Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges

Evaluation and analysis of respiratory infectious disease prevention behaviors in older adults

Background

Respiratory infectious diseases (RIDs) are a global public health problem, characterized by strong infectivity, high transmissibility, and a high incidence in the population. This study aimed to explore RID prevention behaviors among older adults and analyze their influencing factors.

Methods

A cross-sectional study was conducted to examine RID prevention behaviors among 2219 Chinese older adults. Analysis of variance and the Kruskal-Wallis test were used to compare behaviors among subjects with different characteristics. Pearson's correlation analysis was used to assess the relationships between knowledge, skills, and behavior, and a generalized linear model was used for multi-factor analysis.

Results

The participants in this questionnaire survey were predominantly older adults individuals aged 65-70 years (45.65%), with no more than a primary school educational level (86.70%). Univariate analysis revealed statistically significant associations between age, education, place of residence, living condition, marital status, annual income in the past year, type of medical insurance, health status, smoking status, drinking status, weekly exercise durations, and sleep status in older adults and their RID prevention behavior. Pearson's correlation analysis indicated a moderate correlation between knowledge, skills, and behavioral scores. Multivariate analysis identified place of residence, annual income, smoking habits, alcohol consumption, exercise frequency, knowledge level, and skill level as influential factors for behaviors related to the prevention and control of RID in older adults.

Conclusion

Our results confirm the importance of a healthy lifestyle in RID prevention among older adults, especially in terms of smoking, alcohol consumption, and regular exercise, and provide empirical evidence for the development of health promotion programs for older adults people, particularly in rural areas.

Emergence of infectious diseases and role of advanced nanomaterials in point-of-care diagnostics: a review

Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.

Leishmania tarentolae as a platform for the production of vaccines against viral pathogens

Infectious diseases remain a persistent public health problem and a leading cause of morbidity and mortality in both humans and animals. The most effective method of combating viral infections is the widespread use of prophylactic vaccinations, which are administered to both people at risk of disease and animals that may serve as significant sources of infection. Therefore, it is crucial to develop technologies for the production of vaccines that are highly effective, easy to transport and store, and cost-effective. The protein expression system based on the protozoan Leishmania tarentolae offers several advantages, validated by numerous studies, making it a good platform for producing vaccine antigens. This review provides a comprehensive overview into the potential applications of L. tarentolae for the safe production of effective viral antigens.

Understanding bacterial diversity, infection dynamics, prevention of antibiotic resistance: an integrated study in an Algerian hospital context

PURPOSE

Bacterial infections, particularly bacteremia, urinary tract infections (UTIs), and pus infections, remain among hospitals' most worrying medical problems. This study aimed to explore bacterial diversity, infection dynamics, and antibiotic resistance profiles of bacterial isolates.

METHODS

We analyzed data from 1750 outpatients and 920 inpatients, of whom 1.6% and 8.47% respectively had various bacterial infections.

RESULTS

The analysis revealed that UTIs were the most prevalent at 41.01%, particularly affecting women. UTIs also showed a distinct distribution across admission departments, notably in emergency (23.07%) and pediatric (14.10%) units. The most frequently isolated microorganisms were Escherichia coli (E. coli), followed by Klebsiella ornithinolytica. Skin infections followed UTIs, accounting for 35.88% of cases, more prevalent in men, with Staphylococcus aureus (S. aureus) being the primary pathogen (57%). Gram-negative bacteria (GNB) like E. coli and Pseudomonas aeruginosa contributed significantly to skin infections (43%). Bacteremia cases constituted 11.52% of bacterial infections, predominantly affecting women (67%) and linked to GNB (78%). A comparative study of antibiotic susceptibility profiles revealed more pronounced resistance in GNB strains isolated from inpatients, particularly to antibiotics such as Amoxicillin/clavulanic acid, Tetracyclin, Gentamicin, Chloramphenicol, and Ampicillin. In contrast, strains from ambulatory patients showed greater resistance to Colistin. Gram-positive bacteria from hospitalized patients showed higher resistance to quinolones and cephalosporins, while ambulatory strains showed high resistance to aminoglycosides, macrolides, fluoroquinolones, and penicillin. Furthermore, these analyses identified the most effective antibiotics for the empirical treatment of both community-acquired and nosocomial infections. Ciprofloxacin, aztreonam, and amikacin exhibited low resistance rates among GNB, with gentamicin and chloramphenicol being particularly effective for community-acquired strains. For S. aureus, ciprofloxacin, rifampicin, and cefoxitin were especially effective, with vancomycin showing high efficacy against community-acquired isolates and fosfomycin and chloramphenicol being effective for hospital-acquired strains.

CONCLUSION

These results are essential for guiding antibiotic therapy and improving clinical outcomes, thus contributing to precision medicine and antimicrobial stewardship efforts.

From clove oil to bioactive agents: synthetic routes, antimicrobial and antiparasitic activities of eugenol derivatives

Eugenol, a natural compound found in essential oils such as clove oil, has been extensively studied for its diverse biological activities including the therapeutic potential against microbial and parasitic infections. This review provides an overview of the synthetic strategies (shown in Supplementary Material) employed to develop bioactive derivatives and analogues derived from eugenol and related compounds (e.g., dihydroeugenol and isoeugenol), focusing on biological activity of more than 100 bioactive eugenol derivatives against bacterial, fungal, viral and protozoal pathogens. Through a comprehensive survey of literature, this paper shows the impact of structural modifications of these phenylpropanoids on antimicrobial and antiparasitic activity. Key findings highlight promising candidates for further development in antimicrobial drug discovery, suggesting directions for future research in the pursuit of effective therapeutic agents.

Can immuno-PCR (IPCR) transform bacterial disease diagnostics?

INTRODUCTION

Approximately 15 million deaths occur globally each year due to infectious diseases. Timely diagnosis is crucial in promoting cure and preventing disease transmission. Currently, molecular diagnostics have replaced many conventional diagnostic tools due to their inherent limitations. However, the full potential of Immuno Polymerase Chain Reaction (IPCR) remains largely untapped.

AREAS COVERED

This review focuses on the use of IPCR in the diagnosis of different bacterial diseases, highlighting its advantages over traditional methods.

EXPERT OPINION

Early and accurate diagnosis of infectious diseases is crucial because it enhances treatment effectiveness, reduces morbidity and mortality, helps identify potential causes of sepsis earlier, and reduces the risk of unknowingly spreading the disease to others. IPCR in turn has shown promise for the early diagnosis of bacterial diseases as an alternative to conventional culture-based or serological diagnostic assays leading to delayed diagnosis and treatment. IPCR has the potential to revolutionize the diagnostic field due to its increased sensitivity and specificity. Although efforts are needed to reduce the time of the assay and to reduce background noise, IPCR can be combined with other platforms like lateral flow assay/biosensors/automation to improve its use as a point-of-care assay, especially in resource-limited settings.

Mapping the Characteristics of Respiratory Infectious Disease Epidemics in China Based on the Baidu Index from November 2022 to January 2023

Introduction

Infectious diseases pose a significant global health and economic burden, underscoring the critical need for precise predictive models. The Baidu index provides enhanced real-time surveillance capabilities that augment traditional systems.

Methods

Baidu search engine data on the keyword "fever" were extracted from 255 cities in China from November 2022 to January 2023. Onset and peak dates for influenza epidemics were identified by testing various criteria that combined thresholds and consecutive days.

Results

The most effective scenario for indicating epidemic commencement involved a 90th percentile threshold exceeded for seven consecutive days, minimizing false starts. Peak detection was optimized using a 7-day moving average, balancing stability and precision.

Discussion

The use of internet search data, such as the Baidu index, significantly improves the timeliness and accuracy of disease surveillance models. This innovative approach supports faster public health interventions and demonstrates its potential for enhancing epidemic monitoring and response efforts.

A Multidisciplinary Approach in the Management of Infectious Diarrhea in the Emergency Department

Background Globally, infectious diarrhea poses a serious threat to public health, especially in emergency department (ED) settings where timely and efficient treatment is essential. The primary objective of this study was to explore and evaluate the efficacy of a multidisciplinary approach (MDA) in the management of infectious diarrhea within the ED setting. Methodology This prospective cohort study was conducted from January to December 2023 at the Lady Reading Hospital ED in Peshawar, Pakistan. Individuals 18 years of age or older with a confirmed diagnosis of infectious diarrhea were included in the study. Those who refused to participate or had non-infectious reasons were excluded from the study. Through successive sampling, 650 patients comprised the study sample. Using a standardized form, demographic information, clinical presentations, test results, treatment methods, and patient outcomes were collected. Descriptive statistics and logistic regression were used in statistical studies to assess treatment outcomes and complications. Results Of the 650 patients, the majority (203 patients, 31.23%) were between the ages of 30 and 39 years. The gender distribution was about equal (332 men, 51.08%; 318 females, 48.92%). Abdominal pain (383 patients, 58.92%) was the most common presenting complaint. In 310 instances, bacterial pathogens were found, 160 had viral infections, and 110 had parasitic infections. There were notable complications, such as sepsis (37 patients, 5.69%), although the response to treatment effectiveness was notably high (593 patients, 91.08%). Upon follow-up, 590 (90.77%) patients had symptom and sign resolution, while 80 (12.31%) patients had a low recurrence rate. Longer symptom duration (odds ratio (OR) = 1.45, 95% confidence interval (CI) 1.12-1.88, p = 0.005) and specific antibiotics (OR = 1.68, 95% CI = 1.25-2.25, p = 0.001) were found to improve treatment success using logistic regression, whereas the risks of complications increased with age (OR = 1.05, 95% CI = 1.01-1.09, p = 0.012) and severe dehydration (OR = 1.75, 95% CI = 1.32-2.31, p < 0.001). Conclusions The MDA to manage infectious diarrhea in the ED significantly improved patient outcomes and reduced complications.

Antimicrobial properties of WCO-based composites enriched with hops and curly sorrel for green building solutions

Modern production of vegetable oils has reached impressive levels, and the ever-growing quantities of waste cooking oil (WCO) provide a local source of raw materials for innovative materials. The WCO composite production process involves a series of reactions, including polymerisation, esterification, and transesterification, which lead to the hardening of composite materials. In light of the growing problem of bacterial and fungal diseases, materials with high strength properties and biocidal properties are being sought. Fungal infections of the skin are a widespread problem, and the number of cases is steadily increasing. This article presents a study of the antibacterial potential of WCO-based composites enriched with hops or sorrel root in the context of their application in the construction industry. The compressive and flexural strength of the oil composites, their absorbability and hydrophobicity, and their effects on Gram-positive (S. aureus and S. epidermidis) and Gram-negative (E. coli and P. aeruginosa) bacteria and fungi (A. niger, P. anomala) were investigated. Maximum split tensile strength (4.3 MPa) and flexural strength (5.1 MPa) were recorded for oil-hop composites. Oil composites enriched with curly sorrel and hops showed antibacterial activity against S. aureus at 27% and 25%. High biocidal activity (up to 70%) was recorded against E. coli and against S. epidermidis (up to 99%) due to the action of composites with curly sorrel. The antifungal activities of composites with hops was 15% and 19% for P. anomala and A. niger, respectively, while with curly sorrel they were 42% and 30%.

Green synthesized silver nanoparticles from Phoenix dactylifera synergistically interact with bioactive extract of Punica granatum against bacterial virulence and biofilm development

The global rise of antibiotic resistance poses a substantial risk to mankind, underscoring the necessity for alternative antimicrobial options. Developing novel drugs has become challenging in matching the pace at which microbial resistance is evolving. Recently, nanotechnology, coupled with natural compounds, has emerged as a promising solution to combat multidrug-resistant bacteria. In the present study, silver nanoparticles were green-synthesized using aqueous extract of Phoenix dactylifera (variety Ajwa) fruits and characterized by UV-vis spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM) coupled with Energy dispersive X-ray analysis (EDX), Transmission electron microscopy (TEM) and Thermogravimetric-differential thermal analysis (TGA-DTA). The in-vitro synergy of green synthesized P. dactylifera silver nanoparticle (PD-AgNPs) with selected antibiotics and bioactive extract of Punica granatum, i.e., ethyl acetate fraction (PGEF), was investigated using checkerboard assays. The most effective synergistic combination was evaluated against the QS-regulated virulence factors production and biofilm of Pseudomonas aeruginosa PAO1 by spectroscopic assays and electron microscopy. In-vivo anti-infective efficacy was examined in Caenorhabditis elegans N2 worms. PD-AgNPs were characterized as spherical in shape with an average diameter of 28.9 nm. FTIR analysis revealed the presence of functional groups responsible for the decrease and stabilization of PD-AgNPs. The signals produced by TGA-DTA analysis indicated the generation of thermally stable and pure crystallite AgNPs. Key phytocompounds detected in bioactive fractions include gulonic acid, dihydrocaffeic acid 3-O-glucuronide, and various fatty acids. The MIC of PD-AgNPs and PGEF ranged from 32 to 128 μg/mL and 250-500 μg/mL, respectively, against test bacterial strains. In-vitro, PD-AgNPs showed additive interaction with selected antibiotics (FICI 0.625-0.75) and synergy with PGEF (FICI 0.25-0.375). This combination inhibited virulence factors by up to 75 % and biofilm formation by 84.87 % in P. aeruginosa PAO1. Infected C. elegans worms with P. aeruginosa PAO1 had a 92.55 % survival rate when treated with PD-AgNPs and PGEF. The combination also reduced the reactive oxygen species (ROS) level in C. elegans N2 compared to the untreated control. Overall, these findings highlight that biosynthesized PD-AgNPs and bioactive P. granatum extract may be used as a potential therapeutic formulation against MDR bacteria.

Robinsoniella peoriensis Infections in Humans-A Narrative Review

Robinsoniella peoriensis is a Gram-positive, strictly anaerobic, spore-forming, rod-shaped bacterium belonging to the phylum Firmicutes and the family Lachnospiraceae. Until now, R. peoriensis is the only species of its genus. It was first isolated in 2003 during a study into the flora of lagoons and manure pits. Given the rarity of this microorganism and the sparse information in the literature about its way of transmission, the way to diagnose its infections and identify it in the microbiology laboratory, and its public health relevance, the present study aimed to identify all the published cases of Robinsoniella, describe the epidemiological, clinical, and microbiological characteristics, and provide information about its antimicrobial resistance, treatment, and outcomes. A narrative review was performed based on a Pubmed/Medline and Scopus databases search. In total, 14 studies provided data on 17 patients with infections by Robinsoniella. The median age of patients was 63 years and 47% were male. The most common types of infection were bone and joint infections, bacteremia, infective endocarditis, and peritonitis. The only isolated species was R. peoriensis, and antimicrobial resistance to clindamycin was 50%, but was 0% to the combination of piperacillin with tazobactam, aminopenicillin with a beta-lactamase inhibitor, and metronidazole which were the most commonly used antimicrobials for the treatment of these infections. The overall mortality depends on the type of infection and is notable only for bacteremia, while all other infections had an optimal outcome. Future studies should better assess these infections' clinical and epidemiological characteristics and the mechanisms of the antimicrobial resistance of this microorganism from a mechanistic and genetic perspective.

Mitigating the escalating threat of infectious diseases outbreaks in tropical Africa: a perspective examination of challenges and strategies for future preparedness

Background

The escalating threat of infectious disease outbreaks in Africa, particularly emerging and re-emerging diseases, necessitates urgent and comprehensive action. The frequency of these outbreaks demands a robust enhancement of notification and reporting systems to enable swift public health interventions.

Main body of the abstract

Tropical diseases such as malaria, COVID-19, typhoid fever, yellow fever, arboviruses, cholera, rabies, schistosomiasis, tuberculosis, black fungus, meningitis, evolving pathogens, and antimicrobial resistance pose significant health risks globally, especially in Sub-Saharan Africa. The region faces complexities in healthcare, including weak systems, inadequate surveillance, socioeconomic disparities, and other issues. Poor health literacy, traditional practices, and distrust hinder effective disease control and contribute to disease emergence in Sub-Saharan Africa. Continuous research and global collaboration are essential to address these public health concerns, especially given Africa's unique challenges. Disease surveillance emerges as a highly effective strategy, crucial in regions vulnerable to infectious diseases. Establishing and strengthening comprehensive surveillance and reporting systems at individual, regional, national, and international levels is crucial due to the unpredictable nature of borderless outbreaks and their significant impact on morbidity, mortality, and economic stability. National surveillance relies heavily on effective control mechanisms within local community areas, necessitating the active involvement of medical personnel. Successful systems depend on functional countries using collected data for timely warnings and localized interventions. Stakeholders, including governments, health authorities, and international organizations, must collaborate urgently to implement and sustain these vital systems, mitigating the devastating consequences of infectious disease outbreaks. Additionally, a holistic approach is crucial, involving prioritized local production of vaccines, medicines, and diagnostics through initiatives like the African Vaccine Producers Initiative. This approach emphasizes the need for domestic pharmaceutical production, intensified public awareness campaigns, and the training of the next generation of global health leaders, ensuring multidimensional strategies, political and diplomatic skills, and evidence-based assessments.

Conclusion

Collaboration among governments, international organizations, and educational institutions is essential for successful policy advocacy and implementation to strengthen health security and mitigate the continuous rise of infectious diseases on the continent.

Clinical application of nanopore-targeted sequencing technology in bronchoalveolar lavage fluid from patients with pulmonary infections

The rapid and effective identification of pathogens in patients with pulmonary infections has posed a persistent challenge in medicine, with conventional microbiological tests (CMTs) proving time-consuming and less sensitive, hindering early diagnosis of respiratory infections. While there has been some research on the clinical performance of targeted sequencing technologies, limited focus has been directed toward bronchoalveolar lavage fluid (BALF). This study primarily evaluates the pathogen detection capabilities of nanopore-targeted sequencing (NTS) in BALF, providing a comprehensive analysis. The retrospective study, spanning from January 2022 to November 2023, includes 223 patients exclusively sourced from a single center. We conducted a detailed comparative analysis among NTS, targeted next-generation sequencing (tNGS), and CMTs. Initially, we compared the detection capabilities of NTS and tNGS and found no significant differences in their sensitivity and specificity. Specifically, we observed that the sensitivity of NTS was significantly higher than that of CMTs (74.83% vs 33.11%, P < 0.001). Furthermore, NTS exhibited a higher positivity rate in common pulmonary infections (62.88% vs. 23.48%) and in clinically suspected tuberculosis patients compared to CMTs (87.18% vs. 48.72%). Additionally, NTS showed less susceptibility to antibiotic interference, indicating a more sensitive detection capability, especially in detecting fastidious organisms. It complements GeneXpert in tuberculosis diagnosis and offers excellent advantages in identifying pathogens challenging for CMTs, such as non-tuberculous mycobacteria and viruses. Moreover, NTS significantly shortens the reporting time and is only a quarter of the cost of metagenomic next-generation sequencing. Clearly, NTS can facilitate faster and more cost-effective early diagnosis of respiratory infections.IMPORTANCEThis study holds paramount significance in advancing the field of respiratory infection diagnostics. By assessing the pathogen detection capabilities in bronchoalveolar lavage fluid (BALF) of patients with pulmonary infections, we illuminate the promising potential of nanopore-targeted sequencing (NTS). The findings underscore NTS as a comparable yet distinct alternative to traditional methods like comprehensive conventional microbiological tests (CMTs). Notably, NTS demonstrates a pivotal edge, expanding the spectrum of identified pathogens, particularly excelling in the detection of challenging entities like non-tuberculous mycobacteria and viruses. The study also highlights the complementary role of NTS alongside GeneXpert in the identification of tuberculosis, providing a comprehensive overview of the diagnostic landscape for respiratory infections. This insight carries significant implications for clinicians seeking rapid, cost-effective, and accurate diagnostic tools in the realm of pulmonary infections.

Target Recognition Initiated Self-Assembly-Based Signal Amplification Strategy for Sensitive and Colorimetric Staphylococcus aureus Detection and Diagnosis of Skin Infection

Staphylococcus aureus (S. aureus), as a Gram-positive bacterium, is commonly encountered in various infectious diseases, such as acute skin and soft tissue infections. Despite that many efforts have been made, sensitive and reliable quantitative determination of S. aureus remains a huge challenge. Here, we depict a novel colorimetric approach for sensitive and accurate detection by combining allosteric probe-based target recognition and chain extension-based dual signal recycling. The single-strand DNA (ssDNA) products generated by the chain extension process lead to the liberation of G-quadruplex sequences, which can fold into active DNAzyme under the assistance of hemin. The active DNAzyme can work as peroxidase mimics to catalyze the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS2-)-H2O2 system, causing the color change of the system. Eventually, the method exhibits a wide detection range from 103 cfu/mL to 106 cfu/mL. The limit of detection of the approach was determined 232 cfu/mL. Considering the robust capability of the approach in S. aureus detection, we believe that it will be a potential alternative tool for biomedical research and clinical molecular diagnostics.

Associations of diet with infectious diseases in UK Biobank

This research aims to utilize multivariate logistic regression to explore associations between the frequency of 13 food groups intake (or four diet groups) and infectious diseases. 487849 participants from the UK Biobank were enrolled, and 75209 participants were diagnosed with infectious diseases. Participants reporting the highest intake frequency of processed meat [odds ratio ( OR) = 1.0964; 95% CI: 1.0622-1.1318] and red meat ( OR = 1.0895; 95% CI: 1.0563-1.1239) had a higher risk of infectious diseases compared to those with the lowest intake frequency. Consuming fish 2.0-2.9 times ( OR = 0.8221; 95% CI: 0.7955-0.8496), cheese ≥5.0 times ( OR = 0.8822; 95% CI: 0.8559-0.9092), fruit 3.0-3.9 servings ( OR = 0.8867; 95% CI: 0.8661-0.9078), and vegetables 2.0-2.9 servings ( OR = 0.9372; 95% CI: 0.9189-0.9559) per week were associated with a lower risk of infection. Low meat-eaters ( OR = 0.9404; 95% CI: 0.9243-0.9567), fish-eaters ( OR = 0.8391; 95% CI: 0.7887-0.8919), and vegetarians ( OR = 0.9154; 95% CI: 0.8561-0.9778) had a lower risk of infectious diseases compared to regular meat-eaters. Mediation analysis was performed, revealing glycosylated hemoglobin, white blood cell counts, and body mass index were mediators in the relationships between diet groups and infectious diseases. This study suggested that intake frequency of food groups is a factor in infectious diseases and fish-eaters have a lower risk of infection.

Factors influencing length of stay and costs in inpatient cases of human brucellosis as the primary diagnosis over a decade in Beijing, China

Aims

In the year 2021, human brucellosis ranked fifth in terms of the number of cases among all statutorily notifiable infectious diseases in China, thus remaining a significant concern for public health. This study aims to provide insights into the financial burden of human brucellosis by examining hospital stays and associated costs for affected individuals.

Methods

In this retrospective study, we gathered updated data from 467 inpatient cases primarily diagnosed with human brucellosis at eight major tertiary hospitals in Beijing, China, spanning from 2013 to 2023. To comprehensively explore the economic impact on individuals, we not only analyzed the duration of hospital stays and total costs but also examined various charge types, including drug, lab test, medical imaging, medical treatment, surgical procedures, medical supplies and consumables, inpatient bed care, nursing services, and other services costs. Statistical analysis was employed to compare differences among gender, age, ethnicity, type of health insurance, condition at admission, comorbidity index, the performance of surgery, and the site of infection.

Results

Both the length of stay and total cost exhibited significant variations among insurance, surgery, and infection site groups. Utilization categories demonstrated significant differences between patients who underwent surgery and those who did not, as well as across different infection sites. Furthermore, multiple linear regression analysis revealed that the condition at admission, Elixhauser comorbidity index, infection site, and surgery influenced both hospital stay and total cost. In addition, age and insurance type were associated with total costs.

Conclusion

By delving into various utilization categories, we have addressed a significant gap in the literature. Our findings provide valuable insights for optimizing the allocation and management of health resources based on the influencing factors identified in this study.

A Nomogram for Predicting the Infectious Disease-specific Health Literacy of Older Adults in China

PURPOSE

To identify the predictors of infectious disease-specific health literacy (IDSHL), and establish an easy-to-apply nomogram to predict the IDSHL of older adults.

METHODS

This cross-sectional study included 380 older adults who completed the IDSHL, self-rated health, socio-demographic and other questionnaires. Logistic regression was used to identify the IDSHL predictors. Nomogram was used to construct a predictive model.

RESULTS

Up to 70.1% of older adults had limited IDSHL. Age, education, place of residence, self-rated health, and Internet access were the important influencing factors of IDSHL. The established nomogram model showed high accuracy (receiver operating characteristic curve: 0.848).

CONCLUSIONS

The IDSHL of Chinese older adults was significantly deficient. The constructed nomogram is an intuitive tool for IDSHL prediction that can not only contribute toward rapid screening of high-risk older adults with limited IDSHL but also provide guidance for healthcare providers to develop prevention strategies for infectious diseases.

One World, One Health: Zoonotic Diseases, Parasitic Diseases, and Infectious Diseases

When we take into account how the boundaries between human, animal, and environmental health are inextricably linked and increasingly intertwined, it comes as no surprise that the One Health approach has assumed an unprecedented level of importance over the past decade [...].

A causal relationship between educational attainment and risk of infectious diseases: A Mendelian randomisation study

Background

Previous observational studies have investigated the association between educational attainment and sepsis, pneumonia, and urinary tract infections (UTIs). However, their findings have been susceptible to reverse causality and confounding factors. Furthermore, no study has examined the effect of educational level on the risk of infections of the skin and subcutaneous tissue (SSTIs). Thus, we aimed to evaluate the causal relationships between educational level and the risk of four infectious diseases using Mendelian randomisation (MR) techniques.

Methods

We used univariable MR analysis to investigate the causal associations between educational attainment (years of schooling (n = 766 345) and holding college or university degree (n = 334 070)) and four infectious diseases (sepsis (n = 486 484), pneumonia (n = 486 484), UTIs (n = 463 010), and SSTIs (n = 218 792)). We included genetic instrumental variables with a genome-wide significance (P < 5 × 10-8) in the study. We used inverse variance-weighted estimation in the primary analysis and explored the stability of the results using multivariable MR analysis after adjusting for smoking, alcohol consumption, and body mass index.

Results

Genetically predicted years of schooling were associated with a reduced risk of sepsis (odds ratio (OR) = 0.763; 95% confidence interval (CI) = 0.668-0.870, P = 5.525 × 10-5), pneumonia (OR = 0.637; 95% CI = 0.577-0.702, P = 1.875 × 10-19), UTIs (OR = 0.995; 95% CI = 0.993-0.997, P = 1.229 × 10-5), and SSTIs (OR = 0.696; 95% CI = 0.605-0.801, P = 4.034 × 10-7). We observed consistent results for the correlation between qualifications and infectious diseases. These findings remained stable in the multivariable MR analyses.

Conclusions

Our findings suggest that increased educational attainment may be causally associated with a decreased risk of sepsis, pneumonia, UTIs, and SSTIs.

Design of Liquid Formulation Based on F127-Loaded Natural Dimeric Flavonoids as a New Perspective Treatment for Leishmaniasis

Infectious and Parasitic Diseases (IPD) remain a challenge for medicine due to several interconnected reasons, such as antimicrobial resistance (AMR). American tegumentary leishmaniasis (ATL) is an overlooked IPD causing persistent skin ulcers that are challenging to heal, resulting in disfiguring scars. Moreover, it has the potential to extend from the skin to the mucous membranes of the nose, mouth, and throat in both humans and various animals. Given the limited effectiveness and AMR of current drugs, the exploration of new substances has emerged as a promising alternative for ATL treatment. Arrabidaea brachypoda (DC). Bureau is a native Brazilian plant rich in dimeric flavonoids, including Brachydin (BRA), which displays antimicrobial activity, but still little has been explored regarding the development of therapeutic formulations. In this work, we present the design of a low-cost liquid formulation based on the use of Pluronic F127 for encapsulation of high BRA concentration (LF-B500). The characterization techniques revealed that BRA-loaded F127 micelles are well-stabilized in an unusual worm-like form. The in vitro cytotoxicity assay demonstrated that LF-B500 was non-toxic to macrophages but efficient in the inactivation of forms of Leishmania amazonensis promastigotes with IC50 of 16.06 µg/mL. The results demonstrated that LF-B500 opened a new perspective on the use of liquid formulation-based natural products for ATL treatment.

Nanobodies: a promising approach to treatment of viral diseases

Since their discovery in the 1990s, heavy chain antibodies have garnered significant interest in the scientific community. These antibodies, found in camelids such as llamas and alpacas, exhibit distinct characteristics from conventional antibodies due to the absence of a light chain in their structure. Furthermore, they possess a single antigen-binding domain known as VHH or Nanobody (Nb). With a small size of approximately 15 kDa, these Nbs demonstrate improved characteristics compared to conventional antibodies, including greater physicochemical stability and enhanced biodistribution, enabling them to bind inaccessible epitopes more effectively. As a result, Nbs have found numerous applications in various medical and veterinary fields, particularly in diagnostics and therapeutics. Advances in biotechnology have made the production of recombinant antibodies feasible and compatible with large-scale manufacturing. Through the construction of immune phage libraries that display VHHs and subsequent selection through biopanning, it has become possible to isolate specific Nbs targeting pharmaceutical targets of interest, such as viruses. This review describes the processes involved in nanobody production, from hyperimmunization to purification, with the aim of their application in the pharmaceutical industry.

Lateral flow immunoassay (LFIA) for dengue diagnosis: Recent progress and prospect

Dengue is one of the most widespread and fatal arboviral infections in the world. Early detection of dengue virus (DENV) is essential to prevent the spread of the disease and provide an immediate response. The lateral flow immunoassay (LFIA) systems are low-cost, rapid, sensitive, targeted, and straightforward detection, which is an ideal early detection candidate for point-of-care testing (POCT) in dengue-affected areas. However, current commercial LFIA kits cannot fully satisfy the sensitivity, specificity, serotype differentiation, and multiplex detection requirements. Therefore, various strategies have been applied to optimize the LFIA for DENV detection, including label material improvement, optical enhancement and novel structure design. In this review, we comprehensively presented the snapshot of dengue, the principle of LFIA, and recent progress in the LFIA optimization for dengue diagnoses. Furthermore, this review also discusses insights into the prospect of LFIA dengue diagnostic methods, such as microfluidics, multiplex design, nucleic acid-typed probes and smartphone-assisted result analysis.

Rapid Visual Detection of Methicillin-Resistant Staphylococcus aureus in Human Clinical Samples via Closed LAMP Assay Targeting mecA and spa Genes

The emergence of antimicrobial resistance (AMR), particularly methicillin-resistant Staphylococcus aureus (MRSA), poses a significant global health threat as these bacteria increasingly become resistant to the most available therapeutic options. Thus, developing an efficient approach to rapidly screen MRSA directly from clinical specimens has become vital. In this study, we establish a closed-tube loop-mediated isothermal amplification (LAMP) method incorporating hydroxy-naphthol blue (HNB) colorimetric dye assay to directly detect MRSA from clinical samples based on the presence of mecA and spa genes. In total, 125 preidentified S. aureus isolates and 93 clinical samples containing S. aureus were sourced from the microbiology laboratory at Hamad General Hospital (HGH). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed based on conventional PCR. The assay demonstrated 100% specificity, 91.23% sensitivity, 0.90 Cohen Kappa (CK), 100% PPV, and 87.8% NPV for the clinical samples, while clinical isolates exhibited 100% specificity, 97% sensitivity, 0.926 CK, 100% PPV, and 88.89% NPV. Compared to cefoxitin disk diffusion, LAMP provided 100% specificity and sensitivity, 1.00 CK, and 100% for PPV and NPV. The study revealed that the closed-tube LAMP incorporating (HNB) dye is a rapid technique with a turnaround time of less than 1 h and high specificity and sensitivity.

Guanidinium-Functionalized Polymer Dielectrics for Triboelectric Bacterial Detection

Development of rapid detection strategies that target potentially pathogenic bacteria has gained increasing attention due to the increasing awareness for better health and safety. In this study, we evaluate an intrinsically antimicrobial polymer, 2Gdm, which is a poly(norbornene)-based functional polymer featuring guanidinium groups as side chains, for bacterial detection by the means of triboelectric nanogenerators (TENGs) and triboelectric nanosensors (TENSs). Attachment of bacteria to the sensing layer is anticipated to alter the overall triboelectric properties of the underlying polymer layer. The positively charged guanidinium functional groups can interact with the negatively charged phospholipid bilayer of bacteria and lead to bacterial death, which can then be detected by optical microscopy, X-ray photoelectron microscopy, and more advanced self-powered sensing techniques such as TENGs and TENSs. The double bonds present along the poly(norbornene) backbone allow for thermally induced cross-linking to obtain X-2Gdm and thus rendering materials remain stable in water. By monitoring the change in voltage output after immersion in various concentrations of Gram-negative Escherichia coli (E. coli) and Gram-positive Streptococcus pneumoniae (S. pneumoniae), we have demonstrated the utility of X-2Gdm as a new polymer dielectric for autonomous bacterial detection. As the bacterial concentration increases, the amount of adsorbed bacteria also increases, resulting in a decrease in the surface potential of the X-2Gdm thin film; this reduction in surface potential can cause a decrease in the triboelectric output for both TENGs and TENSs, which serves as a key working mechanism for facile bacterial detection. TENG and TENS systems are capable of detecting E. coli and S. pneumoniae within a range of 4 × 105 to 4 × 108 CFU/mL with a limit of detection of 106 CFU/mL. This report highlights the promising prospects of employing TENGs and TENSs as innovative sensing technologies for rapid bacterial detection by leveraging the electrostatic interactions between bacterial cell membranes and cationic groups present on polymer surfaces.

The Re-emergence of Diphtheria Amidst Multiple Outbreaks in Nigeria

Diphtheria, a vaccine-preventable disease, has resurfaced in Nigeria, where many outbreaks have been reported in recent years. The outbreaks have occurred across the country, including in areas with high vaccination coverage. Corynebacterium diphtheriae, the causal agent, is a highly contagious bacteria that can cause severe respiratory and systemic symptoms and can be fatal if not treated. The reemergence of diphtheria in Nigeria is most likely due to a combination of factors, including gaps in routine immunization regimens. The outbreak is further aggravated by multiple epidemics, which have diverted resources and attention away from the emergency of other infectious diseases. Furthermore, there is a lack of awareness of diphtheria in Nigeria. With a focus on the difficulties in controlling the disease, methods of diagnosis, available treatments, and preventive measures, this study provides a thorough analysis of diphtheria, covering its historical context, clinical presentation, associated complications, and current outbreaks. It emphasizes how important vaccination, early detection, and better access to healthcare are in reducing diphtheria outbreaks. The study highlights the serious effects of diphtheria on public health, particularly in regions with scarce resources and vaccine resistance, and offers a number of suggestions to overcome these challenges and prevent further outbreaks.

Marine-derived Compounds: A Powerful Platform for the Treatment of Alzheimer's Disease

Alzheimer's disease (AD) is a debilitating form of dementia that primarily affects cholinergic neurons in the brain, significantly reducing an individual's capacity for learning and creative skills and ultimately resulting in an inability to carry out even basic daily tasks. As the elderly population is exponentially increasing, the disease has become a significant concern for society. Therefore, neuroprotective substances have garnered considerable interest in addressing this universal issue. Studies have shown that oxidative damage to neurons contributes to the pathophysiological processes underlying AD progression. In AD, tau phosphorylation and glutamate excitotoxicity may play essential roles, but no permanent cure for AD is available. The existing therapies only manage the early symptoms of AD and often come with numerous side effects and toxicities. To address these challenges, researchers have turned to nature and explored various sources such as plants, animals, and marine organisms. Many historic holy books from different cultures emphasize that adding marine compounds to the regular diet enhances brain function and mitigates its decline. Consequently, researchers have devoted significant time to identifying potentially active neuroprotective substances from marine sources. Marine-derived compounds are gaining recognition due to their abundant supply of diverse chemical compounds with biological and pharmacological potential and unique mechanisms of action. Several studies have reported that plants exhibit multitarget potential in treating AD. In light of this, the current study focuses on marine-derived components with excellent potential for treating this neurodegenerative disease.

Simultaneous detection and quantification of multiple pathogen targets in wastewater

Wastewater-based epidemiology has emerged as a critical tool for public health surveillance, building on decades of environmental surveillance work for pathogens such as poliovirus. Work to date has been limited to monitoring a single pathogen or small numbers of pathogens in targeted studies; however, few studies consider simultaneous quantitative analysis of a wide variety of pathogens, which could greatly increase the utility of wastewater surveillance. We developed a novel quantitative multi-pathogen surveillance approach (35 pathogen targets including bacteria, viruses, protozoa, and helminths) using TaqMan Array Cards (TAC) and applied the method on concentrated wastewater samples collected at four wastewater treatment plants in Atlanta, GA from February to October of 2020. From sewersheds serving approximately 2 million people, we detected a wide range of targets including many we expected to find in wastewater (e.g., enterotoxigenic E. coli and Giardia in 97% of 29 samples at stable concentrations) as well as unexpected targets including Strongyloides stercoralis (a human threadworm rarely observed in the USA). Other notable detections included SARS-CoV-2, but also several pathogen targets that are not commonly included in wastewater surveillance like Acanthamoeba spp., Balantidium coli, Entamoeba histolytica, astrovirus, norovirus, and sapovirus. Our data suggest broad utility in expanding the scope of enteric pathogen surveillance in wastewaters, with potential for application in a variety of settings where pathogen quantification in fecal waste streams can inform public health surveillance and selection of control measures to limit infections.

Etiological characterization of acute undifferentiated febrile illness in Apartadó and Villeta municipalities, Colombia, during COVID-19 pandemic

Background

Acute undifferentiated febrile illness (AUFI) is one of the leading causes of illness in tropical regions. Although malaria is the most important cause, other pathogens such as Dengue (DENV), Leptospira and recently, Coronavirus Disease 2019 (COVID-19) have gained importance. In Colombia, few studies aimed to identify the etiology of AUFI. Most of them performed in Apartadó and Villeta municipalities, identifying the active circulation of several pathogens. Thus, we conducted a cross-sectional study in these municipalities to characterize the etiologies of AUFI during COVID-19 pandemic.

Methods

An active surveillance was conducted between September and December 2021 in local hospitals of Apartadó and Villeta municipalities. Febrile patients were enrolled after voluntarily agreeing to participate in the study. Ten different etiologies were evaluated through direct, serological, molecular and rapid diagnostic methods.

Results

In Apartadó a confirmed etiology was found in 60% of subjects, DENV (25%) being the most frequent, followed by leptospirosis (16.7%), malaria (10%), COVID-19 (8.3%), spotted fever group (SFG) rickettsiosis (6.7%) and Chikungunya (1.7%). In Villeta, a specific etiology was confirmed in 55.4% of patients, of which SFG rickettsiosis (39.3%) was the most frequent, followed by leptospirosis (21.4%), DENV (3.6%) and malaria (1.8%). No cases due to Mayaro, Yellow Fever, Oropouche and Venezuelan Equine Encephalitis viruses were detected.

Conclusion

We confirm the relevance of dengue fever, leptospirosis, SFG rickettsiosis, COVID-19 and malaria as causes of AUFI in the municipality of Apartadó, and highlight the great importance of SFG rickettsiosis as the main cause of AUFI in the municipality of Villeta.

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders

SARS-CoV-2 can trigger autoimmune central nervous system (CNS) diseases in genetically susceptible individuals, a mechanism poorly understood. Molecular mimicry (MM) has been identified in other viral diseases as potential triggers of autoimmune CNS events. This study investigated if MM is the process through which SARS-CoV-2 induces the breakdown of immune tolerance. The frequency of autoimmune CNS disorders was evaluated in a prospective cohort with patients admitted to the COVID-19 Intense Care Unity (ICU) in Rio de Janeiro. Then, an in silico analysis was performed to identify the conserved regions that share a high identity between SARS-CoV-2 antigens and human proteins. The sequences with significant identity and antigenic properties were then assessed for their binding capacity to HLA subtypes. Of the 112 patients included, 3 were classified as having an autoimmune disorder. A total of eleven combinations had significant linear and three-dimensional overlap. NMDAR1, MOG, and MPO were the self-antigens with more significant combinations, followed by GAD65. All sequences presented at least one epitope with strong or intermediate binding capacity to the HLA subtypes selected. This study underscores the possibility that CNS autoimmune attacks observed in COVID-19 patients, including those in our population, could be driven by MM in genetically predisposed individuals.

Clinical application of amplification-based versus amplification-free metagenomic next-generation sequencing test in infectious diseases

Background

Recently, metagenomic next-generation sequencing (mNGS) has been used in the diagnosis of infectious diseases (IDs) as an emerging and powerful tool. However, whether the complicated methodological variation in mNGS detections makes a difference in their clinical performance is still unknown. Here we conducted a method study on the clinical application of mNGS tests in the DNA detection of IDs.

Methods

We analyzed the effect of several potential factors in the whole process of mNGS for DNA detection on microorganism identification in 98 samples of suspected ID patients by amplification-based mNGS. The amplification-based and amplification-free mNGS tests were successfully performed in 41 samples. Then we compared the clinical application of the two mNGS methods in the DNA detection of IDs.

Results

We found that a higher concentration of extracted nucleic acid was more conducive to detecting microorganisms. Other potential factors, such as read depth and proportion of human reads, might not be attributed to microorganism identification. The concordance rate of amplification-based and amplification-free mNGS results was 80.5% (33/41) in the patients with suspected IDs. Amplification-based mNGS showed approximately 16.7% higher sensitivity than amplification-free mNGS. However, 4 cases with causative pathogens only detected by amplification-based mNGS were finally proved false-positive. In addition, empirical antibiotic treatments were adjusted in 18 patients following mNGS testing with unexpected pathogens.

Conclusions

Amplification-based and amplification-free mNGS tests showed their specific advantages and disadvantages in the diagnosis of IDs. The clinical application of mNGS still needs more exploration from a methodological perspective. With advanced technology and standardized procedure, mNGS will play a promising role in the diagnosis of IDs and help guide the use of antibiotics.

Natural products as potential lead compounds to develop new antiviral drugs over the past decade

Virus infection has been one of the main causes of human death since the ancient times. Even though more and more antiviral drugs have been approved in clinic, long-term use can easily lead to the emergence of drug resistance and side effects. Fortunately, there are many kinds of metabolites which were produced by plants, marine organisms and microorganisms in nature with rich structural skeletons, and they are natural treasure house for people to find antiviral active substances. Aiming at many types of viruses that had caused serious harm to human health in recent years, this review summarizes the natural products with antiviral activity that had been reported for the first time in the past ten years, we also sort out the source, chemical structure and safety indicators in order to provide potential lead compounds for the research and development of new antiviral drugs.

Health Systems Preparedness for Infectious Disease Outbreaks: Relevance for Nephrology

The coronavirus disease (COVID-19) crisis glaringly highlighted the critical need to develop resilient health care systems that are better prepared for epidemics. Millions of people died from COVID-19 itself, but almost three times as many died from health system disruptions. People living with kidney disease are highly vulnerable during outbreaks and pandemics and their needs must be included in preparedness planning. Health systems preparedness requires not only early identification and containment of outbreaks and maintenance of critical services during crises, but also bolstering population resilience and ensuring the safety of both health personnel and patients. Planning for surge capacity in an outbreak must include provision for both acute and chronic dialysis, and ensure access to medications for people with kidney diseases. Quality of care should not be compromised and must be monitored and improved where necessary. Technology, such as telemedicine, can support quality and continuity of care and minimize infection risks. Communication at all levels is crucial to ensure all stakeholders, including communities, have the necessary information to support cooperation and collaboration in effective outbreak responses. Research is important during and after pandemics to improve knowledge and build resilience at all levels, from outbreak detection to the development of therapeutics and optimizing equity in access to interventions. Only with adequate preparation and more resilient health systems can we hope, as a global community, to build on the harsh lessons learned during COVID-19, and improve the response to the next infectious disease outbreak, epidemic, or even pandemic.

A looming epidemic: combating the recurrent outbreaks of diphtheria in Nigeria

Nigeria has endured several diphtheria outbreaks over the last few decades, mirroring a suboptimal population immunity across several demographics within the country. The country's northern region has been affected mainly by this infectious disease; it directly depicts the effect of poor DPT vaccine uptake amongst children in this region compared to other geopolitical zones in Nigeria. Whilst pharmaceutical intervention and surveillance activities have commenced as directed by the NCDC, to combat this public health menace, top leaders of the Nigerian healthcare system - public and private sectors, must understudy the predisposing factors gearing the recurrence of diphtheria in Nigeria and provide robust, research-based and scientific mechanisms to arrest the root causes of the incessant outbreaks. This article discusses the factors promoting the recurrent diphtheria outbreaks in Nigeria, the preexisting interventions with their existential deterrents, and new strategies recommended to curb the further resurgence of the disease.

Top 10 public health challenges to track in 2023: Shifting focus beyond a global pandemic

The year 2022 saw COVID‐19 as the primary public health concern, with vaccine rollout and mandates at the forefront. Other viral infectious diseases, such as Monkeypox and Ebola, emerged as public health concerns. Climate change and political conflicts significantly impacted global health, increasing the demand for humanitarian assistance and protection. In 2023, it remains crucial to identify global and public health priority areas to coordinate and implement effective solutions. Through discussions with public health practitioners and researchers, we have identified key priority areas for 2023, namely, health systems, the mental health crisis, substance abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive health challenges, environmental pollution, the climate crisis, cancer, and diabetes. These priority areas highlight shared concerns that should be addressed to facilitate proactive and innovative health interventions and practices. To achieve universal healthcare targets for 2030, prioritization, financial investment, international cooperation, and collaboration in addressing these global health challenges are crucial. This requires coordination among public health decision‐makers, the private health sector, and opinion leaders to implement country‐specific healthcare financing and food security measures. Research, scientific knowledge, and technical capacities must be leveraged to produce sustainable interventions that effectively reduce health disparities and improve health system responsiveness to prevent these challenges from progressing to public health emergencies.

Zebrafish-based platform for emerging bio-contaminants and virus inactivation research

Emerging bio-contaminants such as viruses have affected health and environment settings of every country. Viruses are the minuscule entities resulting in severe contagious diseases like SARS, MERS, Ebola, and avian influenza. Recent epidemic like the SARS-CoV-2, the virus has undergone mutations strengthen them and allowing to escape from the remedies. Comprehensive knowledge of viruses is essential for the development of targeted therapeutic and vaccination treatments. Animal models mimicking human biology like non-human primates, rats, mice, and rabbits offer competitive advantage to assess risk of viral infections, chemical toxins, nanoparticles, and microbes. However, their economic maintenance has always been an issue. Furthermore, the redundancy of experimental results due to aforementioned aspects is also in examine. Hence, exploration for the alternative animal models is crucial for risk assessments. The current review examines zebrafish traits and explores the possibilities to monitor emerging bio-contaminants. Additionally, a comprehensive picture of the bio contaminant and virus particle invasion and abatement mechanisms in zebrafish and human cells is presented. Moreover, a zebrafish model to investigate the emerging viruses such as coronaviridae and poxviridae has been suggested.

Virus-like Magnetic Mesoporous Silica Particles as a Universal Vaccination Platform against Pathogenic Infections

Vaccination is the most important way of population protection from life-threatening pathogenic infections. However, its efficiency is frequently compromised by a failure of strong antigen presentation and immune activation. Herein, we developed virus-like magnetic mesoporous silica nanoparticles as a universal vaccination platform (termed MagParV) for preventing pathogenic infections. This platform was constructed by integrating synthetic biology-based endoplasmic reticulum-targeting vesicles with magnetic mesoporous silica particles. This platform exhibited high antigen-loading capacity, strongly targeting the endoplasmic reticulum and promoting antigen presentation in dendritic cells. After prime-boost vaccination, the antigen-loading MagParV with AMF drastically elicited specific antibody production against corresponding antigens of fungal, bacterial, and viral pathogens. A systemic infection model further revealed that the platform effectively protected the mice from severe fungal systemic infections. This study realized synthetic biology-facilitated green manufacturing of vaccines, which is promising for magnetism-activated vaccination against different kinds of pathogenic infections.

Cancer and Trypanosoma cruzi: Tumor induction or protection?

Trypanosoma cruzi causes Chagas disease, a neglected disease that can be divided, overall, into acute and chronic phases. Understanding the mechanisms underlying its progression is based on the parasite-host interactions occurring during the infection. Although the pathophysiology of the main symptomatic forms of Chagas disease has been the subject of several studies, little is known about their relationship with the development of different types of cancer. Therefore, knowledge regarding the molecular aspects of infection in the host, as well as the influence of the immune response in the parasite and the host, can help to understand the association between Chagas disease and tumor development. This review aims to summarize the main molecular mechanisms related to T. cruzi-dependent carcinogenic development and the mechanisms associated with tumor protection mediated by different parasite components.

Recent approaches in nanocarrier-based therapies for neglected tropical diseases

Neglected tropical diseases (NTDs) remain major public health problems in developing countries. Reducing the burden of NTDs requires sustained collaborative drug discovery efforts to achieve the goals of the new NTDs roadmap launched by the World Health Organization. Oral drugs are the most convenient choice and usually the safest and least expensive. However, the oral use of some drugs for NTDs treatment has many drawbacks, including toxicity, adverse reactions, drug resistance, drug low solubility, and bioavailability. Since there is an imperative need for novel and more effective drugs to treat the various NTDs, in recent years, several compound-loaded nanoparticles have been prepared with the objective of evaluating their application as an oral drug delivery system for the treatment of NTDs. This review focuses on the various types of nanoparticle drug delivery systems that have been recently used against the major NTDs caused by parasites such as leishmaniasis, Chagas disease, and schistosomiasis. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

Development of environmental loop-mediated isothermal amplification (eLAMP) diagnostic tool for Bulinus truncatus field detection

BACKGROUND

Global changes are reshaping the distribution of vector-borne diseases by spreading vectors to previously non-endemic areas. Since 2013, urogenital schistosomiasis has emerged in Corsica and threatens European countries. Gastropod vectors release schistosome larvae that can infect humans who come into contact with freshwater bodies. Monitoring schistosomiasis host vectors is a prerequisite to understand and subsequently to control this pathogen transmission. Because malacological surveys are time consuming and require special expertise, the use of a simple molecular method is desirable.

METHODS

The aim of this study is to develop a ready-to-use protocol using the LAMP (loop-mediated isothermal amplification) method to detect environmental DNA of Bulinus truncatus, vector of Schistosoma haematobium. Interestingly, LAMP method possesses all the characteristics required for adaptability to field conditions particularly in low-income countries: speed, simplicity, lyophilized reagents, low cost and robustness against DNA amplification inhibitors. We have tested this new method on Corsican water samples previously analysed by qPCR and ddPCR.

RESULTS

We demonstrate that our diagnostic tool B. truncatus eLAMP (Bt-eLAMP) can detect the eDNA of Bulinus truncatus as effectively as the two other methods. Bt-eLAMP can even detect 1/4 of positive samples not detectable by qPCR. Moreover, the complete Bt-eLAMP protocol (sampling, sample pre-process, amplification and revelation) does not require sophisticated equipment and can be done in 1 ½ h.

CONCLUSIONS

LAMP detection of environmental DNA provides large-scale sensitive surveillance of urogenital schistosomiasis possible by identifying potentially threatened areas. More generally, eLAMP method has great potential in vector-borne diseases and ecology.

Gongolarones as antiamoeboid chemical scaffold

Free Living Amoeba (FLA) infections caused by Acanthamoeba genus include chronic nervous system diseases such as Granulomatous Amoebic Encephalitis (GAE), or a severe eye infection known as Acanthamoeba keratitis (AK). Current studies focused on therapy against these diseases are aiming to find novel compounds with amoebicidal activity and low toxicity to human tissues. Brown algae, such as Gongolaria abies-marina (previously known as Cystoseira abies-marina, S.G. Gmelin), presents bioactive molecules of interest, including some with antiprotozoal activity. In this study, six meroterpenoids were isolated and purified from the species Gongolaria abies-marina. Gongolarones A (1), B (2) and C (3) were identified as new compounds. Additionally, cystomexicone B (4), 1'-methoxyamentadione (5) and 6Z-1'-methoxyamentadione (6) were isolated. All compounds exhibited amoebicidal activity against Acanthamoeba castellanii Neff, A. polyphaga and A. griffini strains. Gongolarones A (1) and C (3) showed the lowest IC₅₀ values against the two stages of these amoebae (trophozoite and cyst). Structure-activity relationship revealed that the cyclization by ether formation from C-12 to C-15 of 1, and the isomerization Δ^2 t to Δ^3 t of 3, increased the antiamoeboid activity of both compounds. Furthermore, gongolarones A (1) and C (3) triggered chromatin condensation, mitochondrial malfunction, oxidative stress, and disorganization of the tubulin-actin cytoskeleton in treated trophozoites. Moreover, transmission electron microscopy (TEM) images analysis revealed that compounds 1 and 3 induced autophagy process and inhibited the encystation process. All those results suggest that both compounds could induce programmed cell death (PCD) in Acanthamoeba.

Factors influencing utilization of communicable disease prevention and treatment education among the floating population: a cross-sectional study in China

BACKGROUND

In China, communicable diseases (CD) have a negative impact on public health and economic stability. The influx of migrants, who make up a substantial portion of China's population and continue to rapidly expand, has seriously hampered CD prevention and control, needing special care. This study aimed to identify key factors influencing the utilization of CD prevention and treatment education (CDPTE) among the floating population. We are confident that the findings will highlight obstacles facing CDPTE among the migrants, and guide future development prevention, treatment of CD, and health education services.

METHODS

A sample of migrants aged 15 years and above in 32 provincial units nationwide in 2018 was recruited by stratified multi-stage proportional to population size sampling (PPS). A structured questionnaire survey was conducted via face-to-face interviews. Subsequently, the Anderson health service utilization model was used as the theoretical framework and SPSS 26.0 statistical software was applied to analyze the data. The statistical description of the current situation of CDPTE acceptance and the chi-square test were used to compare the differences in CDPTE acceptance by different characteristics. Multivariate logistic regression was used to analyze key factors affecting the use of CDPTE among migrants.

RESULTS

A total of 40.1% of the recruited participants reported receiving education on CD prevention and treatment, primarily delivered through traditional transmission media. Multilevel logistic regression results revealed that male migrants, aged 30-49 years, unmarried, with higher educational attainment, an average monthly household income of CNY 7,500-9,999 (or US$1,176-1,568), working more than 40 h per week, flowing into the Central and Western regions, migrated in the province, self-rated health, contracted family doctors and those with health records were more likely to receive CDPTE (p < 0.05).

CONCLUSION

Our findings revealed unsatisfactory acceptance of education on CD prevention and treatment among migrants, implying that health education should be strengthened further. Publicity of relevant policies and works should be strengthened and specific interventions should be developed for key regions as well as vulnerable groups to enhance CDPTE. More financial support should also be provided to improve the quality of health education.

Factors Influencing Training Transfer Among Infection Control Professionals Participating in Infectious Disease Training

INTRODUCTION

Infectious disease training is considered vital in health care systems to improve knowledge, skills, and work performance of infection control professionals. However, the extent to which trainees effectively transfer knowledge, skills, and attitudes that they acquire through training has received little attention. This study aimed to identify factors influencing training transfer of infection control professionals receiving infectious disease training.

METHODS

This cross-sectional study selected infection control professionals who completed an infectious disease training program provided by Korea Human Resources Development Institute for Health and Welfare. A self-reported questionnaire was used to collect data on sociodemographic variables, trainee characteristics, training design, work environment, and training transfer. Data analysis was conducted using SPSS (version 26.0).

RESULTS

The mean age of the 139 participants was 41.45 years, and 77% were female participants. Regression analysis indicated that the following factors significantly influenced the training transfer of infection control professionals and thereby decrease morbidity and mortality: for trainee characteristics, transfer experience (β = 0.205, P = 0.012) and motivation to learn (β = 0.196, P =0.016); for training design, learning objectives (β = 0.269, P = 0.021), goals (β = 0.356, P =0.023), and methods (β = 0.365, P = 0.020); and for the work environment, supervisor support (β = 0.275, P =0.024) and colleague support (β = 0.474, P = 0.022).

CONCLUSION

Future training programs for improving training transfer should focus more on strategies to improve the motivation for training transfer. Trainees should be guided on (1) how to apply training knowledge in specific clinical contexts to improve their performance and (2) potential methods to get support from their supervisors and colleagues during training.

The emergence of novel infectious diseases and the public health impact of mass gathering events: risks and challenges

To date, there is the continuous emergence of novel infectious diseases endangering individuals' health and well-being worldwide. Over the past few decades, around forty contagious diseases, such as Severe Acute Respiratory Syndrome coronavirus-1 (SARS), Middle East Respiratory Syndrome coronavirus (MERS), Ebola, Zika, and newly, COVID-19 and Monkeypox outbreaks, have been reported globally. Zoonotic transmission is the major cause of these emerging infections in humans. These, whether caused by previously unknown pathogens or by those already well-known to science, heighten global concerns about the spread of communicable diseases and the resulting increase in death and disability. 

The clinical application of metagenomic next-generation sequencing in infectious diseases at a tertiary hospital in China

Background

Compared with traditional diagnostic methods (TDMs), rapid diagnostic methods for infectious diseases (IDs) are urgently needed. Metagenomic next-generation sequencing (mNGS) has emerged as a promising diagnostic technology for clinical infections.

Methods

This retrospective observational study was performed at a tertiary hospital in China between May 2019 and August 2022. The chi-square test was used to compare the sensitivity and specificity of mNGS and TDMs. We also performed a subgroup analysis of the different pathogens and samples.

Results

A total of 435 patients with clinical suspicion of infection were enrolled and 372 (85.5%) patients were finally categorized as the ID group. The overall sensitivity of mNGS was significantly higher than that of the TDMs (59.7% vs. 30.1%, P < 0.05). However, there was no significant difference in the overall specificity between the two methods (83.3% vs. 89.6%, P = 0.37). In patients with identified pathogens, the positive rates of mNGS for detecting bacteria (88.7%), fungi (87.9%), viruses (96.9%), and Nontuberculous mycobacteria (NTM; 100%) were significantly higher than those of TDMs (P < 0.05). The positive rate of mNGS for detecting Mycobacterium tuberculosis was not superior to that of TDMs (77.3% vs. 54.5%, P = 0.11). The sensitivity rates of mNGS for pathogen identification in bronchoalveolar lavage fluid, blood, cerebrospinal fluid, pleural fluid, and tissue were 72.6%, 39.3%, 37.5%, 35.0% and 80.0%, respectively.

Conclusion

With the potential for screening multiple clinical samples, mNGS has an overall advantage over TDMs. It can effectively identify pathogens, especially those that are difficult to identify using TDMs, such as NTM, chlamydia, and parasites.

Microfluidic chip and isothermal amplification technologies for the detection of pathogenic nucleic acid

The frequency of outbreaks of newly emerging infectious diseases has increased in recent years. The coronavirus disease 2019 (COVID-19) outbreak in late 2019 has caused a global pandemic, seriously endangering human health and social stability. Rapid detection of infectious disease pathogens is a key prerequisite for the early screening of cases and the reduction in transmission risk. Fluorescence quantitative polymerase chain reaction (qPCR) is currently the most commonly used pathogen detection method, but this method has high requirements in terms of operating staff, instrumentation, venues, and so forth. As a result, its application in the settings such as poorly conditioned communities and grassroots has been limited, and the detection needs of the first-line field cannot be met. The development of point-of-care testing (POCT) technology is of great practical significance for preventing and controlling infectious diseases. Isothermal amplification technology has advantages such as mild reaction conditions and low instrument dependence. It has a promising prospect in the development of POCT, combined with the advantages of high integration and portability of microfluidic chip technology. This study summarized the principles of several representative isothermal amplification techniques, as well as their advantages and disadvantages. Particularly, it reviewed the research progress on microfluidic chip-based recombinase polymerase isothermal amplification technology and highlighted future prospects.

Green Synthesis and Characterization of Silver Nanoparticles Using Myrsine africana Leaf Extract for Their Antibacterial, Antioxidant and Phytotoxic Activities

Nanotechnology is the study and control of materials at length scales between 1 and 100 nanometers (nm), where incredible phenomena enable new applications. It affects all aspects of human life and is the most active research topic in modern materials science. Among the various metallic nanoparticles used in biomedical applications, silver nanoparticles (AgNPs) are among the most important and interesting nanomaterials. The aim of this study was to synthesize AgNPs from the leaf extract of Myrsine africana to investigate their antibacterial, antioxidant, and phytotoxic activities. When the leaf extract was treated with AgNO3, the color of the reaction solution changed from light brown to dark brown, indicating the formation of AgNPs. The UV-visible spectrum showed an absorption peak at 438 nm, confirming the synthesis of AgNPs. Scanning electron microscopy (SEM) showed that the AgNPs were spherical and oval with an average size of 28.32 nm. Fourier transform infrared spectroscopy confirms the presence of bio-compound functional groups on the surface of the AgNPs. The crystalline nature of the AgNPs was confirmed by XRD pattern. These biosynthesized AgNPs showed pronounced antibacterial activity against Gram-positive and Gram-negative bacteria, with higher inhibitory activity against Escherichia coli. At 40 µg/mL AgNPs, the highest antioxidant activity was obtained, which was 57.7% and an IC50 value of 77.56 µg/mL. A significant positive effect was observed on all morphological parameters when AgNPs were applied to wheat seedlings under constant external conditions at the different concentrations. The present study provides a cost-effective and environmentally friendly method for the synthesis of AgNPs, which can be effectively used in the field of therapeutics, as antimicrobial and diagnostic agents, and as plant growth promoters.

Unveiling a New Selenocyanate as a Multitarget Candidate with Anticancer, Antileishmanial and Antibacterial Potential

Currently, cancer, leishmaniasis and bacterial infections represent a serious public health burden worldwide. Six cinnamyl and benzodioxyl derivatives incorporating selenium (Se) as selenocyanate, diselenide, or selenide were designed and synthesized through a nucleophilic substitution and/or a reduction using hydrides. Ferrocene was also incorporated by a Friedel–Crafts acylation. All the compounds were screened in vitro for their antiproliferative, antileishmanial, and antibacterial properties. Their capacity to scavenge free radicals was also assessed as a first approach to test their antioxidant activity. Benzodioxyl derivatives 2a –b showed cytotoxicity against colon (HT-29) and lung (H1299) cancer cell lines, with IC50 values below 12 µM, and were also fairly selective when tested in nonmalignant cells. Selenocyanate compounds 1 –2a displayed potent antileishmanial activity in L. major and L. infantum , with IC50 values below 5 µM. They also exhibited antibacterial activity in six bacterial strains, notably in S. epidermidis with MIC and MBC values of 12.5 µg/mL. Ferrocene-containing selenide 2c was also identified as a potent antileishmanial agent with radical scavenging activity. Remarkably, derivative 2a with a selenocyanate moiety was found to act as a multitarget compound with antiproliferative, leishmanicidal, and antibacterial activities. Thus, the current work showed that 2a could be an appealing scaffold to design potential therapeutic drugs for multiple pathologies.

Structural Basis of Parasitic HSP90 ATPase Inhibition by Small Molecules

Protozoan parasites are responsible for several harmful and widespread human diseases that cause high morbidity and mortality. Currently available treatments have serious limitations due to poor efficiency, strong adverse effects, and high cost. Hence, the identification of new targets and the development of specific drug therapies against parasitic diseases are urgent needs. Heat shock protein 90 (HSP90) is an ATP-dependent molecular chaperone that plays a key role in parasite survival during the various differentiation stages, spread over the vector insect and the human host, which they undergo during their life cycle. The N-terminal domain (NTD) of HSP90, containing the main determinants for ATPase activity, represents the most druggable domain for inhibitor targeting. The molecules investigated on parasite HSP90 are mainly developed from known inhibitors of the human counterpart, and they have strong limitations due to selectivity issues, accounting for the high conservation of the ATP-binding site between the parasite and human proteins. The current review highlights the recent structural progress made to support the rational design of new molecules able to effectively block the chaperone activity of parasite HSP90.

Molecular docking used as an advanced tool to determine novel compounds on emerging infectious diseases: A systematic review

Emerging infectious diseases (EID) as well as reappearing irresistible infections are expanding worldwide. Utmost of similar cases, it was seen that the EIDs have long been perceived as a predominant conclusion of host-pathogen adaption. Here, one should get to analyze their host-pathogen interlink and their by needs to look ways, as an example, by exploitation process methodology particularly molecular docking and molecular dynamics simulation, have been utilized in recent time as the most outstanding tools. Hence, we have overviewed some of important factors that influences on EIDs especially HIV/AIDs, H1N1 and coronavirus. Moreover, here we specified the importance of molecular docking applications especially molecular dynamics simulations approach to determine novel compounds on the emerging infectious diseases. Additionally, in vivo and in vitro studies approach to determine novel compounds on the emerging infectious diseases that has implemented to evaluate the limiting affinities between small particles as well as macromolecule that can further, used as a target of HIV/AIDs, H1N1, and coronavirus were also discussed. These novel drug molecules approved in vivo and in vitro studies with reaffirm results and hence, it is clear that the computational methods (mainly molecular docking and molecular dynamics) are found to be more effective technique for drug discovery and medical practitioners.