Global Health Epidemiology and Genomics最新文献

Cholera continues to pose a significant public health challenge in Nigeria, driven by socioeconomic disparities, poor sanitation, and environmental factors such as recurrent flooding. This narrative review examines cholera outbreaks in Nigeria, exploring epidemiological trends, socioeconomic and meteorological drivers, and advancements in diagnostic technologies. Emphasis is placed on the role of artificial intelligence (AI) in transforming cholera management through predictive modeling, early detection, and resource optimization. Rapid diagnostic tests (RDTs), molecular diagnostics, and biosensors are highlighted as tools for enhancing surveillance and improving outbreak response. Despite these advancements, Nigeria faces significant challenges, including inadequate laboratory infrastructure, insufficient environmental monitoring, and limited access to diagnostic tools in rural areas. Recommendations include strengthening diagnostic capacity, integrating AI-driven tools, and implementing proactive environmental surveillance. The manuscript underscores the importance of coordinated efforts among federal and state health agencies, international partners, and local communities to address the persistent cholera burden. By leveraging these strategies, Nigeria can improve its outbreak preparedness and mitigate the morbidity and mortality associated with cholera. This review provides actionable insights for public health interventions and policy-making, offering a forward-looking perspective on combating cholera through innovation and collaboration.

Clade 1b of the MPox virus has emerged as a highly virulent strain, causing significant public health challenges globally. Initially endemic to Central Africa, this strain has spread to nonendemic regions, including Europe, Asia, and the Americas. With its high transmission rate and severe outcomes, especially among vulnerable populations like children, Clade 1b has raised global concerns. The Africa Center for Disease Control and Prevention (CDC) has declared it a public health emergency of international concern. Clade 1b MPox shows a higher case fatality rate and increased transmissibility compared to other strains. It has moved beyond traditional zoonotic transmission to widespread human-to-human transmission. The variant's spread to countries such as Sweden and Thailand demonstrates its global reach. Public health efforts, including cross-border coordination, rapid response teams, and awareness campaigns, have been essential in containing the outbreaks. However, barriers such as limited resources, vaccine shortages, and logistical challenges in conflict-affected areas have hindered effective control, particularly in low-resource regions. The spread and severity of Clade 1b MPox highlight the need for global cooperation to strengthen surveillance, improve diagnostic capabilities, and expand healthcare infrastructure in affected areas. Enhancing access to vaccines and treatments, along with educating the public on preventive measures, will be key to controlling transmission. Ongoing research and monitoring are essential to mitigate future outbreaks and minimize the virus's global impact.

Background: SARS-CoV-2 is a positive-sense single-stranded RNA virus that has a propensity for infecting epithelial cells and the respiratory system. The two important proteins, structural and nonstructural proteins, make the architecture of this virus. Aim: This research aimed at studying significant mutations in spike protein of SARS-CoV-2 variants of concern (VoCs) and finding shared mutations among omicron and other four variants (alpha, beta, gamma, and delta). The purpose of this study was to draw structural comparisons between wild type and mutant proteins, followed by identifying potent inhibitors (ligand) that could be used against SARS-CoV-2 spike protein and its latest omicron VoC. Methodology: In this research, we had studied 16 major mutations as well as shared mutations (6) present in spike region of SARS-CoV-2. Subsequently, we determined the structure of the wild-type SARS-CoV-2 protein from the Protein Data Bank (PDB) with the ID 7R4I. Furthermore, the structure of the mutant protein of SARS-CoV-2 omicron variant was modeled in SWISS-MODEL. The ligand dataset for spike protein of SARS-CoV-2 was also collected from literature and different databases. Both wild type and mutant proteins were docked with ligand database in Molecular Operating Environment (MOE). The docking analysis was performed, and two best ligand molecules, AZ_2 and AZ_13, were finalized based on their energy values, interactions, and docking scores to be used against our wild and mutant proteins. Results: AZ_2 demonstrated a docking score of -6.1753 in MOE, with energy values of -4.3889 and -6.1753. It formed key hydrogen bond interactions. AZ_13 showed a docking score of -5.9, with energy values of -9.3 and -5.9, forming hydrogen donor and acceptor interactions with Asp950 (3.06 Å), Ile312 (3.13 Å), and Glu309 (3.27 Å). These interactions suggest strong binding affinity and potential efficacy. Thus, present research work emphasized on identification of significant mutations and finding a potent target-based drug against SARS-CoV-2 and its omicron variant. Outcomes: Based on this computational analysis performed, it is suggested that proposed compound can be used as remedy against SARS-CoV-2 and its omicron variant.

Background: Chandipura virus (CHPV) is an emerging rhabdovirus primarily affecting pediatric populations in India, causing acute encephalitis syndrome (AES) with high mortality rates. First identified in 1965, CHPV has resurfaced in several outbreaks, the most recent being in 2024, with significant public health implications. The virus is transmitted primarily by sandflies, particularly Phlebotomus spp., and has been associated with a rapid progression of symptoms, leading to severe neurological damage and death. Despite advances in diagnostic techniques, no specific antiviral treatment or licensed vaccine currently exists. Main Body of Abstract: This manuscript reviews the latest findings on CHPV, focusing on diagnostic advancements, treatment strategies, and public health responses. Reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) have emerged as vital tools for rapid and accurate diagnosis, enabling the identification of CHPV in clinical and environmental samples. Antiviral therapies, such as ribavirin and favipiravir, have shown promise in vitro and preclinical models, but human trials are lacking. Additionally, the virus's unique epidemiology, including its reliance on sandfly transmission, complicates control efforts, particularly in resource-limited settings. The 2024 outbreak, with a case fatality ratio of over 30%, highlights the urgent need for improved surveillance, vector control measures, and public health interventions to curb the spread of CHPV. Conclusion: Despite considerable progress in diagnostics and experimental treatments, significant challenges remain in controlling CHPV outbreaks. The lack of specific antiviral therapies and vaccines continues to hinder effective management. Strengthened vector control strategies, advanced diagnostic infrastructure, and ongoing research into antiviral development are essential for mitigating the impact of CHPV in affected regions. International collaboration and sustained public health efforts will be crucial in preventing future outbreaks and reducing the disease burden.

Introduction: Antibiotic resistance is a growing global health crisis that complicates the treatment of urinary tract infections (UTIs). While Enterobacterales are primary UTI pathogens, nonenteric pathogens such as Pseudomonas aeruginosa, Burkholderia cepacia, and Enterococcus spp. are increasingly recognized, posing challenges due to their complex resistance mechanisms. This study aims to investigate the prevalence, resistance patterns, and multidrug resistance (MDR) of nonenteric pathogens in community-acquired UTIs in Albania. Materials and Methods: The study was conducted in an outpatient clinic from September 2023 to September 2024, involving adults (≥ 18 years) and excluding individuals with recent antibiotic use or pregnancy. Urine samples were processed using blood and MacConkey Agar, followed by bacterial identification and susceptibility testing with the VITEK 2 system. A total of 11 antibiotics belonging to β-lactams, fluoroquinolones, glycylcyclines, oxazolidinones, lipopeptides, glycopeptides, and tetracyclines were tested. Statistical analysis was performed using SPSS, with significance set at p < 0.05. Results: A total of 550 urine cultures were analyzed, of which 372 (67.6%) were positive for bacterial growth. Among these, 27.7% were identified as nonenteric pathogens, with a higher occurrence in females (66%) and young adults (18-39 years) (60.2%). Enterococcus faecalis was the most common Gram-positive pathogen (15.2% of the positive samples), while P. aeruginosa was the most frequent Gram-negative pathogen (9.1%). P. aeruginosa showed significant resistance to tigecycline (91.2%) and levofloxacin (38.2%), with no resistance to meropenem. E. faecalis showed high resistance to vancomycin (53.6%) and teicoplanin (46.4%), while S. saprophyticus showed moderate resistance. MDR prevalence was highest in P. aeruginosa (26.5%). Conclusion: This study highlights the high prevalence of community-acquired UTIs in Albania, particularly among females, and concerning MDR rates. To address these challenges, it is crucial to implement standardized treatment protocols, improve antibiotic stewardship, and promote research to track resistance patterns, ultimately enhancing patient care and combating antibiotic resistance.

Background: The unprecedented outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has dramatically changed the global approach to public health, emphasizing the importance of measures to control and prevent infections. In response to the COVID-19 crisis, stringent hygiene practices and surface disinfection have become the norm, with an unprecedented surge in the use of disinfectants and antiseptics (DAs). Main Text: While these measures have been crucial in curbing the spread of the virus, an emerging concern has taken center stage: the potential impact of the prolonged and widespread use of antimicrobial compounds in these products on the development of antibiotic resistance. Antimicrobial resistance (AMR) has long been recognized as one of the most pressing global health threats. Quaternary ammonium compounds (QAC) such as benzalkonium chloride, benzethonium chloride, and cetylpyridinium chloride, which are extensively used in DAs formulations, have gained less attention in the context of AMR. Conclusion: A high abundance of QACs was detected in wastewater, and certain bacteria such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterococcus species developed resistance to these compounds over time. We analyzed the available evidence from the scientific literature, examining the presence and concentrations of QACs in different water sources, and their resistance mechanisms. This review aimed to shed light on the multifaceted challenges that arise from the dual battle against the COVID-19 pandemic and the ongoing global fight against AMR.

Multimorbidity is a complex and highly prevalent health condition characterised by the coexistence of two or more chronic diseases within an individual. It is a growing public health issue worldwide, predominantly in low-resource countries like Bangladesh. Therefore, this study aimed to determine the prevalence and associated factors of multimorbidity among the adult population in Bangladesh. A cross-sectional study was carried out among 504 respondents who were 18 years or older. The generalised linear mixed model was used to identify the risk factors. Among the respondents, 65.3% (95% confidence interval [CI]: 61.0 to 69.3) had multimorbidity. The most common chronic conditions were allergic disorder (34%, 95% CI: 30 to 39), gastritis (31%, 95% CI: 27 to 35), low back pain (28.4%, 95% CI: 24.6 to 32.5), oral diseases (27%, 95% CI: 23 to 29) and arthritis (21%, 95% CI: 18 to 25). Middle-aged adults (adjusted odds ratio [AOR] = 7.97; 95% CI: 3.35 to 18.92) and older adults (AOR = 8.44; 95% CI: 1.90 to 36.64) had significantly higher odds of multimorbidity than young adults. Employed respondents had an 86% (AOR = 0.14; 95% CI: 0.07 to 0.36) lower odds of multimorbidity than non-working individuals. Higher sleeping duration (6 to 8 h: AOR = 0.44; 95% CI: 0.25 to 0.80; 8 to 10 h: AOR = 0.26; 95% CI: 0.11 to 0.60), regular vegetable consumption (AOR = 0.42; 95% CI: 0.22 to 0.80) and adequate water intake (AOR = 0.48; 95% CI: 0.29 to 0.79) were protective factors against multimorbidity, whereas obesity increased the odds (AOR = 3.32; 95% CI: 1.06 to 10.43). These findings emphasise the need to promote healthy lifestyle habits, such as maintaining a balanced diet, staying hydrated and engaging in regular physical exercise, to reduce the burden of multimorbidity in low-resource settings.

Background: Cockroaches could play a role in the transmission dynamics of antimicrobial-resistant bacteria (ARB) at variable interfaces in Ugandan communities, acting as both reservoirs and vectors. This study investigated the burden and diversity of ARB carried by cockroaches in human settlements in Uganda, so as to understand their role in the spread of these pathogens and their potential as sentinels in antimicrobial resistance (AMR) surveillance programs. Materials and Methods: A retrospective analysis was conducted on two unpublished studies by Makerere University students. Study one and study two sampled 58 and 110 cockroaches, respectively, from secondary schools in Kampala. Cockroach species identification was determined based on physical characteristics. Bacterial isolation and characterization were performed through microbiological analyses including standard culture methods, biochemical tests, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), disc diffusion method, and polymerase chain reaction (PCR). Results: Majority of the cockroaches (over 80%) were Periplaneta americana. Multidrug resistance (MDR) was prevalent among the isolates, with over 30% of the isolates being resistant to three or more antibiotic classes. Specifically, MDR (over 90%) was rampant in the extended spectrum beta-lactamase (ESBL)- or AmpC-producing Escherichia coli and enterococci isolates. Critical World Health Organization (WHO) priority pathogens, such as ESBL-/AmpC-producing Enterobacteriaceae, and carbapenem-resistant E. coli, were also identified. The most abundant resistance determinants (tetracycline and sulphonamide) were tetA, sul1, and sul2 for E. coli, and tetM and tetL for enterococci. Conclusion: The findings accentuate the potential role of cockroaches: (1) in transmitting multidrug-resistant bacteria at the human-animal-environment interface and (2) as sentinels in the surveillance of community-generated AMR.

Introduction: Studies on the relationship between a family history of hypertension and left ventricular hypertrophy are sparse. We evaluated this relationship in patients with essential hypertension.

Methods: A total of 1668 patients with essential hypertension were consecutively enrolled in the prospective Federal Medical Centre Abuja Hypertension Registry. First-degree family history was defined by the presence of a known history of hypertension in any or both parents, siblings, and children. Echocardiographic left ventricular hypertrophy was diagnosed using the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Results: The prevalence of a family history of hypertension, echocardiographic, and electrocardiographic left ventricular hypertrophy were 61.7%, 46.8%, and 30.8%, respectively. After multivariable adjustment, paternal history of hypertension [OR: 1.56, CI: 1.20-2.05, p=0.001] was associated with an increased risk of echocardiographic left ventricular hypertrophy, while maternal history of hypertension [OR: 0.72, CI 0.58-0.91, p=0.006] was associated with a reduced risk. Age ≥50 years (p=0.026), duration of hypertension ≥1 year (p=0.047), and heart failure (p < 0.001) were associated with an increased risk of left ventricular hypertrophy, while male sex (p < 0.001) was associated with a reduced risk.

Conclusion: Our study showed that a paternal history of hypertension is associated with an increased left ventricular hypertrophy risk among patients with essential hypertension, while maternal history is protective.

Purpose: Neonatal sepsis contributes substantially to neonatal mortality and morbidity and is an ongoing major global public health problem particularly in developing countries. A significant proportion of mothers give birth in primary health care, but studies regarding neonatal sepsis and its associated factors among admitted neonates are limited to the hospital which may not be generalized to the primary health care unit. Therefore, this study aimed to assess the proportion of neonatal sepsis and associated factors in the study areas.

Objective: To assess the magnitude of neonatal sepsis and its associated factors among neonates admitted to Neonatal Intensive Care Units (NICUs) of Hawzen Primary Hospital, Eastern Zone, Tigray, North Ethiopia, 2020.

Methods: An institution-based cross-sectional study design was carried out among 290 study participants in Hawzen Primary Hospital in January-March/2020. A systematic random sampling method was applied to select the study participants, and pretested and structured questionnaires were used to collect data. The collected data were coded, entered, cleaned, and analyzed using SPSS version 20.0 software. Binary logistic regression analyses with a confidence interval of 95% were used to select determinant factors. Statistically significant factors were identified using the adjusted odds ratio (AOR). Statistical significance was determined at p value <0.05. Binary and multivariable logistic regression analyses were applied to see the association of the variables at a p < 0.05.

Results: In this study, the overall proportion of neonatal sepsis was (60.2%) 95% CI (56, 68)]. Birth asphyxia [AOR = 2.04; 95%CI (1.07, 3.93)], maternal age of 15-19 [AOR = 2.00; 95% CI (1.81, 11.93)], duration of labor greater or equal to 24 hours [AOR = 3.00; 95% CI (2.67, 14.21)], history of oxygen administration [AOR = 2.37; 95% CI (1.18, 4.75)], neonatal age of greater or equal to seven days [AOR = 4.0595% CI (1.07, 3.93), and home delivery [AOR = 5.00; 95% CI (2.34, 18.92)] were the predictor variables for neonatal sepsis.

Conclusion: In this study, neonatal sepsis was high. Birth asphyxia, intranasal oxygen administration, age of the mother, home delivery, and duration of labor were associated with neonatal sepsis.