climatic and environmental determinants on HB across the Middle East. Methods:This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in the Open Science Framework. PubMed, Embase, Scopus, and Web of Science were systematically searched from database inception to February 9, 2025. Studies examining the association between climatic or environmental factors and HB in Middle Eastern countries were included. Owing to substantial methodological heterogeneity, findings were synthesized using a structured narrative approach. Results:Thirteen studies met the inclusion criteria. Temperature and precipitation were each investigated in nine studies, whereas humidity was examined in five studies. Temperature demonstrated both positive and negative associations with HB incidence across different climatic settings, indicating context-dependent effects influenced by regional climate, ecological characteristics, and livestock management practices. Precipitation and humidity also showed heterogeneous associations, while wind speed consistently demonstrated a positive indirect association with disease occurrence. Seasonal analyses identified higher HB incidence during spring and summer, and vegetation cover was consistently associated with increased disease risk. Considerable heterogeneity was observed in study design, climatic settings, statistical methods, and adjustment for potential confounding factors. Because most included studies were observational, the reported associations should not be interpreted as evidence of direct causality. Conclusions:Climatic and environmental factors appear to play an important role in shaping HB transmission through interconnected human-animal-environment pathways in the Middle East. However, these relationships are highly context-dependent and influenced by ecological conditions, livestock management systems, and public health factors. Future multinational studies integrating climatic, environmental, veterinary, and epidemiological data within a One Health framework are needed to strengthen climate-informed surveillance, early warning systems, and brucellosis prevention strategies across the region.
Objectives:Q fever, caused by Coxiella burnetii, is an underrecognized zoonotic infection with diverse clinical manifestations. The nonspecific nature and slow progression of Q fever frequently delay diagnosis, sometimes leading to severe or even fatal outcomes. This study describes 32 patients diagnosed with Q fever over an 18-month period in a previously unreported region, highlighting the emerging awareness of this neglected zoonosis. Methods:Patients with seropositive C. burnetii Phase I/II IgM and/or IgG antibodies between October 2023 and March 2025 (18-month period) were included. Cases were classified as acute, probable, chronic, or past infection according to established serological and clinical criteria. Results:Thirty-two patients were diagnosed during the study period, of whom 22 (68.8%) were male; the median age was 60.5 years (IQR: 48-66). More than half were farmers, and 40.6% reported animal exposure. Based on serological and clinical criteria, 11 patients were diagnosed with acute Q fever, 16 with probable infection, one with chronic infection, and four with past infection. Common manifestations included fever, myalgia, arthralgia, hepatitis, and endocarditis; cardiovascular involvement occurred in 40.6% of patients. Two patients died, and notably, three patients with prosthetic valve endocarditis had a history of care at the same cardiac surgery clinic. Conclusions:Given its heterogeneous clinical manifestations and variable serological responses, Q fever poses significant diagnostic challenges. This study presents the first and largest human case series of Q fever from the Black Sea region of Türkiye, highlighting the wide clinical spectrum of the disease and the need for enhanced awareness and diagnostic capacity.
Background:Uganda experiences recurrent Ebola disease (EBOD) outbreaks, yet national suitability maps often pool virus species or are too coarse for district-level planning. We aimed to generate species-resolved, 1 km relative environmental suitability surfaces for reported Ebola spillover events in Uganda; quantify the contribution of environmental, anthropogenic, and reservoir-related predictors to modeled suitability; and translate continuous outputs into operational prioritization tiers for district surveillance and preparedness. Methods:We compiled 71 laboratory-confirmed reported Ebola event localities in Uganda from 2000 to 2023, defined as the most likely documented locality of initial human infection where available, and paired them with 11 minimally collinear predictors. Pooled and virus-specific MaxEnt models were tuned in ENMeval by comparing feature-class sets across β = 0.5 to 3.0, ranked by AICc, and screened for acceptable omission at the 10% training-presence threshold. Performance was estimated using fourfold spatial block cross-validation. Pooled cloglog suitability values were thresholded at the 10% training-presence value and stratified into four operational prioritization tiers. Results:Tuning selected LQHP with β = 1.5 for the pooled model. Under spatial block cross-validation, pooled performance was Test AUC = 0.845 (0.825 to 0.862) and Test Boyce = 0.58 (0.52 to 0.63), with Test OR10 = 0.101 (0.092 to 0.109). The operational threshold was cloglog = 0.084, classifying 25.4% of Uganda as suitable within the modeling framework. Tier 1, defined as the highest-suitability decile among suitable pixels (cloglog ≥ 0.65), covered 5.8% of land area yet contained approximately 12.6 million residents (29%). High-suitability areas were clustered in the Albertine Rift escarpment belt, the Kampala, Wakiso, Mukono peri-urban cluster extending along major corridors, and a northern Lake Kyoga shoreline crescent. Species-specific outputs were interpreted as exploratory secondary analyses. SUDV broadly reproduced the pooled modeled suitability geography, EBOV showed elevated suitability along the western border corridor, and BDBV suitability was concentrated around the Albertine escarpment. Checkerboard2 sensitivity produced a small AUC increase (ΔAUC = +0.006) and high tier agreement. Conclusions:Relative environmental suitability for reported Ebola spillover localities in Uganda is concentrated in compact high-priority belts where elevated modeled suitability overlaps with large resident populations. Tier 1 and Tier 2 areas provide a focused basis for strengthening event-based surveillance, early detection, laboratory referral, infection prevention and control readiness, rapid response capacity, One Health field investigation, and community engagement.
Background:Soil-transmitted helminth (STH) infections are common neglected tropical diseases in areas with poor sanitation. In Ethiopia, urban farmers using contaminated river water for irrigation are exposed to parasite infection. This study examined the incidence and associated risk factors of STH infections among vegetable farmers in Addis Ababa, comparing those using wastewater with those using clean water. Methods:A mixed-methods design was applied, incorporating a community-based cross-sectional survey and a longitudinal laboratory investigation from December 2021 to December 2023. The study involved 290 farmers (136 wastewater-exposed and 129 unexposed) across 10 sites along the Big and Little Akaki Rivers. Data were collected via questionnaires, observation, health diaries, and stool samples, with diagnosis performed using the Kato-Katz method. STATA 14 was used for data analysis, including logistic regression to identify significant risk factors (p < 0.05). Results:STH incidence was significantly higher among wastewater-irrigating farmers (19.8%) compared to nonusers (8.5%), with incidence rates of 7.1 and 3.04 per 1000 person-months, respectively. The relative risk was 2.32, indicating wastewater irrigation increases STH infection. Risk factors among wastewater-exposed farmers, poor fingernail hygiene (AOR = 2.25; 95% CI: 1.65-42.7), and not wearing boots (AOR = 3.4; 95% CI: 1.66-11.5) increased STH infection risk. Defecating on farms raised infection odds in both exposed (AOR = 2.89; 95% CI: 1.55-3.05) and unexposed (AOR = 1.92; 95% CI: 1.55-2.10) groups. Hand contamination (AOR = 6.9; 95% CI: 2.92-55.7), washing vegetables with wastewater (AOR = 11.6; 95% CI: 3.64-23.9), and not wearing protective clothing (exposed: AOR = 1.97; 95% CI: 1.11-87.9; unexposed: AOR = 1.89; 95% CI: 1.31-22.8) also significantly contributed to STH infection. Conclusion:Wastewater irrigation significantly elevates the risk of STH infections, promoting affordable safe wastewater irrigation practices (sand or gravel filters, drip irrigation) along with hygiene, sanitation, and health education for farmers, to protect farming communities.
In Ethiopia, Osyris quadripartita (Santalaceae) and Toddalia asiatica (Rutaceae) are traditionally used to treat malaria, skin and stomach disorders, and other tropical diseases. This study screened the major secondary metabolite profiles and evaluated the in vitro antimicrobial and in vivo acute toxicity effects of chloroform and methanol extracts from the leaves and stem barks of O. quadripartita and T. asiatica. Secondary metabolite profiling was conducted according to the standard protocols. The in vitro antimicrobial activity evaluation was performed using Kirby-Bauer and broth dilution assays. The in vivo acute toxicity was assessed in experimental mice, grouped into experimental and control groups. Detected phytochemicals included tannins, alkaloids, saponins, flavonoids, and terpenoids, while phlobatannins were absent. Methanol stem bark extracts of O. quadripartita and T. asiatica showed higher inhibition zones of 10.67 ± 0.57 and 10.6 ± 0.11 mm, respectively, against methicillin-resistant Staphylococcus aureus at a minimum concentration of 100 mg/mL. These extracts also showed the lowest MIC values against S. aureus (6.25 ± 00 mg/mL) and S. pyogenes (12.5 ± 00 mg/mL), respectively. The methanol leaf extract of O. quadripartita and stem barks of T. asiatica demonstrated MBC values of 25 and 50 mg/mL, respectively, against S. pyogenes. A higher antifungal effect was observed with the methanol leaf extract of T. asiatica against Aspergillus niger (8.33 ± 0.28 mm at 100 mg/mL). The present findings revealed that methanol extracts of both plants exhibited better antimicrobial activity than the chloroform extracts, as evidenced by the lowest MIC and MBC values. This aligns with the presence of polar secondary metabolites in methanol extracts, which may be responsible for the observed activity. All crude extracts from both plants showed no signs of toxicity at doses up to 2000 mg/kg in experimental mice, indicating the absence of acute toxicity. In conclusion, these findings support the traditional therapeutic use of the leaves and stem barks of O. quadripartita and T. asiatica as antimicrobial agents. Further research is needed to quantify the major classes of phytochemicals and identify the compounds responsible for antimicrobial activity using FT-IR, LC-MS, and NMR instruments.
Background:Dengue has shifted from Dhaka-centric to nationwide in Bangladesh. Aim:To quantify spatiotemporal patterns and identify high-risk clusters across all 64 districts from 2021 to 2025, and, extending previous reports with data from 2025, this study aims to observe an ongoing shift in per-capita risk hotspots. Methods:Retrospective ecological study of the Directorate General of Health Services (DGHS) aggregate yearly data on suspected and laboratory-confirmed dengue admissions (n = 637,626 cases). Incidence per 100,000 population was calculated using 2022 census projections with 1.12% annual growth. Global (Moran's I) and local (Getis-Ord Gi∗) spatial autocorrelation and prospective space-time scan statistics (SaTScan) were applied. Results:National incidence: 76.4/100,000/year. 2025 rate-adjusted Moran's I = 0.328 (p = 0.001). Raw-case hotspots: Greater Dhaka; population-adjusted hotspots: Jhalokathi, Barguna (coastal). High-rate space-time cluster (2024-2025): Dhaka, Manikganj (RR = 3.13, p = 0.001). Dhaka O/E = 4.31 (RR = 6.38). Two low-rate clusters (north, southeast). Conclusion:Urban hyperendemicity, characterized by a high case volume, coupled with the emerging coastal per-capita risk, necessitates tailored interventions. Intensive vector control is essential in Dhaka, while early-warning surveillance should be implemented in coastal districts.
This study describes the development and characterization of a hydroxypropyl methylcellulose (HPMC)-based nanogel. The nanogel coencapsulates thymol, carvacrol, and cinnamaldehyde to enhance mosquito repellency. These phytochemicals were selected for their potential complementary and multimodal neurotoxic and olfactory-disrupting effects. The nanogel was synthesized by spontaneous emulsification, followed by polymeric gelation. Its physicochemical properties were assessed with dynamic light scattering (DLS), zeta potential, rheological measurements, and stability tests. The nanogel showed an optimal size (177 ± 6 nm; PDI: 0.17 ± 0.02; SPAN: 0.96), robust colloidal stability, and pseudoplastic flow behavior. This is consistent with the Carreau-Yasuda model. Repellency assays showed complete protection for 410 ± 45 min against Anopheles stephensi and 210 ± 30 min against Aedes aegypti. Specifically, the nanogel was statistically superior to 40% DEET against Anopheles stephensi, while providing comparable (noninferior) protection against Aedes aegypti. Molecular docking showed strong binding affinities of thymol and carvacrol to mosquito odorant-binding proteins providing mechanistic support for the potential complementary activity of the multicomponent formulation. The formulation maintained physical and rheological stability for 6 months. There was no phase separation or syneresis. These findings show this nanogel's promise as an effective natural mosquito repellent.
Background:Leprosy remains endemic in Côte d'Ivoire, with persistent Grade 2 disability cases indicating ongoing challenges in early diagnosis. Classical diagnosis relies on clinical examination and microscopy, which lacks sensitivity because Mycobacterium leprae cannot be cultured. In the context of the WHO "Zero Leprosy" strategy (2021-2030), molecular tools are needed to confirm cases, detect subclinical infections, and monitor transmission. Methods:We developed and evaluated a real-time PCR protocol targeting the M. leprae 16S rRNA gene for molecular diagnosis. Clinical specimens (slit-skin smears and nasal mucus) were collected from 20 clinically diagnosed leprosy patients in Côte d'Ivoire. DNA/RNA extraction was performed using both a semiautomated kit (NucliSENS) and a manual guanidinium thiocyanate (GuSCN) method. Real-time PCR results were compared with direct microscopy (Ziehl-Neelsen staining). The choice of GuSCN was justified by its chaotropic properties, which inactivate mycobacteria, stabilize RNA, and improve biosafety. Results:Among 48 samples, microscopy detected only nine (18.8%) positive cases, all from multibacillary (MB) patients. In contrast, real-time PCR detected 35 (72.9%) positives using the NucliSENS kit and 31 (64.6%) using the GuSCN method. In paucibacillary (PB) patients, PCR positivity reached 59.5%, whereas microscopy was nearly negative. Ear lobe exudates provided the best diagnostic yield. Conclusion:Real-time PCR targeting 16S rRNA significantly improves M. leprae detection compared to microscopy, especially in PB forms. The manual GuSCN method is a reliable, low-cost alternative for endemic settings. This approach can facilitate early case confirmation, subclinical infection detection, and support leprosy control efforts in Côte d'Ivoire within the WHO Zero Leprosy framework.
Acute respiratory infections (ARIs) impose a substantial annual public health burden, largely driven by a diverse range of respiratory pathogens. Given the dynamic and continuously evolving circulation of these pathogens, as well as their markedly different prevalence across age groups, ongoing surveillance is essential. To characterize the current prevalence, seasonal patterns, and age-related distribution of eight key respiratory pathogens among ARI patients in Thailand, from January to December 2025, a retrospective study of 4697 respiratory samples from ARI patients aged 1 month to 97 years was conducted. Using real-time RT-PCR to screen for eight respiratory viruses, 61.1% (2871) of samples tested positive, with coinfections identified in 267 of the positive cases. Influenza virus (IFV) was the most prevalent pathogen at 22.2%, demonstrating a clear biannual pattern with peaks in January-March and July-December. Human rhinovirus (HRV) was the second most frequently detected virus (16.6%) and circulated year-round, whereas SARS-CoV-2 accounted for 9.9% of cases, with a pronounced peak in May. Significant age-specific differences in viral detection were observed. HRV predominated in children < 5 years, while IFV exhibited a broader distribution, with higher prevalence among individuals aged 6-18 years and ≥ 19 years. In contrast, SARS-CoV-2 was more frequently detected in adults and older populations. Coinfections were most common in children aged 3-5 years and were frequently associated with HRV. Notably, IFV, HRV, and RSV showed a significant increase in 2025 compared with 2024. These findings provide updated insights into the circulation of respiratory viruses in 2025, revealing distinct seasonal patterns, increasing influenza activity significantly with prolonged circulation in the latter half of the year, and clear age-related differences in pathogen distribution. This provides effective support for continuous surveillance to inform effective public health strategies for ARI control.
Infantile tremor syndrome (ITS), a self-limiting disorder prevalent in the Indian subcontinent, is characterized by tremors, anemia, pigmentary skin changes, developmental delay or regression, and hypotonia. Although a nutritional etiology is suspected, particularly vitamin B12 deficiency, the roles of the bioactive marker holo-transcobalamin (holo-TC) and essential fatty acids (EFAs) remain unexplored. This comparative pilot study was conducted from December 1, 2023, to April 30, 2024, at Government Medical College, Datia, India. The study included 14 infants who were assigned to two groups. Group 1 (n = 7) comprised infants with ITS and tremors, and Group 2 (n = 7) included those with ITS without tremors to assess threshold-dependent biochemical markers across this clinical spectrum. Laboratory investigations included complete hemogram, serum vitamin B12, holo-TC, and EFA profiles. Data were summarized using medians and interquartile ranges. Between-group differences were expressed as effect sizes (median differences) with 95% confidence intervals. Severe developmental delays were more frequent in Group 1 (5/7) than in Group 2 (mild to moderate in 4/7). Both groups were anemic and had low serum vitamin B12 levels (median: 188 pg/mL in Group 1 vs. 198 pg/mL in Group 2). Holo-TC was undetectable (< 5 pmol/L) in Group 1 and in only one patient from Group 2 (median: 10.12 pmol/L in the remaining Group 2 patients). Macrocytosis was higher in Group 1 (median MCV: 98 fL vs. 75.5 fL), with a median difference of 22.5 fL (95% CI: 6.8 to 38.2). Clinical examination also revealed characteristic hair hypochromotrichia and progressive regression in both phenotypes. Both groups exhibited low omega (ω)-3 fatty acid levels, elevated saturated fatty acid levels, and high ω-6:ω-3 ratios (median: approximately 10:1), with small and imprecise between-group differences (confidence intervals crossing zero). Extremely low holo-TC levels were strongly associated with tremors in ITS, suggesting that holo-TC is a superior marker of bioactive vitamin B12 deficiency and a critical metabolic threshold for tremor manifestation. EFA imbalances were prevalent in both groups but not specific to tremor incidence, highlighting the need for larger studies. The overall pathophysiology points toward significant maternal nutritional depletion during pregnancy and lactation as the relevant origin of the syndrome.
Background:Vector-borne diseases, particularly those transmitted by Aedes mosquitoes, including dengue, chikungunya, Zika, and yellow fever, represent significant public health challenges globally. The rapid spread of these diseases in urban environments, driven by climate change and human activities, necessitates effective surveillance and control strategies. In Iran, the emergence of Aedes aegypti has raised concerns about potential outbreaks of the disease, particularly in southern regions such as Hormozgan Province. Methods:A retrospective descriptive study was conducted using routinely collected entomological surveillance data from the national invasive Aedes surveillance program of Iran CDC. The study covered urban areas of Bandar Abbas County, southern Iran, from January 2022 to December 2025. Biweekly ovitrap surveillance and larval survey data were analyzed to describe temporal trends of egg, house, container, and Breteau indices. Surveillance outputs during full and reduced operational capacity phases were compared descriptively. Associations between indices and meteorological variables were assessed using Pearson or Spearman correlation analyses. Results:Entomological indices showed marked temporal and interannual variability between 2022 and 2025. Egg indices varied seasonally, with an obvious peak in April 2023. House, container, and Breteau indices generally declined during 2023, coinciding with intensified surveillance and control activities, but resurged in parts of 2024 following a substantial reduction in operational capacity. During the reduced-capacity phase, egg indices remained nonzero, whereas larval indices were predominantly zero, likely reflecting decreased surveillance coverage. No statistically significant correlations were observed between entomological indices and temperature, relative humidity, or rainfall. Discussion and Conclusion:The findings emphasize the need for continuous entomological surveillance and community engagement in managing Aedes-borne diseases. This study highlights the necessity for integrated vector management strategies that include community-based interventions and robust monitoring systems. Despite initially low entomological indices, effective surveillance and control measures are essential for preventing Aedes-borne disease outbreaks in southern Iran. The insights gained can guide public health policies and serve as a model for similar regions facing vector-borne disease threats.
Malaria is the most prevalent vector-borne disease worldwide, with Uganda ranking third for malaria burden in 2023. In resource-limited settings, where access to diagnosis and treatment is often constrained and recent vaccination strategies may face challenges, traditional primary prevention remains essential and cost-effective. This study evaluated the effectiveness of the smart home model-an integrated malaria prevention strategy promoted by the Uganda Ministry of Health-in reducing infections among children aged < 5 years. A case-control study was conducted in Oyam District, Northern Uganda, between October 2023 and February 2024. Data from 3093 households were analyzed. Malaria status was assessed using rapid diagnostic tests. Household adherence to nine vector-control measures defined the smart home score, categorized as low (0-3), intermediate (4-6), or high (7-9). Higher scores were significantly associated with lower malaria prevalence. An inverse association emerged between household score and infection status: households with scores ≥ 7 were associated with a 80% lower presence of infection, as compared to households with scores ≤ 3 (AOR: 0.21; 95% CI: 0.16-0.27). The most protective measures included consistent use of bed nets, closing windows and doors by 6 p.m., eliminating water reservoirs, adopting proper farming practices, and compound cleanliness. These findings may provide further evidence supporting integrated malaria control strategies, alongside vaccines deployment, particularly in low-resource settings.
Background:Malaria is a major public health problem in Cameroon, disproportionately affecting children under five. The success of prevention and control programmes depends on caregivers' knowledge, attitudes, and practices (KAP). Assessing these domains and their determinants could provide evidence for targeted interventions. The study set out to determine the levels of KAP towards malaria prevention and identify associated factors among caregivers of children under five in the Buea Health District in Cameroon. Methods:A community-based cross-sectional study was conducted among 394 caregivers in peri-urban and rural communities of the Buea Health District. The survey was conducted from April 3 to July 12, 2024. Participants were interviewed using a structured questionnaire which captured the KAP of caregivers of under-five children. Association between variables and community setting was measured using chi square test, and a multivariate logistic regression model was fitted to identify factors associated with adequate knowledge, positive attitudes, and good practices on malaria prevention. Results:Most respondents were female (85.3%), parents of the child (88.6%), and self-employed (78.2%). Overall, 58.4% (95% CI: 53.5%-63.0%) had adequate knowledge, 42.9% (95% CI: 38.0%-47.8%) demonstrated positive attitudes, and 54.1% (95% CI: 49.2%-59.0%) reported good practices towards malaria prevention. Adequate knowledge was associated with being a caregiver rather than household head (AOR = 2.23, 95% CI: 1.10-4.49), employed (AOR = 8.12, 95% CI: 1.86-35.28), and living in brick houses (AOR = 1.88, 95% CI: 1.20-2.95).Positive attitudes were more likely among caregivers in peri-urban areas (AOR = 1.72, 95% CI: 1.12-2.65), those with secondary (AOR = 2.21, 95% CI: 1.04-4.67) or tertiary education (AOR = 3.18, 95% CI: 1.16-8.71), and those with better living standards (e.g., owned a television set, radio, or phone [AOR = 2.16, 95% CI: 1.29-3.63]). Good practices were associated with peri-urban residence (AOR = 1.73, 95% CI: 1.12-2.67), adequate knowledge (AOR = 2.06, 95% CI: 1.37-3.09), positive attitudes (AOR = 1.84, 95% CI: 1.23-2.77), higher maternal education (secondary: AOR = 1.90, 95% CI: 1.01-3.58), and requesting malaria testing before treatment (AOR = 3.15, 95% CI: 2.01-4.94). Conclusion:Over half of caregivers had adequate knowledge and good practices, but fewer demonstrated positive attitudes, with rural caregivers showing significant gaps. KAP were influenced by sociodemographic, socioeconomic, and behavioural factors. Targeted health education, particularly for rural caregivers and those with lower education or fewer assets, could improve malaria prevention behaviours and reduce disease burden among children under five.
The emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa in healthcare settings poses a critical global health challenge, intensified by limited therapeutic options and the environmental spread of pathogens through hospital waste. This study addresses the urgent need for alternative strategies by investigating the phylogenetic profile and antimicrobial resistance of P. aeruginosa isolated from hospital dry waste in Saidu Sharif, Pakistan, while evaluating the antibacterial and antioxidant potential of nine ethnomedicinal herbs. The isolate, identified via 16S rRNA sequencing, exhibited 99% homology to the MDR strain P. aeruginosa 610D6 reported from China, underscoring potential transboundary resistance dissemination. Antibiotic susceptibility testing revealed resistance to 14 of 21 tested agents, with retained efficacy only for imipenem, cefoperazone/sulbactam (25-mm inhibition zones), and fosfomycin (24 mm). Ethanol extracts of Punica granatum, Myrtus communis, and Olea ferruginea demonstrated remarkable antipseudomonad activity (26-mm, 26-mm, and 25-mm zone of inhibitions, respectively) and potent antioxidant properties (97.57%, 95.55%, and 96.85% DPPH scavenging). Notably, solvent polarity significantly influenced extraction yields and bioactivity, with ethanol. This work highlights the therapeutic promise of plant-derived compounds against MDR pathogens while encouraging for One Health approaches to mitigate antibiotic resistance.
BackgroundMosquitoes are significant vectors of infectious diseases such as malaria and arboviruses, which pose public health challenges globally. Anopheles hyrcanus is widely distributed in northern Iran and neighboring Middle Eastern countries and is considered a potential vector of mosquito-borne diseases in these regions. Wolbachia, an endosymbiotic bacterium, is known for its reproductive manipulations and potential to reduce the transmission of mosquito-borne diseases. This study aimed to investigate the molecular identification and phylogeny of Wolbachia in mosquito species from Golestan Province, Iran, with a focus on Anopheles hyrcanus, Culex theileri, Culex tritaeniorhynchus, and Culex pipiens.MethodsAdult mosquitoes were collected from nine locations in Golestan Province between April and December 2023. DNA was extracted from these mosquitoes, and the Wolbachia surface protein (WSP) gene was amplified via PCR. The resulting sequences were analyzed to determine phylogenetic relationships using the maximum likelihood method.ResultsA total of 491 female mosquitoes representing six species were morphologically identified, of which five species were screened for Wolbachia infection using wsp-PCR. Infection was detected in four species. The observed infection prevalence among tested specimens was 100% in Culex pipiens (15/15; 95% CI: 79.6%-100%), 100% in Culex theileri (1/1 pooled sample; 95% CI: 20.6%-99.9%), 37.5% in Culex tritaeniorhynchus (15/40; 95% CI: 24.2%-53.0%), and 25% in Anopheles hyrcanus (10/40; 95% CI: 14.2%-40.2%), while Anopheles maculipennis tested negative (0/9; 95% CI: 0.0%-29.9%). Phylogenetic analysis revealed that all detected strains clustered within Wolbachia Supergroup B. Notably, this study represents the first report of Wolbachia Supergroup B detected in Anopheles hyrcanus in the Middle East region.ConclusionsThe detection of Wolbachia Supergroup B in Anopheles hyrcanus provides new insights into the distribution and phylogeny of Wolbachia in Iranian mosquito populations. However, these findings represent preliminary molecular evidence, and further experimental studies are required to determine infection stability, transmission dynamics, and any potential implications for vector control.
