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Yaws - A Review of Clinical Features, Diagnosis and Treatment.
Get PDFYaws, a neglected tropical disease caused by Treponema pallidum subsp. pertenue, primarily affects children in impoverished rural areas. It is spread through direct skin contact. The disease progresses through clinical stages. In the primary stage, patients develop a, usually painless, papilloma or ulcer, often on the lower extremities, which is highly contagious. If untreated, this lesion heals spontaneously but may progress to secondary yaws, characterised by disseminated skin lesions, scaly papules and painful hyperkeratotic plaques on the palms and soles. Tertiary cases occur in 10% of untreated individuals and can cause severe disfigurement, but with the wider availability of treatment this is rare today. Though yaws can be treated with benzathine penicillin, oral azithromycin has become the preferred treatment due to its ease of administration. Currently, it is known to be endemic in 16 countries, with the majority of cases found in the Western Pacific, followed by West Africa and parts of South East Asia. The World Health Organization has renewed eradication efforts, targeting global eradication by 2030 through mass drug administration (MDA) campaigns and enhanced diagnostics. However, challenges such as emerging azithromycin resistance, difficulties in achieving high MDA coverage, and potential zoonotic transmission from nonhuman primates threaten progress. Accurate diagnosis is critical, especially in distinguishing yaws from similar skin conditions and ensuring all endemic communities are identified and offered treatment. Strengthening surveillance and enhancing laboratory capacity for molecular diagnostics is essential for the success of the eradication campaign. With sustained effort and innovation, the global eradication of yaws by 2030 remains achievable
Subtype AD Recombinant HIV-1 Transmitted/Founder Viruses Are Less Sensitive to Type I Interferons than Subtype D.
Get PDFInitial interactions between HIV-1 and the immune system at mucosal exposure sites play a critical role in determining whether the virus is eliminated or progresses to establish systemic infection. The virus that successfully crosses the mucosal barrier to establish infection in the new host is referred to as the transmitted/founder (TF) virus. Following mucosal HIV-1 transmission, type 1 interferons (IFN-I) are rapidly induced at sites of initial virus replication. The resistance of TF variants to these antiviral effects of the IFN-I has been studied among HIV-1 subtypes B and C. However, their role in restricting HIV-1 replication among subtypes D and AD recombinant remains unexplored. This study assessed the sensitivity of HIV-1 subtype D and AD recombinant TF viruses to IFN-I by infecting peripheral blood mononuclear cells in vitro with infectious molecular clones of these viruses. Cells were exposed to varying concentrations of interferon-α and interferon-β, and viral replicative capacity was measured using HIV-1 p24 antigen ELISA from culture supernatants. Sensitivity to IFN-I was quantified based on viral replication levels. The results showed that interferon-α was more effective in inhibiting viral replication than interferon-β, regardless of the varying amounts of IFN-I used. However, recombinant AD viruses were found to be more resistant to the antiviral effects of IFN-I compared to subtype D viruses. These findings highlight the differential sensitivity of HIV-1 subtypes AD recombinant and D TF viruses to IFN-I and underscore the potential of IFN-I as a therapeutic strategy to target TF viruses and reduce HIV-1 transmission, particularly in populations where subtype D is prevalent
The Future Hospital in Global Health Systems: The Future Hospital as an Entity.
Get PDFHealth care is changing rapidly. Hospitals are, and will remain, an essential setting to deliver it. We discuss how to maximise the benefits of hospitals in the future in different geographic and health system settings, highlighting a series of cross-cutting issues. We do this by exploring the evolving roles of hospitals and the main factors that we must consider as they adapt. These include changing population and disease profiles, the impact of evolving technology, and new concepts in hospital design and planning. Our focus is on delivering high-quality, patient-centred care while ensuring equitable access, even if strategic decisions require compromise across these functions. The COVID-19 pandemic has shown the importance of hospitals in societies while also revealing the limitations of current structures and the potential of technology to transform hospital services within the broader healthcare system. The aim of this multidisciplinary perspective is to provide an overview of pertinent issues whilst highlighting the challenges and opportunities in optimising future hospital planning, construction, design, and development in high-income (HIC) and low -and medium-income country (LMIC) settings
School Meals Case Study: Ghana
Get PDFThis school meals case study forms part of a collection led by the Research Consortium for School Health and Nutrition’s "Good Examples" Community of Practice. The School Meals Case Study of Ghana serves to document how the national school meals programme is organized, funded, and monitored throughout the country. The objectives of this case study include presenting an introduction to the country profile, outlining the design and implementation of school feeding programmes, describing their monitoring and evaluation processes, and highlighting lessons learned, best practices, and challenges. This case study is written as a working paper, and can be updated to reflect evolving circumstances. The ‘Good Examples’ Community of Practice supports the evidence generation of the Research Consortium for School Health and Nutrition, the evidence-generating arm of the School Meals Coalition. The Research Consortium’s objective is to carry out independent research across diverse sectors and generate solid, compelling, and actionable evidence regarding the benefits of school food programs to inform evidence-based decision-making on school health and nutrition policies and practices
The use of storytelling in COVID-19 vaccine promotion: A scoping review of interventions and campaigns.
Get PDFBACKGROUND: The development of the COVID-19 vaccine, a groundbreaking scientific advancement, also fueled vaccine hesitancy mainly due to vaccine misinformation and the limited public understanding of the new technology and its rapid pace of development and deployment. A variety of public health communication strategies have been used that include engaging the community in identifying and developing messages, using culturally appropriate communication methods, applying behavioral health principles, and storytelling. The purpose of this scoping review was to assess the most relevant evidence from the research literature on storytelling interventions to mitigate COVID vaccine hesitancy during the pandemic. METHODS: A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, examining studies across 16 databases published between 2020 and October 2025. RESULTS: Twelve studies met inclusion criteria. Studies involved diverse populations and four implementation themes (cultural relevance, emotional engagement, participant involvement and reach) were identified. The experimental and quasi-experimental studies consistently found that narratives elicited greater emotional engagement, heightened perceived credibility, and stronger identification with the messenger. CONCLUSION: Storytelling is recognized as a critical component of public health campaigns in its ability to leverage the power of community influencers, such as religious leaders, educators, and local advocates who echo community values. Long-term cohort studies, community-based social marketing campaigns, and qualitative studies are needed to assess specific impacts on vaccination behaviors. Storytelling, when tailored to audience, culture, and context, can contribute to promotion of vaccination, particularly in improving trust, empathy, and misinformation
Microbiota and resistome dynamics in untreated and treated wastewater: A ten-month study leveraging RNA-probe capture and subspecies-level metagenomics.
Get PDFWastewater is regarded as a hotspot for the acquisition and dissemination of antimicrobial resistance genes (ARGs) in bacteria, and wastewater treatment plants are key sites for studying and monitoring these phenomena. This study employed metagenomic approaches, with and without targeted ARG enrichment, to investigate the composition and dynamics of the microbiota, resistome, and mobilome in untreated (UWW) and treated (TWW) wastewater from a full-scale treatment plant serving municipal and hospital wastewater in Oslo, Norway. Over a ten-month period, we observed that wastewater treatment led to a significant reduction in the relative abundance of human gut-associated bacterial species and total load of coliform bacteria, alongside an increase in environmental bacterial taxa. This shift correlated with a significant reduction in the relative abundance and richness of ARGs and mobile genetic elements. Despite this, the effect of treatment on the relative abundance of key AMR-associated pathogens was highly inconsistent. Further subspecies analysis revealed several Escherichia coli and Klebsiella pneumoniae lineages persisted in UWW and TWW over multiple months, suggesting stable colonization and survival despite treatment processes. Targeted RNA probe-hybridisation enrichment detected clinically important ARGs in both UWW and TWW samples, including genes encoding extended-spectrum β-lactamases, carbapenemases, glycopeptide resistance, and colistin resistance. Most of these were undetectable by shotgun metagenomics alone, demonstrating the strength of this technique in high-sensitivity ARG surveillance. These findings highlight the value of combined metagenomic methods in wastewater AMR surveillance, the potential for monitoring high-risk bacterial lineages, and high-sensitivity detection of clinically important ARGs, in a low AMR prevalence setting
IOLs in India: How and where they are used
Get PDFA wide variety of IOL types are now available in India
Household health-seeking behaviour and response to Informal payment: does economic status matter?
Get PDFINTRODUCTION: Corruption is a major factor that influences health seeking behaviour. However, there is paucity of empirical evidence from research on how corruption affects different population groups when they seek healthcare services from formal healthcare facilities. The paper presents new evidence on how informal payments, which is a major form of corruption, affect health-seeking behaviour people and how household economic status has sustained it in Nigeria.
METHODS: We used a pre-tested interviewer-administered questionnaire to conduct interviews in 1,652 households in Enugu and Kano states, in the south and north of Nigeria, respectively. Descriptive statistics was used to estimate household health-seeking behaviour and Ordinary Least Square, binary logistic and multinomial logistic regression analyses to assess how experience of informal payment and economic status (quintiles: extremely poor, poor, average, rich, extremely rich quintiles) affect household health-seeking behaviour.
RESULTS: Poorer households were most likely to attend health posts and health centres, while extremely rich households disproportionately used hospitals (59%). Household economic status determines the likelihood of paying informally, with richer ones paying more (p < 0.05). Household size, age of the patient, sex, years spent on formal education and state were other identified determinants of informal payments. Experience of informal payment in public facilities significantly reduces household use of tertiary hospitals compared to primary health centres or health posts by 58% (p < 0.05). The choice of tertiary hospital compared to a primary health centre or health post is significantly reduced by 31% because of informal payments (p < 0.01).
CONCLUSION: Informal payments in public facilities negatively affect health seeking, driving the poorest households to use low-quality care services. This problem needs to be widely recognised and sufficiently tackled in order for the country to reduce the economic burden of health seeking and achieve equitable access and utilisation of high-quality health services