Cysteine-Based Redox-Responsive Nanoparticles for Fibroblast-Targeted Drug Delivery in the Treatment of Myocardial Infarction

Upon myocardial infarction (MI), activated cardiac fibroblasts (CFs) begin to remodel the myocardium, leading to cardiac fibrosis and even heart failure. No therapeutic approaches are currently available to prevent the development of MI-induced pathological fibrosis. Most pharmacological trials fail from poor local drug activity and side effects caused by systemic toxicity, largely due to the lack of a heart-targeted drug delivery system that is selective for activated CFs. Here, we developed a reduced glutathione (GSH)-responsive nanoparticle platform capable of targeted delivering of drugs to activated CFs within the infarct area of a post-MI heart. Compared with systemic drug administration, CF-targeted delivery of PF543, a sphingosine kinase 1 inhibitor identified in a high-throughput antifibrotic drug screening, had higher therapeutic efficacy and lower systemic toxicity in a MI mouse model. Our results provide a CF-targeted strategy to deliver therapeutic agents for pharmacological intervention of cardiac fibrosis.

Genome-wide identification and expression analysis of SlRR genes in response to abiotic stress in tomato

The cytokinin two-component signal transduction system (TCS) is involved in many biological processes, including hormone signal transduction and plant growth regulation. Although cytokinin TCS has been well characterized in Arabidopsis thaliana, its role in tomato remains elusive. In this study, we characterized the diversity and function of response regulator (RR) genes, a critical component of TCS, in tomato. In total, we identified 31 RR genes in the tomato genome. These SlRR genes were classified into three subgroups (type-A, type-B and type-C). Various stress-responsive cis-elements were present in the tomato RR gene promoters. Their expression responses under pesticide treatment were evaluated by transcriptome analysis. Their expression under heat, cold, ABA, salinity and NaHCO₃ treatments was further investigated by qRT-PCR and complemented with the available transcription data under these treatments. Specifically, SlRR13 expression was significantly upregulated under salinity, drought, cold and pesticide stress and was downregulated under ABA treatment. SlRR23 expression was induced under salt treatment, while the transcription level of SlRR1 was increased under cold and decreased under salt stress. We also found that GATA transcription factors played a significant role in the regulation of SlRR genes. Based on our results, tomato SlRR genes are involved in responses to abiotic stress in tomato and could be implemented in molecular breeding approaches to increase resistance of tomato to environmental stresses.

Application of B-flow imaging and its enhanced mode in perforator mapping

AIM

To explore the value of B-flow (B-mode blood flow) imaging and its enhanced mode in perforator mapping.

MATERIALS AND METHODS

Before surgery, B-flow imaging, enhanced B-flow imaging, colour Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) were used to detect the skin-perforating vessels and small vessels in the fat layer of the donor site. Taking the intra-operative results as the reference standard, the diagnostic consistency and efficiency of the four modes were compared. Statistical analysis was performed using the Friedman M-test, Cochran's Q-test, and the Z-test.

RESULTS

Thirty flaps were excised, with 34 skin-perforating vessels and 25 non-skin-perforating vessels, as confirmed during surgery. In order of the number of skin-perforating vessels detected, the results showed that enhanced B-flow imaging detected more vessels than B-flow imaging and CDFI (all p<0.05), CEUS detected more vessels than B-flow imaging and CDFI (all p<0.05), B-flow imaging detected more vessels than CDFI (p<0.05). All four modes had remarkable and satisfactory diagnostic consistency and effectiveness, but B-flow imaging was the best (sensitivity 100%, specificity 92%, Youden index 0.92). In order of the number of small vessels in the fat layer detected, the results showed that enhanced B-flow imaging detected more vessels than CEUS, B-flow imaging, and CDFI (all p<0.05). CEUS detected more vessels than B-flow imaging and CDFI (all p<0.05).

CONCLUSION

B-flow imaging is an alternative method for perforator mapping. Enhanced B-flow imaging can reveal the microcirculation of flaps.

Belzutifan (MK-6482): Biology and Clinical Development in Solid Tumors

PURPOSE OF REVIEW

To review the biology, drug development, and clinical data regarding the efficacy and safety of belzutifan (MK-6482), a small molecule inhibitor of HIF-2α.

RECENT FINDINGS

Belzutifan, a second-generation HIF-2α inhibitor, was shown to provide clinically meaningful benefit in the treatment of VHL-associated tumors (including ccRCC, pancreatic lesions as well as neuroendocrine tumor, and CNS hemangioblastomas). The recommended dose of belzutifan is 120 mg orally daily and half-life is 14 h. In pretreated ccRCC, belzutifan achieved disease control rate of 80% in phase I trial. The most common side effects include anemia and hypoxia related symptoms. Investigation into the important role HIF-2α plays in the expression of genes associated with angiogenesis, erythropoiesis, carcinogenesis, and progression of tumors and the discovery of structural vulnerability within HIF-2α have resulted in the development of a new therapy that has demonstrated efficacy and safety in recent clinical trials. Further research is ongoing to optimize therapeutic benefits from this new exciting therapeutic modality and to improve the outcome of HIF-2α-driven tumors.

Association of Dental Caries with Muscle Mass, Muscle Strength, and Sarcopenia: A Community-Based Study

OBJECTIVES

Changes in the oral cavity can reflect other changes throughout the body. This study aimed to investigate the association of dental caries with muscle mass, muscle strength, and sarcopenia, and also to describe the microbial diversity, composition, and community structure of severe dental caries and sarcopenia.

DESIGN

Cross-sectional study based on a Chinese population aged from 50 to 85 years.

SETTING

Communities from Lanxi City, Zhejiang Province, China.

PARTICIPANTS

A total of 1,442 participants aged from 50 to 85 years from a general community (62.8% women; median age 61.0 [interquartile range: 55.0, 68.0]).

MEASUREMENTS

Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. Sarcopenia was defined as the presence of both low muscle mass (assessed by dual-energy X-ray absorptiometry scanning) and low muscle strength (assessed by handgrip strength). Multivariate logistic regression models were used to analyze the association of dental caries with muscle mass, muscle strength, and sarcopenia. Fecal samples underwent 16S rRNA profiling to evaluate the diversity and composition of the gut microbiota in patients with severe dental caries and/or sarcopenia.

RESULTS

In the fully adjusted logistic models, dental caries was positively associated with low muscle strength (DMFT ≥ 7: OR, 1.61; 95% CI, 1.25-2.06), and sarcopenia (DMFT ≥ 7: OR, 1.51; 95% CI, 1.01-2.26), but not low muscle mass. Severe dental caries was positively associated with higher alpha-diversity indices (richness, chao1, and ACE, all p < 0.05) and associated with beta-diversity based on Bray-Curtis distance (p = 0.006). The severe dental caries group and the sarcopenia group overlapped with 11 depleted and 13 enriched genera.

CONCLUSION

Dental caries was positively associated with low muscle strength and sarcopenia but not muscle mass, and this association was more pronounced in male individuals. Significant differences were observed in gut microbiota composition both in severe dental caries and sarcopenia, and there was an overlap of the genera features. Future longitudinal studies are needed to clarify causal relationships.

Response of sugar metabolism in the cotyledons and roots of Ricinus communis subjected to salt stress

Ricinus communis is an important oilseed crop worldwide and is also considered one of the best potential plants for salt-affected soil improvement in northeast China. However, little is known about photosynthesis and carbohydrate metabolism in this plant, nor the distribution of carbohydrates in cotyledons and roots under salinity stress. In the present study, seedling growth, gas exchange parameters (P_N , E, g_s and C_i ), carbohydrate (fructose, sucrose, glucose, soluble sugar and starch) metabolism and related enzymes and genes were measured in Ricinus plants. Under salt stress, P_N of cotyledons decreased significantly (P < 0.05), resulting in weak photosynthetic capacity. Furthermore, salt stress increased sucrose and glucose content in cotyledons, but decreased soluble sugar and starch content. However, sucrose increased and starch decreased in roots. This may be correlated with the increasing sugar metabolism under salinity, including notable changes in sugar-related enzyme activities (SPS, SuSy, α-amylase and β-amylase) and gene expression of RcINV, RcSUS, RcAmY, RcBAM and RcGBE1. The results suggest that salinity reduces photosynthesis of cotyledons, alters carbohydrate allocation between cotyledons and roots and also promotes starch utilization in cotyledons and starch biosynthesis in roots, leading to a functional imbalance between cotyledons and roots. Together, these findings provide insights into the crucial role of sugar metabolism in improving salt-tolerance of Ricinus during the early seedling growth stage.

An exosome-related long non-coding RNAs risk model could predict survival outcomes in patients with breast cancer

Breast cancer (BC) is one of the most frequent malignancies among women worldwide. Accumulating evidence indicates that long non-coding RNA (lncRNA) may affect BC progression. Exosomes, a class of small membrane vesicles, have been reported to promote tumor progression through transporting proteins, mRNAs, lncRNAs and some other small molecules. However, the interaction between exosome-related lncRNAs and the microenvironment of malignancies is unclear. Hence, we proceeded to investigate the relationship between exosome-related lncRNAs and BC microenvironment. 121 exosome-associated genes were extracted from ExoBCD database. Then, the Pearson analysis was used to screened out the exosome-related lncRNAs. After that, 15 exosome-related differentially expressed lncRNAs were identified by the correlation with BC prognosis. According to the sum of the expression of these 15 lncRNAs, extracted from The Cancer Genome Atlas, and the regression coefficients, an exosome-related lncRNAs signature was developed by using Cox regression analysis. With the median risk score of the training set, the patients in training and validation sets were separated to low-risk group and high-risk group. Subsequently, the lncRNA-mRNA co-expression network was constructed. The distinct enrichment pathways were compared among the different risk groups by using the R package clusterProfiler. The ESTIMATE method and ssGESA database were adopted to study the ESTIMATE Score and immune cell infiltration. Eventually, the expression of immune checkpoint associated genes, microsatellite instable and the immunophenoscore were further analyzed between different risk groups. Different risk groups exhibited different prognosis, with lower survival rate in the high-risk group. The differentially expressed genes between the different risk groups were enriched in biological processes pathways as well as immune responses. BC patients in high-risk group were identified with lower scores of ESTIMATE scores. Subsequently, we noticed that the infiltrating levels of aDCs, B cells, CD8+ T cells, iDCs, DCs, Neutrophils, macrophages, NK cells, pDCs, Tfh, T helper cells, TIL and Tregs were obvious elevated with the decreased risk score in training and validation cohorts. And some immune signatures were significantly activated with the decreased risk score in both cohorts. Eventually, the exosome-associated lncRNAs risk model was demonstrated to accurately predict immunotherapy response in patients with BC. The results of our study suggest that exosome-related lncRNAs risk model has close relationship with prognosis and immune cells infiltration in BC patients. These findings could make a great contribution to improving BC immunotherapy.

Comprehensive analysis of cuproptosis-related long non-coding RNA signature and personalized therapeutic strategy of breast cancer patients

Background

Breast cancer (BC) is considered to be one of the primary causes of cancer deaths in women. Cuproptosis was suggested to play an important role in tumor proliferation and tumor immune microenvironment. Therefore, an investigation was conducted to identify the relationship between cuproptosis-related long non-coding RNAs (lncRNAs) and BC prognosis.

Method

Based on The Cancer Genome Atlas (TCGA), nine cuproptosis-related lncRNAs were identified by Pearson's analysis and Cox regression analysis to create a cuproptosis-related lncRNA signature. Subsequently, patients with BC were divided into high-risk and low-risk groups. The Kaplan-Meier curves and a time-dependent receiver operating characteristic (ROC) analysis were employed to elucidate the predictive capability of the signature. After that, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was conducted by Gene Set Enrichment Analysis (GSEA), and the lncRNA-mRNA co-expression network was established by Cytoscape software. Furthermore, the ESTIMATE score was calculated, and the immune cell type component analysis was conducted. Eventually, immunotherapy response analysis was applied to identify the predictive power of cuproptosis-related lncRNAs to tumor immunotherapy response, including immune checkpoint gene expression levels, tumor mutational burden (TMB), and microsatellite instability (MSI).

Results

Patients with BC in the low-risk groups showed better clinical outcomes. The KEGG pathways in the high-risk groups were mainly enriched in immune response and immune cell activation. Furthermore, the ESTIMATE scores were higher in the low-risk groups, and their immune cell infiltrations were dramatically different from those of the high-risk groups. The low-risk groups were shown to have higher infiltration levels of CD8+ T cells and TMB-high status, resulting in better response to immunotherapies.

Conclusion

The findings of this study revealed that the nine-cuproptosis-related lncRNA risk score was an independent prognostic factor for BC. This signature was a potential predictor for BC immunotherapy response. What we found will provide novel insight into immunotherapeutic treatment strategies in BC.

Interspecies differences in mammalian susceptibility to legacy POPs and trace metals using skin fibroblast cells

The susceptibility to trace metals and legacy POPs is different between terrestrial and marine mammals. In this study, we established the first cell line from Indo-Pacific finless porpoises and compared the cellular responses of skin fibroblast cells from Pygmy killer whales, Pantropic spotted dolphins, Indo-Pacific finless porpoises, mice, and humans following exposure to copper, methylmercury, cadmium, PCB126, PCB153, and BDE47 to better understand the interspecies sensitivities of mammals to chemical pollutants. We conducted a risk assessment by comparing no-observed effect concentrations (NOEC), lowest-observed effect concentrations (LOEC), and half maximal effective concentrations (EC50) from cell viability assays and previously reported pollutant body burdens in mammals. Based on the in vitro data, Indo-Pacific finless porpoises were more sensitive to copper and methylmercury than other mammals. PCB153 exposure reduced cell viability in all mammals except humans, while PCB126 was more potent, with 13.33 μg/mL exposure reducing cell viability in all mammals. In contrast, BDE47 exposure reduced cell viability only in terrestrial mammals in addition to pantropic spotted dolphin. Based on the in vitro data and the natural context of metal concentrations, both methylmercury and cadmium posed a higher risk to cetaceans than human, while copper posed a lower risk to cetaceans. All three legacy POPs (PCB126, PCB153, and BDE47) posed minor risk to cetaceans for short-term exposure. This study demonstrated that a species-specific in vitro model may provide more accurate information on the potential risk of pollutants to mammals. However, due to the bioamplification of POPs and their potential impact on the endocrine system and immune system of cetaceans, risk assessment with long-term exposure with more in vitro models should be further studied.

[Efficacy analysis of lidocaine plaster combined with gabapentin in the treatment of herpes zoster neuralgia]

Objective: To evaluate the efficacy and safety of lidocaine plaster combined with gabapentin in the treatment of herpes zoster neuralgia (HZN). Methods: A total of 93 patients diagnosed with HZN from June 4, 2021 to January 5, 2022 in the Department of Pain Clinic of Nanjing Drum Tower Hospital were selected, and their gender was not limited. They were divided into 3 groups by random number table method: group A (n=32) prescribed gabapentin alone, group B (n=30) lidocaine plaster alone, and group C (n=31) lidocaine plaster combined with gabapentin. After excluding patients who did not meet the criteria, there were 28 cases in group A, 28 cases in group B, and 29 cases in group C. The visual analogue scale (VAS), the short-form McGill pain questionnaire (SF-MPQ) score, and drug dosage and adverse reaction in each group at pre-treatment (T0), post-treatment in one week (T1), in two weeks (T2), in four weeks (T4), and in 12 weeks (T12) were recorded and evaluated; Pittsburgh Sleep Quality Index (PSQI) score and Medical Outcomes Study short-form 36 (SF-36) score at T0, T4, and T12 were recorded. Adverse reactions and drug dosage in each group were documented. Repeated measures ANOVA was used to compare the curative effects of the three groups at different time points before and after treatment. Results: The ages of the three groups of patients were (67.8±10.0), (60.9±11.4) and (63.5±12.5) years old respectively (P=0.318), and the proportions of men were 46.4 % (13 cases), 35.7% (10 cases) and 44.8 % (13 cases), respectively (P=0.472). After treatment, the VAS scores and SF-MPQ scores of patients in the three groups were decreased at each time point compared with those before treatment (all P<0.05), the VAS and SF-MPQ scores of patients in group C at T12 time point were 1.2±0.4 and 5.2±2.4 respectively, which were lower than those of patients in groups A and B (both P<0.05). The dosages of gabapentin and lidocaine plaster in group C were lower than those in groups A and B at each time point after treatment (all P<0.05). The PSQI scores of patients in the three groups at T4 and T12 were lower than those before treatment (all P<0.05). The PSQI scores of patients in group C at T4 and T12 were 5.7±1.2 and 4.5±1.2, which were lower than those of patients in groups A and B. (all P<0.05), The SF-36 scores of patients in three groups at T4 and T12 were higher than those before treatment (all P<0.05), and the SF-36 scores of group C at T4 and T12 were 91.7±8.5, 93.1±6.3, which were higher than that of patients in groups A and B (both P<0.05). The incidence of adverse reactions in the three groups were 35.7% (9 cases), 10.7% (3 cases), and 13.8% (4 cases) respectively (P<0.05), the adverse reactions in groups B and C were less than those in group A (P<0.05), and there was no statistical difference between groups B and C (P>0.05). Conclusion: Lidocaine plaster combined with gabapentin has better analgesic effect in the treatment of HZN, with less incidence of adverse reactions, and can reduce the dosage of systemic drugs, improve patients' sleep and quality of life, and thus could provide a safe and effective method for the treatment of HZN.

Hysteresis analysis reveals dissolved carbon concentration - discharge relationships during and between storm events

The dissolved carbon concentration, which is responsible for aquatic ecosystem productivity and water quality, is tightly coupled with hydrological processes. Excess dissolved carbon may exacerbate eutrophication and hypoxia in aquatic ecosystems and lead to deterioration of water quality. Storm events dominate the dynamics of dissolved carbon concentrations, and this nonlinear behavior exhibits significant time scale dependence. Here, we identified inter- and intra-event variability in the dissolved carbon concentration-discharge (C-Q) relationship in an agriculture-intensive catchment. The driving factors of C-Q hysteresis patterns for dissolved inorganic carbon (DIC) and organic carbon (DOC) were quantified by redundancy analysis combined with hierarchical partitioning. At the inter-event scale, DIC exhibited mainly clockwise hysteresis, indicating an exhaustible, proximal source (e.g., groundwater). However, DOC hysteresis was generally counter-clockwise, indicating distal and plentiful sources (e.g., soil water) in the agricultural catchment. Hierarchical partitioning showed that total rainfall, peak discharge and flood intensity explained 28.38% of the total variation in C-Q hysteresis for DIC and 39.87% for DOC at the inter-event scale. At the intra-event scale, time series analysis of dissolved carbon concentration and discharge indicated the interconversion of supply limitation to transport limitation, which depends on the activation of the specific DIC or DOC source zones. These findings provide significant insights into understanding the dynamics of dissolved carbon during storm periods and are important for targeted watershed management practices aimed at reducing carbon loading to surface waters.

Effect of Preoperative Oral Saline Administration on Postoperative Delirium in Older Persons: A Randomized Controlled Trial

Objective

Postoperative delirium (POD) seriously affects recovery of older persons, increasing their mortality rate after surgery. We aimed to evaluate preoperative oral saline administration on postoperative delirium in older persons undergoing spinal decompression.

Design

A randomised controlled trial in a large tertiary hospital.

Setting and Participants

A total of 76 older persons (≧65 years old) undergoing spinal surgery from May 2020 to January 2021.

Methods

Older persons (65–83 years old) who underwent elective spinal canal decompression were randomly grouped into either the control group (n = 38) or the intervention group (n = 38). The control group was forbidden from drinking 8 hours prior to the operation while the intervention group was administered 5 mL·kg⁻¹ of normal saline 2 hours before anesthesia. Hemodynamic indicators, diagnostic biomarkers, preoperative mini-mental status scores, and intraoperative fluid dynamics were recorded at baseline and at various postoperative timepoints. Subjects were then scored for POD and postoperative pain.

Results

S100β protein was lowered in S₁ (F_S1 = 12.289, P <0.001) and S₂ (F_S2 = 12.440, P <0.001) in the intervention group while mean arterial blood pressure (F_T1= 42.997, P<0.001) and heart rate (F_T1= 8.974, P=0.004) were increased. The Ln c-reactive protein of the intervention group was lowered 1 day postoperatively (F_S2 = 6.305, P = 0.014). The incidence of postoperative delirium in the control group was higher than in the intervention group (27.8% vs 8.3%, χ² = 4.547, P = 0.033).

Conclusion

Preoperative oral saline can reduce the incidence of postoperative delirium in older persons by minimizing perioperative hemodynamic fluctuations and central nervous system damage.

Fatty acid metabolism predicts prognosis and NK cell immunosurveillance of acute myeloid leukemia patients

Background

Cell metabolic reprogramming is a hallmark of tumor prognosis, and fatty acid metabolism (FAM) plays a crucial role in the tumor microenvironment (TME). However, the relationship between FAM, TME, and prognosis of acute myeloid leukemia (AML) patients remains elusive.

Methods

We extracted the single-cell RNA sequencing (scRNA-Seq) and bulk transcriptome data of AML patients from the TCGA and GEO databases and assessed the relationship between FAM, TME, and AML patient prognosis. We also performed functional enrichment (FE) assay to evaluate the significance of FAM in anti-AML immunosurveillance.

Results

Our scRNA-Seq analysis revealed that the leukemic stem cell (LSC)-enriched population exhibited elevated levels of FAM-related genes. Using these FAM-related genes, we developed a prognostic model that accurately estimated AML patient outcome. FE analysis showed that FAM was strongly related to alterations of TME-based immunosurveillance in AML patients. More importantly, we demonstrated that FAM inhibition via pharmaceutical targeting of PLA2G4A, a highly expressed FAM gene in AML patients with poor prognosis, enhanced the NK cell-mediated immunosurveillance in leukemia cells.

Conclusions

Leukemic stem cell (LSC)-enriched population exhibited elevated levels of FAM-related genes. We have successfully established the FAM formula that predicts AML patient prognosis and alterations in the TME-based immunosurveillance. We also found that PLA2G4A was a highly expressed FAM gene in AML patients with poor prognoses. Pharmaceutical targeting of PLA2G4A increased the expression of NKG2DL in leukemia cells in vitro and thus enhanced the NK cell-mediated immunosurveillance.

A pyroptosis-associated gene risk model for predicting the prognosis of triple-negative breast cancer

BACKGROUND

Pyroptosis is a novel identified form of inflammatory cell death that is important in the development and progression of various diseases, including malignancies. However, the relationship between pyroptosis and triple-negative breast cancer (TNBC) is still unclear. Therefore, we started to investigate the potential prognostic value of pyroptosis-associated genes in TNBC.

METHODS

Thirty-three genes associated with pyroptosis were extracted from previous publications, 30 of which were identified in the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort. On the basis of the 30 pyroptosis-related genes, patients with TNBC were divided into three subtypes through unsupervised cluster analysis. The prognostic value of each pyroptosis-associated gene was assessed, and six genes were selected by univariate and LASSO Cox regression analysis to establish a multigene signature. According to the median value of risk score, patients with TNBC in the training and validation cohorts were separated to high- and low-risk sets. The enrichment analysis was conducted on the differentially expressed genes (DEGs) of the two risk sets using R clusterProfiler package. Moreover, the ESTIMATE score and immune cell infiltration were calculated by the ESTIMATE and CIBERSORT methods. After that, the correlation among pyroptosis-associated risk score and the expression of immune checkpoint-associated genes as well as anti-cancer drugs sensitivities were further analyzed.

RESULTS

In the training and validation cohorts, patients with TNBC in the high-risk set were found in a lower survival rate than those in the low-risk set. Combined with the clinical characteristics, the pyroptosis-related risk score was identified as an independent risk factor for the prognosis of patients with TNBC. The enrichment analysis indicated that the DEGs between the two risk groups were mainly enriched by immune responses and activities. In addition, patients with TNBC in the low-risk set were found to have a higher value of ESTIMATE score and a higher rate of immune cell infiltration. Finally, the expression levels of five genes [programmed cell death protein 1 (PD-1); cytotoxic t-lymphocyte antigen-4 (CTLA4); lymphocyte activation gene 3 (LAG3); T cell immunoreceptor with Ig and ITIM domains (TIGIT)] associated with immune checkpoint inhibitors were identified to be higher in the low-risk sets. The sensitivities of some anti-cancer drugs commonly used in breast cancer were found closely related to the pyroptosis-associated risk model.

CONCLUSION

The pyproptosis-associated risk model plays a vital role in the tumor immunity of TNBC and can be applied to be a prognostic predictor of patients with TNBC. Our discovery will provide novel insight for TNBC immunotherapies.

Determinants of diarrhoeal infections among users of shared sanitation in informal settlements in Durban, South Africa

Diarrhoeal disease continues to be a major health problem in many parts of the world, especially in developing countries, mainly due to the lack of access to sanitation, water, and hygienic living conditions. Identifying the determinants of diarrhoeal infections continues to be a challenge in developing countries. In this study, we ascertained the factors behind diarrhoea among inhabitants of informal settlements in the city of Durban, South Africa. Prevalence of diarrhoea in the study area varied between 7-year historical clinical records and data collected during the current study (primary data), with the primary data giving the highest monthly prevalence odds ratio (POR) up to 18.1 (±1.6)%. The main factors associated with diarrhoeal infections were open defaecation (POR = 1.8; 95% confidence interval (CI): 0.9-3.12), use of shared sanitation (POR = 1.7; 95%; CI: 1.05-2.26), and exposure to faecal matter around the homes (POR = 1.69; 95% CI: 1.25-3.10). Several other factors were also determined to be associated with diarrhoeal infections, such as hygiene practices in the communities, the non-treatment of water before use, and the presence of solid waste and faecal materials around the households. This study shows that diarrhoeal disease infections in informal settlements could be multifactorial; therefore, a multifactorial approach is needed to reduce these infections. These could include improving education on hygiene practices within the home setting as well as in public places, such as the community ablution blocks.