ABSTRACT Background: Fleas transmit a variety of zoonotic agents whose epidemiology and public health risk remains poorly understood in sub-Saharan Africa, including Uganda particularly outside plague-endemic areas. Common flea-borne zoonotic agents include Rickettsia felis and Yersinia pestis.. Objectives: The study aimed at detecting and characterising flea-borne pathogens in peridomestic environments in Uganda. Methods: We collected fleas from domestic animals, chickens, rodents, and homestead environments; pooled them by species, collection time, and host species. A total of 172 pools were analyzed for Y. pestis Pla gene. Further, 62 pools were tested for Rickettsia species gltA, ompA, and htrA genes by PCR and Sanger sequencing. Results: Five flea species were identified: C. canis, C. felis, Echidnophaga gallinacea, Pulex irritans, and X. cheopis. Genus, Ctenocephalides, accounted for 84.8% of fleas collected, mostly found on dogs and goats. The flea species were found across all districts, year-round, with higher numbers collected in dry seasons than rainy seasons. Rattus rattus constituted 74% of rodents captured from human dwellings and was the only rodent species with fleas, where X. cheopis was the predominant species. All 172 pools were negative for Y. pestis. Rickettsia spp. was detected in 29/62 (46.8%) pools by the target genes. Of 25 htrA amplicons sequenced, 4% were identified as R. felis from C. canis, 92% were R. asembonensis from multiple flea species, and 4% were identified as Candidatus Rickettsia senegalensis. Conclusion:The survey identified high pool detection rate of Rickettsia spp. in fleas,suggestingrisk of human exposure and infection. This was the first report of Rickettsia spp. in E. gallinacea and detection of Candidatus R. senegalensis in Uganda.

ABSTRACT Background: Dengue fever (DF) is endemic in Pakistan, posing health risks. Recent flooding in 2022 and strong monsoon rains in 2024 have increased the possibility of an epidemic. It is an infectious disease having potentially severe outcomes including thrombocytopenia. Discussion: Carica Papaya Leaf Extract (CPLE) has emerged as an off-label treatment option, showing promising results in increasing platelet counts and reducing hospital stays. However, a critical assessment of existing research reveals methodological flaws, hindering specific recommendations. Conclusion: This perspective advocates for comprehensive research to evaluate the risks and benefits of CPLE as a potential remedy for thrombocytopenia associated with dengue fever. A robust investigation will inform clinical practice and guide healthcare decisions, contributing to improved patient outcomes in dengue-endemic areas.

ABSTRACT Background: Brucellosis remains a significant public health concern, especially in regions like the Mediterranean and Afghanistan. While its direct health effects are well-documented, its impact on quality of life is less explored. Objective: This study investigated the risk factors and quality of life effects of brucellosis in Herat, Afghanistan. Methods: Between October 2020 and February 2021, 155 participants were enrolled at Herat Regional Hospital and affiliated brucellosis laboratories. The sample included 75 individuals with confirmed brucellosis and 80 controls without a history of the disease. Data were collected using structured questionnaires, and quality of life was assessed with the SF-36. Statistical analyses included chi-square tests, logistic regression, and General Linear Model. Results: Key risk factors associated with brucellosis included marriage, lower education, contact with pets, infected family members, and using non-protected water (p < 0.05). Logistic regression confirmed increased odds of infection linked to these exposures. Quality of life assessments revealed significantly lower SF-36 scores among male patients across most components, with similar trends observed in female patients. Conclusion: Brucellosis significantly impacts quality of life, particularly among men, and is strongly linked to specific risk factors. Public health measures are essential to reduce infection rates and improve well-being in this region.

ABSTRACT Background Infectious disease agents pose significant threats to humans, wildlife, and livestock, with rodents carrying a third of these agents, many linked to human diseases. However, the range of pathogens in rodents and the hotspots for disease remain poorly understood. Aim This study evaluated the prevalence of viral, bacterial, and parasitic pathogens in Mastomys natalensis rodents in riverine and non-riverine areas in selected districts in Zambia. Methods The study applied metagenomic next generation sequencing (mNGS). Tissues analysed included semen, foetal tissues, and blood-rich organs (liver, spleen, kidneys, and lungs). A multivariate logistic regression model explored the relationship between pathogen presence and host or ecological factors. Results A total of 182 rodents were captured, and 14 pathogens were detected in 10.4% of the samples (19/182). Detected organisms included zoonoses (Klebsiella michiganensis, Klebsiella pneumoniae, Salmonella enterica, and Bartonella elizabethae); Emerging zoonoses (Elizabethkingia miricola, Klebsiella variicola, Bartonella tribocorum, and Cardiovirus B); among others (Eimeria papillata etc). Riverine areas showed higher odds of pathogen presence (OR = 8.45; p < 0.001; 95% CI: 3.07–23.26). Conclusion These results suggest that M. natalensis harbours multiple infectious agents with zoonotic potential, and riverine regions may be key hotspots for rodent-borne pathogens in Zambia.

ABSTRACT This article investigates the escalating occurrence of zoonotic diseases in Africa, attributing their spread to climate change and human activities. Africa’s unique combination of biodiversity, reliance on animal husbandry, and swift urbanization heightens its susceptibility. Climate change disrupts ecosystems and animal habitats, intensifying human-wildlife interactions. Urbanization, inadequate sanitation, and insufficient healthcare infrastructure further facilitate disease spread. Climate-induced displacement adds another layer of complexity. Mitigation strategies include improving surveillance systems, fostering early detection via point-of-care diagnostics and digital contact tracing, and investing in vaccines and therapeutics. Our purpose of this is to advocate for sustainable land use, robust community-level public health systems, international cooperation, and resource-sharing. We also emphasize the need for effective vector-control policies, dedicated research funding, and annual awareness, vaccination, and early detection campaigns in endemic regions.

ABSTRACT Background Hepatitis E Virus is a major cause of acute and fulminant hepatitis, particularly in developing countries. While the virus is commonly spread through the fecal-oral route, numerous cases of transfusion transmitted Hepatitis E Virus (TT-HEV) have been reported, raising concerns about its transmission via blood transfusions, especially in industrialized countries. The high prevalence of antibodies and viremia among asymptomatic blood donors further heightens the risk of transfusion-related transmission. However, there is still debate about the best strategy to minimize TT-HEV. Objective The review was conducted to Summarize the literature on TT-HEV infection cases and the prevalence of HEV among blood donors. Methods The databases PubMed, Scopus, Web of Science, Embase, and CINAHL were searched for relevant studies from 2000 to 2022. Serological and molecular screening data of HEV in blood donors were used to gather prevalence and incidence rates. TT-HEV cases were reviewed by examining evidence of HEV infection before and after transfusion. Results A total of 121 manuscripts reports the prevalence and incidence of HEV among blood donors and cases of TT-HEV. Twenty-six articles reported confirmed cases of TT-HEV and 101 articles reported on HEV prevalence or incidence among blood donors. Conclusion TT-HEV transmission through blood products is a real concern, especially for immunocompromised patients. The risk and severity of infection could vary between immunocompetent and immunosuppressed patients. To increase transfusion safety, the evaluation recommends HEV screening protocols, especially in endemic region.

ABSTRACT Background: Cattle colonised by the zoonotic pathogen verotoxin-producing Escherichia coli of serotype O157 (VTEC O157) can shed high levels of the pathogen in their faeces. A suggested key for controlling VTEC O157 is preventing colonisation of individuals. Aim: In this study the role of individual super-shedders and factors related to susceptibility and environmental exposure in the transmission of VTEC O157 among dairy calves are explored. Methods: The association between sex, age, pen hygiene, pen type and stocking density and colonisation of individual calves, established by recto-anal mucosal swabs, on farms where pathogenic VTEC O157 had been confirmed was investigated. In a follow-up sampling, the consistency of previously identified risk factors and the role of shedding pen mates was assessed by studying the risk of new/re-colonisation. Results: The results suggest an important role of stocking density that decreases with age, possibly due to increased resistance to colonisation following exposure. However, previous colonisation did not influence the risk of being colonised in the second sampling. Super-shedders (shedding >103 colony forming units/g faeces) significantly increased the risk of colonisation in peers (OR = 10, CI 4.2–52). In addition, environmental factors associated with survival of the bacteria, affected risk. Conclusion: The results confirm the suggested importance of super-shedders but also emphasises the importance of considering the combined exposure from peers and the environment.

ABSTRACT Background: In the Netherlands, living in proximity to goat farms has been consistently associated with an increased incidence of community-acquired pneumonia (CAP). The cause remains largely unknown though airborne microbial agents could play a role. Objective: The aim of this study is to explore micro-organisms present in goats that can cause human pneumonia. Methods: An extensive literature review was conducted to identify all micro-organisms detected in goats that are associated with human pneumonia. Additionally, the identified micro-organisms were prioritized using a self-developed scoring system and expert opinion. Results: Through extensive literature review, 4309 references describing 302 different micro-organisms in goats or on goat farms were identified. Additional searches and reviews for human respiratory disease caused by each of these micro-organisms yielded a final list of 76 bacteria, 7 viruses, 7 fungi, and 6 protozoa. They were assigned scores based on pneumonia type, diagnosis of respiratory disease, patient immune status, and evidence strength. Based on these scores, the most likely potential causal micro-organisms included Moraxella spp. Chlamydia psittaci, Staphylococcus aureus, and Streptococcus pneumoniae. Subsequently, the list of micro-organisms was reviewed by external experts on their perceived likelihood of the organism causing this CAP. Conclusion: Results of this literature study can give insight into the possible causes of pneumonia. Nonetheless, no unambiguous conclusion on the actual cause of the increased CAP risk around goat farms can be drawn solely based on these results.

ABSTRACT Background: Onchocerciasis infection is one of the neglected tropical diseases targeted for eradication by 2030. The disease is usually transmitted to humans through the bites of black flies. These black flies mostly breed near well-oxygenated fast-running water bodies. The disease is common in mostly remote agricultural villages near rivers and streams. Objective: In this study, a deterministic model describing the infection dynamics of human onchocerciasis disease with control measures is presented. Methods: We derived the model’s reproductive number and used a stability theorem of a Metzler matrix to show that disease-free equilibrium is both locally and globally asymptotically stable whenever the reproductive number is less than one. Parameter contribution was conducted using sensitivity analysis. The model endemic equation is shown to be a cubic polynomial in the presence of infected immigrants and a quadratic form in their absence. Results: When the inflow of infected immigrants is null, the model endemic equation may admit a unique equilibrium if the reproductive number is greater than one, or admits multiple endemic equilibria if the reproductive number is less than unity. We carried out a sensitivity analysis to identify the significant parameters that contribute to onchocerciasis spread. Conclusion: Onchocerciasis disease can be eradicated if the importation of infected immigrants is properly monitored. The integration of the One Health concept in the public health system is key in tackling the emergence and spread of diseases.