Multinational appraisal of the epidemiological distribution of opioid fatalities: a systematic review and meta-analysis

Background

The global or multinational scientific evidence on the distribution of opioid fatality is unknown. Hence, the current study collects epidemiological characteristics to shed light on the ongoing global or multinational opioid crisis and to promote the development of public health prevention/management strategies.

Method

All documents on PRISMA standards were retrieved via electronic databases.

Results

Among the 47 articles relevant to our studies, which depict a total population size of 10,191 individuals, the prevalence of opioid fatal overdose was 15,022 (14.74%). Among the 47 articles, 14 of them reported the gender of the participants, with 22,125 (15.79%) male individuals and 7,235 (5.17%) female individuals, and the age distribution of the participants that was most affected by the overdose was as follows: 29,272 (31.13%) belonged to the 18-34-year-old age group and 25,316 (26.92%) belonged to the less than 18-year-old age group. Eighteen studies qualified for the meta-analysis of the multinational prevalence of fatal opioid overdose, depicting an overall pooled prevalence estimate of 19.66%, with 95% CIs (0.13-0.29), I2 = 99.76% determined using the random-effects model, and Q statistic of 7198.77 (p < 0.0001). The Egger test models of publication bias revealed an insubstantial level of bias (p = 0.015). The subgroup analysis of the study design (cohort or other) revealed that others have the highest prevalence estimate of 34.37, 95% CIs (0.1600-0.5901), I2 = 97.04%, and a sample size of less than 1,000 shows the highest prevalence of 34.66, 95% CIs (0.2039-0.5234), I2 = 97.82%, compared to that of more than 1,000 with a prevalence of 12.28, 95% CIs (0.0675-0.2131), I2 = 99.85%. The meta-regression analysis revealed that sample size (less-than or greater-than 1,000), (p = 0.0098; R2 = 3.83%) is significantly associated with the observed heterogeneity.

Conclusion

Research-based findings of fatal opioid overdose are grossly lacking in middle- and low-income nations. We established that there is a need for opioid fatality surveillance systems in developing nations.

Fluoxetine attenuates stress-induced depression-like behavior due to decrease in pro-inflammatory cytokines in male rats

Background: Pro-inflammatory cytokines are implicated in depression caused by both environmental- and alcohol-induced stress. The purpose of the study was to investigate the cytokine levels in serum and hippocampus following induction of depression-like behaviors (DLB) by either forced swimming test (FST) or ethanol-induced DLB (EID). We also investigated the effect of prior administration of antidepressant drug fluoxetine on cytokines in animals exposed to both models of DLB. Methods: Animals were pretreated with fluoxetine before inducing DLB, while DLB was induced in some animals using FST and ethanol in different groups of rats without fluoxetine pretreatment. The ELISA was used to detect changes in cytokine (IL-1β, IL-6, and TNF-α) levels in serum and hippocampus. Results: The mean levels of IL-1β and IL-6 measured in serum and hippocampus were significantly higher in FST and EID models when compared to the control group. The serum concentrations of IL-1β and IL-6 were significantly reduced in animals pre-treated with 5 mg/kg and 10 mg/kg of fluoxetine in both FST and EID models when compared to the untreated FST and EID groups respectively. Conclusions: In conclusion, both environment and alcohol can induce stress and DLB in rats with similar intensity, and their mechanisms of DLB induction involve activation of pro-inflammatory cytokines. Moreover, fluoxetine can prevent stress-induced inflammation in models of DLB.

Polymyxin sensitivity/resistance cosmopolitan status, epidemiology and prevalence among O1/O139 and non-O1/non-O139 Vibrio cholerae: A meta-analysis

Resistance/sensitivity to polymyxin-B (PB) antibiotic has been employed as one among other epidemiologically relevant biotyping-scheme for Vibrio cholerae into Classical/El Tor biotypes. However, recent studies have revealed some pitfalls bordering on PB-sensitivity/resistance (PBR/S) necessitating study. Current study assesses the PBR/S cosmopolitan prevalence, epidemiology/distribution among O1/O139 and nonO1/nonO139 V. cholerae strains. Relevant databases (Web of Science, Scopus and PubMed) were searched to retrieve data from environmental and clinical samples employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effect-model (REM) and common-effect-model (CEM) of meta-analysis was performed to determine prevalence of PBR/S V. cholerae strains, describe the cosmopolitan epidemiological potentials and biotype relevance. Heterogeneity was determined by meta-regression and subgroup analyses. The pooled analyzed isolates from articles (7290), with sensitive and resistance are 2219 (30.44%) and 5028 (69.56%). Among these PB-sensitive strains, more than 1944 (26.67%) were O1 strains, 132 (1.81%) were nonO1 strains while mis-reported Classical biotype were 2080 (28.53) respectively indicating potential spread of variant/dual biotype. A significant PB-resistance was observed in the models (CEM = 0.66, 95% CI [0.65; 0.68], p-value = 0.001; REM = 0.83 [0.74; 0.90], p = 0.001) as both models had a high level of heterogeneity (I2 = 98.0%; d f = 33 2 = 1755.09 , Q p = 2.4932 ). Egger test (z = 5.4017, p < 0.0001) reveal publication bias by funnel plot asymmetry. The subgroup analysis for continents (Asia, Africa) and sources (acute diarrhea) revealed (98% CI (0.73; 0.93); 55% CI (0.20; 0.86)), and 92% CI (0.67; 0.98). The Epidemiological prevalence for El tor/variant/dual biotype showed 88% CI (0.78; 0.94) with O1 strains at 88% CI (0.78; 0.94). Such global prevalence, distribution/spread of phenotypes/genotypes necessitates updating the decades-long biotype classification scheme. An antibiotic stewardship in the post antibiotic era is suggestive/recommended. Also, there is need for holistic monitoring/evaluation of clinical/epidemiological relevance of the disseminating strains in endemic localities.

Polymorphism and mutational diversity of virulence (vcgCPI/vcgCPE) and resistance determinants (aac(3)-IIa, (aacC2, strA, Sul 1, and 11) among human pathogenic Vibrio species recovered from surface waters in South-Western districts of Uganda

BACKGROUND

Vibrio species are among the autochthonous bacterial  populations found in surface waters and associated with various life-threatening extraintestinal diseases, especially in human populations with underlying illnesses and wound infections. Presently, very diminutive information exists regarding these species' mutational diversity of virulence and resistance genes. This study evaluated variations in endonucleases and mutational diversity of the virulence and resistance genes of Vibrio isolates, harboring virulence-correlated gene (vcgCPI), dihydropteroate synthase type 1 and type II genes (Sul 1 and 11), (aadA) aminoglycoside (3'') (9) adenylyltransferase gene, (aac(3)-IIa, (aacC2)a, aminoglycoside N(3)-acetyltransferase III, and (strA) aminoglycoside 3'-phosphotransferase resistance genes.

METHODS

Using combinations of molecular biology techniques, bioinformatics tools, and sequence analysis.

RESULTS

Our result revealed various nucleotide variations in virulence determinants of V. vulnificus (vcgCPI) at nucleotide positions (codon) 73-75 (A → G) and 300-302 (N → S). The aminoglycosides resistance gene (aadA) of Vibrio species depicts a nucleotide difference at position 482 (A → G), while the aminoglycosides resistance gene (sul 1 and 11) showed two variable regions of nucleotide polymorphism (102 and 140). The amino acid differences exist with the nucleotide polymorphism at position 140 (A → E). The banding patterns produced by the restriction enzymes HinP1I, MwoI, and StyD4I showed significant variations. Also, the restriction enzyme digestion of protein dihydropteroate synthase type 1 and type II genes (Sul 1 and 11) differed significantly, while enzymes DpnI and Hinf1 indicate no significant differences. The restriction enzyme NlaIV showed no band compared to reference isolates from the GenBank. However, the resistant determinants show significant point nucleotide mutation, which does not produce any amino acid change with diverse polymorphic regions, as revealed in the restriction digest profile.

CONCLUSION

The described virulence and resistance determinants possess specific polymorphic locus relevant to pathogenomics studies, pharmacogenomic, and control of such water-associated strains.

Occurrence, environmental impact and fate of pharmaceuticals in groundwater and surface water: a critical review

In many nations and locations, groundwater serves as the population's primary drinking water supply. However, pharmaceuticals found in groundwater and surface waters may affect aquatic ecosystems and public health. As a result, their existence in natural raw waters are now more widely acknowledged as a concern. This review summarises the evidence of research on pharmaceuticals' occurrence, impact and fate, considering results from different water bodies. Also, various analytical techniques were reviewed to compare different pharmaceuticals' detection frequencies in water bodies. These include liquid chromatography-mass spectrometry (LC-MS), high-performance liquid chromatography (HPLC), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and gas chromatography-mass spectrometry (GC-MS). However, owing to LC-MS's high sensitivity and specification, it is the most reported instrument used for analysis. The PRISMA reviewing methodology was adopted based on relevant literature in order to focus on aim of the review. Among other pharmaceuticals reviewed, sulfamethoxazole was found to be the most frequently detected drug in wastewater (up to 100% detection frequency). The most reported pharmaceutical group in this review is antibiotics, with sulfamethoxazole having the highest concentration among the analysed pharmaceuticals in groundwater and freshwater (up to 5600 ng/L). Despite extensive study and analysis on the occurrence and fate of pharmaceuticals in the environment, appropriate wastewater management and disposal of pharmaceuticals in the water environment are not still monitored regularly. Therefore, there is a need for mainstream studies tailored to the surveillance of pharmaceuticals in water bodies to limit environmental risks to human and aquatic habitats in both mid and low-income nations.

Association between hemoglobin variants and laboratory outcomes in patients infected with P. falciparum from South West Uganda

Aims

We assess the relationship between various hemoglobin variants and some hematological parameters packed cell volume, white blood cells (PCV, WBC) and parasitemia level of patients with malaria in the southwestern, Uganda.

Methods

Patient were enrolled by rapid diagnostic tests (RDTs), confirmed by microscopy, and laboratory outcomes were determined.

Results

Patients positive for malaria RDTs were 155, microscopic-confirmed P. falciparum parasites were 95 (61.29%) having hemoglobin variants HbAA and HbAS; 75 (78.95%) and 13 (13.68%), respectively. The laboratory outcomes showed mean, PCV (32.19 ± 4.83), WBC (5831.66 ± 2888.29) and P. falciparum parasitaemia density (32,605.45 ± 14031), while the hemoglobin variants mean values AA (39,008.85 ± 31,261.56), AC (15908 ± 10173.48), AS (16,561.46 ± 15,380.93), SC (30,524 ± 0.000) and SS(1652 ± 0.000) were significantly different from the total population (34,321.5 ± 21,924.26) parasite-density.

Conclusion

Patients with hemoglobin variants HbAA had a significantly higher parasite-carrying capacity and PCV levels.

Demographic dynamics of waterborne disease and perceived associated WASH factors in Bushenyi and Sheema districts of South-Western Uganda

Water remains a significant player in spreading pathogens, including those associated with neglected tropical diseases. The implications of socio-demographic delineations of water quality, sanitation, and hygiene ("WASH") interventions are on the downswing. This study assessed waterborne diseases and perceived associated WASH factors in the Bushenyi and Sheema districts of South-Western Uganda. This study examines the linear relationship between WASH and identifies the association of specific demographic factors as well as their contributions/correlations to waterborne disease in the study area. A structured qualitative and quantitative data collection approach was adopted in face-to-face questionnaire-guided interviews of 200 respondents on eight surface water usage. Most participants, 65.5%, were females and had a higher score of knowledge of WASH (71%), 68% score on the improper practice of WASH, and 64% score on unsafe water quality. Low score for basic economic status was (57%), report of common diarrhoea was (47%), and a low incidence of waterborne disease outbreaks (27%). The principal component analysis (PCA) depicts the knowledge and practice of WASH to have a strong positive correlation (r = 0.84, p < 0.001; r = 0.82, p < 0.001); also economic status positively correlated with grade of water source, knowledge, and practice of WASH (correlation coefficient = 0.72; 0.99; 0.76 and p-values = 0.001; < 0.001; < 0.001 respectively). Occupation (p = 0.0001, OR = 6.798) was significantly associated with knowledge and practice of WASH, while age (r = -0.21, p < 0.001) was negatively associated with knowledge and practice of WASH. The basic economic status explains why "low economic population groups" in the remote villages may not effectively implement WASH, and diarrhoea was common among the population. Diarrhoea associated with unsafe water quality and improper practice of WASH is common among the study population, and there is a low incidence of waterborne disease outbreaks. Therefore, government, stakeholders, and non-governmental organisations should work together to promote proper practice of WASH conditions to limit the occurrence of diarrhoea and prevent potential waterborne disease outbreaks.

UCP-LF and other assay methods for schistosome circulating anodic antigen between 1978 and 2022

Detection of circulating anodic antigen (CAA) is known for its high sensitivity in diagnosing schistosomiasis infection, even in low-prevalence settings. The Up-Converting Phosphor-Lateral Flow (UCP-LF) assay developed in 2008 presented greater sensitivity than other assay methods in use for CAA detection. Our study aims to comprehensively review all studies conducted in this area and thus generate informed conclusions on the potential for adopting the UCP-LF assay for diagnosing this important yet neglected tropical disease. Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, we generated search criteria to capture all studies in English journals available in the Scopus and PubMed databases on 20 December 2022. A total of 219 articles were identified, and 84 that met the inclusion criteria were retrieved and eventually included in the study. Twelve different assay methods were identified with a noteworthy transition from enzyme-linked immunosorbent assay (ELISA) to the UCP-LF assay, a laboratory-based assay that may be applicable as a point-of-care (POC) diagnostic test for schistosomiasis. Reducing the time, cost, and dependence on specialized laboratory skills and equipment, especially relating to the trichloroacetic acid extraction step and centrifugation in the UCP-LF CAA assay may go a long way to aid its potential as a POC tool. We also propose the development of a CAA-specific aptamer (short protein/antigen-binding oligonucleotide) as a possible alternative to monoclonal antibodies in the assay. UCP-LF has great potential for POC application.

Elucidation of chemical profiles and molecular targets of Mondia whitei leave fractions bioactive as novel therapeutics: an in vitro and in silico assay

BACKGROUND

Mondia whitei root is often used in Africa as a local therapeutic agent for libido enhancement. The fractions of the M. whitei leaves (MWL) lack chemical characterization of their bioactive components and possible molecular targets. We characterized and investigated its molecular target as therapeutic agents in an in vitro and in silico assay. Mineral compositions, antioxidant, and GC-MS characterization were studied. The cytotoxicity effect was measured on HeLa and HT-29 cells by MTT assay. In silico potential inhibitors of Cathepsin B (CathB) as a cancer biomarker were determined.

RESULTS

The flame photometry produced marked Na⁺ and K⁺. GC-MS revealed eighteen bioactive components. The fractions (chloroformic 47.00, ethanolic 45.52, and aqueous 40.13) of MWL caused a higher inhibition ratio compared to standards. The MWL showed a significant cytotoxic effect on the treated cell lines at concentrations of 150 and 200 μg/ml and 100, 150, and 200 μg/ml for HT-29 and HeLa cells, respectively. Ten bioactives (MWL 4, 5, 6, 8, 9, 10, 14, 15, 17, and 18) showed potential inhibition of CathB with binding affinities of -4.40 to -8.3 Kcal/Mol. However, MWL 4, 9, 14, and 17 which have higher binding affinities (-6.7, -7.1, -8.2, and -8.3, respectively) than the standard inhibitor (-6.5) were the lead molecules.

CONCLUSION

These chemical profiles and potential molecular targets unraveled in this study propose that MWL has a promising anticancer activity.

Modern knowledge-scape possess petite influence on the factual persistence of resistance determinants (ARGs/MGEs): A map and assessment of discharged wastewater and water bodies

Antibiotic resistance genes (ARGs) and Mobile genetic elements (MGEs) are major global emerging pollutants of the environment and water nexus which various investigators of related studies have reported. Observing ARGs and MGEs in water bodies, wastewater treatment systems, and estuaries is indicative of relevant risk, resistant bacteria/ARGs spread or potential health concern and may result environmental pathogen bloom if appropriate research-based strategies are not implemented to remove these lethal genetic materials. Despite reports and knowledge-based strategies for removal, the challenge yet persists. This study aims to appraise the impact/contribution of related studies and emphasize the necessity for applying combined research-based/practitioners approach in addressing the expanding challenge of ARGs/MGEs in wastewater/waterbodies. The study describes a bibliometric assessment of antibiotic resistance determinants annual scientific publications on the Web of Science, an annual growth rate of related articles, top articles per citations with search topics and content-review analysis to evaluate the methods of removal of ARGs/MGEs. A total of 1301 articles of wastewater treatment systems were retrieved with date range of 1997-2019. A description of the study Annual Growth Rate of 37.82% at R² of 0.7863 was observed with an increasing article publication and a decreasing total citation rate indicating persistent reports of dispersion on ARGs/MGEs studies in the water bodies and environment. Although there abound extensive studies and reports of ARGs and MGEs in water nexus and wastewater release with research based removal strategies, the impact of such reports have not been fully actualized amongst wastewater system practitioners. A lucid drive towards implementing ARGs/MGEs removal strategies from the environment by applying affirmed research-based methods are suggestive.

Epidemiology of neurodegenerative diseases in the East African region: A meta-analysis

INTRODUCTION

There is a scarcity of epidemiological data on neurodegenerative diseases (NDs) in East Africa. This meta-analysis provides the regional prevalence of NDs, their contributing factors, and evidence of change over time concerning gender per age or year.

METHODS

Articles were retrieved from electronic databases following the PRISMA standard.

RESULTS

Forty-two studies were reviewed, and 25 were meta-analyzed with a random-effects model. The pool estimate proportion of 15.27%, 95% CI (0.09-0.23) (I² = 98.25%), (Q = 1,369.15, p < 0.0001) among a population of 15,813 male/female and 1,257 with NDs. Epidemiological characteristics associated with NDs include Dyskinesias prevalence 55.4%, 95% CI (13.5; 90.9), I² (96%) and subsistence farming prevalence 11.3%, 95% CI (5.8; 20.9), I² (99%). Publication bias by Egger test was (z = 4.1913, p < 0.0001), while rank correlation test using Kendall's model was (tau = 0.1237, p = 0.3873). Heterogeneity (R² design = 5.23%, p design < 0.0001; R² size = 52.163%, p size < 0.001; and R² period = 48.13, p period < 0.0001. Covariates (R² design + size + period = 48.41%, p < 0.001).

CONCLUSION

There is a high prevalence of NDs in the East African region, which could impact life expectancy, morbidity, and quality of life. Thus, early screening and regular surveillance could assist in management strategies.

A Global Perspective of Vibrio Species and Associated Diseases: Three-Decade Meta-Synthesis of Research Advancement

Outbreaks of Vibrio infections have a long history of global public health concern and threat to the aquaculture industry. This 3-decade (1990-2019) meta-synthesis of global research progress in Vibrio species and associated disease outbreaks was undertaken to generate the knowledge needed to design effective interventions with policy implications. Using PRISMA protocol, we obtained data on the online version of the Institute for Scientific Information (ISI), Web of Science (WOS), and Scopus from January 1990 to September 2021 by title search of the keywords "Vibrio species OR Vibrio spp. OR vibriosis." On the 3-decade survey, the result has shown that a total of 776 publications document types were published on the subject, with an average of 24.25 ± 13.6 published documents per year with an annual growth rate of 4.71%. The year 2020 recorded the highest output of 52 published documents accounting for 6.70% of the total. The most prolific author, Blanch A., published 12 articles on the subject and has received citations of 1003 with an h-index of 10. While the most global cited paper author is the journal of J. Bacteriol (Bassler et al), receiving total citation (TC) (550) and per Year (22). The top active corresponding authors country is the United States of America with (92) articles, freq. 12.40%; TC of 3103. The observations in this study, such as the collaborations network map, and index, which have outlined a big difference between countries based on economic status, have underscored the need for a sustained research mentorship program that can define future policies.

Occurrence, Antibiotic Susceptibility and Genes Encoding Antibacterial Resistance of Salmonella spp. and Escherichia coli From Milk and Meat Sold in Markets of Bushenyi District, Uganda

The bacteriological safety of food/food products and the menace of antimicrobial resistance amongst enteropathogenic bacteria raise therapeutic management concerns within the public health system. Recently consumers of food/food products purchased from the public market of Bushenyi District presents with Enterobacteriaceae infection-associated symptoms and clinical conditions. We determine the molecular characterization and antibiotic signatures of some enteric bacterial recovered from foods/food products in markets of Bushenyi District, Uganda. Standard molecular biology techniques (Polymerase chain reaction PCR) and microbiological procedures were applied. Meat (MT) and milk (MK) samples were collected from 4 communities/town markets (Kizinda, Ishaka, Bushenyi, kashenyi) between April and September 2020 and analyzed. Our result reveals high differential counts of Salmonella species (175.33 ± 59.71 Log 10 CFU/100 ml) and Escherichia coli (53.33 ± 26.03 Log 10 CFU/100 ml) within the 4 markets with the count of Salmonella species higher than that of E. coli in each sampled market. The PCR further confirmed the detected strains (22.72% of E. coli and 54.29% of Salmonella species) and diverse multiple antibiotic-resistant determinants {TEM: (12 (23.1%) blaTEM-2 gene, 3 (5.8%) blaTEM gene}, 5 (9.6%) blaSHV gene, 3 (5.8%) bla-CTX-M-2, 1 (1.9%) bla-CTX-M-9 }. Other resistance genes detected were {10 (21.7%) strA gene} and 8 (17.4%) aadA gene} indicating a potential antibiotic failure. The need for alternative medicine and therapeutic measure is suggestive. Astute and routine surveillance/monitoring of potential pathogens and food products in the public market remains a core for maintaining future consumer safety.

Meta-synthesis and science mapping analysis of HIV/HPV co-infection: a global perspective with emphasis on Africa

Background

Viral infections are emerging with diverse clinical relevance both in endemic environments and non-endemic regions of the world. Some of the viruses cause co-infections that are of public health importance. The progress of studies on human immunodeficiency virus / Human papillomavirus (HIV/HPV) co-infection is not well documented especially in Africa where cases are endemic.

Method

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a global three-decade meta-synthesis and science mapping analysis on HIV/HPV co-infections. Assessment of progress, Author/Country productivity/trends, topic conceptual framework, and international collaborative networks were analyzed.

Results

We recovered 196 documents of 115 sources from the web of science database. The meta-synthesis revealed 1203 prolific authors containing nine solo authors, an annual growth rate of 8.09%, a significant average citation per article of 20.7%, and an average citation per year per document of 2.1. A significant high correlation between the mean/TC per article and the mean total citation (TC) per year showed 80.98% of the articles produced between 2005 and 2007 on HPV/HIV co-infection. The co-author per document index were 7.0 and the collaboration index was 6.4. The meta-analysis also revealed inadequate funding from individual or governmental organizations; among the 196 documents dataset, 114 (58.2%) were funded, and only 31 (15.8%) were funded in Africa where HIV/HPV co-infection cases are endemic.

Conclusions

Authors’ collaboration network, countries’ collaboration, authors’ citations and implementation of research-based finding in previous studies are yet to receive the relevant outcome, especially as various countries in the African continent have received poor funding with a repeated reporting of co-infection associated with HIV/HPV. African needs to re-awaken and stir up research-based interest in HPV/HIV co-infection studies to resolve indigenous public health concerns associated with the viral endemicity.

Water bodies are potential hub for spatio-allotment of cell-free nucleic acid and pandemic: a pentadecadal (1969-2021) critical review on particulate cell-free DNA reservoirs in water nexus

BACKGROUND

In recent times, there had been report of diverse particulate nucleic acid-related infections and diseases which have been associated with endemic, sporadic, and pandemic reports spreading within water nexus. Some of such disease cases were seldom reported in earlier years of technological advancement and research based knowledge-scape. Although the usefulness of water, wastewater treatment systems, water regulatory organizations and water re-use policy in compliant regions remains sacrosanct, it has been implicated in diverse gene distribution.

MAIN BODY

A cosmopolitan bibliometric and critical assessment of cell-free DNA reservoir in water bodies was determined. This is done by analysing retrieved pentadecadal scientific publications in Scopus and Pubmed centre database, determining the twelve-monthly publication rates of related articles, and a content-review assessment of cell-free nucleic acids (cfNAs) in water environment. Our results revealed thirty-eight metric documents with sources as journals and books that conform to the inclusion criteria. The average reports/publication rate per year shows 16.7, while several single and collaborating authors are included with a collaboration index of 4.31. A zero average citation per document and citation per year indicate poor research interest and awareness.

SHORT CONCLUSION

It is important to note that a redirected interest to studies on cfNAs in water environments would encourage advancement of water treatment strategies to include specific approaches on the removal of cfNAs, membrane vesicles or DNA reservoirs, plasmids or extra-chromosomal DNA and other exogenous nucleic acids from water bodies. It may also lead to a generational development/improvement of water treatment strategies for the removals of cfNAs and its members from water bodies.

Antibiogram signatures of Vibrio species recovered from surface waters in South Western districts of Uganda: Implications for environmental pollution and infection control

Reports of vibriosis and other related gastrointestinal infections have remained a recurring concern in the diverse global continent. The safety of drinking surface water and associated environmental pollution has remained a public health concern in limited resource sittings. Seen in this light, we report the antibiogram signatures of Vibrio species recovered from surface waters in the South-Western districts of Uganda. Surface water samples were collected for four months for Vibrio species isolation in four districts (Bushenyi-B, Mitooma-M, Rubirizi-R, and Sheema-S) using bacteria culture procedures, disc diffusion and Polymerase Chain Reaction (PCR) technique. Isolates were characterised, and the antibiotic fingerprints were determined using PCR and nine selected antibiotics in routine use. A total of 392 Vibrio species were confirmed from the various districts (B: 172, M: 79. R: 60, S: 81), with 163 (94.77%) resistant to colistin (polymixin), 145 (84.3%) resistant to cefotaxime, 127 (73.84%) resistant to azithromycin, and 33 (19.19%) resistant to chloramphenicol among Bushenyi isolates. A similar high resistance to fluoroquinolones and carbapenem antibiotics were also recorded in other districts of the study area. A complete multiple antibiotic resistance phenotype ((M)ARPs) to the applied antibiotics (A-CTX-CXM-MEM-ATH-K-TM-C-PB-NI-CIP-NA) were also recorded among some isolates, which produced multiple antibiotic resistance indexes of 1, suggesting a high-risk source of contamination due to the usage of several antibiotics. The PCR reports also confirm ampC gene {20 (10.9%)}, beta-lactamase TEM gene (blaTEM2), {30 (10%)} and dihydropteroate synthase type-1 and 11 gene (sul 1 & 11) {16 (8%)}. The results present an implicated environmental pollution problem and a potential concern to public health, therefore there is the need for control of such infectious bacteria and environmental pollution monitoring. Hence, it is recommended various approaches crucial to monitoring of emerging trends in drug resistance at the local and international levels.

COVID-19 and erythrocrine function: The roller coaster and danger

Erythrocrine function refers to erythrocytes’ ability to synthesize and release active signaling molecules such as ATP and nitric oxide (NO). Erythrocyte NO regulates its deformability and increases its perfusion and circulation that prevent tissue hypoxia. Recently, there is a connotation between SARS-CoV-2 infection and erythrocrine function due to alteration in the release of NO and ATP from erythrocytes. SARS-CoV-2 binds erythrocyte band3 protein, which has a similar characteristic of ACE2, leading to alteration of erythrocyte physiology like oxygen transport with development of hypoxia. Similarly, SARS-CoV-2 infection activates erythrocyte protein kinase C alpha (PKC-α), causing significant changes in the erythrocyte functions. The erythrocytes can bind SARS-CoV-2 and its active particles with subsequent virus delivery to the liver and spleen macrophages. Thus, the erythrocytes act as elimination for SARS-CoV-2 in COVID-19. Moreover, the erythrocyte stored, release sphingosine-1 phosphate (S1P) improves endothelial and regulates lymphocyte functions. SARS-CoV-2 ORF8 protein binds the porphyrin part of hemoglobin heme at the β1 chain, causing hemolysis and dysfunctional hemoglobin to reduce oxygen-carrying capacity. In conclusion, SARS-CoV-2 infection and associated pro-inflammatory disorders lead to abnormal erythrocrine function with subsequent inflammatory complications and endothelial dysfunction due to deficiency of protective released molecules (NO, G1P, and ATP) from functional erythrocytes. In vitro, preclinical, and clinical studies are mandatory in this regard.

COVID-19-Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low-Income Earners of Western Uganda

Objective: The study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda.

Methods: This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively.

Results: The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r² = 47.4% and 6.4%, respectively) had a negative correlation with awareness of mental health care. In addition, no formal education had a positive correlation with anger and depression (r² = 1.9% and 0.3%, respectively). Singleness in this study had a negative correlation with awareness of mental health care, anger, and depression (r² = 1.9, 0.8, and 0.3%, respectively), and a positive correlation with anxiety (r² = 3.9%).

Conclusion: It is evident that education and relationship status influenced awareness on mental health care and mental health state among low-income earners in Western Uganda during the first COVID-19 lockdown. Therefore, policymakers should strengthen social transformation through the proper engagement of low-income earners in this COVID-19 era.

Epidemiologic potentials and correlational analysis of Vibrio species and virulence toxins from water sources in greater Bushenyi districts, Uganda

Adequate water supply is one of the public health issues among the population living in low-income settings. Vibriosis remain a significant health challenge drawing the attention of both healthcare planners and researchers in South West districts of Uganda. Intending to clamp down the disease cases in the safest water deprive locality, we investigated the virulent toxins as contaminants and epidemiologic potentials of Vibrio species recovered from surface waters in greater Bushenyi districts, Uganda. Surface water sources within 46 villages located in the study districts were obtained between June and October 2018. Standard microbiological and molecular methods were used to analyse samples. Our results showed that 981 presumptive isolates retrieved cell counts of 10-100 CFU/g, with, with (640) 65% confirmed as Vibrio genus using polymerase chain reaction, which is distributed as follows; V. vulnificus 46/640 (7.2%), V. fluvialis 30/594 (5.1), V. parahaemolyticus 21/564 (3.7), V. cholera 5/543 (0.9), V. alginolyticus 62/538 (11.5) and V. mimicus 20/476 (4.2). The virulence toxins observed were heat-stable enterotoxin (stn) 46 (82.10%), V. vulnificus virulence gene (vcgCPI) 40 (87.00%), extracellular haemolysin gene {vfh 21 (70.00)} and Heme utilization protein gene {hupO 5 (16.70)}. The cluster analysis depicts hupO (4.46% n = 112); vfh (18.75%, n = 112); vcgCPI and stn (35.71%, & 41.07%, n = 112). The principal component analysis revealed the toxins (hupO, vfh) were correlated with the isolate recovered from Bohole water (BW) source, while (vcgCPI, stn) toxins are correlated with natural raw water (NRW) and open springs (OS) water sources isolates. Such observation indicates that surface waters sources are highly contaminated with an odds ratio of 1.00, 95% CI (70.48-90.5), attributed risk of (aR = 64.29) and relative risk of (RR = 73.91). In addition, it also implies that the surface waters sources have > 1 risk of contamination with vfh and > six times of contamination with hupO (aR = 40, - 66). This is a call of utmost importance to the population, which depends on these water sources to undertake appropriate sanitation, personal hygienic practices and potential measures that ensure water quality.

Anti-apoptotic effect of Buchholzia coriacea Engl. stem back extracts on AsPC-1 and mechanisms of action

Ethnopharmacological relevance

Buchholzia coriacea Engl. is popularly called wonderful cola due to its wide ethnomedicinal use for the treatment of various ailments. We investigated the possible cytotoxic effect of its various fractions on human pancreatic cancer cell (AsPC-1) and also determined its mechanisms of action.

Materials and methods

The AsPC-1 cells were cultivated and separately treated with 5-fluorouracil (5-FU) or Buchholzia coriacea Engl. bark (BC) (ethanol, aqueous, chloroform or ethyl acetate extract) for 72 h. Cell viability, caspase 3 and mitochondrial membrane potential (ΔΨm) were determined in vitro after the treatment. Nitric oxide (NO) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals’ scavenging property, ferric reducing power and lipid peroxidation assays were also done to examine the antioxidant effect of BC in vitro.

Results

Various extracts of BC, especially at 2500 μg/ml and 5000 μg/ml, increased the AsPC-1 viability while 5-FU decreased it. The activity of caspase 3 was increased by 5-FU but reduced by all concentrations of various extracts of BC. Incubation of AsPC-1 with 5-FU showed the majority of cells having the monomeric form of JC-1 dye (bright green fluorescence), which indicated de-energized mitochondria. However, fluorescence photomicrograph of cells incubated with different concentrations (20, 40 and 100 μg/ml) of BC extracts (aqueous, ethanol, chloroform and ethyl acetate) showed strong JC-1 aggregation (yellow), which indicated mitochondria with intact membrane potentials. BC extracts also scavenged NO and DPPH radicals, inhibited lipid peroxidation and increased ferric reduction, though not as much as ascorbic acid.

Conclusion

This study suggests that BC elicits anti-apoptotic activity in AsPC-1 by increasing cell viability, decreasing caspase 3 activity, stabilizing the ∆Ψm, and scavenging free radicals. Even though BC is used ethnomedicinally as anti-cancer agent, our findings in the present study suggest that it has pro-cancer potential in-vitro, especially on pancreatic cells. Its anti-apoptotic activity in AsPC-1 could be of clinical significance, especially to counteract the effect of apoptotic agents on pancreatic cells.

Covid-19 and development of heart failure: mystery and truth

Coronavirus disease 2019 (Covid-19) is a novel worldwide pandemic caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During Covid-19 pandemic, socioeconomic deprivation, social isolation, and reduced physical activities may induce heart failure (HF), destabilization, and cause more complications. HF appears as a potential hazard due to SARS-CoV-2 infection, chiefly in elderly patients with underlying comorbidities. In reality, the expression of cardiac ACE2 is implicated as a target point for SARS-CoV-2-induced acute cardiac injury. In SARS-CoV-2 infection, like other febrile illnesses, high blood viscosity, exaggerated pro-inflammatory response, multisystem inflammatory syndrome, and endothelial dysfunction-induced coagulation disorders may increase risk of HF development. Hypoxic respiratory failure, as in pulmonary edema, severe acute lung injury (ALI), and acute respiratory distress syndrome (ARDS) may affect heart hemodynamic stability due to the development of pulmonary hypertension. Indeed, Covid-19-induced HF could be through the development of cytokine storm, characterized by high proliferation pro-inflammatory cytokines. In cytokine storm-mediated cardiac dysfunction, there is a positive correlation between levels of pro-inflammatory cytokine and myocarditis-induced acute cardiac injury biomarkers. Therefore, Covid-19-induced HF is more complex and related from a molecular background in releasing pro-inflammatory cytokines to the neuro-metabolic derangements that together affect cardiomyocyte functions and development of HF. Anti-heart failure medications, mainly digoxin and carvedilol, have potent anti-SARS-CoV-2 and anti-inflammatory properties that may mitigate Covid-19 severity and development of HF. In conclusion, SARS-CoV-2 infection may lead to the development of HF due to direct acute cardiac injury or through the development of cytokine storms, which depress cardiomyocyte function and cardiac contractility. Anti-heart failure drugs, mainly digoxin and carvedilol, may attenuate severity of HF by reducing the infectivity of SARS-CoV-2 and prevent the development of cytokine storms in severely affected Covid-19 patients.

Annona muricata Linn and Khaya grandifoliola C.DC. Reduce Oxidative Stress In Vitro and Ameliorate Plasmodium berghei-Induced Parasitemia and Cytokines in BALB/c Mice

Background.

Annona muricata and Khaya grandifoliola are ethnomedicinally used for the treatment of malaria and have been experimentally shown to have an anti-plasmodial effect, but the mechanisms involved are not fully understood. This study investigated the effect of the ethanol extracts of their leaves on parasitemia, radical scavenging and cytokines in Plasmodium berghei ANKA-infected BALB/c mice.

Methods.

BALB/c mice were infected with P. berghei and treated with chloroquine, A. muricata or K. grandifoliola extract for 4 days. The percentage of parasitemia and the level of cytokine expression were determined after treatment. Trace element, phytochemical and nitric oxide (NO) scavenging activity, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging properties assays were done to study the antioxidant effects of AN and KG in vitro.

Results.

P. berghei consistently increased parasitemia in BALB/c mice. The tested doses (100-, 200-, and 400 mg/kg) of A. muricata and K. grandifoliola attenuated the P. berghei-induced elevation of parasitemia and cytokines (TNF-α, IL-5, and IL-6) in vivo during the experimental period, though not as much as chloroquine. Moreover, both extracts scavenged the DPPH and NO radicals, though A. muricata had more anti-oxidant effect than K. grandifoliola in-vitro.

Conclusion.

The ethanol extracts of A. muricata and K. grandifoliola reduce parasitemia in P. berghei-treated mice BALB/c by scavenging free radicals and reducing cytokines, though the extracts were not as effective as chloroquine.

Misconceptions on COVID-19 Risk Among Ugandan Men: Results From a Rapid Exploratory Survey, April 2020

Background: Transmission of COVID-19 in developing countries is expected to surpass that in developed countries; however, information on community perceptions of this new disease is scarce. The aim of the study was to identify possible misconceptions among males and females toward COVID-19 in Uganda using a rapid online survey distributed via social media. Methods: A cross-sectional survey carried out in early April 2020 was conducted with 161 Ugandans, who purposively participated in the online questionnaire that assessed understandings of COVID-19 risk and infection. Sixty-four percent of respondents were male and 36% were female. Results: We found significant divergences of opinion on gendered susceptibility to COVID-19. Most female respondents considered infection risk, symptoms, severe signs, and death to be equally distributed between genders. In contrast, male respondents believed they were more at risk of infection, severe symptoms, severe signs, and death (52.7 vs. 30.6%, RR = 1.79, 95% CI: 1.14-2.8). Most women did not share this perception and disagreed that males were at higher risk of infection (by a factor of three), symptoms (79% disagree), severe signs (71%, disagree), and death (70.2% disagree). Overall, most respondents considered children less vulnerable (OR = 1.12, 95% CI: 0.55-2.2) to COVID-19 than adults, that children present with less symptoms (OR = 1.57, 95% CI: 0.77-3.19), and that there would be less mortality in children (OR = 0.92, 95% CI: 0.41-1.88). Of female respondents, 76.4% considered mortality from COVID-19 to be different between the young and the elderly (RR = 1.7, 95% CI: 1.01-2.92) and 92.7% believed young adults would show fewer signs than the elderly, and 71.4% agreed that elderly COVID-19 patients would show more severe signs than the young (OR = 2.2, 95% CI: 1.4, 4.8). While respondents considered that all races were susceptible to the signs and symptoms of infection as well as death from COVID-19, they considered mortality would be highest among white people from Europe and the USA. Some respondents (mostly male 33/102, 32.4%) considered COVID-19 to be a "disease of whites" (30.2%). Conclusion: The WHO has identified women and children in rural communities as vulnerable persons who should be given more attention in the COVID-19 national response programs across Africa; however, our study has found that men in Uganda perceive themselves to be at greater risk and that these contradictory perceptions (including the association of COVID-19 with "the white" race) suggest an important discrepancy in the communication of who is most vulnerable and why. Further research is urgently needed to validate and expand the results of this small exploratory study.