Tuberculosis (TB) has resurfaced as the leading cause of death by an infectious agent after the COVID-19 pandemic. The fight against TB needs to consider factors associated with mycobacterial reactivation and treatment of TB disease. Recent findings showed that Schistosoma mansoni co-infection leads to a Th2/Th1 profile that results in an immune modulation that favors the escape of the Mycobacteria. Schistosoma mansoni may contribute to tuberculosis (TB) incidence in endemic regions. We aimed to determine the co-infection rate and treatment outcomes. A prospective cohort study was conducted between 2020 and 2022 at the University Clinical Research Center (UCRC). We included culture-confirmed pulmonary TB patients who were tested for Schistosoma mansoni in stools using Kato-Katz. S. mansoni co-infection was determined at baseline. Patients were classified into two -groups: TB/S. mansoni co-infected and TB-mono-infected. Univariable and multivariable logistic regression were performed to identify factors associated with the co-infection. We analyzed data from 174 tuberculosis-confirmed patients tested with Kato-Katz technique. Schistosoma mansoni co-infection among TB patients was 28.7

Effective mentorship is essential for advancing global health research, particularly in low- and middle-income countries (LMICs). This review synthesizes expert perspectives from a highly experienced group of global health research mentors. We identify the characteristics and core competencies of effective global health mentors, emphasizing adaptability, cultural competence, and equitable collaboration. Special attention is paid to addressing barriers faced by underrepresented groups in academia, highlighting the role of mentorship in career advancement and enhancing workforce diversity. We describe a variety of mentoring models, e.g., one-to-one, peer, group, and virtual, and mentoring tools and frameworks, evaluating their relevance to diverse global health contexts. This review emphasizes their potential for customization in LMICs and provides guidance for structuring effective mentor-mentee communication. Recognizing that sustainable impact extends beyond individual relationships, we present strategies for developing institutional mentorship programs, drawing on lessons from Ethiopia and Kenya. Key recommendations include capacity-building for mentors and mentees, institutional ownership of mentoring activities, mentor-mentee matching, accessible training, and regular evaluation linked to recognition and career advancement. The transition from structured mentorship to professional independence merits special consideration, including mechanisms for fostering ongoing collegiality and long-term career support. Our findings underscore the importance of structured, intentional mentorship for building research capacity, driving academic productivity, and advancing global health equity. We advocate for sustained investment by individuals and institutions, recommending adaptable mentorship frameworks and supportive cultures to foster emerging global health leaders. By institutionalizing best practices, global health research mentorship can contribute decisively to stronger health systems worldwide.

BACKGROUND Recent evidence suggests a role for biological factors in increased risk for active pulmonary tuberculosis (PTB) among males. We determined the relationship between alterations in gonadal steroids, tuberculosis (TB) disease status, and treatment outcomes. METHODS We conducted a prospective cohort study in Mali of treatment naïve males and females with laboratory-confirmed PTB, latent TB infection (LTBI), and healthy controls of similar ages. RESULTS Prior to treatment, males with PTB had lower testosterone concentrations compared to males with LTBI or healthy males. Reduced testosterone concentrations in males with PTB were transient, returning to healthy ranges by month 2 of treatment, which corresponded to the end of intensive TB treatment. Estradiol concentrations in females were not altered by PTB or infection status yet increased at month 6 of treatment. Testosterone, but not estradiol, was a strong predictor of cure during treatment. Testosterone, but not estradiol, concentrations in PTB cases were inversely correlated with serum IFN-γ, IL-6, and IL-2. Concentrations of IL-17 and IL-10 were lower in males than females at the end of TB treatment. CONCLUSION Our results suggest that TB-induced changes in testosterone concentrations during PTB and in response to treatment occur in males and could contribute to sex differences in TB pathogenesis. FUNDING The Fogarty International Center and the Office of Research on Women’s Health (K43TW011426); the Institute for Global Health at the Feinberg School of Medicine of the Northwestern University (Catalyzer Award); 2021 TWAS Abdool Karim Award; NIH grants R37AI167750 and 5D43TW010350.

Background Men who have sex with men living with HIV (MSMLWHIV) have a high risk of persistent high-risk HPV infection, and rapid tools like Xpert HPV can help expand screening in low-resource settings. Objectives This study aimed to assess the feasibility of using self-collected anal swabs for detecting high-risk human papillomavirus (HR-HPV) infections in MSMLWHIV, using the Xpert® HPV assay. Additionally, we investigated factors associated with HR-HPV positivity. Design This was a single-center cross-sectional study conducted from 22 nd May 2024 to 31 st July 2024 among MSMLWHIV in Bamako. Methods Participants were recruited from the Soutoura NGO in Bamako, Mali. To be eligible, individuals had to be HIV-1 positive, on antiretroviral therapy, 18 years or older, and self-identified as MSM. The prevalence of HR-HPV was reported by sociodemographic characteristics and sexual behaviors. We used a penalized logistic regression model using Firth’s method to identify sociodemographic and behavioral factors associated with HR-HPV positivity. Results A total of 245 MSMLWHIV were initially tested. Of these, 170 yielded successful results and were subsequently included in the study analysis. The participants had a median age of 26 years (IQR 24-29) with the median age of first anal intercourse at 16 years (IQR 16-18). Among the participants, 29% (49/170) identified as bisexual, 42% (72/170) reported never using condoms, 16% (27/170) participated in group intercourse, and 42% (71/170) had at least two different sexual partners in the past six months. Among those successfully tested, 65% (110/170) were positive for HR-HPV, with HPV16 detected in 12% (21/170) of participants. No or primary education and consistent condom use were associated with lower odds of HR-HPV positivity, while the unexpected association observed with smoking should be interpreted with caution. Conclusion The high HR-HPV prevalence among MSMLWHIV calls for targeted screening and prevention. Although Xpert HPV shows promise, the 31% failure rate with self-collected samples underscores the need for improvements in sample collection procedures and technical performance.

Background Women living with human immunodeficiency virus (WLWH) have a higher risk of acquiring human papillomavirus (HPV) and other sexually transmitted infections (STIs) due to their compromised immune systems. The presence of HPV, HIV, and other STIs has been implicated in cervical carcinogenesis. This study sought to understand and estimate the association between HPV infection and other STIs among HIV-positive women with and without cervical precancer. Methodology This study looked at women living with HIV who had been diagnosed with either low- or high-grade squamous intraepithelial lesions. This study was a part of the U54 cervical cancer project in Jos, Nigeria, from August 2019 to January 2022. Cervical swab samples were used for DNA extraction and genotyping using the HPV 28 Anyplex II (Seegene). To identify seven of the most common STIs, we used the Allplex™ STI Essential Assay (Seegene) and the Allplex™ Genital Ulcer Assay (Seegene) for seven ulcer-causing microbes. Results In total, 101 women were included in this study. The median age of the participants was 50 years (interquartile range = 43-57). The overall HPV prevalence was 65.3% (66/101). Among these, hrHPV infection occurred in 40.0% of the women in the age group of <40 years and 31.0% in the age group of ≥40 years. Approximately 40% of hrHPV-positive women were co-infected with at least one STI (p = 0.006). Having multiple STIs was associated with hrHPV infection (p = 0.019 for multiple essential STIs and p = 0.007 for multiple genital ulcers causing STIs). On univariate analysis, we found hrHPV to be associated at 95% confidence interval with any essential STI (p = 0.008), a single STI (p = 0.016), any genital ulcer microbe (p = 0.003), herpes simplex virus 1 (p = 0.043), Lymphogranuloma venereum (p = 0.017), and having a single ulcer-causing microbe (p = 0.004). In multivariate models adjusted for age, parity, HIV duration, and cervical neoplastic lesions, the odds ratio comparing hrHPV-positive to hrHPV-negative women was 10.4 (p < 0.001) for any genital ulcers causing microbial infections. Conclusions High-risk HPV infection was associated with the presence of other STIs in WLWH in Nigeria. Testing for STIs in women with hrHPV could have an impact on hrHPV-related carcinogenesis.

The National Institutes of Health's Rapid Acceleration of Diagnostics (RADx) program answered the call to accelerate the development of point-of-care (POC) and over-the-counter (OTC) COVID-19 tests. The widespread availability and access to self-tests has increased the public's familiarity and acceptance of at-home diagnostics. This paper examines the current state of OTC diagnostic testing, discusses potential applications of OTC testing, and highlights the implications of widespread OTC testing for clinical medicine.

Introduction:Like many other countries, Mali, a West African country, has encountered various obstacles in the fight against the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite resource constraints, however, the country implemented containment strategies. Therefore, in early 2021, Mali initiated a vaccination campaign as a tangible defense against COVID-19, prioritizing the administration of the first vaccine doses to healthcare personnel. Consequently, we found assessing anti-SARS-CoV-2 IgG antibody levels important to gauge the efficacy of vaccines administered to frontline healthcare workers in Bamako, Mali. Methods:The study enrolled 172 vaccinated front-line healthcare workers from referral hospitals in Bamako, Mali, between March and June 2022. Serum samples were subjected to enzyme-linked immunosorbent assay (ELISA) to assess the levels of anti-SARS-CoV-2 IgG antibodies. Prevaccination serum samples served as controls. Chi-square and Mann-Whitney tests were used to compare proportions and means. Results:Among the 172 participants, 98.2% had high levels of anti-SARS-CoV-2 spike protein antibodies; only 1.6% (n=2) were seronegative. The majority, 62.2% (n=107), received a two-dose vaccination schedule, and the Astra Zeneca® vaccine was the most widely used (52.3%). The average level of postvaccine antibodies was significantly greater in participants who received two doses of vaccine than in those who received one dose (33.7 index vs. 29.1 index; p=0.02). Conclusions:Most healthcare workers exhibited favorable vaccine responses, as indicated by their positive reactivity to anti-SARS-CoV-2 IgG spike proteins. The nature and dosage of the vaccines influenced the antibody response, with a notable advantage observed for individuals who received a two-dose regimen. These findings underscore the importance of continuous research and evaluation to understand and enhance vaccine effectiveness.

Human papillomavirus (HPV) is prevalent in mucocutaneous surfaces, with the persistence of infections causing approximately 5% of human cancers. While HPV presence at one site increases the risk at others and, possibly, increases the risk of cancer(s) in other anatomical sites, this risk varies among individuals despite similar sexual behaviors. Identifying women with high-risk cervical HPV who are also at risk for high-risk oral HPV could help reduce HPV-associated cancers. This study aims to identify methylation biomarkers explaining the risk of concordant high-risk oral HPV in women with cervical high-risk HPV infections. As part of the Sexual Behavior and HPV Infections in Nigerians in Ibadan study, we conducted a cross-sectional analysis of sexually active women aged 18-45 years in Ibadan, Nigeria. Participants had interviews and clinical examinations and provided oral rinse and cervical swab samples. DNA was extracted and genotyped for HPV using the Anyplex™ II HPV28 assay. An epigenome-wide association study compared DNA methylation patterns between women with high-risk HPV types 16, 18, or 35 detected in both oral and cervical samples (concordant group) and those with high-risk HPV only in cervical samples (control group), matched by age, sexual behaviors, and lifestyle factors. Genome-wide DNA methylation profiling was performed on both sample types (total n=32) using the Infinium Methylation EPIC v2.0 BeadChip. We identified 61 differentially methylated CpG sites in the concordant group, with consistent associations in both cervical and oral samples (Pearson's r = 0.91, p<0.001). Notably, cg11201654 in the promoter region of a non-classical human leukocyte antigen (HLA) gene, HLA-F, was one of the top significant CpGs and showed approximately two-fold hypermethylation in the concordant group in cervical (p = 0.00080) and oral samples (p = 0.00005). Similarly, cg27020253 in the promoter of another non-classical HLA gene, HLA-L, exhibited ∼1.7-fold hypermethylation in both cervical (p = 0.00039) and oral samples (p = 0.00025). These epigenetic modifications suggest that HPV may facilitate immune evasion and persistent infection by suppressing non-classical HLA genes, which are known for modulating immune responses through interactions with natural killer cells. Hypermethylation of non-classical HLA genes may serve as novel biomarkers for identifying women at elevated risk for persistent high-risk HPV infections and related malignancies, offering insights into HPV-mediated immune evasion mechanisms. The consistent methylation patterns across oral and cervical tissues highlight the capacity of HPV to broadly influence host gene regulation. These epigenetic biomarkers could have applications in broader contexts of immunogenetics and cancer risk prediction, potentially refining the stratification of high-risk women. Yinan Zheng, Imran Morhason-Bello, Yishu Qu, Jun Wang, Adeola Fowotade, Adekunle Daniel, Akinyele Adisa, Olutosin Awolude, John Ogunbiyi, Miquel Pavon, Robert Murphy, Isaac Adewole, Deborah Watson-Jones, Lifang Hou. Non-classical HLA epigenetic biomarkers associated with concordant cervical and oral HPV infection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4110.

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality globally, with particularly high burdens among people living with HIV (PLWH) in low-resource settings like Nigeria. Effective early detection remains a major challenge due to limited access to imaging-based surveillance and the low sensitivity of current biomarkers such as alpha-fetoprotein (AFP). We conducted an epigenome-wide association study (EWAS) of circulating cell-free DNA (ccfDNA) methylation in a Nigerian cohort of HIV-positive individuals (n = 245), spanning HCC, cirrhosis (FibroScan ≥12.3 kPa), fibrosis (FibroScan ≥7.6 and <12.3 kPa), and HCC-free without fibrosis (FibroScan <7.6 kPa) groups. Using random forest modeling, we developed and evaluated a ccfDNA methylation classifier (ccfDNAmRF) for HCC risk prediction. We identified 73 CpG sites significantly associated with HCC (false discovery rate <0.01). The ccfDNAmRF model demonstrated strong discriminatory power, achieving 100% sensitivity and 80%-91% specificity for distinguishing HCC from cirrhosis, fibrosis, and HCC-free groups (area under the curve [AUC]: 92%-97%). Combining ccfDNA methylation risk scores with AFP further improved classification accuracy (AUC up to 98.5%). Notably, ccfDNA methylation patterns displayed clear dose-response relationships across the disease spectrum, supporting their utility for early-stage detection and risk stratification. Our findings highlight the promise of ccfDNA methylation biomarkers as a non-invasive, blood-based screening tool for improving early identification of HCC cases among PLWH.

BACKGROUND:This study updates the COVID-19 pandemic surveillance in East Asia and the Pacific region that we first conducted in 2020 with 2 additional years of data for the region. OBJECTIVE:First, we aimed to measure whether there was an expansion or contraction of the pandemic in East Asia and the Pacific region when the World Health Organization (WHO) declared the end of the COVID-19 public health emergency of international concern on May 5, 2023. Second, we used dynamic and genomic surveillance methods to describe the dynamic history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Finally, we aimed to provide historical context for the course of the pandemic in East Asia and the Pacific region. METHODS:In addition to updates of traditional surveillance data and dynamic panel estimates from the original study, this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a 1-sided t test to determine whether the regional weekly speed was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data across the sample period. RESULTS:Several countries in East Asia and the Pacific region had COVID-19 transmission rates above an outbreak threshold at the point of the WHO declaration (Brunei, New Zealand, Australia, and South Korea). However, the regional transmission rate had remained below the outbreak threshold for 4 months. In the rolling 6-month window t test for regional outbreak status, the final P value ≤.10 implies a rejection of the null hypothesis (at the α=.10 level) that the region as a whole was not in an outbreak for the period from November 5, 2022, to May 5, 2023. From January 2022 onward, nearly every sequenced SARS-CoV-2 specimen in the region was identified as the Omicron variant. CONCLUSIONS:While COVID-19 continued to circulate in East Asia and the Pacific region, transmission rates had fallen below outbreak status by the time of the WHO declaration. Compared to other global regions, East Asia and the Pacific region had the latest outbreaks driven by the Omicron variant. COVID-19 appears to be endemic in the region, no longer reaching the threshold for a pandemic definition. However, the late outbreaks raise uncertainty about whether the pandemic was truly over in the region at the time of the WHO declaration.

The growing cancer burden and suboptimal diagnostic capacity in low- and middle-income countries calls for urgent innovation in diagnostic solutions. Point-of-care technologies (POCTs) offer a transformative approach to decentralizing cancer diagnostics by providing rapid, affordable, and scalable testing in resource-constrained settings. Recent advancements, including loop-mediated isothermal amplification and multiplexed lateral flow immunoassay, enable high-sensitivity detection of cancer biomarkers without the need for complex laboratory infrastructure. Additionally, noninvasive imaging tools, such as optical coherence tomography and fluorescence-guided microscopy, offer portable and cost-effective solutions for early cancer detection in settings with limited health care services. These innovations are complemented by the integration of artificial intelligence, which improves diagnostic accuracy and reduces reliance on highly trained personnel. However, significant infrastructure and logistical challenges persist, including resource constraints, unreliable electricity, and insufficient cold-chain logistics, which limit diagnostic precision and accessibility. This review discusses recent advances in POCTs for oncology and examines how public-private partnerships and multisector collaborations can address key implementation barriers. By prioritizing inclusivity, cross-sector collaboration, and targeted investments, POCTs can sustainably narrow global disparities in cancer diagnosis and treatment.

Cervical cancer (CC) remains a significant public health issue in low- and middle-income countries (LMICs), especially in Western sub-Saharan Africa and Nigeria. While global CC incidence and mortality have declined, these regions continue to face high rates due to inadequate screening and the high prevalence of HIV, which increases CC risk by promoting persistent HPV infections. This study aimed to identify DNA methylation (DNAm) biomarkers for cervical intraepithelial neoplasia (CIN) and CC in HIV-positive Nigerian women and to assess their potential for clinical risk prediction. From 2018 to 2020, 538 participants were recruited from Nigerian tertiary hospitals. Cervical tissue samples were analyzed for DNAm using the Infinium MethylationEPIC BeadChip array, and HPV genotyping was conducted via next-generation sequencing. An epigenome-wide association study revealed 24 significant DNAm biomarkers associated with CIN and CC. These biomarkers showed hypermethylation in tumor suppressor genes (e.g., PRMD8), hypomethylation in oncogenes (e.g., MIR520H), and aberrant methylation in genes related to HIV/HPV infection and oncogenesis (e.g., GNB5, LMO4, FOXK2, NMT1). A machine learning-based DNAm classifier achieved 92.9% sensitivity and 88.6% specificity in predicting CC risk, with higher risk observed in adjacent normal cervical samples from CIN/CC patients and HIV/HPV co-infected women. DNAm biomarkers offer a promising approach to enhancing CC screening and early detection, particularly for HIV-positive women in LMICs. The DNAm-based model developed in this study shows potential for more accurate CC risk stratification, highlighting the need for further optimization, validation, and implementation in low-resource settings.

Cervical cancer is one of the most frequently diagnosed cancers and a leading cause of cancer-related deaths in women in low- and middle-income countries (LMICs), accounting for nearly 85

Background: This study aimed to assess the seroprevalence of SARS-CoV-2 among children attending pediatric consultations in Bamako, Mali, using a rapid diagnostic test (RDT) on fingertip or venous blood samples. Methods: A single-center, prospective cross-sectional study was conducted from May to September 2022 at the Pediatric Hospital in Bamako, Mali. Children aged 1 to 15 years underwent phlebotomy or fingertip blood sampling for SARS-CoV-2 antibody testing using the Abbott Panbio COVID-19 IgG/IgM Test. Demographic data and potential risk factors were collected. Categorical variables were compared using Fisher's exact test, and quantitative variables were analyzed using the Mann-Whitney test. Results: A total of 315 children were included, with a median age of 6 years (range 3-9 years); 45.7% (144/315) were younger than 6 years, and 54% (170/315) were male. The majority lived in urban areas (89.9%) and used public transportation (85.7%). The overall seroprevalence was 63.5%, with a higher seroprevalence observed among children aged 6 years and older compared to those under 6 years. The odds of having a positive serology were approximately twice as high in children aged ≥6 years in both univariate (OR 1.99; 95% CI: 1.25-3.17; P=0.0014) and multivariable analyses (OR 2.05; 95% CI: 1.26-3.32; P=0.0038). No significant differences in seropositivity were found for other demographic or risk factors. Conclusions: A substantial proportion of children in Bamako showed evidence of past SARS-CoV-2 infection, underscoring the importance of continued surveillance and preventive measures in this population.

BackgroundCervical cancer (CC) is highly prevalent in Nigeria, with over 12,000 cases and 8000 deaths annually. Differences in diagnostic methods for human papillomavirus (HPV) genotypes have generated varied prevalence rates across populations.MethodsWe analyzed the prevalence and distribution of high-risk HPV (HR-HPV) genotypes among women with CC, comparing HIV-negative women and women living with HIV (WLWH), using data from a prospective Nigerian cohort study (2018-2022). High-throughput next-generation sequencing (NGS) of the HPV L-1 gene identified and classified genotypes.ResultsAmong 189 women tested for HR-HPV, 74.1% (140/189) were HIV-negative, and 25.9% (49/189) were WLWH. The median age was lower for WLWH at 48 years [IQR: 41-54] compared to HIV-negative women at 60 years [IQR: 49-69] (p < .001). The overall prevalence of HR-HPV was 64.6% (122/189; 95% CI: 57.4-71.1), with higher rates in WLWH (77.6%, 38/49) than HIV-negative women (60.0%, 84/140) (p < .001). Among HR-HPV-positive cases, HPV16 or HPV18 accounted for the highest proportion, representing 67.2% (95% CI: 58.3-75.0). The most prevalent HR-HPV types detected were HPV16 (46.7%), HPV18 (20.5%), HPV45 (9.8%), HPV35 (6.6%), and HPV52 (5.7%). Quadrivalent and nonavalent HPV vaccines would cover 67.2% (95% CI: 58.3-75.0) and 86.1% of HR-HPV infections, respectively.ConclusionOur NGS approach findings among women with CC identified HPV types not covered by the Gardasil-4 vaccine used in Nigeria. This highlights the need for broader vaccine coverage against most HR-HPV types, regardless of HIV status, in Nigeria.

BACKGROUND:The optimal approach to the diagnosis of atrial fibrillation in primary care is unclear. AIM:To determine if external loop recorder (ELR) screening improves atrial fibrillation detection in community-dwelling adults with a CHA2DS2-VASc score of greater than two. DESIGN:Randomized cross-over clinical trial. METHODS:Community-dwelling adults ≥55 years with a CHA2DS2-VASc score of greater than two, who were deemed suitable for atrial fibrillation screening and oral anticoagulation by their general practitioner were randomly assigned to immediate or delayed ELR monitoring. The intervention period was ELR cardiac monitoring for 1 week and the usual care period was healthcare professional pulse screening and completion of electrocardiogram (ECG) or cardiac rhythm strip if pulse was identified as irregular. RESULTS:Of the 488 participants randomized, 244 were assigned to the immediate monitoring period (intervention) and 244 were assigned to the delayed monitoring period. Mean (SD) age was 75.0 (7.0) years and 333 participants were women (68%). Atrial fibrillation was detected in 32 of 488 participants (6.6%) in the intervention period versus five of 488 (1%) in the usual care period (absolute difference, 5.53% (3.2-7.9%), P < 0.001; number needed to screen 15 (11-23)). Twelve cases (37.5%) of ELR-detected atrial fibrillation were greater than 24 h in duration. Oral anticoagulation was initiated in all participants (n = 32). CONCLUSIONS:Among older community-dwelling adults with a CHA2DS2-VASc score of greater than two, screening with ELR for one week was associated with a 5.5% incremental detection of new atrial fibrillation over usual care. TRIAL REGISTRATION:ClinicalTrials.gov Register: NCT03911986.

BACKGROUND:An enhanced understanding of renal outcomes in persons with chronic HBV, HIV, and HBV/HIV coinfection is needed to mitigate chronic kidney disease in regions where HBV and HIV are endemic. OBJECTIVES:To investigate changes in estimated glomerular filtration rate (eGFR) in adults with HBV, HIV or HBV/HIV enrolled in a 3 year prospective cohort study of liver outcomes in Dar es Salaam, Tanzania and initiated on antiviral therapy. METHODS:We compared eGFR between and within groups over time using mixed-effects models. RESULTS:Four hundred and ninety-nine participants were included in the analysis (HBV: 164; HIV: 271; HBV/HIV: 64). Mean baseline eGFRs were 106.88, 106.03 and 107.18 mL/min/1.73 m2, respectively. From baseline to Year 3, mean eGFR declined by 4.3 mL/min/1.73 m2 (95% CI -9.3 to 0.7) and 3.7 (-7.8 to 0.5) in participants with HBV and HIV, respectively, and increased by 5.1 (-4.7 to 14.9) in those with HBV/HIV. In multivariable models, participants with HBV had lower eGFRs compared with those with HIV or HBV/HIV and, after adjusting for HBV DNA level and hepatitis B e antigen (HBeAg) status, significantly lower eGFRs than those with HBV/HIV at all follow-up visits. CONCLUSIONS:In this Tanzanian cohort, coinfection with HBV/HIV did not appear to exacerbate renal dysfunction compared with those with either infection alone. Although overall changes in eGFR were small, persons with HBV experienced lower eGFRs throughout follow-up despite their younger age and similar baseline values. Longer-term studies are needed to evaluate continuing changes in eGFR and contributions from infection duration and other comorbidities.

Background:People with Latent tuberculosis infection (LTBI) remain the reservoir of tuberculosis. One-third to 1/4 of the world's population is infected. Its reactivation is due to factors that disrupt the host's immune response. Recent findings showed that Schistosoma mansoni coinfection leads to a Th2/Th1 profile which results in an immune modulation that favors the escape of the Mycobacteria. Schistosoma mansoni may contribute to TB incidence in endemic regions. We aimed to investigate the co-infection rate and patient outcomes. Methods:A prospective cohort study was conducted between 2020-2022 at University Clinical Research Center (UCRC), including culture-confirmed active pulmonary TB patients and tested for Schistosoma mansoni in stools using Kato-Katz Technique. After descriptive analysis a logistic regression was performed to determine risk factors associated with TB and Schistosoma mansoni co-infection. Results:Data of 174 tuberculosis-confirmed patients, Kato-Katz tested were analyzed. Males represented 62.6%, mean age was 34.9 ± 13.8 years, 29.9% were smokers, alcohol consumption 13.8%, TB contact history 26.4%, HIV coinfection 11.5%, diabetes 6.3%, undernourished 55.7%. Schistosoma mansoni prevalence was 28.7%. The co-infection was associated with less lung cavitation [aOR = 0.24 [95% CI (0.06-0.85), p = 0.028], unfavorable treatment result [aOR = 2.95 (1.23-7.08), p = 0.015] and death [aOR = 3.43 (1.12-10.58), p = 0.032]. Conclusions:Despite Kato-Katz's low sensitivity, Schistosoma mansoni coinfection was found in one-third of the TB patients; 2.5-fold higher than that of HIV. The coinfection was associated with poor treatment results and death.

Background The prevalence of invasive cervical cancer (ICC) is high in Nigeria, with over 12,000 new cases and 8,000 deaths annually. Differences in diagnostic methods for human papillomavirus (HPV) genotypes have generated varied prevalence rates across populations. Methods We examined the prevalence and distribution of HPV genotypes among HIV-negative women with ICC, HIV-positive women with ICC, and HIV-positive women without ICC. We utilized baseline data and DNA samples from cervical tissue obtained from a prospective cohort study between March 2018 and September 2022. High-throughput next-generation amplicon sequencing of the HPV L-1 gene was used to identify and classify the HPV genotypes. Modified Poisson regression models estimated associations between HIV and HPV status, adjusting for other variables of interest. Results Among 286 women tested for HPV, 48.9% were HIV-negative with ICC, 17.2% were HIV-positive with ICC, and 33.9% were HIV-positive without ICC. The prevalence of high-risk HPV (HR-HPV) was 77.6% among HIV-positive women with ICC, whereas it was 60.0% among HIV-negative women with ICC (p < 0.001). HIV-positive women more frequently had multiple HPV genotypes (8.2% versus 1.4% among HIV-negative women with ICC and 2.1% among HIV-negative women without ICC) (p < 0.001). HPV16 or HPV18 accounted for 29.4% of all HPV cases. The most frequently detected HR-HPV genotypes included HPV16 (20.6%), HPV18 (8.7%), HPV45 (4.2%), and HPV35 (2.8%). In multivariable models adjusted for age, BMI, parity, and study site, HIV-positive women had an increased risk of HR-HPV (aPRR = 1.46, 95% CI: 1.17, 1.82) and any HPV infection (aPRR = 2.29, 95% CI: 1.83, 2.74) compared to HIV-negative women. Conclusion Our NGS approach to HPV typing in Nigerian women, including those with cervical cancer and HIV, revealed the presence of HPV types not covered by the Gardasil-4 vaccine. This highlights the need for broader coverage of vaccines to protect against most HR-HPV types, irrespective of HIV status.