The control of human African trypanosomiasis (HAT) relies primarily on the early detection and appropriate treatment of cases, which remain central components of current elimination strategies, while no vaccine or chemoprophylaxis is available. However, under-screening by mobile units is observed. Low HAT prevalence may lower motivation to participate in active screening programs that are important for early detection of cases, because people do not perceive the risk of infection. In this context, the integration of passive HAT screening into primary health services is encouraged but faces multiple challenges. This study aimed to explore the opinions and perceptions of the different actors involved in the integration of passive HAT screening into first level health establishments (Health Center and General Referral Hospital) in Bibanga Health District and identify the potential obstacles likely to affect it. A qualitative study was conducted in four health areas, selected based on their performance in reporting passive screening (PS) activities and their geographical distance from the Central District Office. Thirteen focus group discussions (FGDs) were held with men, women, and young people, as well as twelve semi-structured interviews (SSIs) with former HAT patients, community volunteers (Presidents of the Health Committee), healthcare providers, and local and provincial decision-makers. The discussions were digitally recorded, transcribed, translated from Tshiluba into French, and thematically analyzed using ATLAS.ti 7.5.16 software. A documentary review was also carried out to complement the empirical data. Community perceptions indicate a limited knowledge about HAT, especially among young people, with confusion between HAT and malaria, fear of testing, and persistent rumors. Women expressed feelings of marginalization due to a lack of targeted information. On the provider side, demotivation is evident, linked to the absence of passive screening integration into official policies, lack of training, and lack of recognition. Community volunteer complained of a lack of support and motivation. The identified obstacles include: (i) structural barriers (geographical accessibility, stockouts, low attendance), (ii) economic constraints (medical expenses, transportation costs), (iii) sociocultural barriers (rumors, stigmatization), and (iv) institutional limitations (lack of supervision, low community involvement). Perception gaps have been noted between field actors and health authorities. The integration of passive screening into primary healthcare programs requires a multisectoral approach tailored to the local context. Simplifying the diagnostic process would facilitate integration. However, the healthcare system must be adequately funded and equipped. These results offer concrete pathways to enhance the integration of passive screening and contribute to the elimination of HAT by 2030.
Pertussis has witnessed a resurgence in morbidity in recent years. In most countries, pertussis surveillance is inadequate for accurately estimating numbers of cases or deaths. The study aimed to identify the true burden of pertussis based on the published seroepidemiology studies of pertussis worldwide. A systematic search of five databases was conducted to identify relevant population-based studies published between January 1, 2013, and December 31, 2024. The seroprevalence and sero-incidence of anti-pertussis (anti-PT) IgG antibodies were extracted and the estimated incidence of Bordetella pertussis (B. pertussis) infection was calculated based on the meaning of the cut-off value of anti-PT IgG with meta-analysis. The estimated case numbers and incidence of B. pertussis infection across WHO regions were calculated and compared with the data from ‌Global Burden of Disease (GBD) and Global Health Observatory (GHO). Totally 164 articles were eligible for inclusion in our systematic review and meta-analysis after screening. Overall, the global seroprevalence of pertussis anti-PT IgG antibodies was 23.39% (95% CI 12.63-39.20%) during 2010-2023 and the estimated incidence of B. pertussis infection was 5.11% (95% CI 2.97-8.63%). Compared with regions using whole-cell pertussis (wP) vaccines (24.63%), those predominantly employing acellular pertussis (aP) vaccines demonstrated a higher seroprevalence (26.39%) but lower estimated infection rates (aP: 4.23% vs. wP: 6.15%; P<0.001). Subgroup analysis showed that the seroprevalence of pertussis anti-PT IgG antibodies in different age groups ranged from 16.72% to 56.27%, while the estimated incidence of B. pertussis infection ranged from 3.84% to 13.75%. The World Health Organization African Region contributed the highest seroprevalence of pertussis anti-PT IgG antibodies at 46.28%, while the World Health Organization American Region had the highest incidence of B. pertussis infection at 13.46%. It is estimated that annual pertussis cases can reach 386 million and the incidence of pertussis is much higher than the reported data from GHO and the estimated data from GBD. The true burden of pertussis has likely been grossly underestimated, with its incidence potentially much higher than currently recognized.
The aim of this study was to analyze the correlation between the levels of 12 cytokines in the cervical microenvironment and cervical intraepithelial neoplasia in patients with high-risk human papillomavirus (HR-HPV) infection. Female patients ( n = 73) with HR-HPV infection were enrolled and divided into a high-grade squamous intraepithelial lesion (HSIL) group ( n = 33) and a non-HSIL (N-HSIL) group ( n = 40), which include low-grade squamous intraepithelial lesions and inflammation. Healthy screening subjects ( n = 31) with negative HR-HPV results were enrolled as a control group. We examined contemporaneous plasma and secretory cytokines from 25 study subjects to investigate the difference between systemic cytokine profiles and the local microenvironment immunity using the Wilcoxon matched-pairs signed rank test. The 12 cytokines from cervical secretions were compared between the three groups using the Mann-Whitney test, and logistic regression was used to analyze HSIL and N-HSIL. There were statistical differences in eight cytokines (IL-2, IL-6, TNF-α, IFN-γ, IL-1β, IL-12p70, IFN-α, and IL-8) between cervical secretion and plasma of the same patient, and seven cytokines were statistically different between the control and other two groups. We selected four independent variables (TNF-α, IFN-γ, IL-12p70, and IFN-α) commonly identified by univariate regression analysis and non-parametric tests for multivariate logistic regression analysis. Based on this model, HSIL could be predicted in patients with HR-HPV infection, with the area under the curve being 0.76. The systemic cytokine profile cannot reflect the local microenvironment immunity, and the occurrence of HSIL is related to the cytokine levels in the cervical microenvironment.
We aimed at estimating the frequency of local transmission of arboviral infections in Verona province, Italy, between June and September 2025. People presenting with acute fever and without recent travel history (and less than WBC 10,000 per µL, unless there was a history of tick bite) were screened for arboviruses following a multi-step protocol. Cases were confirmed by a molecular assay and/or virus-specific IgM antibodies, including rising antibody titre in a second serum sample collected 15-20 days later and a positive seroneutralization test. One hundred and two people were included. Of these, 29 out of 102 (28.4%, 95% CI 20.2-38.4%) demonstrated autochthonous arboviral infections. Specifically, three cases of West Nile fever, four cases of tick-borne encephalitis, and 22 cases of chikungunya infections were diagnosed. A large proportion of unexplained acute fever cases had arboviral infections from local transmission. Of note, the protocol permitted an early detection of a local outbreak of chikungunya. These findings support the importance of strengthening public health surveillance in southern Europe, for an early detection of transmission foci and to adapt screening protocols to the changing epidemiology of arboviral infections.
The aim of this study was to identify and quantify the risk factors with the greatest impact on the development of CIN2+ in patients with low-grade cytology and either HPV-negative or high-risk HPV-positive (non-16/18) results. The secondary aim was to develop and validate a multiparameter, risk-based prediction system. This retrospective cohort study was conducted in the Department of Obstetrics and Gynecology at Thammasat University Hospital between January 2021 and December 2024. Women who underwent cervical cancer screening and had a report of low-grade cytological abnormalities (ASC-US or LSIL), with either non-16/18 high-risk HPV infection or a negative HPV test, were included. A total of 480 participants were included. The mean age of participants was 40.7 years. The prevalence of CIN2+ was 15.6% (75/480). The predictive model was developed by incorporating six factors: having three or more deliveries, six or more lifetime sexual partners, smoking, no cervical screening within five years, lack of HPV vaccination, and high-risk HPV positivity (non-16/18). Subjects with a score of 5 or more out of 14 points were classified as high-risk and recommended to undergo colposcopy within four weeks. The model demonstrated a sensitivity of 97.3% and a negative predictive value (NPV) of 98.6%. The risk factors for CIN2+ included having three or more deliveries, six or more lifetime sexual partners, smoking, no cervical screening within the past five years, lack of HPV vaccination, and high-risk HPV positivity (non-16/18). The predictive model demonstrated a sensitivity of 97.3% and a negative predictive value (NPV) of 98.6%.
A global resurgence of pertussis has followed the COVID-19 pandemic, yet the underlying drivers remain unclear. We investigated the contribution of Bordetella pertussis genomic evolution to the post-pandemic resurgence. We analyzed 8117 B. pertussis genomes from 35 countries, including 249 newly sequenced isolates collected from six regions in China. Temporal dynamics of genotypes, antigenic profiles, and macrolide resistance were examined before, during, and after the pandemic. Shared post-pandemic evolutionary patterns were identified across global B. pertussis populations. These included the emergence of macrolide-resistant strains in France, the United States, and Australia, and their dominance in eastern China, driven by the expansion of the MR-MT28 sublineage (ptxP3/fim3-1/prn150 or PRN-deficient). Parallel antigenic shifts were observed, with declining PRN-deficient strains accompanied by increasing prn2 allele frequencies in multiple regions. Region-specific dynamics were also evident. In China, the post-pandemic resurgence was characterized by near-complete replacement of circulating strains by the MR-MT28 sublineage. In contrast, the resurgence in Europe and the United States largely reflected the persistence and expansion of locally established lineages. Expanded sampling further revealed that MR-MT28 sublineage is no longer genetically homogeneous, having diversified into multiple phylogenetic groups, with most isolates detected outside China (72%, 8/11) being PRN-deficient. This unified global genomic analysis demonstrates both shared and region-specific post-pandemic shifts in B. pertussis populations. The dominance of the MR-MT28 sublineage in China, together with its international dissemination and ongoing diversification, represents a growing public health concern and underscores the need for coordinated global genomic surveillance.
To explore the trends and patterns of human papillomavirus (HPV) infection in mainland China from 2015 to 2025, and to investigate the distribution of non-infected populations. HPV detection data were from 27,000 participating hospitals across 341 cities in all 31 provinces, covering 69.2% of hospitals in mainland China. A total of 33,750,381 women who underwent HPV testing between January 2015 and September 2025 were included. The distribution of 17 high-risk genotypes (HPV-16, -18, -26, -31, -33, -35, -39, -45, -51, -52, -53, -56, -58, -59, -66, -68, and -82) and 10 low-risk genotypes (HPV-6, -11, -40, -42, -43, -44, -55, -61, -81, and -83) was assessed by year, age group, and region, respectively. The overall prevalence of HPV infection was 21.81%, with high- and low-risk genotypes being 17.02% and 4.79%, respectively. HPV prevalence generally increased from 7.75% in 2015 to 22.48% in 2025, participants aged less than 20 years (81.46%) exhibited the highest HPV infection burden, and the overall HPV prevalence trended slightly higher in eastern China (22.66%). The most common genotypes were HPV-52 (3.20%), HPV-16 (2.19%), and HPV-53 (1.67%). 51.16% of the participants had infection with one HPV genotype. The distribution of non-infected populations differed across years, age groups, and regions. The prevalence of HPV infection shows an increasing trend in the past ten years among women in mainland China, with the predominant genotypes being HPV-52, HPV-16, and HPV-53. Our findings highlight the importance of scaling up the HPV vaccination nationwide particularly targeting the youth and eastern China.
Despite global efforts to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), important gaps remain, particularly in low-resource countries. Community-based health systems strengthening (HSS) interventions are emerging as a strategy towards effective prevention of mother-to-child transmission (PMTCT) of HIV services. However, the nexus between interventions and impact indicators remains unclear. This systematic review aims to assess all available evidence on the impact of community-driven HSS interventions on PMTCT. We will develop a search of studies published between 2015 and 2025 from databases such as PubMed/Medline, Scopus, Web of Science, Google Scholar and African Journals. We will use a combination of search terms such as 'participatory action research', 'health systems strengthening', 'PMTCT of HIV', 'childhood HIV', 'MTCT of HIV' and 'under-five mortality'. Studies aimed at community-based participatory health system intervention on PMTCT of HIV published in English will be used. Experimental, quasi-experimental and observational (including cohort and case-control) studies will be included. Data will be analysed using narrative and meta-analysis approaches. The risk of bias will be assessed using Cochrane Handbook guidelines. The primary outcome measure will cover PMTCT of HIV and secondary outcome measures are HIV prevalence and under-five mortality. Finally, the quality of evidence will be assessed using Grades of Recommendation, Assessment, Development and Evaluation technique. As no original data will be collected, ethical approval is not applicable for this study. The results will be disseminated through peer-reviewed publication and presentations at health summits and conferences. The review would inform context-sensitive HIV policies and interventions in developing countries, particularly for women and children. CRD420251131511.
Denosumab is a humanized monoclonal antibody targeting receptor activator of nuclear factor-κB ligand (RANKL) and is commonly used in the treatment of osteoporosis and cancer-related bone metastases. However, the persistent use of denosumab has been associated with an increasing incidence of denosumab-related osteonecrosis of the jaw (DRONJ), particularly following tooth extraction. This expert consensus aims to develop clinical management guidelines for the perioperative period of tooth extraction in patients who are currently receiving or have previously received denosumab therapy. The consensus covers the definition, etiology, epidemiology, staging, and risk factors of DRONJ, focusing on preoperative assessment, risk-based prevention strategies, minimally invasive surgical techniques, and postoperative follow-up protocols. The core management strategy for DRONJ emphasizes individualized decision-making based on a comprehensive preoperative assessment of medication history, local infection, and systemic conditions. The main risk factors for DRONJ include high-dose and long-term denosumab therapy, preexisting oral infections, such as periodontitis and periapical periodontitis, and invasive dental procedures, including tooth extraction, diabetes, and concomitant use of glucocorticoids or antiangiogenic agents. Core preventive measures include strict perioperative oral care, risk assessment-based antibiotic prophylaxis, long-term drug holidays, which were developed by dentists and physicians prio-ritizing the primary disease, and minimally invasive surgical techniques for managing trauma, preserving local blood supply, thoroughly removing infected tissues, and ensuring tight wound closure. This consensus highlights the importance of multidisciplinary collaboration between dental and clinical medicine experts in managing DRONJ. High-quality research is necessary to provide an evidence-based foundation for optimizing DRONJ prevention and treatment strategies. 地舒单抗是一种靶向核因子κB受体活化因子配体（RANKL）的人源化单克隆抗体，常用于治疗骨质疏松症和癌症相关骨转移。然而，随着地舒单抗在临床患者中应用越来越多，地舒单抗相关颌骨坏死（DRONJ）的病例也随之增加，尤其是在拔牙后。本专家共识旨在为正在或曾接受地舒单抗治疗的患者，制定拔牙围手术期的临床管理指南。共识内容涉及DRONJ的定义、病因、流行病学、分期、风险因素，并重点阐述了术前评估、基于风险的预防策略、微创手术技术及术后随访方案。DRONJ的核心管理策略强调基于术前全面评估用药史、局部感染及全身状况的个体化决策，DRONJ主要风险因素包括大剂量长疗程的地舒单抗治疗、牙周炎或根尖周炎等既存口腔感染、拔牙等口腔侵入性操作、糖尿病以及合并使用糖皮质激素或抗血管生成药物等。核心预防措施包括严格的围手术期口腔护理、基于风险评估的抗生素预防、以优先保障原发病治疗为前提的由口腔医生与内科医生共同制定的长期药物假期以及控制创伤、保障局部血供、彻底清除感染灶并实现创口严密闭合的微创外科技术。该共识强调了口腔和临床医学专家在处理DRONJ时进行多学科合作的重要性。未来有必要开展更多高质量研究，为优化DRONJ的防治策略提供循证依据。.
Autoimmune nodopathy (AN) is a subtype of antibody-mediated inflammatory neuropathy targeting the node of Ranvier (NoR). Diagnosis requires detection of anti-(para)nodal autoantibodies like contactin-1 and neurofascin-155 via ELISA or cell-based assays, but protocols are inconsistent. Causes of node autoimmunity are unknown, and respiratory infections, including SARS-CoV-2 infection or COVID-19 vaccination as triggers, have not been thoroughly investigated. We aim to establish and validate a next-generation automated ELISA for anti-(para)nodal antibodies and investigate whether low-titer antibodies occur in recently COVID-19-vaccinated healthy individuals. We used the Ella platform to customize an automated ELISA for anti-contactin-1, -neurofascin-155, and -Caspr-1 serum IgG. Patients with known AN (23 anti-neurofascin, 13 anti-contactin-1, and 8 anti-Caspr-1), 64 patients with seronegative (sub) acute inflammatory neuropathies, and 30 healthy controls served for validation, including quality analysis versus standard ELISA. Thirty-seven diagnostic samples of patients with suspected AN and 280 sera of healthcare workers included in the CoVacSer study, collected 3 weeks after COVID-19 vaccination or infection, were tested for anti-contactin-1 and anti-neurofascin-155. The automated ELISA showed high sensitivity (87.5%-100%) and specificity (98.4%-100%) for identifying AN, with reduced hands-on time, high automation, and similar quality and titer characteristics as standard ELISA. Low-titer anti-neurofascin-155, but no anti-contactin-1 autoantibodies, were detected in 1/280 post-SARS-CoV-2-vaccination or infection sera (0.36%). Longitudinal testing and clinical assessment did not indicate SARS-CoV-2-related neurological symptoms. We provide a highly automated, rapid, universally applicable test platform for anti-(para)nodal antibodies. The low frequency of anti-(para)nodal antibodies and absence of clinical AN manifestations in COVID-19-vaccinated individuals support vaccination safety regarding AN development.
Despite the success of long-term antiretroviral therapy (ART), immune dysfunction-including incomplete T helper cell recovery, immune activation, and inflammation-persists and may affect the benefits of analytical ART treatment interruption (ATI) trials among people living with human immunodeficiency virus (HIV) (PLHIV) in sub-Saharan Africa (SSA). This narrative review summarizes evidence of incomplete immune function recovery among PLHIV on long-term ART and potential interventions to enhance their ability to participate in ATI trials with immunotherapies in the quest for an HIV cure in SSA. A PubMed search query was used "([Immunity, Innate{MeSH Terms}] OR [Adaptive Immunity{MeSH Terms}] AND [HIV{MeSH Terms}] AND [Anti-HIV Agents{MeSH Terms}] AND [function{Title/Abstract} OR dysfunction{Title/Abstract} OR recovery{Title/Abstract} OR restoration{Title/Abstract} OR reconstitution{Title/Abstract} OR regeneration{Title/Abstract}])", which retrieved 165 articles. These articles were filtered using an English-language filter, resulting in 160 papers. This query was translated to Web of Science and Google Scholar. In addition, we conducted a specific literature search on documented "cured" HIV cases globally to understand innate and adaptive immune functions relevant to supporting post-ART immunological viral control. Persistent dysfunction of host innate and adaptive immunity during suppressive ART is reported in SSA HIV treatment cohorts. Natural killer (NK) cells, dendritic cells, and monocyte dysfunction potentially limit post-ART viral control. In addition, persistently impaired CD4 and CD8 T-cell proliferation capacity, immune activation, and exhaustion during ART may limit host HIV-specific responses during ATI trials with broadly neutralizing antibodies (bNAbs) and therapeutic vaccines, thereby increasing the risk of post-ART viral rebound. Similarly, adjunct therapies with TLR7 agonists, such as vesatolimod, could potentially increase cytotoxic capabilities of dendritic and natural killer cells to improve HIV latency reversal and viral clearance during ART. Innovative combination immunotherapies to avert persistent immune dysfunction, such as therapeutic vaccines, combination bNabs, enhancer of zeste homolog 2 (EZH2) inhibitors to boost CD8+ T-cell function and augment post-ART viral control, and latency reversal agents to increase cytotoxicity potential of dendritic cell and natural killer cells, among others, could potentially optimize HIV-specific CD8 T-cell cytotoxicity and viral clearance, and delay viral rebound during ATI trials in SSA.
Female sex workers (FSWs) face heightened health risks, particularly from HIV, which accounts for 8% of FSW deaths in low- and middle-income countries. Adherence to antiretroviral therapy (ART) remains suboptimal and few studies have explored drivers of ART non-adherence among FSWs who died from HIV in sub-Saharan Africa. Using a community knowledge approach methodology, data on HIV-related deaths among FSWs were collected from a convenience sample across Kenya, Nigeria, and the Democratic Republic of the Congo between 1 February 2022, and 28 February 2023. Participants were recruited through local sex worker organizations and non-governmental organizations. A structured questionnaire was used to collect demographic data, HIV treatment history, and reasons for ART non-adherence from participants about the deaths of FSWs they knew of personally. A qualitative descriptive analysis was used to code the interviews for reasons for ART non-adherence. A total of 853 FSWs reported the deaths of 445 peers who had died from HIV/AIDS. The mean age at death was 27 years; 70.6% were mothers. Among the deceased, 95.1% were not taking antiretrovirals at the time of their death, and 90% had stopped using ART, rather than never initiating treatment. The most cited reasons for ART non-adherence were food insecurity (97; 22.9%), alcohol and drug use (44; 10.4%), depression (57; 13.5%), and stigma (24; 5.7%). HIV-related deaths among FSWs in these three sub-Saharan African countries are associated with food insecurity, mental health issues, substance use, and stigma. Improving access to ART alone is insufficient to reduce mortality.
Plasmodium vivax relapses can lead to episodes of recurrent parasitemia. We longitudinally assessed parasite and gametocyte kinetics and infectivity to mosquitoes during P. vivax recurrent infections in Ethiopia. Patients presenting with clinical P. vivax infections were enrolled at Shele health center in Arba Minch Zuria district, Ethiopia. All participants received chloroquine plus 14-day primaquine for radical cure, and were subsequently followed for one year with scheduled monthly visits. Parasite and gametocyte densities were quantified using molecular assays, and infectivity was assessed through mosquito feeding assays. Over the follow up period, 54.6% (96/176) of patients experienced at least one recurrent parasitemia. Gametocyte density was similar between baseline and recurrent symptomatic episodes but lower during asymptomatic parasitemia (p<0.001). Across all mosquito feeding assays, 167 (70.2%) of 238 feedings resulted in at least one infected mosquito, with similar proportions between baseline (117 [70.5%] of 166) and recurrent symptomatic infections (50 [69.4%] of 72). Mosquito infection rates were strongly associated with both asexual parasite density (ρ=0.29; p<0.0001; n=166) and gametocyte density (ρ=0.32; p<0.0001) at baseline. Genotyping a subset of recurrent infections indicated 45.7% (42/92) of recurrences were likely to be relapses. After adjusting for gametocyte density, mosquito infection rates appeared lower when feeding on blood of relapsing infections as opposed to new infections (Odds Ratio 0.48, 95% CI 0.26-0.87, p=0.016). This comprehensive assessment of parasite kinetics and transmissibility over the course of infections uncovers a high frequency of recurring episodes of parasitemia that are accompanied by infectious gametocytes. This work further supports the need to strengthen radical cure to prevent relapsing infections and sustain malaria transmission control.
Globally, approximately 10% of all babies are born prematurely. The vast majority of preterm births, defined as birth <37 weeks of gestation, occur in low- and middle-income countries (LMICs) in Asia and Africa. Furthermore, premature birth has become the leading cause of death in infants under the age of 5 years. Thus, to improve maternal and infant health outcomes, better diagnostics and intervention strategies are urgently needed. However, the multifactorial etiology of preterm birth provides a major obstacle in achieving this goal. A common factor to many adverse birth outcomes, including preterm birth, is aberrant immune activation at the maternal-fetal interface. The specific cause of immune activation, however, remains unknown. Both HIV and an anaerobe-rich vaginal microbiota have been independently identified as risk factors for preterm birth, and both factors also promote inflammation and immune activation at mucosal sites. The interplay of HIV and microbiota is widely acknowledged, although mostly in the context of the intestinal microbiome. This review will highlight how the regulatory function of macrophages at the maternal-fetal interface can be altered in response to HIV and antiretroviral therapy and to changes in vaginal microbiota. We proceed to discuss interactions between the various factors and propose a dual-hit model in which macrophages act as mediators of inflammation at the maternal-fetal interface in response to specific vaginal commensals and HIV infection in sub-Saharan African women with preterm birth outcomes.
This scoping review aims to evaluate the application of environmental DNA/RNA (eNA) technology in real-world studies on neglected tropical diseases (NTDs), assessing its methodology and detection effectiveness, and providing an evidence-based roadmap for optimizing eNA used to support progress toward the 2030 targets. As the NTDs roadmap reaches its midpoint, eNA technology has seen increasing adoption. This non-invasive approach enables qualitative/quantitative assessment of environmental transmission risks, complementing conventional detection methods. We synthesized real-world field applications of eNA technology across NTDs through systematic searches in four English, and one Chinese database (2002-2024). A total of 71 studies met our inclusion criteria after screening. Despite heterogeneous transmission mechanisms among NTDs, we identified 6 standardized field applications for eNA studies, along with practical optimization strategies. A total of 3 pathways were concluded of how eNA technology can accelerate the NTDs elimination. For the performance, comparative analyses showed moderate concordance with conventional methods, while eNA demonstrated superior sensitivity in detection of pathogens and hosts. With the gap analysis, we demonstrated the advances of eNA applications in all NTDs. This scoping review supports eNA technology as a promising tool for NTDs detection and surveillance. Through experience sharing and summarization, the eNA technology needs further optimization and standardization to enhance its disease surveillance capacity, thereby accelerating the achievement of NTDs roadmap targets.
Cancer patients are vulnerable to SARS-CoV-2 reinfection due to impaired immunity. We estimated the effectiveness of bivalent COVID-19 vaccination against reinfection in adults with cancer and prior SARS-CoV-2 infection. We conducted a nationwide target trial emulation study using the K-CoV-N cohort, including 84,748 adults with cancer and prior SARS-CoV-2 infection (follow-up: Oct 2022-Jun 2023). The clone-censor-weight method with inverse probability of censoring weights compared bivalent vaccination versus none. SARS-CoV-2 reinfection ≥14 days post-vaccination and ≥90 days after prior infection was the primary outcome. Vaccine effectiveness (VE) was estimated via pooled logistic regression (1-HR). 24.1% received bivalent vaccines. Reinfection risk was 5.2% (bivalent) versus 8.4% (no-bivalent). Overall, VE was 22.2% (95% CI, 15.8%-28.2%). Protection was greater among younger adults, those with prior boosters, and those with more distant prior infections (≥1 year). Significant protection was observed in patients with solid tumors, whereas estimates for hematologic malignancies were attenuated and non-significant. Bivalent vaccination meaningfully reduced reinfection risk among adults with cancer, extending and strengthening the existing evidence base through a causal inference framework. These findings provide real-world evidence to support their continued role in routine and seasonal immunization strategies while highlighting the need for risk-stratified approaches tailored to immune capacity.
Crimean-Congo hemorrhagic fever virus (CCHFV) was first isolated in the Democratic Republic of the Congo (DRC) in 1956. To date, only 3 sporadic human cases have been reported in the DRC, and data on CCHFV infection in livestock, which are key players in transmission, are scant. We conducted a cross-sectional seroepidemiological study on archived human and animal serum samples collected from 25 provinces across the DRC. Samples were tested using an ELISA detecting CCHFV nucleoprotein-specific antibodies. The seroprevalence of CCHFV infection in humans was 4.4% (55/1,239) and in domestic ruminants was 28.9% (322/1,114). High seroprevalences tended to correlate with increased age, specific climate conditions (e.g., tropical monsoon) and vegetation (e.g., mountain savanna) types, and higher elevation (>600 m). Our findings suggest that CCHFV actively circulates in animals and sporadically transmits to humans in the DRC, highlighting the need for continued surveillance of CCHFV infection.
Despite the production of protective cross-reactive antibodies during COVID-19, data on immunoglobulin G (IgG) and immunoglobulin M (IgM) levels prior to vaccination remain limited in the Democratic Republic of Congo (DRC). This study aimed to assess serum IgG and IgM antibodies against SARS-CoV-2 in asymptomatic individuals COVID-19 vaccination in the DRC. A total of 1,500 individuals who presented for COVID-19 vaccination at the University Clinics of Kinshasa between April 19 and December 31, 2021, were included. The mean age was 47.5 ± 16.0 years, with a predominance of males (69.4%, sex ratio 2:1). Prior to vaccination, 38.8% of participants had elevated IgG levels, while 32.9% had elevated IgM levels. After multivariable adjustment, female sex (adjusted odds ratio [aOR] 1.54; 95% confidence interval [CI] 1.14-2.46), non-healthcare professional status (aOR 2.24; 95% CI 1.42-3.58), and the absence of comorbidities (aOR 2.33; 95% CI 1.38-3.71) remained independently associated with IgM seropositivity. Overall, IgG and IgM seroprevalence were high prior to vaccination. IgM positivity was associated with specific sociodemographic, biochemical, and hematological profiles. These findings highlight the importance of routine serological surveillance before vaccination to better understand infection dynamics and to inform public health interventions.
To evaluate the efficacy of photodynamic therapy (PDT) in treating cervical low-grade squamous intraepithelial lesions (LSIL) and to identify factors influencing treatment outcomes. We conducted a retrospective study of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) treatment of 93 women diagnosed with cervical LSIL and concurrent high-risk human papillomavirus (HR-HPV) infection. Follow-up assessments of HPV, cytology and colposcope were performed at 6 and 12 months. At the 6-month follow-up, pathological regression was observed in 79.8% (71/89) of patients and HR-HPV in clearance 65.2% (58/89). By 12 months the regression rate increased to 85.9% (73/85) and HR-HPV clearance rate to 78.8% (67/85), while one patient experienced disease progression. Analysis indicated that HPV vaccination history was associated with LSIL reversal and HPV clearance at 6 months (P < 0.05). ALA-PDT is effective and well-tolerated for the treatment of LSIL patients with HR-HPV infection, with outcomes influenced by prior HPV vaccination. The combination of vaccination and PDT may yield synergistic therapeutic benefits for cervical lesions.
Sub-Saharan Africa (SSA) continues to be the hub of the global HIV/AIDS pandemic, globally. Despite several attempts to meet their HIV prevention needs, men continue to have high rates of HIV infection. Pre-exposure prophylaxis (PrEP) is an effective treatment that, when taken as prescribed, can be very efficient in preventing and reducing the risk of HIV acquisition. HIV self-testing (HIVST) has been demonstrated to be acceptable among men in SSA. As such, this review aims to explore the existing literature on the integration of PrEP dispensing with HIVST among men in SSA. We will systematically search bibliometric databases, including PubMed/MEDLINE, Embase, Scopus, the Cumulative Index to Nursing and Allied Health Literature Plus, Sociological Abstracts, ProQuest Dissertations and Theses global. Our review will be guided by the Arskey and O'Malley framework and Levac et al. The review results will be reported using the preferred reporting items for systematic reviews and meta-analysis: extension for scoping reviews guidelines. To assess the methodological quality of the included articles, the mixed methods appraisal tool version 2018 will be used. We will use NVivo software (V.11) to synthesise data from the included studies using a thematic approach. Ethical approval is not required, as this review uses publicly available data. Findings will be disseminated through peer-reviewed publication, conference presentations and engagement with key stakeholders in HIV prevention and treatment across SSA.